Thursday, 16 October 2008

Mambo Italiano

Further to the last post:

1st half performance in Minsk: England are malfunctioning in midfield again, the ball is passed around with some aplomb at the back and then hoofed forward at Heskey, circumnavigating midfield, in the hope that he can hold it up for Rooney to produce the preferred outcome. Meantime Walcot tears up and down the right channel with pace, but is messy in his final delivery. A brief lead is undone by more fragility in the middle as Belarus slip the ball neatly through.

Wednesday morning: following, by now, a near 48 hour gap between toilet visits, all early hubris is undone at 9am. During a, thankfully, free period I have to undertake that hilariously familar run to the toilet - hilarious because I can only imagine what it must look like to the casual observer as I run and desperately clench my buttcheeks at the same time. What better place to indulge in this weird stiff legged run than in a school, where nobody is on the lookout for reasons to undermine you... Upon reaching said toilet something approaching a heinous McDonalds thick shake is delivered in the nick of time.

2nd half in Minsk: a little Italian jiggery-pokery at half-time sees Gerrard push forward in midfield and suddenly Belarus are on the back foot. England still regularly lose possesion, but there's menace in their attacks - even Heskey is taking on and running at defenders. Rooneys game suddenly comes alive, slick passing ensues, then goals. The last 15 minutes are a cakewalk.

Thursday morning: the toilet beckons at about 10.45. But there is no urgency or cramps. Rather that, I hesitate to say this but, 'pleasant' full colon feeling that tends to preceed a proper log. What arrives is probably best described as initially log-like and then stodgy. A hugely improved outcome.

Like I said, inconsistency. Weird.

Maybe, as I sleep, Fabio comes and talks to my bottom.

Tuesday, 14 October 2008

A New England


I know how Fabio Capello feels.


A few weeks ago he was watching his England team perform at first caustiously, then with growing confidence and finally exactly how he wanted them - with a more than satisfying outcome (Croatia 1 - England 4). He must have been extremely pleased (if not completely, 100% convinced it was going to last). And so was everybody else. So, imagine his dispair when they delivered an utterly demoralising performance when faced at home with the mighty Kazakhstan: unsteady at the back; malfunctioning in midfield; and with a forward line that did not inspire confidence and did not produce anything solid... OK, they won 5 - 1, but the point is they are unable to produce any kind of consistency even from one game to the next. How can he ever rely on them? How can he ever relax to the degree that he can stop thinking about the likelyhood that their next performance may be another that pains and potentially embarasses him?


Now consider my stupid bowels. A few weeks ago they were working in perfect harmony: no dodgy pains or twinges/flutters creating nervous apprehension; good, slow digestion in the middle, and a pleasing solid outcome at the end... All was good. I even started to experiment (non-alcoholic beer, curries, olives: the gastro equivelent of the christmas tree formation) - all was functioning satisfactorily. Then... all of a sudden, no explanation forthcoming, things go wrong in mid-colon and everything gets sloppy (ok, forgive that turn of phrase, I'm trying to maintain an analogy here). So now I'm under the pressure of an underperforming colon and despite all my best efforts (tactical use of preds, substitute bland food, not eating etc etc) I cannot engineer a change. Until...


Today, I had to go a school fieldtrip. I won't bore you with the details, but it essentially meant a day miles away from a loo. So, I went to school early, hoping the current urgent morning poo would arrive whilst still on school grounds. Nothing. I reluctantly boarded the bus, fearing the worst. Nothing. I eagerly alighted at the one short stop of the day (I was even prepared to use the public loo!). Nothing. I am sat here at home at 8.30 in the evening. Nothing. That means I have been something like 36 hours - no pain, no urgency, no... nothing.


So, just like Fabio, I sit here contemplating the inconsistency. Why is it there? What can we do? Why can't Gerrard/my bowels and Lampard/my immune system work in better harmony and produce a nice solid end-product? And where does Theo Walcott fit into a weak international-football-as-ulcerative-colitis metaphor?

Wednesday, 8 October 2008

Walk on the wild side

"Whisper it: I've only gone and done a number 4"





Such was the start of a post I almost put up yesterday. Then I thought better of it. Too late - merely thinking it was enough. I am still wavering around the upper 5/6 area of the Bristol Chart. I haven't decided whether to change my pred dose or not yet - its a case of ensuring I've got enough to last until the next hospital appt on the 4th November. I have been having sustained thoughts of embarking on the azathioprine... but it really depends on the mood I'm in when that hospital appointment comes around.





And so to other matters. Until the recent mini-flare-up, I had begun to appreciate the restorative powers of (the once anathema) non-alcoholic beer. Yep. Thats what I said: NON-alcoholic beer. Far be it from me or my blog to become a vessel for capitalist advertising, but this is the stuff I'd been drinking:

In the formative years of my drinking life the main contributors to the world of alcohol free beer were Kalibur and Barbican... hoho, remember those: "Bar-be-can... alcohol free beer...??!" Cue californian prohibition era policemen with the feeling of redundancy dawning on their faces as in the background others smash up a speakeasy... ah, I used to love that advert. However, when it came to drinking the stuff i) never in a million drunken years would you be seen dead with one of those clutched in your lifeless hand, and ii) everybody I ever knew, including me, claimed they tasted disgusting "euuugh nuffink like 'real' beer". Even the efforts of Sean (I am an adult, honest) Bean couldn't get us to drink em.

However, needs must when the Devil lives in your bottom. And so, with weary reluctance I dutifully tried a gulp when offered by a pregnant aquaintance recently. And, blow me, if it wasn't pretty bloody good. Now I have to temper this sudden embracing of contemporary alcohol free beer with the footnote that I haven't touched a drop (your honour) for 42 months... which may mean my beer tasting buds have gone wonky, but really the stuff tasted wonderful. Just like the real thing! Lordy, a glimmer of hope! Upon closer inspection it seems that the brewers achieve that authentic beery taste by brewing it first AND THEN removing the alcohol. Marvellous.

Two points to note, however:

1) After 3 bottles, I had to try to ignore the hollow feeling that was starting to grow... Maybe one or two is enough.

2) I woke up with a bloody hangover! Can anyboy explain...?

Tuesday, 30 September 2008

Bone machine

Aha. Messrs Brown and Cameron must have read yesterday post...

Visited the GP this morn to get more drugs. I should have reduced my pred dose to 5mgs a day by now (and therefore have some left) but all is not well in the world of the bowel. Not awful (I have yet to completely refuse to fart), but not good, not right, and most importantly not solid. So, I waited for an appt with my usual GP to avoid the complex issue of persuading a less familiar doc that I am capable of deciding for myself when I need more steroids, rather than speaking to a consultant first. Fortunately the doc agreed and gave me a prescription for enough preds to last until the beginning of Nov, when I have another appt with the rheumotologist, at the current 5/10mg dose. Although after the most recent visit to the bathroom I may just have to up that to 10 mg a day. Mmmm, I'll give it a few more days.

What was new, though, was an extra concoction of drugs. My GP was concerned that I had been on the preds for a while (about 4 months, though pretty low doses), citing worry about weakening my bones, particularly as he seemed pretty intent that I was a 'fit young chap'. Does 35 still count as 'young'? So to counter this he has also prescribed me Fosamax and Adcal-D3. The adcal stuff is just a vit D supplement, so no great fears there, but the Fosamax is some sort of bone strengthening stuff (some sorta acid, I forget exactly what now), and so I read the possible side effects and 'when not to take this medicine' stuff as usual. This included instruction not to take if you have/are suffering from stomach problems including ulcers. Ulcers. Ulcers. Ul-cer-a-tive colitis... Bum. Both the doc and the chemist assured me that this was strictly related to the upper digestive system - the doc looked it up on the computer and the chemist looked it up in her little black book. But the seed is sowed...

Anyway, they didn't have in the chemist, so I 've ordered it. Excellent news, as this means I can delay any decision for at least, ooooo, a day.

Interestingly, it also instructs you to take it 30 mins before breakfast and stand upright for that period of time. But only once a week.

Monday, 29 September 2008

Don't believe the hype

At the Tory party conference today the Tory health spokesman Mr Andrew Landsley announced plans to create the option for anybody going in to hospital for planned care to have a single room.


Haha.

I would also like:

  • to see the same consultant every time I go to gastroenterology
  • to wait less than 4 months for my 'rushed through' appointment to discuss azathioprine (still waiting...)
  • to have access to drugs and therapies that are not yet even being considered by NICE
  • not to be told by a consultant that he can't help me unless I do exactly as he says even when I have serious reservations
  • to be able to get a prescrition from the hospital rather than having to make appointments with my GP that are a minimum of 2 weeks away
  • to not have to experience the farce that is sitting in front of my consultant while he dictates a letter to my work, which he then emails to SOUTH AFRICA to be typed up and posted back to the UK...
  • to get a blood test without having to wait for over an hour clutching a Tesco-deli ticket
  • to have an appointment for an x-ray/scan that does not involve a wait of hours
  • better pay and conditions for my wife - a nurse (yes, we are the classic key worker family)
  • and so on and so on and so on ad infinitum.

And while he's at it he can bloody well go and find a cure for UC. I am not a Conservative voter. But I am not happy with my experience of the NHS as a sufferer of chronic illness.

The NHS, in my opinion, is much like the current economic situation - a hugely important issue used as a political football. Instead of cheap, and indeed faintly ludicrous, point-scoring opportunities isn't it about time political parties worked together to reach a solution instead of vacuous polemic and rhetoric?

It's not staying on a ward with other people that bothers me, it's the inexorable demise of our health system.

