25 January 2016

The choice is yours

After my latest experience with the medical profession, I was left pondering the question 'Are patients sometimes given too much freedom of choice?' 

One evening early last month, I started having heart palpitations at least two to three times a minute. Somewhat panicked, I called my doctor's surgery the next morning, and they invited me in for an ECG that afternoon. As soon as I lay down, however, the palpitations eased, so I wasn't surprised when the doctor later told me the test results were normal.

After I'd described my experiences of the last 18 hours, which seemed to contradict these findings, he said, 'Well, if it's troubling you, we can run some blood tests and possibly a 24-hour monitor. What would you like to do?'

I was bemused by the question. Now that I'd explained the true extent of the problem, why was he was putting the decision in my hands? This seemed, to me, to be a genuine issue; I wanted to know what was causing it, why didn't he? 

I opted for the blood tests and by the time these came around I'd concluded - from my hours of online research - that I was experiencing ectopic beats: premature or extra beats. While these can be completely innocuous, and are often idiopathic, ie with no certain cause, they can also be the result of a serious underlying condition.

If I'd been more easily persuaded by my doctor's assurances, or had lacked the confidence to challenge them, I would surely be running the risk of something significant being missed?

The blood test results were all fine and although the doctor noted that the ECG had picked up some ectopic beats, he told me this was normal. I reiterated that these were occurring far more frequently than recorded and requested the 24-hour monitoring.

Image courtesy of Stuart Miles/
Incidentally, he didn't elaborate on the term 'ectopic beats', which is another issue: patients are not always given an explanation of their diagnosis, or the treatment offered, and may be too confused, upset or timid to request one. 

I had the same experience two years ago, when my gynaecologist briefly outlined three treatment options before saying 'Go away and look into them, then give my office a call and let me know what you'd like to do.' While I appreciate that he may not have had time to go into the pros and cons of each one, a little more of a steer would have been welcome. 

Things have obviously improved on days gone by, when doctors would brook no discussion and their word was law, but any patient-led decision does need to be informed by clear, and expert, guidance.

If this 'light touch' approach is applied to those with mental health disorders, it could prove particularly detrimental. 

How, for example, is somebody with anxiety or compulsive thoughts supposed to handle researching their situation and deciding on treatment? The internet is full of conflicting advice and scare stories that are fuel to the fire of such conditions. And I doubt somebody with depression is going to have sufficient motivation to engage in this way.

Is this increase in patient choice a growing trend or are my experiences untypical? If it is a trend, is this degree of choice always a good thing? I'd be interested to hear your thoughts.

* * *

PS The heart monitoring starts tomorrow - fortunately the palpitations have now subsided considerably, so I'm hoping for an 'innocuous' or 'idiopathic' outcome.

18 January 2016

Cry baby

During the news coverage of the terrorist attacks in Paris last November, one television reporter broke down while presenting from a memorial site. Some denounced this behaviour as unprofessional, but many expressed support and understanding for the reporter concerned.

I'm definitely in the latter camp. While news reporters clearly can't become tearful over every story they cover, we shouldn't condemn the occasional emotional lapse. It's not a sign of either unprofessionalism or weakness - whether you are a man or a woman - just that they're human beings. 

More recently, of course, we've also seen President Obama cry while talking about gun control. 

I probably sympathise with them both, because I cry at the drop of a hat and have done since childhood.

On Sunday afternoons, I'd often watch a 'weepie' film with my mum and younger sister. Mum would always be first to cave, with me quick to follow, and my sister finally following suit. 'I was all right until you two started,' she'd grumble. Dad would then peer over the top of his newspaper and say, in his dry way, 'Are you all enjoying this?' 'Yes!' Mum would sob back at him.

I was once howling my way through an episode of a television drama in which First World War deserters were being put before a firing squad, when Dad asked me 'What are you crying for, it's only a story?' 'I know,' I said, 'but it used to happen!'

The problem is that my imagination and empathy conspire to put me right at the centre of whatever I'm watching or hearing, whether truth or fiction, and really feel it.

Image courtesy of Theeradech Sanin/FreeDigitalPhotos.net
People say crying is good for you, but I get a headache after only a few minutes and, for hours afterwards, look as if I've been punched in the face. Then again, I do know how to have a proper cry: think Juliet Stevenson's character in Truly Madly Deeply, snot and all!

From my research, it seems that some of us fall into the category of 'Highly sensitive person', and those of us who are anxious or neurotic by nature are also quicker to tears. Others shouldn't judge us for that, but nor should we judge as uncaring those who are made of stronger stuff.

In fact, in spite of my frequent waterworks, I'm actually a really strong person, who - like the Duracell Bunny - just keeps going.

