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Another GP Visit
Written by Chloe on Saturday, December 27, 2008
Today I had my third GP visit with regard to depression. There were a couple of things I wanted to bring up in connection with BIID. I was nervous about this, so I asked my partner to accompany me.
It was a good job my partner came because the only parking spaces were downhill from the clinic. I’ve been finding that trying to wheel myself uphill on ice covered parking lots is just about impossible.
In the waiting room I was noticing my partner’s shoes, high heels as usual. I thought it was hilarious that she would wear high heels in ice and snow, so I started laughing. She asked me why I was laughing and I told her. She looked at my wheelchair and started laughing too. We both got the joke. She was the one with high heels who had been pushing ME through the ice and snow beacuse I couldn’t manage it. People in the waiting room were giving us funny looks.
I told my GP that my depression was a LOT better, probably partly on account of the Prozac. I was nervous about telling her the other reason though. I said I’d been skiing a lot. She was surprised at this and wondered how I could manage it. She was thinking that the BIID would render me psychologically incapable of such a thing. Well, I admit that it is a bit weird, but I refrained from telling her that it’s very helpful for my BIID because of the possibility of a desired injury. I told her about the increasing weakness in my left leg, explaining that there are a couple of skiing techniques that I am now unable to do on this account; long traverses with the left leg uphill, and also side climbs with the left leg uphill. She was not at all surprised at this. She had told me in March that I could gradually lose all innervation to the left quadriceps. She also had not known until today about the reinjury two weeks after she said that. I was nervous about her reaction to understanding that I was pleased and happy about the skiing revealing that I had more paralysis than I thought I had, thereby helping with the depression. She responded with a smile and one word: "Cool!"… Wow, that was a relief; she actually thinks it’s cool that paralysis makes me happy!
My GP decided it would be good for me to up the dose of Prozac to 60mg, despite the decrease in depression. My anxiety levels are still raging high, so she thought it would help with that too.
There was another thing I wanted to discuss with my GP. A little while ago my partner had walked in on me several times while I was trying to pee; one of those half hour sessions. She said "You can’t access those muscles?" I said "No, I can’t access those muscles". She said "You spend two to three hours every day trying to pee". I paused, thinking, and said "Yeah, that’s probably pretty accurate". This seemed like a big chunk of the day so I wanted to find a more time saving solution. There seemed to be two possibilities. Either I do intermittent self catheterisation or I hold it for longer, peeing less often (which is already less than half the number of times compared with a year ago). Thank you Sean, for persuading me to ask my GP about this.
My GP asked if I can empty my bladder. I said yes, although the urethra can slam shut several times before I’m done. She also asked if I can feel if I have a full bladder. I said yes, although having a very full bladder is much less uncomfortable than it used to be. She said in that case it would be better if I just held it longer and peed less frequently; shouldn’t cause any problems, except… Well the corollary is that I’ll be peeing myself by accident more often. No big deal since I wear protection in any case. Also as soon as I’m aware of it, which isn’t immediate because of the sensory loss, I can shut it off so I don’t have to deal with a whole bladder full.
The other BIID issue that I was nervous about bringing up concerns my wheelchair. I’m getting a new one. I was wondering if my GP would write a prescription for it. She said yes, without hesitating for a second. Wow! I have a prescription for a wheelchair! That made me really happy. She understands that my BIID engenders a genuine need for a wheelchair. That’s not what she wrote on the prescription as my need though. She wrote "fibromyalgia, leg weakness, back pain". I had enough physical stuff going on that she could tell the truth even though it wasn’t the real reason.
In the afternoon I was working on brain imaging stuff with my colleague, who is a physician. We had lunch together, then went to my office to discuss the experiment, then to my adjoining lab where we worked on preparing things for the experiment. Since we had several hours together I took the opportunity of asking some questions about the spinal cord. I had been quite confused about the ensemble of symptoms I have from my SCI.
My colleague asked a lot of questions about the symptoms, drew a bunch of diagrams of the spinal cord, and explained a lot of stuff. He asked me to point to where my back pain is. He said "Yeah, that’s T10 -T12". It all makes sense if some of the nerves coming out of the spinal cord in that area are damaged; but in addition there would also be a partial blockage of some signals going up and down the spinal cord in that segment.
We had a long talk about the bladder issues. He explained about the bladder emptying reflex that occurs lower down in the spinal cord, bypassing the brain. It happens when the bladder gets very full. Since the full bladder message only partially gets through to my brain now, it can reach the point where the reflex mechanism engages, with the brain completely out of the loop. This is all completely consistent with my peeing accidents. I am very glad to have a much better understanding of this.
At the end of the day as I’m writing, I look down at something that I’ve been carrying around with me, something that is symbolic, something that brings me joy, something that validates me…
My prescription for a wheelchair.
Tags: Anxiety, BIID, Bladder, Depression, Paralysis, Physician, SCI, Wheelchair
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1 On 27 December, 2008, Ada said:
WOW Chloe – that’s a whole lot of validation! Thanks for sharing.