The Costly Mistake

“A mistake was made.  Dr. G. needs a half an hour with you, so you have to come in at 4:15PM.”

The third attempt in three days on my doctor’s part to reschedule me.

I panicked.  The plan was for Xan to come home and cart me off to my 5:30PM appointment.  That in itself was stressful enough.  Xan rarely gets off of work on time anyhow.  I would be playing this pacing game where I wear a rut into the corkwood floor of my eroding living room.

“But, I can’t.  I don’t have transportation.”

She was uncompromising.  “Dr. G. leaves the office at 5PM.  It’s 4:15PM or she will not see you today.”

I anxiously stammered, “I’ll see what I can do.  I’ll call you back.”

In her cheery, patronizing voice she said, “Okay, we’ll pencil you in for 4:15PM.  Hope to see you then!  Bye!”

And the phone went dead.  I was cast off that easily.  Complete disregard for my needs.  She’s one of those people who is just doing their job and nothing more.  Patient care doesn’t matter.  My threads started coming loose as I desperately grasped at the fabric that remained.  Hope was dimming.  Trapped in my head, trapped in this perpetual hell called my life, completely alone with this demon so inadequately named Bipolar Disorder.

For a moment, I let the wholeness of the situation set deeply into myself.  I read my prescription bottles closely and they said in big, haunting letters NO REFILLSWaves of panic nipped at me at the shoreline.   The tide suddenly grabbed me, and ripped into murky, black waters with the undertow.  There was no sense of what was up and what was down.  The air escaped me, as if being viciously sucked from my lungs, and they shriveled into nothing.

My fingers flew fast as I texted Xan.  The idealization took control as my head filled with these surrounding waters.  My mind swam around my skull, looking for solutions.  Grasping at the fabric, the tearing fabric holding my sanity, my hope, any kind of connection to reality and sanity.

“Hold for a moment on this.”

I am a business call.  Twenty minutes elapsed.  It was like standing in a queue for my husband’s attention at a clear crisis.  Those glimmers faded as I clung to anger.  Anger, my failing life preserver as it began to deflate into complete hopelessness and despair.  I trashed with distress, but to no matter.  Anything.  Anything . . .

“I’m calling the scheduler.”  I warned him that wasn’t wise.  The ultimatum was set forth.  4:15PM or not at all today.  4:15PM I could see this new doctor, and maybe in coming days, I could exit the tunnel of misery and dimness.  I could reclaim myself, my life, and everything that awaited me on the other side.

I wanted to beg him.  I wanted to get down on my knees and plead with him to leave work early.  He would have put his eight hours in that day, and it would have been alright.  Be my knight in shining armor.  Save me.  Save me from myself.

I started crying, huge, loud sobs belting through my house.  My son, my little four year old son with autism spectrum disorder approached me.  And he said, “Mommy, are we okay?”  I cried even harder, despite any efforts to control myself.  My son’s first four word sentence, his first appropriately placed words relevant to the situation, occurred because his mother was hysterical.

I said to him, wiping the tears from my face and pushing everything down, “Yes, Beast.  We’re okay.”  I wish I could have meant what I said to him.  His first question, and I had to lie to him.

The phone rang, playing a melody that I hope meant promise.  Promise that someone had conceded or made an exception for my desperate pleas.  I answered despondently, even with my head overflowing with idealistic notions of the outcome.

“Here’s the good news,” he started.  My heart seized up, anxiously hopeful.  “The nurse agreed to put a fill in for your prescriptions.”

“And my appointment?”

He continued, “It’s a bit of bad news.  Dr. G. is booked up until December 11th.  I scheduled you in for that day.”

I choked on my own voice, the bile rising from my stomach and the wires of my brain sparking as they frayed.  “December 11th?!  I can’t wait until then!”

“It was the soonest she had.  It was the best I could possibly do for you.  But, at least you have your medication until then.”

The tears finally came, screaming down my faced as I sunk against the sink.  “I need a doctor.  I need to get this fixed.  I live every single day in this perpetual hell.  This was my last hope, my only hope.  It has been stolen away from me.  Is there nothing we can do?”

He started to become cross, “What do you want me to do?  What more could I possibly do?”

“You can’t leave work?” I pleaded desperately.

“It wouldn’t matter anyway,” he informed me, “The scheduler already complained to me about your poor attendance record, and gave your appointment to someone else, anyway.”

