August 28, 2004

Excerpts from an email to Stew's parents today:

Hello.

We have achieved stabilization today . . . everything's okay, but I thought I should let you know about yesterday. Stew's rather talked out about it, he'd like to not have to deal with it anymore at the moment. He's been to his therapist, and both the therapist and I have told him that if he seems to be posing a threat to anyone (including himself), we'll have to have him confined.

I know, it's a very bad thing to think about.

Yesterday . . . and here I describe yesterday's activities that I'd rather not put here at this time. Let's just say that it caused some uneasineness and concern. As I'm sure you know, Stew's been taking politics very seriously and personalizing it. And overall he's been getting better in some regards. However, because he is better in some regards (I can't remember the last time his affect was flat, for instance), other issues arise . . . (the therapist says this, I'm obviously not an expert but I see how it's working with him). He's not sure what to do with himself next, and so somehow he becomes, uhm, a tad bit perhaps maybe homicidal. Oh, I hate using that word.

It's like all the anger that's inside him has to come out somewhere, so that's where he focuses it.

Anyway. There was a . . . and here I talk about mitigating factors that helped with the favorable outcome . . ., luckily, so he turned around and headed back. I don't think anyone was in any danger, and neither does his therapist, but predictability is not something we're familiar with -- since my main goal is to keep him safe I have to take it all seriously. He called me on his way back, first I knew he was even out. Told me where he was and what he was doing, and that he was headed back because there was no parking.

He didn't seem to know why exactly, other than of course the political thing, but why he's so upset about it, no one knows -- he doesn't know, so asking him doesn't get any answers.

He got home about 8 pm or so, I think, and seemed to be doing okay once I'd talked to him for awhile. In fact, he was very easy to talk to and not at all delusional except in that his perceptions are a bit skewed. He was psychotic though -- I can usually tell (not that his actions weren't a big enough clue). We laughed about how he was foiled by a lack of parking . . . (there comes a time when all we can do is laugh or . . . )

I called him at 11 pm to see how he was. He said he was fine and sounded like it, but said he'd been suicidal half an hour before. We talked for a bit, and he actually sounded good -- his moods can change so quickly that it can be a challenge to keep up, but it does mean that his suicidal ideations tend to pass pretty quickly, which is a good thing.

He stopped by this morning on his way to his therapist (and delivered one mangy mutt) and was doing okay. After therapy he called me, really upset, so we talked, he came over. The session went okay, he said, but I think it was what the therapist was telling him . . . that if what happened yesterday happens again the therapist will have to do something about it. I told him that I would also -- the important thing is to keep him safe, and if he's going to grab a knife and go somewhere with intent, whether or not we think there's any chance he'll do anything, we'll do what we have to do to keep him safe. Then we had lunch and talked about them Mariners. They're not doing so well. (That's not true. We actually talked about me a whole lot, but that's boring.) He ate well, he was in pretty good shape. Had on a nice new shirt too.

So there we are -- he's better in some respects, but there are other things going on that we need to be aware of. It's like a balancing act I think. Or juggling. Or something.

He's supposed to be napping right now. I roasted a couple of chickens yesterday, and told him to come over and get one after his nap for his dinner. His productivity is up, he's been feeling better physically it appears, and overall things look good. But we're a bit concerned naturally.
He's been told to avoid the news, and I'll keep after him about that. He sees his doctor again Tuesday -- and I think he has plantar fasciitis -- I had that last year and it hurt, but I fixed it by wearing better shoes. :-)

All questions and comments are welcomed. He's a bit overwhelmed with it at the moment though, so feel free to ask me. (Not that I have answers, mind you . . . but you can ask anyway.)

Love,

The Caretaker
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That's about it for today. Scary to think about confinement, hospitalization, drastic measures, but we do what we have to do.

August 18, 2004

The following email was sent by Stew on the evening of the 18th. I called him when I received the email, about an hour after he wrote it, and he was doing quite well.


Hi all.

On the trip back, Dad had asked me if I had experienced any demons during my stay in California, and I had indicated that I hadn’t.

