What's your happy pill???

When I left the hospital last week they gave me a nice little gift bag. This is what was inside:

Mmmmmn! This is about R1200 ( $177/ £109 ) worth of meds. I am very blessed in that in South Africa if you are unemployed, specifically in the Western Cape you get your meds free. I can't say the same for the US...I virtually went bankrupt trying to pay medical bills when I lived there.

Only two of these boxes contain my "happy pills"...antidepressants, the rest is for my BIH and one is to stabilize my shaky blood sugar. I take eleven and a half pills a day, most of them in the morning. When I am taking supplements ( these are VERY expensive in SA ) I can take up 10 pills in the morning alone- little B was always in awe of how I would be able swallow them all at once. Actually this would amaze everyone. I only take painkillers as a last resort...like say, when I'm blind. So those really don't factor into the equation.

The antidepressants I take are 50mg of Citalopram (brand name Celexa or Cipramil) and 25mg Amitriptyline - I take those for the headaches so I am not on a antidepressant dose. When I first started taking antidepressants in America I started on 20mg of Lexapro. The side effects of going on to antidepressants were really weird: a strong burning sensation on my face, neck, arms and chest, manic talking (just about ANYTHING would tumble out of my mouth), serious disassociation and really weird fevers!. Those are just the unusual side effects...I had all the usual side effects as well.

The long term side effects have been a little more unnerving. Both my long term and short term memory have taken a knock. In some cases with my long term memory it has been for the best, making some awful childhood memories seem more misty lessening their conscious impact on me. But for my short term memory it's another thing. I can't remember appointments, instructions or where I put things. I forget dates for assignments or what I even need to look at to remind me of assignment dates. Studying is a nightmare as I forget something as soon as I read it and I have trouble recalling something I have read a hundred times. This is not good as my exams start end of next month. The physical side effects, or those that are visible are weight gain ( I had to give away most of the fabulous clothes I bought in London), fatigue, thirst and sweating like a freakin' pig.

Then there is the emotional side of things. I still struggle with physical side of depression but I have no way of expressing any emotion because antidepressants have turned me into an emotionless, cold icicle. The only emotion I feel now days is anger and that's mostly when I am around my Dad. I can't cry, during the blue moon that I do cry it's only a couple of tears but I feel nothing. I don't feel happiness, sadness, contentedness, motivation just nothing, I just don't care. This has really perplexed and in many cases, hurt the people who knew me before my breakdown. They don't understand what has happened they can't accept that I have changed so a lot of those relationships have now grown apart and some have fallen by the wayside.

I am interested to know what meds some of you are on and what the positives and the negatives are...it's different for everyone so should be really interesting to compare.

Tomorrow I have the dreaded task of going into animal welfare and volunteering. I am looking forward to caring for the animals, also nervous as it can be really heartbreaking. But I am not looking forward to interacting with the "delightful social club" that are the other volunteers. They are really a miserable bunch of people and I don't want to spend even two minutes in their company but since they did save Milo's life I'm going to grin and bear it.

Milo the trooper! Me the pooper!

I feel like I am over blogging this week but I just wanted to let everyone know that Milo had his surgery this morning and it went very well. He is awake, eating and trying to move around. Unfortunately he has to be kept absolutely still for 7 days in a cage. I have never seen him still for longer than 7 seconds and we don't own a cage so he will have to remain at the welfare for the rest of the week. We live half an hour away from the welfare so I actually haven't seen my baby boy since I brought him in on Saturday and I have this weird fear that he will have forgotten who I am already. I will be seeing him tomorrow though.

I didn't want to go into hospital today until I had heard about Milo and by the time we had, it was really to late to go. This might not have been very wise but I have been steadily losing faith in those people. Despite the tremendous pain I have had since my lumbar puncture/ spinal tap last Wednesday, I have also gone deaf in one ear and become exhausted by doing the simplest of tasks like making lunch!!. What a crime it is for a girl in her mid- twenties...who once lead the high life living in London, very active, social etc to have been reduced to this.  I f**king won't accept this!. What type of a life is this to live?. For those of you that are mothers you can only imagine what it has been like for my mother to watch this happen.

