So, what am i hiding?
Some of my self-doubt yesterday is focused on my worry and nagging guilt when i get behind on calling patients back, when we end up playing phone tag, when i don't know what to do and it is unclear what to do.
My current patient that i'm worried about is a young black girl, about 15, who seems to have schizophrenia, but with significant mood swings and episodic dissociative or conversion reactions (no one is quite sure). She also has had some severe edema, which the docs at the ER told her was a side effect from one of her medicines. But i think they just told her that because they couldn't figure out what was wrong with her. She' s been hospitalized at least three times this year. She goes from being a straight A student for 2 or 3 months, to being completely paranoid, wandering the streets aimlessly for hours, her mother anxiously trailing her in her car. i'm concerned she might have lupus. There may be another difficult to diagnose condition going on, but i haven't gotten that far yet. And it could be one of her medicines causing the swelling, except she's been on them for months without this much trouble, so it just doesn't make sense. i spoke to her today, so she's still alive, uncomfortable, but quite rational and will have a few blood tests on Monday.
When i get home from work, i usually plan to make some phone calls or do some other work related chore that i haven't gotten to at the office. Then something distracts me and by the time i remember, it is not really the proper hour to call people, unless it is a life threatening emergency, in which case i would have been paged. The same goes for my "day off" Monday. So when i have routine "crises" going on i feel a nagging guilt. And then when i have something exceptional going on at work i feel uneasy and worried. If i haven't done what i think i should have clinically or humanly, i feel guilty when i have a lapse.
Sometimes i have over compensated and will call people up to follow their progress only to have them say, "What, it's you again!!" Then of course i back off. So sometimes my judgement here is totally out of wack at least as far as the patient's family is concerned. Sometimes i'm right to be so concerned and sometimes i'm not.
Why i tend to avoid this stuff. Sometimes it's someone i don't want to deal with. Sometimes it's someone i know has to talk for half an hour to say something which could be said in 5 minutes. Sometimes i don't mind at all. Like today i should have called a mother whose daughter i recommended be started on Zoloft for anxiety (she has Asperger's). She has had some response to Buspar, which is gentler, but they are going on a big trip to visit distant relatives and so . . . they wanted to try something stronger. i guess my avoidance is that when i saw them face to face i asked about 3 times if there were any other questions, i had explained about potential side effects every way i could think of. And i'm just tired of dealing with the furor about anti-depressants at this point. The only viable alternative is an anti-psychotic and really, that's not what i would want for my child as a second choice med. However, it is really my duty to have called her already. And to patiently explain my point of view and let them make their decision. On the other hand nothing exceptional will happen because i wait until Monday to be a patient explainer. She can continue on the Buspar for a few more days, no big deal.
So those are a couple of examples of the sort of thing i was feeling i should have done yesterday afternoon/evening instead of walking Blue, working on bills and planning P's summer activities.
Otherwise, when i realized that i should be more open about what is troubling me. i was surprised that i had forgotten. This is a big part of the whole point, give things over. Stop trying to do everything and be everything all the time. It is a way of trying to keep control, very unpleasant really. And also sort of insulting for others. i mean if i ask for assistance, surely people can tell me that they are either willing to help or not. All on their own, without me deciding for them that i am a burden. Imagine that!!
i am very slowly working my way through CM. The cover promises that it will hold me tighter than a pair of handcuffs. i think my handcuffs are too loose. i keep slipping away. i am getting more out of it now that i'm in the section about details. When i finish it i will write more about my impressions of it.
i managed to get the stairs and hall cleared!! i used my new 2nd strategy. i told the boys that i was going to take anything they didn't clear out of the porch, the stair and the hallway to Good will. First i would give them a half-hour warning and be available to help them if needed. So J helped me some, and those things he helped sort will go to GUTS. The other stuff all went to Goodwill. And is thankfully GONE. i did relent on one of J's beanie babies and some little lego pieces, but everything else got taken away or tossed. With this approach i think i can do the rest of the house more quickly. Both for my clutter and for the kids. P is finally to the point where he is not attached like a leach to everything he's ever owned. J has never been all that attached to things. So as long as S and i can restrain our tendencies to accumulate, we should be ok.
i can take tomorrow off. i'm not sure i'll want to, but thanks anyway. It's a nice gift.
Posted by briannawaters
at 9:25 PM EDT