Into the system…

blogging, work, mental health, therapy, disability, benefits and more…

Posts Tagged ‘constipation

Tummy Troubles…

with 14 comments

I am still struggling with the tummy troubles. I have been taking the higher dose (120mg TDS) of Alverine Citrate for a few weeks now and I do think it has helped a little, despite the fact I have also increased the Reboxetine to 8mg in that time. I was getting less cramps at least, although I was still having problems with diarrhoea or constipation all the time. My appetite had improved a little, which must suggest things have been a little better.

Unfortunately that slight improvement has been completely negated by the events of last night. A warning – this post definitely scores high on a rating of too much information!

I had been feeling fine and had enjoyed my dinner of roasted ham, mash, kale and carrots. As I was getting ready for bed and just settling down to watch Newsnight, I got a sudden shooting pain in my tummy and next thing I knew I’d had a somewhat messy accident. :S :( I was so shocked and upset, it took me a second to act and jump into the bathroom (which is within a metre of the bed), although by this point it was far too late anyway. The bloke was horrified and just shouted at me, called me disgusting and hid in the back bedroom, whilst I stripped the bed and took a shower. :( I was feeling pretty rough by this point and thought I might be sick as well, but managed to keep that end under control! The bloke eventually realised I wasn’t very well and that he was being unreasonable and he apologised and started to make the bed. I didn’t know what to do with myself. He wasn’t going to let me in the bed after that, so suggested I got the air-bed out! At least that is plastic and cleanable in case of further episodes. I didn’t expect to sleep much anyway, so decided to do this and settled down under the spare duvet on the lounge floor.

I was awake most of the night and felt pretty rough, but managed to survive without any further accidents. I’m still feeling pretty dodgy now, although by now I could just be hungry. I am too scared to eat anything though.

I don’t really know how to say this, but the poo didn’t look good at all. Very dark brown, sticky, runny and lumpy including some undigested carrots. Not nice at all. The fact it happened so suddenly suggests things aren’t very happy in there either. If I could have done anything about it, I would have. There was no warning at all, except for the shooting pain that came with the attack. It literally came out and exploded like the lid off a pop bottle that had been shaken up. bleugh. Sorry. You don’t need to know that.

The bloke wanted me to book an appointment with Dr N, so I am seeing him this afternoon. I am not sure what he can say or do. I have no idea how I am going to tell him without dying of shame. Part of the reason I am writing this, is to practice describing what happened! I am far too British and shy to talk about poo. Even with a doctor. It has been hard enough to tell him of my tummy troubles so far, but this is an extra level of embarrassment.

I wasn’t sure about writing about this here as it is so embarrassing, but it is the latest thing to happen in the whole tummy troubles saga and something so horrible seemed worthy of note. After all, this blog is an account of some of the more grim elements of mental health. Coping with the side effects of medication is a big part of dealing with mental illness, so I may as well be honest about it.

My bloke was very shocked and not very impressed. He wants me to stop taking the Reboxetine if that is what is causing this. He said he doesn’t like living with an 80 year old. I agree. I don’t enjoy feeling like one.

I had been struggling with the increase in dose aside from this. My sleep has deteriorated and I only find I can sleep properly when the dose wears off in the morning, when I should really be getting up and taking the next dose. It takes ages to get to sleep, I am waking up all the time and struggling to get back off to sleep and I am having nightmares and feeling restless. It is exhausting. I was getting palpitations at night too, immediately after the increase, although that seems to have settled down a little after a couple of weeks at the higher dose. I felt really low in the first week or so too, but that also seems to have improved over the last couple of days, so maybe it is starting to have a more positive effect now. That said, I feel crappy today after the night I’ve had!

I am too scared to stop the Reboxetine though. I don’t want to go back to how I was before. I don’t want to end up really depressed and suicidal again. The perpetual low mood and vague depression of late is draining enough, but that constant despairing depression is much, much worse. I don’t know what alternatives there are. Maybe I should just go med-free and sod all the drugs and their stupid side effects. I still wonder if my mood would have resolved itself a lot faster if I hadn’t have started taking bloody medication. Then again, it may have killed me first.

In good news. I got my driving license back!

I now have a 1 year license, so I need to stay sane over the next year or I will lose it again. Apparently, I will get a form 3 months before it expires to request a renewal. They will go through the medical enquiries again and decide if to reissue. No doubt it will take 5 months again to do that, so I will not be able to drive again for a wee while, but I guess we will see how it goes next time. If I get worse or am told by my doctors to stop driving for whatever reason, I have to let them know and presumably I will have to wait months for them to decide again, so I hope that doesn’t happen.

It is great to have my car back. I am looking forward to going places and having my independence again. I think it will make a big difference in helping my recovery. Being able to go where I want and not having to rely on public transport or lifts from the other half is going to be a massive help. I have a lot more choice about what I do with myself and will be tempted to go out more.

