Just Another Day

Last night I managed to get some sleep. Not a lot, but sleep nonetheless. This has meant that I have not felt quite so awful today and have managed to do a little bit of knitting and some reading.

This afternoon I have been to see my GP. This was for my monthly visit so that he can ensure that I am okay and to get a prescription for my antidepressants. He is not very good at keeping to time with his appointments, but today I was seen five minutes early and gave us something to laugh about when I went in. Usually his opening remark is an apology for keeping me waiting, but today it wasn't necessary.

He asked whether I had received a letter for my appointment at the hospital to see the consultant about the little (actually not so little) problem that makes sitting down uncomfortable. I told him that I had been a couple of weeks ago and I'm now waiting for an appointment for the surgery that is necessary.

Then he told me that it was necessary for me to have my blood pressure taken. As luck would have it, I was wearing a short-sleeved top under my fleece so attaching the cuff to my arm was easy. As this was being done he checked that I had taken my blood pressure medication this morning and I had to think about it. Had I taken it? I have to take four different medications every morning and for the life of me I couldn't remember whether I had taken them this morning. Then I remembered. I take aspirin, and this morning when I had put the various tablets in my mouth and taken a good swig of water, four tablets had gone down but the aspirin had stuck to the roof of my mouth and had started to dissolve there. A second swig of water had taken care of that. Anyway, I was told to sit back in the chair and relax. I needn't have worried; my blood pressure was fine, perfect.

We talked about my depression, the support that I was getting from my consultant psychiatrist, and my psychotherapy. Then it was just a case of printing off the prescription for my antidepressants and I was done.

Since I have been back from the appointment (and collecting the medication from the chemist) I have managed to do two rows of my knitting (I have started knitting a lace shawl) and read a couple of chapters of a book that arrived from Amazon today. The book is The C-word by Lisa Lynch and is based on her blog which is one that I have been reading for more than a year now. For any of you who haven't read the blog, I would recommend it to you all and if you can't be bothered to work your way through the blog, then get the book. It is the amazing story of how Lisa found herself suffering from breast cancer at the age of 28 and her fight with 'The Bullshit' as it was to become known.

I shall get back to the book when I go to bed tonight, but I shall pick up the knitting after I have finished this post and written an email to There and Back.

A Brief Update

After a few nights of not sleeping particularly well and a certain amount of anxiety over my psychotherapy session and the forthcoming job interview, I took my sleep medication last night and I slept. Admittedly it was nearly 2am before I dropped off but it was definitely the medication causing the sleep because I just could not keep my eyes open a moment longer and I literally fell asleep as soon as my head hit the pillow.

I woke up at about 10.30 to answer a call of nature and then climbed back into bed and instantly fell asleep again until nearly 3pm. this means that I have pretty much lost my day, but I do feel completely rested and while it means that I probably won't get any work done on preparing my presentation for the interview today, I will feel better tomorrow and can get to work nice and early and hopefully complete it then.

I went to see my GP yesterday afternoon and I had a lot to tell him. We talked about my being in the mental health loop now after my stay in hospital and how I seem to be getting the help that I need. Then we talked about how the news about Mr Smiley had affected me. My blog was the next subject of conversation. I told him about the Mental Nurse TWIM Award and how my readership has increased dramatically since starting to write the Tackling the Mental Health Minefield posts. Then we talked about the job interview and he wished me luck. Eventually we actually got to the reason that I had gone to see him. Over the last few weeks I have been getting occasional pains in my right leg. They can occur at any time, are excruciatingly painful and last for just a second. The pain is very sharp and feels as though it is in the bone rather than being muscular. "Shin splints" he said and had a look at my leg and the place where I was feeling the pain. So with a weight off my mind knowing it wasn't anything too serious I said that I needed a prescription for most of my medication. We went through the long list of things that I take on a regular basis and apart from GTN spray and the cream for my eczema I needed everything. The prescription printed out and signed and then I was on my way to the chemist to get the prescription filled and walked home with a carrier bag full of pills.

I think that it was the first time that I have been to see my GP for many months and not cried at some point through the appointment. I see this as a good thing because it is a real indicator of how my mood is improving. Now I have to hope that my confidence will start returning so that I can do well at my interview next week. And while we are on the subject of the interview, I would like to thank all of you who have sent me good luck wishes. I really appreciate the fact that you have taken time out of your day to read my blog and send me a comment.

Off To The Doctor's

It was off to see my GP for my monthly mood check this morning. I know that it was only last Friday that I saw a doctor, but that wasn't to see my usual one who does my monthly checks and makes sure that I am not getting suicidal.

We talked about how this is a difficult time of year for me and what I was doing to try to cope with the depression. I talked about living one day at a time and how even the lovely day that I have planned for next Wednesday isn't helping very much at the moment. I am sure that when Wednesday arrives I shall be much better. Spending time with There and Back is always great and we have the added bonus of our visit to the theatre to enjoy.

