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A diagram of the tender points apparent in Fibromyalgia from Arthritis Research UK |
Tuesday, 13 August 2013
What is Fibromyalgia?
Sunday, 11 August 2013
The rheumatologist appointment
First of all it was quite the mamouth effort to get there. Remember for more than a week before hand my only adventures had been to the bathroom and a couple of trips downstairs if I was lucky. So getting out of the house and then actually going somewhere was quite the effort. But in good ME patient style I made sure that I took it in small chunks. Starting with having a wash (well baby wipe wash, I didn't have that much energy to spare, all hail baby wipes) and getting dressed, with help and I made it as simple as possible by just slipping on a maxi dress. Then I rested for a bit before going downstairs doing the bum shuffle technique and then rested again downstairs for an hour before getting into the car. The car ride was only 10 minutes but it was really painful and felt like it was a lot longer. Just getting into the car was a struggle with the limited space to swing your legs and with winging my legs being a problem anyway. Maybe next time I could try my gravity technique and hope I can get myself back up into a sitting position.
But we got there in one piece and I was wheeled by Mother dearest into the hospital. Firstly I needed to have all my bits and pieces checked like my weight and height and blood pressure and the nurse doing this was really helpful in supporting me. They also checked my wee, because of course you cannot set foot into a hospital without doing a wee sample an them taking blood (more on that later). Anyhow they said that it was showing signs of infection, which was a bit of a surprise to me but when I thought about it my lower back had been hurting more and I was rather feverishly sweaty. But of course sometimes you just think that these are 'normal' and put them down to ME, which can often be a big mistake. But here's the thing after getting a bit paranoid about it (yes Mikey paranoid) and then of course you start 'noticing' certain symptoms more I decided to take another sample up to my GP's to get some antibiotics before it got nasty and I was left with yet more ugliness to deal with and then recover from. Anyway the nurse check it and miraculously there were no signs of infection!!!! Odd but actually that suited me fine. But back to the appointment.
I actually saw the rheumatologist that I saw a few years back for my wrists so that was good, not that she remembered me but I knew that she was easy to talk to and had done a good job the first time around. So after talking and examining me, oh bejabus how that hurt! I think she got the message that I was in a lot of pain. Let me just explain that Fibromyalgia can be diagnosed by tender points in certain areas across the body that can be extremely sore to the touch, even very gentley. So that was a given. At first she didn't mention the word Fibromyalgia until I did because she believed that ME/ CFS and Fibromyalgia were all in some way connected, different faces for the same beast as it were. She noted that I usually present more fatigue and sleepy symptoms but because my body is in recovery after a flare, which was a bad chest infection I had a few months ago and left a bit too long to get treated, that now my body was presenting more Fibro symptoms. Just goes to show how long it takes to get over something as simple as a chest infection and the lasting effects it has on our bodies.
On the other hand I'm not too sure about the whole lumping the two illnesses together. I guess that could be down to her referring to it as CFS- chronic fatigue syndrome rather than ME- myalgic encephalitis. Chronic fatigue syndrome is a term hated by many sufferers as it doesn't describe even half of the other symptoms that are all part and parcel of this condition, whereas myalgic encephalitis describes a range of symptoms and has that all important word 'myalgic' which refers to muscular pain. It is certainly possible to have one without the other and there are two different societies for them. But many people with ME will get Fibromyalgia too. Like I say there are so many theories and opinions out there on these conditions that it is quite confusing and each person you see will have different terms and opinions. Oh dear. Anyhow as I meet all the criteria for Fibromyalgia based on the tender points and some other symptoms such as fatigue and foggy brain I think it's safe to say that I have ME and Fibromyalgia. She did give me a booklet on Fibromyalgia from Arthritis Research UK so I am slowly working my way through that and when I do I shall be back here to explain fibro in a bit more depth for you all.