Thank- you again for all your support, it means the world to me :)

This week...

With the happenings of last week, I really didn't think it was appropriate to continue my post on the hereafter, not to mention the actual movie Hereafter had a scene of a tsunami engulfing a coastline- I read somewhere that they actually stopped showing the movie in Japan because of this. I will continue this post in a few days.

And I felt, and have been feeling all this week that in the grander scheme of things my musings really didn't matter. It's the same feeling you get when you gaze up at the stars at night, realise how unimaginably big the universe is and how insignificant you are...not even a grain sand. I read somewhere that there are more stars in the universe than there are grains of sand on this earth.

I have been truly devastated by the events happening in Japan. I actually haven't felt this way since 9/11. All week I have seen pictures of carnage, bewildered people, bodies covered and landscapes forever changed. I wish there was something I could do but I know that's impossible Those of you who have been reading this blog for a while will remember that one of my dreams was to go and teach English in Japan after I graduate. My fascination with Japan started when I was the only girl in my class that would watch Dragonball Z with the boys. Forget I said that.

It's also been a week of "one-thing-after-another". On Monday I had my last session with my psychologist. My godfather is unable to pay for my sessions anymore. Obviously this is a huge loss but I am so grateful to him for his kindness, it saved me. Last Friday, I refused to go to therapy because I found out my Dad was e-mailing my therapist in what I think was an attempt to influence her. As far as I know you have to get the patient's consent to e-mail their therapist. It was the worst breach of privacy and although it may seem childish I decided not go to make statement that this was one area he would never be able to control

I ended a friendship last week before the earthquake. Believe me this was not something that do often and I didn't take it very lightly. I am still wondering if I did the right thing. Basically it boiled down to: "How long am I going to let this girl hurt me?" "Do I really have time for a flake?. The answer to both questions was in the negative. You see I have been really blessed when it comes to friends. I don't have a truckload of friends like my sister, but the friends I do have,have walked through fire with me, loved me unconditionally are constant sources of hope. I would do anything for them. Once you have had a friendship like that you really don't have time for the social butterflies who are here today and gone tomorrow but still depend heavily on you. That's what this girl was.

I was in hospital on Wednesday. What was meant to be a check up with the combined services of neurology and psychiatry turned into my having lumbar puncture/ spinal tap number 6. The actual procedure went well but it is now Friday and I STILL have a headache from the LP and body aches. I feel like I am 80. My one daily focus right now is painkillers.

For the last two days the surrounding area where I live has been engulfed in flames. The result of some fog throwing a cigarette butt out of a car window. At night the symphony of flames dancing with the moon can be very beautiful but once a new day dawns reality hits. Magical forests are now piles of ash, wild animals have burnt to death, the once beautiful landscape blackened. This morning I wondered where Basil and Buttercup were. Along the main road there is a mass exodus of fire trucks carry filthy, exhausted firemen. While new shiny ones go in the opposite direction, ready for battle.

Everything seems so big at the moment and I feel so little! So I am going to lay this very achy little head of mine down and try and get some sleep...

My two days in hospital

I wasn't in hospital per se- I basically went home to sleep- Thank God. But I have had to spend the past two days here:

Tygerberg hospital, the 2nd largest hospital in the world...otherwise known as a big- ass state hospital with passages over a mile long. And we walked up and down these passages from Neurology to Psychiatry and back again "conveniently" located on two opposite ends of the hospital. To give you an idea of the length of said passages:

Note how the lights kinda disappear into oblivion

Stopping for a break halfway through

I've said it before on this blog....whatever sadist designed this hospital- knowing that sick patients would have to walk the length of these passages- should be shot. My mom tells me that when this hospital was being built, in the 1970's there was great excitement as it was to be a "high tech" facility with "breakthrough technology"....as you can see that is no longer the case.

As I have also said before, I am truly grateful for the medical care that I am getting- it isn't fancy or comfortable but it has saved my life. I would be blind if it wasn't for neurology and the employment policy at this hospital has ensured that my Dad doesn't have to fork out half his pension each month for my meds (seriously) I get them for free. Not only that, when I think of the lack of medical care some of my fellow South Africans have and  how hundreds of thousands of people on the African continent die each year because they have no medical care. I am so thankful.

