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!

Worth A Mention?

strange how medications to alleviate a condition can make that same condition much worse

never sure what's a reaction to new medication and what's part of the underlying condition

Having just "tweeted" the above (apparently trivial) observations, I suddenly realized that they may be expressing a deeper underlying concern

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I knew when I made the appointment that it was a follow up to check how a change of ppi is affecting me. Informed GP that for a few days it seemed better, explaining an inadvertent side effect of the extra dosage of the former ppi, but now it didn't seem as effective as I was experiencing a greater degree of discomfort. The GP of course asks me, do I think that my current discomfort, an amplified version of what I'd been already been experiencing, was related to the gastric problem. Having acknowledged fairly recent A&E incidents which confirmed that there was no apparent heart problem, and last years endoscopy finding no obvious cause for my gastric problems, I could only reply that according to previous GP guidance that did seem to be the case.

The outcome was a decision made, with my uninformed collusion, that I should continue with the new ppi but also take a dopamine antagonist 3 times per day. The first couple of days on this new regimen and, I'm feeling markedly more discomforted, in the gastro-intestinal / gastro-oesophogeal stakes, than I've felt for quite some time. The frustration continues. The question is, do I persevere?

Having stated the question, I now return to the larger problematic picture. Any visit to a GP tends to focus on a specific problem and, as a result, other ailments that are part of an ongoing chronic condition are rarely given an airing, in the course of a consultation. The doctor is presumably well aware that I need to take pain-killing medication, primarily tramadol, to treat persistent muscular and skeletal pain but, I sometimes do find myself wondering whether the broader underlying condition could also be responsible for my gastro-intestinal problems.

Unfortunately treatment only seems to be available for specific symptoms whilst the larger underlying picture seems to be trivialised or ignored. Indeed, as an example, there has always been a marked reluctance on the part of the government, and the Medical Research Council, to carry out bio-medical research into the neurological condition Myalgic Encephalomyelitis. One feels, at times, afraid of mentioning the aching tenderness in armpits and under the chin, the sharply bruised leaden hollowness in the lower limbs whilst still abed, a sense of ones skin being pulled too tight over one's flesh, random virulent nightsweats, degrees of orthostatic intolerance, a not infrequent need to don supports on ankles, wrist, back etc in order to cope with the days most basic tasks. 

Don't get me wrong, I've long since learned to cope with the daily onslaught of aches and pains and, I generally manage to pace myself sufficiently to avoid a major crash but, that doesn't mean that life is easy, much as I enjoy it. 

Siskin at feeder

a recent poem ex 'Mal's Factory'

Restless Night


frantic and static
collude
to break the spirit -


the chorussed scream
of roll and stretch
weaves counterpoint


against the searing ache
of stasis -
the chinese burn


of movement
resists
the planned escape



                         Malcolm Evison
                      30/01/11 – 01/02/11

Mal's drifting murmurs

Today's blog post from yours truly, drifting with the flow, can be found on 'Mal's Murmurings'

wonderment and guilt - spontaneous jottings

A strange combination of wonderment and guilt are today's companions. Having allowed myself time to just sit, in the silence of the living room, looking out onto the garden, my mind is once again filled with the question, why is there something rather than nothing? Because there is something, imagining nothing (or a non/state of nothingness) seems impossible - I find myself watching the clouds slowly drift by and, I'm lost in wonder.

To be honest, most of my life these days is spent in some kind of wonderment and, it is because of (rather than in spite of) this appreciation of the wondrous awesomeness of life that I cannot avoid being committed to issues of social justice and hence politics. There must be an alternative to people being bogged down in the vicious cycle of wage slavery and debt; the world has a sufficiency of resources for everyone to be able to enjoy leisure time without being wearied and overburdened about how to acheive even a subsistence lifestyle.

But, you may well ask, where does the guilt enter the equation? It's that old protestant work ethic no doubt - how can I justify stting doing nothing rather than taking some positive action? The straight answer is that I don't need to justify it but, the guilt remains anyway, ignoring the logic of my answer.

Mal's Restless Night

A poem in progress (or perhaps in its final draft), Restless Night, can be found on 'Mal's factory'!

Shattered of a Sudden

That head-floating, gut-wrenching, muscle-nagging shatteredness wraps me of a sudden in its embrace. Yesterday the deeply gnawing muscle spasms, in limbs and torso, felt like a rebuke for having deigned to commit myself to Friday's minor exertions. At times it seems like a game of damned if ... (damned if you do, damned if you don't); accepting one's limitations is an important step towards avoiding a nightmare roller-coaster experience but, in that acceptance one also risks accepting a pretty colourless plateau of existence.

I've always been fortunate in having a rich life of the imagination, and a naggingly active spirituality; this has meant that the health imposed curtailing of my socializing activities didn't lead me into an immediate state of desolation. I have to admit though that the loss of contact with many people, especially those who I'd considered to be my friends, is something that I still find difficult, when I allow my mind to go there, more than seven years on from succumbing to this wretched illness.

At least I understand this early evening's sudden yielding to shatteredness; a connection with last night's discomfortingly disturbed sleep pattern seems pretty obvious! Expressing my dis-ease in words, in some way, alleviates its claustrophobic grip

Testing The Limits

Sometimes the stamina, or at least a small portion of it, seems to have returned along with a lurking fear that it's only a mirage. At first one treats it with caution, only too well aware of the consequence of any over exertion but, one is always tempted to test the limits. I've already suffered a moderate setback, in terms of feeling discomfortedly knocked out (rather more dis-eased than my familiar norm) on Thursday as a result of attending the meeting on Tuesday, even though the actual attendance there proved a great morale booster.

Wednesday found my beloved back at the dentist, her earlier trials and tribulations not yet at an end.

After Thursday mornings painfully aching shatteredness, a fresh influx of stamina seemed to come my way by Friday afternoon and, I actually managed to transfer some of the compost from the bottom of our (compost) bin across to one of the garden borders. The garden always seems to reward us well, in terms of floral display; a disproportionate gratitude for our puny endeavours.



Thursday and Friday both saw an abundance of avian visitors to our garden, nothing new, but a fair cross selection of our familiar visitors, goldfinches, blue tits, dunnocks, sparrows, blackbirds, robin, wood pigeon, collared doves, chaffinch etc but then, today saw only a very sparse sprinkling of any variety. Until this evening I'd forgotten all about the Big Garden Birdwatch so, I'll have to set an hour aside tomorrow, regardless of how representative it turns out to be!

Much Ado about Something

I still wait, in vain, for a stamina infusion but, I'm simultaneously resigned to such a miracle witholding its appearance. At least I managed to attend the Labour Party branch AGM last evening but, didn't have the physical or emotional reserves to hang around for the potentially more interesting ordinary meeting which followed it. It was good to meet some of the other party members and, get a feel for the prevalent mood and spectrum of its activists.



Although physically fairly shattered from this outing, the mental stimulus prevented me from getting a truly restful nights sleep. Actually, having just made that remark, I have to acknowledge that 'refreshing' sleep is, in my case, honoured more by its absence.


My beloved had an appointment with her dentist this morning, to have the majorly offending tooth extracted but, once more the visit took a disproportionate toll. On this occasion part of the problem was that the gum beneath the extracted tooth was still infected, despite the best efforts of a double course of antibiotics and, her dentist was left wondering why the maxillo-facial / dental consultant she saw at the hospital hadn't done more!