My poor attendance record?! I screamed.  “I have no way to get to appointments!  And people keep blowing me off, like I don’t matter!  Like I’m not in a bad way! Like this can wait and as if I’m doing so well.  The only time I get to go to an appointment is to get this stupid medication that doesn’t even work filled.”

I paused, only for the brief moment it took for catch my already shallow breath, “I don’t know if anyone noticed, but I haven’t been well.  I have spent almost my entire year in one episode or another.  It’s beyond discouraging.  It’s thrown me into the jaws of despair and hopelessness that I will never get any better!

We sat in silence for a few minutes.  I sobbed violently, just waiting for some kind of word.  Some kind of solace.  Any rescue from the deep, dark recesses of my own caged mind.  Finally, I asked, “Are you still there?”

“Read your text messages,” was all he could respond.

I have people three feet from me.  I can’t talk about it.

My being shattered so deeply that I had felt fractures of each bone in my entire body.  I became enraged at his choice.  Work.  Work over his ailing wife.  No exceptions could be made.  And in his mind, I’m sure the thought had occurred, This too shall pass.

“Goodbye,” I choked out without another word.

The anger, the scraps that remained, boiled in the water.  The blackness around me turned scarlet and thick like the blood coursing through my veins.  I grasped my phone with a crushing forced and launching it against a wall.  It exploded into three pieces, the unit, the battery, and the backing.

Screams erupted out of shrieking sobs, “I can’t go through this hell anymore!!!  Why do I have to go through this?!  Why?!  Endlessly, I raved and ranted like a mad woman.  A mantra repeated, “I can’t do this!!!   I can’t!!!”

“That job!  I hate that f***ing job!  His work, his work!  Nobody cares!  Nobody!” I grabbed my “Teacher”coffee mug from the cabinet and smashed it against the linoleum floor.  I’m not a teacher anymore.  It is a lie every single time I drink from that mug.  I am a nothing now.  I am a nobody.

I stood there staring at the pile of the remaining shards of ceramic, heaving panting sobs.  I slid down against the stove, next to the pile and pulled me knees to my chest.  A ball.  Nobody can hurt me.  I can’t hurt me.  No one can come near me.

Alone.  I am slated to be alone.  Alone in my own mess.

I WANT TO DIE.

It’s all I could think.  There is no life ahead of me that I want to live.  It’s only a life full of pain and misery, where I am tragically locked in my head.  No one wants to hear of these complaints.  I have no perspective to gain.  No more words left to give the world.  No hope for myself or anyone else.  I have nothing.  I am nothing.  I will always be nothing.  To anyone, anywhere.

And if I were to say goodbye, I would be wished well.  I would be let go without another word, another prayer or any thoughts left for me.

There is no treatment that will make better.  I will always be like this, with this crushing weight upon me.  My eyes are constantly fixed on the rear view when I’m not navigating the endless series of trials within this tomb of a labyrinth.  Even in the fleeting happy, peaceful moments, I will always be cautiously watching over my shoulder for the monster who will eventually gain on me, and overtake me.  I will never find happiness.  I can never find a place of peace and solace within this madness.

A plan started hatching.  There will come a day where I will take my life.  I can’t truly know when, but the day is inevitable.  I must make preparations.  I took a handful of Xanax and considered washing it down with a swig of rum.  No, it would be bad enough that I am doped up around my child.  My child.  My beautiful baby has to witness this in his already confused life.  It fueled the fire to hate myself even more.

I will get my house in order.  I will not leave a mess to clean up, because there will be enough of a mess when I am gone.  I will get my son into a program and have him taken care of.  My belongings will end up in boxes, so that they may easily shipped off.  I will leave nothing but mournful whispers behind.

I wish I had something inspiring to say.  I wish I could tell you that I went on about my life, went to class last night, and came back in better shape.  I wish I could tell you that the rays of hope descended upon me, and I am determined to hold out until December 11th.  I wish I could tell you that I look forward to better days, where this awful, gnawing feeling dissolves into some kind of happiness.

But I can’t.  I can only give up and start to let go.  I can only start to say my goodbyes and write my heartfelt letters to those that I love.  Because in the end, whether I want it or not, this is my fate.  To eventually succumb to my illness.  To eventually self-destruct.

