It’s ok to not be ok.

This past week has been really tough. Asthma is one of those conditions that is on a spectrum. Going from those with the mildest of asthma to those with the most severe and life threatening asthma you get everyone across the board and you can not pick out the one person with mild and the one person with severe asthma. You can’t see asthma, sometimes you can hear it depending on how wheezy you are!!!

Recovery from this last hiccup has taken a lot longer than I ever anticipated. It was not the worst of attacks but equally was not the mildest either. I was only in hospital for a week yet it has taken me a good 3 weeks to get back on my feet and still Im not there yet.

I have been so fortunate this time to have the support of my consultant. When I say support I mean that should I have issues he has said so many times that I just need to call his secretary and she will get him to call me back or the resp reg on call to give me a call. Having that support is so reassuring to me it makes life that little bit easier. Also being seen in clinic every month (which is a faff but won’t be forever) and then on top of that I am at the ward once a month too for my mepolizumab injection with the asthma nurse specialists so if I have any issues I can ask them too.

As much support as there is they cannot speed up the recovery process and help with the everyday symptoms that just take time. The never ending fatigue that no matter how much you rest it just doesn’t go away (Thanks to prednisolone contributing to that), and no it doesn’t help by getting a good night sleep. It is a fatigue that is unlike no other- a fatigue that having a nap won’t fix, it is a feeling where your whole body feels double its weight, you are not tired and sleeping doesn’t help, but you just cant do anything. Until you have experienced it (which I hope you won’t) you have no idea what it is like. This is the really hard bit. Fatigue you cant see, and asthma you cant see.

Keeping your mind motivated is really hard when your body is preventing you from doing what you love. This is the challenge I keep facing. This time of year its all about Christmas, Christmas Parties, going out with friends, shopping and enjoying the festive period, but I feel like I am sitting watching the world go by and seeing photos of people enjoying themselves but I haven’t been able to join them. Just going to the shops to get the messages is hard enough leaving me exhausted.

One big thing that I am really finding hard and one friend who is also on biologic therapy said this can be a side effect is speed of recovery as well as joint and muscle weakness. Speed of recovery has been slow but as I keep trying to tell myself slow and steady wins the race- but truthfully its getting really wearing now. The other thing is the joint and muscles weakness. I always have some weakness after being in hospital as for most of it I am bed bound and not able to get up due to the inability to breath and also the number of IV lines I have which are often in my feet making walking a challenge. Building up slowly isn’t helping. The only way I can describe it is having DOMS (delayed onset muscle soreness) but having DOMS that won’t go away. Normally lasting 48 hours this has been 2 weeks now and my quads feel like they are ripping in half every time I go to sit down or stand up, occasionally jerking as I walk too, stairs are an interesting experience- thankfully I have a lift in my building so can avoid the stairs!!!

I am desperate to get back to work and my consultant knows this. I see him tomorrow to hopefully get the ok. I know it will be tough going back to work but I need something to mentally challenge me. I having been doing bits and pieces of research and evaluation of research conferences too. Evaluation forms I find are so hit or miss especially when there has been positive or negative things that you want to acknowledge etc- there is never the room and I end up putting a covering letter along with the form.

This whole recovery process and hospital admission this time has taught me a lot. The main thing I guess I have finally accepted is that it is ok to not be ok. It is ok to ask for help and admit when you are defeated. Over the years I have been made to see a psychologist to help me deal with life with severe asthma. You could say I was a bit resistant to it initially. I think it was the stigma I associated with it. I felt that if I was seeing a psychologist then something was wrong with me mentally and actually my problems were psychological rather than physical. I think I made this assumption because I was young (this was over 12 years ago) and at the time there was really not much openness about mental health and it really was stigmatised. In more recent years as my asthma has impacted my life in ways I never thought it would and prevented me doing more than I ever thought I have been so thankfully to have access to a psychologist  who I can see regularly and help deal with the restrictive aspects of living with such severe asthma. What I have found though is that I have focused so much on adapting life to cope with my asthma and the majority has been on pacing. I didn’t realise that a major area which we never worked on or spoke about was the severe life threatening attack that comes out the blue much like this last one was, and also the trauma after it. It has almost felt like a mild version of post traumatic stress because even at clinic last week I got this huge sense of fear when I saw those windows of the ICU again.

So tomorrow I have a variety of different appointments all at different hospitals. The morning I have the asthma nurse specialists for my mepolizumab injection and review with my consultant, then the eye pavilion to have tests done on my eye that has lost its peripheral vision and then over to the royal infirmary to see the psychologist and will go up to see work and discuss coming back.

I hope that getting back to work and routine will maybe improve the fatigue I have and give me a purpose to my day again.

Learning to be kind to yourself.

Recently I have found it really tough trying to deal with everyday life and my asthma together. It felt like a full-time job just staying well, making sure I took all my treatment etc and then live life too. It was just way too much physically and mentally.

When dealing with physical health troubles there is so much we push ourselves to do and can often end up pushing ourselves too far because you have that spell of feeling well so everything gets crammed into that small window of time with no care for how you will feel after. This is something I am very guilty of. I will feel well so do everything and anything just like others do. And I feel great doing it. The adrenaline rush of being with friends and just being out and about leaves you feeling on a high and part of “normal” society. Soon after you crash back to earth with a bang.