Friday, 26 September 2008

You've been gone too long

Nope. I have not been sucked into a black hole. As far as I can see the world has not changed since they turned it on. So, where the heck have I been? Um, good question. I think the only answer is: I went back to work. And to balance out the effort of working I have become intellectually lazy in all other elements of life. But, now I'm rousing myself and getting back on it. A brief resume of the first 4 weeks back at school:

  1. The first two weeks back: no toilets. Not ideal for a man in my condition. Actually I exaggerate here, because it was the student toilets, not staff, and it wasn't all, but about 75%. However this still begs two questions: i) surely, if you are going to refurbish the toilets in a school of 1700 students over the summer holiday, you do it before they end? ii) is there not some law about the minimum number of toilets available - some sort of child-to-toilet ratio - that forces the institution to remain closed? I tried that second one in order to secure another week or 2 off, but to no avail (I know, I know...). I shoulda got out my NACC card.
  2. Incidently, I have worked at this school for 7 years and this is the second time the students have had a complete toilet overhaul. The first time they even got to vote on the colour (citizenzhip at work...). This second hold-up was due to the 'vanity units' beng unsuitable. Now call me a cynical old bugger if you like, but never have they refurbished the staff loo. And there are only 3 male cubicles in the whole school - a lenghty building, at least 300m from end to end. And the one nearest me is, frankly, disgusting. Someone should be ashamed.
  3. Crappy timetable. No free periods on a monday or a friday - surely the days when one needs to be cut a little slack?
  4. Good results for my last GCSE group. I cannot take much credit - they were a great group of kids. Sadly this already means somebody is setting targets for next year based on exceeding this year - because year-on-year the government/management/public can only perceive that results must get better (as measured by grade totals). Cos there's nothing invariable about 330 new children each year, is there?
  5. New GCSE group contains the most arrogant girl in the world. Cheeky kids I can take. Lairy kids I can take. Mouthy, sweary, downright bad kids I can take. But, arrogant kids I just want to slap.
  6. A strange cyclical UC situation. I have noticed this happening before. But not while I was on the meds. I am still taking 5/10 mgs of preds alternately, which has continued to keep evertything relatively stable. But I am definately going through a sort of poo-consistancy cycle. It goes something like this: On holiday things got loose (I put it down to the tomatoes) then it all got a bit stuck (change in water thinks I), then we got home and things loosened up again (change back to the normal water, plus pre-school mild apprehension?), then it firms up again, so much so I even started to carelessly risk olives (!) spicey food (!) blue cheese (crazy fool!) and so on, but it only got more stuck (even... brown bread!!), and now its got loose again (doh!). I have not had to go to the loo more than twice a day, during loose periods, too often, so its not been horrendous, but it has lead to more of the old mental scouring of everything I have/have not eaten/drunk. And several occasions of crouching and staring intently into the bowl trying to identify morsels...
  7. So, I 've made an appointment at the GP's for next tuesday to get more preds, cos I don't want to stop taking them just yet and I'm running out. And I've just found a bloods envelope (that I hid from myself) that reminds me I'm supposed to get a test while I'm on the 5/10 split.
  8. I'm back on those blinkin' yogurts...
  9. Everything has been put into perspective by the birth of my best friends baby boy. Fab.

Tuesday, 9 September 2008

Bang, Bang You're Dead.


Currently in our household the Large Hadron Collider is causing much consternation. I have to admit I, myself, have been rather capitivated by this mind-boggling machine. Its job (as I, an utter physics dullard - I have qualifications here: A-level physics, failed twice - understand it) is to collide protons under controlled conditions at speeds just below the speed of light in order to create explosions of energy/matter that closely resemble the circumstances of the fledgling universe right after the 'big bang' (for a better explanation try the BBC). The purpose of this is to seek out the existence of a mystery particle, called the Higgs Boson I think, which will itself help tie togther the principles of Einsteins theory of general relativity and the standard model of quantum physics. Thus bringing harmony to the world of science and proof that the 'big bang' theory is right. I practiced this mini explanation of the (clearly far more complex) experiment on my wife before going to school this week, in preperation for the inevitable questions from the kids. I definately held her attention for at least 50% of it before she glazed over - as she does with all my favorite topics of discussion: geography, football, cricket, the poor state of party politics in this country... etc. I therefore considered this to be a triumph of scientific summary. So what of the consternation...?


Well, my eldest son has also developed an interest in the LHC. However, his attention was caught not by the science but the kind of media driven, gossipy hyperbole that school-kids love so much: "Dad, tomorrow they're gonna switch on a machine that will make a black-hole that will destroy the whole solar system..."! Firstly, I'd love to see his image of the 'they' who he thinks are going to switch on this machine... davros? blofelt? darth vader? Next, I wonder when he will develop that logical thought progression which will enable him to see the futility of anyone willingly creating a blackhole to destroy the whole solar system..."Yes, at the flick of this switch the planet and all her inhabitants will be in my control; that power would set me up above the gods..." SWITCH, BLACKHOLE, DISAPPEAR... "Doh". So having put him straight (Professor Brian Cox assures me that the chances of black hole creation are slim to zero, and anyway they would be contained by the magnetic field. And I believe him, so there), with my specially designed 'brief explanation of the machine' (TM), I sat back with a feeling of Dad-work done well. We then followed that understanding with some light-hearted riffing on the consequences of a black hole. All the while my younger son is listening in and, unbeknownst to me, latching on only to words such as SWITCH ON MACHINE... BLACKHOLE... SUCK IN THE WHOLE PLANET... DOOM... DEATH... MORE DOOM... TOMORROW TOMORROW TOMORROW... Cue one fraught son and at least 2 hours of constant reassurance. If Prof Cox is wrong, I'm gonna look a bloody idiot tomorrow.


All of which left me with one thought. If they can build a machine that replicates the origins of the universe in miniature, under controlled conditions, why the buggery can't one of these damn scientists come up with either i) a proper explanation why my bowels don't work properly, or ii) a better way of controlling IBD than intermitantly effective drugs and eventual surgery?


Bastards.

Monday, 1 September 2008

Hooray Hooray, its a holi-holiday


I've finally dragged myself out of my post holiday blues/torpor (with a twist of pre-school bumming-out) into some blogging activity. The holiday was great and did me the power of good - a fabulous mix of relaxation and adventure, with barely a thought of UC.
A brief summary then. Drove to Dover and got ferry to Calais. From there popped up into Belgium to visit some WW1 cemetaries around Ypres (an odd but poignant start to the holiday). This brief stop-over was somewhat lengthened by: a) the Belgians slightly haphazard approach to road signage; and b) the utter failure of my fellow drivers satnav to work in Belgium (I myself as a self-respecting geography teacher bloody-mindedly refuse to have a satnav in my car - its maps or nothing!) (apropos of that: I am also the worlds worst travelled geography teacher, hence this being something of an adventure)(but I do have good knowledge and a keen sense of direction. Promise.). Eventually, with a large slice of luck, we stumbled onto the road we were after and we were OFF! Drove on through Luxembourg (most of which was obscured by the most insanely heavy rain I have ever experienced in my life - I had to glue my self to the back of a lorry in order to stay on the road), back into France (long, empty toll roads), through Strasbourg, across the Rhine and south along the edge of the Black Forest to a little place called Sulzburg. Here we camped, although arrived with moments to spare before they shut the campsite. Early rise and onward south into Switzerland. Switzerland is the most fantastically beautiful country... with some hilariously serious people. Although I could have happily stayed in the swiss alps forever, we stopped only for a few hours and a fondue (mmmmm) in a place called Andermat. From here we drove over the Alps on the windy St Gottard pass, stopping to stare goggle-eyed into a huge glacial valley leading down into Italy. Then on past Lakes Lugano and Como and into Italy. Here the land flattened out onto the N. Italian plain, which was just that: plain. Around Milan and down to Parma, where we camped again. Up and out early again next morning and south-east past Modena (home of balsamic vinegar...mmmm) and Bologna (home of... ok we all know that) and then south down to Florence - from Bologna south Italy is beautiful. In Florence we spent a few hours wandering, experiencing a flavour of this lovely renaissence city. Then off again into the mountains to Florence's east and another campsite. Next morning we visited a monastry where apparently St Francis experienced the stigmata. Which was nice. Then on for the final leg south, past Perugia, finally stopping in a little farmhouse (on an organic honey farm) situated high on the slopes of the Tiber valley, under a little town called Giove, about an hour north of Rome.
Due to the nature of the trip down we felt under no pressure to do loads of sightseeing - just lots of relaxing around the pool (see pic above). We did get the train down to Rome one day, which was amazing (and stunningly cheap - less than 10euros per adult) and wandered into Giove regularly, frequenting all the superb local food shops.
A week later we came home. A different way. And slightly quicker. First we hammered up to Florence and then across toward Pisa and the coast. Here we encountered only the second traffic jam of the whole trip. Then I took a slight wrong turn so our car detoured through the city of Genoa (looked nice), and then up, up, up through the Val d'Aosta until we reached Mt Blanc. Awesome. Through the tunnel (expensive and dull) and then into Chamonix Mt Blanc, where we camped again - right on the foot of Mt Blanc herself. Hilariously somewhere between Genoa and Chamonix the bottom fell off the car and I dragged it along, haha. So that precipitated a visit to a french garage, where the mechanic was superb. Camping under Mt Blanc was spell-binding. It would appear I have developed a deep love for staring at mountains... After a morning of taboggining down the summer run on the mountain we hit the road again and slowly wound our way through the foothills of the alps and past Geneva and eventually back onto the french toll roads. Thus we sped up into the Champagne region and camped in Epernay. From here a short hop accross to Calais, ferry and home to cloudy Brighton.
So, what of the UC? Apart from a little hiccup (overindulging on tomatoes methinks) pretty much nothing. Which, sadly, hasn't been the case since I got home...

