Sunday, March 3, 2013

David and his anxiety disorder


David and his anxiety disorder

One of my charges, I will call him David, has congestive heart failure as well as two leaking valves in his heart.  He has had this condition for a few years.  He also last year had a blood clot, even though he was on Warfarin for a few years.  When in the hospital they changed his blood thinner to another type hoping that it would do a better job.  It did not.  While it did work, it made his blood too thin and now he is off of it until we go see his doctor, hopefully tomorrow.  He has gained some weight over the last few days, 15 pounds in fact.  He is very thin, so it does not show, but it manifests itself by his struggle to breathe when he walks.  Hence, the importance of him seeing his doctor first thing on Monday morning; if in fact I don’t have to take him to the ER later on today; which I am trying to offset, he hates the ER. 

Took him in last Friday here in Rockdale County; he fainted and had a concussion.  While in the ER they found that his spleen was bleeding, so he had to go to Atlanta Medical Center on Boulevard ST., here in Atlanta.  They have trauma doctors there.  David has a very serious anxiety disorder, which means he worries about everything equally, be it something serious or mundane.  It can be a difficult dealing with him, but he can’t help it so we all cope who take care of him. 

In the second ER they gave him quick service.  Within an hour after arriving he was seen by the unit nurse, and two doctors, one of them a trauma specialist.  The checked him out, looked at the records sent over from Rockdale Hospital and said he would have to stay a couple of days if not longer.  One reason was because of his spleen, the second because of his blood being so thin.  He was also very dehydrated and was given 3 liters of hydration. 

While there he continued to obsess over, well, everything.  I was tired, it was 2 AM in the morning so I listened for the 12th time at least over his anxiety driven concerns and simply told him to please stop it, it was doing him no good, nor me, and to try to go to sleep.  To my surprise he did, he fell right to sleep!

Around 3 AM they came in and told me that they had his room.  So we went upstairs.  When we got to his floor they told me to please go to the waiting area and it would take about 30 minutes to an hour to get him settled.  I was tired, so it did not register that this was an ICU unit.  I decided not to wait, but to start the drive back home which is about 45 minutes away.  I did not want to wait an hour or more, since then there would be lots of traffic and did not want to drive in it when I was so tired.  So I left, got home, and went to sleep.

He is of course home now and not doing as well as hoped.  He is not afraid of death, but is about everything else under the vault of heaven.  He explained to me why he is the way he is and I understand.  So once in a while like last night, as we talked before he tried to go to sleep, that he knows that he irritates people with his anxiety.  I replied that it is ok, I don’t expect him to be able to change that, but he needs to understand that I am also human with limitations and from time to time I will call him on his constant worrying, not to make him guilty or out of a desire to change, but that I have reached a certain limit and need a time out.  My irritation with him will pass, and I love him and actually like taking care of him.

David does have a great sense of humor, dryer than the sands in the desert, which is the kind I like.  So often we also laugh over his good jokes and observations’.  One lesson from being a care giver is that I have limits and need to speak up, or burn out…..I choose to speak up and at the same time let those I take care of, of my love and concern for them, and that my present inability to deal with an issue will pass, often very quickly.  Just speaking it is enough.

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