Goodbye Kate?

I have been thinking about this one quite a lot lately.

There's an entry a while back about my friend Kate. At the time of this entry, it's been six months since I called her. She hasn't contacted me at all. I have had reason to speak to her husband to put some work his way, but from what he didn't say, it seems my absence has been totally unnoticed.

How to feel about this?

Disappointed, as it appears I am disposable. 18 months ago I was witness at their wedding, and now I am nobody.

Angry, because I worked very hard to include her in my life and to help her work thorugh a very tough situation.

And maybe even a little bit vindicated. I suspected that, as she only ever called me when she wanted something/needed to bitch about husband & family/was being ground down by work, I was being used. Looks like I was right.

So here's the thing. Their baby is due in five weeks. I will no doubt be notified of the arrival, probably by a mutual friend or text message. Do I send a card and gift, or do I just maintain radio silence?

Drug Abuse?

It's Saturday night and I'm staying in. It's cold and dark, I have an appointment with the specialist on Monday morning and I thought it might be nice to give him a set of blood samples that are less than 14% ABV.

And I'm in a tiny bit of pain. And I'm bored. But does this justify having a Tramadol?

For those who are not aware, Tramadol is an opiate based painkiller, that, as I understand it, works by increasing the flow of endorphins to either block the pain, or to make you not notice it. And by being an opiate, obviously.

Now, I'm a lucky odditity, as was discovered after my surgery a few years ago. I had the standard morphine push button drip wired up, but was still so stoned post-op that I had misheard almost everything the staff had told me, so thought I could get a hit about every 25 minutes, and jolly nice it was.

Sometimes I didn't need a hit for pain reasons, but took one from time to time as the ward was pretty chaotic and grim, so I guess you could say I used it for mental health reasons.
The days passed and the pain managment team turned up to assess me. And were very impressed by how little morphine I'd used.

Turns out I could have had some every five minutes. Bugger.

This and my reactions to other sedatives led to the conclusion that I have overdeveloped opiate receptors, which means any moderate dose of opiate painkiller works exceptionally well, and I also get all the good side effects - improved mood, a deep fascination with small things and generally have a very nice time.

Consequently, a single Tramadol would do nothing for most people, or at best might give them 3-4 hours pain relief, but leave me happy as a sandboy for about 8 hours.

But opiates can be habit forming (i.e. heroin), so must not be treated lightly. In theory I could take some paracetomol and hope for the best, but if I take some tramadol, I know it will work and also give me a good night being delighted with the thread count on my Egyptian cotton bedsheets....*

So I guess I'm wondering, where is the line between prescription drug use and prescription drug abuse?




*I spent a happy evening in bed after some tramadol pondering the egyptian cotton, thinking about the Nile tide irrigation system, the family that had grown it and how it had got from the cotton field to my bed and being generally grateful for the whole process.

Can I make an appointment to make an appointment?

It's been a few months I know, but I'm back at work and it's all been a bit special. Helped by the following turn of events....

I receive an appointment for my specialist on 19th October, bang in the middle of the day, so I duly book the day off work.

I then receive another letter saying that due to unforseen circumstances, the appointment is changed to 25th October. I suck my teeth a bit, but shove the letter on the pin board with the rest of the stuff I can't find a home for.

I get a third letter advising me that the appointment has been changed to December. This is meant to be a six monthly check, and December stretches it to nine months. I do not suck my teeth this time, this time I say a bad word quite loudly. And ring the hospital.

Kelly seems like a nice girl, but over the phone, I can her her tongue curling over the corner of her mouth as she attempts to enter my details into the computer with evenly spaced clunks. I am kind and patient, and explain that changing an appointment three times really isn't acceptable to me, and that my nice employers are struggling to keep up with the holiday chart.

She is polite, and explains there isn't anything she can do. I ask to speak to her supervisor, she says she will put me through. And the phone rings and rings......

I call back and ask for the supervisors' direct dial number, which I get, because I am kind and patient. I ring the supervisor. Natalie the supervisor is not kind or patient, and I begin to feel sorry for Kelly. Natalie says that appointments are cancelled because consultants 'just go off on holiday whenever they feel like it'. Although she doesn't say it, I think the next part of the sentence was probably 'and leave me to clear up the mess'. I explain that I must have an appointment in October. There is some thudding of keys and she says all clinics are cancelled at that time. I offer to call the Patient Liaison (wonderful people who get things done, and report to the Board). There is a pause, and then suddenly an appointment pops up on screen.

It is my original appointment on 19th October.

So why was it cancelled in the first place? The clinic is running, the consultant is not on holiday, and the NHS have wasted quite some money writing to me three times.

And...

Further to the below, work called at 1.30pm to say that, owing to transport problems, they couldn't come and would need to reschedule AGAIN.

So, next time I fancy a random day off, can I give them a call and say that I can't make it to work today because of transport problems?

Bah and double humbug.

Pick a number, any number...

The home visit from work (absence of over a month triggers a visit from HR) has been changed again. They haven't changed the day, but have changed the time.

My workplace are good. They haven't sacked me and pay me for several months when I'm ill, which I appreciate and am grateful for. But I've planned stuff today around the original time, and it would be nice if they could just stick to the plan.Inability to keep to arrangements is something that irks me. I find it inconsiderate at best and damn rude at worst.