The Friday Confessional : Romancing Suicide

 

 

Though I confess the things that are most intimate to me, I don’t know if I am accurately painting the picture of the real me.  To everyone here, I am Lulu Stark, the writer, the mother, the wife, and most importantly, the woman who bares herself in the name of mental health and disorder awareness and advocacy.  But, I wanted to put some truths out there.  The uglier side.  The real side.

I only Lulu Stark in the persona.  The one that you read about.  The antihero, the antagonist, protagonist, the victim, the perpetrator, the survivor and occasionally, the hero.

What I don’t talk typically talk about is one of my darkest, sickest secrets of all.

 

Suicide.  I regularly have suicidal thoughts and occasionally ideation.  The little voice goes through the back of my mind, sometimes as an unintelligible whisper and other times as clear as a bell, I want to die.  I want to kill myself.  It would be so easy.  No one would miss me.

I imagine ways it would play out.  I idealize all of the scenarios of suicide.  In a way, it seems I’m under it’s spell.  It seems like the only way out of this torturous world of disorder and dysfunction.  I am more crippled by my illness than I let on.  I feel pathetic in my bones, and I desperately search for my solace in this place of distress and despair.  An endless string of hopeless days and bottomless pits.

I fall deeper, clinging to my last shreds of hope.  I am flirting with suicide, with his silver tongue, soft, familiar caresses, and honey sweet kisses on my neck.

I see a sturdy rope swung around a rafter in my basement, tied with a tidy slipknot instead of an impossible noose.  I stand on a rickety chair, dressed in my Sunday best, leaving a pretty, cold, lifeless corpse behind.  The shell of a woman who never really existed.

I stand with a glass of juice and a bottle’s worth of blue pills in my hand.  I am ready, stripped to nothing but a bathrobe.  Down the hatch, the medication leaves a bitter aftertaste.  I draw myself a hot bath and arm myself with a razor.  And then, I wait.  I wait until I am almost seeing double, and world starts to blue around the edges.  I dig the razor into my wrist and drag it with all of the force I can up to my the bend of my elbow.

Or, I just await death.  I lie in the tub, feeling myself slip away under the surface of the water.  In my mind, I imagine all of the people that would be thankful that I am finally gone.  How in a year or two, I will become a distant memory that only leaves the tiniest pang.  How my sullen face starts to fade from everyone’s mind and any trace of me begins to disappear.  I think of how easy the clean up would be.

Or maybe, I would clean myself up to begin with.  I would be powder fresh in a pretty pastel little girl dress I bought for the occasion.  I would empty all of the contents of my medicine into my stomach, washed down with an entire bottle of vodka.  I would tuck myself into a warm bed, and swaddle myself in blankets.  It would look like sleep at first.  My final sleep.  My resting place.  The only place in my life where I ever felt warm and safe.

 

For the record, I’d never do it.  There is an uglier side to suicide that I’m painfully aware of.  It could possibly be the most selfish act I could ever commit.  The finality of it all is too much for me to even wrap my head around.

My son asks where I went when I am gone for an hour for class.  I imagine his confusion and sadness when he comes to see that his mother will never return. I imagine the possibilities of who would raise him if I were to be gone for good.  He would likely fall into the hands of my own parents, and I would be sentencing him to a similar fate that I experienced.

There would never be enough of an apology for my Xan.  A piece of him would die inside, and he might go mad himself.  There wouldn’t be another out there for him.  He couldn’t possibly recover.  Leaving him to his own devices at work, cutting off communication, it’s too much for him to bear for a few hours.  What if I were to be gone for the rest of his lifetime?

And then there’s the matter of the afterlife.  What comes after death?  Through my Christian upbringing, I fear the day of judgement and the sentencing to an eternity of hell, separated from my friends and family, endlessly tortured in unimaginable ways.  Ways that are beyond my comprehension.

But, what if there is nothing?  What if I sacrificed my life for a world of nothingness?  What if a person just dies and there is nothing behind?  What if I am condemned to walk this Earth as a true ethereal being, and not just the kind I feel as a flesh and blood person?  I stand there and watch as people file in for my funeral.  I see my family overlooking my lifeless body, consumed with grief.  Then, I get to watch my family and friends mourn the loss, as someone irreplaceable that met a tragic and unfair end at my own hand.

