Wednesday, September 29, 2010

Calm before the storm

539AM. Cannot sleep. Team conference today. Everyone is meeting to discuss my path of care - PT, OT, SW, Masseuse, Bill from OV. The adjuster from BD. I'm hoping not all of this conference will be spent addressing ongoing issues with the adjuster. This is supposed to be about my care but there have been so many problems with this adjuster that my care is becoming impacted. Delayed responses to Tx plans or no response at all. Repeated mistakes, odd denials of Tx vs. odd approvals of Tx - no sense to it. Never returning phone calls. Seems to dislike reading reports. No payments received. It would be easy to label this woman incompetent but no one is sure if that is the issue. Is all this delay, this headache indicative of the insurance business or is this delay being orchestrated purposely by the insurance company. So frustrating. Back when I was discharged from Bridgepoint, Holly suggested a tempurpedic mattress would be easier to sleep on and improve circulation while decreasing stiffness. Dr Ahn wrote me a prescription, the Tx plan was sent off and we waited. The obligatory 10 days for BD to respond came and went with no answer. Holly phoned, left messages and e-mails still no answer. Almost 3 weeks later Holly got a hold of the adjuster who stated she had never received the Tx plan. When she checked the fax - lo and behold! - there it was sitting there, along with many other Tx plans for myself. The adjuster never checked the fax.
Eventually appproval was granted. Still no check. Holly called to arrange delivery of the mattress and to set up a bill. Holly called the adjuster, was told she has sent the check to Holly's office. when Holly checked the address the adjuster had, it was wrong. Holly gave the correct address, double checked what had been been noted and waited. Still no payment. The adjuster had sent the check to the wrong address again. The lawyers got involved. TWO MONTHS after I had obtained the RX, I finally got my bed.
I also received a Rx for a recliner, as I could sit on any of the chairs and the couch currently in the living room. Seeing as this was where I would pass most of my day, Holly decided to put in a Tx plan for the chair. We went ahead and bought it, because I had no where comfortable to sit. The response finally came a few months later. Denied because the reason for it was not understood. The adjuster paid for an independent OT to come and assess my need for such a chair. He arrived with no background, no list of injuries, no history of the accident. All he was given was one page from another persons chart. Once he saw my state and read though some of our copies of the reports he agreed completely with the Rx and state he would give approval for the chair. To this day, we have heard nothing.
This whole predicament has me thankful that I have a legal team who advocates for me. I never have to deal with the adjuster. I could not imagine being in the condition I was upon discharge and then having to start chasing the insurance company for benefits. This stressor would have had a serious impact on my mental health, but especially on Erick's as he would have most likely dealt with it when I was too upset. The MBI clinic the nurse clinician told me that insurance was a big issue at this clinic. Some Pt's are discharged with no lawyer, no community support and have to start dealing with the insurance. I cannot imagine what this is like and whenever I get frustrated with my lawyers or care givers I try to remember how lucky I am to have them advocating and caring for me.
With the changes brought in on September 1st, insurance has changed drastically - much has been taken away from consumers. Yet no one would know this unless they pay attention to this area, or they are dependent on the insurance companies. The pay out for non-CAT pt's has been slashed in half. Attendant care, housekeeping and anything involved with the home etc. is now extra. Before, these benefits were not taken from the maximum amount of the policy. not it is being deducted from the total amount given. If the public knew just how much was being taken away from them, I think they would be furious. But because this is accessible only when the worst happens, no one thinks about it or pays attention. So typically human.

