My citalopram diary - July 2020

[Sparkle1984]

What a day it's been! It started off so well, then it turned terrible in the space of a few hours! I slept really well last night and woke up feeling relaxed - I think it was the feel-good factor from yesterday's therapy session and my niece's visit from yesterday evening.

However, just before mid-day, things turned sour. My mum and step dad received a phone call from my grandmother's next door neighbour, saying they'd noticed my grandmother hadn't opened her blinds, which was very out of character for her. My grandmother is in her mid-90s and has Alzheimers, so we feared the worst. My mum and step-dad drove round her house to check on her, while I carried on with my work. I couldn't concentrate very well as this was on my mind. About an hour later, my step dad called me to say that my grandmother had had a fall and was suspected to have a broken hip, and she had been taken to hospital in an ambulance. I was sad but also a bit relieved, because I was half-afraid they were going to find her dead!

My step-dad came back home but my mum stayed at my grandmother's house for several hours, tidying up and making sure the dog had been walked and fed.

My grandmother had been found lying down on the lounge floor, but we think she probably actually fell over in the kitchen, as one of the cupboard doors under the sink was broken off, and there were dog biscuits scattered over the kitchen floor. We think she might have tripped over the dog and then crawled through to the lounge to get away from the hard kitchen floor. She was conscious when my mum and step dad found her, and thankfully she wasn't crying out in pain, but due to her Alzheimers she wasn't able to say exactly what had caused her to fall over and when it happened. It's possible she could have been lying there all night (my mum and my aunt take it in turns to visit her each day, and she was fine when my mum left yesterday evening).

I found the evening more upsetting, as my mum was discussing what was said with the hospital staff. The doctor had to ask my mum and aunt for permission for my grandmother to have an operation to fix her hip, and (more upsettingly, they said there's a risk that something could go wrong during the operation, so they asked for permission to resuscitate her if that happens. We were all quite upset and shocked to be asked that, as we thought it would be a given that everything possible should be done to save someone's life. My mum and aunt are adamant that my grandmother should be resuscitated if necessary and that the hospital staff should do all they can to save her. However, my uncle (my aunt's husband) seemed more sceptical, saying that you need to think about what her quality of life could be like after the operation - for example she could end up in a wheelchair or her Alzheimers could get worse. We were rather shocked and upset by my uncle saying that. My oldest sister said that she's aware of another woman in her mid-90s who had an emergency hip operation after a fall, and she was fine afterwards. So that gives me hope.

[panic_down_under]

they said there's a risk that something could go wrong during the operation, so they asked for permission to resuscitate her if that happens. We were all quite upset and shocked to be asked that, as we thought it would be a given that everything possible should be done to save someone's life.

Sorry to hear of your grandmother's fall. Hip replacements can be successful even into the 90s, however, be aware that resuscitation isn't as easy as TV medical shows make out with the patient given a zap and then all is rosy. The reality is that there can be major physical trauma including broken ribs, bruised lungs and damage to other organs. Plus the prognosis is not great with only 5-10% of the elderly (70+ yo) surviving and leaving the hospital. The older the patient the lower the odds. edit:Let's hope it isn't needed. (apologies for the typo )

[Aleman200]

Im really sorry to hear what happened Sparkle. I truly hope everything goes well for her. I cant imagine this has helped your anxiety.

[Sparkle1984]

Thanks for your support. In terms of my anxiety, I think today has been the best day I've had since I started citalopram. I had a solid 10 hours of sleep last night and I woke up this morning feeling enthusiastic for the day ahead, which is something I hadn't felt for quite a while!

We also had good news regarding my grandmother - she had her operation on her hip this afternoon, and it all went well. My mum went to visit her this evening, and she said my grandmother seemed happy and talkative. The nurses said she had a really good appetite at dinner time. They were pleased with how she's doing, and they also suggested that it could be days rather than weeks before she can be discharged. I'm so happy and relieved!

