Tag Archives: Mental Health

PSORIASIS BLOG – Treatment Update Six

Treatment Update Six

November/December 2012

Oh, and a timely reminder to read the disclaimer here – please don’t post a reponse to anything here until you have had a look.

All that is lodged in my memory from Doctor McBride’s session in early November (I’ve been away having fun … I mean working, since) is that my progress has regressed at tad. And I have regressed further since then I am afraid to say. That’s obvious from the physical side: then, I had a few light patches on my arms, and now (at the time of writing I’m seeing her again in just a few hours) there are shadows on my arms and sides. Shadows with a dusty surface and a reddish tinge. Let’s be fair, I’ve not looked after myself as much as I did when I was at the Edinburgh Fringe; wheatgrass shots and fruit/veg smoothies each morning, a strict exercise regime that had me in the gym nearly every day, no alcohol, pretty early nights. Since then I’ve let myself go a little bit, so surprise, surprise my Cholesterol is at a whopping 6.7 (I had it down to 4.5!!) which is not good, whilst my Triglycerides (fat in the blood) are at 3.6. I can’t remember if that is good or bad but it’ll be interesting to see how they compare to the blood I gave yesterday. “Gave”? I make it sound like I am benevolently donating something as opposed to having my plasma sucked from me so that it can be broken down into numbers in order to discover what level of the Unhealthy Scale I have ascended this month. I asked Dr McBride if we could hold off with statins and so keep my daily intake of pills below the hundred mark and in return I would endeavour to get as healthy as before; I am convinced that self-discipline might be a better long term option than pill popping.

Well, I think I have probably failed.

“Can you tell what it is yet?” It’s my arm, with a creeping barrage of mild psoriasis doing its best to ruin an otherwise perfect and robust limb.

I went to a Doctor Who convention (don’t snigger at the back) in Chicago (see, I got to go to Chicago for free, oh ye sniggerers) at Thanksgiving, where I ate American food and drank American drink. The latter is like English drink but weaker, not as nice or three times more expensive, but not especially better or worse for you. The former is like English food but with added dollops of fat, syrup, sugar and insanity. Like sweet potatoes? Not until they’re topped with marshmallow you won’t! So I have put on weight and developed very, very dry(but not red, sore or painful – I’m dusty rather than crusty) patches on my arms and sides. My scalp could single-handedly provide the snow for the world’s entire collection of nativity displays. So bad has it been that I have adopted an entirely beige clothing policy in order to minimise the embarrassment and camouflage the cascade of detritus. My lips have also been drier than a sarcastic Martini but that is because of the acitretin (which, coupled with ubiquitous Stateside air conditioning has left my gob like the lunar surface but with slightly fewer golf balls).

Now, of course, we don’t know if food is a trigger (probably not) but general physical well-being is definitely important. However, my visit to Doctor Mazara yesterday (2nd December) indicates that various personal and professional stresses are responsible for my mild flare up. I don’t need to go into the whys and the wherefores (especially not after my last, rather maudlin, blog), but the fun times in Chicago have been karmically balanced by some less joyous developments. As ever I have tried to greet each unwelcome visitor with a smile and Dr Mazara helps me to do this by offering good advice; only control what you can, life isn’t always easy, and accept the fact that one has to work to keep one’s personal life happy and that the profession I’ve chosen generates frustration and upheaval. Irrespective of what is happening, we are responsible for our own moods; dwelling on the uncontrollable gets us nowhere and taking life by the scruff of the neck and staying positive can work wonders. So that’s the prescription – open the advent calendar doors and make sure there are only happy scenes behind them.

There are certain things I have to do to change the things that aren’t going so well, and I am working on them. Dr Mazara cites coming to her and getting to grips with the emotional side of the disease as positive steps and examples of why one shouldn’t bottle one’s feelings up. Interesting, having gone to her feeling fairly rotten I reacted well to the idea that just being there and talking openly was a marked improvement on how I would have approached this a year ago. In plucking a positive (and you’ll note, one that put me in a good light) from all the surrounding difficulties she managed to spin me out of my self-indulgent miasma (by indulging me!). My visits to her have made me a little raw when I think about the disease, but she assures me that this is a good thing. Great – crying makes one better apparently. That’s no good if you’re on a bus! Oh well then, there’s no alternative fellow sufferers – never mind the pills, just watch Old Yeller or Bambi once a week and you’ll be fine.

So – let’s see what my physical readings are when Dr McBride goes over my bloods later. I also have agony in the joints of three of the fingers of my left hand. I am worried this may be the result of some kind of related arthritis, but let’s not panic … he said, having been panicking all month. But that’s the point, I don’t know if it is or not until I find out, and the only way to find out is to do something about it. Don’t fret about what might be, only deal with what is (oh no, I sound like Yoda except all my words in the right order are). Accentuate the positive. No humbug this Christmas then …

PSORIASIS BLOG – Sunny Misposition

9th October 2012 Part Two

Slightly out of date but I’ve dithered.

DISCLAIMER: If you here for laughs (of which I only aim to provide the mildest), maybe check out some of the earlier entries before this one.

