I Suppose I'm Not Crazy

As promised, here is the latest update on my sleep condition and my dealings with the VA in regards to that and also my “behavioral health” issue.

*There are actually two posts today, so please don't miss "Health Advisory" below.
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Early this week, I received a phone call from the local VA satellite office informing me that my sleep study has identified no “significant sleep abnormalities.” While this is good news, in that I suppose it indicates I have no serious physiological problem, it does leave me some aghast at how poorly most people apparently sleep. But I, apparently, “slept peacefully with mild snoring.” I was unaware I snored, so I do wonder if this was the consequence of having sensors superglued to my head and accoutrements taped over my nose and mouth. In fact, it’s amazing that anybody at all gets normal sleep readings when wired to so many sensors. I was also pleased to learn that I “didn’t forget to breathe.”

The next phase of this ongoing diagnosis (or at least analysis to determine if there was anything at all TO diagnose) was a meeting with a behavioral health specialist within the VA system. I was under the impression that this was a standard procedure for anybody who had made the admission that they are indeed depressed about being tired and unable to sleep, but I was told during my appointment that it was my general practitioner’s attempt to make sure we’d covered all our bases.

At any rate, he was a nice chap, and not a psychologist, as I had expected, but actually a psychiatrist. Naturally cordial yet soft-spoken, he began by asking me what my expectations were from our meeting. After explaining that since I felt no particular need for medication for any of my symptoms or difficulties, that I was unsure. For, at my highest of highs, I am not abnormal or uncontrollable, and at my lowest of lows I remain uninterested in offing myself, I was not a threat to either myself or others. Life, after all, naturally propels us into a series of highs and lows and, so long as their extremes pose no physical threat to oneself or any others, they are simply the expected responses to the typical vacillations of life. Medication, I told him, was unnecessary, and I also wished to do nothing that jeopardized my alertness, numbed my senses, or forbade me write with the clarity (feel free to laugh) that I possess at present.

I also told the psychiatrist that since his purpose within the VA system was mostly to determine pharmacological interventions for patients in need of such things, my visiting him in the future would be a waste of his time. Bad idea.

“I prefer that you allow me to determine what is a waste of my time or not” he replied, quite firmly.

Oops.

At any rate, these weighty questions out of the way, I talked his ear off for an hour about what I’m up to, plant photography (he also has an interest in such things), writing, and expectations for future travel. To my great delight, he patiently listened. As my one-hour yakking session ended, he asked how he could best help me in the future. Digging into my pocket, I handed him a business card.

“Well, you could read the stuff I’ve posted and tell others about it, if you’d like.” Speechless, he took my card. I am unsure if his silence was the consequence of my having just shamelessly marketed to a VA psychiatrist, or because it was just so unusual a response. Others, I presume, ask to meet again with somebody who doesn’t mind listening to them talk. He elected not to schedule me for any further visits, instead writing “PRN” on the paperwork, which translates basically to “as needed.” I, not feeling like I need such a thing (either medication or to have some poor guy endure me running my mouth for an hour), have no plans to schedule any further visits.

To make a long story short, this whole affair has yielded very little in the way of medical diagnosis. On one hand, this is good, since it indicates there are no major medical problems which are in grave need of addressing. On the other, however, it leaves me as clueless as I was before as to how to alleviate the symptoms I have been feeling (tired all the time, cranky, unintelligible, etc). My best solution, therefore, is to devote my efforts to wrenching myself into more routine sleep/wake habits. This I have already begun working on in the following ways: First, during the day, stay awake and avoid taking excessive naps. Second, sleep at fairly normal hours when it is dark (not 3AM to 10AM or whatever else I’ve been doing lately). Third, during waking hours, expend some energy on a regular basis, eat meals at similarly regular intervals, and show all signs of actually being alert and awake, not run down and miserable. In theory, after a period of readjustment, my circadian rhythms will grow accustomed to the new, normal routine, and I will sleep more soundly, wake more rested, and not spend most days in a miserable funk. This is the theory. We’ll see how it works in practice.

And so, I have been seen by doctors, social workers, psychiatrists, nurses and sleep study technicians, and to my relief walked away with no diagnosis of either a sleep disorder, OR PTSD. While such things may, in fact, exist (I am reluctant to say, since I truly don’t know), at least they aren’t sufficiently pervasive and troublesome to require ongoing medical treatment, drug intervention, and therefore excessive worry on my part. It is relieving, frankly, to know that no major problem exists. I am now left to summon the immense self-discipline necessary to change what portion of this I can through routine, normal circadian rhythms, diet and exercise. Some days, obviously, will be poor ones, but some days will also be better. The greatest struggle is not being an awful grump, not blowing up on people, and not retreating from the public to avoid embarrassing altercations. My family, unfortunately, are the ones who will see me at my worst. They will need lots of prayer. For me, however, it’s just one day at a time.

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