Category Archives: Health

Weighing up the benefits

I’ve written previously that, although recovered from anorexia, I continue to struggle with body image and thoughts about my weight etc. I currently have a very difficult decision to make that brings up an important issue frequently faced by people with chronic illness.

Balancing benefits with side effects of medication.

I’ve been on many psychiatric medications in my time, some more beneficial than others. Each time I’ve been up against the decision to try something new, I have point blank refused to take medication with a common side effect of weight gain. A lot of psychiatric medications have a side effect profile that impacts the gut/brain axis, nausea, diarrhea or constipation are very common. Many psychiatric medication increase appetite, which in turn leads to weight gain. Some medications appear to have a near 100% incidence of weight gain as a side effects and I know this would have an incredibly negative impact on my mood and overall mental wellbeing.

I’m currently very mentally well. However, it’s my physical health that’s letting me down! Due to degeneration in my spine I get a lot of pain in my neck, back, across my shoulders and down my arms. This pain, at times, is near unbearable – I say “near unbearable” because, I can bear it, I do bear it, every single day, I get up, get dressed, go to work and most people wouldn’t know I’m in any pain at all.

Painful spine

When I was last seen in the pain clinic (in May) I was advised to try new medication and I was put on the waiting list for anesthetic and steroid injections. I hoped the injections would provide a longer term solution that would mean I wouldn’t have to rely on daily tablets so I decided to hold off making decisions about new mediations. Unfortunately, other than making me feel as though I’d been run over by a sewing machine, the 24 injections I had in my neck and back had no impact! While I await further advice about further intrusive management, I feel I have no option but to review my medication regime.

Medication in hand

The fact that I do bear my pain, doesn’t mean it’s easy – it feels, at times, as though I’m on the edge of coping. What I’d love to do on the majority of days is stay in bed, close my eyes and sleep the pain away; but one of the cruelest things about chronic pain is that it stops you sleeping! Just when your body could do with the time to rest and repair I get a mixture of gnawing/gripping, stabbing (as though I’m actually being stabbed) and electric shocks of pain across my back and down my arms. The best thing I do each day is just get on with my life and keep distracted!

The problem I have with weight gain is difficult to put into words, except to say, it would feel as unbearable as the physical pain I feel in my back and shoulders.

For the neuropathic pain I experience (caused by bone spurs pressing on nerves), a group of drugs called gabapentinoids is recommended.

I’ve read studies quoting between 10-80% people taking gabapentin experience weight gain. This is via a variety of mechanisms: decreased metabolic rate, water retention, increased appetite and decreased motivation to exercise being the major causes. Even in the worst case (a study looking at high dose gabapentin for epilepsy), there’s still a 20% I will not experience weight gain but this may require high levels of self-discipline not to eat more than my metabolism requires and to maintain my exercise regime. But I cannot hold onto this as a guarantee, the maths isn’t on my side!

Maybe I can use this as an opportunity to value my quality of life over what I think about my body? Maybe I can use this as an opportunity to stop valuing myself based on the number on the scale? I know this would be the ideal but it’s not as though I can flick and switch!

Stepping on bathroom scale with tape measure

The struggle is that, the gabapentinoid may not even decrease my pain! I may agonise over this decision, try the medication and it have no or little impact! Worse still, I may experience side effects without any benefit!

People with chronic illness are often faced with decisions such as these. Do the benefits of the treatment outweigh the costs? Common side effects that need to be considered include: drowsiness, headaches, weakness, insomnia, constipation or diarrhea.

Symptoms of chronic illness are usually fairly complex and the question of balancing side effects generally isn’t straight forward. For me, the question is:

“Is my back pain bad enough to risk sides effects that may cause a different type of pain and impact my mental health?” Or can I keep going with the status quo? As much of a struggle as it is, I know where I stand.

