Wednesday, 27 August 2008

I went to bed on Friday afternoon and have spent much of the time since sleeping. I was really taken aback at the pirate fucking me about again and still a bit shell shocked by his kick in the arse farewell. We had a family get together on Saturday night which I managed to attend and play the clown at. Other than that I've felt very distant and detached. My brain feels toxic and a bit bewildered.

Well today was D-Day... the day I got to meet Dr X, my new shrink. My wife is on holiday this week so she came along with me. We arrived at the health centre just in time to meet an elderly, breathless man cursing and wheezing as he shuffled out, telling us in gasps how he had waited for 45 minutes and could wait no longer. I heard him give a similar spiel to the cold, robotic receptionists. They were as silent as mourners at a funeral and did not respond to him. I could imagine their looks of disgust at the poor old bloke as he coughed and spluttered his way out.

Dr X was hardly late at all and it only took a moment to decide on a pseudonym for this middle-aged lady who looked like she had just arrived back from Glastonbury, dressed plainly in olive coloured hemp. We'll call her Dr Moonstone Woodstock. Moonstone was very calm and placid, slow in her movements and I got the idea she was not just dressed in hemp but may also have recently inhaled some while listening to Neil Young on an 8 track tape in her Volkswagen Beetle.

It's actually very unfair of me to make fun of her because she was in fact very nice and seemed very genuine. A million miles away from the the pirate. She had arrived without notes and said she wanted to hear things initially from my perspective rather than prejudge. I was impressed by this as I didn't want her coming armed with the pirate's opinions of me. She asked what I saw as my main problems and I said my weight was number one. Then asked what I wanted from her and I said I wanted my medications sorted out as regardless of what Portillo said I knew they were making me obese. She felt she might be able to eventually reduce the Depakote but it was early days on the quetiapine. She slightly pushed the idea of me getting out of the house occasionally but I resisted this. I explained I was happy to remain socially isolated and that I had no aspirations left in life. She asked me to score my mood out of 0 (dead) - 10 (normal) - 20 (manic), I thought I was about 7 but it's hard for me to tell, I just go by my sleep pattern.

I wasn't particularly forthcoming and there were long silences when she waited for me to answer at times. But I couldn't help it. I felt very unsure of what was wanted of me and what I should say. I think most of all I felt like a fraud and she was sitting there thinking "why am I sitting here listening to this time waster?". Especially near the end when she said she would see me again in two weeks "that is, if you want to be seen again?". Was I supposed to say that I'd rather not. How do you know if you're supposed to be seen? I don't know. Anyway, two weeks it is.

Friday, 22 August 2008

Last night we booked a holiday to Spain. We did it on the cheap through holiday hypermarket and I expected a full package holiday from one operator to pop out at the end. Much to my horror it's a few sets of printouts from your PC, just dodgy amateur looking vouchers for different flights, hotel and taxi transfers. I am really worked up about it all going pear-shaped and us being stranded far from home. I don't really like going on holiday but I know how much Mrs Mo does and by God she deserves it.

Still never heard from the team about Dr X. Today was my 11am appointment with the pirate. Here is the evidence in his own handwriting...

The pirate strolled out of his consulting room just after 11am. I was about to stand up when he called someone elses name and walked over to greet them. He passed me as he was leading the guy back into his room and grinned "Hi Mo, I take it you got that other appointment".

I tell him I haven't got a clue what he's talking about... "Didn't you get the message?" ... I tell him that the team never phoned on the Tuesday as planned and have never been in touch at all. He asks me to wait for a minute while makes a quick phonecall. I don't fuckin' believe this. He quickly returns with an air of smugness "Yes, you have an appointment to see Dr X on Wednesday 27th at 9:15. I don't know why you haven't been informed but I certainly did my bit." It's typical of the NHS "nobody's fault" culture, the buck stops nowhere as there are always "systems in place to prevent this kind of thing occurring".

He asks "is that OK then?". What the fuck am I supposed to answer. How can it not be OK? Can I say "No I want to see you now as agreed, remember the appointment you forced on me and I reluctantly agreed to". I can't go to another shop and ask if they have any fresh shrinks in. I don't have the luxury of city folks who may have access to different areas. I've done all I can to get away from this bastard and he is still screwing me. Of course I don't say any of this, I just mumble "fine", about turn and storm out.

If this had happened yesterday I would have told him to fuck off, requested no further contact with the team and then come off all my fattening medicaton. But we have now booked a holiday and I daren't rock the boat as regards meds. The one thing I can't do is mess up my wife's holiday. The timing of this latest humiliation is strange. It's almost as if he knew I couldn't do anything to complain.

So I'll take the crap for the meantime but I won't forget it.

