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!

Getting Sick When Your Already Sick

One thing that few of us chronically ill people talk about is being ill – and this seems doubly true when it comes to getting a normal illness on top of it all.

When you are chronically ill, feeling a bit crap comes as an every day occurrence. You are already in pain, exhausted and feeling that fluey feeling most people only experience with the actual flue. Personally I find that what I really mean when I say ‘I’m fine thank you’  is actually ‘I am in so much pain I could puke and I’m so exhausted that I feel a tad on the dead side, but thats nothing out of the ordinary thanks’. I do this because like many others, I assume that I am rarely talking to someone who would actually want an honest answer – after all, I suspect most wouldn’t be able to figure out a reply without a spectacularly awkward silence first. My illness is something I have tried to push out of focus to the world around me – I take pride in my ability to mask the bad times and make people forget that I’m ill. After all, I am a woman first and an illness last.

However, let me be the first to tell you that getting ill on top of being ill is not much fun! Today I woke up with a sore throat, a fever that has been raging all day, skin so sensitive I want to peel it off, and that general fluey fog you get with being ill. I have gone between shivering and being so sleepy that I can’t keep my eyes open, and spent most of the day feeling like the world was moving.

Now, for all you well people out there – imagine having the flu, and then adding it to all of the symptoms EDS and POTS gives someone day-to-day. Add it to the joints popping in and out of place all day, the usual constant headache, tight muscles, chronic pain and brain fog (yes, you get a doubly foggy brain!) Add that to issues with swallowing, tachycardia, postural dizziness and fatigue. On top of all of that, add in the nausea, back ache, odd temperature regulation, insomnia and TMJ (jaw) issues. I am not listing everything here, but you get the idea. We already feel like crap day to day, so when the double whammy comes, it tends to hit us hard.

Even on a day like today, I hide it, even tho its perhaps more socially acceptable to talk about this type of illness. I may mention in passing that I’m feeling ‘a bit crap’, but what I actually mean is that I feel bloody horrific. I shut myself away, and I wait for it to pass, all the time knowing that when I get better, I won’t really be better at all – I will just be chronically ill rather then chronically ill with bells and whistles.

The one upside, is that being chronically ill will feel much better then this does.

Part Two of ‘The Not So Sexy Side’…

Part Two of ‘The Not So Sexy Side’…

As you may remember from one of my older posts, EDS causes problems only a woman can get. Pelvic organ prolapse is usually something only reserved for those lucky women who are older and/or have had kids, yet with EDS we often get this thrown into our 20’s free of charge!
Pelvic organ prolapse referes to a prolapse within the pelvic region. A prolapse means that the muscles and ligaments (in this case within the pelvis) have stopped being able to support the organs sufficiently, and this leads to hernias. In pelvic organ prolapse this can be concerning the bladder (a cystocele), the rectum (the rectocele), the small bowl (an entrocele), the uterus (utrine prolapse) and a vaginal vault prolapse (a prolapse following a hysterectomy). With pelvic organ prolapse these organs bulge into the vagina causing an array of fairly uncomfortable symptoms.

 

Having finally been diagnosed with a prolapse after a 2 year fight with medical professionals, I was eventually referred to a local gynaecologist to get things sorted. Being of typically English sensibilities, it was not exactly the least embarrassing appointment I’ve ever attended!

I spent the few days before my appointment in obligatory panic mode. What if I was brushed off again? What if it wasn’t a real illness and I had made everything up? What if I would be laughed out of the clinic in shame?! I am aware non of this was a logical thought process seeing as a professional had already diagnosed me, but with EDS a diagnoses is often brushed aside when it seems inconvenient for the next professional to take into account. I am so used to having to fight my corner that I get huge anxiety before each and every appointment. With this appointment, I thankfully needn’t have worried.

 

As soon as I stepped into the room, the doctor was friendly. The more nervous I am, the more I spout random nonsense, and what with this particular appointment concerning my lady bits, there was a lot of nonsense being spoken. Thankfully, she was more then happy to join in with my nervous chatter.

She started off with some questions concerning my symptoms. We spoke about pain and a downward heaviness down below, issues with incontinence, issues with intercourse etc. She kept the questions going, so there were no awkward silences in which I could get painfully embarrassed.

 

Next came an internal exam – I was expecting the cystocele, but it did come as a bit of a shock when she also diagnosed a utrine prolapse and rectocele. It seems the party for one just turned into a party for three down there.