Trying to manage symptoms of irritable bowel syndrome can involves multiple medication. One may reduce severe pain and bloating, meaning it’s possible to get out of bed and function but the side effects of urgency (when you need to go you need to go) may be incredibly inconvenient. Of course, one symptom of IBS can be urgency so is it possible to know the drug is causing the symptom?

Painful bowel symptoms

Taking a medication for chronic migraines may mean the sufferer is no longer confined to a quiet darkened room for 1-3 days twice a week but are the side effects of drowsiness and poor concentration 24/7 an appropriate pay off?

Weighing up the benefits against the side effects can be a laborious process that involves a lot of trial and error. The process is often complicated by the side effects being similar to the symptoms of the illness! Just because you experience something new, doesn’t automatically mean the medication is producing the symptom or that the medication isn’t working! There are horror stories of (for example) psychiatric medications causing suicidal ideation but instead of fearing the sensationalistic and inflammatory headlines, what we need to remember is that close monitoring by medication professionals is important when introducing new medications.

Please don’t be put off trying new medications. Of course we need to consider the side effects but even common side effects usual only affect 1 in 10 people.

I’m going to try the new medications and my GP is going to help with close monitoring of the impact, I’ll keep you posted!

How did colouring save my life?

This year, 4th-10th October is Occupational Therapy week!

If you’ve heard of Occupational Therapy, you may think about physical health aids such as a commode or guide rails, or maybe basketweaving, but they’re so much more!

The Royal College of Occupational Therapists says:

“Occupational therapists provide practical support to help you do the activities that matter to you. They will consider all of your needs – physical, psychological, social and environmental. Their support can make a real difference giving a renewed sense of purpose, opening up new horizons, and changing the way you feel about the future.”

When mentally ill, you may think you’ll see a psychiatrist or psychologist but the nature of mental illness means a multidisciplinary approach is the best and most successful.

The way that you occupy your time can profoundly impact your mental health. I’ve had contact with occupational therapy during prolonged hospital admissions.

One of the most helpful psychological techniques I’ve used is mindfulness but it can be incredibly difficult, when you mind is sick, to try mindfulness for 10 seconds, let alone a couple of minutes. When most unwell I needed something easier to engage with…

When an occupational therapist first introduced me to colouring, I feared it was a little childish and thought I‘d find it hard to concentrate. But I reserved judgment and gave it a go. I’ve been hooked ever since. Colouring was a simple enough activity, I could engage with it and it enabled me to switch off from my spiralling thoughts. It has a calming effect and therefore reduces symptoms of anxiety without much effort! It can also improve motor skills and vision and also boasts to improve sleep!

Ultimately, mindfulness guides you to be able to focus on your breath but mindful activity can be just as beneficial. Mindful colouring meant I focused my mind; continued practice of mindfulness enables us to remain in the here and now rather than dwelling in the past or worrying about the future.

I was seriously unwell so I had to take medication, work hard in psychotherapy and use a lot of other techniques but colouring was the thing I turned to when I couldn’t muster the strength to do anything else. If I’d used every ounce of energy to get out of bed, showered and dressed, I didn’t have any energy left but I didn’t want to just sit in front of the TV; colouring didn’t require me to use any energy, but it helped keep my mind occupied. It played an important part in me beginning to rebuild my life, 1 tiny step at a time.

Plus, I started to feel quite proud of the results, boosting my self esteem along the way!

Running through Bath tunnel

An introvert’s dream come true!

Being an extreme introvert, preferring long periods of time in my own company or with very few people, it can be difficult to conform to societal expectation to be sociable. Living with depression for a large portion of my life, I was often told that getting out and seeing people would be “best” for me…! When most ill and lacking energy, seeing people would sap more energy, I would put my mask on to “act normal” (without which, I wouldn’t be able to interact with anyone) but the resulting exhausted spiral would lead to me feeling even more of a failure.

Then I discovered running! It was something I could do that has a multitude of benefits!

