E is for Energy

Like most chronically ill people, I know of, and use to some extent, the Spoon Theory to explain my fatigue. If you don’t know, Spoon Theory is the idea that when you are chronically ill or have chronic fatigue, you only have so much energy, or Spoons, to do tasks. Each task taking up a different number of spoons. For example, say you wake up and you have five spoons to spend that day. Having a shower and getting dressed may take up one or it may take up two, depending on your condition. Let’s say it takes up two. You now have three left to use at work, come home and make dinner. But if works takes up three (or in most cases more) spoons, you won’t have any left to make dinner. So, do you have the shower or not?

This is one of the many issues chronically ill people, or “Spoonies” have to deal on a day by day basis.

Some days, I’m ok; I have enough spoons for work, a shower and dinner. But some days, like today, I barely have enough to get dressed. I needed to shower and wash my hair. This is something I really don’t like putting off because it makes me feel worse if I do. So of course I forced myself to shower this morning. Even as I sit here and write this though, I am feeling drained, and worried I’m going to struggle at work. (and its not even 7am yet).

This is my reality. This is why I sometimes cancel plans last minute. This is why, some days, I can do nothing more than get dressed and sit on my computer all day playing games.

And it’s not just me; a lot of Spoonies face the same difficulties. We all get bad days but when your a Spoonie, your bad days can be so much worse.

Please remember to be kind. If someone says they are fatigued, they probably mean it. There is a big difference between being tired and being fatigued.

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Please note: you don’t have to be chronically ill to have Spoon Theory apply to you. It is entirely ok to relate to Spoonies even if you are otherwise healthy.

Also note, there are a lot of variations on Spoon Theory, such as the Match Box and Old Phone Battery. Thanks for reading.

C is for Catch-Up

Again, let me apologise for being MIA for a bit. The truth is, I’ve been struggling a lot recently and blogging hasn’t been that high on my priority list. That being said, let me catch you up on what’s been going on with me lately.

As mentioned in a previous post, brain fog is a very real and serious side-effect of being chronically ill. I don’t usually suffer with it but the last few months have been quite different…

It started with a drop in my appetite. A normal day for me would consist of having lunch and dinner, and maybe breakfast in the morning if I felt like it. But I began to not feel hungry, and the idea of food would make me feel sick or nauseous. I began eating less and less until it began affecting my energy levels at work. I spoke to my IBD team who recommended I started back on the modulen. This lasted for about a week before I couldn’t manage it anymore and reintroduced solid food alongside the modulen until I was able to eat a bit more and could cut out the liquid nutrition all together. However, I soon realised I had “shrunk” my stomach; I wasn’t able to eat a full meal anymore. I started eating little and often, around five to six small meals a day. This has sort of worked but it’s not always possible to eat midmorning or afternoon, especially when I’m working, so I don’t always get enough food. This has continued for some time now and I’m still trying to get my appetite back to normal so that I might be able to eat more.

Lately though, this has proved difficult; because I haven’t been eating that well, I’ve began suffering with fatigue. This fatigue has caused me to be unable to do much after work or on my days off, leaving me incapable of properly taking care of myself.

This drop in appetite and increased fatigue has left me feeling drained and I’ve begun to struggle mentally. I won’t go into details but it’s got to the point that I’ve reached out to Steps2wellbeing, a UK-based mental health organisation who I have used in the past and may have mentioned before. The initial triage session went well and I’m on a waiting list to start CBT (Cognitive Behavioural Therapy). I’m not sure if it’ll work but I feel it’s worth trying because that’s better than doing nothing.

As for my physical health, that’s begun to decline again and I have, once again, been signed off from work. I don’t know how long I’ll need but even my works occupational health team believes I need time off so I’ll take their advise. I’ve had a blood test as well as a faecal calprotectin. These have shown that some of my inflammation markers are a little raised but not a lot else. And to make this even better, I was admitted to hospital on Monday.

⛔ TMI Warning for this next bit! Please don’t read any further if talk of poop or other bodily secessions grosses you out. Thank you for reading this far and I how you are staying safe. ⛔

OK, so since being admitted via a&e, I have had a CT scan as well as an xray, which have shown that I have inflammation in my small intestine (mostly the lower part, below my stoma) but thankfully no twist, like my GP suspected. The CT also showed that there was something in both my old jpouch and the part of bowel going up towards the stoma (most likely mucous) which was making them both a bit distended. My surgeon has recommended I start antibiotics to help control the inflammation (which I have) and, hopefully, whatever is in the old pouch will eventually come out via my back passage. I started the antibiotics Tuesday but it’s still early days yet.

Eventually, I’ll have the excess bowel removed. My surgeon said that should stop (or at least reduce) the inflammation in my small intestine. Obviously, I can’t have that done now due to Covid, but maybe in six or so months time.

