Doctors visits, tests and medication.

Increase in doctors visits.

This was something neither my husband or I gave any thought to before retirement. We have been relatively free of any serious illness throughout out life. Of course we are not immune so we have had the normal everyday occurrences of colds and viruses and short hospital stays etc.

Then we hit 60 and I think the body must have a trigger that comes alive around this time. As it happened we had a regular doctor at the time who was and still is quite thorough and diligent. I have always believed if you have an engaging active doctor it is best to stay with them if possible. A history is then gathered and changes are more noticeable for follow up. Of course it goes without saying one should always question any procedure or medication that is suggested. I feel we are lucky to have a doctor who does let us question and then thoroughly explains everything to us. She also does not prescribe medication unnecessarily or without follow up. I do remember having discussions over the years with ageing relatives about why they were taking a certain medication. The answer I received several times was I don’t remember, I must ask the doctor next time I am there. In my experience elderly people dont like to take up the doctors time, so they minimise the need to be there or they forget to ask questions. If you are reading this and have an elderly person you care for maybe they would let you go in with them as a support. I often wonder how many people are getting the correct care as they get older. We do heavily rely on what our doctors say. Furthermore we have less control of our faculties and therefore while have full control we need to find a doctor we can heavily depend upon for the future. Alternatively we need to ask for help.

Ken and I together have experienced the usual blood tests along with the occasional radiography scan, Colonoscopy, Gastroscopy or Endoscopy and so on. I am certainly not going to explain these procedures with my lack of medical expertise. I will also refrain from going into the gory details. I imagine there are not many people really wanting to know the nuts and bolts of my complaints.

What I would like to explain is a test I have just had which I believe could be quite daunting for some elderly people especially without prior knowledge. Please note here there is no pain involved with this procedure and it is completely safe.

I had a little scare recently experiencing heart palpitations and tightening chest. Ended up in the local emergency room for a few hours having tests. I was discharged with a suggestion that it was a reflux condition not a heart problem. I followed up with my doctor who wanted more tests done to confirm. After several tests and a visit to the cardiac specialist I was asked to have a Cardiac MRI.  

Typical MRI Machine.

I had previously had an MRI for bursitis in my shoulder so I was prepared for it or so I thought. I was referred to St Vincents hospital in Darlinghurst which is a bit of a travel experience on its own. I drove in with the assumption there would be a car park attached. This is the case however it was full so try finding a car space near the centre of Oxford street in the middle of the working week, in a pandemic was a bit challenging. Around and around the tiny, often one way side streets saw me heading quickly into a panic. Finally I came across a private medical centre car park which seemed accessible. I drove in parked and headed for the exit. I did not really know where I was but as it turned out luck was with me as I was just a little way up the street from my destination.

So it’s a pandemic and I have to sign in, but of course there system is slightly different to the norm. My QR code was not recognised. Wait in line, sign the book and then fill out a 2 page questionnaire. Finally I am allowed to proceed to the department. Now to go through the admin procedure of forms to complete, cards and referrals to present, payment to be made. Nurse takes you to another room, takes your temperature, blood pressure etc. She asks you about your medical history and why are you there. Asks you to clarify what test you are having and then more questions. MRI stands for Magnetic Resonance Imaging so naturally there are magnets at work here. Do you have any metal in your body? Maybe, I have a replacement knee but not sure if it is metal or plastic. I have dentures and not really sure if the holdings are metal. Are you claustrophobic? well not that I know of but I have not spent much time in small restricted areas, I guess not? Are you on any medications, thankfully one only. Hate to think if I had a multitude of pills to remember.

It is time to put on the dreaded gown and follow the nurse to a room where she tells you what is going to happen. We will lay you on this bed, strap your body down, put some padded bolsters around your body to hold you firmly. A devise is placed on your chest to be used to send radio wave signals where needed. In my case an intravenous line was inserted in my vein to allow a later injection of contrast material required to help with imaging. The last attachment was headphones. These are to dull the apparently irritating loud drilling sound the machine makes and also allows the technician to instruct you.I was given a push button to call if I needed to. The very pleasant nurse then explained I would slowly slide into the tunnel of the machine, I would hear someone speak through the earphones instructing when to hold my breath and when to breath. You are then told it is important to remain completely still. Please relax and it will only take about 40 minutes and I am just outside the door if you need me. Final step was to inject the die and we are ready to go. Every aspect was explained and every precaution taken considering the magnetisation capabilities of the machine. The nurse was very pleasant so there was no fear in going ahead.