Thursday, 21 August 2008

17 stones and 10 pounds.

Seventeen fuckin' stones and ten fuckin' pounds.

Friday, 15 August 2008

Still awaiting the promised phonecall from the CMHT. I won't hold my breath. What a bunch of complete tossers.

I saw Portillo yesterday. He was cool and laconic.

In his laid back mood he didn't bother me much about the shrinks. I had a rant about my crap treatment and he tried once again to defend his colleagues (as doctors invariably do) and justify why people get lost in the system. I can accept that happens now and again but it happens repeatedly with me. He talked about pressure on services but I emphasised that that wasn't my problem and it certainly didn't excuse them from treating me like shite.

He asked about the palpitations, checked my blood pressure and said if they persisted I was to get back to him so he could arrange for me to go on the treadmill for an excercise tolerance test.

I'm now onto a regular dose of quetiapine, 150mg twice a day. It's making me nice and sleepy and also giving me the old dry mouth. Yesterday afternoon I could hardly speak, dry mouth, light headed and tripping over my tongue like a drunk man. I kept thinking I looked like Jim Carrey in "Me, Myself and Irene" which gave me the giggles. It felt strange laughing.

Despite being sleepy, I've been incredibly busy and productive on the music front, writing and recording tracks for a new album. It's all coming together nicely and I'm enjoying getting back into the music again.

Wednesday, 13 August 2008

I've had some more palpitations, no big deal, I used to get them with chlorpromazine. But my wife phoned the doc who arranged for me to have an ECG which was normal. She also had a chat with him letting him know I was pissed off about Friday's session with the pirate and all the shenanigans about the new shrink... or to put it more correctly the lack of the new shrink. Portillo was surprised about this as he already spoken with the pirate who told him the meeting had gone very well. Eh? What the fuck are they playing at? This is total crap. Just because I'm paranoid doesn't mean they're not out to get me. I don't believe there would be any of this carry on if I was a normal person with a medical problem who asked for a second opinion from another physician.

I've been hard to live with this week. Extremely irritable and intolerant of just about everything my wife does. I'm still wound up about the doctors. I forgot to mention last time that the pirate had assured me that the CMHT would phone me on Tuesday to let me know when Dr X would be able to see me. Needless to say nobody phoned. I've just checked this in case I'm imagining it. The pirate wrote me a list of dosages for my quetiapine regime and at the bottom of the page he has written "the team will phone you on Tuesday to confirm when Dr X will see you".

Just to add insult to injury I am running out of quetiapine and have to see Portillo tomorrow for a repeat script. He'll give me a thorough grilling if I say anything other than everything is great. So I will try my best not to get into a dialogue with him. Just get the prescription and get out.

On a positive note, I have been very sleepy on the quetiapine and am sleeping soundly for 9 hours overnight and also having an hours kip in the afternoon.

Friday, 8 August 2008

All week I had been nervously anticipating my appointment with the new shrink and today was the the day. It took me longer than usual to walk the 2 miles to the surgery as I had to stop briefly due to sweating and palpitations.

A couple of puffs of GTN and I was back rushing on my way. I arrived just in time for my 11:30. I don't know why I bothered, doctors are never on time and as per usual I had loads of time to count the carpet tiles and inspect the plants. Despite their lack of people skills, you have to hand it to the staff in health centres, they sure know how to look after plants.

Eventually the pirate glides into view and stands grinning over me. We exchange greetings and I am led into the black pig. He asks if I mind a medical colleague sitting in with us, I have no problems with this and say hello to the doctor/nurse/student/whatever it is in the other chair. The thing says hello and then never utters another word, even during a 5 minute silence which occurs later on in the session when the pirate plays his palm pilot (not a euphamism.... probably playing scrabble or in a chat room). I am immediately surprised at the lack of the mysterious femme fatale, Dr X. I assume like most doctors, she is running late and will soon join us.

The pirate makes no apology for not seeing me over the past ten months but simply says "it's been a while since we last met. Do you want to fill me in on what's been happening with you". Much as I'd like to "fill him in" I start off on a "bless me father for I have sinned, it has been 10 months since my last confession". I tell him about my usual winter peak when I bought guitars, recorded an album and set up websites. How since then I've been fairly inactive but that we have recently managed a couple of trips away and have also been out for a couple of meals. He also asks about my paranoia, my misanthropy and of course my alcohol consumption.

He then outlines the regime for my increasing doses of quetiapine and says HE will see me again on the 22nd August. Well strike me down with a feather. WHAT THE FUCK IS GOING ON!

