That shoulder thing

My left shoulder started causing me trouble quite a while ago now… about three years ago I guess… and intermittently I try to do something about it.

About Aug/Sept last year I got myself another referral to physio (my 3rd I think) and a promise of some more attention. The local policy appears to be approximately 6 sessions of physiotherapy before they need something new.

This time we were able to make some progress on the underlying issues – above and beyond any basic hypermobility (which was not discussed) the possibility of impingement was raised for the first time (not sure why it wasn’t considered before).
Although I did have a course of acupuncture again, I found that the deep tissue massage and heat treatment were more effective for pain relief and for the first time the suggested strengthening exercises seemed to make a difference – although it was only at the end of the course of physio that they suggested a resistance band to work with.
I was pleased then that I was taking less painkillers and feeling less stiff but determined that this time I would not simply wait another year for another course of physio to prescribed when inevitably all my coping mechanisms broke down and delighted that the physiotherapist was in a position to refer me to a shoulder consultant.
Yup after 3 years I actually went to see someone who specialises in shoulders!

The clinic was clearly quite full of people; some having the rehabilitation after breakages examined, some with sports injuries and a few who probably had arthritis but all cranky and bemused by the self-assessment forms we had to fill in and all sat waiting in the over-hot, loud seating by a hospital cafe.
They sent me (and I think everyone) for an x-ray before letting us see the consultant. The only other time I have had an x-ray that hurt was when I broke my collarbone aged 12 & everything hurt – but putting my arm in that position hurts that is one of the reasons I was there! Then after a series of mobility and strength tests they also did an ultrasound and I was offered something approaching diagnosis.
I was rather troubled by the mobility tests – my range of motion is quite good (its not like the knee that just wouldn’t straighten) but a) that is largely down to extensive physiotherapy and regular exercise and b) it hurts.
I understand that they need to check whether there appears to be some kind of blockage etc but I wonder at what point I am supposed to say ‘please the more of these we do the worse it gets’, I didn’t get the impression that he heard me when I said yes I can get my arm into this position but in my daily life I would avoid it wholeheartedly because it really hurts. And yes, I know it was excruciatingly hot in there, but some of that sweat was from tension and pain.

Still, there was something visible in the ultrasound – I liked the ultrasound; the gel was cooling, the process was not painful and the machine looked pretty nifty. I would really have like to have seen the pictures though.
But, what the consultants could see were lesions from an impingement (which sounds like they are infectious – they aren’t) and what it means is that the bones are essentially rubbing together – hence physio is supposed to strengthen the muscles which hold them apart. They sent me a letter with the technical details which in theory tell a Dr which bits are causing the trouble but didn’t entirely help me work out quite what my shoulder was doing to itself even with the wonders of Google.

So after several hours of waiting and prodding and poking I was offered some ways forward. The plan went as follows: a steroid injection, more physio, a check-up a couple of months down the line, and then possibly another steroid injection and possibly surgery or both…

Steroid injections hurt!

Actually I might stress that some more they really really hurt! According to my letter, there was anaesthetic in the mix as well as the steroids which might explain why I was able to walk home but were definitely not noticeable enough.  [Warning: do not read this next paragraph if you are squeamish about needles]
Part of the problem is that when you stick a needle into a joint you can feel it go in and then you can feel it move around. It honestly felt like it was grinding. I am not a wimp, I am ok with giving blood and getting injections generally, I am used to being in pain but this pain was enough to make me think I was going to pass out. The nurse brought me water and I sat with my head down for ten minutes or so – waiting I guess for the anaesthetic to kick in – at which point the consultant checked I could move my arm (and yes moving it over my shoulder was at that point easier) and sent me home.
Gradually, the stiffness set in. I definitely had a steroid flare up and co-codamol was not touching it. By the following morning I couldn’t raise my arm at all, I could only dress myself in small stages to recover from the intense pain, I couldn’t carry anything, I couldn’t even sit quietly without pain. I was a mess.
Still this too passed and two days later the pain had subsided enough for me to feel normal again. I’d like to think that the following two weeks were noticeably better in terms of ease of pain-free movement but I’m not convinced. To be brutally honest they are going to have to offer me some better improvement than that to make the injection worth going through again… As I type the shoulder is aching and complaining and I am still waiting for the referral for more physio to be acted on.
Sigh.

