Asking for help

There comes a time when we all need a helping hand and sometimes we don’t know how to ask for that help and other times we are too afraid to ask for help. I’ve asked for help many times and it has been a difficult thing to do, asking for help meant I had to be willing to take the help that was given to me. In the beginning I was reluctant, I was reluctant to ask for help, reluctant to take the help and most of all I was reluctant to acknowledge that I actually needed the help. Over the years though it has got easier, I have become more aware of when I need to ask for help, more aware of where to go for help and most importantly I have learned to accept the help that is being offered to me.

When things began to get stressful last week with the news that I would not be getting my surgery for another 6-8 months at least I broke and I knew I needed an extra bit of help however I was not really sure I wanted extra help. When I was discharged from adult mental health services after completing my DBT therapy I was delighted to be free, free from appointments both individual and group, free from DBT homework and glad that I was well enough to be discharged.

In July I received a phone call informing me that if I was in needed of an extra bit of support either before or after my surgery which was due to be in July I could contact the adult services and link in with one of the group therapists and that is what I did. Having had a very rough nighton Sunday I knew I needed to ensure I got an appointment and although I made it through self-harm free and although I wanted to continue to fight this battle by myself I knew that there is no shame in asking for an extra bit of support.

I have worked hard to get where I am today, 6 months self-harm free and working on month 7 and while I know I am in control and despite the confidence I gained overcoming strong urges on Sunday, I couldn’t help but feel that I am not invincible.  After making the phone call and arranging an appointment with one of the therapists I felt relieved, like I could breathe just knowing that I have taken that step, taken the step to reach out for help and more importantly knowing that I have been given that extra support.

Asking for help is hard but it does get easier, it becomes something you want to do because you have a desire to keep well and you have a desire to remain in control. It is that desire that makes you realise it is ok to ask for help, it is that desire that allows you to accept you are not invincible and it is that desire that encouraged to take that step that you know is the right step. I recognised on Wednesday that I needed an extra bit of support and it was Monday when I made it a top priority ensuring I got to speak to the therapist and ensuring I got the support I needed. Through it all I learned that even though I am not self-harming it doesn’t mean I don’t need an extra bit of help, acknowledging that and working towards prevention rather than waiting until I had lost control was a huge milestone and learning curve for me and for that, for that I can actually say I am proud of myself!

An encounter with a razor

It has been almost a week since I have been told that my surgery will not be happening for another 8 months or so and to saw I just got over it would be a huge understatement. It has been hard, I’ve had days where I’ve stayed in bed and days where I got on with my life but never the less knowing that I am going to have to live with an underbite for at least another 8 months has been on my mind every day. I’ve been trying to push it to the back of my mind, right back so that I can move on and in many ways just forget about it but it is proving to be a lot harder than I thought! I think despite everything I have been coping well with the news, after all I have been looking forward to this operation for a while now and I was just so close I thought it was finally going to happen but of course I was wrong. I can’t even begin to explain how living with an underbite makes me feel, I feel so many different things, everything from angry to sadness to feeling ugly and even hating myself for having an underbite.

Sunday was one of my worse days, I felt trapped within my body and I couldn’t do anything, I couldn’t physically make myself do anything! I isolated myself, stayed in bed and did as little as humanly possible in an attempt to get through the day. The day progressed and my feelings of angry and self-hatred intensified so much so I was forced to battle the crippling urges of self-harm.

It’s been a while since I have felt like this! Since finishing my DBT therapy in March I have been doing very well, with no incidents of self-harm and almost no urges however this urges were strong! Incredible strong and I just couldn’t find the power within myself to fight them off and so I planned what I wanted to do, I planned where I was going to harm and I even planned how I was going to hide the marks, I was all systems go but minus my implement. I went in search for something sharp enough to use, something which would cause damage and something which would provide me with the maximum relief and so I was lead to the all too familiar razor blade! What used to be my cushion, my safety net was once again providing me with some much needed comfort.

Now let me tell you, getting a razor blade out of the plastic can take some time and to be honest I was so glad that it took time! Yes I grew frustrated that I couldn’t get the blade out but once I did, once I got the blade out and once I had the opportunity to self-harm I realised I was better than that. Yeah I was hoping to get some relief from my thoughts and yeah I felt that harming myself was the right thing to do but when I actually got there, when I had the opportunity to do it I knew I couldn’t let myself go back down that road, I knew I couldn’t let myself begin destroying my body again.

