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Monthly Archives: August 2013

Feeling sorry for myself..

I just can’t take this anymore. I just want to curl up in a ball somewhere, and wake up when everything’s allright.

Not like that’s going to happen. I’m just so tired of being LIMITED. And right now I’m feeling fairly marginalised. My co-workers are sitting outside, smoking and discussing things.

I’m missing out on things and I am sitting here alone, because I can’t be around cigarette smoke.

It’s not fair. They get to choose to smoke. I don’t get to choose whether or not I have asthma and wether or not I can breathe normally… (Same problem with smokers at bus stops. I have no other travel option because of the asthma. I have had to flee multiple public places outside due to smokers. One lady was horribly offended! I mean, I kind of enjoy not having to gasp for air!)

Smoking should be banned. With harsh punishment for offenders.

Then I don’t have to deal with social exclusion. Then I can be free to go places. Then I can be less sick. And others too, I’m not the only asthmatic!

It’s bad enough an ordeal as it is. I don’t want any of this!

 
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Posted by on August 30, 2013 in Dear Diary, Health

 

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Update

Just a small update.
1) I have completed and submitted my GP training application
2) I’ve been to the pulmonologist, got new puffs, the photo and spiro were fine, lab was fine except for me being allergic to cats and grass. Am to get a histamine provocation test.
3) Cats are easier to avoid than grass. For some reason I’m going through a second allergy season
4) My rat has an ear tumour, can’t be helped and I’m sad.
5) I’ve written a post, but can’t publish it before adding the pictures, which are on my camera, at home.

 
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Posted by on August 30, 2013 in Dear Diary

 

There. All clean

I spent 3h and 35 min doing my housekeeping this evening.

Part ADHD infatuation.
Part suddenly being frustrated by the asthma preventing me from keeping my place reasonably clean due to exercise limitations.
Part feeling hypomanic due to lack of sleep.

Oh well, I feel fairly tired now, so that’s good.

 
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Posted by on August 20, 2013 in ADHD

 

Maybe no asthma?

I feel like shit. After Thursday and the incident at the Out-of-Hours GP, I’ve sort of exhausted myself. I don’t know. My concentration is slightly off.

I’ve lost 2kg in a week. Today is the first day I’ve been able to reasonably breathe. I’ve been coughing. Stupidly, I went to work over the weekend… and exhausted myself. Monday I was incapable of doing anything really… Tuesday I went to see my own GP (In terms of not treating myself anymore). Result: turf pulmonology and Montelukast. (Oral asthma med).

Yes, it IS odd that I’m 27 and suddenly asthmatic to the extent of having to call in sick. I did call in sick, there’s no way I was going to get through the day today. Cigarette smoke triggers coughing fits, not a great plan when working with a patient population in which around 75% smoke. Even if they don’t smoke near me, if they smoke a pack a day it’s everywhere around them.

I’ve retrieved my peak flow meter. Monday I’ve had episodes of ‘blowing’ 200L/min. My max on Monday and Tuesday was 370 L/min, with max salbutamol and my seretide. For the record: my ‘expected’ value would be around 500L/min according to the charts, but my own ‘normal’ value is around 550L/min. Today I’m doing 440.

I’ve also had ‘feverish’ spells; almost like having hot flushes. TDH has commented on how ‘warm’ I am. I coughed a lot last night. My appetite is low, but given the weight loss and my low body weight to start with, I am sort of force feeding myself. (Also to shut a certain little voice up.. no, weight loss isn’t ‘great’ so shut the hell up)
My chest muscles and my abs are hurting from the coughing.

On the up side, I suppose… I WAS looking into an effective core strengthening exercise programme.

