On the Opening and Closing of Doors

ON THE OPENING & CLOSING OF DOORS

Well, life has certainly been eventful, and frustrating, since my fall (http://sinnaluvva.blogspot.co.uk/2017/09/a-fall-becomes-set-back-and-shaggy-dog.html & http://sinnaluvva.blogspot.co.uk/2017/09/gratitude-for-nhs.html) but, nothing really much in any way I could regard as positive. Because my PPI (omeprazole) was not compatible with the clopidogrel, the GP switched my prescription back to lansoprazole; I had taken lansoprazole for a number of years and had discovered the most effective dosage was 30mg twice per day, morning and evening. It, therefore, came as something of a surprise to find that I had only been prescribed 15mg once per day.

The new medication regime began on the 19^th September but, so painful and discomforting had my GORD and IBS symptoms become, that by the 27^th September it became essential for me to have an emergency appointment at my GP surgery. The appointment was with a nurse practitioner who duly increased my dosage to 30mg once per day.  Even with this dosage, I still had to resort to a strong antacid each evening.

Meanwhile, I was twice proffered an earlier appointment (in a saga which began a few months back) with the surgeon to discuss removal of my gall bladder but, I automatically declined as I now needed to get into a pattern with the amlodipine & clopidogrel and, I realized that if an operation was to take place I would need to be off the clopidogrel for around one week.

By way of diversion, we have an additional resident chez nous. Beth, the eldest of my two step-daughters, was discharged from hospital in York on 10^th October following a bicycle accident on the 3^rd. She has a fracture in the neck of her humerus, necessitating immobilizing of her right arm and plates in her jaw at the sites of two of her three jaw fractures. This latter condition means that she is only able to manage soft / pureed food. My beloved OH has to help her both to dress and to bathe / shower.

Eventually the pre-arranged appointment, on the 23^rd October arrived and ma belle chauffeuse accompanied me to the clinic at the District Hospital. The doctor soon explained to me that as I had recently had a stroke, albeit a minor one, she would be unable to carry out the operation as the anaesthetic required could trigger a further more severe stroke and, although I could apply for referral after six months of reasonably good health, she personally didn’t seem much in favour of this, as she felt there would still be the risk of a more major stroke. When my beloved asked the surgeon what should happen if I had a further infection of the gall bladder, she suggested that antibiotics, albeit with the possibility of increased antibiotic resistance, were much preferable to a risk of paralysis. She was of course aware of my family history [my mother suffered a major stroke within seven days of experiencing a TIA – spending her remaining years with total paralysis of one side of her body – when she was of an age only marginally advanced from my current state of being].

Whilst I was somewhat relieved that the doctor hadn’t pussyfooted about the rather stark options, it did seem to emphasize the whole mortality issue as, later in the day, I began to feel a sense of desolation regarding an apparent futility of existence. I wondered, for a while, if I was reverting to a state of depression! In the clear light of a new day, chronic illness notwithstanding, I was so blessed with a loving wife and family, a catholic taste and enjoyment of various musical genres, literature, fine arts, and a faith that never lets go of me even when belief has evaporated.

Rare day

 One of those rare sunshiny bright (albeit chilly) mornings drew me up the garden (lack of) path. Task one was to net out kilos of fallen leaves from the pond, and applying same to garden borders. That task completed, I set to refilling our sundry bird feeders to add a further gleam to my nascent halo!

 

Such was the sun’s effect on my morale that, once back in the house, I forgot to turn the fire on until the chill had begun to gnaw its way into my corporeal being. It wasn’t too long after that when the old familiar aches and pains began to make a negative impression on my sense of well-being. It wasn’t long before the aches in arms and feet induced feelings of nausea. Next thing, a light-headed giddiness hit in as an accompaniment to a sudden, simultaneous, onset of dyspepsia and flatulence.

 

Wrists strapped and tramadol ingested, I rested a while before swallowing lansoprazole and mebeverine in advance preparation for an early evening meal. Thankfully, the intensity of the muscular pains soon settled to a more manageable level and the nausea discharged itself from my psyche.  