There is, of course, a 'release' element to crying - it's believed to release stress hormones from the body - and always bottling things up can be detrimental to your physical health. This quote, from British psychiatrist Henry Maudsley, puts it beautifully: 'The sorrow which has no vent in tears may make other organs weep.'

Now, where are the tissues? Just in case...

11 January 2016

Back to normal

Image courtesy of stockimages/
After the upheaval of the festive period, most of us are relieved not just to return to our usual patterns of existence, but also to reclaim our homes from beneath all the decorations, presents and leftover food.

My ordering compulsions make these temporary changes to my environment particularly hard to bear; by the New Year, I'm desperate to restore normality. 

The first Sunday of the year was dedicated to that mission - and what a mission it was. Not only did I have cards and decorations to take down, and presents to find a home for, but I was behind with all my usual chores, having been away for five nights over the holidays.

I decided to put a wash on while I did the ironing, however, the timing went awry and the wash finished before I'd completed the ironing. So I had to dump the wet clothes on the living room floor rather than hang them up straightaway, to enable me to put the next lot in the machine.

As a result, I could hardly move for the 'mess'. In addition to the clothes on the floor, there was a pile on the sofa waiting to be ironed, and those I'd already pressed were on hangers hooked up all over the room. Oh, and then there was the eyesore of the ironing board. 

Not to mention all the decorations cluttering the place: a small cardboard tree and a row of candles in decorative tins on the coffee table; a vase of hazel twigs on the floor, surrounded by fir cones and presents; and a string of fairy lights around one door and cards stuck up on both.

My heart raced as I looked around me. I suddenly felt overwhelmed: how was I ever going to excavate my flat from this chaos? The only way was finish the tasks at hand. I took a deep breath and carried on slowly - so very slowly - working through them.

It took hours to put everything back exactly where it should be, then, in reaction to this mental overload, my spartanism kicked in: now I also had to get rid of some of my belongings, to reduce my anxiety. 

I identified a few quick wins in the shape of some unread magazines, old holiday brochures and out-of-date food products. The disposal of these unimportant items meant that I avoided losing anything significant, which is a risk of spartanism.

Yet I remained edgy. It still seemed as if I had far too much stuff in my flat. Too many unworn clothes, too many unread books, too many items kept for sentimental reasons. Nothing but a full-scale clearout - drawer by drawer, and room by room - would completely alleviate that feeling, though, and I didn't have time for that.

Fortunately, a week on, that desperate urge to de-clutter has diminished, helped in part by the promise I made to myself: one day I'll move, and I'll do it then...

4 January 2016

Amazing and awful

Last month, I attended a funeral at which the following text was read out: 

'Life is amazing. And then it's awful. And then it's amazing again. And in between the amazing and awful it's ordinary and mundane and routine. Breathe in the amazing, hold on through the awful, and relax and exhale during the ordinary. That's just living heartbreaking, soul-healing, amazing, awful, ordinary life. And it's breathtakingly beautiful.' 

The service was for a friend's wife, who had died very suddenly, and very prematurely, a few weeks earlier, and the couple's 17-year-old son had asked his father to deliver this quote on his behalf.

These words - from L R Knost, a parenting and children's book author - encapsulate a lesson that's hard for one so young to have to learn. In fact, it's a lesson that's hard for any of us to learn. 

I'm three times that boy's age and have only come to realise this truth in the last few years. Even now, I haven't fully accepted it. I still grumble about the routines of existence and rail against the fates when misfortune comes my way, whether great or small.

You don't need to be of an anxious nature to feel this way. We all have times when we feel angry or upset or worried about the hand we've been dealt. It doesn't help that most of us have an in-built expectation that life should be plain sailing, which makes us resentful when things go wrong.

Of course, nobody can expect to pick themselves up straightaway, and carry on as if nothing has happened, when a genuinely life-changing event occurs, such as a bereavement or a serious illness. These things take time to process and to recover from.

Those of us who do suffer from anxiety, however, are likely to respond even more negatively to challenging situations. 

We spend our lives catastrophising and imagining the worst, fearing that we won't be able to cope with whatever emotional, mental or physical pain we may have face. And when such pain is actually upon us, that conviction only grows. 'I'll never get through this,' we tell ourselves. Yet, somehow, most of us do.

Image courtesy of Serge Bertasius Photography/FreeDigitalPhotos.net
Realising the amazing and awful nature of existence is both a blessing and a curse. 

As a curse, it can make us anxious and apprehensive, anticipating disaster around every corner.

As a blessing, though, it allows us to appreciate the joy of the ordinary, savour the amazing, and survive the awful, knowing that the ordinary and the amazing are still within our reach.

Wishing you all a year full of ordinary and amazing moments.