Friday, September 24, 2010

Aftermath

The last day has flitted by in a blur. Situation with a friend reached a nasty rolling boil. Emotions raging, I ranted at a keyboard, poured the acidic bile out of my heart and mind, to see if I could make sense of the cloudy mirk staring me in the face, from a too bright screen. I fell out of my chair and sent an e-mail that was never to be sent. A volcano of hurtful reactions was hurtled back at me and I cannot really blame the poor soul. I sent him quite the bitch slap. Course, he backhanded bitch slapped me and everything fell apart. Good thing my level headed man friend stepped in and smoothed things over. Bless him. Still reeling, but not as fast.
All week I've been sitting more than doing, slothing more than being productive. This happens all too often. It's like my body goes on strike and waits for my mind to slow down. Fatigue is an enemy of rehab. Suc a fine balance - I have to push myself to make limits more pliable, but push too far and I fall with a crash. I tackled a 30 day yoga challenge a while back. Pre-hard ware removal I had begun doing yoga to calm my mind and increase my flexibility, while strengthening my core. Days 1 to 4 were filled with savasanna, light poses and easy, breezy sun salutations, slow like molasses. On day 5 I decided to try a yoga video I had bought online for 21.5.800. Threw myself in with vigorous aplomb but forgot my flotation device. I could barely walk due to too long in pigeon pose, my lower back and gluts were on fire. The next 4 days were recovery, massage and self-scouldings to be kinder to myself.
There is such a pressure to perform in rehab, especially for a perfectionist like myself. If I'm progressing each class I get frustrated. This rehab has been so intermittent, stalled and difficult. Not much flow, nothing continuous be it illness, double booking, rescheduling. It is so easy to lose motivation. So easy to fall into depression.
I haven't had a depressive episode in a while. The anniversary of the accident was hard, but I didn't cry as hard as I thought I would. I started cognitive behavioural therapy a few weeks ago. My therapist is kind, empathetic, the most thoughtful person ever, and clearly driven to provide her clients with the most holistic service possible. I have a CBT notebook to take notes in. She wants me to bring her a copy of my manuscript. I may let her read this blog. She suggests books for me to read, even gave me a book for Erick to read, so we could understand trauma together. I see her every other week and I find her sessions helpful. I also have a social worker who I see weekly and a psychiatrist who keeps track of my medications and mood, and encourages me to share my thoughts and feelings regarding care, the accident etc.
I f anything, Anger is the dominant emotion for me currently. I am so mad at so many things it quickly becomes so overwhelming. I get irritable about the silliest things - noise, neighbours, comments E makes, my own mess and disorganization. Scheduling has become a problem,, as I keep forgetting to input plans into my smart phone. Often I'll get calls asking if plans still work, and I have forgotten all about them. My memory is terrible. Anything short term is very difficult to recall. ith long term memories, not so much. It becomes so frustrating and I often feel that I can't seem to keep my life balanced and in check. Holly my OT and I have been working on strategies, such as carrying my smart phone, med dosette and keys in a pocket. Problem is, have the time I forget to do this, or I misplace the jacket etc. where I put all my vital items. We got a keyless door lock so that I do not have to worry about keys. Sometimes I forget the code but mostly the lock has worked out well.
Sleep continues to be an issue. It is 4AM as I write this post. My eyes are heavy, my body tired yet still I can't drop off to sleep.Late nights seem to become late starts and then my day is all out of whack, all my plans get diverted by my fatigue.

Wednesday, September 22, 2010

Silent night

Silent Night. Quiet, after a raging thunder storm and sheets of rain.
Today started with a bang over at the shed project. Bindu issued a declaration, a slogan, for the shed project. It is: FUCK YOU!
Naturally someone got offended, drama ensued. A member left, cursing the project. order was restored. Somewhat.
Bindu's provocative slogan resonated into my life today. I literally awoke to a mess in my Inbox. A long time friend screwed us over some long laid plans. Apparently a life long friendship is worth $193 and an inability to organize oneself. I tried so hard to make this seamless, e-mailed, researched, organized and for what. A fuck you to the face. I can't sleep I am so upset.

I spoke to the claims adjuster on my legal team today. The insurance company seems to have stopped paying out what they owe me, and with the team meeting next week I am worried that this meeting, which is supposed to be about me, will end up being about this idiot adjuster's incompetence. Completely unacceptable and it makes me so incredibly angry. To think of how much we've paid into car insurance only to be stonewalled by a farce of am adjuster. My lawyers have to undertake harsher measures to obtain way the insurance
I guess this is what my therapy is for. To help me navigate my way through the stages of grief and loss.To figure out why Erick and I always get screwed, why we seem to be targets for the behaviour of others? I am so tired of dealing with other people's shit. I am really beginning to lose my faith in humanity. I feel so much anger building up inside me. Things need to change.
I have Pilates in a few hours, which is the best part of my week. I just hope I can stay awake for the session.
One of my assets or vices, is I care too much about others. i always put myself out there, open to the issues of others. I try to help, get frustrated when it isn't reciprocated. I think I held on to a certain group of friends too long. That maybe it would be better to let them all go. Make new friends, like I did when I was traveling. The problem with travel friends is once you are home, the context is gone. Harder to stay in tough with friends in their natural habit because they will be different at home. The best part about travel was becoming a different person. Clean slate, no one knows you. You can live completely in the moment, without the weight of the past or future.
It would be wicked to be able to change the way I see things. I see only the failures, which overshadow the richness of experiences and makes everything seem horrible. I wish I could only focus on the good stuff, life's treasured moments. A self goal for this time off, maybe even for the shed project if I can get to it, is to go through all my travel photos and saved mementos from my wander years and make a scrapbook, a record of all the amazing stuff. Learning from the bad stuff, while focusing on the positive.
So far I have thinned my closet, my books, my Cds and Dvds. I want to go through my personal effects. I want to work regularly on my manuscript, beginning with re=reading all the critiques from Diamond Cutters, and making a list of chapters, so I can expand my work. I want to attack the basement, organize and purge the clutter.
Beside her drama llama, Bindu also posted a fantastic post bu a guest writer. http://binduwiles.com/buddhism/the-shed-project-guest-post-from-rebecca-self/
The writer stated that our lives should be filled with stuff we love and cherish and use. Our possessions should make us happy, not stressed. Same is true with our friends. Forget emotional attachment or obligatory stuff, and own only items which allow us to shine and be productive. This outlook, while written within a sad context, spoke to me so clearly. Such an overly simple concept. I am quite preoccupied with this drama of my own but once a solution is found I think I am going to take a good look at what sort of existence I truly have and how to improve it or clean it out.
I am so tired of the inefficiencies of others. It is time for some me time.