We also talked about the sore area that I have on my nose, which was one of the main reasons why I had to make an appointment to see one of the doctors last Friday. It has been there for almost a month now, is getting no better, is still very sore and wearing my glasses is very painful. My regular GP is a bit worried about it, so he has referred me to see a dermatologist under the 'two-week rule'. I think it is the fact that the area has a different texture to the other side of my nose that is ringing alarm bells.

It is so nice to be able to have the continuity of care that I have. By seeing the same doctor each time, I don't have to constantly repeat all of the things that I have been through that have caused me to suffer so severely from depression and it makes it easy for a good record of how the depression gets bad and then improves to be maintained. The problem is that to most people who know me I am able to present a 'face' that seems to indicate that all is well. Very few people can see beyond that 'face' and dip into the turmoil that is in my mind.

Since I have been back home from the appointment, the wind has become very gusty. The curtains in the rooms with open windows are being blown all over the place and we have already had one torrential downpour although the sun is doing its best to shine at the moment.

Of course, it is a Bank Holiday weekend so we must expect some pretty awful weather. This is Britain after all

Bed Rest And Penicillin

I really appreciate the kindness and thoughts of Alison, The Dotteral, and cb who have all commented on my post of yesterday about how I hate having a cold. I can usually cope reasonably well with such things but I seem to have been knocked for six this time, so much so that I just had to go to see my GP this morning. And it seems that it was just as well that I did, for what I thought was just a simple cold is not so simple after all.

I knew by yesterday evening that I was getting worse, so I went to my surgery's website and booked an appointment with my GP. When I went in to see him, I think he thought it was because I was still feeling very low with depression as he had told me on Monday that if I was still feeling bad on Friday I was to come back to see him. But when I told him about the golf balls in my throat and the cotton wool in my ears he realised that I was there about quite a different matter.

He looked at my throat, peered into my ears, then listened to my chest, and the diagnosis is a host of infections. The throat and ear infections are almost certainly linked and are viral, however, the chest infection and bronchitis seem to be something separate and almost certainly bacterial so it is a course of penicillin for that. There were also instructions to go home, not to go out for at least 48 hours, to take paracetamol every 4 hours for the fever, and that it would be better if I went to bed so that I could keep warm and sleep whenever I felt like it.

So, when I left the surgery I went to the chemist to get the prescription dealt with, to the corner shop to get some more tissues and some sweets to suck to help with the soreness in my throat (I don't think that you can beat a boiled sweet for helping in these circumstances) and then home to get back into bed. I am armed with my laptop so that I can keep in touch with the world, the box of tissues, plenty of drinks and a couple of books, and I will rest as I have been told to and only get up for calls of nature and to get myself the occasional sustenance.

That is the biggest problem with being on my own. There is no-one to look after me and to take care of my needs when I am ill. So I will just have to hope that the antibiotics take care of what will probably be the worst of the infections and that bed rest, a warm environment, and time will take care of the rest. I'm feeling so ill that I don't even have the energy to be depressed about it all.

A Visit To The Doctor

After the horrendous weekend I decided that the best thing that I could do would be to see my GP if I could get an appointment.  I managed to, so this morning I have had a long chat with him about how I am feeling and what has been going on in my mind.

He was pleased that I had made an appointment and not just tried to get through this on my own.  Having spoken with him, I am now feeling a little better, although I am still very fragile and the smallest thing can start me crying again.

I have come back from the surgery, made myself some lunch, and I am now going to lie down with a book.  If I fall asleep for a little while, that will be fine, but if I don't, it won't matter.  

Manic Monday

Sometimes you have one of those days where everything happens. Today has been one of them for me, hence Manic Monday. I knew that I had a few things to do, but I was not expecting to be running around like an idiot.

The day started normally enough with me waking at some unreasonable hour because of my bad sleeping pattern.  I didn't mind because apart from having to do a few things this morning I was expecting the rest of the day to be quiet and I really thought that I would have a restful afternoon.  I couldn't have been more wrong.

I went to see my GP for my normal monthly visit.  I did need to talk to him about the allergic conjunctivitis which is becoming a real nuisance, but I thought it would be a quick in and out appointment.  No, GP decided that he would check how I was, what I was doing for Christmas, whether I was having enough communication with others, and so it went on.  My 10 minute appointment extended to 25 minutes because my GP was keen to make sure that I wouldn't have a crisis over the next few days.  I was embarrassed about walking out through the waiting room when I did eventually leave because of those who were going to be late for their appointments, but it really wasn't my fault.  And there are some who seem to think that our GPs don't seem to understand or care about their patients.  I can tell them that they are wrong.

After leaving the surgery I had to go into town to the Post Office; I needed to send a package by special delivery.  There was a huge queue in there, but they did have lots of positions open so I didn't have to wait too long.  Then it was a walk back towards home via the chemist to get the anti-histamine tablets and the eyes drops that my GP had given me a prescription for.  I only had to wait a couple of minutes for them and it was time to go home.