Tuesday, 12 August 2008

Holiday Fortnight

Well, I chickened out of lowering my prednisolone dose. I was supposed to move to 10/5mg on alternating days around about last monday (5th), but due to a combination of mentalness and (possibly psychosomatic) physical symptoms I didn't. I know, I'm an idiot. However, I did have my reasons. Firstly, whether they came about because I was stressing or not, there were some definate rumblings in the old bowel. No real pain, an increase in mucus (it is the existence of mucus, and the consistent describing of it, that I have always felt least comfortable with during this illness - describing the consistency of my poo? No problem. Describing how often I have to go? No problem. Describing amounts of blood? No problem. Describing the frequency of accidents and actually having to admit to having been practically incontinent at one point? No problem. Describing the amount, frequency and consistency of mucus in my poo? No, I'm sorry, but that just seems wrong, wrong, wrong. In fact, to be honest, I find it rather uncomfortable just admiting to myself its there. Go figure.), no blood to speak of, but some distincly runny-er poo and... you know that feeling... So it became another few days of crouching over the loo (post movement) and scrutinising its contents. This, I'm afraid, does not lead one into the required mindset for a change in dose. On the contrary, it rather makes one cling desperately to those little white pills all the more. Damn them.

As well as all this mental and physical anquish (actually I've been pretty good mentally. I told the wife straight away how I was feeling, made the decision not to change dose pretty quickly and have stayed pretty cool. Its just the old quiet nagging voice in the back of my head...) there is a second reason. We are about to go on holiday. To Italy. By car. Now driving to Italy (over 3 days I hasten to add) probably has its challenges at the best of times. But driving to Italy with the perpetual fear of where the next toilet might be is too much for me to cope with. Especially with 2 kids in the back. So, for the sake of as enjoyable a holiday as possible I opted to stay on the steroids for a little bit longer. I'll have to change the dose when I get back because I've only got enough tablets for about another month anyway and my GP is never all that keen to give me any more without speaking to the hospital (who, incidentally, I STILL have not heard from, despite them telling me in May that they were 'pushing through' an appt to dicuss azathioprine). I just hope that the driving antics of our european neighbours and my 'roid-rage' do not prove to be too volatile a mix.

I intend to try and post whilst away if I find anywhere (internet cafe etc).

Monday, 4 August 2008

Shake, Rattle and Roll


A long time ago in a place far, far away a man said to me:


"If you vote Conservative in your twenties you've got no conscience. If you vote Labour in your thirties you've got no money."


I didn't believe him then, and, perhaps more importantly (now I'm deep into my 30's) I don't believe him still. Or maybe I just haven't got enough money... But, although the principle is wrong the sentiment has some truth in it. The older we get, the more we change. I have seen more than enough of my parents in my own parental behaviour to drive me to despair. Every day I am faced with the heinous recognition that my eldest sons latest cry of "its not fair" is a retort to one of my own fathers favorite idioms that has just tripped off my tongue. And each time I'm reminded of Larkin's poem, 'This be the verse'. I can remember making vehement pacts with myself that I would never be such a mean old bastard, I would let my kids do what they wanted... But now, well, I'm bloody right and the boy's wrong: life is unfair. So there.


I've changed in other ways too, and recently these changes have been UC instigated. I was reflecting on an aspect of this yesterday as I trawled round Tesco doing our (approximately) fortnightly shop. It was in the loo roll aisle that I was reminded of that quote above. How my attitude to bum wiping has changed...


When I was a kid I barely gave toilet paper a second thought. It may have momentarily entered my consciousness that each roll was colour-coordinated depending on whether it was in the bathroom or downstairs loo (my memory says green for downstairs and peach for the bathroom, but that could be the other way round. Actually my mother still does it, and I still don't take it in properly - are there people who would sit in there and think to themselves "Tut, the toilet paper doesn't even match the walls. Lazy cow."?), but otherwise the only place it really mattered was at school. This was because in the unlikely event that I went for a poo at school (surely this was one of the things most feared at school - or was it just me?) the clean up operation would have to be conducted on what could only be described as tracing paper. How anybody in their right minds could conceive that that stuff was going to be even slightly useful in removing the offending objects from ones tender behind is utterly unfathomable. All it managed to do was broaden the issue, whilst simultaneously being quite painful.


Once I'd left home to be a student toilet roll was never high on my shopping priorities. In fact we were more than happy to buy the cheapest available. In my house we persevered with this throughout our tenure despite the inevitable drawbacks. As I see it value or economy loo paper usually demonstrates one of two unwelcome attributes: EITHER it is made of some substance that is somewhere between sandpaper and card (sort of like compressed woodchips) which (whilst having superlative wiping power in comparison to the school stuff) is guarenteed to lacerate your poor bottom - especially after a night out/curry; OR it has all the strength of real tissue paper, leading to unwanted, but frankly dishearteningly predictable, finger-bottom contact. Despite sitting on the loo on innumerable occasions with either tears streaming from my eyes, or the dejected slump of someone who has just accidently used his fingers, we never ever ever, upgraded...


And, in fact, I persevered with the same old cheapo loo roll well into my relationship with my now-wife. The onset of kids didn't even change me - we were poor, see. But it did introduce the concept of 'wipes' into the bathroom, which have added a soothing aspect to proceedings.
However, the dual factors of increasing household income and UC have changed my outlook completely. Not only have I finally eschewed economy stuff, but i have moved slowly through the loo roll ranks to finally embrace not just ultra soft, but QUILTED! Oh God, that stuff is sooooo good. It's strong, absorbent, soft and caresses my poor sick bottom with a gossamer touch. I don't care how much it costs. I don't even care whether it's recycled or not. Stuff the money, stuff the environment, this is my bum we're talking about. If you use economy loo roll in your 20's you haven't got any money, if you're still using it in your 30's you haven't got an IBD...

Sunday, 3 August 2008

What's Goin On?



The return of the Bristol Stool Chart. It has been 4 weeks since I had my last appointment at the hospital (in rheumatology). An ideal time to consider the current sate of affairs.

1. Prednisolone. I am taking 10mgs every day for the final time today From tomorrow, as discussed with the consultant, I am changing to an alternating 10 - 5 mg dose. This is good because I am sick to death of the shakes and the spots. This is not good because, as usual, up to this point everything has been hunky dory... but now...

2. Poop. 4 weeks ago things were somewhere around Type 1 or 2 (like nuts!). Then I started the probiotics, wherein they went to, ooooh lets call it a 4.5 (for artistic merit). This I took to be my bodies usual mentally stimulated resonse to change (I think my physiology is the perfect representation of a blue-rinse tory: doesn't like change and doesn't like foreigners). Things stabilised and I've had a good two and half weeks of 3/4's. Lovely. But, this also lulled me into a false sense of security - oh, how easily I'm swayed by olives, pickled onions, Thai curries etc. This final week has consequently been a mixture of 4 and 5's again. But then, that might be normal, I've forgotten what that is...

3. Yoghurt. Firstly I can't make up my mind how I want to spell this - with or without an 'H'? I started on the Activia and then moved on to the Muller Vitality as I was informed of their PRO and PREbiotic attributes. There is not much I can say about these. During the period of 3/4's I was taking them regularly, and after the initial bloatedness all seemed well. Then last week, as described above, things not so good. But crucially, I got a bit lazy, and when I ran out of yogs I couldn't be bothered to go and buy more, so I stopped having them every day... Well, I don't know if that would make much difference... Also the vanilla ones are infinately better than the strawberry ones.

4. When I've changed the steroid dose, I have to go and have another blood test. Joy.

Thursday, 24 July 2008

Don't worry baby

I fought the urge to use the obvious title to this post... School is, indeed, out though. And what a long, dragging summer term that turned out to be. It felt like it would never end, and I worked right up to the final day (no cop-out videos in my classroom). But, I know better than to moan about my job as I settle into a 6 week holiday. Needless to say as term petered out laziness ensued and a week has appeared between posts.

The school holidays are always an ironic time for the health conscious. I have had enough experience myself, and as many conversations with colleagues, to concur with the idea that no sooner than the holidays start and you're ill. For most people this involves succumbing to the inevitable cold, and is grounded in the theory that during term time we are somehow running on adrenalin, which in turn fights a 24/7 battle against the army of germs that brew up in the hot overpopulated environment of the classroom. On any given winters day, when I have 32 little monsters sat in my room and the school heating is on full blast (there are 2 settings: ON or OFF) the atmosphere is positively tropical. I'm surprised (with my record for illness) I haven't had malaria yet.

On the penultimate day of school I bumped into the Head in the corridor. We did the obligatory "how are you?" conversation (I am still not at ease with her viewpoint on my UC) and then she said "well now term's over, you'll be able to get a break from the stress". And so she raised an interesting point.