 

Drat!

So apparently depression has properly been biting my backside the last month or so.
Best laid plans have not come to fruition and I haven’t really been able to see where I am going or why. Mostly I have slept, felt tired and complained about how much shoulder hurts (apparently the new physio exercises are very uncomfortable and not making the days easier), and all i have wanted to do is sleep and curl up in the dark.

So.. um. Sorry

 

Turning 30

I pretty much like getting older.
Its kind of comforting, freeing, hopeful and exciting but milestones are pretty scary.

When I was about 15 I had a list of things to achieve before I was 21 (which gradually became 30) – at 15 the list had things like have sex with a man, have sex with a woman, get a degree, take certain drugs, own my own throwing knives, travel to every continent, skydive etc… I did a lot of those things but there were always more experiences and more targets to reach.
I want to tell you that I am proud of what I have done with my life and sometimes I am.. my relationships, my marriage, my doctorate. – all not inconsiderable and all pale gently beside actually living day-to-day
I really am consistently amazed by those strange people who get up every morning like its no big deal – getting out of bed like it doesn’t hurt, like you don’t want to curl up and cry. How do people do jobs and housework without collapsing? What is with leaving the house *every* day?
Nothing makes you feel like a failure like looking at the careers and families of your peers… Knowing the reasons that I don’t have a full-time permanent job and 3 kids (depression, anxiety, chronic pain, relationship choices & financial planning a.k.a. laziness,  cowardliness, deviance & lack of ambition) doesn’t make me feel less like I should be coping better.

Every time I hit a “life event” I start to miss my mother. Its a silly thing, on the basis I no longer have any idea about how she would react to my life now, how she’d feel about modern life like the internet and mobile phones, I can’t imagine what the arguments of my teenage life would have been like, or the discussions about my partners, what her opinions on my wedding might have been or her recommendations about my career. I can’t imagine what my relationship with her would be like and I have no understanding of other people’s relationships with their mothers at all. It seems almost ridiculous to guess and even more daft to still crave her approval and yet I still get blindsided by her loss at inopportune moments.

I guess the point is, if I ever thought I would get to 30 this isn’t what I expected. I am kinda disheartened by the whole process in that I am not all grown-up and barrelling along with my glorious life. In fact I kinda don’t know what next…

• I did the doctorate (which I might add in no way makes up for secondary school & undergrad, sorry) but don’t want to be a lecturer – I think in terms of continuing research its got to be publications
• I found my special someone… and someone… – the next obvious step must be kids which I think I (we?) want but what about the: money, organising, prejudice, fear.
• I have *a* job – I don’t have a real income generator, or even a full time position and I really want to feel like I am contributing financially – next step is erm decide what I can actually do? Could I run a pub? Work in a museum? Even actually manage 9-5?

I don’t feel old, I feel young. But I am jaded, bitter and scared and I only see an economy and a political system that doesn’t want me.
So what now?

Beer Festival 2013

Another year another CAMRA beer festival
A somewhat rearranged and controversial affair this year, it was at least blessed with some sunshine.

For me though it was mostly a reminder that I am older and more broken than I once was.
It seems rather frighteningly that I have been volunteering at this festival for almost ten years. I have done my time at the bar, sat behind membership and at products (kind of a CAMRA gift stall that also does soft drinks); I have run backwards and forwards on traditional pub games, shouting and hustling for all I was worth; I have hefted scaffolding, built bars and lugged firkins; I have worked for a number of years on the cellar team and for plenty of that time I have also worked at the pub.
Double shifts are exhausting.
Somehow every year I forget just how exhausting.

The last couple of years have really taken their toll on me. The new type of breakdown and subsequent anti-depressants reduced the amount of exercise I was taking and helped me pile on the weight [In the c. 4 months I took Mirtazapine I put on over a stone & the same in the 6 months I took prozac before that]. Worse, the last 2 and a half (plus) years of shoulder pain and 9 months of knee issues have left me constantly exhausted and unable to do a fair number of my normal activities.

Some days I notice how much movement, strength and energy I have lost.
It hurts.
Physically and Mentally.

