baratron: (wolfy)
[personal profile] baratron
Trundled off to the doctor's this morning - he was running a mere 20 minutes late, quite impressive for him. He is thoroughly horrified by my experience, and agrees that everyone concerned should have damn well known that I was "anxious" in advance. He said doctors should always tell the patient before doing something with a needle, because it makes it hurt less! It's not just me being unreasonable! He is also mystified by what appears to be a new idea that you can't give the patient anything to relax them prior to getting to the anaesthetic room, as it doesn't just help mentally, it also helps to get muscles relaxed.

Mostly, he was angry: that his patient that he'd spent a lot of time on getting sane & happy had had a horrible experience at the hands of so-called medical "professionals", and was all upset again, as well as still being ill. When I was leaving, he gave me a cuddle. Some people would call that unprofessional, but I call that comforting another human being in distress (he did ask first!). (I hate the fact that in teaching, you're not allowed to touch the kids even when they're very upset and clearly want a sign that you care.)

Current plans are as follows:
1) Try a gallstone-dissolving drug to see if it does anything. If I've got to wait anyway, I might as well try it. The worst it can do is nothing.
2) He will write to the consultant to find out what the wait will be and confirm whether I can get anything to calm me down prior to surgery.
3) If the gallstones don't dissolve themselves, look into just hoicking them out rather than the whole gall bladder. This is done under local anaesthetic, thus mitigating my worries. (The existing consultant refused point blank to do that, arguing that I'd only end up back there in 5 years with the same problem even when I explained I would happily stick to the low-fat diet).
4) If replies to 2) & 3) are non-helpful, get referred to a different hospital. He understands exactly why I don't want to go back to Kingston.

Meanwhile, I will be:
5) Talking to friendly anaesthetists of my acquaintance to find out what current NHS practice really is. [livejournal.com profile] bfo suggested her friend Mhairi, and Richard has a paintballing associate called Puffy. If anyone else has a pet anaesthetist, do let me know - even dental anaesthetists might be helpful.
6) Looking into costs of going privately. The New Victoria Hospital (the nearest private hospital) charges £4000 for laparoscopic cholesystectomy (sp?), but it's not itemised. I don't know whether, for instance, already having the results of two ultrasounds would reduce the work they'd need to do and thus the cost. I haven't looked at the cost of gallstone removal yet.
7) Sorting out a blood cholesterol test. I forgot to ask this time. Gallstones are basically caused by high cholesterol levels. But I'm vegan (thus eating very little cholesterol) and I eat tons of soya (which is supposed to reduce cholesterol levels). So it could be caused by the Efexor. Before the trauma of this, I was extremely sane - in theory, I probably could reduce my dose from 225mg down to 150mg without going nuts, if that would stop further gallstones forming.
8. Looking vaguely into medical hypnosis, although I'm almost as afraid of that as I am of general anaesthetic. (I am a control freak. What's new?)

My mental state has improved not least in part because I rang up the owner of a restaurant we used to go to all the time, and explained why we hadn't been in for so long. We went down there and he pointed out all the low-fat choices, and asked the kitchen to make some of my favourite foods without fat. I'd thought about trying this before, but just didn't have the energy to expend on explaining why I couldn't have fat - in retrospect, this was a bit daft - I would have gained emotional energy from being relaxed & pampered. Damn.

Cooking at home is all very well, but it's tiring, and Richard & I have always eaten out - even when we couldn't really afford it, we still ate out once or twice a week, and just made cutbacks in other areas. Eating out is pleasing on so many levels: eating good food, that you can't make at home, or can't be bothered to make at home; sitting together talking, or just in companionable silence for an hour and a half, rather than eating in 20 minutes with the plate on your lap; making time to physically go somewhere together. If we can start eating out again, even if it must be less often than before and involve fewer restaurants than before - that will make a helluva difference.

