Saturday, October 30, 2010 1 comments

Soap Box - The Tragedy of Trauma

There have been several occasions through my work with St John Ambulance I have treated people with extremely serious and body-altering physical injury and have seen the very worst of physical, emotional and psychological trauma.

Christmas will soon be on its way. This is supposed to be a happy time of year when families or groups of people get together and celebrate. They may celebrate a religious holiday, or simply cerebrate the end of a year. What they are celebrating does not matter. But it is an unfortunate reality that for some families there will be no celebrations.

I encourage everyone to watch the following video and remember it the next time you get behind the wheel of a car. Remember your loved ones shouldn't have to go through this and those of us who attend these scenes and see first hand their horrific results shouldn't either.

Tuesday, October 26, 2010 0 comments

Week 6 from Baseline

This week I've had a bit to whine about and given the chance, I can whine with the grumpiest of the grumpy old men. But aside from 5 minutes of sharp pain in the left foot, over the last few days the pain has subsided quite a bit and I have been pain free.

Nor can I bang on endlessly about today's daft survey questions. As I mentioned last week there is no visit to K Headquaters. So no survey, no blood test, no Flames assessing every joint in my body and no comforting feeling knowing that my CO was there as I infuse myself with a subcutaneous injection.

But I got through it and like every other week day this year, got on with facing the arduousness task that is the daily work commute.
Friday, October 22, 2010 0 comments

Brutal Days

The last two days have been relatively nasty. The offending joint is my still my left hip.

The amount of sleep I had on Wednesday night was miniscule. But Thursday marked only four days since we reached the only project milestone that really matters at WorkWorkWorkWork. Furthermore, it was the type of milestone that was high-profile, was equidistant from the start and end date of the project and affected every department at WorkWorkWorkWork Headquarters.

This is one of those moments in every project when a Project Manager needs to be seen and ready for some responding action. Also, I had a meeting in which all team members from every department would be in attendance. The first since the big milestone was reached. There was little choice. The only excuse I consider acceptable for absence on my part, under such circumstances, is death or the office is full of spiders.

I got up in a lot of pain in my left joint hip. While standing up was possible, but standing up straight was not. The straighter I was, the more pain I felt. Stiffness wasn’t a problem. It never is. Walking and moving was very difficult and quite painful.

Limping around the office in a 160cm ( 5.2 ft ) frame that weighs 55kg ( 120 lbs ) can’t help but attract attention. While I quite enjoy attention in most cases, I’d prefer that any public reputation I have not be entirely based on the fact that I can have the appearance of a harrowed cripple. But I am who I am, and I stopped worrying years ago about the things I can’t do anything about. Occasionally having the appearance of a harrowed cripple is one of those things.

But there is a flip side. Seeing others react to your situation of difference can be quite interesting if you, like me, are a people-watcher. Those that know me have seen it all before and they know how I manage it. They are no longer shocked or surprised or uncomfortable and as such, their reactions are entirely predictable and boring (sorry all!). However, a lot organisational upheaval has occurred at work. Not only have I moved departments, I moved to a different floor. On my new floor there are not many people I have worked with and many more staff who are fresh off the street. No one has seen me in the throes of a violent flare-up. Eventually they will get used to it but in the meantime, seeing how different people react to the same visual presentation can be a very fascinating insight into the beauty and diversity of human behaviour.

I lasted until 2pm until I ate some painkillers. They don’t reduce the pain but they do help in other ways. They were enough to take the edge off and get me through my 3pm meeting.

My sleep last night (Thursday night) was better than Wednesday night but it was still broken up, I was still in pain and still limping. Since, I had no meetings, and no anticipated disasters, I rang The Boss who agreed to me working from home. Around 3pm the pain started to ease a little. It has gradually declined since.
Wednesday, October 20, 2010 0 comments

All good, then not so good

Yesterday I started to think that this blog wasn't going to be all that interesting. This is because in the last few weeks my joints have behaved themselves and pain has been almost non-existent.

That changed a little over an hour ago. My left hip gave a sharp sting announcing its presence. It occurred when I was sitting on the couch with my laptop on my lap. The sight of me with a laptop on my lap while on the couch is common particularly in October. October is always about splitting my time over a bit of out-of-office work, a bit of exam revision, a bit of reading, and a very little bit of any number of projects I have going on the side at any one time.

I was sitting half reclined with my legs stretched out and my feet crossed on the floor. There was nothing bizarre or pretzel-like about it. As I drew my feet closer to the couch and sat up to reach forward, my left hip shouted ‘Allo. Remember me?' and from that moment on my hip hurts each time I move it. The good thing is that if I sit still, it is not painful. I can stand up and no other part of my body feels affected right now.

One of the things I reflect on at these times is the fact that I picked up on this factor with my ankle years ago after I starting keeping a log of the pain I was experiencing. It was so confusing to me back then yet it is so obvious now. If I regret one thing about that period it was that I never asked Dr Flowers about it. I asked everyone else, but not my General Practitioner. Yet it was Dr Flowers who sent me straight to The General in December when my hip flared so badly.

So if there's a lesson to be learned, it is that once every so often, we should all put into our schedules an appointment with our GP, even when we are feeling well. We should and use that visit to talk about ourselves in more general terms. We hear it all the time, but we rarely do it and we all use same book of excuses. 'This isn't the week to be sick' and 'I'm not dying and I can't be arsed’ are two I commonly use. The only times I tend to go and see Dr Flowers is when I have an infection bad enough to snuff me out completely. Dr Flowers will always scold me before handing me a prescription for an antibiotic and the obligatory medical certificate. When you’re in such a state, your face resembles a glazed donut and feels like it’s been stuffed with marshmallow, so the thought of lingering conversation with your doctor and exploring any nuances you have ever been curious about since your last visit, is the farthest thing from your mind. At least it is for me.

