Hypochondria is your enemy

I’m well into my 4th month of my fun with pleurisy. I’ve had several chest x-rays now (all clear) and done skin prick tests, lung function tests and been seen three times by cardiothoracic specialists. The experts think I’m okay. I’m on some drugs (the first proper treatment) sodium diclofenac – an anti-inflammatory drug. The professor says that will fix me, and if it doesn’t he’ll run a CT scan. He’s pretty sure I’m okay. I’m back to see him in 8 weeks. 

Great.  So maybe I’m okay now. It still hurts, but very very very slowly it improves. Very gradually, almost immeasurably, but (I think) there is improvement.

But I’ll tell you what. After six months of feeling crap and being ill and being in pain, I’ve turned into a nervous wreck. Every sensation in my body is now analysed and re-analysed. A sore throat, a funny pain, a twinge, everything is treated with the utmost suspicion and fear. I’ve felt lumps in my throat. I’ve had headaches, and chest pains on the left (my pleurisy is on the right), I think just about anything it is a symptom of some new saga. 

The smallest sensation brings my mind racing and running through ridiculous and far-fetched scenarios. It’s got so bad that I’ve had to ban myself from looking at House. I’ve even suspected lupus.  

I wonder, once the pain is gone, (perhaps now, I can see the end of that tunnel) how long will it take for me to return to my “normal” anxiety levels.

The whole problem with anxiety is that is forms a vicious cycle of making you feel physically rubbish and that feeling makes you feel more anxious. It’s a bloody annoying thing. It’s well documented and I’m well aware of the process, but is that enough to stop it? 

My boys provide welcome relief.  “Daddy, I happy” D tells me every couple hours or so. He doesn’t know, may never know, what good medicine his words are.  The boys are both asleep now. I think I’ll go in and touch their little hands. It stills my heart like CBT never could.


Google Chrome 1 Mozilla Firefox 0

It’s live!

I’ve been playing around with Chrome for a short while now, but I know enough to say this:

It rocks.

I cannot vouch for stability as it has been literally minutes since I’ve downloaded it. But there are new and clever features (not gimmicks).

  • The Crash Control is already 100% smarter than the rather stupid “restore previous session” that you find in Firefox. (including a Task Manager for your browser. Is the browser an OS?)
  • Incognito mode looks smart (IE 8.0 also implements this).
  • A start page!
  • The other thing I really hate about Firefox / IE, the stupid “download manager”, well that’s gone.
  • The developer tools look decent.

I’m sure this is only the tip of the iceberg, but I’m really excited about this. Well done Google. I hope FF can weather the storm.

Don’t forget that apart from the technology factor, Google also help to fund Mozilla, this is no big secret, Time put it very nicely:

Google has long been a patron of its open-source browser, and pays a kind of “click back” to Mozilla for directing its 200 million users to Google search. In 2006, the last time Mozilla released its numbers on the subject, Google had paid the company $65 million.

So quite how that relationship stands now is anyone’s guess, but it cannot be good news for Mozilla Firefox.

Like I said earlier today, Firefox is gonna get a beating.

Firefox about to get a beating from Google

As if things weren’t bad enough for Firefox as it is, Google are about to release their own browser Google Chrome.  Of course, Mozilla are not worried, but let’s face it, this is not going to help Firefox at all.

Developers will happily jump to the Google browser, because that is were the main action is going to happen in the next few years. And with IE 8 promising and delivering new features, suddenly FireFox looks old and tired just like it’s granddaddy Netscape.

Microsoft / IE stand to lose nothing from this at all (in the short term), and if there are any casualties it will be FireFox and not IE (for an opposing view).

When I originally started this, I was bitching about Firefox, having said that I’ld be very sad to see it go, so let’s hope it can somehow, against all odds manage to stand up to both Microsoft and Google.

When I put it like that, I suddenly realise what I liked about FireFox in the first place.

Incidentally, Google Chrome is now live. You can download it too.

Is it a common-cold? No, it’s the flu? No, it’s bronchitis? No, it’s musculo-skeletal pain? No, it’s costochronditis? It’s pleurisy (and chronic rhinitis and post-nasal drip)

Recently, I have been through the wars. I’ve had around 30 days off sick since March , I cannot be certain how much time off I have had, and since my boss cannot be bothered to record it, neither can I.

