Grumbling Stomach v Patient Care

Last week I had my check-up with the rheumatologist – an annual highlight of my social calendar, alongside sorting the car’s MOT and having a smear.  As a rule, these appointments generally consist of 1 part disappointment: 1 part frustration: 2 parts total despondency.  They go something like this:

I arrive at the hospital with a well-prepared list of questions – I’m feeling positive, in control and determined to be heard.  I queue to get into the carpark, hand over a fresh pot of wee, get weighed and then wait.  And wait.  And wait.  I eventually get summoned.

I sit, he asks ‘So how do you feel?’ and I answer ‘Terrible‘ (that’s always a given).  He flicks his eyes across my notes and promptly declares that my bloods are looking good.  Less than two minutes after entering the room I am leaving it.  All my well-prepared questions are unasked and unanswered, my positivity is completely squashed and my ‘in control’ voice has been gagged and muted.  I scuttle off to the ticket machine, often in tears and always fuming – at him for making me feel so unimportant, at my body for being so useless and at myself for not having the balls to speak up more.

Why consultants (particularly male ones) seem to have the ability to render me a pathetic, jibbering wreck who actually feels guilty for taking up their time, is a complete mystery to me.  I think perhaps it’s the overpowering God complex they use to hypnotise patients with.

I wonder, do other people also feel ‘sshhhed’ into submission by all-knowing consultants, or is it just me?  And what about male patients?  Do they let themselves get steamrollered too?  Answers on a postcard – or in the comments below!

Anyway, where was I?  After a lengthy queue at the machine, I find out that once again I’m over the allocated ‘free’ parking time by 0.2 of a second, despite my appointment having only last two minutes.  I also realise I don’t have enough coins to pay.  So I leave the queue and join another, having to buy myself a muffin from the overpriced cafe just so I can get some change.

The muffin is invariably dry and totally inedible; it’s the final insult to an already depressing trip.  The muffin ends up in the carpark bin, I promptly scrape the hubcap against the pavement while trying to negotiate the hairpin bend of the exit and then, low and behold, I see that the ticketing barrier is permanently up.

Like seriously?  Is there anything more annoying than being made to pay for something that you don’t even have to?

On this last trip, for the first time, I decided to take my husband with me for back up.  I thought perhaps this might counteract all that testosterone swirling around the room.  I also wanted him to experience Dr Complete Lack of Bedside Manner for himself.

Sadly, on this appointment, it was not to be.

Being the last patient of the morning shift, Dr CLOBM (as I shall now refer to him) had decided to skip his customary two minutes with me and head off early.  The first I was aware of this was when a registrar called me in and said he’d be filling in for Dr CLOBM as he’d been called away for a ‘meeting’.  Had he heck, a meeting with his stomach perhaps.  My husband had already clocked him in the corridor, heading for the exit and telling his medical student to go on and get them a table for lunch.

I know!  What a bloody liberty!  The man only has to see me once a year, couldn’t he have overcome his hunger pangs for the couple of minutes that he normally allows me?  After all, there’s plenty of other things I’d also like to be doing with my precious energy rather than queueing up, giving wee, getting weighed and waiting.

As it turned out, he and his grumbling stomach had done me an almighty favour.  As the fill-in registrar had not yet reached the lofty pay grade that causes ears to stop working, he actually took the time to listen to me and answer my questions.  Even more of a revelation: he asked about the pain I’m in and, for the very first time, properly acknowledged my fibromyalgia.  Halle-bloody-lujah.

He examined my hands (never happened before) and tested the fibromyalgia pressure points on my body (certainly never happened before; didn’t even know they were there). He also explained why my memory is currently shot to shit, and how and why my body wasn’t able to deal with the pain.  He then referred me to the pain clinic.

Thank god Dr CLOBM had considered himself and his plate of foie gras and chips more important than seeing me that day.  For the first time, I left the hospital feeling vaguely upbeat: not because I think I’m going to be ‘cured’ with revolutionary tips on pain management, but because I’d finally been allowed to have a voice.