Stress, without doubt, has a massive role in the life of the UC sufferer. My first hospitalisation with a flare-up was preceeded by trying to get 60 wonderfully motivated students (!) to complete their coursework on time and to the best of their ability. I can't say for sure that this was the crucial factor, but it definately didn't help matters. In fact in the early years of my teaching life I worked in a very difficult school for 3 years (failed ofsted, special measures, kids from a socio-economically deprived area), and every day was commenced with a 3 floor sprint from my classroom to the staff toilet - at the time I had never heard of UC, but in retrospect I think this may have been a sign of things to come (in sooo many ways...). Since those dark days, and as I have become much more informed and wise about my own condition I have actively sought to reduce stress in my life. Teaching is stressful. So I am a classroom teacher (in a much easier school). No more, no less. The remuneration for taking further resposibilities is not adequately reflective of the extra stress that would be taken on. I see my boss every day, and he constantly walks the precipice between sanity and breakdown. My job is stressful - but so is everybody else's. And to return to the Heads point - is it actually possible to avoid stress even when you are not at work? Some examples:
  • I have been helping some good friends sort out their house before moving to another part of the country. Every inch of this process has caused them stress: sorting through years of accumulated things (what to keep? What to let go?); renting out your home; finding a new suitable home; decorating; actually physically moving...
  • One of my best friends has been trying to fan the embers of his relationship, which has become long distance, meaning weekends of travelling or constant phonecalls...
  • My other best friend is in Jordan with work while his pregnant girlfriend is at home in the UK...
  • My neighbours have just had a premature baby...
  • 6 week summer holiday, 2 kids to entertain!
  • Years ago, before I was a teacher, we never had enough money for anything - but were determined not to go into debt, so each and every day was about scraping by. And now there are thousands of people in that situation...

These are just things off the top of my head. There are too numerous a number of things that make life stressful. And each person has a different factor that causes them more stress. I have ALWAYS had the physiology that means that stress manifests itself straight in my digestive system. Oh yes, I can remember many a pre-job interview rush for the toilet...

So, what's the answer? Well, I can only say that, for me, talking is the key. As hard as it has been sometimes to admit I'm suffering from stress, getting yourself to tell somebody else is vital to dealing with it yourself. Most stressful situations can't be avoided, I find you have to take them on with honesty to yourself and others.

Here's a final thought: If I feel that the UC is starting to flare-up I start to worry about it... anxiety goes straight to my guts... stress is a recognised trigger for UC... so I worry that the UC is flaring and I worry because I'm worried about it... Now, that is stress that's hard to manage.

Wednesday, 16 July 2008

Suicide is painless


When the UC reared its ugly again earlier this year it was the worst it had been for about 3ish years. As this flare-up came on the back of a week in hospital (see here) I decided that I had seen enough of that place for a while - acually the exact moment at which I decided I had seen enough of my delightful local hospital dovetailed neatly with the moment I decided that there was indeed a strong chance I was not going to make it to the next day: feebly laying awake, barely able to move, in the middle of the night, while an extremely surly Balkan 'nurse' made up for the lack of a drip stand by tying my anti-biotic IV drip to the lamp above my bed. I started having hallucinations about being in a combat field hospital... altogether now:


Through early morning fog I see
visions of the things to be
the pains that are withheld for me
I realize and I can see...
[REFRAIN]:
that suicide is painless
It brings on many changes
and I can take or leave it if I plea
Where was Radar when I needed him?


Thus when the cramps and poo and blood started again, I decided that I needed to get more proactive and face up to the truth. Initially this lead to my joining the NACC. Now, I had been blithely saying "Oh yeah, definately" to my GP and IBD Nurse every time I saw either of them and they recommended I take this course of action (which they did EVERY time I saw them). So this time I came good on my word and joined. And made a little donation too, which was nice. Joining the NACC was a good move for me - I've read a great deal of interesting research papers for one thing, and been able to get fully knowledged up on the azathioprine in readiness for crossing that bridge. However, it would seem that those fellows at the NACC passed on my name to my local IBD 'group'. I have absolutely no wish to speak negatively about this or any other group. I am utterly convinced they provide wonderful support for all their members and they have my utmost respect. But I wasn't, and remain, unready to join such a group. The idea of meeting up in cafes in town on a regular basis and sharing experiences is not a place I'm at yet. I can't quite even bring myself to open the newsletter they send me every month.


Despite all that (and I know these are issues of my own, rather than others) I did feel the need to exorcise myself of some of the UC demon. And so I came to blogging, and blogging is fantastic. I have discovered many other UC blogs out there (yes, I need to update my blogroll), each and every one brings new perspectives and, possibly more importantly, recognisable situations: EMPATHY. Not only those, but I have taken great heart from those people who have kindly left comments here at the Mercy Seat. Which brings me to my point (finally!)...


Whilst sifting through the assorted information we keep on the kids at school (special needs, medical info etc) earlier this year, I discovered that a boy I teach has UC. He is a frail looking, pasty and rather quiet chap in year 9. He has that pensive look about him that I often feel is fixed on my face. He has a troubled brow and his shoulders seem to bear a weight. I would guess that his UC is active, there have certainly been periods of absence this year. And yet I have not said anything to him. I cannot decide whether it would be the right thing to do. On the one hand I think I might be able to give him something that the blog has given me. On the other hand, I might come across as an interfering bastard. So, what should I do...?


While you decide, I'm going to have a late-evening medicinal cigarette in the garden.


Sunday, 13 July 2008

The Wind cries Mary

Fart, trump, toot, cut-the-mustard, float the air-biscuit, guff, trouser-cough, a real bronx cheer (come on, didn't you have a whoopee cushion?)... whatever you call 'em, those windy-pops have been my tormentor for the last 5 years.

I grewup in a household where a mans windy emissions were his pride and joy. It was expected for them to be delivered with a triumphant fist clenched and a cheek proudly raised. But UC ended this. I will never forget that instant of crest-fallen realistation when an apparent moment of exaltation in front of my awe-struck audience (the kids) ended in a wide-legged dash to the loo. And since then each new fart is greeted as a potential imposter. Yes, I've been caught out but I've also developed one helluva sphincter...

Its sure had a work out this week. After the initial (clearly metally induced) bowel wobble I've settled into this probiotic diet. Just one a day, as they say in the ads. The main thing I've noticed is an increase in bloaty-ness. Which is weird because I'm sure those ads say that the friendly bacteria get rid of that. Maybe thats only the ladies - why are women the main targets for bifidus digestivum et al? Or, maybe, God forbid they're... lying! Anyway, bloaty-ness always sets me on fart-edge, so I've been walking round with a fully clenched sphincer all week. On the whole though, I've beem feeling pretty good (prednisolone effects aside). So much so I lulled myself into a false sense of security and risked a Thai green curry last night. Whoops. Hello toilet, my old friend...

Tuesday, 8 July 2008

No milk today

Today I embarked on my rheumatologist instigated course of Probiotic yoghurts. The first hurdle was to decide which to buy. Do I go for Bifidus Digestivum? Bifidus acti-regularis? L. Casei Imunitass? Lactilus colonactiviatius? OK, I made that last one up. But, you can't help reading these bloody things and thinking they're all made up. They read like the results of a competition at the marketing departments christmas piss-up. Indeed there is a link to an article on lovely old wikipedia deconstructing each of these cod-latin terms here. Not a good place to start though, so if you're thinking of trying them, don't read that.

In the end I plumped for Actimel. Ths is made by Danone (who get a right spanking in the article linked above!). This was the brand suggested by the professor when asked... but I got the distinct impression he named the first one he thought of. He wasn't amused by my query about whether they sponsored him anyway. The final decision making factor was that they contain L. Casei Imunitass, which in my opinion sounds the most likely of those terms.

So, what the hell is it? Well, thats summed up nicely in another wikipedia article here. Its all based on a 'friendly' bacteria called Lactobacillus casei. This exists naturally in the gut and mouth, and when taken as a supplement can lead to the increase in intestinal microflora which on the whole is consider helpful in balancing the responses of the immune system in the bowel. Very nice too.

But does it really work? Well, I've had a little explore on the 'net (thanks google) and most of the research papers I've found (that I could understand) suggest that... no-one really knows! But the finest minds of medical science seem happy to agree that it sort-of-seems-too. Here's some of what I discovered:
  • p414 of this journal '2nd Probiotics, Prebiotics and NewFoods' has a summary paper about the responses of mice with colitis (!!!) to probiotics. Essentially they decided that the probiotics definately had some effect on the intestinal inflammation of the mouseys, but they're not sure exactly what. I have to say there is a definate trend in trying this stuff out on mice. In this particular one they removed the whole intesinal tract of the mice and transported it in dry-ice to the place where they did the testing. But I still can't over the fact they found some mice with colitis.
  • Daisy Jonkers, PhD and Reinhold Stockbrügger, MD, have written paper helpfully entitled 'Probiotics and inflammatory bowel disease'. Daisy and Rheinhold do go on rather a great deal about mucus but in the end reach the conclusion that "Studies on probiotics in animal models of colitis are promising" and "If probiotics do prove to have beneficial effects in IBD, investigation of the mechanisms may well lead to further advances in treatments". So, thats good. I think.
  • Delphine M.A. Saulnier goes one step further by examining the role of 'Synbiotics', although I can't help feeling were moving into the realm of Marvel comics here (Venom anyone?). Unfortunately I was not allowed access to the lovely delphines article, but her conclusions were as follows: "Recent human studies indicate that ingestion of synbiotics modulates the gut microbiota, promoting a healthier composition; it appears that synbiotics can be more efficient than either pro- or prebiotics alone in inducing this effect. Preliminary results have shown beneficial effects on biomarkers of diseases such as ulcerative colitis (UC) and colorectal cancers." So, that also sounds good, though it seems probiotics might work better in conjunction with prebiotics... whatever they are. And whereever you get them.
  • And then, blow me, but I only went and found a video that sums it all up rather nicely here. I only watched up to the part where they start talking surgery, because I'm a wimp. But watch and learn people, watch and learn. (Although, I'm sure the old guy talks about 'good' bacteria like "e-coli" - huh? Doesn't that stuff kill people?)

