I went to the doctor. Everything is fine. My heart is, if anything, a little slow. When the doc asked me how things had been lately, I told him I'd been a little stressed lately, (true) and my movements* had shown the effects of the stress (also true), and I'd also, oops, been forgetting to take all my medication (true, true, true). We talked about alternate medications for a while, and the overwhelming propensity of human beings to have problems adapting to required, daily handfuls of pills.
Then the doc asked me how THINGS had been lately. Apparently, lower-case "t" things meant crap, and heavily-emphasized "THINGS" meant are you having a nervous breakdown due to mental problems and chronic disease symptoms?
I fumbled and stuttered and somehow managed to perpetuate a multitude of miscommunication, to which my doctor's reaction was "She must have broken up with her boyfriend" and also "Oh, she's unable to pay my office-visit co-pay." (This happened because I had requested upon my arrival that the office bill me, something which is not done in private practices. This is also the first time I realized, shit, I'm seeing a private doctor.) He assured me it was taken care of, which turned out to mean HE had paid it.
After awkward discussions with my doctor and the office administrator, I was allowed to pay my co-pay, which I did immediately, all while feeling like an ungrateful yet ethical (and stupid) jerk.
I have never, ever had a doctor offer to pay my co-pay. The only possible reasons are one of the following:
1. I am incredibly pitiful/pitiable.
2. I am smoking hot.
3. They are watching my bank accounts.
4. Doc took his entire office out to Sicko and afterwards redid the budget system.
5. I can't communicate for a hill of beans.
6. All of the above.
I think my favorite is a combination of 2 and 4.
But embarrassment aside, apparently there's nothing physically wrong with me. I have a feeling the doc wants to send me to a shrink or his accountant.
*Using the word movements for my bathroom sojourns makes me feel like I'm part of a military battalion, or maybe a ninja squad.
I have a PPO so I always get billed. I am sorry you're having a rough time of it. The heart thing can be caused by two or three UC medicines.
ReplyDeleteI hope you feel better and things smooth out for you. I had remission that lasted two days, so I know how crappy (pun intended) that is. Overall, I'm pretty happy I had the surgery and relatively well physically (all things considering). If I had to do it over again, I'd do get the surgery done while I was still in grad school (medical leave of absence over the summer or something). I think things would've worked much better for me if I had done that.
Thanks for your kind thoughts. I think I would consider surgery if things got out of control, but I've been in remission (which I'm defining as "I've not had blood/severe pain/ER trips") for going on three-plus years now. But I'm glad the surgery has worked for you.
ReplyDeleteDo you ever have any interactions with your doctor where they inquire after your mental health? I know the mind's stress and the gut seem to be linked, but my doc was suggesting I see somebody based on almost NO personal information given by me. Maybe there's some secret gastro/psychiatry society we don't know about... :)
While on steroids, yes that was a consideration because steroids are known to have psychotic (manic depressive and schizophrenic effects).
ReplyDeleteIn fact, I never should've been on steroids in the first place. Turns out I (who is adopted) have a family history (my biological mother) of mental illness (retardation/schizophrenia). And my parents knew this all along. In a hospital room--any family history on this patient? "No." They didn't bother to mention the schizophrenia, which they knew about from the beginning. We'll say we've had some interesting conversations in the past week as to why this was kept hidden from me--even when I was sick and desperately needed all information I could get.
After the surgery, I went to a psychologist for 4 sessions. It helped, the surgeon--while not insisting of it--was happy I did it.
i'm so happy to find your blog i may cry.
ReplyDeletei'm 2 weeks into a fiery UC relapse and am hating my own guts and all guts everywhere. i found your blog by googling for famous people with IBD -- thinking maybe if justin timberlake would announce trouble with his crapper that i would feel better.
RE: symptoms with no physical evidence... YES! last christmas, everything non-colonial (i really hate the word "colon") had turned to shit (pun intended), so then everything colonial also turned to shit. i also had a talk about THINGS w/ my gastro and was embarrassed to actually cry in her office. SHAME! later went in 10 lbs lighter, green-gilled, and hunched over for another colonoscopy which showed just a light, delicate, flowery little irritation. nothing at all really. what the hell?
poop sucks.