When you live in a world ruled by chronic illness, where doctors control your drugs, your future and your fate, being ‘heard’ is a monumental achievement – as much as an achievement as when Armstrong went for a stroll on the moon.

So that’s one small step for (chronically ill) me, one giant leap for womankind.

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Why Chronic Illness leads to Loneliness

I think it’s true to say that all chronic illnesses have one symptom in common: Loneliness.

For me, it can be one of the worst symptoms of the lot, often battling it out with Pain and Fatigue to ‘win’ the day and get one over on me.  For healthy, socially active and ‘other side of the bars’ people, it must seem odd that a state of mind could ever pull top trumps on a physical pain, but in many ways it does.

To understand how it’s probably best to dissect each symptom: surgical gloves at the ready!

Let’s start with Chronic Pain.  In whatever wonderful form it takes, there’s no disputing that this one is unquestionably an evil bastard – unrelenting and utterly vindictive.  It takes no prisoners and gives no time off for good behaviour.  I won’t woffle on about just how bad Pain can be, as I’ve already covered that here.  And here.

But Pain (in its simplest, non-chronic form) is a widely known entity.  There isn’t a person alive today who hasn’t felt its wrath, from a grazed knee and pesky splinter to a twisted limb and broken bone.  And let’s not forget childbirth – the mother of them all!

This shared understanding of Pain makes it socially acceptable: it can be openly discussed and easily emphasised with.  No GP will ever panic if you tell them about Pain, they’ll just reach for the prescription pad (or keyboard, these days) and bombard you with drugs.  In the case of Chronic Pain (or mine at least), most of these pain ‘killers’ barely scratch the surface; they’re as effective as a hit man with a cast iron moral compass.  But at least for Pain there’s plenty of meds and it always makes me feel slightly proactive to pop a pill.

Then there’s Chronic Fatigue, an equal to Pain in every way.  Real, wall-hitting, concrete-encasing, treacle-plodding Fatigue is the undisputed Queen of All Bitches.  It drains the life out of life and the fun out of everything.  But I’ve already covered my hatred of Fatigue here.  And here.  And here’s my Top 10 Things That Fatigue Isn’t list.

Unlike Pain, however, Chronic Fatigue has to be experienced to be truly understood.  It is not the same as tiredness (that everyday, run-of-the-mill stuff that everyone feels) and nothing else compares.  In my opinion, Fatigue is a powerful force for evil: The Dark Side, Dementors, Death Eaters and The Eye of Sauron all rolled into one.  It’s impossibly hard to fathom for those with bounce and vigour and this makes empathy rather thin on the ground.  There is some, however, as  Fatigue can make you look like the walking dead and it’s obvious to all that you’re really not feeling great.

Sadly there are no pills for Chronic Fatigue, but it can (according to the ‘medically’ trained) be aided by rest.  And taking it easy.  And learning to pace yourself.  Please just excuse me here while I roll my eyes.  What all this Fatigue and resting and spending time on your own does lead to is… the actual point of this blog.

Loneliness: an entirely different type of beast and the Satan of Symptoms.

For me, Loneliness is something that sweeps in and out of my life, like an all-consuming surge of water in a particularly menacing storm.  Whether it comes from nowhere or accompanies a flare, it always takes me completely unaware.

It creeps up on me whilst I’m focussing on Pain.  It slinks into the room while I battle Fatigue, filling up every last bit of space until I feel I can’t breathe.  It sits beside me when I’m resting, invading my thoughts and slowly drip feeding negativity into my brain.  It’s as if the worst of my insecurities and crippling fears are joining forces, playing games with an already fragile mind.

It’s hardly a surprise that Loneliness stands shoulder to shoulder with Anxiety and Depression.  They’re like a small coven of witches all hell-bent on dragging me down.

Yes, Loneliness is a bleak and terrible place to find yourself: dark and isolated and a million miles from everything that feels familiar.  It has the ability to transform any environment, no matter how safe and secure and make it feel empty and odd.  It’s the unsettling feeling that something is ever so slightly out of place, but you just can’t put your finger on what or why.