My options for treatment at this stage are limited. I will eventually require surgery as these issues don’t fix themselves, but as I am still to have children, and own particularly crappy collagen, they would rather try ‘conservative measures’ first. These consist of specialist physio therapy focusing on training up my rather lax pelvic floor, and the use of a pessary – a silicone device inserted into the vagina that helps to hold everything back in place.

1-pessary-image
A selection of different pessaries

 

The physio doesn’t sound like a whole lot of fun – obviously to retrain your pelvic floor, it requires feedback, and from what I can gather this will be via another person and via specialist equipment. I am not by nature prone to flashing my bits to random strangers in hospital settings, and this will be no less embarrassing then turning up to my own wedding naked. I know that. The physio will largely be aimed at trying to halt the progression rather then curing it, and that is a thought thats hard to swallow.

The pessary is probably the thing that I am struggling most with. There are many different options from your doctor to choose from, each supporting different areas and providing different levels of support. Some will support just the uterus, the bladder, the rectum – some will support more then 1 area. There are things like a ring pessary for those that don’t require as much support, and then there are ‘space filling’ pessaries for those that require a little more help. I am unfortunate enough to end up with the latter. I have been given a cube pessary. This is basically a silicone cube which has indents in that form suction to support the walls of your vagina, complete with a rather undignified silicone cord – just incase you manage to loose where it is up there! For the cube pessary (all pessaries require different care), it needs to be removed every night, washed, and left out until the morning, when you have the really fun job of trying to stuff it back up there whilst trying not to swear – really not an easy task, especially when you fling it half way across the room and have to race your way there before the dog thinks he has a new chew toy (yes, that really happened)!

It is not so much the rigmarole of using the pessary that is the problem – its knowing that I need to use it. I somehow feel less attractive. As it can’t be left in during intercourse, I am dreading the day I will need to push a hand away and shimmy off to the bathroom to get the thing out before things can get started – spontaneity in the bedroom is truly a thing of the past. I feel embarrassed knowing that its now a part of my personal life, and worried about how people will react. As a young woman of 29, it feels unfair that my body has given out now – it is rare for women that haven’t had kids and especially rare for  young woman to suffer with pelvic organ prolapse, but thanks to EDS it here, and its here to stay.  I can cope with so many of the joys that EDS brings to the table – the pain, the subluxes and dislocations, the difficulty swallowing and digesting food, the fatigue – but for it to affect my lady bits just seems like a massive step too far.

As if I wasn’t a crap enough catch before, yet more super attractive health issues are handed to me on a plater!

Tomorrow morning I have a super early appointment to go back to the gynaecologist. Pessary fitting is a bit hit and miss – its basically trial and error to find a shape and size that works for you. Unfortunately mine is shifting down throughout the day and pressing into bits that really don’t want to be pressed. With the right size and shape, in theory it shouldn’t move about, expel from the body or even be noticeable to the wearer – lets hope I find the right one soon! The doctor very kindly offered to see me after being on a night shift to try another size or shape, so I somehow need to make sure that I am up bright and early to duck in for a repeat embarrassing experience.

EDS is one pretty tricky bedfellow to manage these days.

Dealing With Loss

As most of you know, the last few years have been tricky. For someone that used to be thoroughly independent, active and energetic, adjusting to life with an illness is tough.

Recently I have been reminiscing. All of the years spent at music college, I spent my time swinging between love and hate. I loved the sense of excitement and freedom when playing with others, and the means of expression I had when playing beautifully sad music. I loved the social aspect, especially those late night rehearsals with a cuppa (or wine) in hand on a dark and cold winters evening. I even enjoyed early morning practice sessions once I got into the habit of getting up on time! I also enjoyed performing eventually. It took me years to get past the persistent “I’m not good enough” voice – that was my toughest challenge of all. The first couple of years I couldn’t stop sabotaging myself before a concert. I would end up not practicing for 3 weeks before a performance, which I suspect was a way of allowing mistakes without a sense of my whole self being unacceptable. Once I got past that tho, performing turned into a favourite. I was excited to play, to share. I was able to start being myself.

By the time I left college, I thought I had had enough. Try as I might, I was never satisfied with my work, and it was exhausting to keep pushing toward a goal that doesn’t exist. Perfectionist tendencies aren’t always a great thing! I had stayed with my teacher long passed our prime, and I became frustrated. I wanted to move forward in the last year there, but it felt like a mountain I couldn’t climb without help, and I didn’t have the energy to fight for it. I was ready to throw everything in to my final recital, but most of my lessons that year were frustrating and disheartening. With hands that went numb mid piece, and a lung capacity better suited to a mouse, I couldn’t attain the standard I needed. I’m pretty sure my teacher grew just as frustrated as me.