If I ever start taking my own sensible advice, I'll let you know. In the meantime, all this talk about glazed donuts and marshmallow has put me in the mood for something sweet.
Wednesday, October 13, 2010 0 comments

Week 4 from Baseline

My third visit to K Headquarters. This is a visit that came with take-away!

When I left K today I left heavier than when I walked in. In my possession, was a blue binded book that says 'dosing instructions' and 'dosing diary' on the cover. I also left with an dark blue thermal insulated cooler bag. Inside the bag were some gel cold packs, a box containing my next Adalimumab dose, and a sharps container.

The bag is soft so it can be collapsed and flattened really well. The zip is really sturdy yet doesn't appear oversized. It's lined with silver PVC materail and on the outside it has a pocket in the front. It looks a lot like this one. Usually, the syringes of Adalimumab goodness are stored in the fridge but when you are on the move and need to take your goodness with you, this is the tool for transport. Given how much time I am spending interstate on business lately, I expect to use it a lot.

I love this bag for other reasons. Lets be honest, it's not a medications transport device, it's an Esky. A couple of sausages, a small salad and some cutery, a summer's day and you're ready for a BBQ at your mates' place. I love it and I can't wait to put it into use. Strangely enough, it my CO who pointed out it was the perfect size for a six-pack.

But lets get to the details of the appointment.

My CO reported 'something' in my bloods from two weeks ago. I am a little deficient in a certain type of white blood cells called Neutrophils. Specifically, Neutrophils are used to fight bacteria infections, as opposed to viral or other infections. My CO tells me Adalimumab is not known to cause effects with these specific type of white blood cells so they are not concerned about it yet and suggest it may be a 'blip'.

I assume when my CO says 'blip', she is using medical terminology to explain that it is a deviation from the population of Neutrophils that is usually observed due to a currently unknown anomoly and it is likely that the circulatory system will be successful in its efforts to self-correct. Blip works for me.

The 5 pages of surveys reflected the green tick I gave yesterday.

The General came in to see me and told me a story about how he was in a conference and saw some study data of TFN blockers. The key speaker, whose name unfortunately I don't remember, was a Grand Poobah in the world of Arthritis research and it is obvious that The General holds this person in high esteem. That impressed me since I suggest that there are likely to be a few others that hold The General in such high esteem. The General confessed to dropping his jaw when he saw how remarkable the TNF blockers can be. He got quite excited when talking about it and I really do enjoy seeing the passion and love The General has for his vocation.

Flames came in to do my joint assessments. For the first time, there was no swelling in my right elbow. Given that I never actually knew my elbow was swollen prior to my baseline assessment, and given that I haven't had any complaint to make about my elbow, the news had no real consequence for me except knowing it wasn't there anymore.

Since I had jabbed myself twice on the right side of my tummy, this time, I jabbed myself on the left side. Since the sting I felt was the worse of the three shots I've had so far, I might stick to the right in future.

My next appointment is 8 weeks from baseline.
Tuesday, October 12, 2010 0 comments

Next time, I will write lines

I humbly apologise to my CO for not setting notification alarms for our appointments. I understand that my failure to do so was the reason I missed today's appointment.

I will be doing 20 pushups as punishment at our rescheduled appointment tomorrow.
Monday, October 11, 2010 0 comments

Week ending 10th October 2010

You know what? I feel pretty good at the moment.

Over the last two weeks, my hip and my ankle have been behaving themselves like children who become perfect little angels because they want an expensive toy for Christmas.

But being the angels they were, I give the fortnight a big green tick.

There was only one glitch to an almost perfect record. My right achilles tendon, the immediate area around it and the area where the intermediate and laterial cuneiform bone are gave me a little soreness in the evening yesterday. It was a lovely day so I spent the day in my birkenstocks and in bare feet. It always gave me soreness in the same places under the same conditions. The pain and discomfort levels hadn't changed from last year, and I would give the scope as a 3 for the time the pain and discomfort were present.

I see this as evidence of any of the following scenarios:

1. The birkenstocks are the problem.
2. The drugs haven't kicked in yet.
3. I am on the placebo.
4. All or part of this is not due to arthritis and is a result of the trauma.
5. All or part of this is is due to both trauma and arthritis.

No idea really.
Monday, October 4, 2010 0 comments

Week ending 03 October 2010

Overall, the week has been average, but not in a negative way.

On a positive note, I spent Saturday at the AFL Grand Final v2. Normally when I spend all day at a duty, the left ankle always pull up sore and I cannot recall a duty when it didn't. When I go on duty, it is the degree of soreness I will endure at the end of the day I often wonder about. I always have residual soreness. I have occasionally wondered if it had to do with the boots I wear given that there are often duties you spend when little, if anything actually happens. When I got home on Saturday night, I observed that my ankle felt as good as it did when I got out of bed in the morning.

The yin to my yan was last Monday, Thursday and again on Sunday, the day after the Grand Final. But given I spent last Sunday demanding my feet to walk me around Altona for a few hours, a bit of pain on Monday is no real surprise. Wednesday there was noticable pain in the achilles tendon. Or under it. I am never really sure given that palpating the tendon itself doesn't hurt. Yesterday was the day after the Grand Final, but even so, since the ankle wasn't sore after the duty, it didn't make a lot of sense it got sore yesterday.

In all cases, it was the dull ache as opposed to the sharp pain which since starting on Salazopyrin, I don't get anymore. The tendon pain is a sharper when, when walking, the weight transfers from heel of my foot to the front and I push off. Its the pushing off that hurts, but not enough to render me limpy on this particular occasion.