I am good at breathing slowly and relaxing when having needles or tests so I took a deep breath, exhaled and closed my eyes. The first sensation I felt was the sides of the tunnel on my body, definitely smaller than I thought. Once I was in place I opened my eyes and was a little shocked to find the roof of the cylinder looming very close to my face. This I did not expect as previous MRI tunnel was a lot bigger. My arms which were by my side touched each side of the tunnel. The next surprising part was the breathing. it was explained a voice would be heard instructing me to breath in, breath out and then hold breath for about 10 seconds.That’s fine, no big deal I can do that. A very pleasant voice was heard through the head phones telling me when to start and stop. Then the drilling noise started, quite loud, quite scary at first. All good I was expecting it. What everyone omitted to say was that the breathing ritual would happen about 60 or more ( I lost count) times during the 40 minutes you are in the tube. There is no pain or discomfort. I was not scared at all but  continuously worried that I was not doing it correctly so each time it happened my concentration would increase and I tried harder to breath at exactly the right time etc. until I became exhausted. I had this unrealistic fear that at the end the voice would tell me I had to start all over again because I had not been doing it correctly. Finally, when I was beginning to doubt my capabilities I heard the assistants lovely voice saying all done we will bring you out now. 

It was such a relief to slide out and feel space around me once again. The nurse took of all the apparel off and kindly said you can sit up slowly and stand when you are ready.  I could not actually lift myself to a sitting position Either I was too tired or too relaxed from all that breathing and my body felt so heavy I had to ask for her help.Once up and moving I quickly returned to normal. The nurse had asked me prior to starting if had I had an MRI previously and I said yes. That was the wrong answer as it was a totally different experience to the previous one.

Reflection

Looking back on it now, It was interesting and slightly amusing adventure. A test one should not be frightened of but one that could be explained in a little more detail for someone who is even a just little anxious. I have inserted a link here to a youtube video which explains the procedure. https://www.youtube.com/watch?v=g-jj4KrmYPI

My results were excellent with no need for further investigation. Come back in 4 years. Sounds good to me.

Health and its many issues

Mental Illness in this Millennium – a layman trying to work it out.

It was an ordinary morning in June 2021 that I woke remembering a snippet of a dream.A group of young adults sitting around having a discussion. One young lady placing her hand over her chest expressed with sadness that she was in pain and believed she must be suffering depression. Having been in close contact with several people who suffered from depression I jumped in questioning why she felt this.  When I awoke that’s all I remember about the dream but it started a thought process which I had touched on many times over the past 20 odd years.

How does one who has not experienced mental health issues possibly understand what mental illness is? The umbrella of mental illness is very large. It encompasses such a complex range of behaviours. There is a lot of information and misinformation available. There are doctors, psychologist, psychiatrist, councillors, educators all with tools to help but not always helpful. There are books, papers, lectures and blogs which can be helpful but can also be harmful.    

Mental illness has been highlighted in recent years with the hope of bringing awareness and acceptance for those who are suffering. A much needed fight to remove the stigma around being mentally ill. The assumption  that someone with mental illness should be locked away. The thoughts that mental illness rendered people as NOT normal, strange, shameful or scary is something to be obliterated completely. 

Awareness and education is a great thing  and should always be encouraged. The need for money to be allocated for intensive research should be supported. The need to bring back institutions to help those in dangerous or destructive or self abusive situations is absolutely essential.Mental illness is too often silent and must be given a voice.

Having said this I believe awareness has a downside. It can bring false assumptions,  self diagnosis, self medication. Awareness can give people information to abuse and to misuse. It can offer people a false sense of entitlement. In the hands of the inexperienced  it can result in the wrong diagnosis and consequently  the wrong and in fact detrimental treatment.