During my last couple of years at music college my health got noticeably worse. The pain I had experienced from the age of 12 got significantly worse, and I started to suspect that it wasn’t just music to blame. No other musician I knew was waking up 4 times a night in agony, or needing to lie on the floor to find their breath again. My fatigue worsened, my heart was galloping of at 130BPM at rest, and much higher as soon as I was up on my feet. I was constantly fighting to get enough air, which as a recorder player proved quite an issue! In short, music was becoming an unrealistic goal. It became a case of pushing myself through to the end of my course so that I had a degree under my belt, and accepting that I just couldn’t play at my best.

After leaving, I spent 1/4 of a term teaching, and a full 7 months working as a carer. I loved working with mental health, and figured that was a direction I could head to. I would work enough to do a postgrad in art therapy, and then work from there on in. That was the plan, but unfortunately my body thought otherwise.

In November of that year I got optic neuritis (swelling of the optic nerve), and ended up on a long course of very high dose steroids. Contrary to popular belief, I didn’t end up with gym sized muscles, but a couple of walking aids instead! In reality I can’t be sure if the steroids really did finish me off, or whether I would have headed in this direction anyway. My life closed up into being mostly housebound, and I had lost everything.

Today, I am marginally better. Not because my body is any fitter (quite the contrary in fact), but because I am accepting the help I need. Looking back at my studies, I would probably say that I needed walking aids sooner. In reality, POTS and EDS were taking their tole, and I can’t help thinking that if they had of been managed properly, I may have ended college on a much better note. Perhaps I could have managed that first I missed by a couple of marks, or ended my recital on a real high. Perhaps I could have carried on playing for longer.

Tonight I have a painful ache for my past life. No matter how much I struggled, I can’t help feeling that the music I learned for 22 years is being wasted due to the conditions I am living with. I miss playing, and I miss performing. I miss that sense of freedom I experienced in fleeting moments, and the challenges that came with trying to attain it. I miss striving for goals, and being driven to work hard for something that might just be possible. Most of all, I miss the music.

In many ways I am blessed. I have found other ways of doing things, and on a good day, I can pretend that it has been my choice to choose another path. I have other hobbies in my life, and I still have the dream of getting fit enough to study and work again. All is not lost – it can’t be. I refuse to life this life for another 60 years.

Loss is a very tricky beast when it comes to your health.

BRCA2: The Journey Begins

As many of you will have read, I decided to undergo genetic testing a few weeks ago. We have significant family history of breast cancer on my dads side, and are of Ashkanazi Jewish decent – this is a big risk factor. Due to this combination both dad and his sister were tested for the breast cancer genes, and sadly came back as BRCA2 positive.

The choice to go for testing was not an easy one to make. I did my fair share of burying my head in the sand, but no matter how much I tried, the thoughts would randomly pop into my head. Fear of the unknown, fear of having the faulty gene, fear of my siblings having it, fear of cancer – just lots of different flavoured fear really. I would be in the bath, or driving down the M1, and all of a sudden my mind would flip onto it, and I would find myself going round all of the scariest scenarios possible – namely that I would test positive, and life as I had planned would no longer be an option.

At the just shy of 29, my risks would not have been out of the ordinary – for breast cancer, the risks start climbing at 30, and around 40 for ovarian cancer (at least thats the information I’ve been given).  However, it is more then just the risks to me I was worried about. I have always wanted a family, and although I am free and single at the moment (rather perfecting the art of the crazy dog lady), a positive result would have implications as far as my future children would go. So, knowing full well that I couldn’t put it off forever, now seemed as good a time as any to find out.

After a nail biting few weeks, I went to the genetics clinic to get my result.
Its amazing how much of an effect a few simple words can have on the rest of your life.

I sat down, and the genetic counsellor came strait out with “I’m really sorry to say this, but you’ve tested positive for the gene’.

I don’t really remember a huge amount more from that appointment, other then absolute terror, and a fair amount of water pouring from my eyes. The life I have that is already full to bursting with health problems just got a million times more complicated.

Yesturday I was upset. My gem of a neighbour who had offered to accompany me to my appointment escorted me back to hers for 3 very strong cups of irish tea. We spoke for an hour or so, thrashing around all over the place as my mind furiously sifted through too many scenarios to count. She was extremely patient with me, and allowed me to get my head together in my own time – I honestly don’t know what I’d have done without her being there. I then decided I should keep busy, and as much as I didnt want to, I headed to jewellery class where I could spend a couple of hours hitting things (mostly metal, but my hand is a little worse for where… it turns out my aim leaves a lot to be desired when I’m stressed!)