At my last appointment, and in the interests of full disclosure, I had to share with Dr McBride (and therefore do so now with the half dozen of you that read this) that my spirits have not been especially high recently. I do this not for sympathy but because I am trying to fully understand the link between mental health and my condition, and as I am part of an initiative to raise awareness of this (the See Psoriasis: Look Deeper campaign) I will have to be honest about it. There’s a possibility that acitretin can cause depression, but without going into specifics, I think that that is unlikely in my case. We talked about the mental framework of psoriasis patients. Apparently, that subconscious fear that the condition might break out at any moment affects the way we anticipate things. It is not unusual for a psoriasis sufferer to have higher states of anxiety than other, less mottled people. Dr McBride couches this state as an “anticipation of doom”. The way in which we psoriasis sufferers think is different due to the fact that we internalise our fears about a recurrence of the disease (for we are never truly free of it – the dermatological equivalent of the Daleks, it can only ever be kept at bay, not wholly defeated). Much of this is down to learnt emotion: the things we fear are thoughts not actuality. You know the sort of thing – worrying that you’ve left the oven on, fearing you will die on your arse at every gig (maybe that’s specific to me), abject terror that Boris Johnson will end up as Prime Minister (alright, I’m not alone in that one, and it also may have nothing to do with psoriasis and everything to do with having the scantest interest in a positive future for mankind). But anticipatory fear – with which I wrack myself all too consistently – can be traced to my mental attitude to my disease.

 

There you go – clowns are funny. Take a break, smile at the clown, and then dive back in to the angst-ridden text.

I fret about simple things like train journeys and am terrified of phoning people lest I be calling at an inconvenient time or they simply want me to fuck off. Now, these psychological somersaults aren’t the sole province of psoriasis sufferers, but they are examples of behaviour and the cognitive dysfunction of those of us in the cult of the crusty.

One of the reasons I am seeing Dr Mazara is to try to come to terms with the fact that much of what I worry about is abstraction rather than reality. I also need reassurance that the fact that I do fret and worry and suffer from depression isn’t simply self-indulgence (my biggest fear of them all – being thought self-indulgent; a trait I despise). The entire approach being taken to my condition by the experts is to establish that there are sound medical reasons for the way that I feel. It’s a frustrating area: my worry about a recurrence of psoriasis leads to stress, stress exacerbates the psoriasis, the resurgence of the rash exacerbates stress, and so I have two insatiable beasts feeding themselves off each other and having the discourtesy to do so in my brain and body, the inconsiderate sods.

Physically though, I’m in as good shape as I have been since I scored the winning runs for England at Lords’. Sadly, that was in a dream, but I was pretty fit in it, and got comparably so in reality thanks to the physical regimen I stuck to in Edinburgh. Compared to the shambolic, overweight, blotchy man who first shuffled into Dr McBride’s view I am now in a sustained period of remission from those stubborn body-wide plaques and am at a pretty steady 12 stone (could do with losing another half stone to be totally perky, but as a default it’s a hell of a lot better than I am used to). Largely thanks to my wife’s encouragement in such matters I eat better, have a genuinely more positive and proactive attitude to my physical well-being and spent the first half of the year totally alcohol free. To the naked eye I have a healthier colour and more sparkle. “If you were a dog you’d have a nice wet nose,” is how Dr McBride puts it.  I’d also bite children and dry hump a kitchen table leg, but I didn’t tell her that.

But … I am still not well.

The fact that my arms are a little more affected than they were six weeks ago is explicable and not too alarming, and I even came out of my hospital visit feeling much better about the fact that … the fact that I don’t feel much better. And I am not a maudlin whinger – as someone who spends most of his time amongst, and attempting to generate, laughter I think I get a pass on the whole “oh, poor me” brush that depressives can be tarred with. As I type this I’m in two minds about whether to publish it or not, because I am wary of the cult of narcissism that the internet promotes, of self indulgence, and of people who think that things get them down more than they do anybody else. I don’t know how I feel compared to everybody else because I have no idea how everybody else feels. But I know when the blackness descends it is very difficult to motivate myself to do anything. I know I shut down a bit when contemplating awkward situations. I know I stay up to the early hours drinking just so that I get access to those emotions that I generally keep under wraps because I – like most psoriasis sufferers – am used to internalising misery (and physical pain) just so that I can function of a day to day basis. I know that I find myself mired in indolence. I know I feel unable to get enthused about anything and in a state of anxiety about the simplest things like anticipating a train journey. I know I replay conversations, fretting that the way that person X said “hello”/”goodbye”/”when’s the bus due” means that they hate me and think I am an idiot.

This all may well be a very complex and self-absorbed way of saying I’m so lazy my brain has to come up with all sorts of reasons for not doing anything, so that I can then justify them to myself in medical terms rather than admit that I am just a boring, apathetic narcissist. I don’t know, but the two medical professionals I see haven’t laughed me out of the room (I’ve never actually be laughed out of a room – I have been un-laughed out of a room, and that’s bad enough). In fact, the major breakthrough with all of this is that everything I don’t like about my behaviour has been identified and explained by Dr Mazara, and that knowledge brings understanding, understanding brings strength, and strength creates the ability to do something about it. Let’s see eh? I’m game. And if any of this sounds like awful motivational speak then yes, I probably would have thought the same 12 months ago – but it has helped. It really has.

So there we go, that’s how I am today. I am very lucky that my consultant is someone who has made it her mission to create bespoke treatment for psoriasis that takes the patient’s emotions and personality into account as much as their genes and cells. And that I feel able to speak to her about it. So I thought I’d tell you too, just in case it helps. It may just be that you’ll think I’m a dick, but do you know what, my personality is such that I’d assume that’s what you were thinking anyway, so what have I got to lose?

There we go – that blog was awkward, potentially embarrassing and quite painful to endure, but what the hell, I’ve done Christmas gigs at Opus …