In the end of course the only true measure of how useful these yoghurts are is my bum. And wouldn't you know it, today has been the worst its been for about 2 weeks. Still, I'm gonna stick it out a bit longer - I'll keep you posted.

Monday, 7 July 2008

Drug store woman

I think I committed a crime today. And struck a small blow against 'The Man'. The system that stops me being able to be fully in control of my illness. I was driven to it though, m'lud. By a particularly unpleasant pharmacist and the kafkaesque nature of the NHS. And 'roid rage.

I took my prednisolone script to the chemist after school. I went to the Boots on my local high street, because I like the pharmacist in there. She once helped me out in the grips of agonising stomach cramps. I reckoned on her help because I had a problem. The old professor of rheumotology had written me a prescription for 150 preds, but he'd only gone and prescribed preds with enteric coating. Now call me deluded if you want, but 'enteric coating' sits in my file marked: NO! I can't remember why, and I realise this just adds to the irrationality, but at some point in the past I had to take preds with enteric coating and they didn't work as well. So, like admiting I'm feeling well and not saluting magpies, they have become anathema to me. Therefore I needed to explain this to my kindly pharmacist and with her help get the right pills that help me mentally too (never ignore the placebo factor). Unfortunately it was a new/different woman. So, I carefully, quietly and patiently explained the situation to her...

"Huh. You're the second one of these we've had today."
"Oh, sorry"
"Well, I can't change it. I can only dispense whats on the script."
"Yeah, but I NEED the non-enteric coated ones... they work better for me"
"Your doctor obviously doesn't think so"
"Yes, he doesn't normally prescribe them for me, I usually get them from my GP"
"You'll have to phone the hospital and get them to fax you a new one"
"But I've run out - I need them today. Can't you just give me the non-enteric coated ones please... please?"
"No. I can't give you a different drug to the one your doctor prescribed for you"
"But its not different - its prednisolone"
"No its not"
"It is! Its just got a coating on it"
"That makes it different - do you expect me to let everyone decide to take home different drugs to the ones their doctor prescribes?
"No. BUT ITS NOT DIFFERENT"
"You'll have to go to your GP"
"But getting an appointment there takes days, sometimes weeks - I don't have it on a repeat prescription"
"Well. You can have enteric coated prednisolone. But I'm not giving you a different drug"
"ITS NOT DIFFERENT!"

At this point I felt I could no longer hold back the 'roid rage. Fortunately for the pharmacist I had my youngest son with me. So I gripped the counter, counted to 10, took my script and left swallowing profanities. Now, at this point the red mist had descended and my moral compass was askew. I went back into Tesco, to the lottery stand. I used the pen on the stand to change my prescription. Not a high-class, sophisticated piece of fraud, just the simple scribbling out of the words 'enteric coating'. And then the boy and I walked up the road to the other chemist (the one where they dish out the methadone doses: I thought they'd be less perturbed by a shifty looking character...) where they cashed it in without so much as a by-your-leave. So, mwahahahahaha one-nil to me!

Just a final thought: possibly the best UC blog I have read - Number Two's - has come to an end. Reading Number two's gave me the confidence and impetus to start this blog, which in turn has helped me cope with the UC. I am glad that Martin is feeling well and hope that he stays that way. I look forward to seeing the return of such a witty and perceptive writer in a new form soon. Good luck Martin!

Saturday, 5 July 2008

Please please please let me get what I want.


"If music be the food of love, play on..." so spoke Orsino in Twelfth Night. Although he does go on to beg for an excess in the hope that too much will cure him of his need - a metaphor for his unrequited love I believe (but don't quote me, I'm not an English teacher). Without wishing to labour this particular point, it's the first bit of the quote that is relevant to me. Music has been a pillar in my life since my teens. It has been the post upon which I have hang important moments in my life; it has provided the soundtrack to the emotion of my life. We all have a soundtrack to our lives, external, internal and always changing.


That said, for as long as I remember I have had songs that live in my head. Some of these are permanent residents. Burnt into the electronic circuits of my brain. They are ridiculous: the theme tune to the 'Sullivans' for instance (a terrible 80's australian daytime soap). They are great: Danny boy (I love that song). These songs seep into to my consciousness and I find myself whistling them absent-mindedly. They are just there.


But, some are temporary visitors. They dominate my brain for a few days and then disappear back into the record cabinet of my mind. It is these that I often reflect perhaps best represent my inner thoughts. And so it was recently that I found my self repeatedly singing 'Please please please let me get what I want' by the Smiths. I have always been a sucker for a bit of melancholy and I know I can be prone to self-pity, but the sentiment of this song seems to fit an occasional UC state of mind I can get into. Sometimes this damn illness drags on and on. It drains you as you go. And sometimes, when I reach that low point, I do cast a despearte gaze around and bitterly think "Why is this happening to me? Why isn't it happening to that guy, or that guy? Why can't I just be 'normal' and not have to spend every waking hour wondering whats happening in my bowel? See, the life I've had could make a good man bad...". Of course, in clearer moments I can be wonderfully objective, count all my blessings, be humbled by inspirational people who face far greater troubles than mine with dignity and gravitas, and keep everything in proper perspective. But the other day I was down low, it was just me and the Smiths... Still, I always know when I'm really on a bummer, cos then I start listening to 'Exit music (for a film)' by Radiohead...


Don't worry though, because yesterday was a Kings of Leon day - until it got stuck in the CD player in the car and brought on the 'roid rage.

Tuesday, 1 July 2008

I know there's an answer

I went to the Professor armed with questions. Here's what happened:

Firstly I had to have a pretend session with a medical student. I used to hate this - repeating the whole story from the start, watching them hopelessly try to keep up with all the queer anomalies and my own theories on whats happened. Now I feel like I provide a service for the future. The more young doctors that understand the individual nature of UC and all its associated symptoms, the less likely people are to come up against an inflexible old school consultant like my Gastro-doc. I've taken to writing my own 'notes' and this time I also took along photos of my inflammed feet (see 12th June). So I positively bombarded her with information. Eventually she gave up trying to make head or tail of me and went and got the prof.

As usual with Professor Rheumotology, I had a constructive and fulfilling appointment. We made these decisions:

1. My bloods are OK right now. This I managed to ascertain myself because the med student dropped the results from last week and I had a look at the old nitropyhlls and lymphocytes (I can't necessarily spell those though). Both within the 'normal' range. I also was able to assume an air of self-satisfied smugness by answering the profs question to his students (3 in the room with us!) about the purpose of TPMT's - an enzyme count to indicate sensitivity to immunosuppressant. Haha. Well done me.

2. Thus, with bloods OK, the prof suggested there is no need to rush into azathioprine yet. But he did give me another leaflet about it - I'll file that with all the others. He also suggested that azathioprine needn't be the inflexible 5-year course that is oft claimed on the 'net. Rather that it may be carefully monitored and used much more intermittently, when necessary, essentially to reduce reliance on steroids. So, there's a point to raise with old gastro-doc.

3. Seeing as they seem to be working well at the moment, I'll be staying on the prednisolone for a while longer. I did however learn something new here: as we all know steroids have to be tapered down to nothing (if you're lucky enoughto get that far). So, I usually taper by tablet, i.e. 20mgs one week, 15 the next, 10 the next and so on. What this rather dimmly ignores though is that by doing this you reduce your dose by 25%, then 33%, then 50% - in other words far too quickly. No doctor has ever pointed this out to me before. So, my new regime goes: 10mgs a day for another 4 weeks, then alternately 10 one day, 5 the next, then 10, then 5, for 6 weeks (therefore 7.5mgs on average), then down to 5 until I run out. Theoretically within this time I will have had the phantom appointment from Gastroenterology to further discuss azathioprine. The draw back here is the crappy pred side-effects. Unfortunately for a man weighed down by the evil sin of vanity my main side-effect are spots. And they are back in force. Oh, and shouting at people, but I dont mind that so much.

4. He also pretty much insisted that I start drinking probiotic yogurts on a daily basis. Surely 'bifidus digestivum' can't really be real can it? Oh well, I'll give it a go. And his nurse suggested to me I try Acidophollus tablets. Mind you, she whispered this to me as she escorted me out... maybe she shouldn't be trusted... "they keep them in the fridge cabinet of Holland and Barrett".

Monday, 30 June 2008

I'm waiting for the man

To begin with lets talk polyclinics. Following my whole-hearted backing of said clinics I went on to watch a news report that outlined how they are a part of the systematic disassembling of the NHS. The report suggested that they would work on a patient drop-in basis, with a high turnover of doctors, thus reducing waiting times and continuity simultaneously. Now, while I was acclaiming the lack of waiting time for my blood test, the lack of continuity of care I have faced at my local hospital has been perhaps the greatest hurdle I have faced in managing the UC. There is absolutely no way that the family GP should be replaced by polyclinics. And so, unless I need a blood test, I will never go there again...



On to hospital matters. Tomorrow I have an appointment with my consultant rheumotologist. I have found him to be the best doctor I have dealt with. I have only recently been under his care, as I asked for a second opinion earlier this year, and was sent to him (due to the associated arthritic symptoms I suffer). I asked for this after repeatedly being at loggerheads with my gastro-consultant and his narrow-minded god complex. Below I have outlined a brief timeline of my colitis and the list of Q's I am planning to ask. I will report back tomorrow.



Timeline



2002 - symptoms begin

2003 - Largest flare-up (May), treated with Mesalazine, which probably made it worse. Hospitalised and treated with IV steroids. Discharged with Mesalazine and oral Prednisolone. Relapse, medication reduced to oral prednisolone. Flare-up ended.