The colds and the cough

It all started in March when I got struck down by a really nasty nasty cold / flu thing. I was off work for 11 days. I had the worse sore throat and cough ever. I literally could not sleep for about three nights because my throat hurt so bad. Fever, chills, you know the drill. I had it all. And the cough, I think this is where the cough started, it was a violent thing. At this time I wasn’t very concerned about it at all, although the noises I made when coughing were pretty scary.

I see my GP. She says, it’s a virus. Nothing she can do. Take paracetamol and codeine. It’s strongest thing you can get without a prescription. I double up with ibuprofen too. I feel ok.

Roll on a few weeks, and I’m about to go on holiday, and I get struck down by another humdinger of a cold. This one has me feeling really horrible; weak, tired, sleepy. Of course my favourite sore throat and cough are back with a vengeance. Having spent over £2K on some plane tickets, in the middle of my illness we (my wife K, and two baby boys, D & G) jump on a plane to the West Indies. Needless to say, the flight was hell.

When we finally land in the airport, we find that the wheels for our boys’ buggy are with our luggage, and the wheel-less buggy is handed to us as we disembark the plane. We now have to traverse endless corridors of airport carrying two children, three large pieces of hand-luggage and a buggy with no wheels. At one point I turn a corner, expecting to see the luggage carousel and airport corridor extends for another 100 meters. It is one of the most desolate moments in my life. The only thing that keeps me going is knowing that my mother is within spitting distance (she will move heaven and earth for me) and D, my 2 year old, is on my neck and he hasn’t had anything to eat for a long time. He is very tired. I am shattered in a way I have never felt before. My ears almost exploded on the plane (don’t fly with a cold). I can barely hear anything at all. I have been up amusing the boys for about 16 hours. I had 4 hours sleep last night, and probably the same the night before.

Bronchitis, elevated anxiety and coughing

The next day, my mother says I should see a doctor. For once I agree with her. He says I have bronchitis. He gives me a “broncho dilator” AeroFlux which starts me on a 24 hour panic attack and Avelox which is an antibiotic. The visit to the doctor and the prescription come up to a whacking £60 (£40 medicine, £20 for the doctor). After about a week I’m feeling human again. I still have a dry hacking cough.

But most of my other symptoms are gone now. I feel human. Towards the end of my holiday, for perhaps 2 days the cough is gone. Amen. We head back to London.

I get off the plane.

The cough starts again.

I get a sore throat.

I get another cold.

I go to my doctor. I complain about getting ill very often, sore throats, a cough etc. She says it must be a virus again. I complain that I have a chest infection. She gives me a prescription for Amoxicillin, I promise if I start feeling better I won’t take the antibiotics. She also suggests that I get a chest x-ray.

I procrastinate. I do not rush out to get a chest x-ray. I never take the Amoxicillin.

I almost get back to normal (with cough) for a week or so .

Chest pains, anxiety and confusion

It is a Saturday night. I’m watching TV, I notice a new pain in my chest. It hurts when I breathe. K says it’s wind. I’m not so sure. I struggle along, carrying on as normal. Next day, the pain is much worse. I try to continue as normal. The night comes. It’s pretty bad. It’s a sharp stabbing pain in my chest (thankfully on my right side, or I would be rushing to A&E) I cannot really specify better than a sharp stabbing pain. It really is that. A few years ago, someone I knew had a collapsed lung (pneumothorax) I look it up on the Internet.

Chest pain and tightness, shortness of breath and a dry cough are all experienced. The severity depends on how much air gets into the space. from the BBC

I am certain this is me, I have chest pain, I have a cough.

I call NHS Direct. They go through it with me. They say it sounds like “a pleuritic pain”. My GP has an out-of-hours service. They call me. They (over the phone) diagnose me with a generic musculoskeletal pain (ie a pulled muscle).

The chest contains many muscles, bones, tendons, and cartilage (the rubbery tissue that connects muscles and bones). Strains or sprains to any of these can cause chest pains. Chest pains associated with musculoskeletal injury are typically sharp and confined to a specific area of the chest. They may be brought on by movement of the chest and/or arms into certain positions, and often are relieved by changing position. These pains can be triggered by pushing on part of the chest and often become worse when taking a deep breath. These pains usually last only seconds, but can persist for days. from cardiologychannel

I’m happy this is a LOT better than a collapsed lung I think. A whole lifetime better than lung cancer.

I go to see the doctor the next day. She listens to my chest.

