Friday, May 02, 2008

Mini Med School

That was a long-ish hiatus, and I never even warned you!

So, what's been going on chez moi?

Not much apart from work.

I ended up working until 7pm yesterday to tie up loose ends, as it will be a long weekend with Bank Holiday Monday coming up. I took today off to go to the hospital for my long awaited echocardiogram which was recommended after my electrocardiogram last month. Damn, but the ultrasound thing
really hurts - in searching for the best image of my heart they keep kneading the probe into all that sensitive tissue upholstering my female ribs. Go on, have you ever heard it described that way before?

It was a lovely sunny morning in the upper 50s to low 60s (avg 15C) so I wore a nice Ralph Lauren t-shirt and my cotton safari jacket. I preferred to briskly walk the 45 minutes (including getting slightly lost) rather than take the Tube or bus, both horrific roundabout journeys lasting an hour. Got hot and removed the jacket, and when I arrived I was sweating - for the first time in MONTHS! It felt great!

Anyway, I walked unscathed through Harlesden, appropriately comparable to Harlem, or more likely the South Bronx. I did receive a number of stares for looking distinctly out of place.

I arrived the alloted 15 minutes early but ended up waiting an hour even though there were only a handful of people in the waiting room (unusual for the NHS).

The reason I was given this test is because on my visits to the doctor after the shingles, the nurse was unhappy with my blood pressure and heart rate. When I was a teenager, a doctor said she thought I had a heart murmur and should get it checked out before I have children. A few years later another said he could hear a distinct click and whoosh and thought I had mitral valve prolapse (MVP), which is when the mitral valve doesn't close properly, flaps about a bit, and allows blood to seep back into the chamber (mitral regurgitation). This results in a higher risk of infection, so for instance, before going to the dentist I'd take a prophylactic course of antibiotic tablets the morning of the procedure, and then again afterwards. Bleurgh. This is to protect against any bacteria that might get into the bloodstream through the gums. More recently this treatment has been found to be unnecessary.

There are also frequent flutters, skipped or extra beats, and tachycardia (rapid heart rate).
MVP and tachycardia are often symptomatic of a condition called dysautonomia. It is a fickle and varied state, an imbalance of the autonomic nervous system, which regulates the glands and unconscious functions such as breathing and digestion. I have little control over my adrenal glands, for instance, and so it takes very little anticipation to have me awash in adrenaline but because I don't need to run anywhere, I must endure a half hour of weak knees, shaky hands, and some breathlessness due to the hammering heart until it wears off. What's more, sometimes just a half thought can cause my heart to leap. Finally, I sigh a lot and I'm really really easily startled - even if I know someone's coming I can hit the ceiling. Other symptoms of dysautonomia are easy bruising, forgetfulness, frequent headaches, fatigue, panic attacks, joint discomfort, fainting, orthostatic hypotension (dizziness when standing up) aaand so on. For me, personally, the unwanted "fight or flight" state ties for worst with the 2-hour periods of tachycardia when I can sit there feeling as though I've just stepped off the treadmill, only without the sweat.

Then there's the fatigue. Days when you wake up feeling drugged after a long struggle to wake up, somehow glued to the bed because your limbs are deadweight. You drag yourself to work, fighting for every step, then sit glued to the chair, holding your head up with an effort. Lifting your hand to the desk is almost out of the question. You just want to fall face forward into the soup, so to speak. For me, such episodes usually last until mid morning or early afternoon, when it seeps away and then suddenly I bounce up ready to start another day just when everyone else is winding down.

But we very often present as normal people since the symptoms are not always simultaneous, so on good days I doubt whatever happened on bad days. In this way you can go for years without treatment or acknowledgement. You also don't want to walk into a doctor's surgery sounding like a hypochondriac. My current GP is a classic product of the NHS in that the last time I was there and tried to bring up a few of my long-term complaints she clinically shot them down, making me feel rather foolish, and then sat there looking defiance - I think they train them as I've seen it on other British docs' faces before - and probably thinking, "I dare you to come up with another one." This is so that she can get me out of her office in the allotted 10 minutes.

It is 180 degrees from my doc in Houston, who told me that no question was ever a stupid question, so one day I brought up everything that had been troubling me, and in this way he was both kind doctor and reassuring therapist. I left the office that day with a bloody cauterised sinus but all aglow with confidence inside, rather than the mumbling booby I was at my GP last month.

It's ironic since because, let's see, in the US I may have gone to the doctor about 6 times in 14 years. Here, thanks to all the stress and malaise I've been about 6 times in 5 months.

On the other hand, there I went to the dentist every six months. Here, I've been unable to find one so haven't seen one since I visited my old one last time I stopped in Texas (2004).