(i like to call my colonial Colin Powell.)
just read the previous comments about stress & guts. i've been off prednisone for 3 years, and stress is a MAJOR trigger for my UC. i know everyone has their own triggers, but prolonged distress is my biggest one (along w/ chocolate -- so unfair -- and corn chips). i read something somewhere sometime that explained what happens in your body during stress to explain the connection to guts, but i have forgotten. (although i do recall thinking it made sense at the time.) -- something about restricting blood vessels and also constant fight or flight status? increased cortisol? i don't remember.
ReplyDeletewhen i was in grad school i had episodes almost every semester during finals. (although, at the time, doctors were calling it IBS...and then later, chronic appendicitis.)
now, i've come to think of it as sort of a gift, really. (although not currently, because i am tired of crapping.) sometimes i don't FEEL emotionally distressed (if you're like me, you are much too skilled at suppressing extreme emotions, finding them overly "girly" and irrational), so my body tells me i am. there's a quote i keep taped to my computer "Stress is a signal that you've attached to something not true for you." my UC actually helped me quit a job that was making me miserable. when my intestines literally collapsed, i decided perhaps the paycheck wasn't really worth it.
can you relate to that?
Feel better soon! Flares suck so much, and they make me feel so damn helpless when they're happening, like I just have to lay back/acquiesce (or think of England!) and hope some bright young weekend-ER doctor doesn't try to make a surgery decision without my gastro's input. Heh.
ReplyDeleteI totally hear you on the crying thing. I don't think UCers or people with chronic disease are any more prone to tears, but in the first couple years of my diagnosis I think I cried more than I had over the previous ten. I think that comes back to the whole helpless aspect of having this disease, and the stress, and the difficulty in talking about it (for lots of reasons other than the fear someone will react with "ew, poop?" etc.)
Also - I've found that since being diagnosed, my ability to freak out has petered out almost completely. I used to stress/freak about random stupid stuff, but now I've got some weird psychological block against it that's made me the most mellow annoying chick around. :)
If you ever recall that info about the actual physiological connection between stress and the gut, let me know! And thanks for commenting - misery loves company so much she'll do a table dance for it. Or sing Justin Timberlake karaoke.
i've really enjoyed reading through your old posts, by the way. very much like your style. :)
ReplyDeletei still don't know where i read about the physiology of stress & its effects on digestion. thought maybe it was elaine gottschall's book (Breaking the Vicious Cycle), but just leafed through that & didn't see anything.
but here's a different article:
http://healthresources.caremark.com/topic/stressdigestion
if memory & layman's logic serve it comes down to 3 things:
1. cortisol (the "stress" hormone) is released during stress. elevated cortisol triggers diarrhea. (ever had a case of the runs when anxious about giving a speech?) prolonged periods of elevated cortisol needle with the immune system. i think the thing that triggered my recent relapse (besides that i stopped taking my meds a few months ago. ahem.) is that i started january with a nasty 2 weeks of flu virus followed by cold after cold after cold (my students are sick all the time, and i suck at remembering vitamins). lots of sickness = immune system in overdrive. and we UC'ers have abnormal immune systems anyway, so antibodies start attacking the wrong stuff.
in summary: cortisol.
(although, the irony there is that steroids like prednisone come from cortisol, don't they?)
(hmmm...i wonder if there have been any studies about post traumatic stress disorder and digestive disorder...)
2. blood vessels constrict during stress. usual discussed in reference to heart disease, but our guts are full of blood vessels. i think that's why some feel like controlled breathing from the diaphragm is good for people w/ messed up guts -- breath stimulates blood flow. ?? (i might be making that up.)
and 3.
3.... i don't remember. but the article i attached (per link) talks about the intestines as the "mini-brain" with lots of mood receptors.
and one thing that i did get from gottschall is that our digestive tract is very closely linked to our brains. so any messages passed around the nervous system are going to come in direct contact with Colin Powell.
it's fun to talk about poo. i think i feel better already. hopefully will continue -- have started to daydream about food and face fulls of colazal.
(sorry for the long ass comment.)
Since there are so many factors in a flare, like the effect of stress on intestinal behaviour (related to the parasympathetic nervous system as alluded to by previous comments), Docs tend to ask about how "Things" are going, meaning overall wellness and anything else. I often feel like an office visit is a sort of midterm exam where I have to recite all the factors contributing to my success (remission) or failure (symptoms). I've been doing this for about 15 years but I still don't know how to ace the test.
ReplyDeleteMy grandad used to say "An apple a day keeps the doctor away", so I added one apple to the regimine. It sorta works so I try to keep a good stock of apples around.