She says it is not a collapsed lung. I fall in love with her.

She orders me to get an X-ray. My chest hurts alot. “On a scale of 1 – 10” she asks, “how painful is it?”, I laugh and say “Maybe and 8 or a 9?” she says it’s a pulled muscle. I don’t argue.

It really fucking hurts (but only when I breathe, laugh, sneeze, cough and yawn). NHS Direct says “The main symptom of pleurisy is a short sharp pain in the chest area when taking a breath.” This is very accurate but the phrase “sharp pain” doesn’t really do it justice. I also felt that there was “discomfort or tenderness to touch”. These symptoms are also for typical for costochronditis (by this time I was starting to doubt the “pulled muscle / musculo-skeletal” diagnosis) and started thinking maybe this (costochronditis) was the problem.

Pain in the chest wall around the breastbone (or sternum) is the most characteristic feature of the condition known as costochondritis. Medically, the term chondritis refers to inflammation of any cartilage in the body. Costochondritis refers specifically to inflammation of the cartilage that joins the ribs to the breastbone (called costal cartilages). The chest pain of costochondritis sometimes is severe. all about costochronditis from emedicinehealth.com

Pleurisy is not (yet) in my sights even though NHS Direct had mentioned it, as far as I was concerned pleurisy was too serious to consider – due to my mother’s continous warnings to me as a young boy that I would get pleurisy by doing just about anything (standing in the rain, in front of thr fridge, ironing late at night etc etc) and me laughing at her for being such a doom-monger. I also felt this weird clicking that I could actually feel with my fingers. Later on I decided that this must have been the “friction rub” of pleurisy.

The normally smooth surfaces of the parietal and visceral pleurae become rough with inflammation. As these surfaces rub against one another, a rough scratching sound, or friction rub, may be heard with inspiration and expiration. This friction rub is a classic feature of pleurisy from AAJP

I sleep sitting up, this seems to help. I’m not taking drugs. I reason that I need to know if it gets any worse. I want to feel it. I get the chest x-ray.

The next week is really stressful. I’m awaiting the results of the chest x-ray. I have by this time looked on the wretched internet and determined that my symptoms match not only a collapsed lung, but also costochronditis and worse still lung cancer.

I am offered a new (and better) job.

My head is swimming. I cannot sleep. It hurts.

I decide for several reasons (including health concerns) not to take the job.

Normally I worry and I am quite anxious, this week I’ve entered a new level of anxiety. It doesn’t help my chest at all. No, not at all.

I go to work for a few days. The results of the x-ray are back. I call my GP, they have to call me back. Another doctor calls me back and says that my chest looks a bit hazy which usually indicates a chest infection. He recommends I take the Amoxicillin. I do.

The Amoxicillin course ends. The pain is not as bad, but still with me. It’s a pulled muscle I tell myself. These things take time. The anxiety gets the better of me. I call my GP. The annoying and rude receptionist asks “Is it an emergency?” thinking she can fob me off. I say, smugly, “I have a very bad pain in my chest.” She shuts up and says I can come in. HA!. Chest pains RULE!

I rule out costochronditis because my pain is on my side, and I believe that costochronditis pains are around the sternum (ie a bone which holds the ribs in the middle of the chest). I’m not sure what it is any more. I’m worried and paranoid and anxious, as usual.

I see another doctor in my GP surgery. I tell her my story. I explain that I’m really worried and anxious. I hurt, my chronic cough, my fears, my chest pain. She listens. She refers me to a REAL HOSPITAL. She gives me another antibiotic (Erythromycin). I want to marry her, I love her. This is much more than the infatuation I had with the last doctor.

It’s pleurisy! Hooray?!

I go to see a doctor in a cardiothoracic out patients clinic. He is a professor. Thank you god. I am saved. He says he doesn’t “buy” the pulled muscle theory. He says “you would know when you pulled your muscle”. He says I have pleurisy.

He says that between the Amoxicillin and the Erythromycin the infection is probably gone. He orders another chest x-ray and some blood tests. He pokes me and listens to my heart. He says he’s pretty sure I’m okay. He is a professor in a world leading university hospital. If he was a woman….

I tell him about a saying my mother has “after bronchitis is pneumonia, after pneumonia is pleurisy, after pleurisy is death”. He laughs and says, almost angrily, “Not around here it’s not”.

