Testing, Testing… One, Two, Three..

I have had a LOT of tests done recently, which let’s say has not bode well for my attendance at my medical lectures. I have recently recieved a letter informing me the need to “discuss” my recent bone densitometry result, which no doubt means it is lower than expected. But this was the test I was least worried about. Sure, if my T-score is low I’m probably gonna be shattering bones all over the place when I’m fifty+, but I’ve got enough to worry about now, let alone things I may well not live long enough to worry about. I do sometimes do the whole “but in twenty year…” worrying, but I have to be brutaly honest with myself. I may well not make it that far, so no use in worrying about it!

I’m already taking Adcal-D3 for my bones, a calcium and vitamin D supplement for those who don’t know, to prevent osteoporosis. Long term, high dose steroid use increases my risk, but apparently what they’ve been giving me so far isn’t enough. It also probably doesn’t help that my drug compliance is absolutely tragic. I’m so forgetful, and when you have to take as many drugs as I do at different times and different doses I just forget. I’ve run out of many of them too, but I’m not a hundred percent sure how to use the repeat presciption thing at the health service and until I run out of any of the “vital” meds, I’m going to continue to avoid it. I also know that most of my meds aren’t even on my repeats with the health service as I recieved them from the hopsital consultant, so I’m kinda hoping either the hospital has told them or they’ll just “believe me”.

I know this sounds pathetic, a medical student who is too scared to go to the health service to find out about repeat prescriptions. But it’s a while away, and I’ve been so busy… and personally I’ve had enough of seeing doctors for a while so I guess it gives me some vague control just to ignore the problem for a while.

It also didn’t help that I recently turned 19, which in the NHS means I no longer recieve free presciptions. It means it’s £7.20 or so a presciption, and as I get at least ten a month, not really a financially smart option to pay as I go. Therefore I had to get the yearly pre-paid certificate for £104, but that only arrived recently. Now I can actually AFFORD to go get my prescriptions.

The other tests I’m waiting on are the ones that keep me up at night. Well, one in particular. I had a nerve conduction study done as I have repeatly experienced paraesthesia, tingingly or “pins and needles”, in my hands. If it gets worse, it could affect my fitness to practise. For those who don’t know, if I am judged no longer fit to practise, I can and will be removed from my medical course, or if it happens after my medical degree, I will loose my medical licence and can no longer work as a doctor. This, needless to say, TERRIFIES me.

It’s unlikely to mean I can no longer continue, I still have feeling in my hands most of the time, and it tends to be worse at night. But my Churg Strauss could permenantly destroy the nerves in my hands, and if that happens I’m pretty sure I wouldn’t be fit to practise. How can I diagnose and treat patients if I have no sensation in my hands? And surgery would be a definate no-no, something I would really like to persue. It would be nothing, just a bit of carpal tunnel. If so, i’m fine, many doctors have carpal tunnel and its just something to keep an eye on. But if it is my Churg Strauss, the damage may well be permanent, and could get worse. And if it’s effecting the nerves in my hands, it will effect elsewhere. And if it gets really bad, I’ll have to consider have cyclophohphamide therapy, a chemotherapy drug, which I really do not want.

I’m also waiting on some biopsies from my colonoscopy, which “looked” normally macroscopically, but still has to be looked at histologically. I’m hoping they find something if I’m honest, these GI symptoms are starting to become annoying, and if they don’t find anything then it’s going to be something I’ll jsut have to “live with”. But I’m hoping they don’t find anything serious… something that they can give me a pill that will magically cure it. Sigh, a girl can dream!

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The Dark Depths of the Colon

I had a colonoscopy last week, that I realise now that I have not discussed. I think all tests I undergo are invaluable experiences for the future, you only know what it’s like when you’ve been there and all that.

When I was 17, I volunteered with a hospital colorectal surgical firm. One of the  joys of this was spending a morning watching colonoscopies being carried out. It was mostly the elderly, as it often is with hospitals, and some were moaning with pain throughout. I thought to myself, come on, how painful can a colonoscopy be?

Very. Not only was I giving sedation referred to as “conscious sedation”, where you are still aware of whats going on around you, but it’s like being very, very drunk, I also had to be giving gas and air because I honestly thought the guy was trying to push the goddamn endoscope through my abdomen. It hurt like hell.

Not to put anyone off, it doesn’t hurt like that for everyone, but some people have “looping” of the bowel, which makes it difficult to pass the camera through and hence, painful. I also found it hilarious, as it was like being absolutely wasted, when I saw what I believed to be the end of the large bowel on the screen and exclaimed, “OMG its the ileocecal valve” in officially the most insane voice ever to be used in a colonoscopy ever. To which the consultant just laughed and asked if I’d “revised” for this. I don’t remember my response, I don’t remember a whole lot of it in fact. Much like a very drunk night out!

When it was over I was glad, they gave me some tea which I then proceeded to vomit everywhere. I then managed to beg for some antiemetics and for my cannula to be removed before I did it myself. I’m very anti-cannulars, they really freak me out. I then got a taxi home and pretty much passed out for a good eight hours.

The procedure itself was by no means the worst part. That was almost the fun part with its drunk like inducing drugs and hysterical laughter. The preparation is the worst.

In order to actually be able to have a camera inserted where the sun don’t shine, you must have the bowels completely empty. To achieve this, I was given the world’s most vile tasting solution ever conceived. And to make matters worse, I had to drink four litres of the stuff within 5 hours. My recommendation for anyone who has to this is simple. Buy some lime juice and a shot glass  and then chase down every sip with some lime. I don’t know if you’re supposed to have lime juice, but at the time I really didn’t care. It was either that or not drink the liquid. And at any rate my bowel was very clear. I was about two litres in when I had finally discovered this technique. After a good old bout of retching, I decided to use the lime juice, but I drank it before each sip. It helped a little, but the real problem was the after taste. Once I’d found the magical solution of a chaser of lime, it was smooth sailing.

The only good thing to say about the prep is that it made me so nauseated that at least I didn’t notice how hungry I was!

All in all, colonoscopies are not the most pleasant of experiences, but still way better than the endoscope I had done on my stomach. When that consultant hands you that consent form asking you if you’d like to be sedated for god sakes say yes. I didn’t and I still have the nightmares.

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