Countdown to Muskogee. . . 13

My last appointment with Sarah Beattie, my nurse practitioner.

Really.

This is it.

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Daft Trek

Social Services, the Final Frontier.  These are the voyages of one unclassifiable nut-job.  Her ongoing mission: to explore convoluted government gobbledy-gook; to seek out new services that might actually help; to boldly leap over the cracks in the system where no one has leapt before.

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After I finished the Intensive Psychiatric Rehabilitation program in late June, the search was on to find some kind of support that might fill the gap.  IPR wasn’t therapy, but working with Aly for two hours twice a week turned out to be the best therapy I’d ever had.  How can you not go deep and actually problem-solve with that much one-on-one time?  Most participants in IPR spend half their time in groups, but we had trouble finding peers for me (I’ve got so much insight, you know), so Aly and I just met by ourselves.

We both knew no social service could provide what Aly gave me, so we looked at the kinds of support I might find.  She and my therapist thought Lutheran Services of Iowa might be a fit.  I went through two-hour assessments with both my caseworker and LSI, was approved, and started seeing a caregiver in July.

I have a caregiver.  To say I have mixed feelings about that is like saying Emmett is a little nervous (though, here’s a barely-related photo of both guys sitting next to me as I write this with Em combed and smiling).

Together

Anyhoo, it’s taken me all summer to get used to the idea of being a person who could benefit from a caregiver.  When I look at it in terms of what I need to stay out of the hospital, I get it.  But, like everything else concerning my mental health, I don’t fit in the usual categories, so we had to get creative.

Leanne, my caregiver, and I met for coffee once a week all summer at the new coffee house (Yaay! Marshalltown finally has a coffee house!)

Brew House

This was all part of my care plan—to get basic support.  It’s not therapy, but more than friends and family can provide.  For that hour, I get to talk without worrying about my social skills or being reciprocal in any way.  Most human interaction is two-sided.  Conversation is give and take.  And, while Leanne and I do converse, the point is we don’t have to.  For that hour, she’s there for me, and if I need all that time to process, I don’t have to feel guilty, or selfish, or worry about ruining our relationship.  Over the summer, we honed that process to where we’re both comfortable with it.  And it is a true and valuable tool.  Like my new soaking tub, I can relax with Leanne now and just let go.

The other part of my care plan is for Leanne to help me keep my apartment clean this winter.  Since I’m allergic to dust mites, I need a clean living space in order to avoid the asthma flares that lead to bad colds and, often, pneumonia.  And, since winter historically brings more severe depressive symptoms, cleaning (like anything requiring effort) flies out the window.

Halli, the LSI director, told me that their caregivers aren’t housekeepers.  They help clients set goals and work alongside them.  I’m expected to do the real work.  I like that concept.  I asked my sister to do that once, to come over and just help me figure out how to get my place cleaned.  I remembered what a huge help that was.  If I could get used to a stranger coming into my home, I thought that kind of support might help me avoid getting sick so much.

So, last Wednesday, Leanne came over and helped me replace the filters in my air vents.  It’s a big job, I even got the consultation from specialists of air duct cleaning in Kansas City, MO.  All the vents are in the ceiling.  I put filters in the ones I could reach by standing on a chair, but that was five years ago.  Last week, with a real step-stool, we replaced the black filters (ugh!) and got all the vents covered in the hour Leanne helped me.  I spent the rest of the day cleaning the grill on the intake vent (gross!) and laying filter material across that, too.

Intake Vent

Awesome!  Except I didn’t think to wear a mask.  Oops.  Now I’m fighting the very thing I tried to avoid—a bad head cold that will probably go south soon.  I should have known better.  I wore a red shirt that day, and we all know what happens to those guys.

March Madness

TumbleweedPhew!  February is behind us.  Enough, now, of the darkness and bitter cold and on to mud below and sun above.  Historically, March is the time I rouse from my mental hibernation and blink at the mess I’ve made while thrashing around in the dark.  I spend too much money when I’m brain-sick.  I eat compulsively.  Fat and broke, I usually overreact.  Last year and the year before, I put myself on strict money and food diets… and I ended up in partial hospitalization.  Hmmm.  Maybe this is a pattern I need to address in IPR.

The mission of IPR (Intensive Psychiatric Rehabilitation) is to help those of us with mental illness succeed at a goal we choose.  My goal is to keep living in my apartment, not taking sabbaticals in the hospital, so my caseworker, Aly, and I look at any skills needed to do that.

Partial hospitalization gives me structured support, a place to do the hard work of managing my illness when it’s overwhelming, and accountability to professionals who understand me.  One of my new skills is to seek out more structured support outside the hospital setting.

Seeing my therapist and participating in IPR every week are two kinds of structured support.  Recently, I added a weekly meeting with my Peer at Integrated Health Services (where I worked for a time last summer).  Allison and I sit for an hour and talk about doing the hard work of recovery.  The more I can get this kind of help, the less likely another hospitalization.  And since the Partial Hospitalization Program closed its doors last year, my only option now is full admission to a psych ward.  To me, that’s not an option.

So, it’s also important to look at this pattern of deprivation in the early spring.  As Aly and I talked through this, it seemed so simple.  Now is not the time to white-knuckle anything—not my budget, not my diet, not an out-dated version of myself as responsible and in control.  If there was ever a time for my Kinder, Gentler practice to kick in, it’s in March.  Now is the time to acknowledge how ill I’ve been and how well I’ve coped.  Now is the time to gently come back to cooking at home when the depression lifts enough to allow it.  Now is the time to remember that this is what my savings is for—to pay the bills my illness created over the winter and to give me space to breathe.  I’ll be able to live within my means again, but not right now.

This whole idea is radical—not clamping down to pay off my Visa bill or repaying the money I took from savings.  The idea that I can do those things later, should do them later, boggles my mind.  So simple.  So very Kind and Gentle.  It’s lovely to be my own best friend.

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