So by 11am I was ready for an easy day, maybe doing a little bit of one of my TMAs and a bit of knitting if I felt like it.  But that was when the doorbell started ringing, and it seemed to ring every 10 minutes.  It was one delivery service after another with various things that I had ordered over the last week or so.  And my next-door neighbour came with a card and a present.  Every time that I attempted to go to the loo, the bell rang again.

Fortunately things seem to have calmed down now.  I have given up any idea of working on the TMA today, so I am watching television and contemplating picking up my knitting to do a few rows.  I shall heat something in the microwave a bit later to have for my dinner, and I shall head to bed fairly early, take some medication to help with sleeping tonight, and hopefully sleep the whole night through.  Tomorrow I have to go to the local sorting office to pick up a parcel that the postman tried to deliver while I was out this morning, then I shall get the few bits of fresh fruit and vegetables that I need for the rest of the week, and I shall head home with no intention of leaving the house again until Christmas is over.  I shall lay out my study materials in three piles on my desk, one for each of the three TMAs that I need to do over the next couple of weeks, and I shall spend a couple of hours each day on them, drafting my essays and then typing everything up.

Lets hope that Manic Monday doesn't lead on to Traumatic Tuesday.

Blurred Vision

This title could so easily refer to many of the proposals being put forward for the NHS, but it's a lot more mundane than that.  I woke early this morning (4.20am) after not having dropped off to sleep until well past 1am.  My eyesight is not what it was in my younger days, although I have always needed very long arms to hold books or to hold a needle and thread because I am exceedingly long-sighted.  This caused problems when I first told my mother that I had problems seeing the pages of a book, because at the age of four it was very difficult for me to explain to the optician what it was I could and couldn't see.  Anyway, by the age of 11 it was obvious what the problem was and I had to start wearing glasses for reading, usually something that happens when you get older.

When I got to the age of about 45 I realized that I was starting to have problems seeing road signs when I was driving, so further checks at the opticians led to me wearing glasses all the time, and varifocals have been my saviours since then.  This morning, however, when I put my glasses on I was still having problems seeing things.  My first thought was that it was just that I was tired and perhaps a bit more sleep would take care of the problem.  Unfortunately sleep wouldn't come and my blurred vision was not getting any better.  In fact, my eyes seemed to be getting worse and seemed to be filling with a sticky substance.  One of the problems of not being able to see without your glasses is being unable to look in the mirror to see what the problem is, and even with my glasses on I didn't seem to be any better off this morning.

Obviously a trip to see my GP was called for and the immediate diagnosis was conjunctivitis.  So I am having to regularly bathe my eyes to remove the muck that is accumulating in them and I have a prescription for some eye drops if they get any worse.  The problem with everything being blurred is that I can't read my course books, nor can I do any knitting.  So I have to hope that there is something worth watching on the television so that I can pass the time away.

(In case you are wondering how I am managing to write this post, I am using speech recognition software, doing a spell check and trusting to luck that everything is okay.)

When Life Goes Up And Down

When I wrote this post I described how I felt when I got the phone message to say that my psychotherapy session was cancelled as I was travelling to it.  It can be quite difficult getting yourself into the right frame of mind to make meaningful progress during psychotherapy sessions and until quite recently I had real problems with anxiety for several days prior to my Friday morning sessions.  These days I am able to cope a little better and while I still get quite nervous about the session, this only occurs on Friday morning and is not normally something that I worry about too much.  Okay, so the butterflies sometimes take on enormous proportions, but I do not feel physically sick as I used to.

Last week was a bit of an up and down week for me.  I had managed to get over the disappointment of the cancelled psychotherapy session, but I still had the demonstration to give to a room full of doctors to get through.  In actual fact, this turned out to be a bit of a breeze except for the momentary panic when I saw the sea of faces in front of me.  So getting myself up and ready to leave for psychotherapy on Friday morning I was thinking about all the things that I had to talk about.  Meeting a There and Back and our chat over a up of hot chocolate, how I had felt when my last psychotherapy session was cancelled, how I had performed at the demonstration in front of the doctors; all of these things would help me to talk about how I had been feeling over the last week.

I got off the bus a stop earlier than I usually do.  It was a nice morning, I had time before my appointment, so a little exercise wouldn't come amiss.  As I was walking down the road to the hospital I switched off my mobile.  Okay, so I don't get many calls on it, but it is a cardinal rule that phones are switched off before therapy starts.  I turned into the hospital's entrance gates and walked to the Outpatients Department and in through the doors and made my way to the reception desk to book in.  I was told that my psychotherapy session was cancelled again.  I walked out of the hospital and cried.  It may seem a strange reaction, but from being quite upbeat especially after having done so well at what had been a big step for me with the computer demonstration, I was suddenly plummeting into depression; little things had suddenly become mountains again.  I made my way home again and sat down wondering what to do.  In the end I tried reading the course book for one of my OU courses.