Also, being geared up for a home visit puts me under a little pressure, and stress is not good for Crohn's. And it's just such a blah. There will be some small talk, then they will ask if there is anything at work they can do to help, or if anything has happened to make me ill. And, as in numerous return to work interviews, occupation health consultations and 'counselling' interviews, I will say no.

And I will explain that Crohn's disease is an auto immune condition that is chronic, and will continue to flare up on and off for the rest of my life. I'm one of the unlucky ones who has never managed to get into full remission. I've explained all this to the same people on *thinks for a moment* more than a dozen occasions. I've handed over literature, notes from specialists and web links.

I've gone to private consultations with a doctor of their choice in a town 20 miles away. Interestingly, he was quite bemused to see me in a nice but 'what do they expect me to do/say about it?' way. I've given them access to my medical notes, GP and specialist.

As I said, I'm grateful that I still have a job. However, I did make my condition known at interview stage, and it was their risk to employ me.

It's just that if I have to go through my medical history one more time, very slowly, so that it can be written down on another form, spelling out the names of my medication and explaining what it is and what it does, I might just loose the plot.

Should I just type it all up and have twenty copies run off and laminated for future use?

The procedures went well, nothing unexpected turned up, and I go back to the specialist in two weeks for biopsy results. The sedation was unparralled. I will blog more about this another time. In the meantime "Keep on taking the tablets".

I'm entering the state of suspended animation that comes with a long term absence from work and social life. I've been here before, and I'm doing my best, but I'm having extreme mood swings, sometimes affected by outside influences. The swings vary from happiness to utter despair.

The despair end of the spectrum is facilitated by the utter selfishness of two of my 'friends'.

One, we'll call her Kate, has always been fairly useless at being proactive in friendship. You know, the sort of person you speak to regularly as long as you ring them. She married one of my friends, moving from a different area, so we became friends by default I guess, but over the years, I thought we'd become quite close. In the last six months, I have become increasingly resentful of making all the running and have significantly cut down on the amount of times I call her. Result? I've heard nothing from her for weeks, since I last called. I know, with friends like this.....but I also know that when a crisis hits her, my phone will start ringing.

So how do I deal with this? In one respect, I'd like to let her know how much her disregard of me hurts, and say that this is why she has lost touch with friends from university (they got fed up of always being the ones to contact/make arrangements) and that this is why she has no other friends (she's been introduced to lots of people, who later on, have said to me in passing 'Kate never rings me/rings me back. Can't be bothered with that. Shame really, I quite liked her'). In another, I know I should just leave it and be unavailable when the inevitable occurs.
Which will be hard, as I've know her husband for 15 years, and If I ditch her, I ditch him.

The second is more hurtful, because the behaviour is out of character. I can only assume I have done something to offend (brain racked, nothing found) or that he just can't be bothered.

I know all the above will be magnified by the fact that I'm a bit ill at the moment and that I'm stuck at home a lot. I'm trying hard not to sink into a depression, but some days it's just really difficult. But I have other excellent friends who are good at giving me a swift kick in the pants when required. I think it's time to book a foot/butt contact and get myself together.

I had a doctors appointment on Wednesday. The usual receptionist was back in place.

Me: Hi, I have an appointment with Dr Raj at 4.10?
Her:(smiles)Hello, is it name?
Me: It is.
Her: Would you like to go straight in?
Me: Thank you.

And it's that easy.

Also on the postitive side, the conversion of the derelict building next door is going well, judging by the amount of noise created. I'd especially like to commend the chap who was cutting new stone with an angle grinder/stillsaw at 5.30am yesterday morining.

Where the sun don't shine

I have known my Crohn's specialist for longer than my husband. We have a good relationship, I understand my condition, and he respects my opinions and decisions. I appreciate the constraints he works under. We have ridden the test/prescription/funding/admission merry go round many times.
I had an appointment yesterday morning to sort out some drugs and discuss the strategy for the tests I'm having tomorrow. Becuase he knows I will answer questions with more than a grunt, he occasionally throws me a medical student to play with a junior doctor on rotation. This mornings was a very professional and earnest young chap with an African accent. We discuss various things. After a few minutes, my consultant enters. I tell him that the letter about my procedure took several weeks to arrive, so in the interim, I rang the Gastro unit myself and booked a slot.

Him: So, 1.30 on Friday then..I'll ensure the red carpet is out.
Me: If you could. And I'd prefer the string quartet in the corner this time.
Hin: Fine. And the potted palms?
Me: Oh, as before

The junior doctor looks a little confused, but relaxes as we discuss the nitty gritty of canulas and sedation.So this time tomorrow, I will be sleeping off the finest Class A drugs the NHS has to offer, and hopefully be a bit further forward with the latest round of treatment.

Secretly, I'm a bit scared. I'm having an ileoscopy (camera in stoma) colonoscopy (camera up the bum) and endoscopy (camera down the throat into stomach). The first two don't bother me at all. I've had them before, and while I wouldn't recommend them for a fun night out, they are ok. It's the third one. I'm just not keen on something down my throat. At all.

The part of my brain that is rational knows that these tests are necessary and sensible. They will give a clear idea of how my disease is behaving, and any added complications such as ulcers, which will afect the choice of treatment.

The part of my brain that is still four years old knows that I don't want to do this. I want to go to the seaside and eat chips.

The part of my brain that is a gobby socialist knows that if I was rich and living in London, I wouldn't be having anything put inside me. I would be having a scan.

And the part of my brain that gets me through everyday life knows that I will grin and bear it and try not to say 'F***' in front of my good doctor.