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Loneliness for me is like looking out at the world from behind a set of bars.  It’s seeing life carrying on around me, life carrying on without me.  And however much love may surround me it doesn’t change the feeling that I am completely alone.

In part that’s because it’s true.  Loneliness is something that I often feel and think about but very rarely discuss with anyone.  Partly because I don’t want to cause offence to those who are always by my side and partly because I don’t think anyone else would really care.  Maybe I’m wrong, but I don’t think so.

The worse part of Loneliness is feeling that it’s so damned obvious that everyone around me should be able to spot it.  I really, really want someone to notice how I feel, but of course, it’s as invisible as all the other symptoms so no one ever will.

Even my rheumatologist doesn’t.  He’s certainly never asked me whether I feel utterly alone with the collection of diseases it’s his job to treat; he couldn’t be less interested in my state of mind.  All he wants it for me to take my meds, never query his opinion and turn up once or twice a year to be ticked off his ‘to see’ list.  My new GP also steers clear of Loneliness.  Maybe that’s because she can’t afford to open the floodgates and release the tidal wave of tears that’ll inevitably come.  She knows it’ll be nigh on impossible to replug that dam in a 10-minute allocated NHS time slot.

So maybe my worst symptoms come down to how much understanding and empathy they evoke.  This puts Loneliness on the winning podium as how can there be empathy for something when no one even knows it exists?

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Alive. Kicking. Almost.

Oh dear god, it’s been more than a year since the last post.  There’s so much tumbleweed drifting around this barren landscape I call a blog that I can barely beat a pathway through to the ‘New Post’ button.

I do seem to be making a terrible habit of avoiding my screen and I’m not even sure why.  Every day I wake up with the very best of intentions.  Every night I promise that the next day I’ll definitely do better.  Procrastination in its finest form, I’m sure you’ll agree.  Sadly this terrible lack of motivation seems to have infiltrated almost every aspect of my day-to-day life.

Much like a petulant, sulking teenager, one day, Motivation simply gave me a withering look, rolled its eyes and then disappeared under a festering duvet.  Accompanied by (oh so easily led) Mojo, they both holed up in the dark, barely visible amongst piles of cushions, hoodies and assorted technology beginning with ‘i’. They blocked out the world (except for the WiFi, obvs) and slept like the dead, surviving on nothing more than carbs, Spotify and Netflix.  Sunlight was met with shrieks, hygiene was minimal and conversations consisted of no more than one syllable.  Earphones kept all pleads, threats or bribes at bay.

It was neither a battle or a war I could win.  I’m a mother of a teenager, I knew that.

To make matters worse, at the exact time Motivation descended into pubescent hell,  my ‘Oomph’ simultaneously went into hibernation overdrive and Creativity went AWOL – last official sighting, 28th May 2017.  I put that last deserter down to writer’s block on a gargantuan scale.  The Trump wall of writer’s block, if you will.

Like I said, this last year really has been procrastination in its finest form.  To highlight just how bad it became, both my 2017 and 2018 New Year’s resolutions were to try to write more on my blog.  That panned out, clearly.

Come to think of it, my other three resolutions for 2017 and 2018 also proved something of a non-starter.  They were: to start exercising more (and when I say more I mean to actually start); to make the time to meditate (instead of watching trashy but extremely enjoyable TV); to sell everything I don’t need on Ebay.  Needless to say, my yoga mat was last seen loitering on top of the wardrobe, my Headspace membership expired with an embarrassing lack of use and my Ebay account has been as badly neglected as this blog.  Fail, fail and epic fail.

There is, naturally, a valid reason for all the tumbleweed and radio silence.  It’s called life, and it’s mainly been shit.  I’d go so far as to say that life has completely drained the last jot of energy out of me.  If the last year was put on a spectrum ranging from ‘Rainbows and Unicorns’ through to ‘Complete and Utter Misery’, I’ve probably been hovering right around the ‘Big Dark Hole’ mark.  That’s somewhere between ‘Up A Creek’ and ‘Where Exactly Is The Light At The End Of The Tunnel?’  Nope, not a flicker of a rainbow or a bleeding bloody unicorn insight.