So as well a having a flare up of symptoms after this chest infection she also thinks that it could be down to a lack of sleep. Now I know so many people who will laugh at this, myself included, given that I can have 20 hour sleeps and have never in my ME time been able to cope with less than 12 hours. However I never, ever feel refreshed afterwards, it's like a perpetual hangover- oh what is one of those again? This could be a sign of not getting enough restorative sleep or stage 4 non dream sleep and therefore my body isn't recovering as it should. So her first step and that of my GP is to try an address this sleep issue and try and get me some quality zzzz's. So it just goes to show that it doesn't matter how long you sleep for as long as you're not getting restorative sleep you are risk of Fibromyalgia symptoms and other nasties. So the next step is to try to tackle this and find something that gives me better sleep without making me anymore drowsy. She recommended a drug called amitripiline that used to be used to treat depression but now that they have more effective tablets for depression it is often used as a pain medication and for sleep. So fingers crossed it will do some good and if not on to the next.
As well as that she said that every day that I should try and move around a bit more and that means move not exercise. Mainly move more around the house when possible and a little more every day to get the muscles used to moving and to tell those dodgy pain signals that walking around really shouldn't be hurting. But obviously they will hurt at first as they get used to extra movement. So it's just about finding that balance. I have been trying to do a bit more each day even if it's just walking to the bathroom but it's also been nice to have been able to get downstairs. Change of scenery and all that! Plus more sky channels to peruse. Having the pain killers certainly does help though, but I'm pretty sure that I won't be running marathons anytime soon, not that I have ever wished to run a marathon.
She also has repeated my blood tests for muscle wastage and damage and to check my vitamin levels as that can lead to extra pain too. But as well as traditional medicine she said that more holistic treatments could be worth a try. Such as accupuncture, reflexology, massage, reiki etc etc, so there's plenty to have a go at. But for now I it seems like getting my sleep in order is the key issue. My GP rang again on Friday to see how I had got on and he is going to some research into the amitriptiline and other possible drugs and we are going to be gradually reducing the neurontin as they haven't seemed to have worked as well as hoped. We're also going to slowly reduce the oramorph, so good news family my crazy ormorph conversations will be around a little while longer.
So that's where I'm up to. Again apologies it's taken a few days but then it really wouldn't have made any sense. I will try and get a post on Fibromyalgia out as soon as I can.
Thanks for reading
Tuesday, 6 August 2013
The power of a good doctor
This week has been one of the worst, no the worst week since all this ME madness started. Let me just clarify, when I say worst I mean as in for symptoms, no other dramas. Well maybe some drama, ahem. I have been bed bound from Saturday until Friday and when I say bed bound I mean can't even stand up bed bound. This of course meant that I couldn't even stand up to get on the commode so I have been sliding, scooching and launching myself (ye, that last one wasn't too good) on and off it. Needing help but then screaming at my Mum everytime she touched me as it hurt too much. I'm glad she understood that all my 'French' was not aimed at her. At one time I had to kind of reverse onto the commode that had been pushed right up against my bed and sat on it with my legs out on the bed. That wasn't good! I thought I would pass out and actually it's really difficult to wee like that (sorry about that.) I have also found that one of the worst things is when I am sitting on the edge of the bed to try and bring my legs back up onto the bed. I have had this problem for a while now, as I generally need to sit anywhere with my legs out. Anyway in desperation the other (this word is really bothering my battered brain I keep wanting to put over or offer, naughty English language) night I literally just let myself 'drop' onto my side. Problem solved. Thank goodness for being top heavy haha.
The amount of pain that I have been in (and am in) has been actually quite terrifying. I really did not know what to do. If I moved my toes pain shot through my body. Because of the warm weather I have been sleeping with just a sheet and then a fleece blanket on top if needed. I can't do the whole sleeping without some kind of cover for some reason. Maybe it's a comfort thing? But just the tiny tiny extra weight of the fleece blanket felt like an elephant was sat on me. However in taking the blanket or the sheet off that too made me howl (hmm maybe I am a werewolf too Irene.) How can these very tiny simple movements cause so much pain? On top of the constant ache that you already have. It's insane, maddening, literally madenning.