In the evening, I went round my sister's house for a chicken massaman curry and we also played some games.

I feel more at ease and happier than I have done in a long time. I had far fewer intrusive thoughts today, as well. Hopefully this progress will continue!

[panic_down_under]

We also had good news regarding my grandmother - she had her operation on her hip this afternoon, and it all went well. My mum went to visit her this evening, and she said my grandmother seemed happy and talkative. The nurses said she had a really good appetite at dinner time. They were pleased with how she's doing, and they also suggested that it could be days rather than weeks before she can be discharged.

That is very good news indeed. Thanks for the update

[Sparkle1984]

Today has been another pretty good day in terms of my anxiety, but maybe not quite as good as yesterday.

Today my aunt visited my grandmother in hospital. She was able to find out more about the operation - it turns out it was a "dynamic hip screw" operation rather than a full or partial hip replacement. My grandmother was sitting upright in a chair today, so she is already making progress. The hospital staff have said they will create a care plan, which may involve my grandmother being moved to a smaller community hospital for rehabilitative physiotherapy.

Earlier today, I did some more practice of the techniques my therapist has taught me, including the worry time technique. For this, I spent about 20 minutes writing out some of the intrusive thoughts I get. I repeated each phrase 4 or 5 times in attempt to try and desensitise myself to them. The thoughts were:

• I am 36
• I am getting older.
• I will be 40 in 3.5 years.
• There is no way to stop it.
• I will never be in my teens or early twenties again in this life.
• I will be elderly one day.
• I will die one day.
• We can't be sure when.
• There is no scientific proof what happens next, only faith.
• If my faith is wrong, there could be nothingness.
• One day my elderly relatives will die.
• It is inevitable.
• We don't know how or when.

I then finished off with an affirmation: "I can tolerate the uncertainty." While doing the above exercise, I felt more sad than anxious. For the last couple of times when I've done this worry time exercise, I've found that the anxiety comes through in the minutes after I've finished the exercise and moved on with my day. I'll mention this to my therapist.

It brings back memories of a time when I was 9 or 10 years old, pondering the meaning of life and the nature of reality. I recall coming to the rather morose conclusion "we live to die", as that seems to be the only thing that all humans have in common. That same day, I also remember asking my dad "what if life is just a dream that we're all in?" and "why am I me and you you? Why am I in this body and not yours or my best friend's? What makes you, you? " Of course, my dad wasn't able to answer those questions. A few years later, I remember my dad telling me how he and my mum had first met, and I recall asking something like "what if you had never met? Would I not be alive now at all, or would I have been born into a different body in a different family?"

All these years later, I'm still not much clearer on the meaning of life. I sometimes feel like my anxiety would be lower if only there were scientific proof that God and the afterlife exists, and that I knew in advance what to expect, and to know the answer to the questions about reality I mentioned in the previous paragraph. Of course, there is currently no scientific proof that these things exist, but there's also no proof that they don't exist. There are a lot of things in the world that still can't be explained by science. Maybe one day they will be, or maybe we're simply not meant to have proof while we are here on Earth, maybe it's meant to be a test of faith?

I feel a bit better for having got all those thoughts down. A lot of my anxiety is to do with an inability to bear uncertainty!

[Sparkle1984]

This week so far, overall I've felt better than I did last week. I feel like the citalopram has kicked in more now, and most of the side effects have worn off now, except for the rapid heart beat that I always get in the first few weeks (my resting heart rate is currently in the late 70s, whereas when I'm not going through an anxiety episode, it's in the late 60s. Sometimes, during the day it can be in the 80s or early 90s, even if I'm sitting down).

This is my 4th time on citalopram, and the interesting thing is that it seems to be kicking in faster this time than it did the 3rd time around. Also, the side effects didn't last as long this time round. I remember the 3rd time was a total nightmare, and even after 8 weeks I didn't really feel that much better. This time, I'm coming up to 6 weeks and I already feel significantly better (although not 100%). I wonder if it could be because the gap between the 3rd and 4th time is much longer than the gap between the previous times? This time around, it was a whole year before I relapsed and needed to go back on the medication, whereas the previous times, I relapsed after just a matter of weeks or a few months after coming off.