I explain that I only came today as I thought I was being handed over to DrX. "Oh no" he says "Dr X is on holiday. But if you want I can ask her if she wants to sit in on the next session". Are we on the same wavelength here??? I don't believe I'm hearing this. I explain to him that I had only agreed to see a psychiatrist again if it wasn't him and that Dr Portillo had arranged for me to see Dr X. Portillo had later phoned to say that the pirate would have to be at the initial handover session but ensured me I would be seen within four weeks. When this didn't happen I saw my GP again who explained you had both been on holiday but I would see both of you today. The pirate looked flustered and seemed lost for words, he thought long and hard before eventually replying that I would have to be reviewed by a consultant while my quetiapine was being increased so he would have to see me on the 22nd regardless. In the meantime he would try and contact Dr X to see if she could attend that day. During the conversation I got the distinct implication he did not intend to release me but intended shared care but he would not be drawn into clarifying this. Every time I asked him if I was being transferred to Dr X and was this OK, he said he would need to speak to her first, sometimes he avoided the question altogether.

Despite saying he needed to monitor me while my quetiapine was being increased, he failed to ask me if I had noticed any side effects so far. I actually have had some initial palpitations, dizziness and feeling faint but these episodes are decreasing now.

I'm totally pissed off with the doctors now. Each of them gives me a different story and each is a pile of crap.

Friday, 1 August 2008

My wife and I both had appointments to see Portillo this morning. Hers was an hour before me, to review her Citalopram. While she was chatting to the doc there was a knock on the door and much to her surprise.... in walked the pirate!!!!

The three of them then had a mini case conference about me. My wife and Portillo outlined how I had been over the past ten months and the pirate outlined his plan to start me on Quetiapine. The Quetiapine will start today in incremented doses with a view to stopping the Depakote which has not been effective in stabilising my mood. The pirate will be sending me an appointment to see him and Dr X next Friday. My missus explained all this to me when she got home. How quaint and olde worlde... not involving the patient in the care planning process.

So an hour later I see the quack and he asks if my wife has filled me in. I confirm that she has and he starts his advertising campaign on the new bipolar miracle cure that is Quetiapine. He raved that recent research showed this was the best medication for bipolar. He actually said "this is the new sun dried tomato". What the fuck? I've never heard that expression before, I guess he means it's like "is the new black". I don't know why he always has to go overboard on things like this when a simple "shall we try this?" or "this could be the right drug for you" would be fine. I'm sure he thinks he has hypnotic powers of persuasion so powerful that he could throw me a dog turd and convince me that eating it would cure me. Then again, I shouldn't mock, there are days when I might just eat a dog turd on request.

I think that's us done, appointment over... but no, it becomes apparent I am now in a holding cell and am in for a full interrogation. He talks at length about my alcohol consumption. I explain I'm now down to 30-50 units per week instead of 70-100. He rambles on, lecturing how if we gave 1000 people 50 units of alcohol every week, most of them would become depressed (that'll be about 90% of the Scottish population then I reckon... miserable gits). He explains how one day in about 10 years time I'll get fed up with my current anhedonistic lifestyle and decide I want to get back to my old "not enough hours in the day for Mr Busyboy" lifestyle. On that glorious day, I'll stop drinking and suddenly get my life back on track. Once I stop drinking everything will fall into place. What a brilliant doctor, advice like that is surely the best medicine you can get.

I lose interest and gaze at the carpet while he drones on about my late mother's bipolar disorder, her alcoholism and draws comparisons between us. My sighing and removal of eye contact just seems to encourage him further and he preaches like a born again zealot about the demon drink and how I'm now in a vicious circle which I must break. I doubt poor old Portillo will make the finals of this years Motivational Interviewing World Cup.

Hours seem to pass and he's in no mood to stop so I intervene and say that I'm past the pre-contemplative stage and am now trying to cut down because of my weight. He tells me about calories in alcohol and then we're ready to wind up. At this point he realises he's forgotten something and asks me a question...

Why did you come to see me today?
I guess that's the downside of a one sided conversation, you forget what's going on.
I explained that I just wanted to let him know (as he had requested) that I still hadn't got an appointment for the shrink. He's annoyed. He sighs and tells me that although he said "within four weeks", the pirate was on holiday for two weeks then Dr X was on holiday for two weeks so that's four weeks when it wasn't possible for them to see me. He then tells me that being cynical isn't helping. (Just as I had anticipated, me not getting an appointment was going to be my fucking fault!). "It's easy to be cynical. You can be cynical and stay as you are or you can do something positive and move on with your life". I told him he was right and I should be more positive and hope God, aromatherapy or crystal therapy will cure me of these evil spirits that posses me.

I know I've got a bad attitude. Known it all my life. Heard it all my life. But how that pile of crap was supposed to effect change in me, I have no fucking idea. And that was the easy appointment. Wait till I see the two shrinks next Friday. Sheesh!