Saturday, 30 July 2011

Going to the doctors

A week ago I went to the hospital for an Ultrasound scan as my doctor thinks I may have polycystic ovaries (PCOS). I was so nervous going to the hospital appointment (which wasn't helped by the fact that it was in the cancer centre: it was like an insight I never wanted to gain into how scary it would be to be undergoing investigations for cancer). I get SO nervous going to any kind of medical appointment. I usually have the squits at least three times before any doctors appointment and this day was no exception: except that I was required to drink 6 glasses of water and not pee for an hour before the appointment so I couldn't risk going to the loo to relieve my cramps. So instead I was doubled over in agony desperately trying to internally remind us that it was going to be OK and there was nothing to worry about while hoping I wouldn't actually shit myself (which I very nearly did).

From the moment I stepped out of my car to walk to the hospital, I knew it was someone else in charge. I was not myself but I couldn't figure out who I actually was. Whoever it was, was scared. My appointment was for 2.30pm and I arrived at 2pm, already busting for a pee and dissociating like mad. Thankfully the radiographer lady came to call me early. When she called my name in the waiting room, I was far away inside myself. There was a moment when the name seemed like someone else's; a few seconds passed before it registered that the name being called belonged to me and my mouth opened to say: “that's me” while my arm lifted itself in a sort of wave.

I lay on the bed while radiographer lady prodded at me with some kind of contraption and I looked at the wall. I felt like I was in a different time and a different person. It was all strange yet like a memory and I felt unsafe. I wasn't sure what was going to happen to me. 

Radiographer lady did the bladder area part of the scan first before letting me run out to the toilet. The rest of the scan was of my liver, which my doctor had also requested I get scanned. It took quite a long time to do and there were a lot of 'deep breath inn... hold it... and breath out' requests. As if I wasn't already spaced out enough, I was nearly hyperventilating by half way through the session. She had me turn onto my left while she prodded at my liver with the machine, then onto my right while she prodded at the other side of my abdomen. I wondered what the organs she could have been scanning on my left side could have been as I'm pretty sure the liver is on the right and I wondered if she could see my ugly broken rib sticking out. I was half expecting her to ask me what the heck had happened to me and I really hoped she wasn't going to start prodding at it with the contraption. Thankfully she didn't do that and after quite some time she told me it was over and handed me a fistful of tissues to wipe the goo off my stomach, which seemed strangely like a memory.
She then announced that my liver appeared to be fine and that I could go. I managed to muster up the courage to ask about the rest of me and she rather evasively told me that I did appear to have some cysts on my ovaries but that it would be up to the doctor to diagnose anything in conjunction with blood results.
I trotted off back to work with a pain in my head and spent the rest of the day feeling ill and confused about why the experience had been so much an ordeal and why I had switched to someone else for the most of it.

On Monday, I dragged myself to the doctors with Adam in tow this time. Normally when I go to the doctors I switch to a very anxious alter and as this is the part of me my doctor is used to seeing, she probably wonders how on earth I manage to hold down a full time job as a 'health professional'. Adam is used to seeing this part of me at times too but he's not used to seeing this part out in front of other people. I think he was a bit taken aback. I took him along this time for moral support because I wanted to talk to her about my dermatillomania and the excessive exhaustion I have been experiencing. 

My doctor is lovely, I've rarely had negative experiences with her. She is however, a doctor, which means her tendency is to prescribe, prescribe, prescribe... and today was no exception. She wants me to go back on SSRIs for my anxiety. I really don't want to do that, although I do admit, I really should be on some sort of medication. I asked if there was something I could take 'as and when' to relieve the compulsive skin picking episodes and she questioned me about what I thought she could give me, I got the feeling she was trying to test me to see if I would ask for diazepam. I've asked for it before and she refused me because of the addiction risks. I then got it from another doctor at the practice for going on my big trip but I was ironically, so anxious about getting addicted that I was too scared to take them when I needed them. 

