Thursday, November 08, 2007

Due to Circumstances Beyond My Control

No Open Mic Thursday this week. Why? Because I'm tired, stressed out, and dysphoric. Hence the story below, which yesterday and today still makes me hot under the collar.

As many of you know, I am bipolar. A well-managed, functional bipolar, to be sure, and one who's always on the lookout for those situational and seasonal triggers that can cause me to feel lousy and need medication adjustment.

Sunday, after running around like an idiot, I realized when I finally got to E'burg with my carload of boxes that my mood swings were spiking fast and furious. As it's known in the psych biz, rapid cycling. Always a big red flag for me. Neal, the world's perfect new next-door neighbor, grabbed me and fed me some of his famous spaghetti because for some reason, I hadn't been thinking about eating. And had managed to drop 8 pounds in a week. Another red flag.

Time to get a checkup from the neck up. And lo! My former doctor is no longer with the clinic, retired. Shit. And I can't get another doctor for at least three weeks. So Monday, I call the insurance company's behavioral services, figuring that I'll walk the party line.

Aetna was surprisingly helpful. They offered to find me a new doctor and suggested that, in the meanwhile, I go to the ER and they'll evaluate me and get me fixed up with a med change or increase, whatever is best.

Sounded like a good idea to me. So I leave work, go to my local ER, explain to the triage nurse exactly why I was there and what the insurance company told me to expect. Fine. She puts me in a treatment room. And there I sit. For two hours, which was briefly alleviated by the comic-relief appearance of a Filipino nurse who ordered me into a hospital gown. She didn't quite realize who she was ordering. A dysphoric, very cranky, bipolar woman, who basically told her to take the gown and shove it where the sun don't shine.

Finally, a woman from the psych ward appears. "Oh, no, we don't prescribe medication here, we only admit and you're not sick enough for that." Gee, so you're telling me that I got to sit here for more than two hours and you won't help me? Right. And here I thought I was being "proactive" in managing my disorder. So, if I had taken the blood pressure cuff, wrapped it around my neck, and pumped it up, they would have given me some drugs?

I was upset. And Mary, the psych ward lady, gave me two phone numbers to call the next day, one for the local behavioral center and the other for a crisis intervention center. "One of these will help you with your meds right away," she says. OK, now three hours gone and still nothing, so I decide it's time to leave the hospital and go home. I was in tears, completely frustrated.

But wait. There's more. Now, the ER head nurse comes in and says, "Oh no, you can't leave. You told the triage nurse that you were agitated and you wanted to hurt someone, so you can't be discharged."

What the fuck? Discharged? I didn't know I had been admitted. I stared at her and I knew that if I blew my stack, they'd probably commit me. Or worse. So I took a deep breath and said, "No, that's not at all true. Yes, I don't feel well but no, I would never harm anyone." (And Brackets, the little voice in my head, said, "But we'll gladly make an exception in your case.")

Fortunately, Mary turned to the nurse and said, "Oh, that's ridiculous. This woman only came in to see if we could help her with some medication. I gave her some contact numbers and she's going home." So the ER nurse, giving me the evil eye, said, "Fine, Mary. YOU can take responsibility for her." And left, her skull unsullied by my fist.

Out the door I went, disgusted by the state of mental health care in this country. I suppose if you want to get immediate help, you'd better wait until you're a raging homicidal and suicidal maniac. Let yourself stew until all of your juices are at boiling point and then the only solution is to admit you to the hospital, thus making the whole episode even pricier than it needed to be. I ask you, who's making bucks from this? Not hard to guess.

As it all turned out, I have an appointment tomorrow morning for a med review at the crisis intervention center with their shrink, and have an appointment with a new doctor at the end of the month. Two days later, granted. But I was able to hang in there, persevere, and ultimately get the treatment I needed, albeit not when I needed it. I made the calls. I got nothing from Aetna, at least so far. I thanked Mary profusely, because she cared enough to help me. The only one.

The one thing that I've decided is that it's important for me to increase my mental health advocacy. It's time to become an activist. And I will because with the Parity Act languishing in Congress, which, if passed, would put mental illness on an insurance par with physical illness, it's time for those of us who suffer from mental disorders to put our money where our proverbial mouths are.

I want the care I need. Without a runaround, without having to go to a psychiatrist who will not take insurance because the insurance companies do not want to cover it. Bipolar disorder is a chemical imbalance, as best as we know now. Here's a sobering statistic: As many as 1 out of every three people with bipolar disorder try to kill themselves. It can be deadly.

So let's make care and medication immediately available to those of us who are willing to seek it in order to manage our disorders and live a happy, productive life. I don't think that's asking a lot.

And now I'm going to bed and get some sleep, a critical component of feeling well.

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