Written by Fox.
We've now been sectioned for 3 and a half years. We've been back on acute wards since October last year. BUT it's looks like things are on the upwards and we could be getting discharged in several months! By that point we'll have been sectioned for over 4 years.
Dissociating has been a big problem for Keri over the last 23 years and it's not going to disappear any time soon. We are as real as she is and we deserve to live lives too. Keri has, over the last year or so, learned that accepting us and not fighting or ignoring us all the time, makes all of us happier and more cooperative. Sally has reared her head a fair few times and in the last couple of months we've needed about 50 stitches. But we haven't been put in seclusion. Yes, Keri, Sally and a few others have been restrained on various occasions but we haven't been secluded. Hopefully I haven't jinxed us!
Since moving back to the ward we're on now, one of Keri's accommodation workers has been looking for somewhere for us to go. Right now they've referred us to an organisation that is able to provide independence along with 24 hour care. We had the choice of a shared house or a single flat. After Keri had a meeting with us (we have a daily get together every evening so that everyone can air their opinions about the day or anything that's been discussed or experienced) and we all decided we would prefer a flat so that we can live as much as Keri does. The flat would also, initially, be staffed 24 hours a day. I think there's a staff area for a block of flats and basically there's panic buttons or a phone number for you to ring but I'm not definite. I think Keri knows more details. I'm not about constantly. The place they're looking at opens in August. With a phased discharge, and an anniversary that triggers Sally and Keri big time at the beginning of September, we probably will be officially completely discharged by the end of September/beginning of October. We'll be able to celebrate Keri's birthday! Clari already plans to decorate our flat for Keri when we're out as a nice surprise after being in hospital so long. Everyone is hoping that a slow, phased discharge will mean that we stay out of hospital. Sacrificing an extra few months in hospital to make sure we all stay out rather than rushing it and end up yo-yoing is a good option for all of us. We've talked about it.
They're finally sorting our medication out which is good for me because I need medication like Keri does. We're back on two anti-depressants combined together as it's the only thing that seems to fight our depression. We're also back on anti-psychotics, though I don't feel 100% so hopefully Keri can ask the psychiatrist to up the dose, both for her benefit and mine. I haven't felt very good since we were taken off them back in September. That's partially why I haven't been writing posts. Some of the alters keep saying that I've been acting weird. I can't see it myself but I know when I need to listen to them. Hopefully I'll feel good enough to see our therapist soon. I get along with her really well and used to talk to her a lot. I planned to see her last week but when the time came I didn't feel up to it.
Keri's compensation claim has now come through (although I won't state how much as that's Keri's business not yours!). We have a bit of savings now for when we get out of hospital. Keri is also going to look into volunteering so she can build on getting a job when the time is right but the rest of us have issues with that. What about us? We don't all like the same thing. Last time Keri volunteered as at the cats and dogs home and she never actually did any work. It was Clari that did it all. Keri just did the travelling to and from. It annoyed her a little bit as she wanted to experience work life too but I think Clari needed an outlet. I don't see why though as by this point she was still sneaking out and having sex with anyone she came across, both male and female! She's not bisexual, she just has an addictive personality. She gets a little obsessive at times about it!
Keri's met a lovely guy and has been chatting to him since December. A few of us have also had little chats with him just to get a feel of what's going on. I'm hoping that if things start getting serious then Clari will curb her sex habits otherwise it won't be fair on him. He knows about Clari's behaviour and all about us. Even Sally has spoken to him, though I don't know what was said as she doesn't feel like sharing. None of us ask about each other's conversations much either as, even though it's hard respecting privacy with one body to share, we still respect each other's personal space. Hopefully he's coming to see Keri tomorrow. We've all decided to leave them to it when they meet so that they have time together rather than us dissociating all over the place. This guy is very accepting of us and knows we have been sectioned for a few years yet he's still supportive and understanding. Things look promising.
So things are looking up! I can't wait until we're discharged. We have 15 minutes unescorted leave a day now which could be going up to 30 minutes next week. Our therapist and the staff know that at some stage something is going to happen and Sally may kick up a fuss, but they understand it's about MANAGING the risks not ELIMINATING them. Eliminating them will be completely pointless and frustrate us all. But managing them? As long as we can keep safe I don't see the issue. A lot of us are talking to the staff. Penny has spoken to several members of staff and due to this hasn't ligatured since we moved back here in December, which considering what she was like in intensive care is a big improvement.
For some reason Keri has been getting really physically unwell. Since December we've needed to be admitted to a medical ward 3 times which results in fluids, oxygen, and IV antibiotics. Unfortunately we find hospitals threatening so Sally comes out quite a lot when we're in medical hospitals or Keri freaks out with flashbacks. This usually results in restraint and IMs. Last time she was admitted they managed to get her to take oral medication rather than being jabbed so that's good. Hopefully we won't end up in a medical hospital again. I'm not sure why we've had so many serious chest infections but our immune system seems to have gone down the toilet. The doctor said it could be down to poor dietary intake. Keri's eating hasn't been brilliant as she's been purging a lot and because I've not felt great I haven't been able to come out and eat for her. The others have been distracted either looking after me, stopping Sally when they can, or looking after the littles. Our therapist has said anything she can do to help we just have to ask, even if it's for one of the littles to come out and play for an hour. She said give her some warning and she'll arrange to bring a selection of toys for them. She's a lovely woman and I'm going to be very sad when we have to start seeing someone else.