Friday evening I had an appointment with my GP.  Nothing special, just my routine appointment so that he could see how I was and make sure that I was coping with everything.  I arrived early, I can't help it, it's one of the things I do; the computer arrival system told me that my GP was currently running 9 minutes late, so although there would be a short wait it wasn't anything too much.  Then completely out of the blue I started having an angina attack.  This is not an unknown occurrence, but I haven't had an attack for months and I had come out of the house without my handbag because I didn't think I would need anything that was in it; my keys could be put in my coat pocket so a handbag was unnecessary, except that was where my GTN spray was and I needed it now.  I decided that as long as I sat quietly the attack would soon pass, and anyway I would be in with my GP shortly.  Except I wasn't; I was nearly an hour late getting in to see him and I was still having occasional pains.  

Instead of my quick in and out of the consulting room, there were lots of questions about the pain and checks of blood pressure. Blood pressure was absolutely fine, but GP was still considering phoning for an ambulance until I reminded him that I have Prinzmetal's angina.  The angina attacks are caused by an artery in my heart going in to spasm and I have had angiograms that show that my arteries are completely clear of any signs of blockage.  It is a form of angina that is not that common, so it is quite common for doctors to have to look it up when I tell them about it.  Once GP was satisfied that I was okay the consultation continued with me talking about how I felt after having had my psychotherapy cancelled twice, and also about the high that I had after doing the computer demonstration.  After a final admonition to make sure that I always carried my GTN spray with me, I left to go home again.

Saturday morning found me travelling to a tutorial for SK277, the second of my OU courses this year.  It was my first chance to meet the tutor and although I managed to stay for the whole tutorial I did have some very uncomfortable moments.  Once the tutorial was over I decided to treat myself to some lunch in the nearby shopping centre before setting off home again.  Saturday evening, still feeling a little low after the morning's tutorial I decided to sit down to do some knitting as it had been a few days since I had done any.  It was at this point that my world really fell apart.  Just a little thing made me feel like there was no reason to carry on living.  The little thing, was pulling on the knitting needle and having about 20 or 30 stitches fly off and everything start to unravel.  There was nothing I could do other than pull the knitting off the needles and start again, but Saturday evening was not going to be the time to do that.

So that was why today was one of those days.  I had endured more bad stuff than good stuff over the last 10 days and I was finding it hard to cope with.  I decided that today would be a day for nothing too energetic, nothing that would unduly tax my mind, and if I did some knitting I would put it down as soon as something went wrong.  As luck would have it, my knitting has progressed well this afternoon and evening.  I haven't quite managed to do as much as I had before the catastrophe occurred, but I am getting there.

I'm starting to feel a little more optimistic about tomorrow now.  I plan to spend the morning studying and tomorrow afternoon and evening I will do some knitting and hopefully I will get to a point where I am once again in virgin territory; that is to a point that I have not reached before on this centre panel for the shawl.  I had hoped that I would have finished the centre panel over this weekend, but that didn't happen.  I am aiming for completion next weekend now and with it the four-fold increase in stitches that will signify the start of the borders.

Sometimes you know what causes you to fall into a depression, and sometimes you don't.  When it is caused by a series of small mishaps, which unfortunately begin to seem much larger than they actually are because of the increasing number of them, it is much easier to find your way out of the darkness.  With a bit of luck, by Wednesday I will be feeling fine and wondering why I felt bad at all.  I certainly hope that is what happens.

Into The Jaws Of The Dragon

I have made mention in this blog before about patient-access to medical records, and how strongly I feel about it.  Gone are the days when the patient wasn't told that they had cancer because the doctor didn't think that they should know or that they would be able to cope with the information.  In those days, which were not so long ago, the doctor made all the decisions about managing your illness and you were expected to go along with their choices.

Today, we are encouraged to take an active part in maintaining our health and this includes making decisions about where we are treated as well as making sure that we maintain a healthy lifestyle. With so much information available on the Internet, it is important that we have reliable sources of information for it is well known that much of what appears on the Internet has not been verified in any way.  Some items which appear to be very credible may in fact be bad science, or be misrepresenting information that appears in journals and other specialist publications.  This can be dangerous and it is partly because of this that I think it is important for patients to have access to their own records and through them to reliable information about any conditions that may suffer from or about tests that they may have to undergo.

Last week I received an email from B, my recently retired GP, asking if I would be willing to give a demonstration of the records-access application that my local surgery uses.  This demonstration would be part of a presentation that B would be giving to a group of GPs at an academic institution in London.  B knows that I have problems with being with large groups of people that I don't know, and in his email said he would understand if I preferred not to do the demonstration.  Funnily enough, I didn't hesitate for one moment to say yes to his request, so next Wednesday evening I will be demonstrating how I have access to my medical records, and what I can learn from this, to a  lot of doctors.  At the end of the presentation and demonstration there will be a question and answer session.

I hope that the doctors don't bite.

