#the meds seem to be helping a lot and as gp goes my case is relatively mild so i will live on it seems

[trashlie]

I hope you've gotten some much needed rest and relief. Migraines are the worst. Sorry to pile on more to your inbox. Take care of yourself first!

On the topic of falls. I'd like to point out how in both cases Kousuke and Alyssa were trying to defend Shinae from people who ultimately do not care about them. Yet, despite knowing their toxic behavior it was not enough for them to actually fight back. And how both Nol and Alyssa being cornered by them caused the incident through no real fault of their own. But is there a significant difference for the brothers and not Alyssa falling in after Shinae?

I also want to add. Given the religious imagery surrounding Nol. His plunges into the pool along with the reclamation of his given name could be seen as a symbolic baptism. A form cleansing and transformation. Except that the ritual requires a triple immersion. Nol did promise to retrieve YeongGi one day. So, could it mean he will be submerged in water thrice to fully be reborn as his whole self?

Hi nonny, thank you! Man, I have gotten SO much rest. My gp prescribed me a daily prevention medication to try out on my meds but it was not kidding when it said it makes you drowsy - I lost a whole day yesterday to a sleepy fugue state lol it's... ;~; rough LMAO the quest to fighting off my migraines continues! But thank you for asking! They are a serious plague and I feel like they just get worse and worse each year, so hopefully I can find something that helps out!

Now, as for your ask? I never really thought about these details, but they're SO good so thank you for pointing them out! It's really easy to forget that Kousuke is defending Shinae (and to some degree, himself) against Yui. This isn't the kind of theorizing I ever excel at but I'm going to give it some thought.

At the very base level, I guess there's the idea of involvement - Nol and Kousuke falling with Shinae because they are very much a victim of Yui as Shinae is, where Alyssa doesn't fall because she is more on the "outside" - a lot of the bullying that goes on is because of two separate things: a. they think Shinae is a bully and Alyssa is only targeted because of her affiliation with Shinae; as long as she acts like she has nothing to do with Shinae, she is free from their bullying b. the other bullying seems to be about her sexuality and the girls involved in Shinae's fall didn't seem? to be involved in that part of the bullying (??? maybe? lol). But looking at it even deeper, many of us readers have been anticipating a separate "fall" (from grace) for Alyssa, so it might be that her fall is severely "stunted"? I guess one of the biggest differences here is that while Alyssa was defending Shinae, she also kept flipflopping and insisting she wasn't, whereas Kousuke and Nol were openly defending Shinae, no questions about that. Kousuke was trying to help her, Alyssa wanted to help but was restricted from acting by her own fears and confliction.

I will add a thought that it could just be that quimchee wanted only Shinae to walk away physically hurt by that altercation to demonstrate that though she was the only one harmed, the trauma extended well beyond her (a friend suggested that it's likely the teachers were not fired but instead quit due to their own traumas; we know Shinae's family and friends were badly shaken up) and that even though Alyssa looks like she walked away fine - she winds up becoming a trainee and debuting in an idol group, she appears balanced and happy, she has a boyfriend - she, too, was affected and probably carries layers of scars. I think something worth thinking about is the way those girls' minds worked. Because they believed Shinae to be a bully, they told themselves Shinae deserved what happened. Just moments before the fall, they were accusing Alyssa of still being friends with Shinae - had Alyssa failed to prove they weren't, had she helped Shinae more than she did, had she fallen trying to save Shinae, would they have said the same about her? Their wishy-washiness is even worse than Alyssa's!

Another thought I'm having, while we're on this topic, is that another difference between the boys falling vs Alyssa is that Kousuke is the most "free" of any burden here. He reflexively acted and tried to save Shinae - his falling was not his own doing, but Nol's, and I'm waffling on this point because technically, yes, Nol is the reason they fell - Yui reached out to touch him full-well knowing how he'd react and he did exactly that, dropping everyone and falling himself. On the flipside, Alyssa also inadvertently pushed Shinae and as a result, I don't think there was enough time for her to process what had happened and reach out to help Shinae. So while it's very similar to Noll, it's still different in the execution, I suppose?

And if we want to REALLY read into things, we can get really faux-deep lol. In the case of Shinae + Alyssa vs the bullies, unfortunately, Shinae probably would have been bullied regardless of whether she was friends with Alyssa. From the get go, kids were weird about her and treated her badly, and the kid who was friends with the asshole from her old school could still have spread lies about her. On the other hand, Shinae never would have wound up at the formal if not for her involvement with Nol and Kousuke. We still don't know how much Yui knew of Shinae's involvement with Nol at the time, but you can still draw a line all the way back to Nol: had Shinae never gotten Nol to the hospital and saved Nol and Kousuke's hides, Kousuke never would have extended a favor to Shinae, and without the favor, Yui would not have been manipulating Shinae and trapping her in both an employment contract and blackmailing her into attending the formal. It all still cycles back to Nol. As a result, everyone who falls is involved in Shinae being there at all - including Yui's wig! And I guess in a way, as a result, we've seen that Shinae is very much so still tethered to Kousuke and Nol (and Yui) wheras she and Alyssa are so distant and are no longer entwined.

I especially like your second question because this something I'd NEVER have thought of! I've largely thought of his pool jump as a rebirth - which I guess in some way a baptism is? I am not a very religious person, so forgive my ignorance here! It's not the first time we've seen some kind of religious symbology in ILY so I wouldn't be surprised if you're right on the mark! Because baptisms specifically involve water, I don't think there would be a way to take a metaphorical plunge for him, so a third act sounds very likely! It doesn't have to be exactly the perilous scenarios we've seen, either, I think, as long as the thought and intention is there, maybe? This is really interesting to think about because I like to hope that Nol in the present will feel some kind of.... well maybe not hope exactly, but I hope in learning Shinae's story, he'll borrow some of her strength and try to find that in himself, too?

to fully be reborn as his whole self?

This is the part that's making me think the most about this - because he has to be ready to be his whole self, to embrace all parts of himself, it has to come when he's made the decision to be his whole self. So yes, I think you are absolutely on to something! Though he's embracing Nolan as his identity, we know that's still a part of who he is. Nolan and Yeonggi are very much a part of him, and perhaps a third submersion would when Nol is finally able to embrace all parts of himself? Oh this was good thinking, I'd love to hear what you're thinking, too!

[dykeogenes]

oh i might have gastroparesis which is fun and new

[shelleyvanniekerk]

Cant find a fitting title ???

I have not blogged much of late, mainly because I feel like a stuck record and also I don't think people have time to read blogs much anymore, and my topic is rather depressing to say the least. I hate to always sound like I am complaining, but somehow writing about what goes on in your head allows it to make sense for yourself so you don't think you going mad, and maybe sometimes it hits home for others, and they can look at things with a different view and have a little bit more understanding.

So my question is this. Imagine you were told you had a terminal disease, and there is no cure. And the only thing that may extend your life (for no guaranteed time), is medication that you have to take daily. That's not too bad you might think, I mean most people are on some sort of medication for a chronic condition and the meds may be life saving. But add to that, that this medication has no guarantee, and hellish side effects! You also have to go for monthly injections, monthly blood tests, and three monthly scans, and oncology visits to hear the outcome. I'm on my 16th cycle now so its been just over a year that this has been gone on. I cant count how many times I have been poked by needles and how many pills I've swallowed, and how many scans/tests I've had and how many times I've had to sit at the Doctors rooms waiting for results. The worst is I've done it all pretty much alone, because of Covid I've not been allowed to take anyone with me. And yes on top of all this you have Covid to worry about. You are high risk and so as if you don't have enough to worry about there is a virus going around killing people also, and guess what, it affects the lungs. 

So my cancer has spread to my lungs and in the beginning they said spine, ribs and right femur. They have since ruled out spine as what they saw on the scans was a life long issue with my discs, even though I told them that in the beginning, they are more likely to assume its cancer. They don't comment on the ribs anymore - I am assuming since they haven't responded to the treatment that it is not cancer and the right femur we don't know about because they have not done another full body scan to actually check that.

I've made peace with the fact that I have to take the pills daily, it is after all a small price to pay for extended life. Although sometimes when I have a few wines in, (yes I drink), I get really annoyed with it and have violently thrown the tablets around some nights spewing out some vulgar language about how much I hate taking them. I have to diarize each time I take them, so obviously I do take them and at the same time everyday, 6h30 each night to be exact.

What I cant seem to make peace with is for starters, the monthly injections. Mostly because they are painful and its not a pleasant experience being jabbed in the stomach each time and you left with a nasty bruise. Sometimes the bruise from the month before is still there and then you get the next bruise. I have the decision of having my ovaries removed, that way I wont need the monthly jabs anymore, but again that's surgery, and now with Covid I don't really want to go to hospital unnecessarily any time soon. But I do get dreadful pains in the ovaries, much like a period and that just makes me mad, I mean, why do I need to put up with unnecessary pain? But its something I will do before the end of the year I think. That will sort one issue out at least. Well two, considering the pain.

Also I have not made peace with the scans and the results.... it really is a difficult thing for me. Its called in cancer terms, scanxiety and yes it exists its not something I made up. And the thing is because its every three months, its like you in a never ending cycle of anxiety. I never relax. I can never sit back and be complacent and think ‘everything is ok’, because with cancer you just never know. I mean 7 years ago I was stage one, it didn't go to the lymph nodes where it apparently goes first if it does spread, and I had a mastectomy and chemo and radiation and and and - and I thought back then that its all over. But it wasn't was it. It went to the lungs and I found out myself because I could not stop coughing and went to see a new GP who suggested bloods. Funny that my oncologist never did bloods - she said they just don't do them and a physical examination is good enough. Well clearly its not. Clearly. If anyone is ever in this situation demand blood tests.... at least every three months. I think its very necessary to keep a record of your cancer count. I mean how the hell else are you supposed to know what's going on it your body? Had they picked it up 3 years ago when I had a normal chest x-ray and started me on treatment then, maybe things would have been different. Who knows.

And that brings me to the anger. That on top of the anxiety. Its the anger that I cant deal with. I thought I had dealt with it but every time I hit a wobbly, its very evident to those around me, especially my husband who gets the brunt of it, that I have not dealt with the anger. But then again, how can you? How can you make peace with the fact that you did everything you should have, and then this nasty disease still decided to come back. How do you make peace with the negligence on the doctors side? And how do I make peace with the fact that this is my lot in life and nothing I do can change it. I mean I love the fact that some people can become NED (no evidence of the disease) after being stage 3 or 4.... and apparently they do so with various things. But its not the case for everyone. Some peoples bodies just don't respond to any diet, any miracle pill, any exercise, and it just keeps spreading elsewhere. And trust me its not for lack of trying. I do follow a reasonably good diet, I do try exercise and drink water, I do take vitamins and constantly searching for new things. I do take cannabis oil, and I'm forever trying to incorporate natural things that have proven to have good results for cancer like turmeric, ginger, bicarb and lemon blah blah blah. The only thing I have been consistent on is the cannabis because it took me from being on 3 patches of morphine to almost no pain in a matter of months so I truly believe in its benefits.

And so far after about 14 months (or more I don't know) I have had good results. Meds and all. There has been about 40% shrinkage and there is no new cancer so that is great news. But I'm at a point now that no matter the results, even though they have been good and I'm very grateful, I still feel so defeated. I cannot get excited and jump up for joy, purely because A) I am anxious about what lies ahead and B) because I've been disappointed before. I've been misdiagnosed and been through so much already that even though its good news I just cant find inner peace, happiness or joy right now. The anxiety outweighs everything, and I wish I could shake it off somehow, but I just cant. I am constantly reminded of cancer, and I'm constantly going for scans and bloods and tests that one never gets to a point where you can forget, even for just a little while. Why cant I just be happy and forget about all this, just for a little while?

I've tried to hand things over to God, I talk to him daily. He knows my struggle. I so hate people who say you don't have enough faith... gosh, whatever. Some people just need a kick up the arse for their insensitivity. They don't know my relationship with God and let me tell you if you were in my shoes you would be quivering in your shoes also, and trust me faith is hard to find when you got all this going on!

So I wake up scared and I go to bed scared and the anxiety is just the pits. And I just try to the best of my ability to function like a normal person, wife, mother, friend, daughter etc. But this thing has seriously taken over my personality. Most of the time I'm faking everything and its so exhausting. So so exhausting. This Covid hasn't helped because that in itself has presented new challenges and has made life rather depressing on top of everything else. But here we all are, trying hard to keep our heads above water and plod on despite the horrible stuff happening around us. 

I am however exceptionally lucky to have a very understanding husband and some really awesome friends. There are a few people in my life that truly understand and never judge me. There are also some who have no clue and they judge me for sure behind my back. I'm not too worried about the judgements because you know, none of us are perfect and if you think you are then you have a big surprise when God Almighty comes down one day soon and tells you what a terrible person you have been.... (eeek, I am judging now too). But I am very grateful to those who have stuck around despite my Wobblies, who genuinely care and love me despite my craziness. You know who you are and I love you so so so very much. And of course my daughter who keeps me on my toes. Without her I would be locked up in an asylum pleading with the nurses to let me go!

To anyone and everyone who is going through a similar journey (I hate that word) , I get you, I totally get you. I love you and I pray for you. And most of all I wish I could make everyone’s pain go away. 

Blessings and love always

Shelley

[createdbybadhands]

My story

So, here goes. I don’t have a clue what I’m doing but, for some reason, this morning when I woke up I felt the need to anonymously share what my story is. I don’t tend to talk about the experience I have had or how it’s led me to what I’m currently doing, because I don’t know how people will react. 

So maybe I should drop the whole I’m mentally ill bomb. 

I’m mentally ill.

There it’s dropped. 

This post will feature details of peri-natal mental health.

So on December 14th 2018 I found out that I was pregnant. My then fiance, now husband, was recovering from a back operation and that moment of showing him the pee stick, with joyful tears streaming down my face, he awkwardly pulled himself from the chair and slowly made his way to me so that we could share a hug in the moment. 

Sadly my pregnancy was awful, the above is probably the happiest moment that would resemble a hallmark gift card we had. Before you get pregnant, you imagine it will be this amazing, I feel so special, experience. The pressure to be constantly giddy was extreme. Obviously, I knew about the not so nice parts, morning sickness, the need pee...constantly and suddenly hating what was my favourite foods and drinks. 

Also, the coffee withdrawal was real. 

But I didn’t know that you could be depressed and so anxious that you can’t leave the house alone. 

It crept up on me, week by week the feelings got heavier, the anxiety took over. I stopped driving because I was so scared that I would crash, or how and where do I park? (the works car park was insane at this time). As March came up, my husband realised that I wasn’t myself. I couldn’t go to uni anymore (I was doing a masters in design), especially if I knew friends was working from home. I used to get the train to Bristol to go to uni, but it became this metal beast that induced heart palpitations and just the thought of boarding it. My husband encouraged me to seek help. Thankfully, my appointment was with the best GP I have ever met, he was kind, understanding and listened without judgement. He explained that hormones really can mess you up and signed me off work. 

All this seemed temporary, but, blimey, it most certainly wasn’t. As time went by I got iller, I went onto anti-depressants and went to counselling, but I wasn’t making progress.  My midwife, an amazing woman who went above and beyond for me, she referred me onto mental health services, which eventually meant I was taking on by the perinatal mental health team. And I was so fortunate to have this support. I was also going to classes for expectant mums who may be struggling in some way, they were also so amazing, I can’t tell you how amazing they really were. I was suddenly surrounded by people who understood that little bit more. My friends, they tried, and some were brilliant, but others stuck their foot in it, accidentally, but still... awkward. I couldn’t handle the comparisons from what I was going through to what they thought I was going through. Being told I was just stressed because I took too much on, some how blaming me for the failings of the hormones in my body. Like I chose to be ill. 

As time went on I differed my final year at uni, I wasn’t able to do the work. I tried to go back to work, but couldn’t. I also had a wedding to plan (just to clarify, not a shotgun wedding we booked the date way before I found out I was pregnant) but my husband had to take on a lot of the wedding planning, bless him, he took on a lot.

So fast forwarding a bit, this time was a lot of crying, sitting and eating, it wasn’t a pretty sight. I tried to prep for baby coming, but every time we went to buy something I had a panic attack, even just looking at clothes, because it had to be perfect, I had to be perfect but didn’t know how to be. 

I should quickly clarify, a lot of my thoughts weren’t about not wanting a baby, it was about me not being good enough for her and she’d be better off if I wasn’t here. 

So a little more fast forwarding, despite having such amazing support, my mental health deteriorated further and at 35 weeks pregnant I voluntarily went into a Mother and Baby Unit (MBU). 

For those who don’t know, MBU’s are mental health wards for mothers who are suffering from perinatal mental health illness. At the time, I was talked into going, because I didn’t want to be away from my husband. The closest MBU is still an hours drive away in a different town. 

I didn’t think I would be there long, maybe a couple of weeks. I was very wrong. I found out that the average stay is 6 weeks (I was actually there for 3 months), this meant I would have my baby there, which I hated the idea of. 

Again, the people who worked with me were so brilliant and so caring. They saved my life. I am fortunate to have met them all (even the one person who worked there that wound me up, and had very poor tv choice ha). It’s strange looking back at the MBU. I have a fondness for the staff, but a hatred for having to be there. It’s odd. You felt constantly watched, because you was. I had my own room but they would come look through a little window to make sure your ok, every hour, even through the night. It’s bizarre how used to it you become. You also had baby monitors in your room, in case you needed help with the baby, but it also felt weird to know I could be heard (I could switch it off when with visitors or on the phone, they weren’t that nosey). 

Last night I had the weirdest feeling, I was in bed in the dark, alone and suddenly I felt like I was there again, like they were going to look through the window and I should hide that I was awake because I didn’t want to talk to anyone. Sometimes when you saw the torch shine through so they could look at you I would hide my phone or what ever I was doing, not because I was doing anything wrong but because I didn’t want to talk about why I was still awake, even with sleeping tablets. 

Oh my this post has got long, fair play if you’re still reading. 

So what this long rambling is saying is that, my motherhood journey so far hasn’t been your usual run of the mill. After leaving hospital I received my diagnosis, one of them was post-natal psychosis. They never explained this diagnosis to me, I didn’t know about it until this letter was sent, so I have no idea what part of me was that, presumably the belief that my daughter hated me and I shouldn’t be here. I was also diagnosed with severe reoccurring depression and anxiety, fun right? 

Now this get to the creative stuff, so before all of the above happened I was studying a masters in design, my practice was a little uncertain. I very much worked with 3D printing, electronics and coding. I just hadn’t nailed the direction I wanted to go in. I also lacked some finalisation in my work. During my last year I was doing a really fun project with automation and character, making ways to interact with your surroundings (such as a light switch) by remote and a character, e.g. an astronaut, would complete it. 

The idea was to turn any room into a smart room in a temporary, cost effective way. 

Things have changed since then, a side to me no one knew existed was awakened. When I was in the MBU I was taught how to crochet, now everyone was surprised I took this on. I never had any inclination to do this before, but I loved it. I made a Yoda, who doesn’t love a Yoda. Everyone said I picked it up really quickly and how good I was doing. I didn’t actually enjoy the other craft activities much because I had a sense of perfection that I couldn’t escape, but because crochet was new I could let go of this perfectionism. 

I have carried on with this thought process into other crafts, I went to (pre lockdown) some workshops for mums with mental health trouble and learnt some more crafts. The biggest shocker was sewing, just ask my mum I have always HATED sewing, now I love it. I have learnt how to do embroidery and making my daughter a quilt. It’s freeing. And now I feel like a better designer because I allow myself to fail, which has always been my problem and held me back. I always wanted to acheive the best straight off the bat, it’s nice to let go of that. 

This blog is going to be me being brutally honest, I’ve been through a lot and want a platform to be honest. I know no one is really going to read it but hey ho. It’s also going to be my creative journey. 

Also, no one talks about MBUs and mental health during pregnancy. The only thing I had seen about it was an awful episode of the good doctor where a mother took medication for her mental health to then have a sickly child, of which the blame is placed on her for taking the meds. That’s not the whole episode, there is some other interjections in there but that’s what I saw, whilst being pregnant taking medication, a tad unhelpful.  

Don’t worry this post is coming to an end, mainly as my baby has woken from her nap, so for today toodles. 

[mylifeasavetstudent]

I just finished my first year of undergrad, and while I've shadowed at a vet clinic before, I'm about to start a job as a veterinary assistant. While I'm super excited, I'm also extremely nervous. Any advice for starting a first job at a vet clinic?

Ooh fun question! Congrats on finishing your first year and getting your first job as a vet assistant!

I volunteered/shadowed on and off from when I was 12-18, then got my first job as a part-time assistant at a general practice when I was 18-22, and now I’ve been working full-time as an assistant at an emergency hospital for the past year.

So much comes to mind, so this may be pretty long.

———-

-Be willing to learn! Accept that there is a lot you don’t know, and always be willing to listen and learn from more experienced people.

-Don’t be afraid to ask the doctors questions about cases. Most are more than willing to answer and explain. (Everyone there who is more experienced has been where you are now one day in their life - when you become an experienced person, remember what it was like to be a nervous, new assistant.)

-Don’t be afraid to ask the other assistants/techs for help. If you don’t know how to do something, it’s a million times better to ask than to guess and do something incorrectly. (Same goes for clarifying what you’re ALLOWED to do.)

-On the same note, if you don’t know how to do something, but want to learn, say so, or the experienced assistant/tech may just do it FOR you.

-Restraint. Start with the nice ones! If you’re not comfortable restraining an aggressive animal - SAY SO. Don’t be afraid to use muzzles, e-collars, comforters for big dogs or cat-muzzles, e-collars, towels for cats - they don’t hurt the animal and they help keep everyone safe. Despite what the owner believes, the dog CAN breathe through the muzzle (be careful with muzzles and vomiting patients though). Sometimes you can even distract patients with food (make sure they’re not on a special diet or NPO or anything). You can also pet their heads (if they’re not aggressive, just squirmy) or tap their heads gently with a pen (if they are aggressive) to distract them. If an animal is really stressing themselves out or has a high possibility of hurting you or someone else - tell the doctor. Medical restraint (drugs) is great! There are so many different ways to restrain animals of different sizes and temperaments for different procedures, that I don’t even know where to start. You’ll learn over time! Always be cautious. Even the nicest animals will bite when scared or in pain. Watch out for teeth and claws, but also those sneaky back feet and headbutts.

-Bring a notebook! Write down any questions you have (if it’s too busy to ask them) - you can look them up yourself, or ask them later. Write down things you learn, write down instructions on how to do something new, etc. (I actually looked back at my notebook from a year ago and had some fun reading my old questions).

-Bring snacks/drinks. My GP (general practice) shifts were 12 hours, my ECC (emergency and critical care) shifts are 11 hours. It’s a long day!

-Wear good shoes. When I started working, I wore converse sneakers and my god did my ankles hurt. It’s constant standing and walking - buy good walking sneakers!

-Everyone has their own way of doing things. If it’s something menial, take everyone’s methods into account and form your own way. If it’s something important, find a high ranking person (doctor, practice owner, head technician) and get it clarified which way YOU should do it.

-Try to keep busy! If you don’t know what to do, ask anyone if there’s anything you can do to help them. If not, you can always sweep/mop/clean. Your coworkers and employers will definitely take note of it.

-Check on patients. Maybe this comes from my emergency experience, but you can never check on patients too often! From something small like pee sitting in the cage, to a change in breathing patterns, you don’t want anything to go unnoticed for too long. If anything looks abnormal to you - ask for a second opinion.

-(May be targeted more toward Emergency.) Learn normal vitals. These are your first indicators of something going seriously wrong. Learn what a normal heart rate is for a small/medium/large dog and for a cat (and how it sounds!), learn a normal respiration rate, and normal gum color. Not as urgent - but temperature too. A change in vitals may be a normal occurrence of a disease process or side effect of medication, but always bring it up to the doctor just in case. Hopefully you’ve been around mostly healthy animals before shadowing, so learn what “breathing weird” looks like, and whether it’s increased effort (dyspnea) or increased rate (tachypnea)… or both. You hear about pale gums and cyanotic (blue/purple) gums a lot, but if you ever get to see them, take note of what they actually look like on a living patient. Mentation is important too - is that crazy energetic puppy suddenly only glancing over at you when you open the cage door? That cat who wanted to kill you an hour ago not even hissing when you disconnect his fluids?

-(May be targeted toward emergency). Triage. In the emergency room, we triage everything. In GP, we did not. Sometimes it’s obvious, like a patient hit by a car needs to be rushed straight back, and a puppy hopping around for a vaccine appointment does not. But if you get a chance to look around the waiting room, take a look at the patients. Take note of any abnormal breathing, mucous membrane color, a patient lying on its side (laterally recumbent) and not really reacting to its environment. Sometimes owners don’t realize how serious of an emergency they have. It’s important to pick out the important pieces of information from what owners tell you. You’ll learn how to ask the right questions.

-Double check your math. If your doctor gives you medication doses in milligrams, you’ll have to convert them to milliliters. Even if you’re just filling oral meds in the pharmacy, you may need to figure out how many tablets equates to the right number of milligrams. Double check your math. Triple check your math. Ask someone else to check it. Check it until you’re confident. (Soon you’ll get an idea of “that seems like a really high dose”, is it written correctly?)

-Be clear. Working around other people who know a lot about animals and medicine gives us a skewed perspective. Don’t assume every owner knows something that’s “common sense” to you. Be very clear with explanations or medication instructions. 

-Label everything! If you have a pill just sitting somewhere, that’s extremely dangerous. Always write the type of medication, the dose, and the patient name. If an owner drops off treats for their pet in the hospital - label it! If you have a pet temporarily in a cage, write his name (you definitely don’t want patients getting mixed up and getting the wrong treatments). Label everything!

-Always keep a record, write things down. When the doctor asks you 8 hours later what diet you fed a specific patient this morning when there’s 20 other in-patients, you’ll be glad you did!

-Be nice to clients. People are frustrating, some people are very rude, but get used to your “customer service” persona!

-If you don’t have qualifications, be careful answering client questions. Depending on the rules of your practice, you may not be allowed to answer certain questions unless you’re a doctor. Unless the doctor explicitly tells you that you can tell an owner something, always tell the client that you will have the doctor come right in to talk with them. Unless it’s a straightforward question like, “Has he vomited today?”. (I’m talking about questions like: “When are we gonna decrease his medication?” “When can he come home from the hospital?” “Do you think he’s gonna live?” “Have his kidneys gotten worse?”)

-Learn how the front desk works! Just because you’re working as an assistant in the back doesn’t mean you should be confined back there. In my first job, the front desk was completely separate from the back treatment area, and none of the assistants knew how to work the front desk. Sometimes it’s busy or you need to cover someone for lunch, and you should learn how to check someone out, book an appointment, answer a phone call. It’s very helpful to understanding how the practice works as a whole. 

-Clean up after yourself. If you make a mess, don’t leave it for someone else to clean up - this is a good way to annoy coworkers, haha. Of course, this isn’t always doable. Sometimes it gets busy, and everything turns into a mess at once.

-Respect the dead. Everyone in the medical field gets calloused to death/euthanasia because we have to. As sad as it is, sometimes euthanasia really is the best option for a suffering animal. We see death so often that letting every death tear us apart emotionally would be unsustainable. (Ever see that Scrubs episode where they talk about a patient dying, and how his whole family is taking the day off, but all the doctors have to move right on to the next patient a minute later? They say how they make jokes because it’s the only way to cope.)All that aside, have some respect for the patients. It’s okay to be emotionally calloused, but don’t be disrespectful. Don’t throw patients into body bags. Remember that this was someone’s best friend for a number of years. Treat them how you would want your deceased pet to be treated. 

-That’s a good overall rule. Treat your patients how you would want your own pet to be treated in a hospital. 

-Shadowing is a lot different than working. I’ve heard stories of people who graduate veterinary school, and all their experience is shadowing. They’ve never worked as an assistant or a technician, and when they handle their first patient, it’s clear they’ve never restrained a fractious cat. When shadowing, you just kind of stand there and watch. Your whole purpose for being there is to watch and learn - so you get to see all the “cool” cases and procedures and ask questions whenever. When you’re working, you may miss a “cool case” because you’re busy restraining the dog with an ear infection. But you learn what it’s REALLY like to work in an animal hospital on a daily basis - your future career! And it taught me a huge amount. A recent veterinary graduate told me that having all this experience working will help me immensely in veterinary school. Instead of just learning the concept of a disease in school, you’ll be able to relate it to that patient who HAD the disease and what the symptoms actually looked like.

——-

Good luck! 

[life-with-an-external-fixator]

If you only read one post, make it this one!

so basically thought I’d do a top tip run through of my journey with a frame, starting at the hospital stay when it first went on and the challenges I faced and how I hope to help anyone else with it.

TOP TIP; take all the pain medication they give you because in the early days although it may not be hurting at that current time, when the pain does settle in it is very difficult to get rid of / overcome, so best option is to keep onto the pain meds. I’d say to carry on with the 4 x 2 paracetamol a day until you are really ready to give it up, first couple months I was on this and dihydrocodiene. I was also put on zapain and Amitriptyline for my nerve pain / sleep issues. obviously please seek doctors advice on medication as everyone is different. I was told to avoid anti-inflamitories as it can effect the bone healing process. Additionally when you’re in hospital if the physios come around to see you, trust them and your leg. I was walking with crutches around the hospital about 36 hours after the operation. when you leave the hospital, you’ve had a trauma so don’t over do it, but weight bearing is essential for bone growth when treating it this way so the more you can do it / the earlier you feel comfortable and confident to do so the better. (Took me around 3 months to really trust my leg and it’s really put a set back in my recovery)

Please don’t beat yourself up when you’re not back to “normal” straight away! we take such minor things like walking for granted, or walking with a cup in your hand. don’t think any less of yourself for asking for help. we all need it sometimes.

Physio therapy - I go weekly to a frame class which has been great both for physical rehabilitation and the mental side of the recovery, everyone at the class is at a different stage of recovery and went through the same challenges I faced so was good to have the moral support of those and the OT that comes around with goal setting activities and tips on diet / exercise / sleeping / clothing / practicalities of the frame. I also had quite a few hydrotherapy sessions which massively helped my with the confidence to put weight through the leg fully. 👩‍⚕️🦵💪 took me three months to trust my leg and the frame and once I started walking it wasn’t pretty but it was progress, I know I should’ve trusted it earlier and it was mind over matter. I’ll put my traditional workout at the bottom for anyone who’s interested😊

Sleeping with the frame. I really struggled to sleep at the start of this, but elevation is the key. I put my leg on two pillows and then a blanket under my foot so I wasn’t constricted to the ex-gaitor overnight, the hospital did provide me with a lug cuff to tie around the foot and attach to the frame but I didn’t get on with it. dependent on how high your frame goes and where the pins are it may be possible to sleep on your side but I’ve found that I can only sleep on my back, luckily I have a double bed that I don’t have to share so can sleep diagonally for more comfort. During the winter I adapted a pillow case to go around the frame so the metal wasn’t cold on my other leg. Doing a full body relaxation / mindfulness programme could really help settle you down for the night. additionally at the start napping is brilliant, if you’re tired and have time for a nap then do so. 😴🛏

Clothing - many different things you can do with adapting clothing, I have cut the legs of many pairs of leggings so I can minipulate bit over the frame and then use a mini skirt / scarf / pillow case to cover the frame. stretchy trousers, poppers joggers and large shorts have also been useful. Dresses were also very useful for me too. you can can the seams and Velcro or zipper the side of clothing but I didn’t have the skills to do so. Pyjama shorts / clothing are normally quite stretchy / baggy so I got myself a couple new pj sets and loungeware that have really helped. Underwear snags easily but with all clothing dress the frame leg first to reduce the snagging and always reduces the stress and frustration of getting dressed! additionally when you undress, undress the good leg first so leaves you more manoeuvre room with the frame. Keeping the frame covered does help reduce chances of infection and protects the leg as the metal is in your bones, if the frame gets too hot or too cold then it goes through. My foot was very swollen for lots of the recovery and I found that in winter my toes were very cold so ended up cutting the elastic of my socks so they could go on. For shoes I had an exgaitor shoe that attached to the frame and held my foot up, but as long as it fits under the frame you can wear trainers, flip flops, converse etc. I tended to wear a trainer on the left foot. 👟👗👚 the main issue with the clothing, bed sheets or towels is snagging, I am replacing all of the above once the frame is off! Some people found that wrapping the frame allowed clothing to go over / on easier without snagging. cling film, scarves and bandages were all mentioned by people in my group!

Showering - when your doctor clears you, nothing nicer than getting in the shower. I was washing myself from the sink for a very long time but once I invested in a shower stool it was a game changer. if you’re still unsteady on your feet, whack on swim wear and get someone to help you, I put a slip proof mat in front of the stool which was level with my bath so I could sit and then swing my legs in. I had my own towel and flannel to reduce the chances of any infection. once I dried the leg I then cleaned with the solution and wrapped any pin sites that needed wrapping. 💦🚿 on the topic of pin sites, they will ooze a bit when you start walking as they move naturally with your leg, but if you are worried about an infection, see the GP asap. I had one and the skin was red, was hot, felt unwell in myself and the pinsite was painful and very oozy. you’ll also know your body and frame better than anyone so if something changes or feels different get it checked 🦵 (drying the frame can be tricky and fiddly but a cheat I’ve used is to lightly put the hair dryer over it and get the droplets of water off that way)(not to close to the skin though as the frame does heat up really quickly)

Life in general - please don’t let the frame run your life. I had to give up work and driving but it can be very isolating. get out and about as much as you can or have family and friends over for a cup of tea / glass of wine or a pint. I had an active job so couldn’t go back for health and safety but a few people I know with the frames have gone back to office work with one on. People will point and they will stare in public, most people are lovely about it and will ask questions or try and help in any way they can. Meal prep is something that I found really helpful in my recovery, it allowed me to feel useful and do physio weight transfer exercises without thinking too much about it, for example stiring pasta sauces or cutting an onion. even things like making a drink and being able to carry it back into the room seem like such tiny things but it’s amazing. Going up and down stairs can be tricky with a frame but the physio will reach you how to use crutches to do it, either that or using the banister/wall. Coming down I found harder and my foot was at an angle due to the size of the frame. At the start I went up and down on my bottom which was cheating a bit but I didn’t have the energy to walk. a bad habit I soon had to get out of! 😂

Diet and Supplements - my surgeon had me on vitamin D supplements as well as Zinc/Magnesium. Additionally you’re told to try and take more calcium as it’s for bone strength and density. In regards to diet although you’re not doing as much during the day it’s important to keep the calorie intake at a normal rate, try eating lots of fibre, vegetables, fruit, protein etc. It’s also recommended that you lower your caffeine, fizzy drink and alcohol consumption. towards the end of my journey I was also put on vitamin C supplements but again please consult with a doctor before taking supplements 💊

Adjustments - if you have to do any adjustments my top tip would be to take your baseline medication at the same times you do your adjustments, so when I did mine it was at 8am, 12pm, 4pm and 8pm so I took my paracetamol at those times and then tended to take a stronger pain killer at about 10pm before I went to bed to ease the pain over night. The adjustments are meant to be staggered so it’s not too much in one go but I found the closer I was to the end of the programme the more it ached. Don’t worry if you hear any bone clicking, this was common for me. common side effects during the adjustments were achy pains, oozing pin sites, fatigue (napping between the 12 and 4 rotations was common for me) pins and needles and general discomfort. if you miss a turn don’t bulk do it, the programme is set for the way the bone should be, if you miss one simply postpone everything a day and start doing them a day behind when you’re meant to.

Swelling, elevation and anything else - swelling I found was really bad so elevating the foot was key, I am lucky enough to have reclining sofa’s so can now pop it out and elevate like that, but at the start I couldn’t lift my leg that high, so it started with a couple pillows on the floor and then a beanbag under it and then I worked up to the recliner. taking shoes and socks off also helped reduce the swelling. 🦶 if you have an adjustment programme then take your paracetamol baseline throughout as some days can be very painful. During the healing process your leg may feel itchy, swollen, hot, pins and needles, achy, painful. you may hear some clicking but I’ve been assured this is all normal. If The frame gets too hot or too cold then you will feel it in your bone, keep it well wrapped in the winter months and loosely covered from direct sunlight in summer. Transport is an issue for many and debating whether sitting in the back of the car with your leg across the back seats or the front and pushing the chair right back is a difficult decision. I found that the front seat is more comfortable and I felt less bumpy when sitting there than the back seats.

Mentally and Physically - as a therapist I understand how important mental health and wellbeing is. During this process there will be times where you feel low and days where you don’t want to get out of bed or wish things were different, if those feelings are becoming normal or overwhelming for you or your support system, please contact a GP about it. The journey with the frame is like a rollercoaster, you’ll be up and down, round and round. Speaking about your emotions to a support system can really help, please don’t isolate yourself! try and live day to day activities as normal as you can, adapt to life with a frame. get out the house and see your friends, staring at the same four walls isn’t healthy for you. Mental health is just as important as physical health, you won’t be able to fully recover if you’re not healthy in both mind and body. Headspace is a great app for mindfulness and relaxation techniques if this is something you think would be helpful.

So there are my top tips and experiences, can’t currently think of anything else that I haven’t mentioned somewhere in this post. Everyone will have good and bad days, the people around you are also affected by the frame and impact it has on both your and their lives.

Keep up with the medication, supplements, physio / hydro, keep your step count high and your spirit higher. Surround yourself with people who care and please don’t be afraid to ask for help or take a day off to rest. I am currently also on ultra sound machine for the break hoping to see some progress with that on the next X-ray.

I have never used a wheel chair (apart from in the hospital) to get around, always went out with crutches but know a few of the others in the group have used mobility scooters as an extra sense of security and reassurance when going out in public. Don’t be scared to ask for help or if you are walking don’t worry about being slower than people or needing frequent stops.

If you’re having a good day, do those extra 100 steps or whatever your targets are, it makes up for those down days where you barley move! 😃

General physio routine / circuit

- leg press 5 x 10 reps, single leg. I do 35kg on the frame leg and 45kg on the non frame leg. I then do 2 x 10 reps of 45kg using both legs.

- wobble board I do 5 minutes front and back and then 5 minutes side to side, also try and do a few minutes balancing it in the middle. (This is really helpful at the start of therapy as it helps weight transference.

- 10 minutes cross trainer on level 10. sometimes I have to do this is two 5 minute stints as it very hard work.

- step ups x30 left leg first, x30 right leg first. this one I have to do next to the bars as sometimes when putting the framed leg up first I want the extra support. (Try and do this on the stairs at home too)

- stairs - just go up and down a few times, at the start of the journey it was both legs onto the same step but now i try and alternate my legs. Going down is much harder to alternate and I still need the hand rails for support. (Do this at least twice a day at home)

- tip toe and heel dips, after I’ve done the stairs I remove my exgaitor shoe and do some tip top and heel dips, this is to try and gain the movement in my toes and ankles. I have to use both hand rails for support on this one. (Can do this one easily at home with the stairs too so try and do it once a day)

- trampet, on this one I also do it shoe less and it’s just about trying to increase the ankle range of movement. I either do marching / high knees or do something similar to the side to side on the wobble board rolling my foot.

- calf stretches, medicine ball squats, tightrope style walking and side steps are also part of the routine of i feel like I need them. I also like to stand on my bad leg and stretch/tap the good leg at 6-12 positions on a clock but do it slow and controlled. My physios have also tried throwing and catching making me stretch on the frame leg, we tried a game of football where I could only kick with the unframed leg. Hydrotherapy was also a big part of my road to recovery as it allowed me to get the weight transference and help my knee bends! hula hooping was also an exercise I did when I was struggling to load the frame leg, it just allows you to work on balancing yourself and the weight evenly. could be worth giving it a go if you’re able to stand unaided. Additional help for the knee bend I found was putting a plastic bag under the foot and bringing your knee back, i found it worked best on tiled/wooden flooring so I did this in my bathroom sat on the toilet. Push and pull your leg/foot forwards and backwards. this was great for the first month or so when I was really struggling.

[dxmedstudent]

You seem like an incredibly dedicated doctor who spends a lot of her time working. How do you manage to keep your mental health at its optimum? My grasp of healthcare is that it is both physically and emotionally laborious. I know that often, you have shared with us that has been difficult to maintain a work life balance. Do you feel that medicine itself is fulfilling for you?

Thank you! It’s an immense privilege to be able to share some of my thoughts and experiences with you. You’re right that it’s hard work. Physically, night shifts and long days do things to your body that you didn’t quite realise before you went to med school. It can mess up your eating patterns, sleep patterns, and set off any other conditions you have, for example. I find it much harder to maintain a normal daily rhythm than I used to; after months or years of telling your body ‘you’ll eat/sleep/rest when I have time’ rather than listening to it, you get less good at listening to what your body is telling you that you need. Plus maintaining a healthy diet becomes harder…Emotionally, it can be draining. Difficult cases. Stressed out patients or relatives. Stressed out colleagues. Too many things to do in too little time; the feeling that you’re always just trying to get by. The background feeling that the NHS is going downwards instead of changing for the better. I don’t spend more time working than my other colleagues (in fact, right now, this month, being on a gap-year of sorts, I spend *less* time doing so). But I have worked some particularly difficult rotas where it felt like I was always on-call. I’m not more dedicated than anyone else, I’m just lucky in the placements I’ve had. Hard work, but with supportive colleagues and friends who have made it possible to stay focused and sane. Not everyone is so lucky; some people had more problems to begin with, or happened to work in departments that are much more understaffed and poorly supported. Some people have to deal with unhelpful or abusive colleagues. Or with patients and relatives far worse than the ones I encountered.  Perhaps they don’t have the same support from friends and colleagues that I did, or they have a lot more problems to deal with. Some people really struggle, but that’s not because they are worse doctors, or worse people. It’s because they’ve got a lot more on their plates. And medicine really does load our plates unequally. Some people get stuck with unfair circumstances, others are much luckier. I count myself lucky. I was talking abot this with a close friend the other day; there is little difference between me and a doctor who hates medicine, or my colleagues who sadly took their lives. Those of us who got by without major burnout (or worse) arent’ stronger, or better; under the right circumstances we too could really struggle. There were a few times during the more challenging parts of my job when I could really see myself coming close, and I began to understand just how easy it is to be sucked into despair. Any of us, could, under the wrong set of circumstances, end up in their shoes. How to look after yourself:This is why we all need support. I rely heavily on my medical friends and our whatsapp groups. When I’m having a bad day, or when I need stress relief, or when I’ve had a learning point to reflect on, or an interesting case, or genuinely don’t know what to do, they are there. It’s not just them; reaching out to close family and friends is vital, because isolating yourself harms you in the longterm, even if it feels protective. Choose a living situation that works for you.Personally, I like living with flatmates, because it’s nice to come home and rant to someone (and I usually live with medics so they have an idea how it is) and when you get on, it really works well. I’m a bit of an introvert, so whilst I’ll gladly go to the pub with friends (or out for a meal, film, etc) I don’t really put myself out there every night socialising with strangers, particularly if I’m working out of London and I don’t know anyone locally apart from colleagues. If I lived alone I’d find it more difficult to motivate myself to go out. And I know a lot of my friends feel the same. But when you live with friends or flatmates, you encourage each other to do stuff, and also take care of each other. We’d take it in turns to clean and buy food etc so nobody would have to come home from a horrific batch of oncalls to find no food in the cubpoards and that it’s their turn to do all the cleaning. Ovbiously, you can substitute ‘partner’ for ‘friends and flatmates’, or even ‘family’ if you decide to live at home.. I’m not saying you can’t or shouldn’t live alone; some of my friends love their alone-space. But interestingly, these are usually also the friends who are super-organised, really motivated to meet up and organise things, and get out of the house, so it works well for them. But rather that it helps to build in support into your life, especially if you have a tendency to isolate yourself, or are starting somewhere new and far from friends and family. This goes hand in hand, but also support each other at work. Be a team, in the truest sense of the word. Be there for your nurse colleagues, and your team. Be kind to the other teams you work with. Look out for the juniors. Be supportive to your seniors.  And they’ll do the same for you. In FY1 we used to help each other out all the time; it made a chaotic year much more fun and manageable and helped us make firm friendships. during my paeds job it usually meant gently walking the surgical/ENT/ortho SHOs through bleeding and cannulating kids when they asked our team to do it (because secretly they didn’t know or felt terrified at the prospect). Whenever you can, act in the spirit of kindness rather than being obstructive; if you have the time and energy to help, consider doing it. There will be times when you have to stick up for yourself and will be cross, but try not to let that be your default response.  Having hobbies and interests outside of medicine is also important. It’s easier said and done. Ask me how many novels I’ve read in the past few years and I’ll laugh in your face. I count myself a prolific reader, but something has to give; when you’ve got one or two hours in a long day to eat and de-stress before bed, you ealise how finite your time and energy are. Even the things you decide to prioritise might not cooperate with you; medicine can sap you because it leaves you with little time and energy. Even when I had time to create, you can guess how creative I felt after a difficult week at work. Sometimes you look forward to days off ages in advance, but when they come around you are so knackered that all you can manage is cleaning your flat and going to the park. Part of keeping your health as good as you can is trying to maintain some semblance of rhythm in your life. Eat when you know you have ot eat, sleep when you know you have to sleep. Even (as I mention below) when you don’t feel like it). Make time to see your dentist and your GP if you need to; that’s all part of self-care but we are usually the worst at sorting our own problems. You’ll need to put extra effort into your social life. Plan meetups in advance, because I promise you that when your day off comes, you’ll feel too tired to plan something last-mintue then, unless your friends and family drag you out. Give yourself things to look forward to, but be kind to yourself if you decide you aren’t up to them.  This can be a whole other layer of challenging when your friends are either also working hideous rotas, or are married with kids/live on the other end of the country etc; sometimes I look back at when we were all 16 and could just meet up without any effort and wonder at the difference. Is medicine fulfilling?I love doing what I do. I don’t find it horrible working sets of nights or picking up that second long day in the week because when I’m at work, I’m not miserable with what I’m doing. Sure, sometimes it’ll be a stressful day (I arrive in A&E and 9 patients are waiting for me to see them, it doesn’t get better the entire shift) or I’ll be stuck with a colleague who stresses me out and makes me feel inadequate. But on the whole, most of the time, I leave work with a feeling that I’ve done OK, good even. And I don’t dread going back the next day. Even though I’ve got a lot to learn, and I still feel nervous with my ever-increasing responsibilities, I enjoy being ‘clinical me’. I’d say it’s  fulfilling. But medicine can take over your life, not just when it makes you miserable and you hate your placement or colleagues (and boy, can it make you miserable if that’s the case!), but also even when you like what you do. Because working all those shifts, and staying late, can really affect how much time you have to spend being you. The ‘ouside of hospital’ you. It’s just physically much harder to stay in contact with friends and family when you are working all hours of the night or day. When you have projects, and audits, and exams outside of work (which you will do, there’s a ton of stuff behind the scenes which you have to do in your own time in order to continue doctoring), they also take up your precious free time in ways that your 9-5 colleagues don’t have to deal with. I’ve been very lucky; I’ve generally enjoyed my placements, and worked well with my colleagues, and found medicine itself to be really fulfilling. It’s not all nice things; there’s the mundane and the stresfful, but overall I’ve enjoyed it more often than not. I know that’s not true for everyone, and I think how fulfilling it is can depend a lot on finding the right specialities for you. I’m still working on finding the right balance, but I’ve got a good idea. It’s not that medicine isn’t fulfilling for me, but rather that because it is, it can take over your life. It’s because what you do feels important. Because you enjoy it. Because you care. Because you want to be a better doctor. Medicine can take up a lot of time and energy, and it’s hard to carve out a space in your life that it doesn’t take over. It’s something we all have to work on. I love my job, but In the long run, neglecting my out-of-medicine-life wouldn’t be fulfilling. You can be happy in your job but still feel unfilfilled in your life outside of it; if you let friendsips fall by the wayside, or neglect relationships. If you don’t have kids but want them, or have kids and feel you are never there for them. If you miss important life events for work and feel you are never there for the people you love. If you give up the passions in your life that make you happy.  You can still love your job but miss out on the other things that make you happy. There’s no easy choice; you have to find a balance that works for you.It’s one of the reasons I am not planning to stay on in paediatrics, for example. I love the job despite the stresses, but the timetable decimated my personal life; the idea of combinign that with exams made me realise I’d be happy with my job but miserable that I got to do little else. In the long run, I don’t think it would make me happy. Because happiness is more than just enjoying what you do at work. It’s also having time and energy to do the other things that make you happy. So I’ll have to work to find a balance that suits me.

[canaryatlaw]

okay well it’s late because I once again forgot to take my meds and didn’t get tired when I should but I took them now so that’s all we can do for now. today was alright, it was a lot with going to the courthouse and all. it’s just very odd from going from seeing like 1ish people a day (besides like walking by people if I do happen to go out) to being in a big building that’s supposed to be social distancing but is still absolutely flooded with people because people have rights and if they want to file for an emergency order of protection you can’t tell them no too full and lock them out. they still had that going during lockdown, where they’d have people come there, fill out the paperwork, then webcam in from the first floor of the courthouse to the judge on the second or third level. my agency was one of the ones who was like well that’s stupid and literally pushed them into allowing remote hearings, which has mostly been my work life since April. it’s good to be getting back to “normal” court somewhat at least. but I’m off track, anyway. I woke up at 10 and despite not being terribly early or me having stayed up terribly late I really did not want to get out of bed and was tempted to come up with some sort of story so I can go back to sleep, but alas, I persevered and got up. ubered over, things in the office were very hurry up and wait, either a time crunch for a small period of time and then a longer time with nothing to do. The door to our office suite was locked which it sometimes is and the front desk lady called someone to come unlock it and then they just like, didn’t, so I was just sitting there and then I got commissioned to go track down a motion someone in our org had filed that was hitting the wall for a reason that wasn’t an actual reason. so I had to go explain oh, we’re not representing them in this case, just filing (which is the speech I repeat to them every time we’re handling a case) and then it was oh well there’s no motion here and my boss had to be like bitch “petition” is literally the proper word for motion in this case and then it was about vacating orders and I repeated like 3 times this was a petition for a re-hearing, not vacating an order, and then there was something about fees and they eventually took it being like “well that’s what I’m gonna tell the judge, and we’ll see what he thinks” like surprise bitch the judge knew what was actually going on and agreed with us, not you. sigh. it’s always a delicate dance with the clerk’s office between being polite and occasionally having to make them do their jobs when they decide they don’t want to (I handed in an EOP filing today that has the 3 pm deadline and it was like 2:55 and I was READY for a fight, it’s not 3 yet do your fucking jobs, but thankfully it was just accepted without a fight, which was a relief because I’ve been there back when we were all in the office and the deadline was 4:30, banging on their door at 4:29 (not exaggerating) and demanding they do their damn jobs. it’s exhausting). Then when I went to pick up orders everyone was saying different things and one clerk was like “well you need to leave me a note by 11 that you want an order then come back at 2 to pick it up” like bitch do I look like a fucking gopher to you? you literally just have to pick up a paper on your desk and walk 10 feet to where you have a copy machine, make a copy and give it to us. THAT’S IT. sigh. it’s the DMV government worker lack of motivation to actually do their jobs right problem. whenever I had to dig in my heels with them but still don’t want them pissed at me in the future I always try to end with like “thank so much for your patience and help, I know everything is crazy right now but I really appreciate you taking the time to help me” and that tends to make people smile enough that they won’t just roll their eyes at me when I show up at their door in the future. there is the one guy who’s my in at the clerk’s office, he’s like in his 20s and really easy going and is like “hey baby” for every girl he knows but like it’s in a sweet adorable and not at all creepy way? And I’ve gone to him multiple times like help me pls and he’s always come through for me, the only issue is he tends to be a floater so he’s not always there when I need something. ah well. the other thing I did was a call for a court date next week when we’re bringing in a witness at the judge’s request. this is the client who is like 5 years older than me and she’s just SO COOL and I just want to be her friend so badly haha so I always like speaking with her. it’s been a really tough case because the dude is at least under the impression he’s a charming psychopath and he definitely does succeed in charming some people, I’ve had a few short conversations with him and he’s been amenable in a way that could be seen as charming but with everything I know about what he’s done I’m not gonna get caught up in there. I think the last time I saw him was at a court date in March when we were figuring things out and at one point the sheriff was bitching at him to do some stupid arbitrary thing like move back one bench or something they clearly just made up, and he looked at me and I just looked at the sheriff and then back to him and rolled my eyes, because it was very much a very common feeling because that stuff happens all the time. so we shared a small laugh but that was about it. I’m put in a weird position between needing to be professional and having to deal with a lot of slimy people. when there’s a lawyer on the other side of course a level of decorum is expected, and I’ve never really had an actual issue with a lawyer outside of them like, disagreeing with a motion but like, that’s their jobs I’m not going to hold that against him. but when the other part is self-represented, dealing with these dudes (and I’m saying dudes because I’ve personally only seen it from men in my limited experience) when I know every single awful thing they’ve done to my client and trying to be open with them is....frustrating, to say the least. The dude I was talking about yesterday who the judge kicked off the zoom call for being a fucking idiot, I had to spend like a whole morning going in circles with him about trying to reach and agreement and like, I also ofc know all of the super shitty things he’s done since then, but like, the amount of loathing I have towards this man is really here, and so I want to squash him like a bug whenever I get the opportunity to do so, but lately he’s been going out and getting himself squished (usually at his own fault) before I even get to him, and I mean, that makes my life easier haha. but that case is going off the rails and it’s really just a matter of time before he’s going to do something really desperate and extreme and all we can do is track his gps monitor that goes off and alerts my client that he’s close, and hope/pray the precautions we’ve put in place are enough to stop whatever he’s going to snap and finally do. I am really so fond of this client, she has daughters around my age and has sort of adopted me as one and always checks in with me to make sure I’m taking care of myself and everything is okay, and I know if anything happened to her I would be totally devastated and be very tempted to go find him and get the shit beaten out of him (or worse, depending on what happened). But I try not to think about that. I’ve gone so off track here haha lots of creeps who think they’re charming. but we had this phone call, it’s going to be an interesting court date because when we filed the motion we knew it was a long shot and probably wouldn’t get granted as we wanted it to be, but something needed to be done in the situation and this seemed like the best way to deal with it. but basically the judge had asked us to find a witness that it’s a really specific position to talk about the potential consequences for the dude (mainly if he can get reassigned or would just get fired) and we couldn’t quite get that, but we’re being resourceful and coming up with what we can and go from there. Okay, I’ve ranted way too much about work here, I left around 3:30 or so and ubered home, rest of the night was boring but relaxing which I will accept, I was kind of doing some work on different projects that had all required attention at the same time, but I was happy with the results. and yeah, I turned on the Jimmy Kimmel show for a few but he’s still out so it was a different host who was pretty funny, but not long afterwards I decided to shower and start getting ready for bed, and you basically know the story from there up until now. and now it’s past 2 and I do have a 8:45 wake up for court (maybe get to sleep after? we’ll see) so I am going to bed now. Goodnight babes. Stay strong.

[pisati]

it’s never so simple as “just”. just do this, just do that, then...

I wasn’t really surprised by my neuropsych results; in fact if I was surprised at all, it was that it went as well as it did. reading “based on educational achievement and performance on measures tapping general fund of knowledge (99th percentile) and reading (99th percentile), [her] intellect is estimated to be well above average” made me smile. good to know my thinker’s still intact. 

I still really want to take some time to research the tests they ran on me, now that I have the names for them. I want to learn what they’re meant to do. what research has shown that those are good empirical measures of cognitive function. just thinking about that gives me the warm & fuzzies. it feels so quintessentially me. I miss getting excited about things.

I knew what the doctor was going to say, partly because I already got the brief rundown from my psychiatrist. once again proving to my doctors that I don’t just want something to be wrong with me, I’m actually grateful that there doesn’t seem to be anything wrong with my brain. my MRI and EEG both came back normal, and on my cognitive function tests I did, to quote the doctor, “very, very well”. he chalked it up to insomnia and depression, possibly whatever’s behind my insomnia as well. so I’m glad I’m seeing my sleep med doctor on the 29th. I just almost panicked for a second because I’ve had that appointment scheduled since january (the woman is booked out for months) and now I’m starting a job and I am scheduled that day, but thankfully the appointment is at 8:30 and I don’t start work til 12:30. phew.

but yeah. they think I should get a sleep study done; like a legit one. the last one I got was just making sure I didn’t have any physical problems affecting my sleep, and I already know I don’t. my brain just won’t quit. I’m going to have to remember to ask the doc if she recommends any rheumatologists in the hopkins system; anyone who could look at my test results and do anything but shrug at me. university-system doctors like to see weird cases, as far as I know. 

I’ve been sitting on this result for two days now, and I don’t really know how to feel. maybe a little confused, but at the same time not. doc thinks my depression is part of why my memory has been declining. and it’s not really memory, necessarily; we both know that. I had a lot of trouble on the story recall test. I need to look into the results more because I think I might have somehow managed to guess more correct answers than incorrect ones on the second part of the story test: at some point after the “recount as many details as you can remember” part, I was asked to say yes or no to statements about each of the stories that the examiner would recite, if I thought that detail was part of the story or not. I knew I was guessing on a majority of them, but somehow I think my results said I got 13/16 right. it was a 50/50 chance on each detail, so it’s not impossible that I could do that well by accident, but I know it was an accident. I really couldn’t fucking remember. anyway I performed in the 4th percentile on that test. very poorly. but it’s consistent with the memory issues I’ve been having for the last two years; information-heavy material just goes in one ear and out the other now. it doesn’t stick. it’s a lot of effort to remember things and it almost feels like my brain assigns importance to things randomly. I don’t forget everything, but I never know what piece of information is going to disappear next. not really “disappear”, of course. we’ve established I’m not losing anything. it just slips deeper into the sludge bucket until I forget it’s even there. 

I think what’s puzzling me most is that he doesn’t think this is characteristic brain fog stemming from an autoimmune disease. at least, that’s what the report says. it really could just be because I’m tired and sad. and it makes me wonder how that could be. on the one hand, I don’t feel like my depression has made it harder for me to think. but on the other... as doc mentioned to me in our meeting, when you feel bad, things just stop working right. people with long-term illness can’t remember what it’s like to function normally. I literally don’t remember what it was like to not be sad. I told him that I did estimate my depression to have started around 17, but looking back... I was exhibiting signs much younger. 13, 14, definitely 15. possibly even before that; I can’t remember not having a melancholic temperament (though I was a pretty happy kid til maybe 9-10, all said). the depression was only obvious to me at 17. I don’t remember what having energy was like either; I don’t remember if having energy helped my brain work better. that energy kick I felt the first day I was on wellbutrin... that was something else. I felt like someone opened a room-darkening curtain just a crack on a bright, sunny day. I had no idea it was even sunny out, or that the outside could be so bright. I remember thinking to myself, this is language-learning energy. this is what I’ve been missing. and just as soon as it was there it was gone again. maybe that really is what I need.

so the real issue, then, is figuring out why the fuck none of my sleep is restful. that kind of puts it back into the hands of both my sleep medicine doctor and my psychiatrist. I just want to know what’s wrong with me. I want to know that one day I can fix it. one day I’ll be able to pull back that curtain entirely and I’ll always be able to have light when I need it. 

it’s also weird reading an objective report of yourself, based partly on your own words and your doctor’s observations. coming out of my own mouth I guess I don’t see my depression as being that bad, but on paper, written by someone else... if it weren’t me and I was reading that, I’d have said “get that kid to a therapist”, lmao. it doesn’t feel that bad. it just kind of is. we’d talked about my home life back in high school, around the time my depression started. I’d apparently described my home life as “not great” (also unsettling to read so many quotes; definitely my words, but they almost read like sarcasm-quotes). sometimes reading things like that, even though I said them... it makes me feel bad. makes me feel like retracting it. well, it wasn’t that bad... like, no, I totally wasn’t writing blog posts at the tender ages of 15, 16, and 17 saying I couln’t stop crying and felt like I wanted to scream and felt like I was going insane because my mother was being a massive bitch to me for no reason other than the fact that she was stressed from work and having a shitty boyfriend and I was feeling a lot of emotions already related to being a “normal” 15-17 year old girl who couldn’t even process those properly because she couldn’t talk to her own fucking mother and was too stressed out at home to be stressed about those “normal” teenage girl things

mom gave me a lot. she gave up a lot for me and worked really hard for me. she raised me and my brother basically by herself, because, bless my father, he was useless before the divorce. I feel like I was able to take those things for granted, and I’m sure I did. but at the same time... you’re supposed to provide for your kids. spoiling us was her choice. but the value of those things, I think, diminishes if you neglect your kids emotionally. I can’t forget some of the awful things she said to me; when she’d storm into my room looking for things early in the morning, snapping at me and calling me a lazy bitch because my room was messy. taking away my things if I didn’t do something she wanted me to. I still don’t feel like I can talk to her about anything personal. sometimes I have to and I’m cautious about it. and even still, she’ll try to hold things over my head. I didn’t think it happened much anymore. I haven’t been able to think of examples to explain it, because it hasn’t happened in so long. but today...

I went to get my EKG done today. I couldn’t tell her that; my psychiatrist ordered it to make sure I was cleared to be on adderall, and I had to go to my GP to do it. mom doesn’t know I’m seeing a psychiatrist. but when I got to the office today (they could only schedule me before the 20th with a doctor that wasn’t my primary), they told me that since my doc wasn’t on my insurance card, insurance might charge a specialist visit fee for the EKG. I texted my mom later asking if we could make my doc my PCP through the insurance, since it’s her policy and I don’t know if I can make those changes, and she said she could do it when she got home. cool. but later I went downstairs and she snapped at me for not visiting her mother. now that we’ve moved grandma to a building a few miles down the road she’s been asking me to go over every single day, and I haven’t been. I guess that makes me a shitty person, but I just really don’t want to. if my grandmother had ever been any kind of pleasant to be around, I’d be more inclined. but anyway, mom said “I’m not changing your insurance til you go visit grandma”. are you fucking kidding me? this shit again? holding something I need over my head til I do what you want? I’m glad I’ll be getting my own health insurance through my job soon. I had to bite my tongue so I didn’t tell her that she’d be footing the specialist bill if that came, then. I get it, grandma’s alone. I’m a major asshole. I’d also like to enjoy my last few days of freedom. it’s absolutely not fucking fair to not change my PCP on my insurance, something that should have been done two years ago when I moved home and started going to this GP, because I don’t want to sit by myself in a room with someone who can barely hear anything I say if I say anything at all and will only talk about her hearing or what a pretty little girl I am; little girl, like I’m still 5

and it is unfair, I suppose, to be talking about my grandma like that. to be actively avoiding spending time with her. I feel like a callous dickhead for feeling the way I do. it’s the same thing I felt about being around my dad, almost. he could be so frustrating and doing literally anything with him, especially towards the end, was ulcer-inducing. I loved my dad to pieces, but I dreaded spending time doing things with him; even a simple trip to the store, it was always something. those conflicting emotions were, and still are, really hard to deal with. 

grandma’s schizophrenic. or, at least, very likely is. she’s lonely. she’s losing it a little (but she’s always been pretty nuts). I feel bad, I really do. I should want to be there for her more. but even my mom says it’s been the same story as long as she could remember. it was always about her. everything was always about her. a lot of it was the schizo. she’d never been diagnosed-- refused to talk to doctors. there’d be no getting her on meds. it just was how she was. but now mom has to hear every single day about how she just doesn’t hear so well anymore and she doesn’t get why (because being 94 doesn’t have anything to do with it) and how she’s terrified of losing her hearing (what’s left of it anyway; she’s deaf in one ear and has a hearing aid for the other). the schizo makes it so that she’s terrified that literally anything will affect her hearing. the AC unit in her apartment. a truck going by. a light, somehow. mom says the blinking light on the phone bothers her and she gets nonstop calls when there’s a voicemail on the machine. mom put a camera in her old apartment to keep an eye on her just in case anything happened, but apparently she couldn’t remotely pivot it if grandma was in the room because the motion would freak her out. and I feel awful about those things. I know what it’s like to live in constant irrational fear. it’s horrible. torturous.

but even as someone who tries to be patient and compassionate when it comes to mental illness, it’s really hard to stay sympathetic when it’s years and years of the same shit and she doesn’t even try to help herself. won’t try to distract herself. keep herself busy. she just wants to stew in thoughts about shit that happened 50 years ago and obsess about her hearing. and there’s really nothing to do besides just try to work around it, since we can’t get her to a psych. mom has tried everything. she won’t do anything by herself or with much of anyone besides my mom, so mom has tried playing boggle with her, coloring in coloring books with her (my idea), sitting and reading with her.. I recommended watching ASL videos with her and doing the signs with her like a game (but of course grandma outright refuses to learn ASL because even the thought of being totally deaf scares her; like, ok, but how will you communicate then). mom says she won’t sit still for long. she just wants to get up and leave the room for a few minutes, turn on the tv real loud for a few seconds to make sure she can still hear, whatever else. there’s only so much you can do and my mom has done all of it. it’s been years of this. sometimes I’ll hear mom yelling on the phone at her because she called, yet again, to ask her if she thinks some completely harmless thing will hurt her hearing (no, ma, it has nothing to do with your hearing! now stop!) or “this lady in my building was asking me about my family and my kids and I don’t know why she wants to know those things” (that’s just what people do! they ask questions to be polite!). even my mom loses her cool with her. it’s so, so frustrating, and it’s even more frustrating to feel so conflicted; like we’re not allowed to be frustrated because she’s mentally ill.

and that’s not to say I haven’t tried too. whenever I’m dragged over there with my mom I’ve tried talking to her, but no reasoning gets through. my aunt is awful to her, but no matter how much we tell her that’s just how she is, she’s like that to everyone, it’s the same things. I told her how my aunt didn’t talk to me for 3 years after a trip she took me on where I did exactly what she said I could do (but didn’t want me to do anyway), and she kind of laughed at it, but then continued on about how my aunt is so awful to her. don’t take it personally... followed by more taking it personally. it’s exhausting. if she can hear me at all, it’s like my words mean nothing anyway. she did like hearing about my rats and seeing pictures of them. she thinks they’re kind of cute. she was really surprised that they have so many babies and she kept talking about how amazing that was. that was probably one of the only good conversations I’ve been able to have with her in years. but I really had to reach and come up with more things to talk about so we didn’t steer back into talk about hearing loss and how pretty I am

it’s just. a lot. I do feel bad about not wanting to spend time with her, especially because I know she needs it. but it’s exhausting and awkward for me; I’d rather not be alone with her because I have nothing to talk about and she’s just going to go on about her hearing and won’t listen to anything I tell her if she can hear me at all and just ugh

don’t remember how my post took that hard left, but it did. writing is nice, tangents and all. I’m still feeling mixed emotions over my results, where to go from here. it probably won’t be as simple as “just” going to another rheumatologist, “just” getting a sleep study done... I don’t know what this is but it’s going to continue being an uphill battle for a while. I’m just glad I have people in my corner who have been reminding me that there’s always something else. I haven’t exhausted every option yet. encouraging me to keep going. it helps so much. if I didn’t even have that little bit to hold on to these last few months... I don’t want to know where I’d be.

I was just thinking about that last night, actually. one of my journal prompts had me thinking about it. the tiniest little things make such a big difference. just hearing I did a good job with something, or that someone’s proud of me. even if it didn’t seem like I did much, or even if my brain wants to tell me they’re just saying those things to be nice. I really haven’t been talking to much of anyone in at least a year. only one person with any kind of regularity. it’s been deafeningly quiet and honestly really lonely. and it easily could have been much quieter and lonelier. I’m not sure I want to know where I’d be if I hadn’t been talking to anyone this last year or so. probably would’ve spent a lot of time back on okcupid, reactivating, feeling sick to my stomach, and deactivating. over winter I was looking for any kind of community online; facebook groups, meetup groups, hell even subreddits... I felt too late to the party on everything. but I guess it hit me real hard that I just missed having company. people to talk to. it was really frustrating watching everyone else living their lives and feeling cocooned away; like I wasn’t doing anything worthwhile and I wasn’t ever going to. I guess that urge mostly subsided. winter is a lonely time in general. I can only imagine where I’d have been mentally if I’d spent the whole thing completely alone.

part of that is really on me for not reaching out. I know I need to let people know more often that I care about them. I’m learning that I’m pretty damn bad at showing it, but I don’t think I realized I was never good at it. I know I show it in different ways from most people, but I thought it was a little more obvious than it probably is. I feel, from an outsider’s perspective, that I seem kind of like a cat. even when I am showing affection, it’s hard to tell. I do wait for people to talk to me first, and I’m not sure why. I don’t think it’s necessarily fear of being annoying, but that does cross my mind occasionally. it feels more like... they don’t want to hear from me anyway. they’ll look at the notification and ignore it for a while before they think of a polite reply. what do I even have to offer them? I guess it’s more fear of being rejected. people have asked me why I don’t invite friends over to do things instead of waiting to be invited out, and I asked myself the same question. but then I realized... I did do that. I’d ask charlotte to go to concerts with me, she’d either ignore me or not really want to go. I asked her if she wanted to do even a monthly craft night, if I could go over and help her clean her house; anything. we did two yoga classes together and that was it. now she’s too busy to even talk to me; my messages go unread for days. all of a sudden she actually wants to spend time with sawyer; the boy she’d ditch handily for me when they were still dating. she’d nudge me out the door when it was about time for him to come home from work, even though he’d usually go straight upstairs and not bother us anyway. she just posted pictures on snapchat of them going to a peach farm to pick peaches, and she takes him to all these antique markets and stuff that she knows I’d like going to too. always busy doing something with his family, when I do ask if she has a free weekend. can’t really invite my PA friends over either, and I’d only ever been successful in getting one of them to come visit me more than once. the others, and only some of them, came down for my little grad party in 2017. that was it. I absolutely am projecting the results of a few past rejections on to my future, but I really do fear rejection. I’d rather not even bother. good thing I spent a lot of time learning how to be alone, I guess.

I forget where I was going with this. my eyes are starting to cross; I think it’s bedtime

[endowarrior877]

Endometriosis and my treatment experiences.

If your doctor thinks that you might have endometriosis, they may offer various treatments to see if that helps with symptoms at first. This is normally offered before any surgical treatment/diagnosis' are done but as the only way to diagnose endometriosis is by doing a laparoscopy sometimes it can be a long wait for woman before they get to that stage. This prolongs the pain and symptoms woman suffer greatly and impacts on a woman's day to day life.

On average it takes around 7 years for a diagnosis which is a massively long time and can cost some woman years of their lives. Although I did unknowingly waste about 6/7 years thinking my problems were caused by a bowel issue, from the first time I spoke to the GP about the possibility of me having endometriosis to my actual diagnosis from laprascopy in October 2016, the whole time was just over a year and a half. I could spend hours thinking if only I'd have known about this condition earlier then I could have saved myself some pain and time or if doctors would have picked up my symptoms up sooner would I have suffered any less? Too right i think more education should be offered to trained medical professionals and the general public because this disease is actually more common than people think. If we all knew more about it maybe it could save woman so many years. I can't get those years back but other woman don't have to give up so much of their precious life. Thinking about the what ifs and buts won't help my current situation so there's no point dwelling on it. It is what it is. I am lucky in the sense that as soon as thought I had endometriosis I made it my mission to at least push for the laprascopy for answers and not just try treatments. I still don't quite think It makes sense to try and treat something without knowing if it definitely is that for sure. I got my answers after surgery but sadly didn't expect to have to still fight for a pain free life but there you go. Can't have your cake and eat it I guess!

It's crazy and upsetting to think that I'm not the only one living like this crazy nightmare and that there are so many woman out there just simply surviving and not living due to being in constant pain. As well as having a good understanding of my condition, I have a very good support network especially hubby and it has at times been a team effort in the quest to getting me my life back. So down below are the treatments I've tried with some general info and how I found them. Remember what has worked for me may not have the same results for someone else and the same for anything that hasn't worked for me, it could be great for someone else. In most cases some of the things on here do work for a lot of woman and their endometriosis is manageable. Endometriosis is completely personal and unique in each case so we all react different to treatments. Making sure you have done plenty research on what you're taking is the best way of really knowing if what you're taking will actually help and why or why not.

The first treatment I was offered was birth control pills. These types of meds are for usually used for contraception but over the years the pill has been used to treat a range of other conditions such as: irregular periods, polycystic ovary syndrome, migraines, acne and of course endometriosis. The pill has been used for decades to help with endometriosis and although birth control will not cure the disease, taking this back to back and not having a break for 7 days every 3 weeks can help lesson symptoms.

Unless you are using the mini pill most types will contain both progestin and estrogen. These hormones are something your body creates naturally. The pill taken continuously through out the month will stop your period. It is advised to let your body have a period every 3 months for a week. This can be an effective method to relieve symptoms but it didn't help for me. Hormonal treatments haven't worked for me mainly because I believe the endometriosis I have in my body is feeding itself as it produces its own estrogen. My periods did stop until it was time to take a week break but i still continued to experience pain including when moving my bowels, i suffered bad migraines, really bad acne, weight increased and it effected my emotions.

The second treatment i tried was a course Provera and I didn't last long on this one. This is taken in the form of a tablet and is basically just progesterone or progestins and works to decrease the estrogen in the body. This was prescribed before I had my official diagnosis. I'm not sure of my exact dose but I started on the highest and cut that in half after I was experiencing some not nice side effects. Some of these included migraine, sickness and leg pains. All in all I lasted a month on this treatment but the side effects were almost as annoying as my original symptoms so I was put back on to birth control instead. This can also be given in an injection form and belongs to the same drug family as the implant that goes in your arm and the Marina coil.

After the failed Provera I was referred to the gynecology team at my local hospital to see if they could help. As I was already known from my recent pregnancy I didn't need to do any introductions we just got straight down to business. It was suggested that because of my c-section and no obvious signs of endometriosis being found then, there was a good chance that this was in my head and my mind was tricking my nerves into thinking that they were feeling pain. Somehow my mind had got into the habit of making me feel the worst imaginable pain possible. Yes I know this all may seem a little odd but that's what I was told. Lucky for me there was a drug that would help my mind stop telling the nerves they were in pain. This would be treatment number three and was Amitriptyline.

It wasn't very nice the feeling I was being made out to simply have all of this in my head and it seemed so far fetched that my mind could cause this much actual physical pain. There was no denying that in the middle of a flare I was in a lot of pain, but was it only happening because my nerves were damaged from previous pain episodes and were simply stuck in the habit of causing me phantom like pains? This particular drug isn't a pain killer and can be used for a range of problems and can be an ideal solution for some people. It wasn't in my case which was disappointing. I knew people on these for other things and they helped so I did think they might be good.

You have to build up a tolerance with this medicine, it doesn't just work after immediately taking. I waited 3 weeks and was always super tired. It was great at bed time because I could fall asleep so easily but when the morning time came around i struggled to get up and could have slept all day if that was possible. I slowly increased the dosage up to 3 tablets a night at the recommendation of the doctor but as a result was so tired and groggy in the morning. It hadn't done anything for my pain, especially bowel movements so after another appointment to complain about my pain levels, I was passed on to the endometriosis specialist team in a different hospital over an hour away to see if they could help. During this time I was told to stay on the birth control and Amitriptyline. I really didn't feel it was necessary to take something and feel the same pain and other additional symptoms so I weaned myself slowly off the amitriptyline and felt better after I stopped taking it. I stayed on the birth control until i could see the specialist. Playing with my periods like that would always cost me In pain so keeping that the same would save me any additional flares and pain.

I saw the specialist and was very happy at feeling like I was being listened too for once. He didn't dismiss my pain or tell me it was in my head. The fourth treatment I had was a diagnostic laparoscopy with removal of endometriosis if necessary. Unlucky for me it was necessary and they removed some of endometriosis they found and sent some away to be tested which came back positive for endometriosis. They couldn't remove it all and some still remains on one of my kidneys and I'm pretty sure I have some hiding in my bowels, bladder and possibly other places too eg the pouch of Douglas. In terms of pain management it did and didn't do anything. The easiest way I can explain it is like this; Its like I have blankets of pain on my tummy. The lap removed 5 of the pain blankets but left about 10. Some areas especially in my left side where I did have lots pain has gone down since the lap, but others areas of pain have stayed and got much worse mainly on my right side and center.

When you have a laparoscopic procedure you are put to sleep and then holes are placed in your tummy then gas and cameras are inserted through the tubes. The gas opens and lifts your body allowing the surgeon room to work and look around with the cameras. The cameras are there to look at the parts of the body and find any endo. Any endometriosis is then cut away or an later depending on the surgeon. If endometriosis is left or ablated this can sometimes be an indication that you need a surgeon with more expertise. That isn't a dig at the surgeon with less knowledge in any way. It's just that endometriosis is a highly complex disease and needs to be tackled by someone who fully understands it inside and out. An endometriosis specialist will have done further education and training than a standard gynecologist and in more cases isn't specialized in endometriosis. This is why one of the most important things to do in order to deal this condition is have a doctor trained in that field.

Sometimes endometriosis is burnt away with ablation but in order to stand a real chance and live a somewhat pain free life, it should be cut out at the root always. This is better as it removes all of the unwanted cells attacking the healthy parts of the body. Hysterectomies and removal of ovaries can be done during this procedure too if necessary. Recovery time is so important and if you're booked in for a lap please make sure you rest up after. Although it may seem like it's just tiny holes in your body, they are there so that the surgeon didn't have to cut you open from hip to hip. If the laprascopy is done by a trained endo specialist then there is a real good chance that surgery will be a complete success and will greatly improve the patients quality of life. In 80% of cases woman were living pain free lives, the other 20% was missing endometriosis because it can be hidden anywhere. It's been found on the lungs and brain. Ablation surgery to remove endometriosis simple isn't good enough and it will just grow back causing pain if it isn't completely removed.

I kept going back to the specialist after my laparoscopy because the pain had not really settled and was ruining my life still. Before my laparoscopy I was offered the Marina coil to stop my periods and try and help with my pain. This would be my turn out to be the fifth treatment I would accept to try and help me. Having had a bad experience in the past getting something taken out of my body (the implant in my arm) i was terrified of getting anything else placed inside me and then years later the dreaded removal. I was also not sure what was going to happen and be found during the procedure as every test for anything I'd ever had always came back negative, way way back to the first tests so I didn't have much hope and kind of thought I would go throughout life not knowing what was wrong with me. If you throw in a hand full of doctors saying it wasn't endometriosis compared to the couple that did think it was and I was now questioning myself wondering if they would really find anything. I wanted to know the results before I made any more decisions. I'd taken so many unwanted medicines and this one in particular was not as easy as just taking a pill. I'd be getting something inserted into my delicate cervix. So I panicked and said I'd decide that when I knew my results.

Looking back If I'd have know how much pain and discomfort it was going to cause me just going in, I'd have definitely got it in when I was getting my laparoscopy, asleep and blissfully unaware. Saying all that though, if I'd have known I was going to bleed long and heavy all of the time, have different cramps to experience, different flares and the additional pain the next day if I'd had sex, plus all my usual symptoms, then I most definitely would have told them to keep it away from me full stop! I'll be fair though the Marina coil did stop after dinner flares and flares when I passed gas as I am getting them more frequently since it was removed nearly 3 weeks ago.

The Marina coil is progesterone drug that is placed internally inside the cervix for upto 5 years. Someone woman do have to have it replaced every 3 years because it becomes inactive. It looks like the letter T and is made of plastic. It has cords on the bottom which sit outside the cervix and are used for it's removal. This is another treatment that is also used as a contraceptive but can be used for helping with endometriosis. The coil works in the same way as birth control and provera work in that it stops the body producing estrogen. There are reports of this being a great help to woman but I would not recommend this to anyone. When it was first fitted I bled constantly for months on end. I had a lot more really bad cramps and my mood was horrible. I was angry and emotional most of the time. Supposedly after the first 6 months have passed and the body is used to the coil then your periods should stop and life should be hunky dory. Mines never did and I bled more times that i didn't. I eventually got the coil removed and although my baseline pain and symptoms have more or less stayed the same, I'm not as moody, short tempered or emotional, my acne has gone away already, my hair looks healthier and I'm bleeding less. I used to worry that it had moved, gone missing and/or could pierce my cervix and since its removal I've not spared one second thinking about it so that's been good. The coil was the second worst treatment that I tried. I'm saving the worst till the end.

It didn't take me long to be making another appointment with my GP and specialist after the coil was fitted. I was bleeding very heavily, constantly sometimes having to change my pad every couple of hours on some occasions and the cramps were pretty much still causing me just as much problems. I wasn't able to leave the house for being in so much pain. After another appointment with the pain clinic it was suggested that I should try treatment number 6 pregabalin which is a anti-convulsant and also is in the same family as gabapentin. These types of drugs effect how our nerves send and receive pain signals and is more pain management than hormonal suppression. You are less likely to get any of the unwanted side effects that come with gabapentin if you take pregabalin. As I'd already explained to the docs I'd been feeling nauseous a lot because of the pain and because I have children i couldn't be drowsy and under the influence of drugs that might effect my mind state, it was suggested i should try pregabalin as there were less side effects.

I started on a low dose, given a prescription and off I went. I did my usual research and just noted that it might make me sleepy and groggy in the morning. It was basically going to work on my nerves and hopefully block the pain signals that would normally go to the different parts of my body. I also read that it was good for anxiety and since I had plenty of that I thought it might be beneficial there and as I'd always wanted to see if there was something to help with that I'd see if it did help and then tell the doctor. I felt pretty confident in trying this.

Once again they worked great at bed time because I was out like a light in no time at all. I slept all through the night, always. Waking up was a different story and I felt liked I'd been drinking for the last couple of days non stop, even though I'd made the decision to cut alcohol out for good because it just did more harm than good. It made my cramps continuous the next day and made me feel so ill. It wasn't worth it. Alcohol is not good for endometriosis and should be avoided.

I continued on with the pills and there was no change in the mornings and I still felt hungover for hours. After the 'morning sickness' had gone it was then time to wait for the flares to come and just try and get on with the day. Pregabalin didn't stop the pains but made them slightly duller and not so intense. It's so frustrating that most things go this way it's like the endometriosis is just to strong and always over powers what ever I'm putting against it. One thing that I noticed was that my anxiety levels were a lot lower than normal and I was having less panic attacks. Maybe the pills were also helping my anxiety so I kept an eye on things and just enjoyed being less worried all the time. I actually think they added to me having slightly less flares and pain during that time because I was a more relaxed and calm. Unfortunately it wasn't worth feeling like I'd drank 4 liters of rum every night so I eventually just stopped taking them. At this point my relationship with the specialist was becoming strained as anything they tried eventually failed and he was running out of things to try. I eventually managed to get in contact with someone in the department to make an appointment and tell them I'd stopped taking the tablets because of the way they made me feel.

Treatment number seven, the Decapeptyl Injection aka induced menopause and is similar to Lupron. This would be the last thing I'd try before I emigrated to Holland. I was offered this 7 months into getting the Marina coil as I was still complaining of pretty much the same pains so this was the last thing really to try. After almost coming to the end of my appointment with the specialist/pain management nurse that I'd arranged to discus how the coil was working, I kind of lost it a bit and said that I couldn't be left in this much pain and that It is so debilitating and I really needed help to try and stop get my life back on track. She went away to speak to another specialist and said I could wait and he would see me.

After a bit of waiting me and hubby shook hands with a new doctor and took a seat. He ran over my symptoms and the fact they still hadn't got any better even after various treatments and said he could give me a 6 month course of Decapeptyl injections that would put me through the menopause and suppress any endometriosis in my body. I was only 27 and had heard about the menopause but barely knew anything else about it. Without even knowing much more about it and because I was so desperate to try anything to stop the pains, I said yes. He wrote me out a prescription and told me to go and book and an appointment with my GP who would administer it. He didn't explain many of the short term or long term side effects, he didn't really go into much about what it would do to me or how it would effect my body. Just that it would stop me ovulating, I wouldn't have a period and wouldn't be able to get pregnant. He said that it would stop the endo and it would just fade away supposedly. If only I'd have done my research back then, I wouldn't have been so keen to jump in. I was pretty desperate though.

I left his room and was keen to get started after I'd done my usual research about what I was taking. Baaaaaad idea and even though I normally try and find actual facts and true evidence based research, in this case everything I read was just horror stories. I had scared myself stupid and no longer wanted to be dragged through the menopause. I put handing my prescription in to the chemist off for as long as I could but after I couldn't handle the pain anymore I gave in and was ready to try this after all. Fuck it, what did I have to loose now? The appointment was booked and after some confusion about who would be giving me the injection I had a date and it was going to happen.

On the actual day I was so nervous. More so because I knew my body was going to change so much and once It was in me, then even if it went totally horrible I'd have to live like this for the next month at least. I was aware of all of the changes my body would go through now and also aware of all the side effects. I was prepared for everything to come, or so I thought. The nurse called me into the room and after a bit of small talk I'm laid up on the bed with my tiny butt in the air ready to take on the menopause, palms sweating and my heart about to jump about of my chest. Wiggle my toes I said to myself.

The needle went in and the pain was intense. Holy shit! I screamed! That was sore!!! I'm sure she must have missed my muscle because boy did that hurt something rotten! Another downside to these types of treatments is the pain you have to go through sometimes just getting the procedures done. It's horrible having to experience a totally different kind of pain to stop the one you feel day in day out. It's so unfair. I cried out loud, sorted myself out and just wanted to go home. I instantly felt something different in my body like a strange feeling had passed through me and it was slightly warm. I left the surgery and started to walk home with so much on my mind. I'd love nothing more than some respite from my own body sometimes. I was going to get a little shock as the first week was absolute heaven. All my pain has ceased pretty much. It was so bizarre but just as equally amazing. I could even go to the toilet with no pains during and after. It was the best week ever.

Slowly the pains were coming back and by the end of the month my pains had pretty much returned. Everyone put that down to the injection wearing off so I was looking forward to my second one, although not looking forward to actually getting jagged with the needle again. I was unable to sit or lay on my right side for a couple of days after the jag, my butt ached. I also suffered really bad hot flashes and night sweets but they were worth the lessened pain I was experiencing. It wasn't a nice price to pay but I could move my bowels in peace and that was just amazing! My mood also changed and I was angry about everything. Everything irritated me and wound me up. I was a hot, angry, sore menopausal beast but my period had stopped which was a bonus! I did learn from this treatment that I experience a lot of pain extra when I'm ovulating and that's one thing the injections did eliminate and makes me think I need to stop ovulating on a permanent basis.

The second injection came and it didn't hurt at all which was strange. I made sure to ask for this nurse every time because she had a good way of finding the right muscle by feeling for it and didn't just use her eye. I experienced more hot flashes, night sweats and even more bad mood swings. I found that slightly more annoying than last month but the lessoned pain was still a lot better so I was willing to deal with the nasty side effects for now. I started to get a little stressed from the random hot flashes and night sweets over time though. I'd not slept properly in weeks and during the day I'd just randomly feel like I'd been set on fire no matter where I was or what I was doing. At 27 it was hard to deal with and no one my age could even relate. I felt like such an old lady, no offense if you're reading this and fall into this category. I don't mean it in a horrible way.

The pains came back quicker each month and it was like the injection was starting to ware off quicker. I continued getting them every month until the last one was due and at that point I'd had enough of the side effects. They were brutal. Life was so hard and the pain was coming back earlier and earlier and by month five i had one good week, 3 bad weeks and going to toilet was pretty much back normal. It didn't make sense, it was working at the start.

Aside from being all hot and angry I completely lost my sex drive, had bad acne, dizziness, migraines, my breasts decreased much to my dismay (I didn't think they could get any smaller they just vanished though!!), my hair thinned and my bones and joints were very sore by the end of the treatment. My shoulders hurt so bad! I still have sore hands, wrists and night sweats even though it's been months after treatment stopped. For me what I've learnt from this is this drug is just like poison and shouldn't be used at all to treat endometriosis. The side effects experienced are much worse than the original symptoms and some side effects are irreversible like bone density. Bone density is the most common serious side effect and unfortunately can not be reversed.

This treatment is not meant to be a long term solution and should be only used a max 12 doses per life time. Basically this drug works by stopping the body producing estrogen by blocking signals being sent to the pituitary gland in the brain. If you don't produce estrogen then you can't ovulate. It can be given in monthly, 3 monthly, daily injections or as a nasal spray but they all work the same. Other uses for this medicine include: prostate cancer as a chemotherapy drug, fibroids of the uterus and premature puberty in girls under 8. When using to help treat endometriosis 'add back medication' will be added in conjunction with the injections which will give you a little bit of a synthetic version of the missing suppressed hormones to balance the overwhelming side effects found with being catapulted into the menopause. In my particular case this made my symptoms so much more worse so I didn't last long taking those. Surprise surprise! My cramps were 24/7 whilst taking these pills and I seemed to cry a lot too, like all the time. As soon as I stopped taking them those particular issues eased up too.

Everything continued to not work as well as any of us had hoped for and I think if I'd had of stayed in Scotland then i would have been looking for a new specialist as there was nothing more this particular one could do for me I felt. Again I don't mean any disrespect to the doctor. I appreciate how hard he has worked to get where he is so I don't ever want to come across as if I'm dismissing the mountains of knowledge these doctors do have.

I've tried a lot of things after being recommended them by the GP, gynecologist and specialists. I've also tried a lot of things at home by myself. I've tried acupuncture. This was very relaxing but didn't stop the flares. I couldn't afford to keep doing this and since it only helped relax me and not cure me of my pain I couldn't justify spending the large amounts of money. I've also tried meditation and yoga. Again they are very good at relaxing my mind but don't stop the physical pains I feel. I've cut out caffeine, alcohol, processed foods and dairy. I'm still working on gluten but very rarely eat red meat. I have also tried omega 3 fish oils and found that if I stick to a strict diet, take vitamins and omega fish oils I can bring my pain levels down slightly. Again it's not enough to just say it actually helps and I'm cured but I do see a difference in the levels of pain felt if I go super healthy. When your miserable and depressed and bleeding constantly it's hard not to grab a chocolate muffin to drown your sorrows and by pass the salad. I also find that drawing is a great way to relax if I've had a bad day and found that I'm actually not too bad at it if I concentrate.

I've also just got into playing around with essential oils. Frankincense is one that I have read is good for endometriosis and also lavender. I've had fun making bath bombs recently and using them in my diffuser after I've had a flare to try and take my mind off things and relax me. It all makes dealing with the pain a little easier and keeps me occupied when I'm not in pain and able to do something crafty. I also found some CBD oil in my local chemist and tried that a few times. You put 3/4 drops under the tongue and it helps a range of ailments. I did noticed a difference when I first started taking it but I think I need a stronger dose and they get pretty pricey when you move up strengths. I only got this one as it was €14 but I don't think I can throw $80+ at it just yet. It's annoying because you kind of have to just buy it in order to see if it works. I'm still doing research on that though. I did find if I doubled the dose it would help more but I started to feel sick shortly after taking it so haven't touched it for a few weeks. I hate adding sickness on to the cramps.

I'm not quite sure what this new specialist will suggest after my MRI results come back. I'm not going to spend any time thinking about and all the possible outcomes as I have no idea what he will say because it's so different here. I might get lucky and offered surgery. Who knows? I've told him I don't want to try any more hormonal treatments and I think the best way forward is to have a second laparoscopy but until i have my MRI there's absolutely nothing I can really do but wait. I can't and don't want to do any of the treatments again that I've mention above because one way or another they just cause more harm than good so I'm hoping that's not something that's suggested. We will see in due course and I'm sure I'll fill you in on how that goes!

#endo #endometriosis #chronicillness #invisibleillness #treatment #cure #findacure #hope #pain #painmanagement #birthcontrol #pcos #periods #timeofthemonth #provera #marinacoil #menopause #hotflush #nightsweats #injection #monthly #cramps #pain #sore #cry #depressed #anxiety #mri #hosptial #journey #blog #mystory

[practicalhelp]

THE BORING STUFF

It’s been a helluva couple of weeks and it’s reminded me that there are soo many irritating things involved in keeping yourself afloat in the midst of a flare up. I’m actually not even sure where to begin but it seems logical to list the issues that have come up for me recently as I know that unfortunately, they will come up for everyone who suffers with a chronic condition at some point. In the past few weeks I’ve started a new job, had my first pain clinic appointment, had a day treatment at the hospital (requiring sedation and day or two of recovery), had my period (awful), had a number of GP appointments, sent off a claim for DSA (disabled students allowance), applied for an extension on a uni deadline (due to hospital/period/illness/work) and attempted to keep up with all missed lectures and tutorials due to work and sickness whilst trying to keep myself fed, watered and relatively sane. And if that doesn’t seem like a lot, imagine doing all those things while feeling like you’re dragging a led weight behind you everywhere you go, having a hazy memory and slow reactions due to heavy duty pain meds as well as the extreme fatigue and low mood that endo flare ups bring. Not to mention my fun new symptom.. completely numb legs and horrible joint pain?! What is that about. Ultimately having a chronic illness (or two, or three!) feels like a part time job. There is so much planning involved, so many forms, calculating the best dates to do things so that you don’t let people down and the financial stress of working out how much medication and hospital trips are going to cost you. I don’t know if people realise quite how much work has to go into these things before you can allow yourself to relax and heal. I’m so so lucky that I have a network of extremely supportive and helpful people at my fingertips, who overwhelm me with their kindness and understanding, but I’m sure many of you are familiar with not wanting to feel like a burden on them and trying to do everything yourself. It gets overwhelming. The past few weeks, I was overwhelmed. I feel quite positive at the moment having come back from my treatment last week with news that there doesn’t appear to be endo on my bowel and that the extreme pain is just (another) unfortunate side effect of the condition. It sounds strange to be positive about that, but it means going ahead with trying some different pain relief targetted more to IBS symptoms rather than surgery (for now) so it feels like a small victory and I think it’s important to treat it like one. BUT the general chaos has caught up with me and I know I’m trying to cram too much in at the moment. Although they’re all positive things that will improve life in the long run, the combination of them is exhausting and finally, this weekend, I have a couple of days to regroup and readjust. I try really hard to handle things practically and as efficiently as possible these days, rather than let my worries build up and feel like something unmanageable. This is a lot easier said than done and luckily I’m in quite a stable and positive mental state at the moment which helps HUGELY in the organising of my day to day routine. For me, it helps to divide my life into five sections: uni, work, money, health and social life. Instead of feeling completely overwhelmed by a swirling mass of problems, I’ll think about how I can improve each of them in small ways and it feels a lot less daunting. I often feel like as one gets worse, so does another. What happened this past couple of weeks goes like this: work was busy and stressful, so uni work suffered. I was feeling tired and ill so was spending money on unnecessary things to perk myself up as well as more expensive food because I had no time to food shop. I got my period which along with being mega painful, turned into a vicious coldy run down bug which dragged on for longer than it should have because I wasn’t letting myself rest. And the idea of a social life at this point is laughable, although going for a drink on Monday night in an attempt to be a regular carefree young person resulted in me throwing up all of Tuesday because my body likes to punish me for trying to be normal. And why the throwing up? Probably because I’m out of my stomach meds and had no time to get them as well as the fact that I’ve started a new contraceptive pill which has historically given me an upset belly for the first couple of months. Constant, niggling, little problems that add up total stressy meltdown if not monitored. Incredibly boring explanations aside, I guarantee that if you separate your life into sections right now and try to think up easy solutions to the problems in each you might feel a bit less overwhelmed. If you’re thinking that this method seems familiar - you got me. It’s typically used in CBT sessions for anxiety and quite honestly it’s the only useful technique I ever got out those sessions. I’m thinking I’m gonna do a post on each of these five topics separately because I have been blessed with two solid days off and also - there’s a lot of shit to get through. For now let’s talk about moneeeeys and how to not lose it all on paying for meds! Essentially, financial help means a million forms that can be difficult to fill in. As I’m a student I can claim for DSA (Disabled Students Allowance) which is relatively straight forward. If you’re in education and suffer from endometriosis or any long term health condition (including a mental health condition) it’s definitely worth getting in touch with the Disability team at your college/university. I initially felt as if I wasn’t ‘ill’ enough to be entitled to help from them but a quick chat with them let me know that they would help me in any way they could. Sometimes you get so used to the complications and negative aspects of managing illness that you forgetting they’re even happening to you, and it’s useful to make a third party aware of that they can remind that you that you do need extra support. I’m also applying for financial help with prescriptions and travel costs through the NHS, using an HC1 form, Again, this is a super long, boring form to fill out and because I now have a part time job I’m not sure what I’ll be entitled to. But it really is all worth doing and you never know what you might gain from it. Head to the NHS website and you’ll find a form for almost every situation that is usually worth having a skim through. You can also go to a local pharmacy and ask if they carry any of these forms or even if they have a moment to speak to you about getting financial help with prescriptions and hospital visits. The same can be said for your GP and they’re usually very willing to help. Aside from HC1 (and HC2) forms, there are Prescription prepayment certificates which allow you pay for prescriptions in 3-month or 12-month blocks which ultimately saves you money and mean you pay no more than £2 a week for the meds. Obviously, this is dependent on how many prescriptions you’re currently on, and this is something I need to speak to my GP about because I am confused and maths is not my strong point. There’s also a page specifically for students on a low income here. On that note, a lot of the financial stuff is difficult to get your head around and it might be helpful to ask a friend/colleague/medical professional to help you understand it, especially if you’re pain and have a lot on your plate already. The theme that will run through these posts is this: don’t be afraid to ask for what you need. Even if it feels difficult or awkward at first, it will get easier as soon as you realise how much it will benefit you and how willing people are to help. If you buy any over the counter medication AT all, always ask your GP if it is cheaper on prescription because it often will be. This goes for any pain you may have, even if it isn’t necessarily related to your condition. For example, I would pay a fortune for fancy herbal IBS remedies and peppermint oil capsules and god knows what else when there is usually a very similar product available in bulk from the GP (i.e. mebeverine/colofac). This was also the case with the antihistamines I was taking and can even go as far as medicines you buy and don’t think about like antacids and vitamins. It’s always worth explaining your situation to your doctor and seeing if there is a more cost effective option. The same rule applies when you are buying over the counter, for example when you don’t have time to get a prescription or when what you need can’t be prescribed (like my beloved heat patches waaahh). The pharmacy will have branded products and then they’ll have other options with IDENTICAL ingredients for a fraction of the price. Ask the pharmacist for the cheapest possible option as long as it has the same desired effects and basic ingredients. Don’t buy health stuff from Poundland though because in my experience you will get a rash (and use their heat pads with extreme caution - they’re lethal). LASTLY, sounds like an obvious one but it’s where I often let myself down health wise - know what to eat to make you feel good and always have a lot of it in the house! Ultimately you never know when you’ll be struck down by your temperamental illness and it’s best to be prepared and not fall into bad habits (like constantly ordering pizza even tho it is godly and delicious). My advice is to online grocery shop (Asda is a great option with only £20 min delivery) and stock up on cheap, healthy food whilst monitoring what you spend. My latest trick is to always have excellent smoothie ingredients in so that if I’m mega busy and feeling run down I can make super nutritious, filling, vitaminy, tasty, drinkable meals. Vitaminy is a word, I’ve decided. Have a gander at Holland and Barrett’s website as they always have mega good deals on vitamins and smoothie mixes to keep your immune system in a good state! But also don’t replace meals with smoothies because that’s mad. Also eat non liquid food plz. Next post will beeeee… how to stay sane when your employer doesn’t give a fuck that you’re in debilitating pain! Or more eloquently put: knowing your rights in the workplace as someone with a disability. Hope this made some vague sense and feel free to message me with questions!