I'll update as soon as I can. All depends on whether the psychiatrist can help me. I'm not sure how accepting he is of all of us but he's a lot better than the last one in our old unit who didn't even believe we existed. It was horrible.
Sunday 19 March 2017
Saturday 18 March 2017
Psychiatric Intensive Care Unit
Written by Fox.
We've been in many different types of unit, but up until several months ago we'd never been in psychiatric intensive care aka PICU. So what is a PICU like?
We had been in the open rehab for a few months. In September last year we went downhill very quickly. On Keri's daughter's anniversary Sally absconded and ended up being brought back by police after she ended up at Keri's birth mother's again. The staff dealt with it. What they couldn't deal with a few weeks later was Keri's risk to herself. She was suicidal. And I mean acutely. She had to be placed on 1:1 observation (a member of staff with her at all times) and a few days later we were all told that we were going to be transferred to psychiatric intensive care due to the high risk.
We were sat in our room and Keri was talking to her 1:1. The deputy manager came upstairs and told us we were going to be transferred. They grabbed a bag of her stuff and we went downstairs, where 4 members of staff from the PICU were waiting. Obviously they'd been expecting trouble. They were right to. Keri panicked. As soon as she stepped out of the door she tried to make a break for it and ended up restrained until we got to the PICU (which was only a 5 minute walk across the hospital grounds).
When we first arrived on the unit, we were taken through an airlock and into a secluded area. All of us were on red alert due to the fact we'd never been in intensive care. Sally was ready to explode at any threatening opportunity. Keri was strip searched and had literally everything taken away and was given a set of hospital pyjamas with no pockets or any hidey holes. This meant that her and Sally's razors that Sally had hidden in the lining of Keri's tracksuit bottoms were found due to the metal detector they used.
We were shown around the unit. It was the bare minimum. Intensive care units are classed as 'low stimulus' which means there is literally nothing there to distract you except the TV, and at that point none of us had the concentration to focus on it anyway. We were shown to our room and put on 5 minute observations (a member of staff had to check on us literally every 5 minutes). If anything this was worse than 1:1. At least with 1:1 you know someone is there constantly so you know there is no point whatsoever in trying to do anything. However, if you're on 5 minutes, you have that freedom to self-harm or try and kill yourself but you also know that if it takes more than 5 minutes then you're going to get caught pretty quickly.
Due to Keri's state of mind, even a minute alone was enough for her to try stuff. Headbanging, punching walls, trying to choke herself on tissue paper (which was also restricted, you had to ask for toilet paper every time you went to the toilet). The unit also triggered off Penny. Penny ligatured a couple of times in the secure unit but in intensive care she was doing it every chance she got. Keri only did it a couple of times in the beginning, the rest of the time it was Penny. Penny is also suicidal so it's not a great combination to have.
At one point Keri and Penny had ligatured so many times in the space of several hours that the only thing the staff could do was to strip us of everything and put Keri in an anti-ligature suit. This is a suit that is made of material that can't be ripped. It's basically shorts and t-shirt in the same material that Keri's anti-ligature blanket was made out of (she wasn't allowed a duvet or pillow due to her risk). We were all freezing while we were stuck in that suit.
Sally came out a couple of times so we did end up in seclusion at one stage. Sally kicked a member of staff in the back and ended up being dragged to seclusion. What made her even worse was the fact that the staff had to restrain her while also taking off her clothes and underwear to put her in an anti-ligature suit just in case Penny came out while we were stuck in seclusion. Despite Keri switching back out after about an hour we were kept in there for over 4 hours. It was horrible and, for Sally, humiliating.
We spent about a month there before we stepped down to an acute ward (which is A LOT less restrictive). We weren't allowed to make our own drinks and were given lukewarm drinks every hour in paper cups. The garden was open for 10 minutes an hour for people to smoke and between midnight and 6am it was kept shut so no smoking allowed unless you had a restless night. If you did then they allowed you one 'discretional cigarette' in that time period.
Overall we never want to go there again. It was worse than the secure unit. It was degrading and humiliating. The things the staff had to do were last resorts and were to keep us safe but it didn't stop us feeling like our dignity was completely taken away. Even Sally felt ashamed when they had to strip her off in seclusion and that, of course, made her worse.