Daily existence has mainly centred around pain, with some exhaustion, frustration, upheaval and therapy thrown in for good measure.  Then there’s been the depression, with a side helping of despondency, debt and despair.  Oh yes, and a little bit of death, like a sprinkle on top.

A right barrel of laughs it’s been.  A ‘fed up/screw everything/ I give up’ type of year in which I just haven’t felt engaged enough with my brain to type anything worth reading.  Certainly, nothing that you, most lovely reader, would want to digest.  That said, other people’s misery does have a wonderfully warped way of giving perspective and cheering the soul, so perhaps I’ve done you all a massive disservice.

Anyhow, I’ve decided that things need to improve, at least on the blog front.  So I’ve dragged a stinking Motivation and Mojo out from under the duvet and slung them in the shower.  Oomph has been given a triple espresso and Creativity has been frogmarched back from the wilderness and shackled to the keyboard.  Now we’ll just have to see how that all goes.

So thank you – to everyone who hasn’t unfollowed me, to all those who’ve recently shown their support and for the truly lovely comments that have helped to remind me why I started the blog in the first place.  It’s a mixture of all of the above and my therapist’s steel-capped boot up my backside that’s (hopefully) got me back on track.

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‘Top 10’ things that chronic fatigue ISN’T

Following on from the last blog about unwanted opinions, here’s my ‘Top 10’ list of all the things that chronic fatigue isn’t.

Feel free to print it off and wave it around in the faces of all those doubting non-believers!  Better still, why not download the PDF, print onto A3 paper and stick multiple copies around your home or place of work!

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When opinions come thick and fast

There are just so many helpful people out there in the world, all rushing to give their opinion on what chronic illnesses are or aren’t, and what they think will cure them. Opinions that are, more often than not, based on judgmental presumptions, half-baked facts and an irrelevant article they once read about an entirely unrelated medical condition.  A condition that was (according to Bella magazine) miraculously cured by dancing naked in the moonlight whilst chewing on the roots of a cactus plant.

Granted, sometimes these opinions do come from a place of caring and concern, but that doesn’t mean they sound any less patronising, insulting or annoying. Accusatory is how they often come across.  Like we’re somehow greatly exaggerating how we feel.  Or perhaps all these ailments are really just in our heads.  Or maybe there’s a glaringly obvious solution that we simply haven’t bothered to find out about for ourselves.

You haven’t got the first bloody clue.  Please remove your interfering beak from my business“.  Is what you want to yell.  But you don’t.

Who knows, perhaps it’s human nature that makes people always feel obliged to offer up an opinion or want to ‘fix’ things they don’t fully understand.  A bit like a man, I suppose, who when presented with a problem, will always try to solve it, instead of just dishing out the sympathy that’s required!

Having read countless posts on countless Facebook forums, it would appear that the majority of these uninvited and insensitive opinion givers are often those found closest to home: the spouses, parents, siblings and friends of the chronically ill. People, in other words, who you’d expect to be offering empathy, sympathy and a whole lot of understanding.

I think the trouble here lies with so many of these conditions (Lupus, Sjogren’s, fibromyalgia, CFS, chronic fatigue, chronic pain etc) being an invisible illness – and one that often involves two very different faces.  So unless the opinionated person in question has seen firsthand the fatigue or symptoms at their very worst, they can’t even begin to comprehend how life-changing and debilitating such a disease can be.

On the other hand, all these unsolicited opinions could just be down to that person being a thoughtless, self-involved, mentally draining, arrogant arsehole.  And if that’s the case, telling them to sod off out of your life is probably the simplest solution of all.

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Oh, give me strength

Forgive me while I scream.

Back in August, I clocked in at the hospital for a check up with my Lupus nurse.  It was one of those ‘we understand, we care’ sort of appointments.  I told her how let down I felt by those overseeing my healthcare.  I mentioned I was concerned about my periodic bouts of doom and gloom.  I said I was worried the Azathioprine might not be doing its job.

