296.44

Last week I went to the mental health clinic to get blood drawn. Now those of you that know me and know what I've been through are well aware that it is nearly impossible for me to be afraid of needles. After all, I spent two years often getting blood drawn every week or two. Not to mention I've had regular bloodwork done to make sure my kidney and liver continue to function normally even while being thrashed by Lithium and Topamax. But something about getting my blood drawn this time had me antsy. Call it intuition, a 'sixth sense' or what have you. I just knew this nurse was going to have trouble getting my blood.

Oh how I hate to be right.

First, let me say, that I was appalled by their 'facility' for lab work. I understand this place probably has a crappy budget but come on. Invest in some lab work equipment if you're going to be sticking people with needles! When the nurse asked me "Are you an easy stick?" my intuition was confirmed. I answered, as smugly as possible I might add, "Well, I've been stuck so many times for fertility treatment that I've honestly lost count. Only one nurse has ever missed on me and she was the only one that ever complained about my veins." And really, that is the truth. The nurses at the clinic in Montgomery never so much as made me flinch when they stuck me. And they never ever missed. Neither did the girl at LabCorp for that matter or any of the other dozens of people that have stuck me with needles for IVs or lab work or surgery or anything else over the past 10 years. Even an Army attending got my IV in on the first try after a 12 hour puking spell that left me severely dehyrdrated didn't miss! But I digress. So the nurse shrugged and fussed around in the cabinet in search of all the bits and pieces she needed to drain out two vials of my blood.

After 10 minutes of rooting around she finally got everything set up on a desk and had me sign some paperwork. Then she tied the tourniquet around my left arm -- the arm that is almost every nurse/phlebotomist's choice -- and started poking around the crook of my arm with her finger. After about five minutes of prodding she declared that I had "tiny little veins" and went back to the cabinet to retrieve only god knows what without first removing her gloves! What the hell, man?? Haven't these people ever heard of cross-contamination?? Whatever. Finally, after about 20 minutes of anticipation and anxiety, she gave it a shot.

Poke, vacutube.......nothing.

I'd already told her that I'd rather be restuck any day than to have her root around and try to roll the vein in favor of removing the needle and trying again. So after the first stick and a little bit of maneuvering she removed the needle, placed it on the desk (which was NOT a sterile surface) and began prodding at my "tiny veins" once again.

I have been a patient so many times that I am almost 100% certain that when you restick a patient for blood or injection that you're supposed to use a fresh needle each time. By all means, correct me if I'm mistaken. So, yeah, she reused that same needle when she stuck me a second and third time on my left arm and then again when she stuck me twice in my right arm! So that's five sticks all with the same needle that she put down on the NON-STERILE surface between each poke.

Now, if I remember correctly from my Follistim training (and I do), I was told that if I had to stick myself more than once to get a full dose (this is a common occurence when using the Follistim Pen Cartridge) that I was to use a fresh needle for each stick, hence the dozen and a half needles for a 10 day course of treatment. I can only assume the protocol is the same for lab work, but, like I said, I could be mistaken. At any rate, after the two sticks in the right arm she simply gave up. No blood work for Liss! Screw it that I've been on Lithium for a month now and that Lithium levels can quite easily (and rather quickly) become toxic. I was completely livid! Then she told me that I could take my lab paperwork to the hospital and have them do it but they'd likely charge me extra fees and what not. Ok, I'm uninsured (which they know) and currently in a holding pattern with the SSA for my SSD claim (which they also know). Do I look like I am made of money?? Seriously, folks, what the hell??

While I'm not crazy about the other staff members, I do like my therapist. I don't feel like I'm getting any help from the sessions but he is a nice guy and he really does want to help me get/feel better and get my SSD claim approved as quickly as possible. But the rest of the staff, the pdoc included, suck balls. Did I ever mention that I went to the clinic THREE separate times to have this lab work done only to be told to come back next week because the nurse wasn't on the schedule?? I mean, really. They have a scheduling book.

So I still haven't had my lithium levels checked nor was I able to have the metabolic lab work done to check my thyroid and all that jazz that the pdoc requested. (Which is bad bad bad because Lithium is known to screw with the thyroid and now they won't have baseline/normal levels to compare my future levels to.) As if being mentally interesting isn't stressful enough, right?

After all of that the nurse handed me a piece of paper that listed what labs I needed to have drawn. Written in the "diagnosis code" was the number 296.44. Being the ever-so-inquisitive person that I am, I came home and Googled DSM-IV diagnostic codes. 296.44 is listed as Bipolar I, most recent episode manic, severe with psychotic features.

While this is probably an EXCELLENT code to have on my charts for my SSD claim, I absolutely do NOT agree with it and would lobby to have it changed if I thought they would listen. First, I do not think I am Bipolar I. I have only recently come to accept that I am any flavor of Bipolar at all. And I do not believe that flavor is Bipolar I. First, I don't think I've ever experienced a full blow manic episode. Though I'd have to ask those around me to confirm because my BFF thinks that maybe I have. BUT if I have experienced a full blown episode it was most certainly triggered by an antidepressant (Zoloft) which, if I remember correctly, doesn't put me in the Bipolar I category but rather Bipolar II because the mania was triggered by a medication.. The psychotic features I will (reluctantly) agree with because I have had (and sometimes do still have) hallucinations. And grandiosity. Definitely 'flight of ideas'. Not-so-much on the 'I am GOD.' thing but I have had paranoid delusions where I've felt like people were reading my thoughts and/or stealing thoughts from my head. I've had episodes/occurances of 'inflated self-esteem'. Which is kind of ironic because on a 'normal' day I have a very low opinion of myself. Then again, with the 'rapid cycling' feature I have (which is what made it difficult for me to get a diagnosis of Bipolar at all) makes me a whole different flavor of Bipolar all together. In the hospital last April the pdoc there said Bipolar NOS (not otherwise specified). But what do I know. I got my "degree" from Google and personal experience. :P

Have I ever mentioned that the DSM-IV kind of makes me laugh?