Sometimes, I feel as if I am condemned to life.  Sometimes, I feel like I’ve chosen life over the alternatives.  Sometimes, it’s for the sake of my family and friends.  And there are those brief shining moments where I live life as the gift it was meant to be with the promise of tomorrow.

Flirting with Suicide

Warning: This post has strong themes of suicide and self-injury within. It may contain potential triggers. Reader discretion is advised.

Suicide is a major, preventable public health problem. In 2007, it was the tenth leading cause of death in the U.S., accounting for 34,598 deaths.1

An estimated 11 attempted suicides occur per every suicide death.1

Essentially, statistics indicate that there are 380,578 reported cases of attempted suicide each year.  Personally, I see this as a gross underestimate.  The botched attempts are the ones that end up in the hospital.  But what about the folks who take a handful of pills, pass out, and wake up like nothing happened the very next day?  It is in my personal experience, as a person who has never ended up hospitalized by a suicide attempt, that I would jump that number up by at least 20 times the amount of completed suicides.

Today is suicide prevention day.  And today, I wanted to bare my soul and share my sordid past with suicide attempts.

Is suicide common among children and young people?

In 2007, suicide was the third leading cause of death for young people ages 15 to 24.1 Of every 100,000 young people in each age group, the following number died by suicide:1

  • Children ages 10 to 14 — 0.9 per 100,000
  • Adolescents ages 15 to 19 — 6.9 per 100,000
  • Young adults ages 20 to 24 — 12.7 per 100,000

I started in the earliest age group.  I was a deeply troubled young teenager.  I have only written about this in a personal journal, but I feel it’s time to share.

It was a warm March Friday, humid after a fresh rain.  I was rather excited for that Friday, because it would have been the first Friday I was released from my grounding since January.  It was the truth that my grades had slipped into the toilet.  But, so had my mental health.  I dressed in my funeral best daily.  Every single day was a day that I had wished, nay, prayed for death.  Only a merciful God would release me from this suffering, I thought constantly.  And as a result of my downward spiral, I felt the entire verbally abusive arsenal my parents had to offer.

Another bad progress report.  I was failing math and gym.  Truthfully, I wasn’t good at math.  And what teenage girl in the entire world wants to be seen in front of all of her peers in a swimsuit?  My “excuses” fell on deaf ears.  This warranted more time in isolation.  I begged.  I pleaded.  Just this one Friday, and then I will begrudgingly accept my punishment.  I had surely earned it, after all.

I was berated for not trying hard enough.  “Are you lazy or stupid?  I can’t decide anymore.”  The words stung, like a clean slap across the face.  I lost my temper and started to storm up the stairs.  I called back to my father, “You’re an asshole.”

“Get your little ass back down here!”

I glanced backward to see the furious, crazy look in his eyes.  But, I was beyond caring.  I was beyond fear anymore.  I continued up the stairs as he screamed after me.  Do your worst.

“You little bitch, come down here and face me!” he challenged.

I did.  He grabbed my by my collar and snatched me up so close to his face that he spat every angry word at me.  “Come on.  Take a shot.  The first one is free.”

I knew better.  If I were to take the shot, that would justify any beating I would have received after that.  I was only 4’9″, and he towered over me at a grand 6’3″.  I was a little girl in comparison to this adult man.  I stared into his eyes defiantly, gnashed teeth and a snarl.  I never lost his gaze in that moment.  I refused.

With one twist of his arm, he dragged me down the last three stairs.  Violently, he pulled me into the air by my collar and thrust me into the kitchen wall.  I was terrified, but I would never show it.  I would not give him the satisfaction.  I looked behind him to see my mother standing there, doing nothing to help me.  She looked at me with these vindictive eyes and a satisfied face.  He screamed in my face about disrespect, what an ungrateful piece of shit I was, and how I didn’t even deserve all of the things they had given me.  I started to lose my air as my collar choked me.  I panicked, as I started to black out.  His words faded.  I closed my eyes.

Thud.  He dropped me three feet to the floor, and I hit the ground hard.  I crumpled onto myself as he stormed off.  I looked up at my mother who was looking down at me.  And without a word, she walked away.  My last hope of salvation had betrayed me.  And I curled into a ball and cried.

(This part I have to omit because it is going to be in a future installation of “The Friday Confessional”.)

