October 22, 2007

First Update and An interesting Website

I want to pass on a link to the Rolex Laureate website that I found while researching the two-pot method of cooling and preserving food (I confess to indulging a moment's panic surrounding how to survive a global Great Depression and the resulting social collapse, but I won't say any more on that).

Mohammed Bah Abba's work in Nigeria, spawning similar efforts in poor communities in other Third World countries, seemed to me truly useful and inspiring, an example of how one individual can have an effect on an entire large group. It's not that the idea has not been known or used before. Porous material and evaporative cooling has been understood or at least utilized for centuries, even millennia. But it was Abba who turned a desultorily applied concept into mass production, and mass distributed the inexpensive pots free of charge (also employing local pot-makers in the process).I should add that this had far reaching ramifications, such as permitting unmarried Nigerian girls the time free from vegetable selling to go to school.

I realize this project may be of little interest to many of my readers, but it deeply moved me. Since the article provides Mr Abba's address, I decided to pass it on.


I spent about 5 weeks at a psychiatric hospital I shall call, for lack of a better name, Brock Hill, a private, but now like most of those once posh institutions, open to patients with Medicare and Medicaid. (Title 19) as well. Appearances not withstanding, and the acreage was certainly "country club" though most of it inaccessible to patients and hence useless and unused, it was mostly a psychiatric unit like any other. The nursing shortage was as evident there as elsewhere, though they had plenty of mental health workers (MHWs) to call upon. Travel nurses made up a large part of the staff, RNs living in another state who signed on for approximately 12 weeks as a way to work and travel the country. My favorite nurse was a travel RN in her 7th week at Brock Hill. She will not be there if I ever have to return.

The nurses and MHWs were a mixed bag, some I liked, most I liked, but a certain few I detested, and the last weekend I was there I had a run-in with two that was truly awful. But that I will deal with another time. For now, just an overview.

As I was, as usual mute for the first few days, I was given a single room, which I kept for the duration of my stay, much to my relief as I spent almost all of the time on CO and in my room, except for the very last week (I was still on constant observation up till the very moment of discharge, but that final week I was encouraged to do some "power walking" down the corridor with COs who were athletically inclined). I ought to have attended groups, but alas, boycotted most of them, laboring under the flase belief that they were similar to those in city hospitals: designed to babysit only, not meant to encourage any therapeutic work lest wounds be opened that could not heal in the average 3-5 day stay permitted. My social worker, who saw me every day, seemed only to agree with this assessment, and failed to disabuse me of the notion, even though the average stay at Brock Hill was 2-4 weeks and the groups, as it turned out, were greatly appreciated, and productive.

I can only say that because I finally attended a music therapy group on my final day there...and actually dared to pound out my anger (then) on a drum in front of everyone, and drum unself-consciously, if softly, to an emotional song, making up my own rhythm as I went. The very fact that I trusted the leader of the group enough to do all this moved me, and amazed me, as I trust very few people, and then only after knowing them a long time. I understood then how powerful music therapy could be, how important it could have been to me, had I been going reguarly, rather than just that once. Extrapolating from that, I realized that most likely the other groups too would have been helpful, and not useless or babysitting at all. I should have been encouraged to try them. I felt cheated, and misled, and on my last day there, both angry and sad.

It's a long story why I was angry, but it was for another reason, having to do with my taking 20mg Zyprexa, then suddenly deciding to stop taking it the weekend before my scheduled discharge...Not a very enlightened thing to do, but I was desperate, certain that I was gaining weight, but even more certain that my food-obsessive thoughts in-hospital, controlled there by the unavilability of food, would translate to massive weight gain once left to my own devices outside. Everyone was POd at me, and unwilling to change the prescribed drug regimen at that point, leaving it all up to Dr O when I got home. But I felt left in the lurch, unwilling to take the Zyprexa but left with only PRN Haldol I wasn't sure I wanted either!