Friday Is Doctor Day

I've written before about Friday being a day of seeing doctors.  Friday morning sees me attending my regular appointment for psychotherapy, and my first appointment of the day with a doctor. This hour of talking about myself and my feelings and thoughts about things in my life is not the easiest hour of my week, but it is helping me.  My friend, Mr Smiley, has said that he has noticed a big difference in how I am over the last few months and I know that going through the psychotherapy is a big factor in this.

I have always tried to set myself high standards to achieve, and for many years I did just that. But when I lost the support of my husband, I started to lose confidence in myself and my ability to do many of the things that I had done without thinking previously.  It wasn't just the depression that I started to suffer when my husband died, but also the harassment and discrimination that I started to encounter from some people at work.  For years I managed to keep working despite all this, but eventually it had such an effect on me that work became impossible.  During this time my mother had died very suddenly, so in addition to all the problems that I had at work and with my health, I had to keep an eye on my elderly father from a distance of almost 100 miles.  When my father died a little more than two years after my mother, work became impossible and my GP sought early retirement for me on medical grounds.

I decided to move back to London when I retired, mainly because I was not happy in the home that I had shared with my husband, but also because I felt it better to get away from the area where I was likely to see many of the people that I had worked with, and I could not face constant questioning about why I had to give up work. With the move came a change of GP, and a year ago, concerned with the depressive state that I was in, my new GP decided to refer me to the local Mental Health Trust to be assessed for psychotherapy.  I was lucky, I didn't have anywhere near as long to wait for assessment as my GP had warned me that I could expect to wait, and after being assessed as suitable for individual psychodynamic psychotherapy and warned that I would be on a waiting list for some considerable time; I started therapy three months later.  

I have been attending most Fridays since the beginning of May and the six months of 'talking therapy' have definitely made a difference to how I am feeling.  I still have periods where I fall into that black hole of depression, but I find that I can climb out of it more easily now.  And after suffering for so many years, I think that we have uncovered some of the things that caused me to be the way that I am and possibly why my depression, which originally was thought to be a grief reaction, has continued for so long.

This afternoon, I had to go and see my GP for a check on my present state.  Regular readers will know that the GP who I had been seeing when I registered at the local practice when I moved back to London retired a few months back.  I had needed to see a doctor when my GP was away at a conference, so I saw one of his partners, and finding that I got on well with this other doctor, it was decided that he would take over my care when my GP retired.  So new GP has been seeing me at fortnightly intervals since taking over my care, so that he can get familiar with me and my problems and we can develop a relationship that I will be comfortable with.

Today's appointment was the first since we had managed to get my blood pressure under control, so it really was just a case of me reporting in and saying that I felt fine. I expected it to be a five minute visit, but I was wrong. When I was called through, I got to GP's consulting room and he opened the door just as I arrived and as I was walking in told me that he had a medical student with him, and asked if I would be happy for the student to stay during the consultation. I surprised myself and my GP by saying that I was happy for him to stay.

The consultation that I expected to last just a few minutes took a little longer than that.  After getting over the shock of me agreeing to the medical student staying for the consultation, GP decided to use me for a good teaching experience.  I think I coped with it all quite well. Tears were very close on a couple of occasions, but GP kept a close grip on things so that I never went over the edge.  I hope that the medical student gained from the experience, I believe that I managed to climb another hurdle and get over it without any harm.  My psychotherapy was discussed in general terms, we discussed the strategies that I use to manage my day to day life when I am feeling depressed, and how studying has been one of my lifesavers over the last few years.

So I have seen two doctors and an almost doctor (he takes his finals next year) today, and I'm not even ill. Well, I have the last remnants of my cold, but nothing worse than that today.  Maybe my life is starting to take a turn for the better after all those years of despair.  I will obviously be susceptible to depression whenever I encounter really difficult times, but I seem to be learning how to deal with it and come out the other side without too much harm.

Success!

Yes, I can report success on two fronts today.  I managed to get the first appointment of the day with my GP and got the prescription for the tablets that were missed off Friday's prescriptions and then I went to the pharmacy and got the little blue pills.

Then I went off to the library, and spent the day there working on the first TMA for my current OU course.  I managed to draft the first essay and compile the notes for the second one.  That made me feel good.  And then I had a brainwave.  Why not look to see if the library had any books about Cezanne and Matisse, the two artists whose works I was going to have to compare for the second essay.  I found a book about each of the artists, and on scanning through the book on Matisse I found that his painting that I have to look at was painted in tribute to Paul Cezanne, so there is a nice reference for me to include in my essay showing that I have read around the subject.  I decided to take the Cezanne book out on loan because although it does not include the painting that I have to write about, it does include many other examples of his still life paintings and it will enable me to make comment about his repeated use of certain objects.

I had planned to take myself out for a meal at the local Italian restaurant in celebration of my successful day, but I am too tired after having three bad nights, so I have got myself ready for bed, I've taken my night-time tablets, including one of the little blue ones, and I am going to have an early night.  I'm hoping that the successful day will lead to a successful night.  After all, I might enjoy having a meal out more on a day that hasn't gone quite so well.

