Wednesday 9 July 2014

My 1st Urology Appointment (bit of a TMI post)

I had my first Urology appointment last Thursday (3rd July). I wasn't sure what to expect with this visit, and internet searches gave me conflicting information. The appointment letter was quite a short one, and only asked me to bring any medication I currently took. I wanted to be prepared for a whole host of questions from the Urologist, so I took down some notes of the kind of symptoms I had:

Urinary Frequency (At least 10 times in the day. 1 or 2 times at night, so not too bad at night)

Sudden, unexpected urges to urinate: Not fun at all, if a toilet isn't easy to get to.

Difficulty urinating sometimes (I can be absolutely bursting, but it feels as if my body is too weak to be able to. I also get a bit of a nervous bladder, where hearing voices outside the toilet will put me off).

Feeling as if I'm retaining some of the urine; hence the need to keep going back. (I have developed a very unhealthy routine when I need to leave the house, of 'going' 4 times, sorting out what I need to take with me (after washing my hands of course!), then going back to the toilet another 2 times before I feel I've emptied my bladder enough to actually leave the house. I also have to wipe a certain number of times before I can leave. If I don't, I feel as if I will be absolutely desperate for the toilet when I leave the house.)

Very occasional small leaks: This happened at least once when I was at school, at least once on holiday, and at least once since. Luckily the leaks were too small to be noticed, but I still felt incredibly embarrassed.

Occasional occurrences of Cystitis from the age of 16 to now.

I wasn't sure if I needed to bring a urine sample to my appointment, as it didn't mention it on the letter (yes I know it's a Urology dept, so probably common sense to bring one. Shh!) , but I figured I would be able to do one if needed when I got there.

My mum came with me in the taxi, as luckily the Urology department at my local hospital is a small one; very easily accessed from the car park. I recognised a couple of members of staff there too (I used to temp as a research assistant at the hospital). At first, I thought it'd be a bit awkward (with this post, you'd never guess I'd feel embarrassed, speaking about my waterworks!), but I think knowing some people there actually put my mind at ease a little. I always get nervous at my first visit to a new specialist. After such a long time of seeing doctors who would fob me off, tell me it's "just" Depression, or simply not believe me at all, I do tend to expect the worst.

It wasn't too long before my name was called. It turns out, I was supposed to bring a sample. It would've been nice for the letter to mention that! Anyway, I went to produce one, gave it to them, had my blood pressure tested (normal, as bloody usual, even though I felt like hell and was incredibly faint and dizzy!) and then was asked to sit and wait for the doctor. It was a longer wait (possibly half an hour? Maybe more?) before I was called to the doctor's office. The brainfog had kicked in by this time, so I was struggling to remember how to string a sentence together, let alone actually remembering what I'd noted down.

The doctor introduced himself, then asked what had brought me here today. I know I tripped over my words a lot, and mum had to prompt me, but I managed to explain that I'd had the symptoms a while, they'd got worse, these were the symptoms etc (I forgot to mention the trouble urinating though!). He asked questions such as how many times do I go in the day, at night, have I ever leaked, do I fully empty my bladder etc. I also mentioned the cystitis. He then asked whether I'm sure I'd had cystitis, and whether I'd been tested and had it confirmed by the GP. I said that the times I'd had it, I'd just had a quick phone appointment with my doctor, my symptoms had matched the criteria for cystitis so the GP had confirmed it and prescribed me that cranberry powder stuff, which is supposed to help. I explained the symptoms I'd had, but the doctor said he didn't see any evidence of it on my medical notes, and the GP really should've tested me for it. I have a feeling he didn't believe me...

(TW: Suicidal thoughts)
We also went through my existing diagnoses. I listed them: Fibromyalgia, Vitamin D Deficiency, Suspected Overactive Bladder, Depression and Generalised Anxiety Disorder. He commented on my mention of Depression, and asked (very rudely might I add!) "What've you got to be so depressed about then?!". I felt a bit shocked that he'd asked such an ignorant and insensitive question.

This isn't me feeling a little down. This is constant, unrelenting, hopelessness and despair. This is suicidal thoughts and urges. This is taking all my mental strength to not take all the tablets in my bedside cabinet, when I should only be taking my prescribed dosage, because how could I bear to have my parents find me like this. This is being frustrated with myself for just. not. doing it. This is falling asleep at night, wishing I don't wake up the next day. This is feeling like a disappointment. This is feeling like I don't deserve to have anyone love me, so there is no point talking to them because all I do is bring burden and pain upon them. This is knowing I shouldn't think like this, knowing it's not a logical or healthy way to think, but not finding a single way to stop myself from thinking like this. Depression is an illness, not a reaction. There's not always a reason. Assuming someone must have a reason to be depressed, only serves to make the guilty feelings worse.

I couldn't answer this insensitive question. It took all of my strength not to have a go at him (because I needed some treatment!). He rephrased his question and asked "Did you have some kind of trauma, that caused the Depression?". Now, whilst a Psychologist, Psychiatrist, Psychiatric Nurse etc might have some reason for asking this, a Urologist certainly does not. I was here for a physical problem. Sure, Anxiety probably makes these symptoms worse, but it's not the Depression! I just said that having the Fibromyalgia, and my life changing so much (giving up work, losing friends, a relationship etc) probably led to it being this bad. I then showed him all the prescription meds I was taking, and the subject was changed.

He confirmed the diagnosis of Overactive Bladder Syndrome, and said that he would write a letter to my GP, so that she could write a prescription for some medication in a week's time. I was surprised he hadn't written out the prescription there and then, but I've had these symptoms for around 8 years. I'm sure I could wait one week. He also said he'd like me to have a bladder scan, to see if I was retaining any urine. The appointment was then over, and I was asked to go to the toilet to try and empty my bladder, then sit and wait for the nurse to fetch me for my scan.

The scan showed that I retained about 46ml (this was after going to the toilet 3 times since my last full drink (a good few hours before I'd left the house), and only having a couple of sips of water inbetween). I was glad that I was right, but the doctor said this was normal, so no further investigation was needed for this.

My next appointment with him is in 2 months time, to see if the medication is helping much. I really really hope that this is the one symptom that can be sorted out.

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