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Playing catch-up: healthwork edition
Two major things: Yet More Lung Tests (I get to find out results on the 26th) and pain clinic psychologist assessment (physiotherapist will be happening tomorrow afternoon).
So far so good on the fluoxetine -- I'm not now getting BV every time I spend more than about two hours using a wheelchair (I am still managing to set it off occasionally, but by "occasionally" I mean "when spending all day travelling internationally after a solid preceding several days of Out And About In A Chair", which is consistent with other folk I know seeing slooow returns to baseline after discontinuing mirtazapine due to unacceptable side-effects). I'm still under-medicated (in that I'm irritable and weepy), so that's not brilliant, but I'm seeing my GP on Thursday, whereupon we will bump up the dose.
PAIN CLINIC. I went to an introduction session for UCLH's COPE pain management course back in July, which I don't think I ever wrote up; I was grumpy and antagonistic at the back, but they still annoyed me less than any of my previous interactions with pain services, so as intended I requested being referred on for one-to-one psych/physio assessments, to determine whether I'd be suitable for the group course.
(The specifics of being less annoyed: they were very definite about how neuroplasticity/sensitisation/etc doesn't mean you're not actually in pain; they were willing to talk about reasonable adaptations to ongoing medical conditions; they were willing to admit that some chronic pain is due to underlying physiological pathology.)
Answer: no. Because I already have and am applying all the skills they teach in the COPE course, my problems are not the problems that course is set up to address, and it's a big time commitment.
Which is very much the answer I was hoping for, having taken as read that "yes, we can fix all your problems" wasn't... going to actually be an option. And they'd've recommended me for it if I'd asked really nicely, I think, but the psych did pause partway through the assessment and go "... so... um... why were you referred to us?"
Which means I am pretty much at "grim satisfaction that I was already doing all the thing". (Unless, of course, I get referred back to them for medical rather than psych intervention.)
Rather than discharge me immediately I'm being permitted to keep the physio assessment, with the expectation that it'll turn into 2-3 one-to-one appointments focussed on talking through how to better manage fatigue and flare-ups, and particularly how to apply the concept of "pacing" to my Rather Complicated Situation.
So that's good.
So far so good on the fluoxetine -- I'm not now getting BV every time I spend more than about two hours using a wheelchair (I am still managing to set it off occasionally, but by "occasionally" I mean "when spending all day travelling internationally after a solid preceding several days of Out And About In A Chair", which is consistent with other folk I know seeing slooow returns to baseline after discontinuing mirtazapine due to unacceptable side-effects). I'm still under-medicated (in that I'm irritable and weepy), so that's not brilliant, but I'm seeing my GP on Thursday, whereupon we will bump up the dose.
PAIN CLINIC. I went to an introduction session for UCLH's COPE pain management course back in July, which I don't think I ever wrote up; I was grumpy and antagonistic at the back, but they still annoyed me less than any of my previous interactions with pain services, so as intended I requested being referred on for one-to-one psych/physio assessments, to determine whether I'd be suitable for the group course.
(The specifics of being less annoyed: they were very definite about how neuroplasticity/sensitisation/etc doesn't mean you're not actually in pain; they were willing to talk about reasonable adaptations to ongoing medical conditions; they were willing to admit that some chronic pain is due to underlying physiological pathology.)
Answer: no. Because I already have and am applying all the skills they teach in the COPE course, my problems are not the problems that course is set up to address, and it's a big time commitment.
Which is very much the answer I was hoping for, having taken as read that "yes, we can fix all your problems" wasn't... going to actually be an option. And they'd've recommended me for it if I'd asked really nicely, I think, but the psych did pause partway through the assessment and go "... so... um... why were you referred to us?"
Which means I am pretty much at "grim satisfaction that I was already doing all the thing". (Unless, of course, I get referred back to them for medical rather than psych intervention.)
Rather than discharge me immediately I'm being permitted to keep the physio assessment, with the expectation that it'll turn into 2-3 one-to-one appointments focussed on talking through how to better manage fatigue and flare-ups, and particularly how to apply the concept of "pacing" to my Rather Complicated Situation.
So that's good.
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I started Fluoxetine almost 4 weeks ago and I'm wondering if the dose should be bumped up. As it is, I'll take it. I'm no longer completely overwhelmed by anxiety. It's back down to manageable levels. Mostly. Glad you've got improvement from it as well!
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Which is of itself impressive, btw.
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*gutteral growl of having dealt with bouncy young OTs who think pacing is easy if you just follow their simple worksheet! *
very glad your appointment was Not That type of thing, and also i feel you on the "grim satisfaction"