Fear not, she reassured me, I’ll book you an appointment for 3 months time, that way I can double-check you’re ok and see if the meds are on track. Offer accepted and appreciated.

Then yesterday I received two letters in the mail.  The first informed me that my appointment in November has now been cancelled; they hoped this wouldn’t cause me too much of an inconvenience.  The second letter said my appointment had now been re-booked.  For 8th August 2017.

2000 and bleeding 17.  I admit I did a double-take on the year.  Then I swore.

How reassuring that one minute they deem it necessary to check I’m not wallowing in depression or taking ineffective meds, then the next I’m put on hold for another 10 months.

I’d like to say I was shocked to the core, but I’m not.

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Dr. Pitbull takes charge

Recently something I never thought possible happened: I stumbled upon the very best GP in the world.  Who knew such a doctor even existed?  I’d certainly given up all hope of hunting down such a rare and mystical beast.  Up until this point, I’d have probably given better odds to coming down one morning and finding a unicorn eating breakfast at my kitchen table.

It was a friendly, blood-taking nurse who originally pointed me in his direction.  I’d been having a moan about the less than impressive medical care (namely the great Azathioprine fiasco) I’d experienced recently, saying I felt completely let down.

I know just the doctor for you,” this nurse told me.  “You’ll like this one, I promise.  He really cares and he’ll definitely fight your corner; he’s like a pit bull.

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It all sounded too good to be true, I thought, but worth I punt, so I made an appointment to see him. A month later (yes, it can sometimes take that long to get an appointment) I rocked up to the surgery.

Well, blow me down with a feather if that nurse wasn’t right.

He didn’t try to rush me out of my seat or make me feel like an inconvenient hypochondriac.  He asked questions; he listened; he genuinely cared. And then, just when I thought he couldn’t have got any better, he said something that I’ve often thought but would have never dared say out loud, and certainly not to a doctor.

Lupus is a really terrible thing to have,” he agreed.  “If it were cancer, then everyone would know you were sick; they’d make allowances and care a little more.  But I image when it’s a disease like this that no one can see, it must be very frustrating to have it ignored or not taken seriously.”

Well, didn’t Dr. Pitbull hit that one square on the head.  It definitely goes down as the most empathetic thing a doctor has ever uttered in my presence.  And then it got better still.

You don’t have to settle for inadequate treatment, you know,” he continued. “You do have other options“.  This was news to me.  “Would you like me to refer you to the Lupus Unit at Guy’s Hospital in London? ” he asked.

Can you even do that? ” I said, “No other doctor has ever mentioned the place, let alone offered to send me there.

Yes, of course I can, ” Dr. Pitbull said.

This all happened a month or so ago, and, if I’m honest, I’d filed our conversation to the back of my mind, along with all the other pipe dreams that are unlikely to ever happen.  You know the ones:  full health recovery, Euro lottery win, shifting the muffin top – that sort of thing.
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And then, out of the blue, an appointment alert popped up on my phone.  Dear god, he’s only gone and done it.  On 10th November I’m getting my foot through the door of the largest Lupus unit in Europe – a place filled with doctors who treat nothing but Lupus every single day.

As if that wasn’t enough of a reason to worship at the feet of my new, wonder GP, in the months since I transferred over to him, he’s also proved to be everything the nurse prophesied and more.  As promised, he emails me the minute my bloods come in to tell me the results and check I’m OK.  He then replies within minutes of my reply, regardless of whether it’s his day off or rather too late at night.

Yesterday, (a Saturday, no less) he took doctor care to a whole new level.  When replying to his email, I said I’d felt terrible all week and couldn’t sleep.  Straight away he came back and asked if I’d like to see him next week.  That would be great, I replied, but I’ll never get an appointment with you.

Low and behold, a few minutes later, another appointment alert for this Thursday popped up on my phone: he’d only gone and sorted it out himself.

Give the man an early sainthood.  He’s single-handedly proved that some doctors are worth their weight in diamonds.  And that, with the right people in place, there’s still hope for our NHS yet!

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