Tuesday 5 April 2016

THE GATE

We used two have two gates - until one got stolen one Saturday night when we were all in and Son still up with his mates.

That aside, Missus' OCD means that she's terrified of leaving the other one (now secured with a heavy-duty chain) open. At least with one gate missing she'll now just walk all the way round to the other entrance. In the morning when I see her off, I of course have to walk with her to the gate to close it again (and further if the cat's out - see "Stupid Cat" post).

Monday 4 April 2016

SORT THEM TABLETS

With the vast array of medications and supplements Missus is now on, left to herself she'd scramble through one big paper bag to find the right ones for the morning or evening dose. I therefore with each fresh prescription she brings home, I sort them for her into a large number of paper bags, each one with one type of tablet and dose, because individual tablets aren't the right number of milligrams. She may need to take a 5 milligram tablet and a 10 milligram to get the correct 15 milligram dose for example.

This means there's a vast assortment of paper bags on her side of the bed, but she takes everything at the right dose at the right time. She does this because she knows our marriage counts on it. In this way I am fortunate. Many delusional people simply don't take their medication and get in a cycle of being sectioned and released. 

THE NEWS

Apart from Saturday Kitchen and Miranda Hart, she only ever wants to watch BBC News 24. If however a bulletin is on BBC1, that's more important news so she'll switch over to watch BBC1 news instead - even though it's the same news programme. She'll watch the same stories loop round and round all day, but if you were to ask her what was on the news, she couldn't remember any of it. What's really going on is just more OCD, a compulsion to keep informed, even though she is actually informed about nothing.

INSPECTING THRESHOLDS

Her condition is complicated with OCD, which means that she feels she needs to do stuff when she doesn't. She has had a longstanding obsession with taps being off, and multiple inspections of the handbag to ensure everything's in there, but has recently developed one for carefully examining the floor of doorways before walking through them.

My training regarding OCD is to simply not allow these behaviours. When she does them I tell her off. In this way she gets reassured that nothing bad will happen. Unfortunately it doesn't "stick" and she would revert to severe OCD if I wasn't constantly on top of her irrational fears. 

Sunday 6 March 2016

DELUSIONAL DISORDER

Missus doesn't get the voices in her head typical of bog-standard Paranoid Schizophrenia. She gets paranoid beliefs. Stuff that happens to her is explained by her persecution by a criminal gang because she knows too much.

When she finally went completely out of control in January 2002, she became lost in a waking nightmare fantasy. It was complicated with severe OCD. She still has these beliefs, but the antipsychotic damp it all down so she's not continually in an angry fear about it. 

In recent years the paranoia has settled right down and doesn't trouble her, but essential to keeping her settled is low stress. Stressful situations cause relapses. This is why I have to work hard at my own self-management - I can't afford to "lose it" because then she will as well! 

Now she is happy in her world, but still has many quirks, most of which I intend to record in this blog. 

STUPID CAT

All cats have their quirks. Revan the cat for example likes to sleep in bizarre positions and mainly wants to be with Son. 

Shadow the cat chirps when wanting attention, and most annoyingly, thinks she's a dog. When we go out anywhere, she would follow us literally wherever we went. In my case, this is not a problem - I shoo her away. 

Loony Missus cannot do this. The cat has consequently followed her way out of its territory on two occasions - on one it got itself lost in the local cemetery. It took us several hours to find her, then she followed us all the way home. On the other occasion the stupid thing followed Missus to the bus stop. Missus got on the bus, and the cat was stranded with no idea where it was, and harassed by local cats pissed off at this stranger in their territory. Again I had to go find her and she followed me home.

Now every time Missus goes out, we have to lock the cat in until Missus has long gone. If the cat is out, I have to escort Missus up the road and bar the cat from following her beyond the top of the road. I must surely be the only man in the universe who has to do this. It's somewhat humiliating and makes me feel lonely.

HEAVY WEARS THE CROWN

Then you have a mentally ill wife, a son lost in his own world and an ex-daughter banished forever, you are left undisputed master of your home. What I say goes! I like to think I don't abuse this power, and my central priority is the dependents. 

It is however lonely. With the other two clueless and unable to do anything, I am sole housekeeper  responsible for maintenance and upkeep, and meeting the various needs of Missus. When you feel low, you can't just stop, you still have to get on with the cooking, cleaning, ironing, laundry and shopping. When I'm upset, I can't turn to them - they care but they can't do anything useful to help. 

Yes I have unprecedented freedom and comfort, and I'm loved - for this I'm profoundly grateful, but there's no one to look after me. When you're low, that's when the loneliness really bites.

Friday 4 March 2016

WORK

Bizarrely, she's the patient but also the chief breadwinner. She's always been good at getting jobs, as she comes across in interviews so positive. Holding them down is another matter, but she has now held down this one as a classroom assistant (clerical rather than child support) for ten years. She must be doing something right, though I don't know how much slack she is cut or how well she performs.

I kept her illness to myself until the day she shared her delusions with a colleague and was sent home for six weeks pending an assessment. The Psychiatrist attached to Occupational Health diagnosed Paranoid Schizophrenia, but that it was well-managed and she was fit to work. Since that time, the cat has been out of the bag and I've shared the matter openly. 

She went back to work and there have been no incidents since.

I bring in income from my Hypnotherapy Practice and a weekend job at ASDA, but it's less than Missus earns over the year.  

DRUGS

I am a lot more fortunate than many carers in my position, because Missus faithfully takes all of her medication - there's a lot of it.
OLANZAPINE - HIGH DOSE - This is the most important one. A powerful anti-psychotic, it suppresses her tendency to form paranoid delusions. There are side effects - sleepiness, major weight gain, loss of perception and depression
CITALOPRAM - HIGH DOSE - Happy pills, used to counteract the depressive effect of Olanzapine. Very effective, her personality is generally sunny.
CARBAMAZAPINE - LOW DOSE - She has mild epilepsy, that developed in pregnancy. Though mild in terms of not easily triggered, if triggered she has full Grand Mal fits, with asphyxia, unconsciousness and temporary memory loss. She has not had a fit for 20 years, but sometimes gets blank moments.
STATINS - A tendency to high cholesterol caused by weight/Olanzapine is controlled by this drug.
LANSOPRAZOLE - A "proton pump inhibitor" used to treat gastritis, unrelated to Delusional Disorder, more to do with age
IRON SUPPLEMENT to treat simple anaemia, possibly a side-effect of the other drugs

INTRODUCTION

I have been meaning to start this blog for some time. It has three basic purposes:
1. As a form of self-therapy
2. As an insight to my patient that people can draw on a resource should I become incapacitated or dead
3. Help and encouragement for other carers

It is not intended to be a daily journal, but more a list of The Patient's quirks and my emotions in dealing with them, as and when time allows and when they occur to me. All helpful feedback is welcome.

I have to state right off the bat that my life is happy. Happiness is not I believe the absence of challenges, but rather a life of fulfilment where your contribution is recognized. I certainly have that, so whilst I will discuss at length my sadness, it has to be seen in the context of someone at peace inside - at least until further notice!