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.