 

As the indigestion settled down a little, I ventured into the kitchen and griddled a couple of oak-smoked salmon fillets, accompanied by a gently spiced stir-fry of red peppers, cherry tomatoes and mushrooms (marinated in a garlic, turmeric, tikka and soy sauce concoction) sprinkled with a few flakes of oak-smoked sea salt.

 

And that was my day … so far!

Woes and Gratitude

It’s becoming increasingly difficult not to sound like a moaning wimp. It isn’t that I feel much worse than has become my familiar norm and, I’ve frequently experienced more excruciating aches and pains than at present, but it’s an overall sense of feeling ‘off-colour’ that nags and gnaws at me for at least half of my waking hours.

It’s almost impossible to get used to those times when one suddenly experiences a cloying, gut-wrenching, nauseating giddiness, and sudden change from warm to cold skin as the colour can almost be felt draining away from ones face. Sometimes the overall sense of queasiness persists for only a few minutes, before the healthier glow returns, at other times the period of dis-ease is much more prolonged.

The spastic colon & diverticular disease randomly asserts itself, with little regard to whether I’ve maintained a regular dose of anti-spasmodic pills (mebeverine) but, fortunately the ppi’s (lansoprazole) function reasonably well in curbing the worst excesses of gastro-oesophageal reflux (although there are some days when, come bedtime, I still require a dose of antacids.

On a positive note, I’ve suddenly realized that up to this point no mention has been made of the painful aches in the upper limbs (not infrequently emanating from the armpit) as these are currently adequately controlled by doses of tramadol. So, I conclude on a note of gratitude once again; if only the flow of thanksgiving could overwhelm the woes that flesh is heir to!

GP or not GP that is the question

and nothing has improved since the previous posting, simply a more sustained discomfort; apart from the spasmodically acute pains in chest and abdomen, yesterday saw a return of my faint giddiness which cut short a visit to Helen's Church (Wesley) for a spot of lunch.

Up until 19 January, apart from my usual tramadol (painkiller), mometasone (nasal spray), I'd be taking 2x30mg lansoprazole (proton pump inhibitor) each day but still needing the odd dose of Gaviscon at night. On the 19th, the doctor I saw took me off the lansoprazole and switched me to a different ppi, namely 1x40mg esomeprazole daily.

On 9 February, I had the appointment mentioned in my previous posting (Worth A Mention?). In his effort to ensure that he involved me in the decision making process, the GP I saw this time somehow decided that I should continue with the esomeprazole (although it was proving less effective than the double dose of lansoprazole - except briefly on the initial few days) but also prescribed 10mg domperidone (a dopamine antagonist) to be taken 3 times a day.

Apart from the increased discomfort, and even occasional bouts of volatile diaorrhea, I once again find myself wondering whether the chest pains are in fact directly connected with my gastro-oesophageal problems. I quite simply had the feeling that the GP just wasn't interested!

Back To Normal

i seem to have fallen back onto the ailment roundabout, fortunately it has not yet transmogrified into a full rollercoaster ride at this point. Persistent irritations, of the over production of acid and mucus variety, still make their presence felt alongside the, probably related, ache and bruise sensations (with the occasional sharp nudge) around the chest and lower ribcage area.

Now the leaden ache of the lower limbs has reaffirmed its presence, as has a gnawing ache in wrist and armpits which seems to have re-appeared on a whim and then hangs around for indeterminate / unpredictable periods of time. Even as I sit and type this I'm finding it necessary to take breaks wherein I place both forearms behind my back and push my shoulders firmly back on the comfortably supporting high back chair.

Having had a little stroll down to Open Church, this morning, my legs began to ache as if I'd been on a marathon trek; to be honest they weren't really painful, just more of a gnawing discomfort. The thought occurred that maybe they needed a further stretch so, with the aid of my trusty walking stick, I set off on a brisk walk around the block. Please note that I "set off on a brisk walk", I can't make any claims to having sustained any degree of briskness beyond the 100 metre mark. I thought at least it would prove good for the morale and, it hasn't made the gnawing ache any worse or better.

By late afternoon, an additional dose of lansoprazole (to cut down on acid production) and a couple more tramadol capsules served to alleviate the more extreme edge of discomfort. That extra bit of relief allowed me to get on with preparing a meal in time for my beloved's return from work, and even enabled me to enjoy accompanying ma belle for a grocery shop at Waitrose post dining!