Today I just feel numb. I know that there are a million and one feelings hidden underneath, but I just can’t seem to find them. The prospect of now needing to consider prophylactic surgery is extremely daunting, and what effects will this have on my already difficult dating scenario? At what point would I drop this one into the conversation. “Hey, by the way not only do I have the body of a 90 year old, but these boobs you see here are for a limited time only, and if you’re up for having children its likely to involve microscopes and something resembling a turkey baster”… Not the ideal selling point.

It will be a process of letting go of the things I had dreamed of doing. A big thing for me has always been that I wanted to breastfeed any kids that I had, but if I choose to go for surgery, this will no longer be an option unless I risk leaving it till I’ve had them.  I had also never fathomed having the one part of my body I’ve never hated being lopped off by a surgeon and replaced with imposters. This will be a grieving process on a very personal level.

Fortunately, I really have stumbled across some amazing people who are supporting me. For all of the friends who have been dropping me little messages to keep my chin up and calling me and allowing me to talk until I find a stopping point without complaint, I can not say thank you enough. There are also 2 rather fantastic charities providing me with access to people who have trodden this path, and this is absolutely invaluable to me. I got a call from one volunteer to ask how my appointment had gone, and her response was exactly right for me – “I’m so sorry to hear that, but welcome to the mutant club!”

So, from one very stripy BRCA2 mutant, I will leave this post here for now. I will keep posting this journey alongside that of EDS and POTS, so I certainly won’t be short of ideas!

The Not So Sexy Side to EDS

Ehlers Danlos Syndrome is a funny beast. Day after day, I am constantly amazed at the weird and weirder things my body decides to do – or not do as the case may be. I would go so far as to say that my collagen is inherently lazy, and no matter how much caffeine I feed it, it just never gets its act together.

Along with all of the usual things that people understand when you say the words ‘faulty connective tissue’, there are the rather embarrassing issues that we all keep rather quiet about. As if pain, chronic join subluxions/dislocations and spectacularly large stretch marks aren’t enough, it seems that all of your insides need to join in the party – and when I say all, I mean all!

So – if you are squeamish about the inward workings of a lady, I would pop off and make a cuppa without reading any further!

Due to everything being stretchy, prolapses of all varieties are all too common. I was aware of prolapses in your digestive tract, but had given little thought to potential Pelvic Organ Prolapse until the last couple of years when something decidedly stopped being where it was supposed to be.

Initially I had noticed issues with discharge of sorts. It was thought to be chronic thrush, but after 6 months of medication, nothing had changed. I had already started having the odd issue with my urinary tract, but after a while, I started to suspect that my discharge was actually leakage from my bladder. I was constantly worried about whether I smelt, and had taken to carrying spare clothing around, as often I would leak just a little too much to get away with staying in the same clothes. I was also experiencing an odd sensation of heaviness/pulling. It wasn’t quite painful, but it was uncomfortable. Upon checking the strings of my coil one day, I found that there was a bulge. After some initial panic, I hopped it off to the doctors and mentioned all of the above.

Unfortunately, that first doctors appointment was bad enough to stop me seeking help for way over a year. He examined me intensely, but proceeded to suggest that the thing I could see and feel was nothing more then my vaginal wall – to which I exclaimed “Well it certainly might me, but it isn’t where I left it”. He proceeded to suggest I probably suffered from an overactive bladder, and gave me medication that in big letter stated “DO NOT TAKE IF YOU HAVE A HEART CONDITION” – obviously totally out of the question for someone with POTS. I came out of that appointment and cried for hours in humiliation. He made me feel like I was visiting for attention, and it made me question myself for months. I really did wonder weather I was subconsciously looking for extra diagnoses and that everything I felt was actually totally fabricated.

Fast forward a year or so, and I was in bed with a guy for the first time since a rather nasty break up years earlier. Just after everything had calmed down, he propped himself up, and explained that I may want to get myself checked as he could feel himself being ‘pushed out’ – hardly the conversation any young woman wants to have with a man. Red faced, I nodded, although the issue didn’t stop there. I had also managed to stab him with my IUD (it seems the weird superpowers were going spare on the day that I was created) – I felt awful! As EDS gives us the power of being super stretchy, even things like the coil are likely to move about. Mine has shifted down over the years, and the combination between a coil sitting too low, and your insides resembling a bouncy castle can wreck havoc on your sex life. Most embarrassingly of all, with the combination of a bladder that is too stretchy (thus retaining far more, and emptying far less then usual) and a prolapse comes the issue of leaking during sex. Again, not exactly a hot date. That night I had to change my bed because of the sheer volume that had literally been knocked out of me – feel free to stop reading this at any time!

