Health Update- Part 3 (The Finale)

Congratulations…..get your cap and gowns as you’ve all graduated from the “Ali’s crash course of health issues”. This will be my last health update post and the aim from now on will be to update weekly/fortnightly on what is happening, how I’m feeling and run alongside that some hot topics I am itching to write about. Grab yourself a celebratory tipple for the final instalment. 

Gastro-

My gastro system was one of the first issues I had going back 10 plus years and we went round a merry go round of IBS, Crohns disease and many more illnesses over the course of that time having more investigations than I care to think about. You can read more about this in one of my earlier blogs “A gut feeling”.  Once I was referred to a neuro-gastroenterologist I started to have the right investigations and gradually the pieces of the puzzle started to fit together. Many people with EDS have gastric dysmotility this can be in the form of too fast or too slow transit or it can swing between the two. Both conditions share some similar symptoms but there are marked differences between them. One thing they both have in common is how debilitating they can be for the patient. 

A few years back I had exploratory surgery for a mystery “lump” during the surgery adhesions were found which are bands of tissue that were wrapped around my lower bowel. I remember the relief thinking we had finally found the cause, this tissue was cut and removed however I was told the possibility of this tissue growing back was high and in fact the more times you go in and cut the more scar tissue forms and the worse the problem becomes, great stuff!! Shortly ensued a colonoscopy and barium studies.

 My most recent “bowel” related test was something called a tracer study under nuclear medicine. I had to take a set of pills over the course of a few days, each pill dissolved releasing various shapes into my digestive tract which are highlighted on an x-ray. On day 7 I was scanned with the aim of the game being 80% of the markers to have packed up and gone down south, I’m clearly a Northern lass through and through as you will see!! The follow up with my gastro came who said the good news was the markers weren’t stopping at a particular junction which meant there was no need to remove a particular section of my bowel that had nerve death. I thought I was home and dry I turned to my mum relieved about this however I soon noticed the expression on his face and he explained that the entire bowel seemed to not be as it should even parts of my small intestine and it was a worry that this related to the nerves and muscles ability to propel contents along. He said if this was a case of ‘simple constipation’ the transit time is usually normal and most markers would have left with only a few residual in the sigmoid colon.  Below are x-rays of my small and large intestine, the images were clearer on my consultants computer whereby he could fade some of the white out for clarity particularly at the bottom of picture 1.  Off memory 59 remained from 72.

As you can see there is quite the shape game going on here and unfortunately they are dotted throughout which signifies an issue with the nerves and muscles throughout the large bowel and a portion of the small bowel. This is called colonic Inertia. The pain this causes at times is unmanageable, all of our systems propel food in what should be a nice rhythmic manner however mine is out of sync, completely un-coordinated and poor functioning which leads to such extreme cramping at times I have passed out not long after eating. The pain can fluctuate throughout the day but never leaves.  My diet is extremely limited and standard laxatives just sit in my bowel causing further cramping instead of doing the job they are aimed to do.  To try and relieve the pain of the cramping I am unable to take opiates as they feed into the problem further as they slow the bowel down and they don’t stay down long due to inflammation of my stomach lining. I was assigned a bowel function nurse and currently experimenting as and when with a medication called linaclotide, enemas, self bowel massage (funnily enough I can’t find a beauty establishment that lists this in there treatments) and some home remedies. There have been a fair few trips to hospital over the years with suspected bowel blockages.

A radioactive egg and jam sandwich came next, yes you hear me correct!! It was certainly not gourmet. This test was to study the motility of my upper stomach.  I explained to my consultant some days I feel my food is sat in my stomach for hours and I can only manage a few bites through nausea and feeling full and other days it feels its tipping out of my stomach too quickly and I get shaky, nauseas, low blood sugar and some other symptoms I will kindly leave out. Once I managed to get the sandwich down which is no mean feat I can assure you I was scanned at regular intervals. The radioactive substance within the sandwich is highlighted so they can trace its location in your system. On this day the result showed rapid gastric emptying, essentially my food is tipping out of my upper stomach quicker than it should leading to nausea, sweating, cramping, low blood sugar and not really feeling you have eaten shortly after a meal. I know there are times when my stomach is extremely slow and this would be slow gastric emptying of which I feel sick and I can’t actually get any food down at all of which I have nutritional drinks as a back up. It basically swings between the two but on this day it showed rapid.  As you can imagine its quite hard to treat a stomach thats tipping too quickly and a bowel and small intestine that are on a permanent vacation as the two contradict each other.