After I had been dragged home, I took refuge in my room.  All hope was lost.  There was no escape.  There was no one who could save me from this.  There was only one way out.

I went into the medicine cabinet and grabbed an entire bottle of Advil and another of Tylenol.  I washed it down with another bottle of Nyquil and waited on the edge of the bathtub.  This was going to be my way out.  If God wasn’t going to come to my rescue, and the authorities felt this was a gross exaggeration of the truth, then I would take matters into my own hands.  Let me be damned to eternal hell.  It couldn’t be much worse than this.

I filled the tub and waited some more.  I undressed.  This should make the cleanup convenient, I thought to myself.  I sure didn’t want my death to be a major inconvenience.   Everyone would celebrate my departure.  Everyone would be happier without me.

Botched.  I woke up a few hours later and crawled into my bed for warmth.  And I slept for over 24 hours.  No one took any kind of note at the missing medications or my inexplicable hypersomnia.

That was the first in dozens of attempts to take my own life.  At the young age of thirteen.  The idea of suffering the abuse and neglect of my parents for the next five years until I was a legal adult was too much to bear.  And I was absolutely convinced that I would be dead by my seventeenth birthday at the rate I was going.  I had tried so many times that I eventually started calling it, “Flirting with Suicide”, just because there was something of a romance between it and me.

And every single attempt was the best I could possibly manage with the materials provided.  I suppose a person can call that parasuicidal if they choose.  Maybe it was.  I’m not sure anymore.

I’m nearly twenty-eight now.  All of that was nearly fifteen years ago.  And the last time I attempted suicide was over a year ago, a few days before I started writing As the Pendulum Swings.  In that year, I learned that I had a relapse back into a more serious cervical cancer.  And it dawned on me that there was a possibility that I could one day die from it.  I had resigned myself to life.  If I couldn’t die on my own terms, a survivor of multiple attempts, then I would live.

In the end, I chose to live.

What are some risk factors for nonfatal suicide attempts?

  • As noted, an estimated 11 nonfatal suicide attempts occur per every suicide death. Men and the elderly are more likely to have fatal attempts than are women and youth.1
  • Risk factors for nonfatal suicide attempts by adults include depression and other mental disorders, alcohol and other substance abuse and separation or divorce.5,6
  • Risk factors for attempted suicide by youth include depression, alcohol or other drug-use disorder, physical or sexual abuse, and disruptive behavior.6,7
  • Most suicide attempts are expressions of extreme distress, not harmless bids for attention. A person who appears suicidal should not be left alone and needs immediate mental-health treatment.

Educate yourselves.  Realize that every suicide attempt is serious and should be treated immediately.  Realize that suicidal gestures, ideation, and plans are all extremely serious and significant.  And find the courage to find yourself, a family member, or a friend immediate treatment.  Suicide is completely preventable when people are educated.

Thank you for reading.  Take care.

The Heath Ledger Paradox

Warning: This post has contents that may be hazardous to mental health.  It contains strong themes of suicide, suicidal behavior, and substance abuse.  Reader discretion is advised.

Have you ever had a moment where you heard the distinct and deafening sound of your own clock ticking down?

I have only heard this sound a handful of times. The first few times, it was difficult to distinguish from the other garble in my mind. But, the last time this occurred, the sound was unmistakable.

Tick.
Tock.

It happens when my physical state is badly threatened, but I’m not mentally aware. That is my defense mechanism that seems to be biologically programmed to protect me. It is what creates the Heath Ledger paradox.

And that’s what I experienced.

The Heath Ledger Paradox

Some things happen by accident

Personally, not proudly, I have attempted suicide between a half of a dozen and a dozen times in my life. I don’t really keep score; there is no tally anywhere. In fact, in total, I have only left a handful of notes behind. They don’t always correspond to the actual attempt, though.

I am not a violent woman. My method of choice was almost always centered around substances. My very first attempt landed me in a bathtub with a belly full of pills. It was an unintentional coincidence between Sylvia Plath’s and Virgina Woolf’s suicides. I know this to be truth, because I was only in my early teens at the time. I had yet to read about these authors. And despite these attempts, even some carefully orchestrated with blatant drug interactions, I never succeeded.