After another few months of trying to ignore it (needless to say with a very inactive sex-life), I finally built up the courage to mention it for the second time. I was already under a urogynacologist, and brought it up there thinking I would stand the best chance of getting it taken seriously. She told me I would have an internal examination during one of the tests, and so I agreed to wait until then. Unfortunately this didn’t take place, and so a few days ago, I travelled down to see a member of her team to ask to have it checked. Roll on embarrassing appointment number two.

This second appointment was little better. Initially, the nurse tried to suggest that the man had made it up just to be mean to me. In all honesty, this is so unlikely that he would have deserved a medal for inventiveness if this had of been the case! I didn’t even know much about a prolapse, could you really imagine many men being knowledgeable enough in that area to use as a way of being nasty?! I explained that I could also notice a difference and went into detail explaining my symptoms. She eventually agreed to attempt an internal examination, but persisted in her attempts to dismiss it. She said she could feel a bump, but that lots of women had this and it could be considered normal. She said she could feel it descending upon talking, laughing and coughing, but that she wasn’t really sure what it meant. Eventually she called an on call gynaecologist, so after a 30 minute wait, I was finally able to get it looked at by a specialist. Finally after a 2 year wait I was diagnosed with ‘grade 2 descent with a cystocele’ – essentially this means that my bladder is prolapsing into my vagina.

The gynaecologist told me that there is no reason a normal 28 year old who hasn’t given birth would have this, but that due to my collagen being overly stretchy, it is unfortunately very common in women with EDS. She explained it will either require surgery or a peccary (a device thats inserted to support the vaginal wall), but it would require a more in depth look before anything can be sorted.

So, yet another label added to the list, and this one for me is probably one of the worst. The impact this has had on my confidence, sex life and desires to get into relationships are vast. As if having chronic health conditions weren’t enough, EDS has added yet another source of humiliation, embarrassment and inconvenience to my life. I have no idea how you work your way past this and into a happy and healthy long term relationship when you feel like you need to mark your nether regions with a do not enter sign. It is bad enough that you are in constant pain, with joints that flop about more then a rag doll without it taking away your enjoyment in the bedroom to boot.

A Mini Update, and The Eve Before My Second Genetics Appointment

So as always, a lot seems to happen in a tiny amount of time.

On the medical front, I am happy to report a productive appointment with the very lovely GP yesterday. I feel extremely lucky to have gone from one extreme to the total opposite by chance, and for the first time in my life I actually walk out of an appointment feeling positive.

Having made contact with the endocrine team, they have suggested a referral to them, and a scan of my thyroid as I am now clinically diagnosable as having hyperthyroid (or however you’re meant to phrase that mouthful). So being on the case, this GP was more then happy to sort those referrals out – no hint of annoyance or complacency to be found! Although having thyroid issues are nothing to celebrate, I feel so much relief that they are finally being looked into. Its been over a year of battling – up till now they have been brushed off, and only by TSH and T4 were ever checked (TSH always came back as low, but T4 was normal). Thankfully this GP tagged on a test for my T3 levels, and low and behold they came back as high – hence the hyperthyroid diagnosis. I have been feeling pretty rough since my very long encounter with high dose steroids, and it was around the end of those that my thyroid was checked and found to be not behaving. I am dearly hoping that this is a step in the right direction, and that I can get properly diagnosed, treated and begin to feel much more myself again.

I also spoke to her about my issues with the gastro team discharging me. Apart from spending a lot of time laughing about it (I genuinely believe you could make a comedy script based on my encounters with the NHS), she was pretty unimpressed. She is making contact with my POTS team to ask if they want me referred to any other specific teams (preferably those that are EDS aware), and if not will either try some strategies herself, and/or refer me to a local gastro team. Had this have been the old GP, she would have given me a blank look, scribbled on a peace of paper, told me she couldn’t do anything and written it off as another problem not worth trying to solve. Thank goodness this has happened now and not a few months ago.

We also discussed the rheumatology appointment – I had received a letter questioning why my doctor had asked for them to see me. She assured me it was all written into the first letter, but obviously they hadn’t bothered to read it properly. So she is writing a second time making it clear it is so that I can get a referral to Stanmore – fingers crossed its second time lucky!