And I’m breathing. That’s good. ‘Dropping by’ the city centre as I was passing anyway after sleeping at TDH’s house to pick up paint was a bad idea. (I’m working on a crafts project and ran out of ‘Primary Yellow’ acrylic paint, and I thought I ran out of ‘carmine red’ as well but I had an entire tube somewhere so now I have 2). Funnily, I’m completely OK with the acrylic paint… well, the better ones. Just don’t let me near a bottle of nail polish!
After running into a Hare Krishna monk who wanted to save my life (Yes, I know I look like the walking dead, but that’s exactly the reason I’m not talking to you…) I got lucky with those black skinny jeans I’ve been looking for since last year. Some groceries later and I could barely stand on my feet.

I suppose. I’m breathing, and my heart rate has dropped below 100 for the first time in days and I haven’t used Ventolin today. So things are looking up. And my own differential diagnosis: Good old asthma/bronchitis, atypical infection, sarcoidosis… and hopefully not something causing my immune system to be non existent. Low probability. I don’t think I can have TB: I haven’t been exposed to it lately and even if prior exposure did get me infected without knowing it… a healthy 27 year old doesn’t ‘just’ get secondary TB.

Anyway. Time to get some sleep.

 
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Posted by on August 14, 2013 in Health

 

Breathless…

Well, I suppose this is both a problem of trying to be your own doctor, and having ADHD. Seriously. ADHD won’t prevent you from becoming a good doctor (Ok, this I hope). For other people. Being a doctor makes you a shitty patient. Having ADHD makes you a shitty patient.

Combine the two and
well

Not all visits to out-of-hours medical services are completely unpreventable. (In this city -like in many Dutch cities- GP out of hours services are right next to the hospital Emergency Department. It’s wisest to phone the GP out of hours services unless you need to phone 112, because the ED will likely bounce you back to the GP if you just drop by. GP’s also do home visits. In most cases this system will work best. Human error is as present in GP’s as it is in ED docs.

Well.

Hi! I’m Busy Darling and I am an asthmatic.

I’ve been in denial. I’ve had light asthma for a few years, after being symptom free from age 8 to roughly 20. Bronchial hyperreactivity more like. I had an inhaler, which was usually lost. At some point I’ve managed to find 3 inhalers. I had some exercise induced wheezing, I had some bronchial problems whenever I had a cold. Nothing much to worry about, just annoying. I had minor attacks when cleaning out rabbit cages but not the cages of any animal that didn’t sit on hay.

Then last winter I had severe bronchitis, probably with a secondary budding pneumonia because I’m not buying the rapid response to antibiotics that this ‘viral bronchitis’ had. It landed me -accompanied by a worried TDH- at the GP out of hours service. Me: unable to speak full sentences or remain standing for a few minutes. The GP: convinced that I was a very weird lady. ‘I’m sure there’s something else going on’. Me, racking my half-functioning mind: ‘Nothing I can think of…’. TDH almost forcing the first dose of antibiotics down my throat as soon as the pharmacist handed it to me. A friend of mine, who is also a doc, pointed out that she thought the GP should have sent me in, she would have admitted me to Pulmonology or the Acute medical ward.. Later on, I realised that I would have admitted me to Pulmonology as well had I been on the ED, and had I been on the GP services I’d send in a 26-year-old female with an acute worsening of an already long-standing bronchitis who is obviously lethargic, short of breath and doesn’t seem to make enough sense. I wonder if my mental health history -hinted by methylphenidate as medication- influenced him.
Anyway. I recovered. I don’t remember much, apart from being unable to provide basic self care. I don’t remember ever being so ill in my life. But the antibiotics worked.

And I had another bout of viral bronchitis, this time it was nicely self-limiting like a good viral bronchitis should be. All fine and dandy.

Then came hay fever season, and asthma was a problem for the first time in my life. There have been a few minor attacks in the meantime. But allergy season revealed allergic asthma. I had anti-allergy meds, I had salmeterol, I had salbutamol. At some point I was quite limited: pollen get everywhere. But, yeah. Whatever. It will be ok soon, right?

Wrong, of course.