2004/5 - Intermittent flare-ups of associated arthritic problems. Treated with Prednisolone

2005/07 - Management of illness through lifestyle changes (e.g. stopping drinking alcohol). Mild flare-ups. No drugs. Acupuncture.

2008 - February: hospitalised with pneumonia. Treated with high dose of antibiotics (IV in hospital, oral on discharge). UC flared up following end of antibiotic course, end of March. Prednisolone (30mgs tapering on a weekly basis). Flare-up while on 5mgs lead to extended course. Flare-up after completion (first in colon, then arthritic June 7th – 12th). Back on Prednisolone, tapering 15mgs to 10 after one week.

Questions:

  1. How likely is it that this flare-up has been caused by the Pneumonia Antibiotics?
  2. Would it be sensible to stay on a low dose of prednisolone for a while to attempt to get back to a stable situation (i.e. 2005 – 07)?
  3. If yes, what would be the recommended course of action? Can you prescribe me enough prednisolone?
  4. Gastroenterology want to discuss with me moving onto Azathioprine (essentially due to the recent flare-up following the prednisolone course in April/May) – what is your opinion on this?
  5. So, should I be considering immunosuppressant now?
  6. I believe Azathioprine has a maximum 5 year course – what happens if UC/Arthritis flare-up after that?
  7. Is Azathioprine useful in the treatment of the arthritic symptoms?
  8. Should it come to surgery, will this also end the arthritic symptoms?
  9. And my wife wants to know if there would be any benefit of moving to a warmer climate?!


Wednesday, 25 June 2008

It's alright Ma (I'm only bleeding...)

Yesterday I had a blood test. These are an occupational hazard for the professional UC sufferer. Christ only knows how much of my blood they took when they were still struggling to decide if I had an IBD or not. I'm a pasty looking guy at the best of times, but back then I was really rocking that 'heroin-chic' look... Anyway despite pints and pints of the precious red stuff being taken I have barely been able to approach them with even an iota of courage or masculinity. God, I hate it so much. I'm not a 'fainter', as the phlebotomist so succinctly put it, but I am a 'can't-look-fist-biting-panicy-almost-tearful-big-girls-blouse'. So, what was special about yesterday? Well, originally I was asked by the rheumatologist to go for the blood test in April. Knowing my innate ability to 'forget' to do these things I went straight over to outpatients to get it done there and then. However, up the hospital its a take a ticket and wait your turn system. Disturbingly they use the same tickets as the Deli counter in Tesco. I guess there are only a few ticket distributing machines available on the market - but I think they ought to go out of their way to find a different one. I took my ticket and realised I was number 90. The sign said next up was 48. I waited as long as I could, sweaty-palmed, becoming more and more agitated, starting to hate everyone in front of me. It is not healthy to displace fear into sociopathy, so in the end I chickened out and ran away.

Now, I'm due back at the rheumotologist next tuesday hence I finally had to bite the bullet. But herein lies the point to this post. Locally we have something called a polyclinic. Usefully it's very close to my school. I phoned them. They do bloods by appointment only. So I made one (mentally that meant I HAD to go) and off I went at 9.55 for a 10.05 appt. I was there slightly early, no one else was there: they whisked me in, bled me and sent me on my way. I was back in school by 10.05. I didn't even have time to consider what was about to happen. Admitedly I still had the shakes, heart-rate was up, nurse asked me if I wanted to "lie down", but, bloody hell, I felt much better about the whole affair. So it's they polyclinic for me from now on. I highly recommend them (though I don't know if they are peculiar to this area).

Tuesday, 24 June 2008

Tobacco Road


I have just been reading the excellent UC blog 'Number Twos'. A comment on the most recent post raised the issue of smoking and UC. This is interesting to me because when I was first being investigated for possible UC, one question that I was asked was whether or not I had just stopped or cut down smoking. As it happened I was a smoker at the time and had been slowly cutting down for a couple of years. I was never a heavy smoker anyway, but I had more or less cut down to the level of a 'social smoker'. That'd be a social smoker who wasn't out smoking all that often. My doctor at the time (a youngish SHO who was very good, better in fact than my subsequent consultant - I wonder what happened to him?) outlined to me the theory that reducing or stopping smoking may have some as-yet unexplained link to the onset of UC. He also suggested in hippocratically-motivated couched terms that I think long and hard before I give up for good.


Conducting a brief survey of research papers available on the internet reveals studies dating back to before 1997 relating to the possibilty that nicotine may have some effect in reducing the activity of UC in general, or even the immune system in particular. Now, clearly I'm no expert but there appears to be an awful lot of circumstantial evidence for this to be utterly without foundation. There are, however, quite a few occurances of the old "patients responded just as well to the placebos" though, which is always disheartening. That just makes me wonder again about the role of the old prednisolone in my own strange UC world. Somewhere or other I found a research paper on the use of nicotine patches in UC sufferers - I've lost the link, but when I find it again I'll stick it up on a post.


As for my own smoking. Well, I still do. Not much, too little in fact to ever fit into those little medical surveys you have to do from time to time. I reckon it must average out at less than 1 every 2 days. Usually I only smoke when I go down the pub. Which is sadly none too often these days. I occassionally go through a little stage of having a cheeky one in the back garden late at night. And all the while I puff away, evil Nick-o-tine whispers in my ear: "Thats right. Its making you all better..."

Saturday, 21 June 2008

Head Cut


A quiet week. Year 10 are on work experience, the 6th form and year 11 have finally finished all their exams so they are enjoying that lengthy seminal summer of their lives, in the first flushes of young adulthood. So I took the opportunity to have a meeting with my new Head. Unlike Worzel Gummidge, for whom this would mean a illicit meeting in some potting shed with the (deeply creepy) Crowman, this meant traipsing all the way down to the other end of school and hanging around outside her office like some chastened schoolboy. Eventually I gave up waiting (my appointment time having passed) and knocked and went in, only to interupt her in mid-flow with some other officious looking peeps. Good start. It was so much easier with the old head: if the door was open, go in, if closed wait at all costs. Having said that he was an inscrutable old bugger, meeting him was not unlike being grilled by a particularly dogged barrister. He always made me feel guilty for crimes I had not committed. Well, mostly not committed. He was, however, very supportive over the UC, diagnosis having arrived shortly after I'd joined the school. And to be honest I had no reason to doubt a similar reaction from the new Head, she seeming a much more personable character so far.


So, having broken up her previous meeting, I went in and had THE chat: 'I've got a chronic illness called UC, with a nice bit of associated arthritis on the side'


Now, why had it taken until June to have this chat? Because until March all was lovely and therefore I'd 'forgotten' about it. And having built up quite a large number of absences since the pneumonia in February, I couldn't help thinking she might well have decided I was a malingerer. As it happened, it all went well. She made the right sympathetic noises, promised me the school would support me in any way it could, made me promise to ask for help when I needed it, etc etc. All hunky-dory. Untill... virtually as we were bringing this short but constructive meeting to an end, we had this passage of converstaion:


Me: Well, thanks for listening

Her: No problem, thanks for being open. Your health is important. Keep me posted if anything changes.

Me: Yeah, I will, hopefully the drugs will damp things down again.

Her: Good. And then if you start to have too much time off, we'll have another meeting.

Me: !!Oh! Right, ooookkkkkk...

Her: Close the door on your way out...


What the hell does that mean? 80% of me reckons she meant well, you know - if things deteriorate we'll meet and review what can be done. But the rest of me felt like that was a shot across the bows. It can't be great having a chronically ill person on your books. Maybe she's one of those cycnical people who, having never had to cope with constant ill-health, treats those of us who do with suspicion. Maybe I'm just guilty of thinking about it too much, as usual.


Anyway, 15mgs of pred daily this week have kept things settled. Been around 2 or 3 on the old bristol chart. Feet fully back to normal.


Oh. and I appeared on Youtube for the first time!

Tuesday, 17 June 2008

Weekend

This weekend presented two challenges to the man in the grips of a UC flare-up: a trip to the cinema and a barbeque (not simultaneously). Two relatively straight-forward weekend outings one might be fooled into thinking, but just another pair of high-hurdles in the 110m of UC-governed life.

1. The cinema: after weeks of promising the kids I would take them to the pictures to see Indiana Jones and the Whatever George and Steven Thought Of, I finally relented. This was undoubtedly a fatherly duty. Indy, presents no attraction to my goodlady, not even in a world-weary-quipping-rugged kinda way. Now this trip presented issues to be planned for on several fronts (including packing the spare pants). Firstly, the bus. There is no point in driving into our city centre at all on a saturday. You may aswell park your car close behind another and sit staring at it for a couple of hours. So, the bus it is. And very good buses they are too. But they have no loo. Neither does my car, but at least I dont have to share it with strangers (including the inevitable kids form school) in times of dire need or worse. So, there was public transport anxiety. Secondly, the cinema itself. There is, of course, the obvious issue of having to use the public toilet. This is something we have to quickly come to terms with. Sadly it is not something I am comfortable with yet, even after 5 years. Its not the noise, or the smell... its my troubling obsessive-compulsiveness. I have to lower seat with my foot: I could not possible touch it! I have to paper the seat! This can make for a fabulously amusing spectacle - well, I make the asumption that should anybody be able to see a man frantically trying to lay paper on a loo seat whilst simultaneously, desperately trying not to let go too early would be amusing. Ah, imagine that contorted body now! Indeed I have often felt relief-tinged amusement myself as I've finally plonked myself down only to waft all the paper off at that instant. That would be relief-and-revulsion-tinged amusement... However, the main issue is what to do with the kids should i have to suddenly make a quick break for the loo? My youngest (8) is arguably too young to leave in there alone - I think he would get frightened, especially if it was one of those longer visits. And yet, I might suggest that having to accompany me may be even more truamatic, and I'm not talking about missing a bit of the film...

