Innerspace - part I

First off, call me daft, but this made me really quite sad: Pharmacists Defence Association

How have things got so bad that pharmacists have a union with a name like that? I know that unions are there to attempt to defend workers in all fields, but seriously, how under attack must they feel to need the word 'defence' as part of a name.

I'm aware that in recent years pharmacists have been pushed into taking on more and more duties, having consultation rooms on premises and so on - see The Welsh Pharmacist for a few cracking examples - but the name of the union says it all.

I had a capsule endoscopy last week. I think this is fantastic, non invasive relativley low risk test. But it's damn expensive, so my PCT view it as something of a last resort of all other methods have failed.

The first hiccup came with the instructions for the pre-test preperation regime. It would appear that a member of non-clinical staff has taken it upon themselves to amend this information.When I say 'amend' what I mean is 'balls-up'. Basic prep for any kind of internal camera is roughly breakfast the morning before test, light snack mid morning, clear fluids from midday and nil by mouth from midnight. It's a good job I know that, as the new leaflet advised me to have breakfast on the morning of the test and then go clear fluids during the test and nil by mouth after the test.

So I'm guessing there will have been a few people sent home recently, because good as the capsule technology is, it can't stand up to a full english.

So I turn up at the unit, get wired up and ingest the camera. So far so good. On checking with the nurse, she thinks that as I am off all meds, transit time should be fairly rapid, 6 to 8 hours.

So I settle down and wait.

High Noon

Good news. After an emergency appointment with my lovely specialist yesterday, I have new drugs.
I explained the whole work thing, how I am constantly tired and so on. I got a little bit emotional but managed to wheel out the stiff upper lip.

Me: I never wanted to go round the world on a skateboard before I had Crohn's, and I still don't, but I do expect to be able to go to work and not have to go to bed at 8pm.
Him: Not unreasonable
M:To give you an idea of how crap things are, I did two loads of washing yesterday and washed up - then had to have a lie down
H: So you would describe your life as?
M: In all honesty, crap. If this is to be my life, I'm not sure I want it.

Dr looks through huge file on me, being careful to keep a firm hold on it lest it slip off the desk and render the 2ft tall nurse unconscious.

H: Hmmm. Yup, your recent bloods suggest that you are indeed feeling like crap, physically. And I'm not surprised you are at the end of your tether with work.

I know he believes me, as under todays date in the file he writes ' X is feeling crap, employers being ridiculous.'

Here somes the sticking point. We both know that a steriod called Prednisolone will fix me up straight off. But we also both know that I will have to be off work to take the initial big doses and that eventually, steroids will make my arms and legs fall off.

There is an audible bing - followed by more leafing through the file - and a lightbulb goes on...

H: I've never given you Budesonide, have I?
M: No, but I have read about it
H: So you'll know it's a steroid, but with far fewer side effects than Pred?
M: Yes
H: How have I never given you this before? Humph

Dr tuts at hinself for a bit.

A shaft of sunlight enters the room accompanied by a choir of angels.

H: Right, lets do that then. You should feel better in about a week.

And just before I fall to my knees to give thanks that there is hope,and that there will be no hospital admission, he also says:

H: And if your enployers give you any more problems, refer them to me. You've been through a hell of a time in the last few years. I'll either speak to them or write to them, the idiots. Pfft.

And off I trot the hospital pharmacy to pick up my new drugs.

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.