Responsibilization? More adventures in psychiatry and the doctor’s office…

Jennifer L Reimer (Practice of Madness)"Health Care", Bipolar, Meds, Meds, Meds!, Sociology of Medicine2 Comments

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After much ado about nothing, I finally obtained a steady supply of codeine for my severe menstrual cramps, brought on by the fact that taking an atypical antipsychotic for three years pressed the stop button on my reproductive system.  Now it’s making up for lost time by torturing me for seven days out of each 28.

This only took one year!

…and the reason that I am finally “allowed” to have 45 of these pills in my possession at one time is the topic I want to discuss, but I’ll give a bit of background history first.

In my hometown of Winnipeg, my GP, who I started seeing when I was 13, had her practice across the street from the Victoria General Hospital, where I spent much time at what we nicknamed “The Hotel Vic” – a.k.a. “Unit Six”, the psych ward.  Thus, she was well aware of each institutionalization I underwent, and I always updated her on the cocktail of psych meds that I was on, as it changed after each hospitalization.

However, I started having severe menstrual cramps (similar to a migraine headache, in that they make me want to hide in a dark, quiet room, hoping only that I will fall asleep to get some relief) at age 15.  We went through the NSAIDS (non-steroidal antiinflammatory drugs) – naproxen, tordal, and then ketaroilic acid – the last one caused an allergic reaction, the rest of them didn’t touch the pain.  From then on, she prescribed me about 40 tablets of Tylenol #3 each month.  She knew me before I became a “psych patient” (at age 19), and I suppose this made her realize that my need for some codeine (I emphasize the word as it is the least strong of opiod painkillers, it comes in some over-the-counter cough syrups, it is really not a big deal!) once a month had nothing to do with my ever-changing psychiatric diagnose099901420s, the possibility of trying to “self-medicate”, or the chance that I might have a “dual-diagnosis” (i.e. drug addiction + psychiatric illness).  Alaryyk and I witnessed a good example of the latter when Wellbutrinwoman invaded our home the other night and started chopping up her antidepressants to snort them.

Even when I was in the hospital, if I happened to get my period, one of the psychiatrists would immediately prescribe me two Tylenol #3 tablets every four hours as needed for pain.

If you’ve been keeping up with this blog for some time, you know that my ability to get the pain medication I’ve needed for 10 years has been incredibly difficult since I moved to Vancouver.  In part, this is because my liver can no longer tolerate Tylenol.  Did you know that the majority of visits to the emergency room that are liver-related are due to Tylenol over-usage, or extended usage?  In my case it’s not only the Tylenol that has weakened my liver, but also the incredibly high doses of various psych meds that I’ve ingested since I was 19.  Effexor is particularly bad for the liver, and Effexor has been a staple in my psych meds diet.  They put me on it on the morning of my first hospitalization, and I’ve been on it ever since.

Docs here in Vancouver are terrified of prescribing Tylenol #3s minus the Tylenol – i.e. 30 mg, generic codeine tablets, as they are opiates not cut with something that will destroy your liver if you attempt to take more of them than a doctor tells you to.  It would still take a hell of a lot of codeine to overdose, but they could also be used recreationally.  Using pain medication for recreational purposes is so far from any reality that I live in right now that the proposition seems ridiculous.  Unfortunately, all meds that could possibly be used for purposes outside of “medical treatment” carry labels warning physicians not to prescribe them to “people with a past history of addiction”, “people with a mental illness”, or “people with a family history of mental illness”!  Vancouver docs seem to take this WARNING very seriously, at least the GP I ended up with.

For the past two days I have been writhing in pain, in bed, taking my clonazepam as a sleep-aid, because my doctor was not able to see me until 3:45 pm on Friday (today).  She could not fax a prescription to my pharmacy, as can be done! – she had returned from her 8-week vacation to China, and I suppose she wanted to check on my “stability” before giving me *gasp* a few codeine pills! I had to get an extension for an assignment again - something I was really hoping not to have to do after my extended period of illness throughout January – April, when a “medical certificate” per week excusing an absence was pretty much the standard.

After waiting in the waiting room and filling out a form outlining “the reason for my visit today – note that your visit is 15 minutes long“, and then waiting in the doc’s office, with Alaryyk sitting beside me because he’s the most wonderful, supportive man I’ve ever met :) , my physician entered the room.

She looked slightly peeved.  I had called the office in the morning asking if I could speak with herSpeak with a doctor on the phone?!?!?! The lovely receptionist (all of the receptionists at the office hate me, not because I’m rude or demanding, but because I expect them to perform their jobs) basically hung up on me.  Alaryyk reminded me that this had probably been reported to her, “That crazy scars woman called again!…”  These receptionists infuriate me – I would love to have a part-time job sitting on my butt answering phones and typing things into a computer at a doc’s office, getting paid at least $20/hour ($12 more than minimum wage; $11 more than I make as a “paid student” as my grant is disbursed).  If you ask them to do anything that involves having to stand up, they lash out.  Maybe they need a little Effexor. :razz:

I ignored this expression and started into my very reasonable and logical argument – I need a steady supply of codeine during my periods.  I cannot afford to be paralyzed by pain for days each month, and I think that such unnecessary suffering is inhumane.  I have been on this medication for ten years, I do not “abuse” it, it is the only thing that works for my pain, and I will have to go elsewhere if this is not facilitated.