I asked her if there was anything she could recommend and she launched into the diazepam lecture again, while I sat there scratching at myself and trying to remember to breathe normally and agreeing and then before I knew it she was prescribing diazepam with strict instructions as to how often I can take them. I was grateful but to be honest, I probably won't take them at all because of the aforementioned fears. It's comforting to know I have something in an emergency anyway. Part of me feels curious about whether she has given me enough to kill myself with... but just to emphasize, that is just one part, we don't all want to die and I don't think suicide is on the cards just at the moment.

Mrs Dr then asked me again about clinical psychology (she always asks) and if I have spoken to my psychologist about the skin picking issue. I tried to explain that we don't really get to talk about day to day things at the sessions because there is so much else to cover and she seemed rather sympathetic at this point. I couldn't help wondering what my psychologist has told her when they've talked (my T chatted with her about DID and diagnosis in the past as my doctor is not familiar with it). She recommended that I speak to T about the skin problem. Is it silly that the prospect of talking to T about my dermatillomania is really nerve wracking? What does that say about our relationship?

Adam then prompted me to talk about the exhaustion and Mrs Dr after listening and 'umm'ing and 'ahh'ing she came to the conclusion that I probably have chronic fatigue syndrome and that there's not really anything that can be done for me. This may sound like a negative diagnosis. For me, it was like a big burden being lifted off my shoulders: I'm NOT just lazy! There's a name for it! Names for things make everything easier. Five years ago I was pretty much exactly the same as I am now: frequently ill, depressed or numb or acting in strange ways, having weird experiences which to me felt more supernatural than psychological and often exhausted... definitely not normal, but with no real name to put on it to explain to myself or anyone else what was wrong. Now, it's so much easier: I have names for the ailments... I make sense, somehow. 

Mrs Dr sent me off to the nurse with two sheets of blood requests and I braced myself for the blood sucking ordeal. I though it best to remind her there were two sheets for the bloods (and managed to get anxious alter to tell her that) and she duly arrived at my arm with four tubes and efficiently sapped the red stuff out. Anxious alter was not quite brave enough to tell her I am allergic to latex so compliantly held out my arm for the nice latex plaster and off I trotted back to work where I was later called by Mrs Nurse to tell me she hadn't realised there were two sheets and I'd need to go back for the rest of the bloods (wasn't four tubes enough? Can't they just pour some into the other tubes?). So I dragged myself back yesterday with my post latex exposure rashed arm for the rest and Mrs Nurse sucked another six tubes from my arm. While she was doing this I got a good read of my medical notes on her computer and reflected on how succinct they were: ''anxioussness (skin picking and scratching). Not keen on medication. Attends psychology (name of T). Discussed pros and cons of diazepam. Chronic fatigue Syndrome.'' I could take a leaf out of Mrs Drs book when writing patient notes (although is 'anxiousness' a word?!). Indeed I could take a leaf, when writing this blog!

Today I checked my blood results and although they are not all back yet I was shocked to see that my liver function tests are abnormal. I had been monitored for this when I was on medication as they had been high but had just assumed it would be better now that I'm not on any. What's wrong with me? OK it's probably nothing but part of me can't help wondering if I've been taking way more pain killers than I realise. I'm also afraid that it could be something worse, like hepatitis. What if I've picked up hepatitis from some of my more negative experiences of being exposed to blood/urine/saliva/semen/mucus/raw flesh (don't ask) in the past and one day am going to get really sick and die? Maybe that's why I feel ill so much. I'm sure I'm just being paranoid.


lindaandtherestofus said...

first i would like to say i laughed out loud probably four different times during this. You may not realize it but your sense of humour is really refreshing.
Also, I myself just entered the scary world of being diagnosed with hepc. I don't know yet if it's from my drug use, or more likely by the seemingly progressiveness of it from the unmentionable things you mentioned in your post. I wish you well in your doctor endeavors and would love to get to know you a little better cuz it looks like we have a whole lot in common.