In other news, its my second appointment with the genetics team tomorrow, and I am feeling a little bit on edge. I had the first appointment a week and a half ago, and decided I needed time to take in the information before going ahead with the test. It turns out they use the numbers of an 80% lifetime risk of breast cancer, and a 30% risk of ovarian cancer for the BRCA 2 mutation – pretty high numbers for a single gene eh? It will take 4 weeks to get the results once you do the test, and obviously they encourage you to think about both outcomes, and what you would do with a positive result. I am fairly certain that although I don’t want to deal with having the operations and the emotions that they would entail, it would be the most sensible path for me to choose. I don’t want to end up with cancer on top of everything else, and as much as I love my boobs, I am pretty sure I will love them less if I know they stand an 80% chance of giving me something potentially life threatening  (and at least unpleasant). Still, its a rather crazily big decision to make – the choice to know if I carry the gene or not. I didn’t think I would ever need to consider the question, let alone formulate an answer.

So, at 11 o’clock tomorrow morning I will be heading to my appointment, and I think biting the bullet and going through with the test. I would be lying if I said I wasn’t scared.

If you are near Birmingham and fancy a drink and an evening of sarcastic entertainment, then drop me a line – I will need all the distraction I can get!

Another Set Back

Having been relatively surprised with the care I received from my first really caring GP, it should not have come as a surprise that life in the NHS would not stay all that rosy for long. Having said that, it would have been nice to have had slightly longer feeling all warm inside before another blow was dealt.

It took me a year and a half to see a gastroenterologist – I was not all that upset by the waiting time. I know that the NHS is stretched and things are tight – heck, I was just relieved to even be on a waiting list. I got several tests done, and hey presto I have 3 diagnosis to boot (it seems that us EDS’ers really do earn our stripes) – oesophageal and gut dysmotility and a hernia. Nothing particularly surprising really – I struggle with things like dysphagia, regurgitation, the feeling that my oesophagus just won’t push things down (liquids and solids alike), pain and getting full after mouse sized portions (somebody really needs to make my oesophagus stomach sized… design fault me thinks) pretty much every time I eat. Its frustrating on my good days, and makes me want to rip my hair out on my bad days – but I am all good with pretending to look normal whilst holding regurgitated dinner in my mouth before forcing it down for a second go.

The last appointment I had was results day. The guy was nice enough – pretty pushed for time, so gave me a very quick take on things which didnt give my head much time to process. He decided on a treatment plan, and told me he would see me within 3-4 months time, and even had his nurse book me in an appointment there and then, just to be sure. In the mean time, he gave me a list of things to try before we met again – where he would shift things, look into medication etc in order to get things sorted. All fine(ish) – at least we were going to do something and hopefully work on getting my digestive tract back on track.

Imagine my surprise then when I opened an ominous looking envelope a few days ago that simply stated ‘You’re appointment to see Dr X has been cancelled as he has discharged you from the pathway’. After an initial outburst of profanities and tears of sheer panic for an hour, I pulled myself together enough to ring the hospital and ask what on earth has gone on.

The receptionist then proceeded to explain how Dr X had made a ‘typographical error’ and I should never have been offered a follow up appointment. This would have been easier to believe had he not reiterated several times that I would be seeing him again, made his nurse book me an appointment before leaving the hospital and hadn’t sent me a letter following the last appointment detailing out the treatment plan – including the arranged next appointment. I pointed out these little details to the receptionist who promptly told me ‘If you want to discuss this further, you’ll have to go back to your GP as you are now formally discharged’.

Helpful.

So, having calmed down enough to book in another appointment with my GP for Wednesday, I got home yesterday for a second letter of insanity – this one explaining my discharge – surely someone aught to at least post these the right way round? This letter, if it is at all possible, makes even less sense then the former. So much so that I am pretty sure I could have won the award for Best Confused Face of the Year.

Not only does it mention the good old ‘typographical error’ that was ‘greeted with the impression that she will be reviewed again’, it also says: ‘I outlined in the last paragraph my recommendations on the cumulative strategy that cannot improve her symptoms and I therefore do not feel that it is necessary to follow her up’.

Not only does the last paragraph of the letter he is referring to mention nothing about his recommendations on his cumulative strategy (it actually talks about a referral to Stanmore) – but apparently the strategy was a totally pointless (fictitious) exercise anyhow.