I’m currently experiencing demons right now.

They started when I was walking the dog tonight. I had an inclination that somebody was following me, but there was nobody there. In fact there wasn’t anybody around. (Which, for 9pm, is actually a little unusual.)

The demon(s) were telling me that I should remove my skin. Not just cutting it like I tend to do, but to take a potato peeler and peel away the skin. (I’m not even sure if I own a potato peeler.)

They kept showing me images of how it would feel better (can you really “show” a “feeling”?) if my skin was removed.

The often-asked question is what was I doing or thinking about right before this happened.

I was watching TV. I was flipping back and forth between the Olympics and Smallville (not a show I normally watch.) The last Olympic event had been swimming (men’s 200m backstroke I think)…and the only thing that stands out in my mind about that is that American Olympian just recently celebrated his 22nd or 23rd birthday. The episode of Smallville (Smallville is a TV show about Superman [well, actually Clark Kent] as a teenager going to high school and the mis-adventures he gets into learning about his powers) Anyway, one of Clark’s friends got mixed up with illegal street drag racing, because it was the only thing he seemed to be good at, and it allowed him to get out of Clark’s shadow.

So, that’s the status of the demons on August 18, 2004. Whatever that information is worth.

Oh, and no… I did not cut, nor am I inclined too.

Stew

August 10, 2004

It's been days since I've posted, as you no doubt have noticed. Time is fluid around here, it ebbs and flows unpredictably.

That, and I tend to get rather lazy now and then. Let's call it laziness and be honest about it.

Stew's preparing for his road trip, and he's rather nervous about it. He's told me he won't make it, that he won't last . . . and he has been sick a lot. Retching, mostly, nauseous a lot, headaches, and it's been hot, which doesn't help matters in the least. I told him he'll be fine. I know he doesn't want to let anyone down, and he worries about that. There are so many things that can go wrong, after all, but that's the case with everything in life. Unfortunately, that's what he sees so often. I want him to go and have a good time. Spend time with Jake, see his parents, have fun.

The other day he said that when he gets back he'll really get to work on his business.

Overall, he's been holding up pretty well. Had a bad time one night last week, disassociated, cut himself, called me late at night. We talked on the phone and I did my best reassuring come-back-to-earth spiel, or at least what I could at the time. It exhausted me, so I can't imagine how it exhausted him. If it does that to me, what must it do to him? And then he gets frustrated because he's so tired and doesn't feel like he can get anything done.

The next morning I was still worried about him; even though he said he was better after we'd talked it's really hard to tell at times. I called him, and there was no answer. Both phones. So, assuming something needed looking into immediately, I ran (drove, actually) over there . . . only to discover he'd been in the shower and was doing much much better. That's quite normal. There I am, still in the trough from the night before, while he's moved on to other, better emotions. It was such a relief that he was okay that I didn't pummel him too badly for not letting me know sooner. Besides, he's bigger than me, and pummeling must be performed with caution.

Today he helps Jake and Chris pack up the U-Haul. I hope the heat isn't unbearable for him. Other than the physical demands, it should be an okay day. Even that is an unknown though, since he is so often physically ill these days. Tomorrow they head off to California. And Dog can come stay with me for the duration. I've missed Dog, as annoying as she is.


Monique

August 5, 2004

Stew Prepares for a Road Trip

The following instructions/helpful tips have been issued to concerned parties in preparation for the Stew & Jake upcoming moving expedition, in which Stew will drive down to California with Jake in order to move Jake's mom to California, and then Stew will come back to Washington via his Dad. Personally, I would love to have a road trip like this to look forward to, but I am trapped in this apartment with a pile of work. Okay, next month I'm going to leave town for a couple of days to go to a wedding . . . not mine, of course.

Later we'll talk about Stew's disassociative episode from the other night.
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It’s almost time for the Jake & Stew Moving Company to get back to work. In preparation for this occasion, we have prepared the following tips on the care and feeding of Stew.