So that’s what’s been happening with me recently. If you made it this far, thank you. I appreciate you reading my rambling posts. This one in particular is a bit disjointed because I wrote over several weeks where a lot was going on, making it hard to concentrate. I’m sorry if some parts didn’t make a lot of sense but the brain fog is pretty strong right now. Anyway, thank you again for reading and I hope you are staying safe.

Liver update

I saw my GI a few days ago, and I was expecting to only see him. To my surprise, I actually had a joint GI/Liver appointment. This is really helpful for them and for me as having IBD, and Ulcerative Colitis specifically, means I am more prone to certain liver diseases, and seeing me at the same time makes it easier to assess and treat my symptoms without having to keep going back and forth.

Just over a year ago, I had some problems with my liver. An ultrasound showed it was enlarged after I presented with abdominal pains to A&E, and I had a biopsy to determine if I had something called Primary Scleroring Cholangitis (PSC), a progressive autoimmune disease that causes the bile ducts in the liver to become inflammed and eventually blocked. At the time, I didn’t think I had this as the biopsy didn’t show any signs of it – or so I thought. As it turns out, I do have PSC but it is very very mild at the moment. It means I’ll need yearly ultrasounds but that’s it unless it shows signs of progressing, then I’ll need biopsies. At the moment, there are no treatments for PSC but it is something they are working on.

As for my IBD, everything is fine. My GI wants to check my sodium and calprotectin so I’ll be doing several samples and blood tests over the next few months. In the meantime, I’ve been advised to have St. Mark’s rehydration solution or dioralyte every now and then or if I’m feeling very thirsty during the day. This should help keep my electrolytes up and save me from getting dehydrated.

IBD open day & a work update

I went to an IBD information open day today at my local hospital. There were lots of resources for patients as well as their friends and family, and the talks covered things like exercise, research, diet and the hospital’s IBD helpline. Even though I know a lot about my disease already, I still found it informative and interesting. There wasn’t much time for networking or socialising but it was still good to be there among those who suffer as well and those who are helping make it bearable.

Next week, I’m going to a Crohn’s & Colitis UK coffee morning meet up. I haven’t been to one for a while so I’m looking forward to seeing how everyone is doing. Although I don’t feel I “know” any of the regulars at the meet-ups, I still feel some sort of connection because we have this disease in common.

As for how I am doing, I feel my recovery is going well. I went back to work three weeks ago and it’s going well so far; I’ve a gradual return, with my first week consisting of one and a half weeks because I had a week of annual leave straight after. The second week was two full days but they were easy as it was quiet and there wasn’t as much to do. This last week I worked four days with a day off in the middle to give me time to rest. I have found getting back into it easier than I thought and there are only a couple of minor adjustments I need at the moment. These adjustments are mostly regarding my ability to aid a disabled patient, specifically mobility aid users, as I can’t push a wheelchair nor support another person due to my stomach muscles still healing. This is to protect both me as well as the patient as if I am unable to support someone and they fall, I can’t help them back up again. It’s frustrating because I hate how I am not able to help my patients the way I should. Still, this is only temporary for me and I know eventually I will get better. I am for the forseeable future going to keep wearing my support belt as it helps prevent muscle pains during my work day.

As for my diet, it’s great; consisting of lots of bread, crisps, chicken, potato and chocolate. I’m not underweight but I’m on the lower end for my height so it wouldn’t hurt for me to put some back on. Plus, I’m almost always hungry so snacking is a good thing as far as I’m conscerned. This need to snack does pose a slight issue with my work though as I only get one break during the day and, no, unfortunately I can’t split it due to task assignment. I may have to start stashing snacks in various places so I can eat when it’s quiet.

Anyway, that’s all for now. Hopefully, I’ll have more to share over winter with the cold weathers effects on stoma bags etc, as well as the perils of Christmas dinner. Thank you for reading!

Salts bag trial and review

I saw my stoma nurse earlier this week and, after a brief chat, we decided I may need a convex bag again but because she was conscerned my stoma might prolapse if the bag was putting too much pressure on my bowel, she offered the Salts 1-piece drainable convex bag to try for a bit as they are meant to be more flexible than other convex bags and so shouldn’t put as much pressure on the bowel.

It’s a tad bit smaller than the Sensura Mio, with a petal shaped baseplate and a drainage end similar to the Dansac drainable, except it has a small tab on the end which makes opening it easier. The material used to cover the bag is soft, water repellent and makes the bag look a lot less clinical. First impressions after wearing it for an afternoon where that it was a good bag that held it’s shape fairly well when full and that didn’t rustle when moving.

But.

I had issues with the opening. I found, although easier to open and clean than the Dansac, it was still messy and would leak a tiny amount of output when closed because it lacked the extra side tabs that the Sensura Mio has.

I thought that maybe I could get used to the opening but then I realised that I was scratching myself raw around the edges of the baseplate – something I was told shouldn’t happen because there is aloe vera in the adhesive to prevent such itchiness. If this was the only issue then I might not have minded too much but because of the opening as well, I’ve decided I prefer the Sensura Mio.