2. The Barbeque: how do you go to someone else's house for a barbeque, expressly for a barbeque, and then snub over half of the food. I resent looking like some picky fool who doesn't enjoy his food, because that couldn't be further from the truth: I bloody love eating. But as the burger (homemade by my host) was hanging tantalisingly between my lips, someone mentioned chilli. "Aaaaaahhhhh, I cant eat this" I think, and thus slowly remove it from my mouth and place it back on my plate. Unfortunately this is not unnoticed: "Wots wrong with the burger?" "Oh, er, nothing. I just cant eat chilli right now." Only its been in my mouth so neither can anybody else now. Cue suspicious stares etc. Followed later by the same old 'what do you want to drink' conversation. Joy. Incidently I also had to forego the olives, homemade relish, houmous, amongst other things, leaving me sausages and salad. Great.


Having said all that, the preds have kicked back in again and the flare-up is dying down. I went up to 15mgs on saturday and have stayed there, but I guess that's still quite low. Planning to bring it down to 10mgs next saturday and then hold out until I see the consultant rheumotologist on July 1st. Still waiting for new appt with Digestive Diseases.

And now there is a man eating Italian cheese with maggots in it on TV. Why hasn't he got bowel problems?

Oh, and Indiana Jones... disappointing. That magic aint working any more. How depressing.

Friday, 13 June 2008

Something changed

"I think, and I stress the think here, that I prefer hobbling around like an old geezer than rushing to the loo and pooing through the eye of a needle throughout the day. But I reserve the right to change my mind on that regularly and without reason."


I begin with a quote from yesterdays post. Why? Because the UC has already insisted that I reflect on that statement. Two days back on the steroids (10mg a day) and the foot/ankle swelling has reduced enormously - goodbye flip-flops, hello again shoes! They're still very sore and my calves have got very stiff, but defo on the mend. All good eh? Nope. At 4.30am I was awoken by excrutiating stomach cramps and had to rush-hobble to the loo. Nothing happened. 6am, same awakening, this time with some outcome: loosish poop, say a number 5 on the old Bristol chart (why does Glasgow get coma, while Bristol gets stools?). Bloody hell, I was supposed to be going back to school today. I did go back and there have been 4 or 5 (lost count) further visits, following cramps at about 5/6 on the chart (mmm 'fluffy'). Damn it.

So, at the moment, I have decided that I absolutely still agree with the above statement. There is more dignity in hobbling, and it is easier to endure than stomach cramps and repetedly running to the loo. I think I might up the dose tomorrow, maybe 15mgs?

As for school, that was OK, lots of well wishers and a few fools who asked me how I was. Mwahaha - I soon bored them to tears with a full account of the current situation: the UC story never comes in small chapters...

Thursday, 12 June 2008

One step beyond




Here I am, Captain Bligh-like, cast adrift again on the UC (clever, eh!?) whilst my Fletcher Christian of a body chuckles from the bridge of the Bounty...
A tortured analogy/metaphor to describe my current status. Having blind-sided me all weekend by hinting at new pneumonia, I had almost stopped thinking about the UC. Until, that is, Monday when the cold started to subside, and I started to feel a little better: ahhh, yes breathing normal, no lung pain, no coughed up nasties, no feverishness... yep, I'm feeling... well! Wait a minute, what's this? Agonising cramps? Dashing to the loo? Aha, of course! What was I thinking? Of course I'm not well. Bugger.
However, that was not the end. My body always has another little trick up its sleeve... like a cheeky Paul Daniels: "You're gonna like it... but not a lot..."
The cramps and toilet-dashes did not develop over Monday, leading me to believe I may had a little cold-induced aberation to my continuing improvement. Then when I got home from school I noticed a dreaded 'red-spot-type-thing' on the back of my leg. Then I found a little swelling (on my leg - it's not THAT type of blog). Then another... By tuesday morning, they were worse, but not awful, so I manfully went to school anyway. Manfully, but stupidly, wore my normal boots. By the end of the day my feet were threatening to tear open my shoes in a Bruce Banner moment. My left foot had started to swell underneath, making every footstep agonising. Excacerbated by hundreds of little lovely children: "Wotchya dun sir?" "Whyyer limpin?" and the bastard stairs to my bastard classroom. Oh, and having to stay until 8pm for parents evening. By the time I got home my feet were as the pictures above show. And ankles - they don't normally look like that. Honest.
So, I stayed home Wednesday and today. Phoned my GP to ask for a prescription for more prednisolone (checked packet - only 3 left - would have had to have stopped last week anyway). Couldn't speak to my usual Doc, who does at least vaguely recognise me, so no prescription without being examined first. I seemed to make this obstructivist attitude worse by asking if the doctor could make sure she prescribed non-enteric coated preds (enteric coating seems to make my symptoms worse - or this could just be more psychological madness), which she seemed to get really suspicious about. Anyway, after seeing me and hearing me demonstrating huge knowledge in my own condition and managing it, agreed to give me the drugs. Which means I'm back on the preds and self-medicating at 10mgs a day.
A mixed blessing all this. Whilst the arthritic thing is painful and makes me immobile, and in winter means no football, it usually brings an end to any bowel-related symptoms. I think, and I stress the think here, that I prefer hobbling around like an old geezer than rushing to the loo and pooing through the eye of a needle throughout the day. But I reserve the right to change my mind on that regularly and without reason.

Sunday, 8 June 2008

Paranoid android

Its a beautiful weekend, the sun has been shining, Euro 2008 has started, England have won the cricket convincingly... can i enjoy it? No. Because I have spent the whole weekend rapidly descending a spiral of paranoia. And for once it's not UC related. Well, I say that, but i wonder if the underlying reasons are actually to do with living with a chronic disease.

At best, I would say that UC has made me a more reflective and conservative person. In many ways I am a far healthier person. Healthier that is, except for my colon, joints and... the fact I'm increasingly becoming a mentalist. I'm guessing that I would be typical of most chronic illness sufferers in that I am much more introspective than I ever used to be. I pretty much consider the consequences of every thing I do and, especially, eat. I literally cannot do anything on a whim or impulse any more. Virtually every decision I make is preceeded by the thought: "mmm, how will that affect the UC?". And I can talk myself out of anything on those grounds. I spend all day every day weighing up the relative importance of every twinge in my stomach and every bump or lump on my limbs. I have to constantly fight with myself to prevent my becoming utterly superstitious and reading portents and omens in everything. For instance, I can rarely bring myself to admit out loud that I'm feeling OK, and things are quite settled... that would be tempting fate. And, of course, I have to salute every bloody magpie that I pass. See, MENTAL!

So, it is with this crazy attitude that I have struggled through a weekend in which I have developed a cold. I'm afraid I am beyond the stereotypical man-flu archetype. Oh no, sir, no simple influenza for me. I had a particularly nasty bout of pneumonia in february and was hospitalized for a week (HA! as if i dont see enough of that place as it is) - it was horrible. I thought I was going to die. But I didn't. In fact I very much got better (another 6 week spell off work, but it must made a change for them to write pneumonia instead of UC on the paperwork. Incidently, 'hilarious' rumours spread among the kids at school like wildfire: cancer, AIDS... amputation!?). However, as a sniffle developed into a cold, and then moved down on to my chest, it has been terrifyingly easy for me to convince myself that IT'S BACK - I'M GOING TO DIIIIIEEEEE OF PNEUMONIA. God, I have spent hours breathing deeply to pinpoint any chest pain. I have tried repeatedly to take my own temperature - without a thermometer - "Oh Christ, I feel really hot..." yes, it's hot and sunny out today, you idiot. And most grotesquely I have developed a disgracful new habit of ejecting anything I cough up to inspect it for anything nasty (this has to be an extension of religiously examining poo). I don't even know what I'm looking for. Somebody heeeeellppp me...

Thursday, 5 June 2008

Like a sausage...



This damn colitis is so inconsistent - hoho, in so many ways...




  1. I've stopped taking the preds. Well, I forgot this morning - too busy making packed lunches for me and the boys, stuffing down toast and trying to squeeze in as many cups of tea as possible before work. So, thats that.
  2. I am feeling pretty good. Or am I? Stools are number 4 on the Bristol chart: like a sausage or snake, smooth and soft! Great, I love that chart. Occasionally they've even been a 3. Sometimes 2 or 1. But...
  3. Things aren't 'normal'. Not that I can really remember what it felt like to have a normal digestive system.
  4. I've been bloaty and hugely windy. Nice.
  5. And a bit crampy today, which was weird because that was before I produced the No. 4 in todays moment of glory. Cramp! Urgency! Enormous snakey log! Uh?
  6. Knees hurt. Have done for 2 or 3 weeks. Not swelling but hurting in an old-man-y artritic type way. Somethings definately active.
  7. Why-oh-why have short doses of prednisolone worked a treat for 4 years, but this time don't want to? Why do some poor people take loads of the horrible stuff to no avail at all?
  8. The other day I read someone suggesting nuts and tomatoes are the absolute anathema for UC sufferers. But my colon seems to love cashew nuts. Loves those little kidney shaped blighters. And, whilst I wouldn't eat a raw tomato too often, cook 'em and they're no problem. Its so inconsistent.

And now I'm getting a cold. Which scares me, because this recent flare began on the back of the anti-biotics I was forced to take because in Feb I hilariously came down with Pnuemonia! (apparently it's not just a disease for old men and junkies). Which started as a cold...