I had a drive on Saturday afternoon after I’d insured and taxed it and it didn’t feel too strange to be back at the wheel. The bloke went with me and we made it in one piece. My left arm has remembered where all the gears are and it felt pretty natural, so I am glad I hadn’t forgotten it all.

On Saturday night we went out in my car and got pulled over by the police! I wasn’t driving, the bloke was. It had flashed up on the policeman’s dash that the car was uninsured – obviously the database hadn’t been updated since I had only insured it that morning. I am glad I wasn’t driving or I’d have panicked. I would say I’d have shat myself, (I think I did on Saturday night!), but I’m not sure that’s appropriate now! *blush* At least we can say the police are on the ball! We were off to a beer festival and although my bloke was only going to have a pint as designated driver, we decided not to take the risk of being pulled over again later, so we left the car and got a taxi back. We went back to get it on Sunday morning and I took my first solo drive, driving my car back. I was okay, although I had forgotten which lanes I needed to be in a couple of times, so I made life harder for myself.

Anyway, I need to get ready for my doctors appointment. I haven’t got dressed yet and am just lying on the sofa with a blanket. Walking around makes me feel worse, so the temptation is to lie here all day. I have a meeting to go to this evening though, so will have to get up eventually.

Edit (3pm): Appointment with Dr N was very embarrassing and not too much help. I had been taking senna daily, plus the occasional dose of lactulose to counteract the constipation I was struggling with, but he thinks that won’t help on the maintaining control front, so I should stop that for now. If I don’t take it, I usually end up in pain and bloated from the constipation within a day. He has given me a script for something else to take if that happens, so we shall see how we go.

We talked about coming off the Reboxetine, but he didn’t think that was worth the risk at all. We don’t know if my mood picked up spontaneously or if the Reboxetine helped, but either way, my mood is a lot better and it doesn’t seem wise to mess around with it. I may have to drop the dose to 6mg if the problems persist, but I was struggling enough on that dose, so don’t suppose it makes much difference.

We talked about sleep and he asked if I wanted to try more sedatives, but neither of us really saw the point as they don’t seem to help all that much. He made the suggestion that actually getting back to work and having more brain stimulus may help, which in theory is true, but I never slept that great when I was at work. Even when I have been busy lately, it hasn’t made any difference, so I’m really not convinced by this. If anything if my brain is busy during the day, I really struggle to slow it down at night, especially if I get anxious too.

Mentioning work, I told him about seeing Dr Occy Health again on Thursday. He thinks I should push to agree a planned return to work as having a structure and plan may help give me something to aim for. I think he is right, although I am wary of the risk of too much, too fast. I told him about going in a couple of times and he agreed that was promising, although I also said that my work are very hesitant to let me rush back. They are being very cautious about how much I can do and when I can do it. I actually got told off for doing work-related activities whilst I was there the other day. We will see though.

Other things…

with 7 comments

Aside from the therapy assessment, there is a whole host of other things that I want to write about. I don’t really know where to start, but I’m going to have a go, because I think it may help me to get some of these thoughts down at last.

I need to start giving myself some more time. I’ve taken a twitter hiatus lately to try and free up some time, but it doesn’t seem to have made any difference. If I was spending an hour a day or whatever (probably more like 3 if I’m honest!) on twitter, I want to know why I don’t have an extra hour spare each day?

I am not sure if I prefer to have twitter in my life or not. Leaving twitter should at least reduce the number of arguments with the bloke – twitter is quite often the trigger for them, but whether or not it really has remains to be seen. He will probably just find something else to criticise. If he gets to win the argument on twitter, he will go back to trying to get me to completely stop blogging as well.

It should in theory give me more time to do other things, but I don’t think it has made much difference. It is very much true that whatever you have to do, will always expand itself to fill however much time you have to do it in. It is the same in that I haven’t worked for 2 years, yet I seem to have filled my time with other things. I don’t quite know how I would squeeze work back into my life, although I’d work out how to somehow I guess.

I do feel like I’ve lost something without twitter. It gave me two things. A feed of interesting information about the world in general and a more personal support group from the madosphere. I am missing both of these for different reasons.

The lack of general stuff leaves me feeling just a little bit behind. Twitter is great in that it can keep you up to date with things, real time. I have to go to more effort to find out things and to keep on top of the latest goings on. If a band that I follow releases tour dates, they will usually tweet about it. Now I have to wait until I spot them on some listings or on their website. If someone posts a news story about something I’m interested in, chances are I’d see a link to it on twitter pretty quickly. I am having to pay more attention on BBC News to spot things of interest. I guess I can do without this info, but when you are used to having it fed to you all the time, it is weird to go back to having to look for it. Twitter is certainly convenient. You can pretty much find anything on there if you wanted.