 

 

 

On a related but very different note – I think I get more pissed off every year at the self-righteousness of CAMRA members and volunteers about how much better They could run the festival.

 

New Year – New Health Plan

When I logged into my surgery’s online system today it told me it had been 3 months since I last made an appointment..

I haven’t been that long without seeing a Dr in about 5 years. This is the first time I have spent 2 months without painkillers in that time and for a lot of it I was also on various Psych meds. Ironically I am going back because I need to ask for more contraceptives – otherwise I’d stick med free til I crashed..again, but as it is I don’t know what to say.

Despite the cold weather I am currently functionally mobile and haven’t reached for the co-codamol in tears of pain for at least 3 weeks. This either means that not sitting at the laptop typing for my thesis has reduced the pressure on my joints to an acceptable level (i.e. one that won’t cause trouble in the immediate future) or I have become indifferent to the Naproxen and only occasional painkillers (read extra co-codamol as required) were making any difference anyway.
I am trying to do more physio exercises while my motivation/guilt is high and am really hoping that my joints are doing better. I know that I don’t want to ask for more painkillers, I feel like a junkie just asking, and I really want to focus on making the physio work for me and so thats the plan but in my heart of hearts I know its only a matter of time til I beg for them back again cos that grinding sound aint going away.

As for head-pills.
Fuck
I’m ok. In so far as crying everyday and not being able to get out of bed is ok.
Logic says its the weather and the uncertainty of waiting for a viva added to the sense of pressure about getting a job and finally being a worthwhile financially contributing member of your family that is making you anxious. Logic says sunshine and flowers and exercise and hard work is gonna get you out of this idiocy babe. Logic says eat healthily, get fresh air, exercise, think positively….
Head says – keep doin stuff dammit, wash the dishes and the clothes, walk the dog, do the exercises, write the applications and the articles – you’ll get thereHeart says – I don’t wanna face the world today, hold me and dont let go, please dont die on me, for fucks sake pretty please tell me you want to be with me and you wont kill yourself, just one cut to make the world a little less chaotic, please let me sleep …
But will January blues fade away? Should I go back to citalopram the most successful nothing-in-particular of the past? Is sertraline or something else beckoning? Is it in fact not such a big deal and rather worth skipping over in favour of worrying about it later?

Decisions to be made. Least of which is my wife doesn’t want to be a mother yet.

Man Flu

I don’t officially have man flu on the basis I have been to work.
But I have had a pretty rubbish cold with an especially irksome cough and feel rather sorry for myself. I’m pretty sure that going to work and uni libraries and stressing about my writing-up has not helped me recover but finances and submission deadlines await no woman.
Now as I start to feel marginally less like the walking dead a weird thought has struck me – it occurs to me that I had not mentally listed joint pain and aching muscles as symptoms of the bug but merely chalked them up to my everyday pain problems with a twist of poor sleep. I know (impersonally/logically/academically) that physical discomfort and painful muscles are usually listed as symptoms of a cold/flu but I can no longer tell what counts as normal and what as ill. I wonder what else this applies to… what level of pain would I would consider ‘normal’ when lifting or carrying and would I damage myself (further?) simply because I expect things to hurt?

Pain is so subjective and I have been conditioned to believe, firstly that mine is less than everyone elses and secondly that it is at best a suggestion you are approaching your limits and at worst a weakness. Mostly I therefore treat it as inconvenience to be endured.
I should know differently.
Not only is pain a warning signal (even a misfiring warning signal is a sign you need to change something) but accepting pain is not the same as merely pretending it isn’t there.
Sigh

Words on Living with Pain

A Fragment.
(Not a definitive description. Not even a drop in the ocean of the different experiences of just one person.)

In my head an awareness of pain sits like static from across the room. It hums at me, irksome and untouchable, just off kilter enough to make me feel irritable. But I am used to this and concentration on other things allows me to forget it is there. Stopping reminds me, getting tired reminds me, I remind me.
Sometimes the buzz of static grows bluebottles. Extra whining buzzes on top of the dull hum. They swoop closer or settle silent only to be raised up by something unexpected. I cannot see the cause of the bluebottles, I don’t know why the short bursts of extra pain appear or settle down again. I cannot open the window for them or squash them, I must be quiet and hope they fall asleep or find their own way out and leave just me and the static.