Nothing that he wrote made any sense at all – but I am now left essentially having been labeled as untreatable before anybody even attempted to help. I am left still struggling to swallow enough to get in adequate nutrition, still getting worse as time goes on, only now with extra labels attached. I am painfully aware that even if I manage to get a new referral in place, it will take months, if not years to see anybody – and in that time, I am left to deal with this totally alone.

This is not help. This surely qualifies as a form of torture in some countries? I am fighting every single step of the way to get help for conditions that I have actually been diagnosed with. I naively thought that getting the name was the hard part, but with EDS that battle does not stop. For whatever reason, we have to push and push, and fight and fight just to get appointments or treatment. This continuous battle wears you down and leads to you getting sicker and more exhausted – it is a downward spiral into god knows where.

I am sure most issues are funding related, but a little bit of humanity wouldn’t go amiss. These letters made me feel like I was in the wrong. That I had created false memories, or had made up what I wanted him to say. It would be far more respectful to have received correspondence apologising for the change of plan, with maybe even a suggestion of what to do next, rather then just dropping a bomb shell and running. Humanity costs nothing, but can make the difference between leaving a patient distraught and suicidal, or leaving them able to face another fight and push for the care they need.

For me, I have no idea where this leaves me. Having spent 12 years of my life engaged in an eating disorder, oesophageal dysmotility seems a particularly cruel joke from the universe. I am desperate to get it sorted, but I have no where else to turn. I can not afford private health care, and the so called specialist is now out of reach. I am left to wait – for what I am unsure.

I would give anything for a working NHS right now.

The Difference of a Good GP

Having been battling with pretty much every GP practice I have been (un)fortunate enough to cross paths with, I had long since given up on the idea that any doctor would ever be of use to me. I have spent years fighting to get help for each of my many conditions, and every time I have come up against wall upon wall. Of late (since the last rant I had about funding), I had point blank stopped going, feeling that I am happier dealing with my health issues alone rather then deal with any more upset and refusal of the help I need. That is, until now!
Having avoided my GP surgery for the last few months, I completely missed any idea that my old useless frustrating GP would be needing some time off for maternity leave. I got a call a few weeks ago asking me to go in to see her – and was petrified it was to try and take away the painkillers that I know they aren’t so happy prescribing. So I took a friend along to help fight my corner (I learnt very quickly that nobody listens to this zebra directly), and very nervously sat in the waiting room waiting for battle to commence. The door opened and to my surprise a totally new face stuck their head out and called my name.

This doctor is maternity leave cover, but she is truly an angel in doctor for. She had called me in purely because she had been reading my notes and realised I’m on a lot of medication, so wanted to get to know my face and discuss how things are going. After a quick blow by blow account, she had decided that a referral to a rheumatologist needed doing strait away (the referral that I have been fighting to get for months/years), stating ‘your young, you shouldn’t be having to deal with this and if the practice have an issue with it, they can come to me!’ And that my other thyroid hormone needed to be checked (up til now my TSH has always been low suggesting hyperthyroid, but t4 was always normal – nobody had gone further and checked my t3) and surprise surprise it has actually come back abnormal! She also told me she was going to go through all of my notes, research things and read my hospital letters – all of which she has now done! She is now chasing advice from an endocrinology team for me! 

I am literally bowled over by how genuinely caring this doctor is. I have never had any support like this before, and the difference it makes is astounding. I have gone from feeling totally hopeless, demoralised and burdensome to feeling like I have a physician I can actually talk to about my health issues. I even mentioned a little about my mental health, and she was absolutely amazing about it. No telling me my pain was obviously caused by that or dismissing it, she actually told me she was very pleased I told her as it’s important to get the right support in place before it gets any worse! That has never happened before.

I feel like I am dreaming it all. I am dreading the day my original GP comes back to work again as I know that I will be right back in the position I have been in, but for now I will make use of this absolute Godsend and go to the doctor when I need help!

Making The Decision To Have Genetic Testing: BRCA 2

As some of you will know, my father had cancer a few years ago. At the time, it was thought to be secondary breast cancer as it was oestrogen receptive, and therefore would have been a terminal diagnosis. Thankfully, it was cancer of the sweat gland (so rare they wanted pictures!), and after treatment he has fully recovered.

Due to a family history of cancer, he underwent genetic testing for the BRCA genes. It is fairly common in a few ethnic minority groups, and we fall into that category. Up until that point, I hadn’t even thought about it. I knew that my Nana’s mum had died of breast cancer, and my aunt had also developed it (tho is in the clear thankfully). It hadn’t crossed my mind that it was genetic, and I had never really considered that possibility.