Richard had garlic bread, and I got plain bread - lovely organic wholemeal bread, that until recently I would have turned my nose up at. But I found I actually appreciate the texture of it now. (My tastes have changed a lot over the past few months - I find even the thought of potato crisps nauseating now, and can't imagine that I'll ever start eating them again. Still crave tortilla chips occasionally, but there must be a trick to making your own.) My main course was savoury pancake with four beans and potato filling. I always count the beans to make sure :) Actually, there were five types this time - kidney, cannellini, runner, butter and black-eye beans. Sometimes there are chickpeas as well, and then we have the whole question of whether chickpeas are a bean (Americans call them garbanzo beans), and should they be included in the count? Richard had nut roast with creamy wild mushroom sauce, roast potatoes and saute vegetables - something that we haven't been able to have at home for months. For pudding, I had fruit sorbet - lemon, mango and blackcurrant, while Richard had a double espresso. All in all, we came home thoroughly relaxed - well, until I had a flashback to the anaesthetic room :/

I have, btw, lost another 4kg of mass since two weeks ago. I'm just mentioning this. Still don't want congratulating, but it's impressive how an ultra-low fat diet plus lots of stress can make you lose "weight" ;) Whether the low-fat diet without the stress would do the same thing, I'm not sure, but it's probably worth trying. When I have copious free time (read: enough mental/emotional energy), I'm going to type up all my recipes and put them on my web site for other people to enjoy. If you can make fantastic chocolate brownies that are totally fat-free, why bother with the unhealthy kind?

Date: 2005-10-29 07:27 am (UTC)
From: [identity profile] esbat.livejournal.com
High cholesterol is a _risk factor_ but it isn't the _cause_ per se of gall stones or biliary colic. So, a subset of people with high cholesterol get gall stones and a subset of those get biliary colic. Lots of people with high cholesterol don't get gallstones and lots of people with gallstones are asymptomatic. The best theory at the moment, and it is just a theory but with a reasonable amount of supporting evidence, is that biliary colic and cholecystitis are the result of a gall bladder motility disorder of as yet unknown etiology. This is the reason why the surgeon was reluctant to remove the stones. The evidence from various trials is that the symptoms recur within a few years regardless of diet/lifestyle, etc. So where controlling risk factors can reduce the chances of someone developing symptomatic gall bladder problems in the first place, once they have developed you seemingly can't undo the problem by treating the risk factors. Basically the gall bladder becomes unable to empty properly and stones keep forming.

Sounds like you have a great GP though. Such creatures are a rare delight. I'll see if I can find an anaesthetist and ask about pre-med procedures.

Date: 2005-10-29 11:41 pm (UTC)
From: [identity profile] baratron.livejournal.com
Ah! Y'know, someone could have explained that before - it makes a damn sight more sense than "your gall bladder is diseased", which I just plain didn't believe. Mind you, I suppose most people wouldn't understand what "a gall bladder motility disorder" was without looking it up :/

One of the reasons my GP is good is that I have successfully trained him to appreciate that I can understand reasonably complicated scientific/medical jargon :) Also, he shows me the MIMS book before prescribing anything, so I can check for myself whether there are any obvious clashes with other medication.

It strikes me a lot of my problems with the medical profession come from what I might call "opaque doctoring" - the idea that only the doctor is allowed to know what's really going on, and the patient must be presented only with a black box. "I know best because I'm the doctor". I cannot deal with people who treat me like that at all. The medical professionals I've got on with (nurses, doctors, psychologists and physiotherapists - physios in particular are brilliant) have all done the opposite, "transparent doctoring", where they've explained to me why a procedure is necessary in full, with the detail at an appropriate level of science for my existing knowledge, and without being patronising. Perhaps food for thought for your student medics, if you feel like writing any more ranty letters? :D

Date: 2005-10-30 10:34 pm (UTC)
barakta: (Default)
From: [personal profile] barakta
MIMses are goood. You can buy them on ebay for about 3-7 quid. I got a July 2005 one in August this year. Very useful for looking things up and checking dosages since I'm not always given helpful information and half the meds I have don't actually work.

I agree with you about some of the problems with the medical profession. I'm lucky that half of my conditions are so obscure that people ask me for the best sources of basic information about them. I've never had anyone medical tell me that my conditions don't exist, although there's a permanent state of debate about what I should be labelled as :)

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