Monday, September 7, 2009

Rogers Doktahs

Every day during the week at Rogers you meet with your psychiatrist. My psychiatrist was Dr. Wiesensel. I think she has been at Rogers for quite some time. She is straightforward and has no sense of humor. But we basically had no problems, just checked in every morning for about five minutes, made minor adjustments on my medications from time to time (she did come in early, like 7 am, and didn’t care if she took you out of breakfast to meet with you, which was sort of annoying). The only thing with Dr. Wisensel is that she is sort of strict or overly cautious or whatever you want to call it, and she would tend to tell you one thing (such as "You can start going to the dining room tomorrow") and then take it back (tomorrow would come and she would want to wait another day or two).
After about two weeks into my stay at Rogers I was making plans to return to Castlewood on a Monday- I had bought plane tickets and everything. Dr. Wisensel was all on board. Then on Friday afternoon at about 4pm, three days before I was scheduled to leave, Castlewood called to let me know I couldn't come back yet- there had been a miscommunication between the staff at Castlewood and the social worker at Rogers and Castlewood had not realized that I had not fully met the requirements to return. I was frantic- I did not want to stay at Rogers one second longer and I had already bought my plane ticket. It was Friday evening, and not much could be done- I decided I was going to follow through with my plane ticket, fly to St. Louis and pick up my car and drive back home to Seattle. Dr. Wisensel was on call for the weekend so I saw her Saturday morning. I explained the situation and my intention to return home. She was fine with the plane; she had no reason to keep me there. In reality I had been hoping that she would not let me leave. I did not really want to return home, I knew that I was not ready and that that was a plan for disaster. I was also aware that staying at Rogers two more weeks (to fulfill the requirements to return to Castlewood) was going to eat up four more weeks of residential insurance benefits that I could have spent at Castlewood.

That afternoon I asked the nursing staff if I should put in a '24 Hour Request to Leave' form, which is basically a form people sign that people can sign that allows patients to let their doctors know that they intend to leave, and requires their doctors to meet with the patient within 24 hours to determine if the patient is stable enough to leave or whether they are not and need to get a court order to make them stay. Anyways, since the nursing staff suggested that I fill one out (since my discharge plans had been changed and were not concrete and were confusing) I did. By late Saturday afternoon I was frenzied. I was somewhat terrified of returning home- it felt like a death sentence. I knew I was nowhere near recovery and that returning home meant that I would just return right back where I was. In addition to that, although I had a plane ticket to St. Louis and planned to drive back to Washington, I had no money whatsoever to make the drive back west. I had no idea what I was going to do- sleep in my car? Where? How was I going to earn money that way? Get a job? I guess grandma might bail me out, but I wasn’t very interested in that, and I don’t think she was, either. I was panicked.
Sunday afternoon Dr. Wisensel came onto the unit to see me, as required per the 24-hour Request to Leave paper. She pulled me into a conference room and immediately lashed out angrily “Why the hell did you make me drag my ass up here on my ass up here on my day off? Did you think I wasn’t going to discharge you? Why are you pulling this shit?” Stunned and scared, I ran back to the dayroom, shaken and crying. I started to try to talk to one of the nurses there, Amanda- fortunately one that I happened to like, but Dr. Wisensel entered the dayroom and continued, in front of everyone “You either need to come rescind you request or you need to leave right now. You need to stop acting like a two-year-old and start acting like an adult. You need to grow up.” I thought I was going to explode. I stared into Amanda’s eyes, silently pleading her to intervene. But she couldn’t. As much as she knew that what was going on was wrong, she couldn’t argue with the doctor right there.
After holding my gaze with Amanda for a minute longer, I silently followed Dr. Wisensel back to the conference room. As I signed the line to rescind my request, she continued “You need to learn to trust what people tell you. If you don’t learn to do that, you will never recover. Don’t pull this shit again.”
I left, and went to my room, quite upset. Amanda came in a bit later to let me know she had called the House Supervisor (HS) (basically the person who oversees and manages the whole hospital) and explained what had gone on. The HS was going to come talk to me shortly. On top of everything else, I was still scheduled to leave in about 15 hours and had no idea what I was going to do.
The HS came, I explained what had occurred with Dr. Wisensel, along with my fears around my disorganized discharge plan. She let me know that she was not comfortable letting me leave with the way things were set up, with all of the uncertainty after arriving in St. Louis. She said she would come back and talk to me later after making a few phone calls. When she returned, she informed me that my care was being transferred to another doctor, Dr. Weltzin, and that I was not going to be able to discharge until he met with me and evaluated me and wrote the discharge order. Since my flight was scheduled to leave at six a.m. the following morning, this meant that my flight was going to have to be rebooked. This provided a little relief- I had some time to put together a plan, and I would not have to deal with Dr. Wisensel. Later that night Dr. Wisensel called in my discharge order (which she never did write) and was not only informed that I was not, in fact, discharging the next morning, but that she could not write orders for me because she did not have authority over my case because it had been switched to another doctor. I was told that she was not very happy with the news.
I met with Dr. Weltzin the next morning. Although he was comfortable discharging me, we decided to hold out for a while, to see if I could try again to meet the requirements to be able to return to Castlewood. I ended up staying at Rogers another three loooong weeks. But Dr. Weltzin turned out to be a much better fit for me. He is the director of all of the eating disorder programs at Rogers, but I felt like he was willing to work with me and do what he could to help out and make my time there less painful (even granting me special privileges, such as being able to take walks or go shopping online).
So, although it was only for a few minutes each day that you saw the doctor, seriously, bedside manner DOES still count in my book!!