Bad days are when the white noise of pain that makes it so hard to concentrate gets so loud I can barely hear people’s words or complete simple tasks. Bad days are when I can’t decide if I need utter isolation to practice breathing or to do everything at once to try and shut it out until I am so exhausted I can sleep. Bad days are snappy, weepy, untouchable, unpredictable, pacing-the-floor, staring-at-the walls days.
But Good days, well I like good days. On good days painkillers work, on good days birdsong is more distracting than the static, on good days I am strong enough.

[Incidentally this description is equally valid for Chronic physical pain and for the mental pain of depression]

 

ACT or analysis

Quick thoughts on therapy:
My current counsellor has proposed two routes for me to take with regard to fighting the blues. One is Exploratory Psychotherapy (think Freud & Jung but with less sex) and the second is Acceptance and Commitment Therapy (think value-oriented mindful action).

The first I apporach with the basic fear of being caught in a blame game and never-ending sessions of attempting to root out a subconscious desire that can’t be proven one way or another. Add to that the basic weirdness of such ‘intimacy’ with a stranger and the horror of opening the broiling wounds of my psyche and the underlying fears and pain that I have spent years learning how to control and it seems a ridiculously frightening and uncomfortable prospect.
On the other hand perhaps some dark recesses would be less shadowy if I faced them, perhaps there is something lurking that a stranger is perfectly positioned to uncover and I would be able to fight my own demons more effectively and just don’t know it yet. Perhaps I secretly yearn to express myself…

The second option has the obvious advantage of a slightly buddhist feel with a smidgen of humanist philosophy and some dialetical language theory thrown in for good measure. I enjoyed mindfulness even if I never had the self discipline to follow through the practice and since ACT can also be used to help manage chronic pain it seems an obvious choice.
What if, however, I am merely throwing another coat of paint over the rust? What if I can’t muster the motivation? What if I don’t put the effort in because I am too comfortable being “ill” even though I’m actually just a malingerer? What if there just isn’t a therapist inside 30 miles?

A huge part of me just wants someone to tell me what to do; to say this is the right thing in your life and you can make it work; to tell me that I’m ok.
Trouble is it doesn’t matter if they do cos I don’t know how to believe them.

2012

It would be fair to say things haven’t started to well this year.

B was burgled, W continues to struggle with her demented grandfather and her family’s other health issues, and my baby sister has been sexually assaulted in a foreign country.
I feel useless, helpless and otherwise crappy – but you know what, other people aren’t the be all and end all of our lives. Sometimes all we have is tomorrow, so lets make it a good’un.

There is still a lot of 2012 for me to get fitter and healthier and to take care of people and be there when they need me so here I am.
I hurt physically and mentally, and I want to make sure my GP pays attention – but more importantly I want to make a difference for those who struggle everyday; I will not let fibromyalgia and cfs disappear this year and I shall try to campaign where I know others are trying to get by, I want to be a voice for those who are too busy living to acknowledge the stigma of mental illness diagnoses. I want to make a difference for those I care about.

I promise that I will try to make you feel safe again sister mine. I know that in our 20s I cant be at your side to take away the horrors of those who would hurt you any more- but I wish I could- I am not abandoning you; Call me and I will be there no matter what. xxxx

Please wish me luck, and strength and keep pushing me when I want to give up because I know I just need that impetus in the dark – I will make someone’s life a little easier with your help.

Don’t let me sink into self-pity, don’t let the voices in my head and the pain in my joints win, don’t let the hurt and the tired and the aching bitterness get the better of me.

Hold on and fight with me
Love you all

Quitting Meds

Ever wake up one day and think what is the point of these pills, I should just Quit?

I realise its probably the crazy talking but right now they could all just sod off. I feel like I am piling chemicals down my throat and gaining nothing but inches round my waist; the mad and sad is beating at my skull and every way I stand, lie down or move hurts. Part of me knows that the idea of stopping pills is a kind of weird self-harm, proof to others that I’m not doing alright and damaging all the progress I’ve made but weirdly that doesn’t seem like a bad plan.
So um stopping meds because I feel fat, weepy, useless and in pain is a bad idea?

Ah well, never mind – sense over feeling etc.