As you may know, Stew has anxiety (severe at times), depression (major), and a mild form of schizophrenia. And borderline personality disorder, though he does have one of the less toxic forms of this. And I think he’s bipolar. No, maybe not. Anyway. Let’s just say that Stew has a few issues, okay? We’ll just leave it at that for now.

If Stew seems a bit out of it, it’s quite all right to ask him if he’s taken his meds. His meds are important for functioning, and he’s pretty good about taking them, but occasionally he may forget, or run out, though we do try to avoid that.

Stew hates the heat. Hates it. Makes him grumpy. You don’t want to be dealing with a grumpy schizophrenic, believe me. If it’s particularly hot, he may seem a bit spacey. Remind him to drink plenty of water and/or Gatorade. And to eat properly. He says that’s not usually a problem, but let’s try to avoid too much bad food.

Migraines. I think, personally, that these are exacerbated by the heat. If he starts to get one, his best bet is to go to a cool dark area for a few minutes and take his migraine meds. Hopefully the migraine will subside in 30 minutes to an hour, but there is the possibility that he’ll have to rest for up to 8 hours.

At times, usually at night, Stew may or may not see things that are or are not there. This is a byproduct of the schizophrenia. What Stew really needs here is reassurance that there is or isn’t anything there, depending on the circumstances, and that it’s safe to continue. He needs to know he’s not, for example, running over anything or anyone. His hallucinations often manifest in the late evening when he’ll see shadows or movement that isn’t there. Fortunately, he’s usually cognizant enough to know that the things really aren’t there, but it still spooks him. (Imagine: You see something or someone, and even though logically you know the thing or person isn’t there, can’t possibly be there, there is still the fact that you see it/him/her anyway. Rational thought is difficult under these circumstances, yet Stew does it pretty well nonetheless.)

Stew snores. Have him wear his Breathrite Nasal Strips if his snoring is bothering you.

Stew has demons. Really. Lifesize real honest-to-Bir Bear demons. Sometimes they, or it, stand behind him, or keep right behind him where he can’t see them, or whisper things to him that are harmful, either philosophically or morally or physically. I’ve found the best way to deal with these demons is to make fun of them. They’re not nearly as dangerous as they make themselves out to be, nor as scary, but they must be dealt with firmly and with purpose, resolutely and with scorn. Let Stew knew the demons, while frightening, have no power over him, no matter what they say. When speaking to the demons themselves, use a calm voice and/or ridicule. Do not buy into their logic.

Stew self-harms. This means he may, or may not, hurt himself intentionally, usually by using a knife. This happens infrequently and is not likely unless he’s alone. (In other words, he won’t start brandishing a knife in your presence.) Do not be alarmed. As a dangerous activity, self-harm is highly overrated. Stew knows to sterilize his knives well and clean up after himself. There are far worse behaviors he could be exhibiting, so please keep this in mind if it should happen and don’t panic. Really, there’s no need to even become upset. If he disassociates, sometimes cutting helps him reconnect again. Sometimes it helps to refocus the pain, and sometimes it serves as a distraction. Just talk to him calmly and assure him that everything is okay.

One more thing. There is 24 hour telephone counseling available by calling 425 772-6218. Technically, while this is advertised as 24 hour, there may be times when the counselor is not available. Say, if she’s with a client, or in a movie, or asleep and doesn’t hear the phone ring. Still, feel free to call this number at any time so the counselor can either guide you through what to do with Stew next or talk to Stew personally to talk him down from whatever heights of panic he has reached. Or up from whatever depths of despair he has fallen to. In the event the counselor is not available, Stew’s therapist may be called, but he’s not nearly as good at this.

Stew does not want to disappoint anyone; it’s one of his biggest fears. He’s stressed about this impending trip not because of what it represents, but because it’s a change from his normal routine, and change is scary. Between worrying about disappointing anyone and the stress of change, he may be a bit on edge. I’ve found the most effective approach to be to soothing and reassuring. Should he be truly impossible, threatening to kick his ass may result in a long-term improvement but with the possibility of short-term repercussions that will make things worse before they get better.

Call me anytime.