All Is Not What It Seems

Usually when I start to fall downhill there is a reason for it; an upcoming anniversary or something that has triggered things in my memory. But, as I fall deeper into the black hole that is depression, this time I am not aware of anything that could have caused it to happen.

Yesterday morning I went off to my psychotherapy session as usual. I was pretty anxious as I left the house and even more so by the time that I arrived at the hospital. My therapist was aware that all was not well almost immediately (I think the tremors in my hands may have been a bit of a giveaway) and decided that the session would take a slightly different path to normal. The session covered how I felt when a period of depression started, how I felt as it deepened and how I felt as I was coming out of it.

For me depression has always had a deeply physical side to it as well as the mental effects. When I am at my worst, my head and body no longer feel connected; there is a significant sensation of numbness in the area of my neck and shoulders. When I get to this stage I find it difficult to concentrate on even the simplest things, my sleep pattern gets worse as the days progress, and I start to have dark thoughts; my mind takes me to places that I really don't want to be.

For the first time ever, the session was a real two-way conversation and as a result I gained a lot from it because of the questions that my therapist was asking and the answers that I gave helped both of us to understand more about me.

Yesterday afternoon I had an appointment with my new GP. This was an appointment to go through the results of my recent blood test, to check on my blood pressure to see if the recent introduction of medication to lower it was having the desired effect, and for him to get to know a little more about me. He has requested that I book double appointments for at least the next few months so that he can get to know me as well as possible so that he can effectively monitor me.

The blood tests showed that all was well, my blood pressure has dropped to normal levels, and we had a good chat about what sort of psychotherapy I was having, about my sleep problems, and how I cope with things when my depression gets really bad. We also discussed a programme that the local council and PCT jointly run for people suffering from depression, anxiety and stress. The result of this discussion is that he has referred me to this programme and hopefully I shall soon be joining a local art class. I've never been much of an artist, but I've always wanted to be able to draw and paint, and I think that this might be a good way to help me with my lack of self-confidence, and help with dealing with social contacts. So with a bit of luck I will soon have a regular art class to form an alternative to my OU studies, and hopefully it will also help me focus on those studies a little better.

So what is this post all about? On the surface it may seem to be about me and my depression, but actually it is about something quite different. It is about two doctors; both of whom helped me on a day when I was feeling very down. Neither of them have made me feel better, but both have helped me to understand why I am the way that I am and have helped me to find ways in which to come to terms with that.

So, why is it that there are so many people in government who feel that doctors are not doing a good job and therefore it is necessary for them to interfere in the NHS? The problem is the government are not talking to the patients about how they feel about the NHS and its staff. They listen to big business, and to people who have an axe to grind. If they really want to know how to improve the NHS they should listen to more people like me; real patients with real problems, who are getting excellent support from their GP, access to treatment for mental health problems, and who appreciate all that is being done for them, and they need to listen to the the kind of doctors who are looking after me. It is always those at the coal face who know most about the business, not those who sit in offices far away and who have no idea about what really happens.

I Lost Saturday - But Why?

Friday evening was spent watching a bit of television and then spending an hour or so doing some proofreading for Project Gutenberg. I went to bed at a reasonable hour and after reading a few pages from my current bed-time book, I fell asleep quickly. I think that I slept pretty well, I certainly didn't wake up until about 7am, but as it was Saturday, a day that I treat as 'my day' so I can do whatever I want, I decided to stay in bed for a little longer. But before I got too carried away with doing my thing, I decided that I ought to take my morning medication, so I got the pills, knocked them back with a really good drink of water, and then tidied up the bed before climbing back in it again. If I fell asleep again, that was fine, but otherwise I thought that it would be nice to lie in bed reading my book before getting up to do some chores.

I'm not sure how long I read for, I don't think it was for very long, and I don't remember feeling myself dropping off. but I woke up again at about midday, looked around me, and promptly fell asleep again. I next woke at about 5.30pm, then at 9.15pm, at which time I managed to drag myself out of bed, make myself something to eat, and then eat it. So that was Saturday gone, but the problem was I wasn't sure why or how this had happened.

I have written before about how I have periods where I don't sleep properly and then quite suddenly my body just decides that it can take no more and I seem to spend a day sleeping to allow my body, and probably my brain, to recuperate. However, although I had not been sleeping well for some days, I didn't think that I was that bad yet and if I was to have one of these periods it probably would not come for at least another week. But I realized that there might be another explanation.

Now before you start to think, "She's lost her marbles", I'm going to head off at a bit of a tangent here, but I can assure you it is relevant, and you'll understand where I am coming from in the end. I am very good and always read the patient information leaflet included with prescription drugs (and usually over-the-counter medication too), paying particular attention to the section about possible side-effects. I know that most people never suffer from any of these undesirable effects, some may suffer from one of them, very rarely maybe more that one, but they do represent a 'get-out clause' for the drug manufacturers if you happen to be one of the unfortunates who do react to the drug. I wasn't always so conscientious in this matter, but I had some quite serious reactions to a couple of anti-depressants in the early days of my depression, when we were still trying to find the right drug for me, so since then I have made sure that I am aware of what may happen when I take a new medication.