JustEliza said...

I have to say.. find a new GP. If she suspects PCOS, she should also suspect insulin resistance. And if you have insulin resistance, you can have chronic headaches and fatigue.

That said, DID alone is enough to cause chronic headaches and fatigue. Your brain is putting a lot of effort into managing the dissociation. It's like you are acting out your life -- people pay good actors lots of money and it's hard work. You are a brilliant actor and are holding down a job as well. Give yourself some credit (and build in some time to rest/care for yourself!).

Even without DID, therapy is exhausting. Going over painful emotions is exhausting.

I'd be more concerned if you weren't exhausted!

But do ask your GP about insulin resistance.

Sandy said...

Eliza is so right. :) I hope you feel better soon. I hate meds but for me it has been the only way to decrease symptoms and give my nervous system - and the rest of me - the break I desperately need.

Candycan said...

Lindaandtherestofus: thanks for your encouraging comment. I convince myself that my blog is really boring and no one reads it so its exciting to find someone who enjoys a post! It's amazing to be getting in touch with people I have things in common with too. I have felt like a freak my whole life because DID does make you different from many. Now I have found people similar to me, it's brilliant!

Eliza, you're right, the whole process of therapy and DID in general is exhausting. I don't doubt that it could be the main factor in my fatigue. My doctor has tested my glucose levels and they have been fine, wouldn't that be what they'd look for with insulin resistance? Thanks for telling me to take some time to rest/care for myself. It's funny how we know what we should be doing but sometimes being told or given permission is what we need.
And thanks Sandy for your well wishes!

JustEliza said...

The GP would test insulin + glucose and determine your resistance through the ratio. =)

This might help give you some perspective on your fatigue:

Specifically the last section:

It is a sad irony that reacting to emotional tiredness in this way can eventually exacerbate it into real physical exhaustion via a process I call the The Cyclothymic Two-Step. PTSD sufferers with a primary or secondary flight response frequently overreact to their tiredness with workaholic or busyholic action. They run so compulsively from their depression, that they eventually exhaust themselves physically, and at times become too depleted or sick to continue running. When this occurs, they collapse into an experience of abandonment so painful, that they re-launch desperately into "flight" speed at the first sign of replenished adrenalin. I have witnessed a number of such clients misdiagnose themselves as bipolar because of the extremes that ensue from desperately pursuing the adrenalin high and eschewing the abandonment low.

Adrenalization often becomes addictive because it self-medicates and counteracts the emotional tiredness that emanates from undigested and unworked through abandonment feelings. Especially noteworthy here is the endless and expensive journey that many survivors undergo trying to remedy emotional tiredness with physiologically-based medical treatments. Even worse, the short-lived (if any) improvements of such an approach increasingly augments the shame and self-hate of the sufferer over time: "What's wrong with me. I've changed everything in my diet and in my sleep and exercise schedule. I've seen every type of practitioner imaginable and I am still waking up feeling dead tired." It is a subtle, hard acquired skill, but learning to self-compassionately focus on the inexorable somatic experiences of sometimes feeling tired, bad, lonely, or depressed is the only way out of this cul-de-sac of self-destructive and unwarranted efforting. In this regard, the notable AA 12 Step acronym, HALT - Hungry, Angry, Lonely, Tired - can remind us to stop and pause introspectively to determine whether our abandonment depression has been triggered and needs the quiet, internal, self-compassionate attention described above.

We can sometimes gain motivation for this difficult work by seeing our depressed feelings as messages from our developmentally arrested child who is flashing back to his abandonment in hopes that his adult self will respond to him in a more comforting, compassionate and appropriate way.

Through such practice, clients can gradually achieve the healing that the Buddhists call separating necessary suffering (normal depression) from unnecessary suffering (the internal hopelessness, shame and fear, and the life-constricting acting out that ensues from unnecessary engagements with the critic and the 4F's).