Thursday 11 February 2021

A Pain in the Arse

(TRIGGER WARNING: Mention of Cancer, Laxatives, Appetite Changes, and TMI symptoms)

 I've mentioned a bit about my stomach and bowel problems in recent posts, where it has affected my mental health. Up until now, I haven't told you the whole story though. 

I've had Irritable Bowel Syndrome for over 10 years; it being suggested by a GP well before my Fibromyalgia diagnosis, and then finally finding its way on to my ever-growing list of medical conditions. I've found it affecting me in a pretty mild way, with constipation being the main problem, and diarrhea only occurring when very stressed out.

The past 5 or 6 months have been very different though. Tell a lie, I notice a lump in my backside just over a year ago, but it didn't really give me any problems until about 5 or 6 months ago, when it grew quite big. I assumed it might be an internal hemorrhoid, or a small prolapse that would need sorting at some point. Over the past few months, I have been experiencing severe constipation, only relieved with 3 kinds of laxatives (Senokot/Dulcolax, Lactulose, and Dulcoease), as well as appetite changes, fluctuating abdominal pain, a lot of noise coming from my stomach, bleeding when wiping with toilet paper, nausea, bloating, mucus with streaks of fresh blood when trying to poo, constant pressure, anal spasms that make me feel the need to poo constantly, and shooting pains up my backside. All in all, not very nice and quite embarrassing to have to talk about. 

After about a month, I decided I needed to talk to the GP about it. It was them who got me on the 3 kinds of laxatives and eventually I was prescribed Laxido to replace Dulcoease (Dulcoease is tolerated very easily so the effects can wear off quickly). I had some initial blood tests to check my thyroid, which all came back negative/normal. I still had problems a couple of months later, however, so I was referred to a Gastroenterologist who sent me for more blood tests and an Ultrasound of my stomach (which I will have at the start of March). These blood tests showed low iron levels (almost to the point of full blown Anaemia) as well as raised CRP and ESR levels (inflammation markers). I was only told about the iron levels at first; being advised to take iron tablets and wait for my ultrasound, and the Gastroenterologist will be in touch in the near future. 

I thought "near future" would mean months away, so I took my laxatives, ordered my iron tablets, upped my fluid and fibre, and accepted I would have to wait. 

Some of the symptoms worsened, however, and the pressure, pain, and constant urges to poo were getting increasingly hard to deal with. After some unsuccessful 111 calls, with uninterested out of hours GPs, I decided an urgent GP appointment was needed. 

I explained all my symptoms, including the fact I thought I had a prolapse that maybe was exacerbating my stomach and bowel problems. I thought I'd need surgery to sort it out. The GP on the phone got me to see a female GP in person later that day. I was hoping I would get something to calm the urges, rather than simply more laxatives. It was a more interesting (and nerve wracking!) appointment than I expected, however.

The GP was a lovely one, I had seen before for other issues (including my now sort-of-diagnosed Raynauds). I told her everything, and really pressed the fact that the pressure, urges, and pain were horrendous, and the "prolapse" needed sorting. She wrote down a lot of what I said, and decided a rectal exam was needed. I had one with another GP initially but nothing "worrying" was found. This time, I was asked to relax, and then push though. Although no bleeding was present at the time of the examination, a very large lump was found inside me. What I thought was a prolapse could be something very different. At best, a hemorrhoid, but it could be more serious. 

Because of this, and my worsening symptoms, the GP decided to refer me to the "2 week wait" Lower GI Clinic for an urgent Colonoscopy. I remember making a face and saying "urgent?!". My GP reassured me it probably wasn't Cancer, but because of my symptoms and presence of a very large lump, it was necessary to get me seen ASAP. If it was a Hemorrhoid, I would need a small procedure called Rubber Banding, to cut off the circulation to it and it would eventually fall off. Until then, I was to take my laxatives (including Laxido this time), take my iron tablets, wait for my referral, and try not to worry too much. 

I had my referral review letter come through yesterday, and made the mistake of Googling what it said. Good ole' Google managed to convince me that it was most probably Colorectal Cancer, as I strongly fit the criteria. Good friends managed to bring me back to Earth however (as my Anxiety had hit the roof at this point!) and I am less distressed today, although still worried that the Big C is a possibility at all. I should get my appointment letter through very soon as they are Triaging my case. (The letter was dated the 8th, and said to call on the 10th if nothing else had come through). 

I also had a letter come from my Gastroenterologist, with a surprisingly quick approaching telephone appointment on 25th February. 

I can only imagine it is very soon because of my GP finding the lump and doing the urgent referral. Again, it made me worry that it was so quick. I usually wait ages for appointments, and initially the Gastroenterologist didn't even think I needed to speak to him. 

So this is where I am, at the moment. I am in a lot of pain, I feel constantly drained and bloated. The laxatives are helping to ease some of the pressure, my appetite is better, and at least I am able to go however. I guess all I can do is what the GP advised and try not to worry (and stay well away from Googling anything to do with my symptoms, test results, or referrals!).

I feel extremely grateful for the support my friends have shown me so far. They have kept me grounded, been realistic with me, but also have been sympathetic, caring, and loving. Whatever the results are, bad news or good, I know they are there when I need them. 

Wednesday 10 February 2021

Interpersonal Therapy (Take Two) - Session 4

As with other sessions, I had to fill in my PHQ9 etc and my Symptom Review. I scored quite highly on the Depression and Anxiety questionnaires particularly, but this was mainly for reasons related to my physical health. For about 5 months now, I have been having some awful stomach and bowel problems. I am already diagnosed with Irritable Bowel Syndrome (IBS), but what I have been experiencing is out of the ordinary for me. Waiting for test results had me worrying about all sorts of possible diagnoses, including Bowel Cancer. (I will talk about this in full in the next blog post). 