As I mentioned in another post, on Saturday night I rang the out of hours doctors service because I was not coping and was at my whits end. But all the 'nurse' said was that there was not much that they could do because they did not have much stock. This out of hours service is run out of a hospital! She just said to take some ibruprofen as well, which I really am not supposed to take, infact a big red banner comes up on my notes to tell them that I cannot take it. But this was all she could say. To say that I was angry and upset is an understatement. I just wanted help. I was reluctant to ring for an ambulance (there is no way that I could have got to the nearest A&E without help) although I was thinking that maybe I would need to. I really did not want to go to hospital though and go through the stress of trying to get an ambulance on a Saturday night (that's if they deemed that I needed to go in to hospital.) Then there would be the crazy, over stimulating environment of A&E where we would probably have to wait sometime to see a doctor and then if I did get admitted I dreaded yet more calamity and the lack of privacy and peace afforded by those dreaded curtains. Seriously once you've heard an old lady shouting I'm doing a poo, you are scarred for life. What's more I would not even be able to help myself to get a drink, even if they put that tray on wheels right by my bed. I had that problem when I was sent in when the ME finally hit me. And of course they are forever moving that tray away. I would be constantly on the buzzer, because I could do very little for myself and that would just annoy everyone. You know yourself that you curse the person who's buzzer goes off when you are just drifting off to sleep or the annoying alarms on drip machines. No hospitals are certainly not the most relaxing of places, especially when you're ill, as silly as that sounds but they don't afford you the rest that you need. I have had many a doctor say this to me even. Anyway I am not hospital bashing, for where would we be without them just pointing out some of my annoyances from far too many stays. I look forward to when there are more single rooms, not that I particularly want to go into hospital but it will certainly solve a lot of issues such as privacy and infection control. But enough digressing. I feared that even if I did go to hospital that they too would say that it was 'just' the ME and that there wasn't very much that they could do either. So I decided to just take the ibruprofen for the time being and see how I got on, or just try and put up with it.
Somehow I got through the weekend and first thing on Monday morning my Mum (bless her heart) was straight on the phone to my doctors to ask whether they could give me a prescription or a phone consultation. The receptionist said that she would put me down for a phone consultation with my regular GP but what happened later was a miracle, well a little one my GP actually came to the house! It was like seeing a mirage when you've been walking for days in the desert, not that I have ever done that, apart from that time me and my sister got lost in Cyprus trying to find this aquarium. Somehow I managed to tell him what was going on and he was very good as to not torture me by doing the whole "does it hurt here? How about here?" thing. He could tell from me having moved my toes and moving the blanket that I was in pure agony and panting like a woman in the last stages of labour. As I have an appointment with the rheumatologist on Wednesday ( that's tomorrow, hooray!) he said that his main concern was to get the pain under control (Halleujia!) and to stop those ruddy ibruprofen before I have anymore problems. So he prescribed me some oramorph and said that he would phone on Wednesday to see how I was getting on. I could go into a big diatribe about the usage of oramorph here but I'll save you all. Let's just say that I was quite shocked that he precribed it for home use (not questionning his ethics at all) but I was glad he did, I sure needed it.
However the oramorph seems seems to be having some effect. By the Wednesday I could tell my GP that I had managed to get some much needed sleep and that I had actually managed to stand up to get on the commode. However I wouldn't be able to make my appointment with him at the surgery the following day and again he said that he would come out to me again. Where I was able to tell him that I had managed to walk to the bathroom and back but that I was still needing to take the oramorph and paracetemol regularly. He was happy with the progress and was hopeful that I'd be able to get to the hospital without too much distress on Wednesday, luckily it's fairly local. Well more local than the main hospital.
He touched a few 'trigger points' ( I will explain more about that soon) on my legs and the radiation of the pain was horrid. However he explained that due to this he was fairly certain that I also have Fibromyalgia (will explain that one soon too) but he'd see what the rheumatologist had to say. He explained to me that what seems to be happening is a problem with my nervous system and pain signals that have gone haywire. In a way that something that shouldn't hurt like a simple tap, wiggling my toes and the weight of the blanket is actually causing me an insane amount of pain. Where of course they shouldn't hurt that much, well actually not at all. A blanket is for comfort after all. Since he explained this though it certainly has helped me understand what is going on and how I can be a bit more careful. This is what the neurontin tablets have been trying to combat but they don't seem to be having much of an affect on me. Oh why am I so awkward? So he has advised me to start cutting down on them. It's important to come off these gradually because otherwise it could be nasty.
The doctor also said that if I am diagnosed with fibromyalgia as well then he has "ways and means" as said in a German accent, he's a funny guy, to hopefully get it under control. So I feel pretty reassured. I am certainly grateful to have a GP that is being proactive with my care and actually researches different treatment options. Maybe he likes a challenge! But having a good GP is paramount. They are your first point of call and have access to the bigger picture in terms of your medical history. Threfore it's important that you have a good rapport with your GP. That you feel you can talk to them. For that is the only way that you can get the best care for you. Of course they have a duty of care but if you can't talk to them openly and honestly then some issues don't get addressed.
When you have a chronic illness admitedly getting to the doctors can be quite a trek. You have to be somewhere near your best to be able to get there and yes I know that again that sounds crazy. So in a way your GP may not get a true sense of what you are experiencing. I will admit that I will generally talk more about my pain and fatigue levels and sometimes forget to focus on the lifestyle aspect, such as how much activity you are able to do. Not on purpose of course but sometimes you forget the necessity of mentioning these things or you somehow assume that they know. Well they're not mind readers. I think that with having the home visits last week my doctor was able to see exactly as I was living. Like I'm sure I never told him about using a commode (sorry I keep going on about that, don't I?).
A good doctor though can really make a big difference and I am really grateful to mine at the moment. He is going the extra mile. I will admit that sometimes I will see other doctors within the medical practise but that's because in my many visits I've learnt who is best for what. Okay, admitedly it's all ME related at the moment but if I were to have more depression issues I have another preferred GP for that, who's a bit more of a listener. The day I go in there with something normal is always a shock. I have to say "can I stop you there I'm actually here as I have a sore throat."
But the lesson is that you need a good allae in your doctor. One that will listen and try everything to help. One that isn't afraid to research and learn new things but also to ask for help. Such as hospital referrals to get you the best possible outcome. With a chronic condition it really is crucial because you will see them more times than you see some members of your family. So if you don't have a GP or doctor that you can gel with don't be afraid to find one that will. Yes it can be a hassle but they might even be in the same surgury. But you owe it to yourself and it's nothing short of what you need and deserve.
So I will keep you posted about how my apppointment goes. I hope she has lots of time as I have been trying to keep a list with everything on there and lots of lots of questions.
Night
Sunday, 28 July 2013
Inventing new swear words
So as the title suggests over the last few days and definitely the last 12 hours I have been inventing a fair few new swear words to express the extent of the pain that is hijacking my body. I've screamed. I've cried. I've sworn. I've taken all my tablets (gabapentin) and extra pain killers (cocodomol and even the dreaded ibruprofen). I have a hot water bottle on my thighs and a tens machine pulsing away on my back and yet I still am in pain. I don't want to be touched but need help and just wiggling my toes sets me off into a diatribe of ugly curse words. I phoned the out of hours doctors but all they could say was that there wasn't much they could do. Cue more crying and curse words.
But today wasn't supposed to be like this at all. Well any day is not supposed to be like this according to society and I would very much love that. But you see today I was supposed to be going to Turkey on holiday with friends. When it was booked my ME was much more fatigue dominated. Not that it isn't still but now there is the all consuming pain that has left me wheelchair bound too. Yes overwhelming fatigue is debilitating enough but I could still care for myself a lot more. So after going to Greece and needing a wheelchair to get onto the plane being able to go to Turkey has been a doubt in my mind.