I return to the cardiothoracic out patients clinic the next week to get the results. They came back clean. I see the X-ray of my chest. I can recognise my skeleton. In a weird way it looks exactly like me. It looks clean and nice. Seems like the 10 years of smoking haven’t killed me yet. He says the only thing is “a very slightly raised white blood cell count”. This he said usually indicates an allergy.

He doesn’t seem at all concerned about the pleurisy (although this is all I care about) and proceeds to tell me all about coughs. I’m relieved I’m not dying and just answer the questions he asks me. My brain slightly frazzled by the relief.

The now chronic cough is still with me. He says nearly all the chronic coughs he sees are because one of three things 1) asthma 2) post-nasal drip or 3) acid reflux.

Days later I would kick myself for not asking “How long does it take to recover from pleurisy?”. It’s been 2 months for me, and I am really not 100%, I’ld say about 75% recovered. I’m seeing him again in 6 weeks time. Hopefully, I won’t need to ask him that question then.

Current status

2 months after initial pleurisy pains, 3 months after the bronchitis and 4 months after the cough started

I’m taking steroids (Nasonex, mometasone furoate monohydrate) up my nose (to help the Chronic Rhinitis and Post-Nasal Drip). It has been about 10 daysnowand I think the cough is improving (ie disappearing). The pleurisy is ongoing, but not the sharp, stabbing pains on breathing. It has been about 8 weeks since the initial onslaught. Now the pains aredulland aching and sometimes in my back, but sometimes I cannot feel them at all. I’ve decided to run a course of ibuprofen for a full week to see if it actually shifts it. I’m recording my lung peakflow witha peak flow meter(!) twice a day. Variations mean asthma. Low values mean asthma. I think I’m in the clear. It has been 10 days now, and I record always between 460 and 510 liters/minute.

>General advice

I’ve just made this up, so don’t take these as gospel eh.

  • Don’t always assume that your GP is correct, try and get a second opinion if you are not happy with your diagnosis. I think you should have some idea when you get a diagnosis if it fits with what you feel. Remember the GPs will not have all the information about your illness. You are the only person with all the info.
  • If you think it is serious, do press your GP to take it further, more often than not they will say it is a cold, it is down to *you* to stress that it is more than a cold.

>About chest pains

I’m not a medical professional, I’ve just read a lot about it on the internet, and this is strongly biased by my own experiences

  • Is it collapsed lung (pneumothorax)? This screener is very helpful. In my case, I had:
    • sharp chest pains on one side of my chest
    • and a dry hacking cough

    The following is a list of the signs and symptoms of collapsed lung:

    • Sharp pain in the chest
    • Sudden shortness of breath
    • Painful breathing
    • Tightness in the chest
    • Dry coughing
    • Cyanosis (blue skin)
    • Rapid heartbeat
    • Distended neck veins (in Tension Pneumothorax)
    • Low blood pressure or shock (in Tension Pneumothorax)

    Presumably the pain from a collapsed lung and pleurisy are quite similiar. This is very easy to definitively rule out pneumothorax , and I think a GP can more or less confirm this by seeing you and listening to your chest. An x-ray will certainly confirm.

  • Is it costochondritis (Tietze’s syndrome)? The symptoms:
    • The predominant symptom is a sharp pain in the affected area, most commonly involving the second or third ribs, which are often very tender to touch. (Ribs are counted down from the top and the first rib lies under the collar bone.)
    • The pain is usually related to movement, coughing and sneezing and can occur in more than one place simultaneously.
    • Pain can also radiate into the arm and can be associated with a feeling of tightness in the chest. These are also the symptoms of a heart attack, so it is always necessary to take them seriously and make the diagnosis of costochondritis with care.

    Note this is not a respiratory illness and is not serious at all (I think :D). No one knows much about it. And although this sounds alot like pleurisy to read about the symptoms, I think the key (although I’ve not felt this myself) is that the pain is in the centre of your chest, and probably feels more like a heart attack (again, I’m making this up) than a pleuritic pain. You would most likely see your GP and he would (should) rigorously check you out to ensure it was not your heart. Cardiac related chest pains are taken very very seriously. Presumably you can have pleurisy pain anywhere around your lungs, so if you had it around your heart, that would be very scary indeed. In my case, the pain was on the right side, almost under my armpit, so quite far from my heart and sternum.

