Tedious healthwork notes
Jun. 13th, 2016 02:49 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
kaberettThe proximate trigger for the recurrent BV seems to be spending more than three hours a day using a wheelchair, even when using a vaginal pH balancing gel once a week. This is kind of suboptimal, because it de facto prevents me from leaving the house for anything other than brief shopping trips (unless I'm willing to take a handful of antibiotics after each trip, which I'm not).
However! The problem arose late September/early October. I've been using the same trousers, the same wheelchairs, the same wheelchair cushions, the same shower routine, etc, for much much longer than that: I haven't actually changed any meaningful part of my routine. (How I wash has been emphatically excluded from meaningfully being a cause: I switched to using aqueous cream in place of shower gels, despite the fact that I was already only using any form of detergent on my external outer labia), and that made precisely 0 difference.) I've not had partnered sex since about December, so that's also excluded as a cause; and I don't douche.
Which leaves medication as the remaining culprit -- but to first approximation, there have been no studies on which medications promote bacterial vaginosis.
Happily the only part of my med regime I've changed in that time frame is switching to the anti-depressant mirtazapine in summer 2015, i.e. recurrent BV started being a problem for me once I'd been on it a couple of months, i.e. at the point at which I'd got sane enough to start leaving the house regularly again. And it turns out mirtazapine sometimes does something baffling with mildly depressing white blood cell production and otherwise mimicking mild infections (which might also explain the grumbling ear infection I've had since the beginning of March, which mysteriously does not show up anything interesting when swabs are cultured, but which has had a brief reduction in symptoms every time I've taken a round of antibiotics for the BV).
So I'll be talking to my GP about changing my anti-depressant when I talk to him anyway on Thursday (about a grab-bag of gynaecological hilarity), because this is having a big enough impact on how much I loathe embodiment/how fast I'm destroying trousers/etc that it's worth playing psychological roulette, as far as I'm concerned -- worst-case scenario we can always decide nothing else works adequately well and put me back on mirtazapine, so. (I mean, given how much mirtazapine helps with my insomnia it's a bit of a pity, but oh well.)
And honestly the major reason I've actually made this post is so that web searches for the combination of mirtazapine and bacterial vaginosis show up some speculation In The Future Days (I will attempt to remember to update this with confirmation if my problems all clear up once I've tapered off the stuff), in the hope that the next lot of people affected won't have to do quite as much working out from first principles as me.
But THERE WE GO, that's been my day today in healthwork.
However! The problem arose late September/early October. I've been using the same trousers, the same wheelchairs, the same wheelchair cushions, the same shower routine, etc, for much much longer than that: I haven't actually changed any meaningful part of my routine. (How I wash has been emphatically excluded from meaningfully being a cause: I switched to using aqueous cream in place of shower gels, despite the fact that I was already only using any form of detergent on my external outer labia), and that made precisely 0 difference.) I've not had partnered sex since about December, so that's also excluded as a cause; and I don't douche.
Which leaves medication as the remaining culprit -- but to first approximation, there have been no studies on which medications promote bacterial vaginosis.
Happily the only part of my med regime I've changed in that time frame is switching to the anti-depressant mirtazapine in summer 2015, i.e. recurrent BV started being a problem for me once I'd been on it a couple of months, i.e. at the point at which I'd got sane enough to start leaving the house regularly again. And it turns out mirtazapine sometimes does something baffling with mildly depressing white blood cell production and otherwise mimicking mild infections (which might also explain the grumbling ear infection I've had since the beginning of March, which mysteriously does not show up anything interesting when swabs are cultured, but which has had a brief reduction in symptoms every time I've taken a round of antibiotics for the BV).
So I'll be talking to my GP about changing my anti-depressant when I talk to him anyway on Thursday (about a grab-bag of gynaecological hilarity), because this is having a big enough impact on how much I loathe embodiment/how fast I'm destroying trousers/etc that it's worth playing psychological roulette, as far as I'm concerned -- worst-case scenario we can always decide nothing else works adequately well and put me back on mirtazapine, so. (I mean, given how much mirtazapine helps with my insomnia it's a bit of a pity, but oh well.)
And honestly the major reason I've actually made this post is so that web searches for the combination of mirtazapine and bacterial vaginosis show up some speculation In The Future Days (I will attempt to remember to update this with confirmation if my problems all clear up once I've tapered off the stuff), in the hope that the next lot of people affected won't have to do quite as much working out from first principles as me.
But THERE WE GO, that's been my day today in healthwork.
(no subject)
Date: 2016-06-13 03:09 pm (UTC)- your detective work and clarity and consistency about what's going on with your body
- your attention to documentation
- your honesty
(no subject)
Date: 2016-06-13 03:27 pm (UTC)("It looked more like yeast," the gynae said, while the swab was being handled by microscopy. "I'm entirely willing to believe I've got BV and yeast at the moment," I said, "because that does keep happening, but I'm really pretty sure it's BV." Whereupon the phone rang, she answered it, and then turned to me and said "... yep, BV.")
(Also goodness but this is a set of thing I am LOATHING being honest about to people other than the highly specific GUM clinic -- I've even been avoiding talking about it with my GP thus far -- but also: I am bored of being miserably ashamed in private so might as well be defensively ashamed in public and at least get some commiseration, amirite.)
(no subject)
Date: 2016-06-13 03:23 pm (UTC)(no subject)
Date: 2016-06-13 06:17 pm (UTC)* i.e. it's much less shit than prozac for this, but really, it's not helping...
(no subject)
Date: 2016-06-13 06:29 pm (UTC)(no subject)
Date: 2016-07-21 12:13 am (UTC)(no subject)
Date: 2018-09-22 04:10 pm (UTC)