Tuesday, June 30, 2009

It is so annoying when the media news is all about sun and heatwaves because it is hot in London - whilst elsewhere we are getting showers of rain and murky cloud and mist.

It was raining this morning. That shouldn't matter. Such a small thing. Except that it is Sam's 30th birthday today and we had got him some leave. Most days he is lucky to get a walk round the hospital grounds with a nurse. Today we had managed to arrange for four hours leave accompanied by a nurse to have a picnic at a local beauty spot that Sam likes. Sam's first extended leave for ages ... for a picnic ... on his birthday ... and it was raining!

But the rain stopped - and the sun even made a very brief appearance as we were eating our picnic together. Sam loved it. He liked his presents and just enjoyed being out. I began to panic slightly when he started to talk of how he could jump into the river as we were standing on a bridge - and the wicked gleam in his eye accompanied by a rather worrying grin as he edged closer to the river as we walked back to the car ... !

But he was returned safely back to the ward without his usual reluctance with thanks for a nice day.

Lets hope the success of today leads to more planned leave.

Monday, June 29, 2009

It was Sam's "Managers' Hearing" on Friday - a kind of appeals tribunal against his detention. Of course it was not found in his favour but he coped with it very well. This time I didn't go - just Jane attended. I think sometimes we can build the tension when we are both there.

On Saturday we managed to arrange to go for a short walk with Sam. It took some organising but was sorted eventually. Sam was fine when we arrived but when we went for the walk he seemed more pensive as if he was having some troubling thoughts. He discussed some of these with us as we walked. I think he had partly been disturbed by a new client on the ward - someone straight from the prison system. But Sam thought he was settling.

By the end of the walk Sam had calmed and seemed settled.

Tomorrow is his birthday. We have managed to get him leave to take him for a picnic at a local beauty spot with a nurse from the ward.

Must dash now to wrap his presents and prepare the picnic!

Thursday, June 25, 2009

He was angry on Wednesday. The day before, at the ward round meeting, the psychiatrist had shown him his care co-ordinator's report for the Mangers' Hearing tomorrow.

A Mangers' Hearing is one of the appeal mechanisms to get out of hospital when detained. It was through one that we - unusually - managed to get Sam out (is it really five years ago now?) to go to France.

Sam was angry because he said his care co-ordinator had lied. He had described again the time when Sam had a serious road accident. It is often used as an example of why Sam is at risk. It was before his first detention in hospital almost ten years ago. Its relevance now seems low - its inclusion just lazy reporting of Sam's current state. Sam may also be right. He probably gt hit by the car because it was a dark night, he was wearing dark clothing and he was drunk. But it gets dragged up again and again because he was seriously injurred. He has done more stupid things and more dangerous ones as a result of his psychosis. If they were emphasised more then Sam might have to reflect rather than turn to anger as a response.

As we talked and explained he calmed and seemed to understand.

We also had to explain that he was unlikely to get out tomorrow - that he needs another strategy - but I think he knows that anyway.

Wednesday, June 17, 2009

We had seen Sam last Wednesday for the family meting. To start of with Sam was surly and uncommunicative - but for the second half of the meeting - after he had been out for a cigarette - he was very sociable and much more rational.

So we were surprised and disappointed to find him really surly and antagonistic when we visited him on Saturday. Conversation was difficult. He seemed to be trying to pick arguments with us when he talked at all. Then he told us that he was finding our presence really oppressive. he said he loved us but we were creating a strong feeling of anxiety in his chest that he could not understand or control. We suggested we should leave but he asked us not to.

"No, I'll go for a cigarette and perhaps I'll feel better."

So he went for a cigarette but on his turn things continued as before ... so we left saddened and disappointed. The staff said how well he was doing - because he is calm on the ward ... but his mental state is still very, very confused.

Tuesday, June 16, 2009

Currently I normally take Sam eight 12.5 gram packs of tobacco each Saturday. The notion is that there is one a day and a spare one. That seems to have been working out okay recently. Then last week he asked if we could take some more in when we were joining him for a meeting on the Wednesday. So I took in four more packs. On Friday there was an urgent call. Please could we take some more tobacco in for Sam.

He has been smoking a bit more recently but it does seem to be getting out of hand. Yes he will be bored ... but perhaps he shouldn't be if there were more activities available. He has few pleasures - but smoking is a danger to his health yet it is a nurse ringing me asking to take it in. His increased weight gain is a risk to his health - but again it is a nurse asking me to give him some more money to buy take-away food from the pizza and burger bar.

Smoking tobacco also works against the effects of the anti-psychotic medication. Perhaps that is another reason that many psychiatric patients smoke - to alleviate the affects of their medication. When smoking has been banned on some wards they have had to reduce the medication as a result.

Thursday, June 04, 2009

We had to go away to visit relatives for a funeral at the beginning of the week. On our return we got a call to say Sam was out of tobacco. He should have had plenty but it seemed it kept getting put in the washing machine with his clothes.

At least he had clean clothes we thought.

Then we had another call to ask if we could take him some more trousers as he had none left that would fit him. As they are prescribing the medication that is making him so fat perhaps they should be providing the larger trousers!

I was a little annoyed because as well as having taken him in plenty of tobaco at the weekend I had also taken him in some more trousers and some shorts but ...

Yes, you've guessed it. The new trousers and shorts were in the washing machine too!

Wednesday, June 03, 2009

On Saturday I went to visit Sam. When I arrived he was laying on the settee. The weather was hot and he must have just come in from outside. He was wearing shorts and nothing else He looked so fat and bloated that it was a shock to me to see him like that. He has put on so much weight in just a few weeks.

During the week he had sounded quite well on the phone. So I was surprised at how excitable he appeared. However we had a good chat and enjoyed each other's company for an hour. But I went away saddened that he seemed to be making less progress than I had imagined

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