Since surgery I have had problems with my swallow, my food is sticking and I can either get it down with fluids or its back up we go. I had a barium swallow which showed some pooling of barium but we have not yet bottomed why this is happening daily. Thankfully I am not aspirating my food which is the real danger however none the less its extremely unpleasant and can be frightening. Due to NHS cutbacks my consultant has had one of his two clinics taken off him so he now has to cram two clinics in one so I don’t get to see him until October (insert frustrated face).

Iron Deficiencies-

I have difficulties with malabsorption of nutrients combined with a very limited diet I often don’t get enough of what I require. I had visited my GP some time ago reporting I felt much more tired than usual, breathless and pale. She ran some bloods which came back as my ferritin (iron stores) were extremely low. I have been here before and recognised the feelings. I have tried many iron supplements over the years and they do not raise my levels, they cause a lot of side effects and are now a contraindication due to my bowel difficulties. My ferritin has dropped further since the initial blood test and an iron infusion (cosmofer) has been arranged for late next week which will take around 6 hours if all goes well, ill get some movies downloaded for that one!!  Ive had one before many years ago and I do tend to feel quite unwell during and a few days after them but when this lifts I feel I have much more energy. Essentially I’m running on fumes at the moment so hopefully topping the tank up will make a positive difference.

Years ago I was placed on B12 injections after reporting the same symptoms as above in addition pins and needles and numbness. My B12 was tested and was rock bottom, I got quite unwell at the time as it was not reported properly by the hospital initially so it went untreated. I was commenced on B12 injections and have them 3 monthly.  As part of a new initiative my GPs practice are training patients or partner/family to do the injections. My partner and I went down for the training with the lovely nurse.  I didn’t think I would have a problem doing this injection myself and drew the fluid up, changed the needles and when it came to putting it in at a 90 degree angle (all the way in I might add) I just couldn’t push it in. I was surprised as I am not in the slightest fearful of needles.  My lovely partner stepped in and was shown how to give it in my arm. The injection is uncomfortable as it has to penetrate the muscle and not hit the tissue so it is a very deep injection and the substance itself stings but it is more than manageable and usually only lasts for a few minutes. My partner did a sterling Job and said he could not have done it to himself either but I have to be nice all the time now as he has the needles 🙂 The lovely nurse said we are welcome to come back anytime for a refresher which we probably will do, I will give it another go myself as I don’t like to be defeated!! Below is the sharps bin, B12 and needles, to be fair you can see why I struggled pushing that needle all the way in myself. My arms are so thin I’m surprised it didn’t come out the other side!!

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ENT-

I see my ENT consultant in a month to discuss setting  a date for my deviated septum surgery. I was on the fence whether to have this surgery or not, to be honest it would be nice to get my right nostril out of retirement and to alleviate the chronic sinusitis it causes as its no fun really. Ive recently been having problems with my ears which will be added to the list to discuss during the appointment.

Eyes-

I have Posterior vitreous detachment of both eyes meaning the membrane has separated from the retina. Its quite a common condition but usually in those over 65 not 33.  On my left eye the membrane has fully come away and on the right its hanging on for dear life and half pulled away causing floaters, flashes of light and sometimes it feels like I am looking through a cobweb, its extremely annoying however not painful.  I have to be careful for any sudden changes and have to be checked out by the eye hospital due to the possibility of retinal detachment which is a serious condition.

My vision is at times blurred, double but more so a loss of focus and clarity.  I am under vision therapy at present trying to get the brain and eye to communicate better however we are not sure if this is related to my head/brain and CSF problems which can cause similar symptoms so it feels a bit of a guessing game at the moment as to what is actually going on.  It is like this with many aspects of my health right now and many conditions mimic each other symptom wise so to pin down the origin is proving a challenge, a frustrating and tedious change at that.

I have dry eyes which are extremely annoying!!  They itch, burn, sting and feel like the gritters have been doing a day shift pretty much 24/7. I use eye drops recommended from my eye doctor about x8 a day and use warm heated pads on my eyes to add moisture to them.

There are MANY other things going on with my health, only yesterday I was told I had yet another issue which I will talk about in my next post. I just wanted to get the bulk of my current situations up to date for fluidity and now I am good to go.  As you can see there is an awful lot going with my body but just how does it feel physically, mentally and emotionally, just what goes on at the appointments, how much advocating has to take place, what mistakes are made, is there joined up care, how much support is available for those living with a chronic illness, what judgments are made about those living with invisible illness….these are just some of the topics I will be writing about over the coming weeks. 

*I receive many e-mails from my blog from patients and families which is lovely, if there are any particular topics you would like me to write about or hear more about please get in touch either via the comments section or you can e-mail me through the contact link via the menu*

 

The Invisibility War

“You look really well” those four words again, the cynicism builds within me.
‘Do they think I’m making this up or something? I may look okay but I certainly don’t feel it or maybe they are just being nice”.