Tuesday, September 7, 2010

Sleeplessness and Similies

Awoke at 5AM, couldn't sleep. Boo.
Busy day today. OT, PTA, Diamond cutters. Doesn't look busy but for my limited energy expenditure it will be. So frustrating.
If someone were to ask me what was the largest hurdle to overcome throughout my entire recovery I would have to say that the fatigue factor wins hands down. No matter how good you slept the night before, no matter how nutritious and energy boosting the meal plan, no matter how pumped up you are to have the best day ever, fatigue or low energy can still wreck all your plans. So incredibly frustrating. Some days making breakfast puts me on the couch for a good hour. Walking the dog around the block can bring on a three hour nap. It amazes me that despite my being active for ten months now, I still feel like I've just been discharged from rehab. The weariness, the droopiness. The sleeplessness.
My banyani recommended Badger Sleep Balm for enhancing slumber. Lovely citrus lavender scent. Rub it on your temples, under your nose and bam!, you're put out like a light. Most nights.
Insomnia has always been a friend of mine. Sleepless nights for no reason other than my brain won't shut down for sleep. Always running, constant ticking. Deep yogic breathing helps sometimes. I'll think back to my time at the Vipassana retreat where even there I still had bouts of insomnia. Despite a waking silence, the mind will not quieten down. I've counted so many sheep that I could make a sweater from all the wool caught in the fence. When I was little I used to think that they should make a nighttime film reel to play on the wall opposite your bed. Sheep jumping over the fence. Polar bears skating in circles. Headbangers doing their thing on repeat. What ever the fancy. I wonder if I should patent these sleepless mind farts, in case there's money to be made from the madness that ensues.
Pain keeps me up. In my back, in my heels, in my foot. Burnings, pulsating, creeping, nagging. A painless night is a treat. Eat it by the spoonful, enjoy it till the reprieve is over. I finally got an appointment at the Wasser Pain Clinic by playing the employee card I didn't realize I had. One of my physician colleagues spoke to the head MD of the emerg, and he spoke to the head of the pain clininc. They made an appointment for me. Maybe this will help. Pain clinics are a wealth of knowledge for just about anything. I am hoping they will have sleeplessness clinics. Coping strategies to make it through the day. I am coping for now but soon the long acting pain meds will have to be weaned down.
I never tell anyone that I am terrified of the pain coming back. I remember those days in hospital where something was on fire and I was too immobilized to do anything except cry and press the call button for the nurse. One night when the pain in my foot was tag teaming with my general discomfort and back pain, I rang for the nurse and an ally appeared. An agency nurse, picking up a shift that night. She came in, all in white, middle aged.
"What do you need, honey?" she said tiredly.
"for my pain to stop," I warbled, tears streaming down my cheeks.
The nurse rounded the bed, her eyes sweeping my small broken form. She helped me reposition, Helped me roll from side to side, tuck a pillow under my aching side.
"I remember where you are," she said. She told me that 20+ years prior she had been in a bad car accident, had been t-boned at an intersection by a impatient driver who had sped through and not seen her till to late. Her back was a mess, multiple fracture down one side. She said it took a few months in hospital, even double in rehab before she felt like herself again. She couldn't sit for long periods of time and felt numb down the left side of her body. She felt the financial disparity of her situation and went back to work too early.
"I see you lying here and you remind me so much of myself back then." She was leaning against the bed, rubbing my foot. "I know how frightened you are. "It's almost worse to be a health care professional and a patient because you are privy to the inside scoop of what's really going on."
I could feel my eyes filling up again as I listened to her tell her story. More than anything, her story was filing me with hope that I do would recover and nurse again. I was really missing it during those first few days on the Trauma unit. Add to that the enormous amount of stress this situation was causing in every aspect of my life, well, it's no wonder I was crying about foot pain. I could have cried 1000 oceans of tears and may not even touch the surface off all that was troubling me. Grief is like a layer cake, the superficial aspects don't take long to show themselves but as the trajectory of accident moves along, the deeper issues begin to show themselves. I am now just starting to understand what the actual impact of this accident has had on my life, with more to follow I'm sure. The legal end, for starters. Whoa.