On Friday my GP started me on medication for my high blood pressure and yesterday morning I took my first dose. The leaflet says quite clearly, in two separate places, that the tablets may make you feel sleepy, so is it possible that it was this tablet that caused me to spend so much of the day asleep? When I took the tablet yesterday, I took it on an empty stomach; this morning I have made sure that I have had something to eat before taking it. Now I have to see what happens as the morning progresses. I'll be honest and say that although I slept pretty much all day yesterday, I had absolutely no trouble sleeping last night. And I can't but help think that I could lie down again now and easily go off to the Land of Nod.

So I am going to have to take things easy today, see how I feel as the day and the week progresses, and if I can't stop sleeping perhaps pay my GP another visit just to check that things are alright.

I Seem To Have Spent The Day With Doctors

With it being Friday, it was psychotherapy day, which meant a night of interrupted sleep, an early exit from the house and a trip to the bus stop to catch a bus to the hospital. I'm a bit paranoid about timekeeping, and I was a little late setting off this morning, so when the wait for the bus seemed a little longer than normal I worried (absolutely needlessly) about being late for my appointment. The bus eventually arrived, and because the kids are still on summer holiday, and because the traffic seemed a little lighter than normal, I arrived at the hospital with time to spare. Not as early as normal, but still early.

Today's session started as usual with me being struck dumb and unable to express myself in any way, but my psychotherapist has become used to this and after a couple of minutes always makes a little comment, half couched as a question, and I generally start talking from that point, and rarely stop for long during the session. When I do take a break from talking, there is usually a simple question about how I was feeling at the time that I am talking about, and off I go again.

If you were asked to talk about yourself for 50-60 minutes, you would probably find it quite difficult. Then imagine what it is like having to do that to someone who is a total stranger on a weekly basis. It is difficult, it is very difficult, and you end up going to places in your mind and finding memories that you didn't know existed. It is an emotional roller-coaster that can be very traumatic at the time that you are talking about those memories, but which can ultimately become therapeutic because of the knowledge of yourself that you gain from the experience.

Today, for the first time, the session did not revolve around my relationships with my family and the causes of my beginning to start to suffer from depression. Today the session was emotional for a different reason because it revolved around the reasons for my having to seek early retirement on medical grounds. It was looking at how difficult other people find it to know what to say or do when confronted by someone with mental illness, how we suffer from discrimination in the workplace because of something over which we have no control, and how it makes you feel when you find yourself in these kinds of situations.

I have to admit that I was quite glad to get outside and start to walk to the bus stop to catch the bus for my journey home.

This afternoon, I had another encounter with a doctor; this time it was a visit to see my GP. Up until a year ago I was blessed with having perfect blood pressure. Then suddenly instead of a text-book perfect BP, it started to rise. The situation has been monitored and the possibility of medication has been discussed. The last time I went to see him, my GP was concerned about the level of anxiety that I was exhibiting, and as a result of this, and the fact that I was finding it difficult to climb out of the depression that I was in, he decided to change my medication. This was my first visit since the change and he commented immediately how much more relaxed I seemed. I knew that he was going to check my BP, he had told me he would the last time we met, so I was prepared for it. To make sure that I was relaxed, I set off for the surgery early, booked myself in, and sat in a quiet corner of the waiting room reading a book to take my mind of things and to get myself into a calm state. Once in the consulting room, and after the pleasantries had taken place, the cuff was put on my arm and I was told to sit back in the chair, close my eyes and to concentrate on my breathing. GP then proceeded to get me into as relaxed a state as he could before pressing the button on the machine. But even after this attempt to get me calm and relaxed my blood pressure was still much higher than it ought to be. At least we both did our best to make sure that it was a measurement taken without the influence of a stressful situation, but the result is yet another tablet to be taken each day.

We then talked about how my psychotherapy was going, the reasons for my feeling low at the moment, but how I wasn't feeling as bad as I expected allowing for the time of year and the anniversaries that will occur next week, and that I felt the change in medication had brought this about. We talked about how I wanted to be monitored in the future, although that won't start until my BP is under control, and I said that I would like to settle into a routine of monthly appointments, which is what I had become used to over the years, but that obviously if things got very bad, additional appointments would be made.

It was a long, totally unhurried consultation (but before anybody complains about me making my GP late for his following patients, it was a prebooked double appointment). I left feeling that I had been treated as a person, not just a number on a balance sheet, and that I had been properly allowed to take part in determining the way in which future management of my health will be conducted. Somehow I really don't think that would be possible if Gordon Brown and Lord Darzi are allowed to ruin the NHS in the way they plan to. I know I won't get treatment like that in a polyclinic.