I had my 3rd therapy session last night, and it went well. Unfortunately the therapist is now on holiday so I won't be able to have another session for 3 weeks - I hope I'll be OK to get through until then!

My grandmother is still doing well in hospital. My mum and aunt take it in turns to visit her each day. Sadly my sisters and I can't visit due to the current coronavirus restrictions, which does make it somewhat more stressful, but my mum tells me in detail what happened after each visit. Hopefully it won't be too long until my grandmother can be moved into one of the local rehabilitation centres for physiotherapy.

[Sparkle1984]

After about a week of feeling very good, since yesterday I've felt a bit of anxiety and intrusive thoughts creep back in again, although it's nowhere near as bad as it was a few weeks ago. I think it's probably due to a combination of hormones (my period started yesterday) and tiredness (it was my first 5-day week at work in over a month, and also there was a lot going on with regards to my grandmother being in hospital and keeping the rest of the family informed - at some points, our phone was ringing nearly constantly!)

My grandmother is continuing to do well and yesterday she was moved to a community hospital for physiotherapy. Sadly, the visiting rules there are even stricter than for the main hospital - even my mum and aunt will only be allowed to visit once a week each, so there's probably no chance I'll be allowed to visit! :(

Today I walked with my mum round my grandmother's house - my step-dad is currently doing some work in the kitchen, repainting the cupboard doors. While we were there, my mum and I looked through some documents and mementos regarding my granddad's death in 1991. He died very suddenly of a heart attack while he was on holiday with my grandmother in what is now Croatia. As I was only 7 at the time, I feel like I was too young to fully understand what was happening, and I also didn't get a chance to say goodbye as he died on holiday, so I probably still have some unresolved grief from that time. I did find it somewhat therapeutic to look through the old sympathy cards, letters of condolences from family friends and even letters from my grandfather's former employer. What made me feel sad was when my step-dad said that if only my granddad had had the heart attack in the UK, he might have survived.

I'm just having a calm weekend - I'm not planning on going out anywhere else. My plan to go round my sister's for dinner this evening fell through as my other sister couldn't make it, so I said I'll come round another Saturday instead. Anyway, I have the next 2 Fridays off work, so hopefully I'll have something exciting to look forward to.

[Sparkle1984]

The last 2 days haven't been too bad. I've felt mostly OK during the day, but for the last 5 nights or so (I forgot to mention this in my previous post), whenever I've woken up in the morning (or even after a nap) I feel anxious for a while. For example, last night I woke up at 4am and whenever I fell back to sleep, I'd have a nightmare and ended up waking up again after a few minutes. In the end, I got up, went to the toilet, had a drink and a small snack, and when I got back into bed a few minutes later I put on one of my Calm sleep stories. Thankfully I was OK after that and didn't have any more nightmares, and I woke up for my alarm just after 7am.

[Aleman200]

The last 2 days haven't been too bad. I've felt mostly OK during the day, but for the last 5 nights or so (I forgot to mention this in my previous post), whenever I've woken up in the morning (or even after a nap) I feel anxious for a while. For example, last night I woke up at 4am and whenever I fell back to sleep, I'd have a nightmare and ended up waking up again after a few minutes. In the end, I got up, went to the toilet, had a drink and a small snack, and when I got back into bed a few minutes later I put on one of my Calm sleep stories. Thankfully I was OK after that and didn't have any more nightmares, and I woke up for my alarm just after 7am.

I'm having this exact same issue at the moment, I've been on 20mg for 3 days now and the waking up doesn't get any easier. I try to get up and do something before even attempting to sleep again, most of the time it doesn't work. But I try anyway. Do the calm sleep stories help alot?