  • Is it pleurisy? First off *I think* you can get pleurisy for many many different reasons. Some of these are very scary. We are dealing here with the non-scary versions, basically spillover from respiratory tract infections.
    • pleurisy can be anywhere in your lungs (so for instance, if it is low down your chest and on your right side, it is almost definitely pleurisy)
    • the friction rub thing (see rub)
    • if you have a chest infection or cold and then you get these pains, it is probably pleurisy (and not costochondritis or collapsed lung or pulled muscle). I had an ongoing chest infection which at some point was confirmed by an x-ray. And rememer my super professor doctor said “You would know when you pulled a muscle.”
    • it is more common that you think

    The NHS list of symptoms seems to be the best (for my purpose of non-scary pleurisy diagnosis):

    The main symptom of pleurisy is a short sharp pain in the chest area when taking a breath. This often occurs at the end of a breath. Other symptoms could include:

    • chest pain when coughing,
    • fever,
    • rapid shallow breathing, and
    • discomfort when touching the affected area, even lightly.

    You may also have other symptoms because of the disease or condition that is causing your pleurisy. For example, if it’s a common cold that is causing your pleurisy other symptoms could include headaches, a sore throat and coughing. from NHS Direct

I think some key points that no one mentions (and I have inferred) are:

  • pleurisy can be anywhere in your lungs (so for instance, if it is low down your chest and on your right side, it is almost definitely pleurisy)
  • the friction rub thing (see rub)
  • if you have a chest infection or cold and then you get these pains, it is probably pleurisy (and not costochondritis or collapsed lung or pulled muscle). I had an ongoing chest infection which at some point was confirmed by an x-ray. And rememer my super professor doctor said “You would know when you pulled a muscle.”
  • it is more common that you think
ok that’s it, i’m exhausted from writing this. please comment and let me know about your experiences and inaccuracies.

beta: getting it right the first time (making it for dummies)

Once every 5 or 10 years an idea so simple, so elegant, so obvious comes along and *SMACKS* you in the kisser. We call these ideas, good ones.  What I really want to talk about has nothing to with “getting it” or “making it”. Are you for real? What the hell did you think I was gonna tell you? The answer, you dumb-ass, is blowin’ in the wind. Bob D. wrote that like 40 years ago, he knew what you should know, but because you are so busy trying to make it, you forgot to think. Forgetting to think is probably the biggest problem around (the next biggest problem is witless assholes who think they have it all figured out). 

Anyway, that’s *slightly* off topic.

The biggest question today is not what you, or your Daily Mail | Express  neighbours think. They are irrelevant, the world is being re-shaped without their bullshit agenda. People are tired of lies, although their propensity to be lied to seems to rise with inflation.

Nirvana killed punk rock (by accident),  does that make them evil? We destroyed our planet (by accident)? Does that make us evil? Or stupid? Does it matter?

Answers on a postcard.

Stop wasting your time, there’s nothing coming; only a fool would think someone could save you

Don’t forget that of all the things that you are, you might best be judged by what you want to be (or do!). If I was a god, that’s how I’ld do it. It’s the intent that matters really, ultimately the truth of what and who you will are will surface. A wasted life would be one where it didn’t.

Remember “It’s the best years of your life they want to steal” (vide infra), so the quicker you listen to “the voices in your head” the better. The time is now, don’t wait till you have the BMW, the house, the knowledge. How much can that stuff really mean to you anyway.

It’s not about save the planet, it’s really about drowning out the other noises and voices which seek to steer you away from doing what it is you need to do.

The voices in your head are calling
Stop wasting your time, there’s nothing coming
Only a fool would think someone could save you
The men at the factory are old and cunning
You don’t owe nothing, so boy get runnin’
It’s the best years of your life they want to steal

Clampdown, The Clash (only a fool wouldn’t know that 🙂 

A work of unqualified greatness

Although, as a policy I’m not supposed to write about me per se or what I’ve been up to. Let me just kick this off by saying I just finished reading American Pastoral, by Phillip Roth. What a book. There are enough ideas in there to fill a lifetime. And some really good ones too.

Anyway. That’s what I’ve been up to.

To change or not to change. The rites of spring, and the fear of change. Is it fear or change that you are afraid of. Some people (let’s call them optimists) proclaim “Change is good”. Others, let’s call them pessimists swear that “Change is bad”.

There is no great wisdom in either philosophy, but it is worth, recognising which camp you belong to.