I find the bang leaves me focusing on all the negatives about what I now can’t do rather than all I have done to end up in such a situation. I find I can’t rationalise sometimes that I did all this good stuff and that is why I feel crap. I think the other way round. I feel crap so now I can’t do what I want to do.

It is a cycle of peaks and troughs with each peak getting that little bit smaller and the trough getting that little bit bigger.

I realised this was not helping me physically or mentally. I went to see a psychologist who specialises in dealing with people with long term health conditions. He actually wrote my anticipatory care plan for when in hospital so know him already and had a good rapport so was looking forward to the appointment.

I went in with a plan of what I wanted to discuss and what I wanted to achieve. Something I was told not to do as I would then set myself up for not achieving goals I set myself but anyway do I ever listen…it seems no!

I took loads from the appointment but 2 things really helped an can be put to use straight away but may take some practice before I get it right.

The first was to allow me to be kind to myself. It took me a while to understand this but after explaining about how people have a part of their brain which determines their drive and another part which allows them to be kind to self I could see where I was going wrong.

From my background of playing sport and being very competitive with it I am very driven. I want to succeed at the best I can, I won’t quit until I reached a goal. I do this in all parts of my life. I will drive and drive and keeping pushing to be the best and achieve the best. In some settings this is good- particularly sport but in health this is not good and its not doing me any favours. I do not allow kindness to self. I tried to argue with the idea that I did and this was when I took a break in a day and rested but this was not what he was meaning. He descried it as lifting my foot off the pedal and applying the break a little bit. I see resting now as something I have to do because if I don’t I will fail at what I want- but in doing this I am not actually resting my body as I am driving myself to rest. I need to accept that my body won’t do all I want it to do but if I allow myself time, rest and recovery I will be able to do more and more often rather than fitting everything in in a short space of time like I do just now!

I have put this in practice already by planning my week better and having evenings I call rest evenings where I go to bed earlier than usual and read my book and try to switch off. I have also planned my weekends to allow myself more time to rest for the week but still doing somethings for example I have a awards dinner on Friday night and lacrosse on saturday afternoon (not sure how much I will play but it still counts), so for Sunday I have planned to spend the morning getting ready for the week and the afternoon watching a film and just chilling out. Have a really good dinner and be ready for the next week. I am not sure how this will go but I hope that I may feel good for it. Time will tell.

The other thing we discussed a lot was about CONTROL. Being a naturally driven person I like to have control in my life and control of my life. I like to have my destiny in my hands and therefore my future dictated by my decisions. This is something I don’t have and have not had for a long time. In the asthma world so to speak to word control is all over the place- mainly when discussing how stable or unstable your asthma is and how much control or lack of you have, we do the asthma control test again to check control. It feels I can never get away from it yet strive to have it all the time.

I desperately want control of my asthma so I can live my life without fear of attacks, or fear of losing my job, without dealing with medications, side effects of medication, not having to go to numerous hospital appointments throughout the year. It would be so great to say I had control. Instead of telling everyone I am trying to get control but not there yet. It often feels I have no control over it. There is no prediction to when I may or may not have an attack, I cannot control the uncontrollable such as external factors like cigarette smoke, pollen, building works. I can’t even really control my medication. The only control I do have is about taking my medication. I control when I take it but other than that there is not much.

I need to work on not needing to have control. And rationalise that there are something you can’t control but to focus on controlling what I can. In doing this I won’t set myself up for failures and frustration when I don’t get to where I want to. By planning my time better I am controlling when I can do things and when I can’t rather than having to listen to when my body has had enough and stop. By planning things and get a good balance I hope I won’t  go back to the ways of filling my good days with loads and then suffering after.

Only time will tell if these things work or not but fingers crossed they do!

Clinic and next steps!

Yesterday I was a bag of nervous, full of fear and also there was a hint of excitement at what may come of going back to see my old consultant again. She knows me the best. I have known her my whole time since I moved back up to Edinburgh. It was a relief to see her again. She just gets me and knows what is important to me and helps me to be able to do what I want to.

What was the outcome of seeing her?

We have a plan. A plan to reduce the prednisilone and much more intensive than was before. In the past we would just reduce and see what was happened. Instead this time I have to go to pulmonary function every 2 weeks to have a FeNo test.  I will then be in email contact with my consultant to give her the result. Depending on the result we will reduce or stay on the same dose of prednisilone. This way I hope that I won’t have the dips and crashes I was having when reducing. We can see exactly what is going on and when. Fingers crossed this will prevent any attacks and I can get off the prednisilone once and for all. Its going to be a long road but hopefully one that will be worth it.

I am also going to see a psychologist to refresh my strategies for pacing myself and dealing with my asthma. I am not the best at getting the balance right between too much and too little. As a result I tend to have peaks and troughs  in my energy and ability to do things. I want to get back into the right balance of work and life.

Even though not a huge amount has happened in the appointment and no big medication changes or anything I do feel like I managed to get a lot out of it and have the reassurance of being under someone who knows me. It is almost a safety net in a way. I also know she will tell me if I am not doing enough and tell me if I do too much which is a good thing.

Hopefully this plan will be positive and have a positive outcome.