Friday, July 31, 2009

Waiting for Surgery

A compromise solution for the management of my blood thinning medication has been agreed to between my psychiatrist and my electrophysiologist. After discharge, I will move into a retirement home in Burlingame, where they will make sure I keep up on the blood thinners. I'm 90% sure I would be fine managing my own meds as I was for months after my heart attack and since my open heart surgery, The 10% uncertainty is due to the fact that I just suffered through a major depressive episode. As I related in the last blog entry, in the last week of that episode my dosing became erratic. I would forget to take the meds and miss doses. I also varied the times I took them because my sleep was disrupted. The risk of dropping below therapeutic levels and suffering a stroke if I have a recurrence of the depression is too much for my surgeon, and for me.

The retirement home is an expensive option. It would last for 3 months. I'm considering whether or not to move out of my apartment. I'd been thinking about that anyway. It would help me bear the additional expense. I'd be prepared for a fresh start after the three months, which I very much need in any case.

My physical/psychological situation has complicated plans for my care in another way. I'm going to enter an outpatient psychiatric program after leaving the hospital. But before that happens, it may be that my psychiatrist would like me on the locked ward for evaluation. That usually takes three days. I've been down there. It's drab and boring and filled with miserable, suffering souls. But if that's what I need to do, then so be it. I'd like to get that over with as soon as possible, but they won't take me until my medical situation is resolved. So I will sit here in the hospital spinning my wheels over the next several days, when I theoretically could be "serving my time" downstairs. On the other hand, it may be that they will be OK with me going directly to the outpatient program. I hope that's the case.

This experience has been an eye opener for me on the relationship between psychiatric and general medicine. I've also gotten a look at how dentistry is treated by "regular" doctors. These topics are ripe for a blog post. I have time to kill, so I may write such a post over the weekend. :)

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