Both dad and his sister tested positive for the BRCA 2 gene, and this means that my siblings, cousins and I have a 50/50 chance of also carrying the same mutation.

This news carried a number of thoughts, feelings and emotions. The biggest initial reaction for me was fear. Cancer is not a light subject, and having seen my closest friend die of terminal cancer just a couple of years previously, it is particularly fresh in my mind. I was scared of knowing, of not knowing, of having the mutation and of not. I was for my siblings and cousins – I never want to see people suffer through anything like what Riya suffered with ever again. As it is a 1:2 chance, it is statistically unlikely that all 4 of my sibling group will test clear (though I would be ecstatic if that was the case), and that is a horrible thought to have. I know I would feel guilty if I test clear when another sibling does not, and probably upset if I have the gene and the rest don’t.

At the time I found out, I didn’t want to know. I didn’t want to learn of either result as it was easier to put it to the back of my mind. I haven’t really spoken to people about knowing we have a BRCA gene in our family. In general, I am used to keeping medical stuff back from the people around me. So it feels natural to do the same with this – however this is slightly different. This is something that I can choose to learn, or choose to ignore and hope for the best, but somewhere I know it will always be in the back of my mind.

As a family, we struggle to talk about this sort of thing. We have had fleeting conversations one  on one, but we are yet to sit around as a group and discuss what genetic testing means to us. It is a hard topic to bring up, and I often find myself keeping quiet – we are all independent adults with our own lives. As much as I feel that I would benefit from an open discussion, it may well be that the rest want to deal with it in their own ways and in their own time. This has made making a decision for me harder tho. Perhaps I would feel more comfortable doing this at the same time as my siblings rather then being the first to seek an answer.

As I have had time to think about the possibilities, I am beginning to look past my initial reaction. There are benefits to both decisions, and different outcomes after someone tests positive.

The benefit of finding out is a clear cut answer. Either you know that you are in the clear from the gene, and therefor have the same chance of having breast cancer as any other woman does, or you know that you have the gene. Having the BRCA 2 gene gives you a lifetime chance of breast cancer between 45%-85%, and a risk of ovarian cancer between 10%-30% (which increases from the mid 40s). This is a fairly substantial mark up from the average woman (which is about a breast cancer chance of 12.5%).

If you do find out that you have a BRCA gene, then there are options you can choose to take which will either mean cancer is more likely to be detected early, or that will reduce your risk substantially of developing breast cancer in the future. I have been looking into this in relation to breast cancer – so the below relates to this.

The first of these options would be choosing to have increased surveillance. Even if you don’t choose to be tested, this is something suggested to those with a known family history of breast cancer. This would include yearly breast screening from the age of 30 (in contrast to the 3 yearly screening from the age of 50), and keeping vigilant with monthly checking at home. It doesn’t cut the risk of development, but it would give a better chance of catching it early, thus a better chance of survival.

Another option for those with BRCA 2 is ‘chemoprevention’. This means that you would take drugs known to reduce the risk of developing breast cancer for 5 years, and this could potentially drop the risk of development for a number of years after treatment ends quite significantly. The downside to this is that these drugs can cause substantial effects, so you would need to weigh up the risks with your doctor to decide if this is a good option for you.

The last option, and the most drastic is to have an elective double mastectomy. This would mean choosing to have your breast tissue removed, and a reconstruction, either with your mastectomy or at a later date. The benefit of this your risk of developing breast cancer drops hugely – even below those with no gene present in their family. Obviously the downsides are primarily surrounding having surgery, and if your anything like me, the prospect of not having your own breasts anymore!

I can’t help feeling that I am too young to be dealing with this decision. I may be 28, but the potential effect of this decision has a far larger effect then I care to imagine. I am single, and I can’t help thinking that a positive result would create more problems in the dating scene then those that I already face as a chronically ill woman. This is also something that is an issue even if I choose not to find out. I’m not sure ‘Hey, I stand a 50/50 chance of having a breast cancer gene, fancy a date?’ is much of a turn on these days.

Having been reading and researching the above, I am slowly coming to the decision that for me, genetic testing seems like the obvious path. I don’t want to know that I have BRCA2, but if I do have it, it seems more sensible to find out and take action, however unpleasant that process might be. In this day and age, science has achieved some amazing things, and I feel someone obliged to take advantage when my great grandmother could not. I don’t want to be sitting here in 20 years time facing breast cancer, knowing that I could have done something to prevent it.