I battled through self-harm and it has not been an easy thing to do, it has been a huge struggle actually. I have had many setbacks, bumps in the road, and relapses whatever you want to call them but right now I have been free from self-harm since February. 6 months, half a year, 20 weeks, 182 days without self-harm and I was not about to let my underbite destroy that!

Im not sure if it was my will power to continue my self-harm free days or if it was that the urges subsided by the time I got the razor out of the plastic but never the less I survived, I made it through the urges and I am so glad that I did not make that cut! I am so glad I can still say I no longer self-harm! Sunday was one of my darkest days which was no doubt brought on by my feelings towards my delay in surgery, my feelings towards my underbite and my feelings towards myself and I’m sure I may have many more of those dark days but now, now I know I can make it through those days! Who know I might self-harm in the future but knowing that I can claim victory against these urges, that could be the difference between a fresh cut and old scars, this victory is what can help me through future darker days and it is with a smile on my face that I can say I am in control and I am strong enough to get through each day without self-harm and what’s even better is that I am strong enough to throw away my razor blade, that cushion I once had is no longer my cushion and with that after getting through Sunday I threw away that new razor blade with delight knowing that it no longer could control me!

A letter to the Minister for Health

2nd September 2015

Dear Minister Varadkar,

I am writing to you with grave concern regarding the HSE services to manage children and young people with severe jaw disproportion.  I myself am a young person with severe jaw disproportion currently under the care of the orthodontic and oral & maxillofacial team from St. James’s Hospital, Dublin 8.

Two and a half years ago I began my treatment to correct an underbite which would involve a total of 18 months pre operation with orthodontics, corrective double jaw surgery involving a Le Fort 1 advancement to 50% of the defect and a mandibular setback of 50% and finishing with 6 months post operation with orthodontics. As part of my pre-operative treatment I was also required to undergo extraction of all four of my wisdom teeth under sedation.

It was to my delight on March 11th that I was informed by my consultant oral and maxillofacial surgeon, Professor Leo Stassen, I would be ready for surgery after having undergone my wisdom tooth extraction 10 months previously and after having my orthodontics in place for 2 years and 1 month. Plans were quickly put in place for a surgical planning meeting on May 6th with the hope of receiving my corrective jaw surgery in July of 2015.

It is with great frustration that I am informing you I have not yet received my corrective double jaw surgery. Since my planning meeting on May 6th 2015 I have struggled to contact members of the oral & maxillofacial team and have been told different reasons as to why my surgery did not go ahead as hoped as well as being told I was not on a waiting list, my surgery would not happen until August, that my surgery would not happen for another four months and now told I have been told that it will be another 6 months before I get another planning meeting which will be 2 and a half months before surgery is intended.

I am a 20 year old student of Maynooth University who has bent over backwards to facilitate this life changing operation, I have even had to change my college course to allow the surgery to take place. I have done everything in my power to ensure my surgery could take place and now I face another 8 and a half months before surgery, which again is not guaranteed and the timeframe could continue to grow in the coming months.

I have a long history of mental health issues including Borderline Personality Disorder and a history of repeated self-harm. It is with great delight that I inform you I have been free from self-harm since February 2015 after undergoing intensive outpatient Dialectical Behavioural Therapy for 6 months. However despite my current remission from self-harming and symptoms associated with BPD and depression the stress of not only having an underbite but also the constant delay of surgery it is beginning to take its toll on my mental health. I am currently in the process of arranging additional support from my community mental health team here in Celbridge to help support me through this difficult time. This surgery is a life changing operation  which will not only change how I eat and how I look but it too will allow me to live my life, it will change how I feel about myself and it too will allow me to move on and have a life. Simple things like getting up in the morning or brushing my teeth are made all the harder with this defect and it cannot continue.

Currently there is no option for me to have the surgery I need due to the lack of oral & maxillofacial surgeons and a lack of theatre capacity all of which can be changed with adequate resources. With this lack of organised care and poorly resourced service treatment is not being provided to patients with the highest need for treatment based on health and psychosocial factors. The HSE orthodontic Eligibility Guidelines were structured in such a manner wo prioritise service for the most disadvantaged children and young people, but we (patients and service providers) are facing a situation where the service completely fails these children and young people. The current situation is not only unsafe but it is unfair to all those involved, both patients and clinicians.

I am writing to you today urging you to make a difference to the lives of children and young people affected by severe jaw disproportion. Help give us our lives back by providing the resources needed to provide us with this life changing operation.

Yours Sincerely,

Siobhán Brady
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