Any form of exercise, if done regularly, can:

  • Improve mood
  • Improve bone density
  • Increase muscle strength
  • Increase energy levels
  • Reduce risk of chronic disease
  • Help with weight management
  • Improve skin health
  • Aid relaxation and sleep

I was “getting out” as I was told would benefit me, but I didn’t have the down sides of being exhausted by people!

But, even the most extreme introverts, require some contact with humans (occasionally)! This is where entering events comes in handy!

Over the years, I’ve done a few 5km, 10km and half marathons but for various reason I’ve not been able to put in the hours to train for the ultimate goal to run a marathon. But I was finally able to put in the hard work, see this blog, I wrote a few days before I was due to attempt my dream.

And that’s what I did, on Sunday 18th August 2019, in Bath, I actually did it, I ran 26.2 miles, all in one go, on the same day, without stopping, I ran a whole marathon!! I cannot tell you how overwhelmed I feel to say I finally achieved my dream! I did not set myself a time target, all I wanted to do as a) run the whole thing and b) enjoy it – I well and truly did both!

I’m still an extreme introvert but, funnily enough, I don’t think I could have achieved the enjoyment aspect without entering an event that involved other people. Lots of people enter with a running club, but I was not alone entering on my own; many individuals gather on the start line but we all set off together with a unified goal in mind – to finish!

Obviously you get the ones that race off, that’s fine, whatever works for them! But the rest of us settled into a steady rhythm with people shuffling up and down the pack gently. For a while I had the pleasure of settling in behind an incredibly tall girl who made each stride look so easy.

The Bath marathon is famous for its “Two Tunnels”, totalling 4kms of renovated railway tunnels, this made for a unique running environment, very cool but a little eerie. As we entered the first there was a little excitement from the runners, we called to each other, enjoying the echo!

As the race continued the runners became more strung out. I slotted in behind a couple of men, one of which was running in barefoot running sandals and having read Born To Run by Christopher McDougall, I couldn’t help but admire his beautifully elegant running style and appreciated the lack of stress he was putting through his body. Again, an absolutely pleasure to run with someone who made running look so natural and easy! The other man was running clutching a massive bag of nuts and raisins – at one point, they discussed their fuelling plans – the barefoot runner produced the tinniest energy bar from his rucksack and said he’d have it about half way around. I loved the simplicity of their plans.

So, here I was, an extreme introvert with multiple reasons why this marathon should not be possible, living out my dream! I was with people, gaining all the benefits of being “out and about” but I didn’t have to interact with any of them if I didn’t want to!

My experience is that at big events, the marshals are incredible, this event was no exception! Some of them had the starting list so they could look up your number as you ran towards them, they’d then cheer you on using your name – a massive motivator when things were feeling tough!

At mile 13 (half way) I was feeling strong, perhaps my concentration dipped a bit, I tripped down a slope, a couple of marshals jumped forward but I managed to catch myself before I hit the deck. It was quite shocking and I jarred my knee but it didn’t feel too serious.

The second half was tough, I knew I was slowing down but as the runners became more and more strung out it occurred to me that I was doing something not everyone can do! I’d trained hard for this and as mile 18 then 19 and 20 passed, I spent short periods of time running on my own; I was used to this in training but then I’d spot a fellow runner or a marshal up ahead and I’d feel spurred on again. I passed the odd person who’d resorted to walking – they were still going which I commend, but I was determined to run it all, it was just what I wanted to do!

Having loved running along the river, reentering the town signalled the end was near. Despite my legs feeling heavy, my hips and my back aching, my heart was singing, I knew I was going to finish!

The finishing straight was surrounded by people, spectators and fellow runners, all there for the purpose of celebrating everyone achievements, the atmosphere was a buzz of positivity.

Even as an extreme introvert, I do see the benefits of spending time with people, the community spirit of running events is fantastic. Looking around at the end, I could tell, people were hurting a lot but it didn’t matter, individually and collectively we’d all achieved something great that day!