Sunday, 13 May 2012

A busy week, Part two: В больнице

Onwards and upwards.
Continuing from the last post, my busy week continued, or at least seemed very hectic. Thinking on it, I didn't really do a great deal but I did have a lot happen to me. 
I've mentioned with increasing frequency my unreliable state of health over my year abroad, and recently I think migraines have featured in most of my posts. Well, this one is going to focus on that because A. it is taking up a large chunk of my life at the moment and B. I get a lot of site views based on migraine and neuro search words. Plus it's therapeutic. Feel free to ignore the rest if you are healthy, it's likely to bore/depress the hell out of you.

My prediction of an approaching migraine on my return from Peterhof proved accurate. I think motion sickness is connected somehow and it took its opportunity to blast into action the moment I lay down, complete with obligatory 'scintillating scotoma'-flashing, moving blind spots and psychodelic zigzags and vibrations in vision. Who needs drugs?

It hurt, a lot. The next day the same thing happened. And the next. Each time the aura became more widespread and the pain would kick in quicker and stay longer and honest to God it was making me unstable. My sleep patterns were ruined and I felt constantly nauseous and exhausted, my eyes couldn't focus and I developed vertigo. The effects of a migraine, in my case, are generally felt up to a week before and a week after the actual episode, and they were just piling on top of eachother. I spent most of the week close to tears from the frustration of not even being able to lie still and the rest of it in tears from the bulldozers hammering around in my head. The heating in the flat was still on at this point despite it being close to 20 degrees outside and I couldn't keep the window open because Russia is noisy beyond belief, and every little sound was thundering through my head bringing me closer to being sick from the further rolling around in pain. I could only crawl, not walk, and my eyes were doing their own thing. Consequently when I did try to stand, I fell over and was left with a very swollen ankle which just added to the strain. In short, it was torture.
 It felt like eternity during episodes and I began to hate being in Russia with a passion. I was prewarned about the climate here being bad for those of us with neurological problems, and even the pressure changes in the most moderate of climates has a palpable effect on my joints and head. Ocassionally I can actually feel the change in the size of the vessels in my brain, which is commonly thought to be the key cause of migraines. But I wanted to come here so I shouldn't complain too much.

Speaking Russian became an even greater labour than normal. As a result of the mix of regular medications I take I suffer from varying degrees of aphasia-impairment of language and processing ability. Sometimes I simply have trouble with words 'on the tip of my tongue', often reading is a slog, other times I can't speak at all and occasionally I am unable to write. That's in english. I all but gave up attempting to communicate with Viktor and Larissa and only ventured out of my room in search of water (praying for lack of contact with a scantily clad Aleksey) when I was truly desperate.

Thursday came and I was just about stable enough to be able to listen to Harry Potter on my kindle. The Prisoner of Azkaban is not exactly the most taxing of literature, but it's sufficiently interesting to be a distraction when the pain dies down enough. In a moment of lapsed concentration, I rolled over on to my stomach and before I'd realised, raised my head ever so slightly. That was it, I could feel the pulsing in my head, hear the whooshing of blood constricted through my neck and the intense pressure. The scotoma started within 45 seconds, my vision was doubled and parts of my hands appeared to be missing. Alice in Wonderland symptoms made their entrance and everything started shrinking at an alarming rate, just to shoot up by giant proportions a few moments later. My arms were shrinking, I felt totally out of proportion and disoriented.

The head pain, when it hit, was unusally sudden and incredibly intense. The visual aura was spread across both eyes and was adding to the chaos of the pain. I lay there for hours digging my head in to the mattress in (futile) attempts to relieve the pain, writhing around and generally sobbing to myself, interspaced with brief tourettes-esque swearing episodes to vent the frustration. It took maybe 4 hours before the nausea passed enough to switch positions. Very, very long hours. The visual issues had all but disappeared, just leaving the drilling into my skull to contend with. I decided to get up to splash water on my face but as I lifted my head, the aura was back. I couldn't even process what was going on by this point, I just knew the pain had suddenly tripled.
I don't really remember a great deal past this point, although I am aware I was very much in what my doctors refer to as 'crisis'. Truth be told I had probably been hovering around it for the past week. It had by this point been around 10 hours in constant, extreme pain, which is definitely not normal. I usually have some let up or at least weakening of symptoms.
I hauled myself down the hallway to Viktor to request a doctor, and exceedingly kindly, he rang the hospital for me and Aleksey drove us there. Can't imagine Lyudmila or George doing that.