Thursday, September 2, 2010

Ho HUM

Past midnight, Thursday night after a loooong day. My mum comes in to stay with us during the week to help me with appointments, life issues etc etc. She stays for a couple of nights, we spa together. She helped me with the move. I love my mum. I'm very lucky to have such a supportive mum. When I was confused in ICU the first image of clarity was my mum, reading to me. I WAS so confused and paranoid but my mum spoke to me normally, told me not to worry, and continued reading from my favoured book from adolescence.
House slowly coming together. Still some things at the old apartment but we seemed to be fully in now. Awesome! We have a lot to still put away during the upcoming long weekend. But slowly it is becoming a home :)
Wednesday was the anniversary of the accident. Weird day. sad yet a joyous occasion. Given that at this point last year I was hooked up to a ventilator, covered in tubes, after enduring multiple invasive surgeries and tests that I am walking and able to think somewhat clearly. At the time that I would have been lying on the road, waiting for EMS to arrive I got a bit weepy. But for the most part I was fine. Life really does just go on.
Diamond Cutters this week was interesting. The manuscript on the dissection table was a memoir in a poem. Really well written, quite visual. Interesting themes, lively discussion, great points on style from Bindu. I have such a girl crush on her. She is so smart and imaginative, writes well, very encouraging. She is launching a new adventure tomorrow called the Shed Project. A few months ago, she had an epiphany to downsize most of her belongings - no more than 100 - and embark on a sojourn to Australia to drive along the coast of Western Australia. She got an incredible response and very encouraging, wistful feedback regarding her downsizing and thus the shed project was born. For a small fee you can join Bindu, and other shedders, and downsize belongings. She has a ton of speakers and readings lined up to encourage us on. Pretty brilliant. Given the move and the horror of all our belongings making themselves known I figured the timing couldn't be better, and I will thus join this little shedventure to see if I can bring about more change.
I had meetings with my OT, PT, OTA and PTA this week to set some goals and plan the next few months in terms of my recovery. Given the pending anniversary of the accident, my Tuesday session will my SW was quite emotional as I was still grieving and felt lost and directionless regarding my rehab. There will be a team meeting at the end of September and the thought of waiting till then to discuss what next seemed very daunting. Clare sent a text to the team, with my stating my worries and what we had discussed in the session.
Last winter was spent adjusting to my life post accident and recuperating from the havoc wrecked on my body and mind during my hospitalization. Spring and summer were spent waiting for and recovering from the hardware removal surgery. Now that I have returned to "normal" the phase of my recovery can move forth: the recuperate phase.
Holly my OT and I set some short and long term goals concerning cognitive work, community accessing and drive training. PT followed suite: we hammered out the rehab schedule for fall and winter - Pilates x 2/wk for three months, with a practitioner recommended to me by my sister. Weekly strengthening with Heather and a swim session, checking in with Liz once a month. After the three weeks had passed, my care would be turned over to a personal trainer, who would work under Liz to design an appropriate program for me to follow indefinitely, with weekly swimming and some yoga.
My reiki practitioner, who is also a yoga instructor, is running a one week yoga retreat at a lodge on the pacific coast of Mexico. It looks like heaven! Morning yoga, followed by free time to partake in nothing, hiking, swimming, surfing, snorkling, body work, etc, then afternoon meditation and finishing with evening yoga. The meals are all provided, save one dinner which the group will out for in the nearby village. I really want to go as I think it would fall during the right time for me rehab wise. I'd be a few months into my personal training sessions at the gym so a week long break of yoga and swimming would be fantastic, not to mention the week of hot weather in the middle of the most wintery month of the year.
I was hoping we could maybe combine it with another trip we had planned, to Tulum on the Caribbean side of Mexico. I have a few friends who spend the winter there and I try to see them once a year. I met them while backpacking through India and we traveled to an island off the coast of Burma. I lived with them in Manchester U.K. for a while and we've stayed in touch ever since. I took Erick to see them when they were living in a tent on the beach, and a few years later they were married on the same beach and hosted a rather international wedding at a beautiful eco-lodge in Tulum. So magical, both the setting and the awesome people that N and D are. If I had a soul sista N would be the closest to it so combining a week of beach healing yoga with beach crazy N and Erick and myself would be absolute heaven. However, Erick doesn't think he can do both. Poo.