What's more, I've been to a hospital twice this year (for the ECG and Echo). The last time I saw the inside of one, apart from visiting people, was when I was a few months old and had aspirated some milk which led to an infection and high fever. (Preemies have lazy swallowing reflexes).

Hm. This post became so much longer than I had intended. I always do this when I think I have nothing to blog about. Therefore I ought to blog more often.


mark (cafe) said...

It is a problem in the UK, getting hold of a decent dentist (by that I mean someone who doesn't charge 100 pounds just to look in your mouth). Sorry to hear you've had a snooty doctor. I must admit I avoid doctors, hospitals etc as much as possible. Apart from anything else, I resent being kept waiting for my appointment for what seems like hours - however you try turning up 5 minutes late yourself, and suddenly you're accused of being Atiila the Hun and Jack the Ripper rolled into one. Anyway, hope the sun shines on you this weekend!!

L B said...

I read thru about three times, I think, but all those medical terms just swished past by my head at the speed of sound.. I recall reading about a doctor, a dentist, and you sweating, and removing your jacket.. :-)

Anonymous said...

Condescending doctors who don't really listen make you feel worse than your symptoms sometimes.

I, too, suffered from a couple of panic attacks in my early twenties. I haven't had any since, but for a long time worried about having one afterwards. My life was super high stress at the time and has since cooled down, which helps.

Sorry to hear about all of your symptoms. We just have to try and enjoy life as much as we can despite the challenging stuff, huh?

Guyana-Gyal said...

This 'thanks to all the stress and malaise I've been about 6 times in 5 months' reminds me of a time when I went to the doc. so often she finally asked me, 'What's happening in your life?' Bad relationship with very moody man, that's what was happening.

I sure hope you feel better soon.

Olivia said...

Mark - better yet, I ate breakfast on the patio this morning with my friends and their baby! We started out there, anyway, then it rained a bit so we moved under the gazebo. Still outdoors though!


LB - you would have perked up if I'd mentioned iPods or lormaikai, right???


Jessica - you're right. It is the stressful times when I am most reminded of this disruptive interference. And I do need to learn to live with it, and maybe get the better of it, rather than compromise with it because unfortunately it can be enough to hinder me in some of the more demanding things I want to do in life.


Guyana Gyal - lucky you had a nice doctor to ask you. I kept trying to mention "what was going on in my life" and MY doctor only decided to ask about it, offhand, as I was getting up to leave AFTER my 3rd visit!!!

It is a good thing that you got out of the relationship with the moody man. That is not really a relationship after all.

Selba said...

Learnt something new in this post :)

Doctor.. oh doctor....

Here in Indonesia, there are a lot of "brain-less" doctors. Indonesian rich people always will go to other country for their medical check-up.

The Moody Minstrel said...

It is a good thing that you got out of the relationship with the moody man. That is not really a relationship after all.

Hey...! {:-(

Have a heart, m'lady!
Actually, I should say, "Look after your heart!"

Snooty or not, at least your doctor actually communicates with you. Doctors here in the Land of the Rising Sun are kind of like an assembly line or something.

Next! Open your mouth! Say, "Ah!" Hmm. Ah. Okay. You have a cold! Here's your prescription! Next!

About the only time you actually get looked at is if you go to one of the really expensive dentists where you are, apparently. (Talk about reinforcing stereotypes!)

Anonymous said...

I feel a little bit as though I'd just perused a case study in a medical journal. There is no perfect health care system, but it sure is easier to get dental care here. So do you have a target relocation spot yet or are you just going to go to NYC and wing it?

Olivia said...

Selby - even in the UK, with the shortage of decent dentistry (oh the stereotype), people are choosing to combine a holiday to Hungary with a visit to one of their well-trained, technologically advanced dentists.


Minstrel - the minute I typed "moody" I hoped you would not pick up on that!

I can very easily imagine the assembly line Japanese doctor. I think I would be frightened away by that prospect.

Although Mark refers to the dentists who quote "£100 just to look in your mouth", doesn't mean they will be nice or even do a good job.

And yet the Brits as a whole mock Americans for wanting straight, white, teeth. Have you ever sat next to someone with bad teeth?


Nikki - hm. Dilemma. My cousin can no longer guarantee the availability of his spare room. Although my cousin in Westchester has a huge house, it's mostly living areas and not near enough to transport.

I have a potential landlord in Houston just begging me to get down there.

I don't know now...but I have to start somewhere and NYC will be most convenient as I don't have to run out and buy a car immediately.

Christopher said...

Sure I'll help ya move..just get me a good bottle of wine to dangle in front of my face and I will do anything! (uh oh, that could be slutty! Oh well!) Hope all is well with you! Come on by and see me sometime!

Jo said...

Sounds like I should be grateful for our ridiculously over-priced but personable, reliable though inaccessible to the poor and needy health care in the U.S.