March 28, 2019

The Long Journey ... Two Steps Forward One Step Back

It has been a long time since I've posted anything so I thought it was about time I got off my ass and did something about it.  When last we spoke I was preparing for major surgery and dealing with the anxiety that accompanied that process.  Surgery went well and I ended up with quadruple bypass grafts.  I have no memory of anything beyond the pre-surgical prep area thanks to the wonders of modern chemistry.  I remember loosely saying goodbye to those who were with me and the next thing I knew I woke up in intensive care not long after having my breathing tube removed.  I'm thankful I don't have any lucid recollection of that experience.  My worst fear was that I'd wake up intubated and go immediately into panic mode.  Luckily I was kept well sedated and chemically altered throughout that process.  I was forced to sit up on the side of the bed shortly after waking up and, as you can probably imagine, that was not a pleasant thing to do.  Just having had my chest cracked open and subsequently wired and sewn shut made it very difficult to say the least, even though it was a necessary evil.  I was soon sitting up in the chair and within 24 hours was walking the halls of the ICU, lugging my IV's and catheter bag along with me.  I remember being exceptionally short of breath with any exertion at all and I had to focus on trying to keep that in check.  I was reminded by the wonderful nurses who cared for me that it was normal since basically the anatomy within my chest cavity was rearranged during the operation.  48 hours later I was transferred to the cardiac step down unit where my recovery continued at what seemed like a rapid pace.  Each walk became longer in distance and duration and the various IV lines, chest tubes and foley catheter were gradually removed one at a time lessening the attachments that needed to be lugged around.  All in all my pain was well controlled and the care I received was beyond any expectation I could have had.  I was in the hospital for a week and then I transferred to an inpatient rehabilitation facility where physical and occupational therapy commenced.  I spent an additional week or so there and gradually progressed as far as what I was physically able to tolerate.  My breathing improved and my stamina started to grow, albeit not as fast as I would have liked; but in all honesty I probably didn't push myself as hard as I could have.  Overall the facility was nice though the food was less than stellar.  Maybe it was just my appetite but I was glad to get some real food once I was discharged.  My sister and her husband graciously accepted me into their home for another week or so as I no longer met inpatient criteria but could not yet be on my own either.  I still needed help getting around, bathing and such and they did their best to keep me comfortable as my recuperation continued.  I also had regular visits by a home health nurse and physical therapist.  As much as I appreciated my family's hospitality I have to admit I was really glad to get back home in my own surroundings.  Family and friends continued to assist me with chores and made themselves available to just be on hand when I bathed in case I got into trouble of some sort.  I gradually got better and was able to make it to follow up appointments and do a little bit more each day.  I have to say I couldn't have made it through the entire process without my friends and family.  I don't know what I would have done had I been forced to go through this on my own.

The down side to being back home was that I allowed depression and anxiety to grow and fester to the point that I once again felt hopeless and worthless and basically quit taking care of myself.  I quit taking my insulin and let my blood sugar get ridiculously out of control.  Even though I had just been through such a miraculous life saving procedure I got to the point that I wanted to just die and get it over with.  They say that depression is common after such a major surgery and I guess I should have heeded the warnings and not let things get to the point they did, but the time came that I was confronted by one of my closest friends and basically told that I needed to seek help again by going to the hospital.  I didn't want to go; I'd been there so many times before and knew the routine and I just didn't feel like it would help, but I reluctantly capitulated and allowed myself to be taken to the emergency room.  It wasn't very surprising to me that my blood sugar was exceptionally high, more than 550 for those who are familiar with blood sugar readings.  I was on the verge of going into diabetic ketoacidosis or DKA as they call it.  I was admitted to the medical floor and was monitored closely for several days as they brought my sugar levels down to a more reasonable range.  During this time I was evaluated by the behavioral health folks and it was determined that I needed to be transferred to that unit once I was deemed stable.  I spent another week there working on my depression and anxiety levels and having some of my medications tweaked.  Part of my aftercare plan included participating in a partial hospitalization day program at a place called Friendship Community Mental Health Center.  I'm now completing my seventh week of the program and graduate tomorrow.  The program is a bit like attending college and has included classes on life management, coping skills, grief and loss, and trauma.  They also provide transportation, breakfast and lunch.  This program has been the primary focus for me over the past seven weeks, getting up at 5:00am every day and riding the van into South Phoenix where their facility is.  The therapists and other staff there has been outstanding and I've certainly learned a lot.  Having a place to go and sense of purpose on a daily basis has been good for me and I plan on continuing to get involved in a couple aftercare programs.  CHEEERS is one program that provides daily groups and activities and offers training on becoming a certified peer support counselor.  I may pursue that as it would prepare me to have a way to help others going through similar circumstances.  The other program I'm planning on exploring is Art Awakenings.  As its name implies they offer classes in all types of art like drawing, painting, glass work, sculpture, and even writing which holds a great deal of interest for me.  They have a gallery in the downtown Phoenix arts district where works are displayed and sold to the public so perhaps one day I'll be able to sell my work.  Either way, these two programs hold the promise of keeping me engaged socially and helping me to not isolate and spend too much time alone closed up in my apartment.

On that note one of my challenges has been living alone and having the tendency to isolate and be on my own too much which has historically led to spiralling downward back into depression and significant agoraphobic behavior.  I have been in discussions with a friend of mine who shares many of the same circumstances and we are talking about becoming roommates.  We feel it would be good for both of us to support one another and be less isolated and alone.  We share so much in common well beyond our mental health issues.  We both love sports, old movies on Turner Classic Movies, good food and hanging out just to name a few things.  He's going to come next week and stay a few days as a trial run to see if it would work.  I'm currently in a one bedroom apartment so we'd need to find a two bedroom two bath place, perhaps in the same complex, once my lease is up.  Will see how things go with that but I anticipate it will be a great situation once we find the right place that's affordable and meets our needs.  Another challenge I'm facing that is a major steps backward is that I unfortunately started smoking again.  I can't believe after all I've been through that I picked up that habit again but I did.  This has been a source of major disappointment for my friends and family and I feel a great deal of shame and guilt for having started yet again.  All my efforts at quitting have failed to date and sometimes I wonder if I'm just destined to be a lifelong smoker even knowing that it very well may kill me.  I can't explain it other than to say that the addiction has just been too strong.  I had quit a month prior to surgery and stayed quit for a couple months afterward but I missed it so much that I broke down and bought a pack.  That led to another ... and another ... and another; I was soon back to getting cartons rather than one or two packs at a time.  I'm incredibly embarrassed and disappointed in myself and I know others can't believe I would do such a thing.  I've been up front and honest with my primary care physician and cardiologist, both of whom want me to work on quitting again of course.  Smoking can lead to reducing the lifespan of the coronary artery bypass grafts which could lead me back to the operating room sooner rather than later.  I consciously know all the many reasons for quitting and staying quit but I'm honestly just not there yet.  Perhaps having a roommate will allow me to focus more on quitting.  He's a smoker too so maybe we can quit together which might make it easier being accountable to someone else; we'll see how it goes.  Well folks, that's pretty much a summary of what's been going on with me.  Between feeling better and perhaps getting involved in a writing class at Art Awakenings I do plan to start posting on a more regular basis.  These past few months have kept me from doing so but I want to write more consistently.  As they say ... more to follow!


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