But because I am thankful it doesn't mean I have to just love everything about this hospital and it doesn't mean that certain things don't make me very, very angry.

I saw something yesterday that was the absolute last straw and made me absolutely livid... take a look:

See, I made it extra large. Not very spectacular right? . Looks like some construction going on.

Well here is the story. It was going to be a long wait for the neurologist so the ward secretary suggested that my Mom and I go have some coffee (aka coffee- flavoured water). On our way to the cafeteria we passed the "new" psychiatric ward. Whenever I pass the psychiatric ward I can't help but stop, there is always a whirlwind of emotion that goes through my head. Thoughts like, "Will I ever land up here?" "What has stopped me from becoming like the people in this ward?" "What will push me over the edge" race through my head.

Almost immediately after we stopped my Mom and I were caught up by the most disgusting smell and it seemed to be coming from the ward. I went up to the door and peered through the crack, the passage was deserted, the atmosphere radiating out of that door was eery. When I turned to walk back I saw that the side doors leading into a courtyard were open and there were a whole lot of flies buzzing in and out of the door. The source of the dreadful smell was that pile of rubbish in the picture above.... RIGHT NEXT TO THE PSYCHIATRY WARD!!!!. I walked a little closer...I'm telling you people the smell was putrid. The pile of rubbish was actually a lot bigger than depicted in the picture it consisted of wood, rubble, plastic, paper and then food in various stages of decay and other green, black and grey slimy things that I really didn't care to get any closer to. Basically it was a pile of sewage. You cannot see the flies in the picture but believe me they were having a field day

I was in so much pain in these pictures, both physically and emotionally, seeing this awful mess- a total lack of respect for human beings who are unable to help themselves- blew away the paper thin barrier holding back a total meltdown. That they have placed these people in underground, in the bowels of the hospital where no one has to see or hear them, away from sunlight, is bad enough. Dumping a pile of stinking rubbish outside their window that could possibly cause further distress and disease takes the bullshit cake. My mother reacted as any loving mother would by getting me out of there as soon as possible. I plan to write some newspapers about this and obviously complain to the hospital.

I guess really should give an update on my BIH, depression and GAD. The first day I saw a psychiatrist (aka doctor studying to be a psychiatrist). I knew right from the start that this was going to be a useless appointment. I told her that things did get better for a while, but after the break with my psychologist they are now worse than ever, I didn't get a chance to tell her I had been suicidal again because she cut me off and told me that "We don't really want to put you on more medication (I already knew that), I think you should go see a psychologist". That's what I have been doing you stupid woman... did you even listen?!. The outcome of the appointment was that they will try and get me to see a psychiatrist at a hospital closer to me and I go back in March, no doubt to see a different doctor studying to be a psychiatrist.

On to Neurology... a lot of time was spent trying to track down my neurologist (aka a doctor studying to be a neurologist)- they close for the Christmas holidays. Eventually my Mom had him paged and spoke to him on the phone where she demanded that he come in to see me. I was told to come in the next day. We were there bright and early the next morning and  waited for four hours to find that my neurologist and palmed me off on his buddy- surprise, surprise the dude that performed or should I say messed up my lumbar- puncture (spinal tap) three weeks ago. How- ahem- happy I was to see him.

This is where it starts to get funny- he refused to see me with my mother, telling her he would chat to her afterwards ( she had wanted to throttle him after my lumbar- puncture). Judging by the look on her face I immediately began to feel sorry....for him. When he asked what had been going on with me I stifled the urge yell, "You f**king mutilated my spine, you dumbass" and calmly told him that I had been extremely ill since the LP and I still had enormously painful headaches accompanied by dizziness, nausea and extreme fatigue. Meanwhile outside...where my Mom was listening through a hole in the door, in came strolling my neurologist. Poor guy... my Mom pounced like a cat on a bird. I could hear her threw the door and immediately fell sorry for whoever was on the other side of her wrath.