In the end, I took Haldol for a few days, PRN or no; my visitng nurse insisted on it. Then, a large bit of good news changed everything: it turns out that Femto Press is going to publish my manuscript of schizophrenia poems, with intro and commentary by Dr O, in their Kalmia Book illness and recovery series! I was so thrilled when I got the unoffical news, I started crying...and called everyone I could think of. But then the indecision set in. What would they want of me to get the ms ready for publication? Would they want rewrites? would I be ABLE to rewrite or add poems, subtract ones I no longer liked? How much could I change or edit? All questions that required a clear and active mind, which Haldol did not reguarly provide me, but which Zyprexa did...Would I take Zyprexa for the sake of the book?

I called Dr O, since she was a part-author...She asked me the same question, wanting the answer to be yes. Okay, I said, I'll try it, but only at a low dose, the lowest possible, and only with the Zantac that Dr G at Brock Hill said had been shown to prevent weight gain in certain susceptible individuals. Good for you! she responded. But let's talk about it again when I see you this Tuesday.

So that's where we've left it. We talk some more tomorrow. So far, I have taken 2.5mg of the drug three days in a row. My appetite is definitely greater than it was without the Zyprexa, but it is hard to know if this is due solely to the drug or partly to having been conditioned by hospital-scheduled meals to eat three times a day. I do know that I feel hunger pangs more, and cannot ignore them, or do not want to...And I think more about food, though I try to ward off the need to eat till meal times by drinking Fresca and Crystal Lite. (I should stick with only Brita-filtered water, that would be better for me, I know!)

But I understand that many people who fight weight problems deal with this successfully, and maybe, even if drug-induced, I can too. It's just hard knowing that it is artificial, and that all I'd have to do is NOT take the drug and I'd not need or want to eat so much. But I'd also not feel very good, or be as creative and productive or be able to read. What sort of a choice is that? That's the choice I'm forced to make. I realize it doesn't sound momentous now, when I've only gained from 92 to 97 pounds (involuntarily, mind you) but that's five pounds in three weeks I did not TRY to put on. If I continue gaining at that rate, I could be 112 by the end of the year and 132lbs by March and 152lbs by June...20lbs every three months and you see what I mean? My father says it's worth it; how many of you would agree (and would do it yourselves? -- I know one of you has, but I'd love to hear from the rest.)


Posted by pamwagg at October 22, 2007 09:33 PM | TrackBack


Hi Pam! I read the book you wrote with your sister and have been reading your blog ever since.

Anyway, I'm a Mental Health Counselor who works in an inpatient psychiatric hospital. I've heard MANY people worry about the weight-gain associated with Zyprexa, and I certainly DON'T blame you. I, myself, have been thinking about quitting smoking, which would be the best thing I could do, but *I* worry about the weight gain that's associated with it. So I can understand your thought-process on this.

That said, I guess I don't have any advice (some counselor I am!) But advice is bullsh*t anyway. You're already doing the best thing by weighing (no pun intended) the pros and cons of the Zyprexa. Keep doing that, then do what you think is best for you. Only YOU know what's best, not Dr.'s, nurses and counselors.

Posted by: Laurie B. at October 24, 2007 08:47 AM

Congrats on the book. No question, I'd definitely take Zyprexa if someone promised me publication. You could be wrong about the rate of weight gain since your current weight seems on the too-slender side (I know you think there is no such thing!). Plus Zyprexa makes you feel better. You are right to be concerned about the long-term side effects of the drug, who wouldn't be, but how often do book contracts come along? Grab this opportunity!!!!!!

Posted by: Debbie at October 24, 2007 05:57 AM

Oh, and BTW--if I were you I would stay on Zyprexa while the book is edited, if possible. Just think of it as a temporary thing. Maybe the new drug will prevent the weight gain. In any case, i'd give it a shot, for the sake of the book.

Posted by: Samantha at October 23, 2007 02:14 PM

Oh Pam--this may sound odd, since I have never met you--but I am so excited I am almost crying, because of the news about your book. I have admired your poetry for years, followed your blog...which is so interesting to me because I am also a poet with schizoaffective disorder. Anyway, I really admire CavanKerry. They are a wonderful press with beautiful book design; they will do a great job with yours. No one deserves this more than you.

Posted by: Samantha at October 23, 2007 01:52 PM

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