Wednesday, September 2, 2009

Rogers:Daily Life has been a long time!!! I am back at Castlewood. I got back a week ago- last Monday. My stay at Rogers did not go well, to say the least. I will try to do my best to summarize my experience.
I flew into Milwaukee after a layover in Memphis, TN. It was sort of odd to have to fly directly south from St. Louis for an hour to Memphis and then directly north for two to get to Milwaukee, but I suppose that is how the airlines work these days. The driver from Rogers was calling to ask where I was before I even made it to the baggage claim. He was an interesting fellow- Norm is his name. He would ask me a question (in a very low voice, so that I would have to have him repeat it several times), such as what was I studying in school? to which I would have to shout back the answer ("Biology!") because he could never hear me. Then he would reply with some completely random or inappropriate response such as "Oh, thats too bad, we don't all get t do what we want in life." Anyways, as we pulled in front of the admissions building, a cop pulled in behind us. I was alarmed at first- was I going to be brought into the building in shackles? Nope, Norm had just ran a stop sign.
After the whole admission and paperwork process I was taken up to the unit. It is a locked psychiatric unit with two halls; one hall is for the adult mental health and drug/alcohol detox patients and the other hall is for the adult eating disorder patients. My stuff was searched and I was given a room. I lucked out in that I got a single room with a bathroom, although it is not that great since the rooms are bare with just a bed and locked windows with heavy screens. Most of the other rooms are doubles and everyone shares the shower rooms located off the hallway.
Since I came in on the weekend I was not able to meet with a dietician right away and was given the standard meal plan they give to people who first come in- the lowest plan which is ver, very little food. That night I asked for some extra fruit for snack, which practically floored them.
The first day I met with the doctor on call. She was able to write me an order that allowed me to have my clothes that had drawstrings and I was also allowed to have my yarn and knitting needles. The dietician that was filling in for the weekend came up to meet with me and we discussed what I had been eating at Castlewood and she greatly increased my meal plan. Rogers goes off the exchange system, which I despise because it tends to make me become more obsessive on calories (it did). They also require 3 meals and 3 snacks, like most programs.
That first day I also completed all of the assignments they give you- a couple of worksheets abut body image and exercise and a workbook about your eating disorder. Monday I met with my regular doctor who advanced me to level three- the highest level. This meant that I was allowed to eat in the dining room (although I still ate off of a prepared tray) and was allowed outside. The days are all the same at Rogers: wake up at 6:30am for weights and vitals (if you have bloodwork ordered, they come around 5 or 5:30 in the morning), shower and get ready. Breakfast is at 7:45. Then everyone kind of hangs out, at some point we have goals group where we would all state our goal for the day. Then came rec group for an hour where would play a teambuilding game (with the exception of Mondays- no group at that time), followed by snack, and an hour of process group. Lunch is at 11:45an, and then we chill until 1pm when we have social serives group for an hour. Sanck at 2, art at 2:15, dinner at 4:45, snack and goals at 8pm. day in and day out. No individual therapy or anything. The weekends are worse- just art group in the morning and process group in the afternoon surrounded by all of the meals and snacks. I fulfilled my time doing lots of jigsaw and sodoku puzzles and crocheting dishcloths.