In one of my early posts, about a month after I arrived in Yaroslavl, I commented on the miracle that was me avoiding hospital for so long. Well, a week to go and it was clearly time to rectify the situation. Just about time to cram in a medical emergency before I left!

Some time within the next hour I had been practically carried through the hospital for assessment, to find my blood pressure was an alarming 175/130. Considering that it's usually on the low side of healthy, it was a little worrying, as was my temperature which was edging towards 39 (although in Russia, once it hits 37 there is a definite problem according to doctors). My eyes were showing uncontrollable independent movements and I lost my spacial awareness.  Essentially, my body was having a massive and slightly dangerous freak out.

Treatment at this hospital was, without doubt, outstanding, and I have been in a fair few hospitals. I have never been so happy for nurses to attack my poor veins with multiple cannulas. Unlike a previous experience in a Russian state hospital, which left me with nerve damage, they identified my difficult veins just by looking and an intensive care nurse was called to deal with the cannula. It did eventually have to be changed a couple of times, because my veins ruptured, but the initial IV medication was bliss and I now have a terrific bruise to admire as my badge of honour for a while.
I've had every single test possible run on me, nearly all I've had before but this time with a slant to identify meningitis, apparently. Had someone asked me if Id been vaccinated, I could probably have saved some time, but whatever.

The dopplerography, annoyingly, showed nothing wrong with the vessels in my neck, despite a previous showing there was. I'm not consistent enough, it's hugely frustrating when you're trying to prove a point to your doctor in your quest to recieve a definitive diagnosis. But the chiropractor, amazingly lovely woman that she is, after warning me not to try to get up from the bench because she'd 'heard about me' (randomly collapsed in the middle of a chest x ray, apparently a massive shock to all involved) explained that there is something wrong with my neck, and 'most likely, the rest of you, looking at the list of your injuries and fractures'. Oops. It can't be a good sign if someone used to dealing with injured people thinks you have too many to focus on.
The MRI showed a weird tangle of vessels on the side I get Trigeminal Neuralgia, which I already knew about and no sign of aneurysm, which I had expected. I've had so many scans that I'm very complacent about the results-it will come as a massive shock if anything does ever show up. I had to be transferred by ambulance to another hospital for these scans, and a nurse called Gleb accompanied me, setting Russia to rights on the way and telling me where to go for the best Russian book shops. Helpfully, he also told me not to be scared and not to faint, just before I went in for the scan. lols.

So, eventually, with mountains of medication, 'manual manipulation' to the neck and head, a few incredibly welcome visits from the outside world and a lot of the BBC news international channel (I swear I put it on one morning and Prince Charles was presenting the weather-can't confirm I wasn't hallucinating, but fairly sure I wasn't) , I finally got rid of the lingering pain and sickness.
Turns out that I have a curved top spine (kyphosis) and scoliosis, but I'm told that regular courses of chiropractitioner care will help significantly and hopefully help to reduce general body pain and fatigue. 

King of the Hill (царь горы- tsar gori) in Russian helped to whittle away the hours, despite
only understanding all of about 1/16th of it

Three days after being admitted I was let out, expecting to have a horrific bill placed in front of me. The hospital hadn't been clear about the insurance when I first got there-or at least, I was in no state to understand and didn't know what I'd signed-so it was a massive relief to find that the (estimated from prices online) £8k bill did not materialise. Private hospitals are lovely, and I definitely recovered far quicker in a private ensuite with personal nurse than I did in the 6 to a room the same size as my private one hospital a few years back, but are they expensive. Also I have to observe that there is significantly less standing around in your underwear to be examined in other hospitals. Maybe there's just less time to get you undressed in state hospitals. Oh well. I honestly don't think I have a scrap of shame left anymore.
NHS, I love you.

And so off I went home, this time to actually sleep.
Nearly made it through my year abroad, so close! Whatever will my year abroad tutor say?! 'I told you so' springs to mind...

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