PICUs are a last resort when someone is critically unwell, for instance being acutely suicidal or dangerous because you're very psychotic. It's not a very good environment to be in at any time, but personally I think it's even worse that very unwell people are put in those kinds of units. It's all well and good keeping them safe from themselves or other people safe from them but there's no distraction or stimulus. It's an environment that you can literally do nothing except brood and reflect, and you end up trapped in your own head. If we ever end up in a place like that again, Sally has already said she'll stay out constantly to protect us all as she sees it as a constant threat. I honestly cannot blame her for thinking like this, but realistically it would mean we'd end up being kept in there a lot longer.
We've been in many different types of unit, but up until several months ago we'd never been in psychiatric intensive care aka PICU. So what is a PICU like?
We had been in the open rehab for a few months. In September last year we went downhill very quickly. On Keri's daughter's anniversary Sally absconded and ended up being brought back by police after she ended up at Keri's birth mother's again. The staff dealt with it. What they couldn't deal with a few weeks later was Keri's risk to herself. She was suicidal. And I mean acutely. She had to be placed on 1:1 observation (a member of staff with her at all times) and a few days later we were all told that we were going to be transferred to psychiatric intensive care due to the high risk.
We were sat in our room and Keri was talking to her 1:1. The deputy manager came upstairs and told us we were going to be transferred. They grabbed a bag of her stuff and we went downstairs, where 4 members of staff from the PICU were waiting. Obviously they'd been expecting trouble. They were right to. Keri panicked. As soon as she stepped out of the door she tried to make a break for it and ended up restrained until we got to the PICU (which was only a 5 minute walk across the hospital grounds).
When we first arrived on the unit, we were taken through an airlock and into a secluded area. All of us were on red alert due to the fact we'd never been in intensive care. Sally was ready to explode at any threatening opportunity. Keri was strip searched and had literally everything taken away and was given a set of hospital pyjamas with no pockets or any hidey holes. This meant that her and Sally's razors that Sally had hidden in the lining of Keri's tracksuit bottoms were found due to the metal detector they used.
We were shown around the unit. It was the bare minimum. Intensive care units are classed as 'low stimulus' which means there is literally nothing there to distract you except the TV, and at that point none of us had the concentration to focus on it anyway. We were shown to our room and put on 5 minute observations (a member of staff had to check on us literally every 5 minutes). If anything this was worse than 1:1. At least with 1:1 you know someone is there constantly so you know there is no point whatsoever in trying to do anything. However, if you're on 5 minutes, you have that freedom to self-harm or try and kill yourself but you also know that if it takes more than 5 minutes then you're going to get caught pretty quickly.
Due to Keri's state of mind, even a minute alone was enough for her to try stuff. Headbanging, punching walls, trying to choke herself on tissue paper (which was also restricted, you had to ask for toilet paper every time you went to the toilet). The unit also triggered off Penny. Penny ligatured a couple of times in the secure unit but in intensive care she was doing it every chance she got. Keri only did it a couple of times in the beginning, the rest of the time it was Penny. Penny is also suicidal so it's not a great combination to have.
At one point Keri and Penny had ligatured so many times in the space of several hours that the only thing the staff could do was to strip us of everything and put Keri in an anti-ligature suit. This is a suit that is made of material that can't be ripped. It's basically shorts and t-shirt in the same material that Keri's anti-ligature blanket was made out of (she wasn't allowed a duvet or pillow due to her risk). We were all freezing while we were stuck in that suit.
Sally came out a couple of times so we did end up in seclusion at one stage. Sally kicked a member of staff in the back and ended up being dragged to seclusion. What made her even worse was the fact that the staff had to restrain her while also taking off her clothes and underwear to put her in an anti-ligature suit just in case Penny came out while we were stuck in seclusion. Despite Keri switching back out after about an hour we were kept in there for over 4 hours. It was horrible and, for Sally, humiliating.
We spent about a month there before we stepped down to an acute ward (which is A LOT less restrictive). We weren't allowed to make our own drinks and were given lukewarm drinks every hour in paper cups. The garden was open for 10 minutes an hour for people to smoke and between midnight and 6am it was kept shut so no smoking allowed unless you had a restless night. If you did then they allowed you one 'discretional cigarette' in that time period.
Overall we never want to go there again. It was worse than the secure unit. It was degrading and humiliating. The things the staff had to do were last resorts and were to keep us safe but it didn't stop us feeling like our dignity was completely taken away. Even Sally felt ashamed when they had to strip her off in seclusion and that, of course, made her worse.
PICUs are a last resort when someone is critically unwell, for instance being acutely suicidal or dangerous because you're very psychotic. It's not a very good environment to be in at any time, but personally I think it's even worse that very unwell people are put in those kinds of units. It's all well and good keeping them safe from themselves or other people safe from them but there's no distraction or stimulus. It's an environment that you can literally do nothing except brood and reflect, and you end up trapped in your own head. If we ever end up in a place like that again, Sally has already said she'll stay out constantly to protect us all as she sees it as a constant threat. I honestly cannot blame her for thinking like this, but realistically it would mean we'd end up being kept in there a lot longer.
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