The dream I mentioned earlier is the catalyst for this following statement, “What I have observed more and more is a behaviour which concerns me. It is the harmful reaction of normalising the illness to the point of minimisation of the illness”

Real mental illness should never be considered as normal. Accepted, yes but not ignored or passed off as a phase. Untreated it is destructive, debilitating, and painful, it silently eats away and constantly manifests itself. It can destroy both the person who is suffering and the family and friends it encounters.  It not only effects behaviour but can also result in many complicated  medical conditions.

Mental illness cannot easily  be identified by a set of  definitive criteria. As I said previously the field is enormous and the unknown is huge.

I continue to write without any formal degrees. I do not claim any expertise in the area of mental illness. I have no training in this area.  These are my thoughts only based on my experience with mental illness. My personal experience was not of my own mental illness but of family members and what I heard and felt over a 25 year span.My experience probably differs from others so what worked or did not work for me and my loved ones may have the reverse effect on other situations. Therefore I will not be presumptuous and give advice to anyone else during these blogs. What I and others should do is to encourage everyone to seek professional help at all times.  And at first you do not get answers please try again, there is someone who will be the person for you.

What I believe we can do as ordinary untrained people is discuss mental illness as you would cancer, heart conditions, dementia or alzheimers, cancer, or any other medical condition. Think about someone you know who has suffered a heart attack. If you do not have a heart condition you would not pretend to know what they are going through. You would possibly ask questions, what happened and then let them give you detailed  description. You would listen without judgement or input, you would express concern and tell them to call if there is something you can do. We certainly do not minimise, heart attacks, we encourage people to seek the opinion of a doctor, to follow up on any signs or warnings. We tell them it is serious and not to dismiss it.  We offer to make appointments for them, to drive them, we offer our help. Basically we confirm to them they are worthy of help.Do we react the same if someone indicates they have BiPolar, Depression, Anxiety, or any of the many other conditions referred to as mental illness. Most likely we do not. We often retreat in fear. People who suffer from Mental Illness are very worthy of our help and their illness is certainly worth your time.

Another thing I believe we should try to do is to maximise our understanding of ourselves and what our feelings and what our behaviours are telling us. Read the basics and ask questions of those who know and have experience with mental illness.We should not make assumptions and we should be careful in our choice of words to describe how we are feeling.

A good example of understanding the basics that comes to mind is the term depression as opposed to feeling depressed. We all have those times when we don’t feel like talking or going to work. We  feel out of sorts or off beat, unable to verbalise our problem. We cannot be bothered and we may feel that we are depressed. The end result is we often experience tears, anger or avoidance.  Usually a change in routine, a good nights sleep, a holiday or simply a chat with a friend etc will pick us up and we are able to move on. If we took the time to think about what we are feeling at these times we would probably realise something triggered our thoughts. Maybe we were grieving, overtired, overwhelmed, scared or angry.  Once we understand what we feel we can  justify it, and therefore can react accordingly. We are feeling sad, we need to cry, we feel life is boring or annoying, we feel depressed.

When someone is suffering depression or chronic depression it is not the same thing. There is often not an immediate feeling. It is something that is just there. They are not necessarily in a bad situation or feeling sad, etc etc etc. It is not something that is easily explained. As described to me they are not there at that time, they are not able to self talk, motivate, explain or describe. They are surrounded by a black cloud. Nothing exists. I experienced this once for a mere day. I did not realise what I was experiencing at the time and still cannot explain the time it happened. After the time passed I certainly identified with what had been previously described to me and it shocked me to have completely lost control of myself at that time. From then I understood in a miniscule way the debilitation that comes with true depression.  To live like that for any length of time, days, weeks or months is unfathomable to the average person. For someone who goes in and out of depression for years on end it becomes normal and therefore minimised both by themselves and by those surrounding it. It is not a passing phase and can be undone by going shopping as some would say. It needs professional help by way of medications and psychological assistance. A few other examples to consider.

  • Feeling depressed vs. Depression or chronic Depression
  • Feeling anxious vs. Anxiety or Chronic Anxiety
  • Feeling indestructible or being a risk taker vs. having Bipolar
  • Dieting vs. Eating Disorder
  • Feeling sad and frightened vs. PTSD Post traumatic Stress Disorder
  • Being clean and tidy or fastidious vs. having OCD

I value others opinions and experiences so ask you to comment below if you wish.