I looked at the resort and to be fair it did look very wheelchair friendly with lots of ramps and flat areas but it was far from the town, which could only be accessed by bus. Something tells me Turkish buses wouldn't be very wheelchair friendly. Nevermind taking the bus twice a day for 2 weeks just to be able to go eat dinner. Plus if I feel asleep during my meal it would have been a nightmare to get me back.
But more than the travelling and the wheelchair logistics it was about needing to be cared for a lot more. As in personal care. Would my friends really be comfortable helping me bathe, washing my hair, get dressed or even helping me on and off the toilet when needed? Not really. Nor would I be comfortable with them doing it. Sometimes it frustrates me having my Mum do it. What's more this was their holiday. They deserved to we having fun and going out exploring not looking after me. I couldn't put that pressure on them. The guilt that comes with putting others out just by me having this condition is already enough without ruining a much needed holiday. My friend even admitted that she would be a rubbish carer. So that was that one out of the window.
Yes I did manage to get to Greece not so long ago but like I have said I know the place, I know the people. I have fallen asleep in the restaurant (right next door) and they don't get offended. They help me out and then ask how I am the next day. They don't try and ply me with alcohol because they know it will make me more ill. Even when I'm over here I get messages of support and well wishes. What's more I go with my parents. So they are there to care for me. Yes I want them to not have to and to be able to enjoy their holiday but at least the pressure is off a bit because they don't have to work or cook or clean.
Some people will think it's strange goinh on holiday with your parents in your late twenties but that's the way it is. It can do us good as a family. Especially as we have become so reliant on one another. I'm just grateful that I can go away with them when my health permits. That we have a great relationship. At the end of the day if I was well I probably wouldn't be going on holiday with them or maybe not at all as I'd be out there working, working working.
Anyhow enough blogging distraction techniques. I am going to try and get some sleep. Think it will be the only way to really shut off this pain.
Monday, 15 July 2013
But I have been so good...
Yesterday was a tough day. Lots of symptoms all vying for attention and not responding to any treatment in the form of pain killers, heat or massage, which left me a little miserable. I did not wake up until 2pm, having only just managed to prise my eyes open for long enough for my Mum to give me my neurontin at 9am and too be honest at 2pm I was all set to roll over and go back to sleep again. But it was time for another tablet and to make sure I ate, to help my pain and fatigue levels and also it was a beautiful sunny day. Yes Newsflash it is still hot in the UK!
As it has been so nice all week my need to be as active (well you know what I mean) or perhaps I should say that my cabin fever has not been too bad as I have been putting in the effort and somedays it has been an effort to get downstairs and to sit in the sun. To try and let the sun heal some of the aches and pains as it often does on holiday and work its psychological wonders. That is predominantly what my week has consisted of, especially this weekend. Me and Mum have just enjoyed lying out in the sun, relaxing. Well except for when the neighbour decides to get out his circular saw to cut paving stones and then hammer, hammer hammer them into place and people feel the need to share their dreadful music tastes to the whole village. But I can honestly say that I have only spent my days sunbathing, resting, reading and blogging and watching tv of an evening. I learnt my lesson about bringing a few sets of clothes etc downstairs with me before I went out so I didn't have to keep traipsing up the stairs earlier in the week. I have been content too, to do this little, which is an achievement. However yesterday everything ached or burnt with pain (not sunburn, luckily) to the point where it turns your stomach and you start breathing like you're in labour. I managed to get outside around 3pm but soon experienced the most strange of symptoms I could feel the heat of the sun on my skin but I had the shivers and goosebumps. It was sheer madness and definitely something very strange. Even at 2am when it was still around 17 degrees I could stand to have a hot water bottle to soothe my aches and pains.
