Documenting my journey through the mental health system

Last night and today was a long day. I took ALL my sleep meds plus Seroquel to try to quiet the voices and calm my anxiety. When I was in the mental hospital, Seroquel quieted my overactive mind.

Tonight, I am particularly tired and worn down. I still did not sleep that great and woke up too early. I am not hearing any voices tonight. My patient load is high. I’ve got 14 and nine of them are pretty extensive care. Two of them are over 450 pounds and it takes three or four people to maneuver them.

Obesity kind of fascinates me. It is unbelievable to me someone could let themselves get that big. Barring a few very rare medical conditions, obesity is always a choice. They come in with things like sepsis, pressure ulcers, diabetic complications, non-healing wounds. All these things are exacerbated by the obesity. I try not to be judgy, but I am only human. I see a lot and the obesity cases are always the most complicated.

I had to help put a brain cancer patient in restraints for his aggression and pulling out his IV. He is at end of life and they’re instituting comfort measures. He’ll shortly be on an IV drip of powerful sedatives, and then hopefully restraint-free. Kept comfortable till he dies.

I’ve got an advance directive/DNI on file at the VA. I’m working on getting it sent to the other area hospitals like Sacred Heart and Deaconess. There is so much horror in these walls. Ever heard of a rectal tube? It is exactly what it sounds like. A tube up your butt pulling out all your shit. Transplants and complications from them. Foley catheters, tube feed, etc. It’s just endless. And it makes me a think a lot about what I would want. I’m putting in all my wishes at every hospital so there can be no doubt.

I don’t want my life if I lose independence and functioning. I will die before I get a colostomy bag, a rectal tube, a transplant, and there will definitely be no tubes up my nose. My desired level of care stops the moment things get invasive. If full recovery is not possible, I don’t want anything to do with it. No life saving measures, no invasive treatments, none of it. I will not go through what all these people go through. I will die in peace before I allow any of that stuff to happen to me. All I would want is comfort care.

I do allow for a couple caveats. If the doctor believes full recovery is possible, I will allow tube feed for up to a week. I’m also not a full DNR, I’m a DNI. Once you’re intubated, your chances of living a normal life again drastically drop. I don’t want anything to do with that.

I don’t want anything to do with hospitals outside of working in them. I don’t really trust doctors who think they know everything. At the same time, they’re the only ones who can make these decisions based on these parameters. The emphasis in western healthcare seems very much to be life elongation at the cost of everything else. We really do live a hell of a lot longer than we’re supposed to and have you ever met a 90 year old who was happy to be here? No you haven’t. I don’t want life elongation. I don’t want anything to do with old age. There are some things much worse than death, like aging and dementia. Losing the ability to work, to walk, to wipe your own ass – I don’t want anything to do with that.

I don’t allow anyone to speak for me except the doctor treating me. Not my brother, not my mother, not my best friend. It is a burden I will not put on anyone. Families are the worst people possible to pick as a POA or health care agent. They are biased and may inadvertently follow their own wishes – life elongation – over yours.

In the patient portals for Sacred Heart and Deaconess, there are places with questionnaires where I can go into more detail. I explain I’ve worked in healthcare all my life and I don’t want to go through what all my patients go through. My desired level of care is low. Comfort measures only.

Today my flooring finally gets installed. It’s going to be another long day. I have an appointment at the VA in the morning and then I have to go straight to my house to meet the installers. I’m really happy with what I picked – teak. I’m sure my mother will find some way to shit all over it. She loves shitting all over my house.