That’s not all to say that the Salts bag isn’t any good. I like it, I really do. It’s just that I can’t get on with the opening (I guess the Sensuro Mio has spoiled me?) and the reaction to the adhesive. I don’t want to deal with the tiny leaks or the itchiness, things that I haven’t had with the Sensura Mio.

I have had other ostomates mention/recommend other bags to me so I may try them in the future but, for now at least, I’m happy with what I’ve got.

Using a mobility aid after surgery

I have had four surgeries on my gut in the last two years. As you might imagine, this puts a lot of strain on my stomach muscles. Muscles we use for pretty much everything, from carrying to simply standing.

When you first start moving after surgery, every twist, every step is painful and you feel like you might just rip your stitches open at any moment. Thankfully, while in hospital, there is always someone to help you, to hold your arm or fetch a wheelchair for you when you can’t quite make it back to your bed. However, when you’re home and out in the real world, those safety nets aren’t always there.

It takes a while for your muscles, and in fact your whole body, to recover and adjust to how things are post-surgery. Sure, a friend or family member will likely be with you on every excursion out the house for the first few weeks but what about when you want to go out when no one can go with you? What about even when someone is with you but you’re not sure you’ll make it to the car, let along the cafe you’re going to for lunch?

That’s where mobility aids come in.

I have a walking stick. I am 31 years old and look fairly healthy, albeit a bit skinny, and I have a walking stick. I got it for the very reasons mentioned above. I can go out with family, sure, but they can’t always hold me and most probably couldn’t lift me if I fell. The walking stick acts as a support for me if I stumble or when going up or down steps, it allows me to keep my independence. It allows me to walk further and for longer and gives me the confidence to go out on my own.

But it’s not only that. It also acts as a warning to others who can’t see the scars, the ostomy bag and the healing wounds, that I may be slower, unable to move out of their way or cross the road in time. It lets people know to give me a little extra space, to catch that door or hold the lift.

My point is that mobility aids are useful and we shouldn’t be ashamed to use them just because we may look healthy or young or otherwise as if we don’t need it. If you feel you need a mobility aid, regardless if it’s a wheelchair, a walker or a walking stick, you should use it. It doesn’t matter if it’s for six days or for the rest of your life, you should use the tools at your disposal if it makes life easier for you.

And to anyone who has felt the need to question why someone is using a mobility aid, it’s none of your business. You don’t know what’s going on inside, what that person is dealing with. They may be walking fine but that’s probably because they are using that mobility aid. Please don’t be so quick to judge.

I’m going home!

So, I am finally going home! I was moved onto low-residue diet last night and have kept down three solid food meals. I feel fine, albeit a bit tired, and am itching to get back to my space.

I don’t know how long I’ll be signed off for but I imagine it’ll be for at least a few weeks.

I’m just waiting for the discharge paperwork and sick note and then I’ll be free to go.

A week post surgery

I’ve had a bit of a set back. Yesterday, I woke up feeling very cold and shaky. My temperature was ~40°c and I was tahycardic, with heart rate over 130bpm!

The nurses and doctors were quite concerned and I was put on a very strong IV antibiotic, which helped a lot. They also put me on IV fluids as I was feeling sick and wasn’t drinking much. They did blood culture checks, both peripherally (from a vein) as well as from my PICC line because there was a chance the line was infected. They also did a urine dip from my cathatar.

While they were waiting for those results, they took me for a CT scan to check if I had any liquid pooling in my pelvis. Unfortunately, I have a pooling near my stoma and they had to put in a drain last night. I believe my PICC line is fine but they’re not using it at the moment.

I’m very sore and achy, and not as mobile as I was a few days ago. I feel like I’ve taken a few steps back.

Recovery update

It has been five days since my surgery and I think I am healing fairly well.

My pain is being well controlled by the PCA but it has been reduced to just morphine without the ketamine, with a low dose of morphine running in the background. They removed the rectus sheaths (anaesthetic being pumped directly into the wound) yesterday as one had broken and was leaking and the other wasn’t doing much either. They’re only meant to be in for three to four days anyway.

I’ve still got my cathatar in, which I suspect will stay in until I’m moving more freely. The drain is due out today, with the NG tube coming out tomorrow. And my diet has been upgraded to clear fluids.

I am feeling a lot more comfortable today and I’m even able to get out of bed, with little assistance. My hope is to start going for short walks to build up my strength.

Intestinal colic

This is what they think I’ve got. It means severe pain that comes in waves, usually around the abdomen. Apparently, it’s caused by the muscles contracting in an attempt to move an obstruction.

At the moment, they’re still wanting to observe me but if things don’t improve soon, I’m assuming they’ll intervene with… something, I don’t know. There have been several mentions of operating but I really hope it doesn’t come to that. Apparently, this can go away on its own but, knowing my gut, I don’t think it will. At least, not quickly, anyway.