My doc seemed to agree with each point that I made.  I was neither frantic nor, heaven forbid, “distraught”, as she cited as the reason for me being banned for Shopper’s Drug Mart pharmacy back in January.  However, the decision did not lie in her hands or mine – after asking the obligatory questions about whether or not I “thought about suicide”, she turned to Alaryyk to make the call.

At first I thought, how patriarchal!  My “man” is the one who is able to determine whether or not I am stable enough to have a bottle of codeine tablets in my possession?  Then, on the ride back to the pharmacy (he assured her that there would be no problem) he reminded me of how similar this was to the power that was placed in my hands while he was hospitalized last November/December.  Family and friends actually have a lot of power in determining a “psych patient’s” fate – not as much as psychiatrists, but still, they end up being the determining factor.

Luckily, this is great for me and Alaryyk…if no other “friends” or family members that get particularly freaked out about our “disordered” minds get involved.  Although Alaryyk pays the rent here, he was not allowed to return home until after the doctor’s had asked me at least three times, on seperate days, if I felt he was safe to live at our residence.  I had to say YES, YES, YES, YES, YES, again, again, and again, until the shrinks at the UBC psych hospital were convinced.

My heart now goes out even more than before to those that are “sent” to the psych ward (read: picked up by the police and left to wait in the ER waiting room in handcuffs until the shrink “on call” arrives to check one in to the ward – it seems that s/he comes back about once every 24 hour period) by friends or family members who do not understand the workings of a mind that is slightly different than others’.  For example, a group of “friends” called the cops on my best friend in Winnipeg last fall, speeding up her plan to escape to Europe, after she had an episode of tears, and made a tiny cut on her face with a razor.  As I know this woman incredibly well, and share her experiences of “mania” and “depression”, I would have been able to help her by having a long talk and holding her as she cried, probably crying in unison, our tears healing one another, getting it all out, and getting ready to move on from whatever spurred the minor breakdown.  I considered flying back to Winnipeg to help out, but luckily, she’s one of the smoothest ladies ever to grace this Earth, and talked her way out of getting stuck at the Hotel Vic.

Like Alaryyk was after time in the hospital last fall, I am also reminded of Goffman‘s comments about “betrayal funnels”, and the quite arbitrary series of “abnormal” behviours/emotions that lead one to be institutionalized by one’s family and/or friends.  It is a mental health “intervention”, and other things like one’s proximity to an appropriate hospital influence the “crazy one’s” fate as well.

However “good” their intentions may be, family and friends who have no experience with us folks who are a little unique, who dare to act out when something strikes a nerve, and do not conform to society’s image of “sanity”, can be very dangerous.  Although the individual is “responsibilized” for their conduct in neo-liberal society – i.e. environmental circumstances and influences are completely disregarded, the problem lies solely in the mind of the “strange” individual – they are “de-responsiblilized” for the outcome of that conduct – this power is placed in the slippery hands of family and friends, who are assumed to know the individual that is “acting strange”.  If these family members and/or friends have no previous experience with psychiatry, they may send someone to be electroshocked or prescribed a cocktail of zombifying meds, not realizing that a little “weirdness” is simply part of who they are.

A lot more could be said about this, and I hope it initiates some discussion.  But, (deep sigh of relief), I am finally out of pain and the friends that were supposed to come over the night of Wellbutrinwoman are going to arrive in a few minutes.  I will cut it off here, and thank my lucky stars that my next of kin knows me for who I am, and is not afraid of me having 40 codeine tablets in my possession!

Good Friday Night,

scars xo

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Jennifer L Reimer (Practice of Madness)Responsibilization? More adventures in psychiatry and the doctor’s office…

2 Comments on “Responsibilization? More adventures in psychiatry and the doctor’s office…”

  1. JanCarol

    In my circles, we call it “getting caught”

    “The Ambulance came after the police called them, and they took me away.”

    “Well what did you do to get caught?”

    “Nothing, I was just – well – I was in this shop and overcome by fear and got paranoid, and crawled in behind on one of the big shelves and wouldn’t come out.”

    “Ah. So you got caught. Always remember what behaviours get you caught, because you can learn to NOT get caught.”

    1. scarsarestories

      Good advice!
      Here in Vancouver, we call it getting “Car 87′d” – there is a police car actually called “Car 87″ that comes and picks you up if you do something like get a little paranoid (and who the hell doesn’t once and a while?)
      The two of us bloggers are lucky to have each other to keep an eye out for impulsive things we might do that end in Car 87 showing up – but when enough “nay-sayers” come in to the picture, often adding wild, absolutely untruthful things to “crawling behind that shelf” (ex/ s/he was menacing people from behind that shelf, naked, and brandishing a sword!). We’ve had to outright stop socializing with certain people who have no understanding of minds that aren’t carbon copies of their own.
      Stay safe and don’t get caught :wink:
      scars

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