I am missing the support group side of things too. I feel that by stepping away I am neglecting people and I really don’t want to do that. I hope that people don’t take my hiatus to mean I am not interested in them or don’t care about them any more. It is not about that at all. I feel like I am letting people down by not being there all the time. Of course I miss receiving the support of my twitter friends too. It is nice to know that there is nearly always someone out there to talk to if you feel like it. It makes the world a little less lonely.

I do miss it, but a lot less than I thought I would to be honest. I can live without it, which maybe surprises me a little. It is convenient though

I don’t know if I will go back, stay away longer or perhaps just change how I use it. Maybe I will go private for a bit? I don’t know. If you are waiting for me to go back though, don’t hold your breath.

I didn’t start out with this post to write about my twitter hiatus, but there we go. It was something I wanted to explain on my twitter feed, but hardly possible with 140 characters. At least by saying it here, I can feel like I haven’t gone without explaining myself.

_______

So what else is there?

Physically, I am struggling. I have been suffering with persistent “tummy trouble” and irritable bowel issues lately. It has been there for months now. I was too embarrassed to say much at first (no one really wants to share their toilet habits do they?) and I thought it would improve, but it just got worse and worse and has been making things pretty rough. Constipation, diarrhoea, both, often with urgency, occasional vomiting, frequent nausea, awful tummy cramps that rival the worst period pain, chest tightness/pain, bloating and lack of appetite… None of which are particularly fun and when it all happens at once it makes you feel pretty awful.

Dr N and I are both pretty sure it is the Reboxetine to blame. I saw the locum last week as Dr N has been on holiday for a few weeks. He got me to have a collection of blood tests to see if there was anything else to explain things, but they didn’t bring anything up. I phoned up for the results on Tuesday and the receptionist reeled off a long list of the ones that were clear, but said I should come in to see the doctor about my liver results. I had a suspicion that this would happen, as it has done in the past. Apparently, one of my liver hormone levels is slightly higher than it should be, but it has been for some time and it is actually a little better than it was earlier this year. The other doctor probably wasn’t aware of this, so wanted me to see a doctor, but Dr N wasn’t worried about it. He did tell me that I should really keep any drinking to a minimum though, as my liver will struggle with any heavy drinking. I don’t tend to drink very often or very much anyway, so this isn’t so much of a worry, but it is a little concerning if I am going to be taking this medication in the long-term. Dr N thinks it will go back to normal if/when I stop taking the Reboxetine and joked that I can hit the booze then, whilst chastising himself for being a bad doctor for saying so. I don’t relish the thought that my liver results make me look like an alcoholic though. It is probably worth trying to be careful for the time being, I guess.

When I last saw Dr N about 6 weeks ago or something, he started me on alverine citrate as an antispasmodic, but so far it hasn’t helped all that much. I am having a few less of the sudden desperate trips to the loo, but still struggling with the pain and diarrhoea/constipation a lot. Today, he’s decided to double the dose, so fingers crossed it will have some impact. I am not sure I can carry on with these kind of problems for much longer. How anyone survives a life of IBS, I have no idea. Hopefully for me this will be temporary and I guess if it is caused by the Reboxetine there is always the option of stopping the meds, but I am not sure I like that idea.

The only good thing about all of this is that I have lost quite a bit of weight. Although that possibly isn’t such a good sign for my health. I put on a stupid amount of weight at the start of this year. Considering I wasn’t eating that much because the food was disgusting, I think I put on about a stone whilst I was in hospital in January and that continued when I came out. I don’t actually know heavy I got, because I stopped getting on the scales when it went over a certain number. I have pretty much always been overweight, although it probably bothers me a lot less than it should do considering my weight is not good for my health. However, over the last 6 months my appetite has disappeared and the weight has been falling off, without much effort at all. I have been more active over the summer, especially when I was travelling, but I think the loss of appetite has made the biggest difference. I often feel too ill to eat and most of the time I could quite easily go all day without eating anything. I am fed, because the bloke does virtually all of the cooking, but if he wasn’t around I’d live on the occasional bit of toast or the odd crumpet. I have lost all of what I put on earlier this year and more. My weight has yo-yoed a lot, but I am now somewhere near the lowest weight I have been since I was about 17. Admittedly, I am still many stone overweight, but I have lost over two stone and getting on for three. My clothes which had all got too small are now all too big. I am fed up of having nothing which fits properly, but I don’t really want to spend too much on new clothes if my weight is still changing. I have cleared a lot of stuff out, but I am reluctant to get rid of stuff in case I put the weight back on. We shall see.

Unfortunately, the way I am feeling physically hasn’t been helping my mood at all. In general, my mood has been dropping off over the last couple months. I felt a lot better during the earlier half of the summer than I did in the latter half and I felt a lot better 8 weeks ago than I do at the moment. At first, there were just a few warning signs and I did my best to ignore them. Whenever I noticed them and started to worry, I tried to stop myself because I didn’t want it to be a self-fulfilling prophesy. Worry that I was getting worse, so I got worse. Unfortunately, that strategy doesn’t seem to have helped much, as my mood seems to have dropped regardless.