My 5 most powerful symptoms this week are as below:

  • Anxiety: This was mainly about some blood test results that had just come through to my Gastroenterologist. The secretary would not tell me the results, and said I would get a letter and a phone appointment to discuss them. This set off my Anxiety, as I worried there might be very bad news. I spent the week waiting for the results and hearing nothing back, which only made me worry more.
  • Wake early in the morning: I have had disturbed sleep through worrying about various things. I'm scared of missing calls or post, in case it is some news about my physical health problems. I have been extremely fatigued, but I have been forcing myself to get up if I haven't naturally woken early anyway. 
  • Can't concentrate: I was hoping to do more "antidepressant activities" such as playing musical instruments and singing. I have not been able to focus on doing that, or watching full television programmes. This is because worrying and fixating on my test results has given me a sort of mental "tunnel vision" where I can't see anything aside from the problem at hand, in front of me. 
  • Sadness: I feel extremely negative about my results. I am sure that I will be given bad, worrying news and will suddenly have something huge to deal with. The constant anxiety is draining any positivity from me too. I have been trying not to be too negative, as I know that has an impact on others, but I can't seem to help myself out of this hole. 
  • Can't get going: I feel far too tired and distracted to do much, and getting started with things such as blogging, housework etc, has become a really difficult task. I have been worried that friends wouldn't understand why I'm so fixated on my current health problems. My To Do list has been getting bigger and bigger. I have been really stressed out, which has exacerbated physical symptoms and made it physically harder to get things started. I particularly notice my Vestibular Migraines have returned with a vengeance, and my Fibromyalgia/Hypermobility pain is worse.

Alongside talking through my Symptom Review, this session was mainly about my support network; i.e. friends, family members etc that I felt close to for various reasons. My homework, leading up to this session, was to draw a social map of people in my life, using increasing circles (with me in the middle) to plot how close I felt each person was to me. I also had to think about why I felt they were so close, how they help me, the roles they play in my life etc. 

I won't say who featured in these circles, as I don't think it is fair to list my favourites in case friends see this. I'm sure the ones who are close to me know they're close anyway. I will use numbers instead of names.

Persons 1-6 are very close to me for different reasons:

Person 1: They have been a support to me all my life; but especially since I turned 18. They provide emotional support, as well as some practical support. I feel I can tell them almost anything and I feel they can tell me almost anything too. There is a lot of trust in this relationship. We both have mental health problems, so have an understanding when one or both of us is depressed. We advise each other and aren't afraid to help out when needed. 

Person 2: This person has also been a support all my life. They do not understand mental health quite as well as Person 1, but they will listen to what I feel comfortable telling them. They are also brilliant with practical help, such as lifts to appointments and sitting with me for assessments/appointments when allowed to. I feel like they are on my side and I try to help them out too.

Person 3: I've known this person since the start of university and I'm not sure if they know this but I see them as my rock. They have been there for me through some of my darkest moments, including the traumatic abortion and the abusive relationship I had. I have had times where I have been afraid of losing them to other people, but they have never given me reason to doubt our friendship. They wouldn't agree, but I feel I owe them everything. This person gives me practical, as well as emotional support, and I can tell them anything that is on my mind without fear of them taking it personally.

Person 4: I became friends with this person from out of the blue. I met them in a club when I was 18. I thought they were part of my friendship group, as they happened to be sitting near us, but years later found they didn't know each other! We hit it off straight away. We have had our differences, and don't talk every day, but I know we have each other's back. This person has seen my disaster of a love life and is not afraid to be honest about it! I respect them for that and I give as good as I get.

Person 5: I met this person online many years ago, and we have met in person a few times. We support each other a lot, especially emotionally. We talk nearly every day and know a lot about each other's mental health, for example. We are very honest with each other and seem to know when the other one needs extra help. They have seen me through some very dark moments too, and I really appreciate their support, honesty, and ability to keep my feet on solid ground.

Person 6: I also met this person at university, while I was with my abusive ex. We have got on well for many years, despite some falling out times. They showed so much support during my abusive relationship especially, and they noticed things that many others didn't. I could confide in them and they would turn up at any time for a good chat, watching a funny TV show, and the best of hugs. We may not be able to meet up much now, but I still feel we are close and have each other's back. 

I talked through most of this with my therapist, and told her I felt I was lucky to have such a large and solid support network. Not everyone has this, and I can't understand why I'm still so paranoid about friends when I feel so supported by the above people especially. Alongside these, I have other close friends, but I worry more that I might lose them. It may not be that I get as much reassurance, although that is neither of our faults. It just shows how different friendships can be. My therapist found this interesting, although she could understand where I was coming from. She sympathised with my worries about my test results too, and said that if anything changed and an appointment clashed with the next therapy session, then to email or phone her as soon as I knew. 

The next session would be about going through all the information I'd given her about my most recent, and some of my past Depressive episodes, as well as my support network, recent events, triggers, interests etc. These would be summarised and she would read them out to me so I could agree with them, amend anything that wasn't quite right etc. We would then move onto the next phase of therapy; where we use skills to improve my symptoms of Depression and my social skills. My homework this time was just to complete the PHQ9 etc questionnaires, and the Symptom Review.  


Irritable Bowel Syndrome:


Am I "Triggered"?: Amy's Mystery Illness:

I'm a Survivor: Amy's Mystery Illness: