When Chronic Conditions Collide

For the past 25 years or so I have been very open about my mental illness diagnoses of bipolar, depression, OCD, anxiety, and panic disorder. Well, that is in most facets of my life except for one.

Since gaining control over most of these conditions I have left them off the medical “cheat sheet” I have made up containing diagnoses, medications, allergies, doctors, surgeries, etc. I have left them off because usually when a doctor sees that and all the pain meds I am on, they pretty well make up their minds what is wrong with me without a full assessment.

I say “gaining control” rather than being healed because I have no delusions that this could ever happen. These conditions are with me for life – it is how I deal with them that makes the difference. And for the last 10 years, I have done whatever it takes to keep on top of my mental well being and believe me, it is a full-time job – as are pain management,  my marriage, my faith, and all other facets of a normal life. It is just a little more challenging for me to look like I have a normal life, that’s all.

Now, this is not to say that I do not mention my mental conditions to doctors when needed. I would be a fool not to. But if I am seeing the doctor for something totally unrelated to my emotional health, I keep it on the QT.

Monday was one of those times when I had to make a judgment call.

Over the last two months, I have had a cold, a sinus infection, another cold, what I thought might be bronchitis, and finally, a never-ending cough which yesterday lead to some severe chest pain. Other than an antibiotic I got for the sinus infection (which I reacted to and stopped after a couple of days), I self-treated all these conditions. It was only when the chest pain started Sunday night that I decided I should maybe go to the ER.

Hubby drove me to the hospital and I was immediately taken for blood tests and an ECG. The triage nurse said I would also go for a chest x-ray. However, when, after two hours no one called us, we pretty well knew that it wasn’t my heart and that was what I came for. The fact that they didn’t do the chest x-ray to rule out infection of some kind, didn’t really surprise us. We talked to a different triage nurse who said things looked fine and I might as well go home but to come back if things got worse.

That was around 7:30 pm.

At 4 am, the phone rang and it was the hospital. The charge nurse said that they called my name several times and asked hubby why I left. He said because the other nurse said it was fine. Well, they wanted me to come back in. I had just finally gotten to sleep about an hour before, but we decided we better do this.

We went back and had to sit in the waiting area a good half hour… with no one else there! Finally, we were sent to get a chest x-ray and were escorted to a place in the Fast Track Department of Emergency. Now the ironic thing about that name is you wait there for hours before you are seen by a doctor and are pretty much ignored until you do.

When I finally did see the doctor it was 7 am and I was exhausted from coughing and no sleep. She told me my ECG, x-ray, and blood tests were all normal. She grilled me about ever having problems with my heart, why my ankles were so swollen (wasn’t I there for her to tell me?), taking my inhalers at the wrong times and the fact that I was JUST having an asthma attack.

I wasn’t allowed to say much and was ready to walk out. Then she mentioned the drug I vowed I would never go on again – prednisone. And I flatly said “no”. She was still playing offense and I was bound and determined I was not going to tell her why I didn’t want to take it, even if it was my only hope for feeling better.

But it came out. I mentioned that for most of my life I have battled with depression and bipolar and how I have worked hard to gain control. Prednisone takes away that control of my moods, actions, and emotions. I told her I did not want to go through all of that again, especially while dealing with asthma and my pain flares.

She changed. All of a sudden she was asking if they weaned me on and off the drug and that they don’t do that anymore. Instead of being on her original plan of 50 mg for 10 days, she suggested one initial dose of 50 mg and four more days of 25 mg. I was also to increase my steroid inhaler to four puffs until everything was settled down.

I still wasn’t happy, but the fact that she seemed more interested in treating me made me accept this plan. She added in Amoxil, which is the only antibiotic that doesn’t give me allergic reactions and works, and more inhalers. We discussed my nebulizer and she said that isn’t as effective as inhalers. We were having a real two-way conversation and I felt good about the diagnosis and treatment. I waited for the meds I was to take there and my prescription and headed on my way.

I had texted hubby to come get me so he was there waiting. I think we got home about 8 am. He went back to bed but I was feeling very anxious from the prednisone and inhalers so it took a few hours before I could sleep. When I did, I had my first few hours of coughless sleep.

When hubby went to get my prescriptions the pharmacist noted that the Advair inhaler has severe interactions with my Flexeril (muscle relaxant). I have been on both for years and no one has ever told me that. Yes, I have felt the symptoms but never knew what it was. So, here was another example of how things can slip through the system to the detriment of the chronically ill patient.

I am having mood swings and am still very fatigued and out of breath. However, I am pretty sure this is the right course of action. If I hadn’t gone to the hospital I wouldn’t be getting any relief and would be much worse. And if I hadn’t explained my fears regarding prednisone I would not have been properly treated.

I guess with chronic illness sometimes you have to take a risk to get better.

Lydia!