I have a cold. I had a cold, actually. It’s all better now, apart from the chest bit. Yesterday morning I noticed a slight roughness in my upper chest, and tossed my inhaler in my bag at the last moment. Good, because I started having an attack 5 minutes into my normally 20 min ride to work. Not that my inhaler did much. Went better after a while at work. Got worse again in the afternoon. It did not get better again. At 8:30PM I phoned the out-of-hours service. They saw me within an hour. The irony being that of course, it just started feeling a tad better right before they saw me, in the waiting room and in the office I had a few minutes of compensatory hyperventilating I think, got my saturation up to 100%. I wasn’t wheezing anymore and while I was there I started thinking clearer. Really, I walked out of the tram (see, I push myself…) and I thought: hey, wow, that’s the best breath I had all evening and afternoon. It wasn’t GONE, it was just slightly better.
I went because I started panicking a bit: what if this gets worse and I’m here alone? I wanted to cry for some reason I can’t remember. Panicking and crying of course doesn’t work too well if you’re having trouble breathing, noticing that it made it even harder snapped me right into logic mode. Ok, so, let’s go then. Asked TDH to go with me.

Went home with Seretide, the combination of salmeterol and the steroid I should have picked up months ago. I knew that. This time the GP was less judgmental, took me more seriously and gave me advice. I didn’t have the coherence to explain that I kind of knew that, and that the doctor managing my asthma so horribly was in fact… me. I could have played the ‘psych’ card; but that’s bull. I know perfectly well how to manage asthma.

Sometimes doctors are hypochondriacs. Med student hypochondria is a real thing. Sometimes doctors are the opposite. I’m one of them. I’ve never been good at being ill anyway. I tend to ignore things, thinking it’s no big deal. It wll pass. This is fuelled by others who tend to dismiss it if I mention anything. Mostly my family I think. I’ve internalised the ‘Busy can’t possibly have anything seriously wrong with her and shouldn’t whine’ concept. It’s based on nothing to do with the actual me. I don’t whine. On the contrary. I keep going too long. And, in this particular case, I had irrational fears about steroids. And it landed me somewhere I didn’t want to be. I hate going to doctors.

And that, ladies and gentlemen, is why you shouldn’t try to be your own doctor.

 
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Posted by on August 8, 2013 in ADHD, Dear Diary, Health, Work

 

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Adventure of the Month: July

Yeah, late with this, I know. I just kind of got really busy….

But without further delay I present the Adventure of the Month July 2013!

Boating!
A good friend of mine has a boat. Since I am absolutely clueless when it comes to boating I can say this much: it has a sail, and a motor and it’s not very large but you can sleep in it, sort of like being in a 2-person tent. TDH and I went over there on a warm Sunday afternoon to join our friends for a day on the water. We didn’t sleep in the boat.

It was just great fun. Great company, and if you don’t do this kind of thing very often, it’s sort of exciting. Climbing off the boat to open small bridges, learning a tiny bit about boating and mostly just enjoying the day. Watching TDH playing Skipper was fun. And sexy. He gets this half-concentrated look on his face, which for some reason turns me into jelly. We forgot to bring, eh, water and, eh, cups. So at some point my friend tried to go ask water on an island where she knew people, but they turned out to not be home… luckily she did find a tap. And we shared bottles.

We jumped off the boat, dived off it (do not attempt this when wearing a padded bikini), played around with a li-lo. No, I did not manage to stand on it. Or kneel on it, this resulted in my knee halfway around my ear. We tried to sail, but it happened to be one of the least windy days of the year… at some point I jumped off the boat, waited a bit and then managed to catch up with it swimming. We tied the li-lo to the back of the boat when using the motor, was kind of fun but not the fast kind. I felt like an action hero climbing back onto the moving boat after pulling myself in. Good exercise.

We found a nice spot, right between a field with cattle (including their dung) and a nest of sting-flies to have a barbecue dinner. We returned too late: thanks to daylight savings the sun sets at bedtime. We were tired but so happy!

I felt so blessed to spend a lovely day with three of my most loved people in the world!

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Posted by on August 5, 2013 in Monthly Adventure