What was different about me that made me a survivor of my own wretched malice? Many a person has done these things accidentally! Marilyn Monroe, Michael Jackson, Elvis Presley, Janis Joplin, Jimi Hendrix, Bruce Lee, Brittany Murphy, and many others are examples in our modern culture of how accidental overdose happens.

I met a guy in college that I stayed friends with. Eventually, we ended up working together. He was dismissed for failure to attend, and we all suspected he had a drug problem. A few days later, he was found dead in his apartment from a multiple-drug interaction. The guy ended his own existence with his own carelessness. How could he do it by accident and I couldn’t possibly do it on purpose?

That’s the Health Ledger Paradox. It is easier to succeed when the mind is unaware.

Last night, I accidentally set my foot onto the other side of the fence for a moment.

I still have impacted wisdom teeth on both the bottom left and right sides. These wisdom teeth have risen up partially in the back, causing skin pockets to form. Occasionally, I will get something trapped back there and a small infection will form. If I treat it immediately with a rinse and keep the pain manageable, I can usually escape a trip to the doctor and an antibiotic.

I detest going to the doctor to hear the same thing repeatedly. Yes, I know I need to have those teeth out. Though, I now have dental insurance, I do not have the money for a serious co-pay there. I just had a major surgery a month and a half ago. I don’t have the time or energy to spend in recovery. And I always feel worse on the “cillan” antibiotics than I did with the infection. Other women will feel me here. I usually end up with a worse infection in the end.

I had some Vicodin remaining from my surgery. Admittedly, I hadn’t taken many. I had a problem where the Vicodin would cancel the Temazepam out. I would be up for hours, sleepless and still aching. I decided that my body needed rest more than I needed pain relief. I had to heal. Last evening seemed like a good time to take it. I don’t know how I let the situation with my teeth go from uncomfortable to agonizing. But, it happened more quickly than my mind could have processed. So, I took the Vicodin.

Bad choice.

I spent the rest of the night staring at the white porcelain bottom of a toilet bowl. At first, it was akin to other bad reactions I had to other narcotics. I do not respond well to Oxycontin or Percocet. And this was a similar episode. But, by the sixth hour, I knew there was something terribly wrong. My stomach had already emptied itself twice and was going for a third. This time, only water remained.

By the seventh hour, it became clear to me. I leaned forward and wretched. It felt like my stomach was turning itself inside out, in hopes to vacate an invader. I literally felt empty, as if I had evacuated every ounce of anything I’d eaten in the last 36 hours. And it dawned on me. My body was having a reaction – but why? I had taken Vicodin before with great success. I took it after my surgery and this didn’t happen.

I couldn’t muster the strength until the morning. I had only slept five hours out of fear that I’d never awaken again. I decided to refer to the almighty Medscape Mutli-Drug Interaction Checker. I thought I remembered doing this. Typically, I screen all new medications coming in. As I was trying to rattle my brain for all of my prescriptions, it occurred to me. I did do this, but I had forgotten a very important medication, Wellbutrin.

Significant – Monitor Closely

bupropion + hydrocodone

bupropion will increase the level or effect of hydrocodone by affecting hepatic enzyme CYP2D6 metabolism. Significant – Monitor Closely.

lamotrigine + acetaminophen

lamotrigine decreases levels of acetaminophen by increasing metabolism. Minor or non-significant interaction. Enhanced metabolism incr levels of hepatotoxic metabolites.

That’s just the tip of the iceberg there. That’s among four additional interactions. Those are the most important though. That’s the reason I was hugging the toilet, wondering why my sedation was outrageous and my pain relief was minimal.

And I realized, I just set foot on the other side of The Heath Ledger Paradox. If it wasn’t for that mechanism, that beautiful inborn, DNA encoded device inside me, I would have been dead. Something in me told me not to take more medication when my pain relief was marginal. And that same thing kept me safe by alerting my body that there was a dangerous toxin that needed to be rejected from my stomach. There was still a tiny bit of knowledge encoded from some source that this was life-threatening.

Not everyone has that, and most people with it can bypass the safeties with enough of a loading dose. That’s the aim in a suicide – to get past the safety, just like a gun. Except, when most people knowingly stand on that ledge and look into the void, they turn back. The point with accidental overdose is that all of that is gone. It’s like playing with a gun without knowing if it’s loaded or if the safety is on.

That gun was loaded last night. Thank the powers that be in the universe that I have a safety.