Stanmore (RNOH) (first appointment and pre-assessment)

Its been a while since I last posted, apologies! So much has gone on over the last few weeks that I haven’t really known where to start. My mental health took a bit of a bashing with my PTSD flaring up, tho thankfully its settling down again now, and sadly dad has cancer again, so theres rather a lot on my mind. Although things have been difficult, there is also rather a big positive happening at the moment – I have finally been able to get seen by a member of the team at Stanmore!!

Its taken a few years of frustrating battling, but finally with a good GP behind me, my first appointment letter arrived. I was partly jumping around with excitement, and partly absolutely terrified. In order to get a referral to Stanmore, you first need to go through a rheumatologist. With EDS this can pose an insanely large challenge, and just as always, I was not to be disappointed. Due to the rheumatologists under my local hospital point blank refusing to believe EDS could even be helped and refusing to see me, let alone refer me to Stanmore, I had to travel down to Orpington to see someone. The person I saw was beyond useless. He insisted I didn’t have EDS, but simply had fibromyalgia. He insisted I only scored 1 on the Beighton scale (far bellow the 5-9 I have been scored in the past) – ignoring my obviously hypermobile elbows, and stating that even tho my thumb could touch my forearm, they weren’t bent backward and therefore didn’t count! When I questioned him about what my internal issues were caused by, he simply tried to brush it off with ‘I don’t know, but not EDS’!! I came out of that appointment absolutely fuming. On my insistence, and the insistence of my cardiologist, he did however agree to refer me onto Stanmore – so I suppose I should count my blessings.

Having been essentially written off by the last person I had seen, it is no surprise that I was feeling pretty nervous about going to one of the UK’s only specialist centres for EDS. I was fully expecting the same reaction, so had been getting steadily more anxious the closer my appointment got. What if he was right and I didn’t have EDS at all? What if they thought I was lying? What if they couldn’t help me?

Thankfully I had nothing to worry about. After the nurses taking my heart rate and blood pressure (and my POTS confusing them as my blood pressure went down upon standing), I was led into a room with a consultant. She took a very detailed history from early life to present, and then proceeded to question me about the referral. She asked why the letter had stated ‘I would appreciate your help with this EDS classification matter’ and was pretty astounded when I explained that the rheumatologist had only scored me a 1 – especially when I held up my elbows and told her he said that they weren’t hypermobile! She told me she would ‘copy him into the letter’ to teach him about EDS! After this, she gave me a thorough examination. Apparently I score a 7 on the beighton scale after all alongside my shoulders and hips being very hypermobile, and she also checked a number of other things. My skin is more stretchy then normal (which I wasn’t aware of), and I have an overcrowded moth with a high arch palette – typical of EDS. She also checked underneath my tongue, and told me that I have no frenulum – I had no idea that this was another sign of EDS – you learn a new thing every day! After all of this, we sat down to have a chat. She has asked for me to have a brain and spine MRI to double check everything as I suffer from certain headaches, so I have been referred to a neurologist for this. We also discussed what Stanmore could offer me. Although they do offer outpatient support, we agreed that as I live so far away, the 3 week rehab programme would be more appropriate, and so she referred me on for this. When I asked about timescale, she said that I would likely go for rehab within 3-4 months. I was sceptical about this, so hadn’t gotten my hopes up – it seems I may be wrong!

A few days after my appointment I received a questionnaire in the post. This was largely about they places I experience pain, and daily functioning. I sent this back, and a week or so after this, I received a letter inviting me to a 2 hour preassesment session held at the rehab centre. Feeling nervous and excited, I travelled down on Friday morning to attend.

When I arrived, I was invited into a room with a fellow 10 or so patients for a presentation. This consisted of a video followed my a question and answer session. Everybody was friendly, and a good proportion of the others turned out to have EDS or Marfan syndrome.

The program is run in 2 settings. Both contain the same materials, but one is run in a hotel, and the other in a hospital setting. The idea of the hotel program is that it replicates the experiences of normal daily live as much as possible, so you have responsibility for all medication, personal and medical care yourself. The hospital program is for those who fall into a higher risk category, and there are nursing staff available for help with personal care, and perhaps a higher level of support if needed. The decision as to which program is most suitable for you falls down to the medical staff, and although they discussed this with me, I didn’t have a choice in the decision.

After this, we were asked to wait, and were called to have an individual assessment with a member of the team. I was called by an absolutely lovely pain psychologist. We sat down, and went slowly through the questionnaires I had filled out before attending. She was extremely detailed with both my physical and mental health history and present symptoms, and not once did I feel uncomfortable or embarrassed. We spoke about how the program is run, and throughout this process she talked about both the hospital and hotel program. She also completed a couple of risk assessment forms covering things like risk of falling, personal care needs and safety with medication/mental state. As the assessment went along, she did suggest that it was likely that the hospital program would be more appropriate for me. This was partly due to my physical care needs, superpowers with regard to falling abilities and also my tendency to dissociate in certain situations. The hospital program also seemed more suitable due to its slightly smaller group side which shouldn’t feel as daunting to me. I struggle in large group settings due to PTSD left over from bullying, and this massively can trigger me to dissociate. On the hotel program, you are with a group of up to 15 people (I believe) for the entire 3 week program – obviously this can be great if you get on with everybody and don’t mind larger groups, but I can also see it being difficult if you happen to clash with a fellow patient. With the hospital program, you come in to the program in a core group of up to 4 people, and work with people who have already on their 2nd or 3rd week of the program. This means that you meet new people every week, and there are also a maximum of 12 people per week. By the end of the assessment we had spoken through my potential concerns with the hospital program – namely that I didn’t see myself as being in need of greater support then others, and that my concerns of coping with such a full timetable/living on the ward, and I felt much more at ease. We laughed and joked a lot which really helped me feel comfortable, and I even spent some time showing off my doggy pictures!

After this, she led me out through the ward, showing me about a bit as she led me back to the waiting area. I was then free to go!

All in all, I was there for about 2.5 hours, tho my assessment was much longer then it normally would be (my poor mother was waiting around much longer then she should have been!)

I was told that I am likely to go into the program some time in January unless they happen to have any last minute cancellations. This seems surprisingly quick to me, and is slightly terrifying. The idea of the program is amazing – it will basically give me specialist and individualised knowledge and skills that I can use to start the process of rehabilitation. There will be a lot of 1-1 physio, occupational therapy and sessions with a specialist psychologist who deals with pain. These should teach me what I need to work on, and give me the tools to begin to change my routine at home in a way that may help me learn to live with both EDS and chronic pain. The scary side to this is that once I have completed the program, the responsibility is on me to be able to maintain the things I need to work on!

Once you have completed the program, you have a review in 3 and 12 months to establish how you’re doing, so I guess you aren’t totally alone.

All in all, I feel very grateful to have finally gotten to Stanmore. It won’t be a quick fix, and there is still no guarantee that you will be back to normal in the future, but what it can do is teach you how to live with your illnesses and chronic pain in a less disruptive way.

I really do hope that this is the beginning of getting things back on track – however far  that will takes me, it has to be better then here!

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