Wednesday 20 June 2018

A reprieve and a celebration of goodwill

The signposts are appointments
The year in almost a decade now has been signposted by my visits to see my hospital consultants first in Amsterdam, then in Wrexham, London and now Manchester.
My visit today for which I took the day off started easy. My Uber ride to the hospital was without event, arriving with about 5 minutes to spare. I do worry about the rides because of the concern about getting to the hospital late has added more millimetres of mercury to my blood pressure readings as to put it in the danger zone.
Up and down and just about right
I booked in at reception and within minutes of my sitting down, a nurse I had not seen before called me in for the initial checks, weight, up a bit, height, down a bit, blood pressure, good, a bit can be improved upon.
After that, I met with a registrar who seemed to have swotted up on my notes before asking a few questions about how I felt. It seemed to me that my concerns about memory in terms of shortness and loss of it at certain times for which I had the HAND test last year had become something to do with my moods.
Moods are not memories
I had to immediately correct the impression, the medication I have been on for 8 years now, might cause cognitive impairment, that impairment is neither psychological nor psychiatric. Then the issue of folic acid deficiency anaemia, the counts are still low and this might need stronger medication than can be bought over the counter. My GP will be instructed to that effect.
The reason I was back for consultation within three months was to review my drug regime, a topic that had come up for the past two years. At my last appointment, I was given four choices to review. One that would have changed my drug regime from single-pill daily to twice a day, I ruled out, but I did have concerns about hepatic and cardiovascular side-effects, whatever is lactic acidosis and the dreaded lipodystrophy.
The registrar assured me that there would be stricter and frequency monitoring considering my medical history, however, we could postpone this activity for another three months.
Giving back wealth and experience
Through our discussions, as I had mentioned the many consultants I had met in that department over the last 3 years, we touched on the activities of the retired head of department who is out in Myanmar working for a foundation proving acute healthcare services in the region. He showed me his blog which makes interesting and revelatory reading, especially when comparing the advances in the West to the issues in less developed countries.
This is after 27 years of being an NHS consultant, he has retired to work in environments that would tax people half his age and he seems to be having a time of his life. Very inspiring.
I had a new drug prescription made before I went for phlebotomy, where the queue was 40 deep until 10 were called off to be fed to vampires in another consulting room, the waiting time was close to 60 minutes. When I did have 6 vials drawn, I returned home and went to bed. Until September comes.

