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.