I haven’t wanted to tell anyone that I am not feeling so good. I am disappointed that my recovery has stalled and almost feel ashamed. I wanted this time to be the time where I get well and stay well. Instead it’s a return to the old “one step forward, two steps back”. I am worried that if I am getting depressed again, then maybe I am to blame for it all. I wish I had made more of the time when I was well, because I don’t think I really appreciated how much better and easier things were.

I hadn’t wanted to write about it here, because I was worried about what the bloke would think, but he had noticed the drop in my mood, despite my best effort to carry on and pretend that nothing had changed. I didn’t and still don’t want to worry him. I do not want to go back to how things were when I was really ill.

I wasn’t sure I was going to tell Dr N today, but he knows me too well now and I think he could tell before I even said anything. I was there about the tummy trouble, but he asked me about my mood and I couldn’t tell him that all was fine. He seemed sad and a little concerned, but he was reassuring too. I think I feel a little better now that I am not hiding it so much.

Thankfully, although things have dropped off, they are still better than they were a year ago or back in January. Most of the time they are still a lot, lot better, but I’ve been having some bad days. Last Wednesday was really rough. I felt truly awful all day. Cried on and off for most of it and at one point instead of sorting out the huge mountain of washing I’d put on the bed, I just lay down next to it and crawled under the covers for a while so I didn’t have to face it. I pretty much cried myself to sleep, but then woke up in a panic that I had less time to get everything done. We had guests around for dinner that evening and the house was a mess, so there was plenty to do.

Unlike usually when I have been depressed, I am not especially suicidal. The thoughts come and go, but it is not like before. I was chronically and painfully suicidal for so long, I thought it would never go away, but it did. Over the summer, I stopped wanting to kill myself. I had started to see the point in life and recognised that I could have a future where I didn’t feel at mercy to my moods or awful all the time. Thankfully, despite the fact I have felt pretty low at times, the suicidal ideation hasn’t come back with such ferocity. I think I have retained the hope that I can be well again. I had lost that before, but Reboxetine has given me that back. I thought I was always going to feel so depressed that I didn’t see any point in life. There are times when I feel like that again. When I think about relapse, I get so frustrated that again I am going backwards. This makes me feel pretty hopeless and I wonder what all the point is. I sometimes just want to throw in the towel and give up, but I am resisting. Occasionally, I do want to die. A lot of the time I don’t really care if I live. Even when I have been well, that hasn’t really completely gone away, but I am managing. The thoughts pass and for now I can handle them. Hopefully, it will stay that way.

I told Dr N today that I do think there is something in the seasons. He has asked me in the spring when I started to feel better if I thought there was and I said I didn’t know. When the Reboxetine showed the first signs of helping earlier this year, it was at the same time as the weather improved, so we weren’t sure if it was one or the other or both. Often my worst times have actually been in Spring, when most people are starting to feel better. However, I think about it now and I think the seasons do have some form of effect. My mood has definitely dropped in September/October for the last three years. Last summer I was better than I had been during the rest of the year (although still much, much worse than I was this year), but things went downhill from September. The year before was generally awful from June onwards, but it wasn’t until September that things completely fell apart and I first ended up in The Priory in October ’08. I used to struggle in October whilst I was at school too, but I always put that down to an increased workload and the fact it was usually a time for deadlines and the ramping up of rehearsals for Christmas concerts and the like. So maybe there is something in it? I don’t know. I just hope that January/February 2011 isn’t as bad as 2009 or 2010.

Anyway, I see Dr M on Monday. Dr N told me to mention the seasonal thing. He said it is worth knowing and perhaps we should be aware of the rough cycle of my moods as it may help us pre-empt things. I have tried to be aware in the past, but it is hard when you often forget how you have felt before, even when you try and keep track.

He said that she may choose to raise the Reboxetine, but he is worried about the side effects. I had of course thought of this too. I considered doing it myself, but thought I had better see what she said first. I am worried about the side effects too. Things are so bad on that front, that it may not be wise. It’s a bit of a chicken and egg problem, because the side effects are making my mood worse, but to counteract that drop in mood, I will probably have to make the side effects worse. I don’t know what is worst. It’s a hard balance to strike. I don’t think I can tolerate the side effects getting any worse unfortunately. They are trying my patience enough as they are. I had hoped that when I was settled on these meds, the side effects would subside and although some of them have done, the tummy troubles just seem to get worse.

Anyway. I have written enough for now. This is a long post and I must try and get to bed. I have been waiting for the bloke to come home from playing computer games with friends, but he is not back yet.