Friday 8 June 2018

Thought Picnic: I did not know I was clinically depressed

The foundations of woe
The so many ways I have been blessed and fortunate sometimes escapes my recollection and the constant need for expressing gratitude.
Having been brought up in an environment where everything was seen in terms of the supernatural, the spiritual, the paranormal and fates over which we had little control than to be in fearful supplication to deities that hardly be bothered with our pleadings because we had not flagellated ourselves enough to be worthy of a hearing. The psychological damage had the strongest foundations to build upon.
The result was fear, foreboding and premonitions, visions and apparitions of things that defy logical explanation, yet, were as real as they could be to one as the principal agent and victim of that circumstance.
Between critique and criticism
A constant questioning of one’s sanity not helped by the reasoning that was projected on my person as being slow, sometimes unsighted, probably dishonest and hardly reflective. None of this was helped by those who found opportunity and latitude to take sexual favours off me from childhood and the absence of someone in whom to confide in about my fears.
My fears as I would learn were signs of weakness, a feeblemindedness that needed a stricter and harder way of life from the simplicity of ease in my home. A boarding school beckoned and away I was from that presumed safety and left at the whim of tortuous cruelty to which I needed to adapt lest I be bullied more than I had the capacity to endure.
Beyond that, I was a bed-wetter, at a time when it was not considered a psychological issue, but one in which I lack self-control or discipline. The antidote it was to shame and to ridicule me, all of which I absorbed because I was the problem. For the first two years of boarding school, my mattress was given a daily airing in the sun, just as was the case for two other classmates.
The things I saw that none believed
It all came to a head, first at home when I thought the monstrous thing I saw twice in one night was the devil, having been primed earlier in the day with tales of horror. My experience was dismissed as excited exuberance and my life became the recitation of Psalms in a language I could hardly speak over cups of water to drink or buckets of water to take a bath.
From prophets to shamans, I found myself in hovels and grottoes, prognosticators, seers, mediums and sages, saw evils and perils ahead for which we needed to appease gods and God, none of which helped my psychological wellbeing.
I did not know I was depressed
It is only recently that I have been able to reflect on the fact that my late childhood into my teenage years' presented classic symptoms of untreated clinical depression. Irrational fears, sinking feelings and waves of terror that greeted my sighting our house from the beginning of the street that led to it. I could not explain it, but it was there, a burden, a weight, an unease and utter discomfort that I just pressed up against as other unhealthy habits and acts began to characterise my personality.
The times I attended lectures and could not for the life of me appreciate why or what I was in class for. The culmination of which was five wasted years of tertiary education, for what I had in mental capacity was nowhere near able to overcome the psychological stresses I was under, conveniently dismissed as lazy on the one hand and me not pulling my weight.
I just muddled through day after day until a sudden decision by my father to work the demons out of me at his flailing farm led to my running away from home. It probably was my saving grace, because the pressure in my chest lifted, but I could see no future yet.
A new lease of freedom
Then, in my darkest hour, my aunt invited me to stay with them, then, rather than press me into their way of life and belief systems, I was given the latitude to explore, to breathe, to grow, to assert and to thrive. That led to the rebuilding of everything that I had lost, the full force of facing my failures and having at the back of my mind that opportunities once lost can be regained, albeit after a temporary setback.
I have not even touched on the compounding issue of addressing, understanding and accepting my sexuality. That, I have borne as a refrain and undercurrent of my life since as early as seven.
I just coped and not out of ability
Depression presented itself too many ways that maybe the Psalms, the prayers, the rituals and much else helped me survive, even if I doubt I was ever free from its effects. The coping mechanisms were a kind of stiff upper lip stoicism, reserves of resilience I never could account for, or a sense of independence or even inviolability or invulnerability left me exposed to situations where I had a false sense of security.
Schooled on the idea that only the weak needed therapy, it was not until a few months before I was struck down with cancer, I had just survived a bout of shingles that discussing all the feelings and apprehensions I had with a neighbour with a career in medical sciences posited that these were signs of depression.
Things I left undone
I gave it no further thought as I ended up in the hospital and traversed a course of five days from denial that my life was in grave danger to the acceptance that whatever danger was presented, there was a possibility of a future beyond this. It meant that when a prognosis was given that I probably only had five weeks to live if I did not tolerate the treatment, I was more in hope than despair that I would see it through.
The fact that I had left this existential threat almost too late to be attended to might have in another setting drawn excoriation and rebuke, I was fortunate to have sympathetic and determined medical personnel supporting me through the ordeal.
How my personality attacked me
As I began the course of treatment, the way I presented gave the false impression that all I needed for the medical intervention, it took demanding a psychological attention to my situation before I was recommended for therapy and psychiatric counselling. My case was, having suffered a catastrophic loss in health, wealth, well-being, status, comforts and on the verge of losing my house, there was no other indicator needed to describe my need for urgent psychiatric help.
My medication presented other issues and side effects, diarrhoea, insomnia and occasional claustrophobia acute in vivid dreams and once experience that had I not resisted stepping out of my apartment, I would never have returned to that safety and enclosure ever again.
I did not present the classic signs or the way the questions were asked of me suggested I needed no help, yet, I felt just the opportunity to talk to a professional was more than necessary before I lost my mind. The bills were mounting, creditors were threatening and there were no easy solutions in the midst of undergoing chemotherapy, the loss of two close friends and no clear future prospects beyond surviving cancer.
The terror of suicidal thoughts
Then I was terrorised with a crazy thought, I lived on the 7th floor of an apartment block, my windows were tall and apart from a single bar at the lower end, I could step out. I had visions of stepping out and flying, then knowing I could not fly, a playback recurred of my body splayed out dead on the tarmac below. It haunted me many times, but something kept me from carrying it through.
I had a story and I did not want it to end in that way, there were enough tragedies and misfortunes swirling around than for my life to culminate in that, I never talked about it to anyone. I am just glad that the thoughts never got to the point that they overwhelmed my reasoning. I found times to cry, probably not to regret, I embraced my humanity and vulnerability and comforted myself with thoughts that things will eventually turn for the better.
I found the support that pulled me through
None of this would have been possible without help; medical, psychological, in friends, in neighbours, in lovers, in my faith, in hope, in God. I was not invincible, I never was, I just by fortune beyond what I probably deserve found peace with myself, an acceptance of who I am and an accommodation for the frailties and failures that have become part of the story of the successes and victories in life that I also celebrate.
As I think of life and also think of death; I hope that as long as I live, I continue to love life whilst not living in the fear of death.