 
In society, there is a mainstream idea of what illness should look like, how long it should last for and expectations of recovery, when you will suddenly become ‘well’ again. Unfortunately, for those living with chronic illnesses we will never meet those expectations, we may fluctuate within them, learn new ways of managing our conditions, go into ‘remission’, our symptoms may wax and wane but we will not get ‘well’.

 
Many chronic illnesses whether it be EDS, depression, anxiety, lupus or Crohns disease, to name but a few can be invisible either on the most part, on days, weeks or even months. This invisibility can make it extremely difficult for even those close to us to be able to relate, acknowledge, understand and empathise with our individual daily battles with illness. It can be hard for people to relate when something isn’t always apparent or visual. However just because you are unable to see it does not mean it is not there, it’s very real.

 
It is estimated that 69% of those with invisible illnesses were told their symptoms were down to anxiety or not even believed, before eventual diagnosis. Many people with invisible illnesses have spent years being disbelieved, poor treatment and care so you can see how the words of others can have such a significant impact on their wellbeing.

 
Over the years, I became somewhat a master of hiding behind my pain. I did not have a name for all the symptoms I was enduring, I could tell at times certain people doubted the validity of my symptoms and suffering. It was somewhat easier to hide behind a smile than attempt to explain just how unwell I was feeling when overall physically, I looked fine. I even took this stance often with certain doctors or consultants as I felt their willingness to help was not there, they could not find the cause of my problems therefore to them they did not exist or exist in the capacity I presented to them.

 
Since my diagnosis’s my attitude has changed to a certain extent, I am much more open about how I feel both physically and emotionally, I no longer actively hide my symptoms behind a smile, I choose too at times. Validation of a diagnosis can help enormously in the ‘believing’ stakes but not necessarily in the ‘understanding’ stakes. Living with a chronic illness is unpredictable, literally not knowing what is coming hour by hour, even minute by minute. It is a hard task constantly adjusting to this unpredictability. What we can do one day we may not be able to do the next day or even again that same day which those without illness can, not always, but can find hard to comprehend. If we have one activity that day (usually hospital) everything pivots around that. We could be seen out ‘looking well’ but it’s not seen that to enable us to make that outing we had to stay in bed until it was time to leave, we couldn’t possibly wash our hair too and afterwards when we get to our homes we crumble with pain and symptoms, all behind closed doors. When you’re seen out, it’s just a snippet, a snap shot, a moment, not your actual reality.

 

In life, we only see what we want to see and only let people see what you want them to see. We often live our lives through many different faces and smiles that may not necessarily reflect how we are feeling. That good old British stiff upper lip!!!

I am ‘a smiler’ it’s my way of coping, almost like my default mode. I don’t want the conditions to define me, I want to hold onto as much of ‘Ali’ as I can. I will often feel terrible but put my make-up on and some nice clothes just to sit in my house for a feeling of normality and to break up the horrendous ‘my heads falling off hobo look’ of late!! I may take a ‘selfie’, I may post on social media, you may see me smiling however don’t be fooled by the smile, it does not mean I am healthy and miraculously cured. It means I am happy in that moment or I am trying my best.

 
It’s strange that we all, myself included on the most part relate more to the visuals in life. Some days my condition can be very visual, will I let you see that? On the most part, no. I’m not ashamed of my illnesses but I still feel uncomfortable allowing people to see me look so sick, on these days, moments, weeks, I will stay in. I could be in numerous braces to steady my joints after dislocating, my neck brace on, using my walking stick or wheel chair, underneath the make-up looking like I’ve done 12 rounds with Mike Tyson with black eyes from brainstem compression, black and blue with bruises, resembling a real-life mummy wrapped in KT tape and on those days, I find I don’t actively talk about my symptoms as much because they are VISIBLE, often speaking for themselves. Does this mean the days I am not in a wrist brace, means I am pain free? If only, the pains in my wrist are constant it just means on the day I’ve worn the brace the bones have disconnected and its dislocated so I need to rest to it.

 
I would say for anyone living with chronic illness, whether invisible or not to go easy on yourselves. Do not feel you need to justify your pain or your symptoms. What you are experiencing is real. People will never fully understand, even people with the same conditions as you, as we all experience pain differently, we all have different symptoms and coping mechanisms. Our lives are already filled with challenges, we may also be in pain from a life un-lived or lived how we had not imagined so be kind to yourselves always.

 

It may at times be invisible but that does not mean it’s not there. See into the invisibility and help make our invisible, visible.

 

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