In Sympathy With The Medical Profession

I am not a doctor (I'm not clever enough and I'm too old to try now) but I find it very interesting, and often very amusing, to read the blogs of the Jobbing Doctor and a number of the other doctors who regularly give us their point of view on things medical and that pertain to the medical world. Over the last week there have been a number of posts from these caring professionals dealing with the Darzi Report as well as the wholesale GP-bashing that seems to be going on at the moment.

As a member of the general public who has the need to consult a doctor on a regular basis, I would like to say how much I sympathise with the doctors in this country and the horrendous attacks that are being made on them by people who really should know better. I was with my last GP for about 15 years and he knew me very well; he helped me through the grieving process when my husband died very suddenly, and he supported me through a number of major illnesses, which eventually led to my having to take medical retirement. My move from Cambridgeshire coincided with this wonderful GP taking early retirement because he was fed up with the way that this government were treating doctors, and GPs in particular. So having moved to London, I had to find myself a new GP and I was lucky because I found one who has been very kind and helpful over the last year. Unfortunately this new GP is retiring in just a few weeks, again pretty much as a result of the GP-bashing that this government seems to be so keen on.

Why am I commenting on this? Well, as someone with a very complex medical history (which has all happened in the last 10 years) it is important to me that I have a GP with whom I can develop a good relationship so that it is not necessary to go through my complete medical history each time I have an appointment. What worries me is that this situation could very likely be what is facing us if Lord Darzi, the Government, and the CBI get their way.

One thing that the NHS will never be is a business; it is a service and should be treated as such. Yes, we should be entitled to expect certain standards, and with the right support the NHS can meet those standards, but if Government is constantly moving the goalposts, it is understandable that doctors will become disenchanted and feel less inclined, as well as being less able, to provide the service that they so obviously want to.

So, I am happy to stand up and be counted. I want to stand with the doctors and say to the Government, "Keep your hands off our GP practices, stop trying to privatise something that needs to remain in the public sector if it is to continue helping those of us on low incomes who can't afford private medical insurance or with complex medical problems that require regular contact with the same doctor for continuity of treatment".

A Patient's View of Darzi et al

I am probably one of the few non-medical, non-journalist types to have read the much heralded report from Lord Darzi, but I am also reasonably sure that I will not be the only person to read it and end up thinking "What is it all about?" I admit that there were some areas that I skim read, whilst there were others that I read in detail, even going back to reread them to make sure that I hadn't misunderstood what was being said. The Jobbing Doctor, who is one of my blog favourites and has already made a number of posts on the report, doesn't seem to be too impressed. And I can't blame him. As a classic example of mean-nothing doublespeak, this report is brilliant.

This is supposed to be putting forward something that will benefit the population of England for the next 10 years, I was unable to find anything that told me what was actually going to happen other than the fact that drugs would get faster NICE approval, and this had already been announced, and that I would have the right to choose my GP, not only which practice I joined, but also which doctor in that practice I could ask to see. Now correct me if I'm wrong, but I thought I was already able to choose which practice I joined, within certain constraints to be sure, and up until a few years ago I could ask to join the list of a particular doctor within that practice.

I consider myself to be reasonably intelligent, I have studied in my own time for a degree while holding down a very responsible job, and I hope that I have a reasonable command of the English language, but I had problems understanding what this report was trying to say. Some years ago there was a push to make sure that important information was put forward in clear language, that anyone could understand. This report fails to meet that criteria. Why do I find this so worrying? Well the NHS is something that affects all our lives and we ought to be able to have a say in what we want. This report claims that the views of patients and NHS staff have been taken into consideration in making the proposals for the future, but we still have things put forward that are not necessarily what the patients (or even the NHS staff) want. Having moved back to London after living in another part of the country for 30 years, I decided that I would try to integrate back into the community and one of the ways in which I thought I could do this was to join the Patient Panel at my GP Surgery. We don't meet very often, but we do thrash out matters quite carefully, and we got agreement for the practice to offer some late evening and Saturday appointments before the government decided to impose this on GPs with threats of funding cuts. We also discussed and agreed to changes in the way that the practice operated its Duty Doctor rota with the result that the practice can now offer a significant number of additional appointments each week. This was achieved through thoughtful discussion, everyone's point of view being listened to, and compromise where it was necessary.

The NHS will never be perfect, will never meet everybody's dreams of what such a service should be, but there must be ways of providing an efficient service that meets the needs of the vast majority without introducing extra layers of service which will be costly and only be pandering to a small section of the population. Why put large sums of money into polyclinics (in London) and heath centres in other areas of the country to help a few people who don't want to take time off work to see a doctor, when that money could be put to use in the NHS that already exists and does a pretty good job as far as I am concerned. I've always understood that the way to get the best out of anything or anyone, is to ensure that the best use of the money available is made and that it should not be wasted on infrastructure and manpower that does not enhance the service provided. In other words, IF IT'S NOT BROKEN, DON'T FIX IT.