Dude checked my eyes- found my optic nerves weren't swollen, although they did appear scared. He asked me a few questions but I already knew what he was thinking: He didn't have a clue what was wrong and that most likely my depression was to blame. We spoke about surgery and it turns out that although my spinal pressure was high, they will not be doing surgery at this stage. I then told him nonchalantly, "So I guess  it's all in my mind then" He didn't really know what to say but eventually said "It's real to you- that's what matters" I told him good luck with my Mom. He told me I was a sweet girl.

We went back out into the passage where Mr. Neurologist had amazingly been able to calm my mother down. We stood talking for a while with him and Dude doctor. The compassionate side of them eventually emerged when Dude doctor said, " I would say now that your BIH is under control but your depression is definitely out of control". It was probably the only thing Dude doctor was able to hit the nail on the head about. Immediately I began tearing up and it was that that put them into action. They called in the psychiatry rotater and for a while there was some finger pointing going on. Neurology were telling Psychiatry that my problem was clearly psychological. Psychiatry were telling Neurology that it was clearly neurological. Somewhere between all of this I began to think about Homer Simpsom...for some reason. Eventually the heads of both departments got involved, seeing them trying to meet each other half way to find a solution was interesting. Eventually it was decided by everyone to put me on Amitriptyline an anti- depressant used a lot by neurology for management of migraines. I have been on it before. Needless to say my Mom was not happy- another pill. I have to go back for another eye test in January and will hopefully have my checkup the same day.

In between all this we found this little guy:

 The pictures don't really do justice to how very tiny this little sweetheart was. His name is Joshua and he was born prematurely. He is a month old and only weighs 2.2kg (4lbs 8oz). He has to wear dolls clothes because he is so tiny. When this picture was taken he was about to have surgery for cataracts on both eyes. His mother was beaming with pride and loved showing him off. We told her that he will be a piano player one day because his miniature hands have such long fingers and he held onto my finger with the most amazing strength.

You see it's this that I am grateful for. Tygerberg with it's stinking rubbish heaps, disintegrating walls, rude staff, toilet paperless bathrooms, looong waits and befuddled student doctors, kept this little boy alive and will give him the ability to see. There will always be things to be thankful for, even in a pile of ashes.

,



OUCH!!

To give y'all an idea of the size of "Mr Pointy"  I've never had the courage to look at the needle so the nurse took a picture for me:)

I will probably regret this picture....

It has been one HELL of a day!. The doc (aka doc studying to be something specific) was a nice guy but he hurt me badly. Dude jabbed me 5 times before he eventually got the fluid to drain from my spine. And I felt  it acutely EACH time he put that needle into my spine and then moved it around and in and out. It feels like a continuous pinched nerve. But I actually think it was worse for my mother and it really didn't help when she started to freak out and get really pissy with the doctor. You really don't want to annoy someone who has a needle in your back. So most of the time I was distracted with trying to calm her down and reassure the doc. What a circus...

However this time I was impressed, the level of pain today was the same as when I had my first lp last year...but I handled it so much better. Last year I was wailing and hyperventilating, today I was very nervous before going in but during the procedure, despite the horrible pain, I was calm and managing quite well. Right now I'm hurting badly, it feels like someone has kicked me in the back and I'm really stiff and achy. In private hospitals they keep you over night when you've had a lumbar puncture and you can't move for six to eight hours. In a state hospital, they make you get up and walk after 15 minutes to make way for the next patient!.

The pressure was high this time- 28 ( normal pressure is 17) but not nearly as high as we thought it would be. I don't know what will happen now and won't until my next appointment.

Anyway I'm sore and my Mom has to help me up the stairs ( I'm a granny for a day!)

x

My day at the hospital: Got some bad news :(

Phew!. What a day this has been. Had an appointment with neurology today, so was up at the crack of dawn this morning for the hour’s drive and then the loooooong wait at the hospital. As I have mentioned before my BIH has just been getting worse and worse over the last 2 months. The headaches, nausea and fatigue have been pushing me to breaking point and it has started to affect my vision and hearing again which is serious.


Unfortunately when I did see a neurologist ( well doctor training to be a neurologist or psychiatrist- state health care!) the news was not was not what I expected and actually far worse than I was wanting to hear.