Tuesday, 3 June 2008

Mothers little helper.

My Marvel-crazed youngest son just asked me: "Which power would you rather have - the power to turn into water or the power to turn into fire?" After a little thought I plumped for fire. Yeah, burst into flames and burn the place up. "Wrong!" he said, "If you are fire, someone could put you out with water. But if you're water nothing can hurt you and you could go into the sea, mix with all the other water and get bigger and bigger." Mmmm, wise words.

Without any power at all, I went off to school today. Well, only the power given by one 5mg tab of prednisolone. What I actually need at the moment is the power to stop taking it. I started this course at the end of March at 30mg's a day for 2 weeks, then 20mgs and so on. But when I got down to 5mgs it all flared up again. So, I went back up to 10mgs and stayed on that until this week. So I need to stop again, but if I do and then it flares up again... well, then I have to start facing up to having to manage things another way, namely Azathioprine. Maybe this is not a big deal, I can't decide. All I know is that I've been fighting without drugs for 3 years and I really thought I had it all under control. And then, through the dumbest luck, it all kicks off and here I am.

How much of all this is real anyway? Every morning I place my faith in that little white pill. But am I OK because my brain excepts the power of the pill and everything wallows in its calm? Whats 5 mg anyway? Is that really enough to do anything? Will I be responsible for causing a renewed flare-up because I keep stressing about finishing the preds? Why do I have to constantly think about this? Jesus, I've spoken to enough other sufferers and read enough other blogs to appreciate how bad things could get for me, but sometimes I think I spend 90% of my daily brainactivity thinking about this bloody disease. Even when its not doing anything its affecting my life.

Today was uneventful. Two visits to the bog at school, neither loose. One since I got home, little nuggets! Feeling bloated and farty still. But thats good enough for me.

Soothed by the sounds of Sparklehorse.

Monday, 2 June 2008

Wincing the day away.


Back to school today. Never easy going back. I obviously wouldn't complain about the number of holidays I get (only perk of the job?), but it does make for rather alot of depressing back to school days... Anyway, back to school, out of the house, and out of the UC comfort zone. Back to scrutinizing every rumble, burble, bubble and twinge. Back to holding in farts (I couldn't survive audibly farting in front of a class - a legacy forever to be passed from sibling to sibling or father to son until I retired or died ) until I can run to a safe place, and then easing them out tantilisingly close to a follow through. I must have the most toned and responsive sphincter in the world.


I have had some terrible experiences with the UC at school: standing at the front of a class listening to a kids point whilst my colon burns inside me; gripping the table white-knuckled; desperately, embarassingly begging a TA to babysit a class while I leg it to the loo; holding on, holding on, holding onnnnn; and the inevitable day of not making it. This I escaped unscathed thanks to it being a teaching period (i.e. not many kids about) and through the help of someone who proved to be utterly discreet. When i returned to school I spent several days wandering the corridors waiting to bump into that kid who would look into my eyes and spell my resignation from the school with the words: "I know...". Never happened, thank God.


So, back today, and it was pretty uneventful. Still on the 5mg's of prednisolone - will I have the nerve to taper it right out this week? - which finally seems to be... well lets not tempt fate. Mondays a full day, no non-contact periods, which can spell terror when in the grips of a flare-up: when will I go? Strictly speaking you can't leave a class, but I guess I could argue my way out of that if push came to shove. It doesn't make for a mentally comfortable day though. And you'd be amazed at the number of parents only too willing to get on the phone either to you or the head because their little darling told them teacher left the room (or a million other things). But, things have calmed right down, so I got through the whole day without having to pay a visit. And, I must say, that the staff toilets at school are a pleasure to visit. Oh, hang on, did I say pleasure to visit? Surely I meant disgusting, disgraceful, shameful, foul, inadequate... I could go on. Lets face it, I've spent time in toilets, I should know when they're good enough. The kids were given a vote on colours and design etc, and theirs were all tarted up. But the staff? Well, who gives a shit, eh?


Cleansed out the day by listening to the Shins (wincing the night away) when I got home. Ahhhhh, now thats better.

Sunday, 1 June 2008

Brother, my cup is empty

On April 1st 2005 I stopped drinking alcohol. Fool. Over the preceeding years I had been cutting down from way too much to a couple of pints here and there and a few glasses of wine at the weekend. Alcohol was clearly proving to be a trigger for the UC. It definately first reared its head following nights out - and was too easily shrugged off as a hangover (a weird toilet-bound hangover, but hangover nonetheless). I distinctly remember being away on a stag weekend and spending the 2nd day glued to the toilet, then going out again that night, and so it went: beer/toilet, beer/toilet, beer/toilet until I got home. And STILL classing it as a hangover without batting an eyelid. Eventually the penny dropped and I quit altogether.

This is not actually as hard as it sounds. As long as you have a terrifying week of UC related hospitalisation, that included having to ask a nurse to apply cream to your bumhole because it was agonisingly raw and sleeping opposite a guy whose body would not accept his lovely new colostomy, then its pretty easy. I have good mates, on the whole they have accepted the sober Rich with open arms.

However, it has turned me into badge-wearing, teatotalitarian, holier-than-thou, ivory tower dwelling bore. And everywhere I look I see the steady decline of our once great nation into a booze-ridden abyss. Except it was never that great anyway. There are 2 main things that I've noticed:
  1. In the UK every pastime/leisure activity has to be accompanied by drink. Going to a football match, going to the beach, going on a picnic, having a barbeque, going to the shops, walking down the street, going on the bus, watching telly, etc etc etc. OK, so I exaggerate, but I did walk past a park full of people on one of our recent sunny days, and I thought "how pleasantly european", until I got close enough to see the sea of empty bottles and cans, and the apathetic blobs of lobster red flesh lolling in the sun, whereupon 2 blokes staggered out of the park and confronted me with incoherent obscenities. Why oh why oh why must sun=pissed? And now look, I sound like some retired old gimmer from Sussex.
  2. British people view you with suspiscion if you dont drink: "what can i get you to drink mate?" "Oh, cheers, I'll have a coke please" "Coke? Wot, you drivin'?" "Um, nooo, I er don't drink..." "Wot?" "I dont drink." "WHY?" "Well..." So how do you explain that you have a disloyal colon and drinking may infact lead to you pooping your pants, perhaps even by the end of the night? One chap (looooovely guy - rugby playing pig farmer) once threatened to "punch" my "f**kin face off" because I wouldn't drink the lovely pint he'd insisted on buying me. Still, he was pissed, so thats ok...

Anyway, I've now taken to saying I'm a recovering alcoholic which proves to create awe amongst those I'm talking to, and actually has lead people to vehemently tell others not to buy drinks for me.

Well, I went out for a good friends birthday last night, and drank loads of coke and couldn't sleep afterwards. But none of them care if I drink or not, God love 'em. So, it was a great night and the only thing I had to complain about was the volume of the music... Just call me Victor.

Friday, 30 May 2008

Prednisolone





Here's a funny little drug. Its a corticosteroid, which means it can reduce inflammation in your body. I don't know why or how. I am currently tapering down a course of these, now on 5mg a day. This is the 4th course i've taken in 5 years.


The first time they were pumped straight into my veins in great big doses, which I was thankful for because at the time I thought I was going to die by gigantic rectal prolapse that would include most of my internal organs and probably my head. After a week of that I was released from hospital with a big bag of oral tabs starting with 80mg a day. These babies did the trick and after 8 weeks or so I was back to normal and at work again (I never thought I would be pleased to be back to work!).


Subsequently I have taken shorter, lower doses for flare-ups although these have been mainly due arthritic symptoms - limb inflammation to elephantine proportions that is at once both hilarious and soul-destroying. Again, they did their work and life went on.


Then I had a period of semi-remmission (could've been the acupuncture, but thats for another post) and didn't touch the little monkeys for nearly 3 years. Until now.


Why now? Well thats for yet another post (Richard's world of stupid health stupidness, thats what I should've called this blog). Instead lets consider some of the side effects. I think I've been pretty lucky here, but they have definately had some effects.


When I read the info sheet that accompanies the tabs (I can never decide whether this is a good idea or not) my eyes are inevitably drawn to the phrase 'moon face'. A moon face!? What the f**k? "Yes sir, these tablets will solve your bowel issues... but you might end up with a face thats huge, round and pitted. Oh, and it lights up too just in case anybody missed it..." Moon face? Surely there's some other way of describing it that won't instantly make people see their future involving a channel 4 documentry production team? Fortunately (especially in my job) I've not experienced this effect. My heart goes out to anybody who does.

So, what effects have they had. Well:

  1. Roid rage - an internal boiling that I am aware of, but just can't keep a lid on. Eventually somebody is gonna break the camels back and whoa... run away, people, run away.
  2. Appetite increase - I'm not sure if this is real or just because I read it on the info sheet its become a handy excuse for STUFFING MY FACE WITH CRAP.
  3. Shakes - for goodness sake, like some old geezer. And why do people like to point this out to you all the time: "Hey, you're really shaking!" I KNOW (cue effect 1)
  4. Acne - Oh god, I'm so vain (I bet i think this blog is about me... oh, it is). I didn't suffer much in the way of spottage as a teenager - why now God? WHY NOW? (cue effect 1)
  5. Hair loss - this is a new one. Is it cos the preds caused me to grow more, and now it's shedding? Or am I just starting to lose it anyway? Bald, at 35? Noooooooo (cue effect 1).

So, why is it a funny little drug? Because this time it aint working properly and the consultant keeps talking to me about Azathioprine... but I can't hear him properly... mmmmmmmm