It really did annoy me a bit. Not so much the new symptoms, or even sleeping till 2pm but the fact that I ached like I had been hit by a bus when I had done so little. I know it happenns, I have blogged about it happenning but I had been being good. I had consciously been doing less and relaxing and not multitasking and was coping. I had even got a bit more of a routine going. But then to still be hit by screming pain to the point of not being able to brush my teeth by myself and having to get my Mum to cut up my dinner for me was a bitter pill to swallow. I felt like screaming "honestly, what more can I do?" But that is the nature of the beast, sometimes it doesn't matter how good you are at the end of the day you still have a chronic illness and as Miseandino said you can never forget about it. It is very easy to have good days and sing Hallelujia from the roof tops but push too far and you're back to suffering but this time as I say I thought I had been being good. Perhaps it is a delayed reaction to to last weekend or last Tuesdays few hours in Chester. All I know is that it has really bit me in the bum. You would think that each flare or bad day gets easier to deal with as time with the condition progresses but actually it still feels as fresh as ever. It is not opening up a new wound but making a whole new cut. Yes your knowledge can improve of how to cope with it and with the condition as a whole but each grasp of pain or new symptom is consuming and frustrating. Especially when like I say you thought you had been being good.
Sunday, 30 June 2013
Grump
Just a short post about the last few days because once again M.E is surprising me in new ways, how generous of it? Wow I have been grumpy these past few days. My sleeping pattern is all over the shop, mostly during the day though to be fair and it is driving me a little bit bonkers. Again I have been kept awake throughout the night in horrible pain in my legs and back, which makes it impossible to relax enough to fall asleep. So I have been mostly trying to get some sleep when I can or I'm just so exhausted that I have no choice in the matter.
Since starting these tablets neurontin I have also been feeling quite nauseous but it's hard to tell if that's just the tablets or that I am overly tired as well and not eating very well. M.E really does mess up your whole body. It feels like you try to deal with one thing but then something else rears it's ugly head. It is a non stop vicious cycle. Lately I have also been hypersensitive and not in the crying at the drop of a hat hypersensitive way, although I have been close to tear on a few occasions where I've not had enough sleep and I'm just lying in an exhausted heap. It feels as though all my senses are just on overload. Obviously there is the pain but one minute I am sweating like a pig and the next I am freezing cold. I have become so sensitive to the cold that I have had to wear long pyjama bottoms and socks in bed. The other night I had a pair of 3/4 length pyjama bottoms on and my legs were really cold. It wasn't even a cold night. But because they were so cold it made my legs stiffen up and hurt all the more and just that sensation of being cold was keeping me awake. It's weird. I've never had that before, not even in winter. My hearing too has been on over drive, everything just sounds 10 times louder than it usually would. It hasn't helped that my next door neighbours daughter is moving house and they have been packing and moving and slamming doors for 2 days from 7am. Then tonight they decided to have a party next door. Ahhh have it in your new house!!! See I am a grumpy bum. Of course they should be celebrating and it wasn't all that late. Then at the same time there was fireworks going on over the road. Honestly I was ready to just break down. What an absolute party pooper. If I could walk better and wasn't on my last legs with exhaustion I would have had the mind to go round there and just cry in their faces. Oh dear me. I very rarely get like that, only if I have one of those really bad migraines where the whole world must stop and be quiet but for the last few days there has been times where I thought people were out to get me. Even the fridge! Honestly it has been so loud, well what I am perceiving to be really loud at the moment that last night I thought that someone was playing really loud music. When I went to investigate and found out it was the fridge I was a bit shocked and slightly embarassed.
At times my heart has felt like it has been racing too and just thumping in my chest, mostly when I am disgustingly tired though. But how are you supposed to sleep when whenever you lie down you can hear your pulse in your ears and your chest is jumping. It's impossible. Then you get all the more frustrated and tired and your pulse quickens. It really is a vicious circle and can be really scary. Especially when you have'nt experienced that symptom before.
It just goes to show I guess how much we need to sleep healthily. It really does affect us in strange ways and turns us into people we do not recognise. Then add that into the mix with M.E and who knows what you're going to get. Everyday is different and a learning curve and when you start to experience something new it's easy to feel like you are right back at square one or just curse "what now?" And when you are overly tired it just becomes even worse. However onwards and upwards with the fight. At least I can laugh now at my Diva strops at the fridge. "How dare it?!"