I was diagnosed with Benign Intercrainial Hypertension last year- this is a fairly uncommon condition in which excess cerebral fluid forms on the brain. No one knows what causes it and there is no cure. I had been sick for most of last year with debilitating headaches, nausea and fatigue. Eventually I started to go deaf and blind in one eye and that’s when I sought help. I was told, very gently that I may have a brain tumor and for 10 days my family and I prepared for the worst. Thankfully an MRI ruled out any tumors or lesions and after a lumbar puncture (spinal tap) I was diagnosed with BIH. I talk more about my diagnosis and treatment here

For the past six months it virtually disappeared and then suddenly decided to rear it’s ugly head again. I had thought when I went in today that the doc would just prescribe a lumbar puncture as usual and then I would go on my merry way. But the doctors were very concerned that my BIH has just come back, out of the blue and even more concerned that my sight is deteriorating. They have booked me for another lumbar puncture on Wednesday – the only way to tell if my intercranial hypertension has increased. If the hypertension is high then they will be referring me to a neurosurgeon for brain surgery. You can imagine how shocked we were.

To top off the day they sent me to opthomology to do a visual field test- this is to check my blind spots and I was presented with more bad news. I have two massive blind spots on the outside of both eyes and my optic nerves are swollen again. They still have to do more tests but unofficially it appears that I have started to go blind- this is the long term effect of BIH.

Right now none of this has been officially confirmed. I just have to wait until Wednesday. I don’t know what is worse when it comes to a health crisis- knowing the possibilities and letting your imagination run wild. Or being completely ignorant until you are hit with the cold hard truth.

I am calm and I am so thankful for that, but I have a feeling my mother is freaking out. This is mostly thanks to the idiot head of neurology telling her last year that surgery was the final option because of the risks. When she asked him what the risks were he casually said, “Death”. This was the same dumbo that told me I had to be “strong” to be sick in that hospital. And when I was told I couldn’t have children he “sympathized”, “It’s a shame, you’re such a pretty girl”. It’s a shame he has no proper beside manner!

Anyway, like I said none of this is definite and that horrible man was just presenting us with the worst case scenario. I have said before that I am thankful for the health care I get through the state: It's far from fancy, most times it's inconvenient and disorganised, but if you compare it to the health care or lack of that millions of other people face on the African continent, I actually am very lucky and I will continue to have faith in them ( I actually don't have a choice!). I most likely will have a freak out session at some stage but for now whatever the outcome my be- I am going to carry on with my life- continuing to fight my depression, GAD and daily battle with food, looking after my little girl (that's my next post), my mother and my wabbits and preparing for my future by living in the PRESENT.
 
Here are some pics that we took during the long wait. Blackberry + boredom = weird photo's
 
 

The "homely" looking hospital reception: The Cage!

Neurology waiting area, look closely...you might just see how bored everyone one is.

About the 5th time I read this magazine

 Finally home to my sweethearts :)

Welcome to my looney bin...

This is were I go to receive psychiatric care. Tygerberg Hospital in Belville (just outside of Cape Town), South Africa. I also see neurology for my BIH, have all my lumbar punctures (or spinal taps) done in this hospital and all my government funded meds come from there. What do you think?...does it have a nice aesthetic feel to it??.

Before I start, I want to say very clearly that I am GRATEFUL for the medical care I receive. I am not on medical aid and therefore rely on the state. It isn't fancy or comfortable and sometimes it's very basic. But I would not be breathing right now if it wasn't for this place. And considering how medical care (or lack of) is on the rest of the African continent and even in different provinces of South Africa, I have been lucky.

Believe it or not some of South Africa's state hospitals are famous. Just down the road from Tygerberg is Groote Schuur hospital where Dr Christiaan Barnard performed the first human heart transplant operation in 1967. Chris Hani Baragwanath Hospital in Johannesburg is the world's largest hospital. Tygerberg was commissioned in 1972 as a teaching hospital for Stellenbosch University. When it was first built it was a world- renowned "state of the art" facility. Unfortunately what was "state of the art" back then is considered to be ancient now and Tygerbery- because of lack of funding- has failed to keep up with the times.

I hope the pictures do justice on how incredibly MASSIVE this place is. Connected behind the building shown in the photo above is another building, it's twin and just as massive. This place has it's own post office, bank and water supply. I will never forget how overwhelmed and terrified I was the first time I came here.

Three of the most well known characteristics of Tygerberg is 1) You WILL get lost, no matter how many times you go there 2) The number of DOORS you will find- there are hundreds of them in each passage and I have no idea what's behind them as they are always locked. And 3) The loooooooong passages.



This is passage I have to walk down get to the outpatient's. I'm estimating it is about 1.5km (almost a mile) long. By the time I get to the end of it I feel slightly more depressed than when I started it. I always wonder about the inconsiderate fool that designed a hospital with passages this long. We have seen people people on BICYCLES riding down here.



On my way to outpatients I pass the lovely, homely looking psychiatric ward. They were in the process of moving when I took this photo, normally the doors are enclosed in big black buzzer gates where you have to identify yourself through an intercom. The police man both the inpatient and outpatient ward. I have gotten to know most of them, they are wonderful gentlemen and very respectful but if you get even slightly fidgety they will start gravitating in your direction.



The both the outpatient and inpatient ward are located on the lower ground. Yep they shoved us underground out of the way and where no one can see us. And you go down that passage and there is a distinct "hush". I feel like I am entering a secret society.



SA State care works on a first come, first serve basis. Basically I make an appointment for a specific date, but your appointment can take place anytime during the morning depending on when the psychiatrist finishes his/her ward rounds. I have to roll my ass out of bed at the crack of dawn to be at the hospital by 8am ( I live over an hour away from the hospital) for when they open at 9am to give them my folder and get in the que. Then between 9am- 11am all the patients eyeball each other ( "it's not what you think! I'm here with my 'friend' ") until the psychiatrists get back from their ward rounds and see the outpatients.

The majority of state health care in South Africa in provided by med students doing their specialty or residency. The same is true for Psychiatry. I have often found myself sitting in the hallway looking warily at some of these students and hoping to hell that they did their homework instead of going out drinking the night before.

You cannot choose who you see, a psychiatrist is assigned to you. If you don't like them I guess you could complain but the general consensus is 'beggars can't be choosers'. I can honestly say that I have been lucky in the two psychiatrists I've had. The first, Dr Dunnit was a young girl just a couple of years older than me. She was soft spoken and very caring and I honestly felt she had a true passion for what she did. Her knowledge was boundless and she was more focused on self- help than doping me up with meds, although she did increase my meds. Because these student are on a rotation basis you'll have them for about a year before you'll get a knew one. My second psychiatrist was a slightly older women who was is very positive. I was pissed off the first time I saw her though because she refused to give me sedatives!. But I guess it was for the best.

There are four state psychiatric hospitals around the Cape Town area. The most famous of which is Valkenberg. We used to make jokes about this place at school -"Dude you're so dumb you should go to Valkenberg! haha!. Whatever. I'm not laughing now. There is still a chance that I may have to be admitted to hospital and since I don't actually live in the catchment area for Tygerberg I will land up at one of these four hospitals. I have heard some hair raising stories about Valkenberg. A girl from college used to live right next to the infamous "Ward 20" - the maximum security ward- and she told us stories about how they would take patients from building to building in steel cages.

Anyone who has visited that hospital will need one of these when they are done.



South Africa's private health care is top notch- rivalling some clinics in Europe and the States but you will need the magic medical aid card to gain access. Because I am unemployed at the moment all my health care and medicine is free. In most cases and depending what province you live in the doctors and specialists take good care of you. But our hospitals and resources are falling apart due to lack of funding. No doubt the sudden explosion of AIDS in the last 30 years has put a lot of pressure on the government. But I do get angry when I read newspaper articles about our defence force writing off R1-billion (about $147 million) in "unexplained expenditure". THAT could have fed every hungry person in South Africa for a year ( I kid you not) or built several new hospitals OR provide the best care to the estimated 4.5 million South Africans living with HIV.