Out Of Control – Me On Steroids

There I was, having been told that there was a good chance that my hearing loss was due to my own actions. Not an easy thing to deal with. Part of me absolutely felt angry with myself, was blaming myself; I have a natural tendency to be very hard on myself – especially when the consequences of my actions turn out to be severely negative. But, there was also another part that just felt confused, because whilst the second most recent overdose was certainly a serious one, the most recent one was one where I didn’t ingest more than about half a teaspoon of the chemical, and I couldn’t quite understand how it could have had such a drastic effect on my hearing. But, clearly it had.

The ENT specialist had prescribed a high dose of Prednisolone which I was to take for a week in the hope that it may reverse some of the recent hearing loss. The name of the medication did ring a bell at the time, but not loudly enough for me to clock why, so I went down to the hospital pharmacy and picked the medicine up. It wasn’t until I got home that I remembered that this was a medication which a previous GP had refused to prescribe when my asthma was really bad, because she felt it was too much of a risk, putting me on it. There were two reasons for this: firstly, that people with a history of serious mental health issues are particularly prone to react badly to this medicine, and, secondly, that I have in the past had extreme adverse reactions to three other medications [one of which I was reacting to when I took the second most recent overdose], so the doctors are always very cautious about prescribing any non-essential new meds to me.

But, there I was with the medication in my hand, not knowing whether or not it would really be a good idea to take it. Yes, this medication could potentially save me from needing cochlear implants down the line, but, at the same time, if I did have a really bad reaction I could end up putting myself at considerable risk. The ENT specialist wasn’t someone who knew me well [or at all, really], so when he prescribed it, he did it on the same premises he would for anyone else; ‘Worth trying, no harm done if it doesn’t work’, whereas I knew that this medication could spell real trouble for me.

There was a part of me that was genuinely scared of a bad reaction; I knew perfectly well the horrible feeling of being out of control because of a medication. I had been through it three times.. Yet, there was another part that so badly wanted to be able to do something to reverse the damage I had apparently caused.

I spent a week going back and forth, unable to decide what to do, talking it through with lots of people, knowing full well that, ultimately, it was still my decision to make. I did speak to my GP [well, technically, the receptionist spoke to her on my behalf], and she said that it would be ‘perfectly fine’ for me to take the steroids, and – after all – I had had no adverse reactions to the steroid injections I was given when treated for anaphylaxis.

In the end I decided that I would give it a go, because I knew that if I didn’t I would always be wondering ‘What if..? What if..?’.

Still, to be on the safe side, I decided to start the course early Monday morning, so that if I did have a bad reaction I would be seeing P. later that day. [With two of the three medications I had previously reacted badly to, it had happened literally within a few hours of taking the first dose]. I also had a doctor’s appointment on Tuesday, and scheduled a ‘just-in-case’ appointment with K., my synagogue social worker who I have been seeing semi-regularly, for Wednesday afternoon.

Monday came round and I took the first dose, which – as this was a high dose treatment – was a good handful of pills, making me feel as if I was actually overdosing on tablets. By the time I was due to see P. – about six hours later – I already knew something wasn’t right. I could feel things firing in my brain, rapid electric sparks in my head, and it was as if I couldn’t keep track of my own thoughts. It was a truly bizarre experience. – Anyone who has ever been seen by the mental health crisis team knows that one of the questions you will be asked during the assessment is ‘Are you having racing thoughts?’. Being prone to deep depression and suicidal ideation rather than mania I have always answered ‘No’ to that question, not really knowing what ‘racing thoughts’ actually were. I’m telling you, by noon that Monday I knew exactly what they were – and it was freaking me out, big time!

So, I had a crazy rambling session with P. that day, very unlike any other session I have ever had. I also spoke to H., my care coordinator, that same afternoon and she sorted out a referral to the crisis resolution team for Wednesday, as it was clear I was not in a good way and would likely need the extra support, particularly over the weekend.

On Tuesday morning I went to see the doctor – an absolutely lovely F2 who I hadn’t met before. By then I had taken the second dose of Prednisolone – more out of a sort of manic compulsion than anything else – and consequently the reaction was getting worse. I had also used a surgical scalpel and cut myself very badly in two places; enough to warrant stitches. The doctor’s reaction was ‘Come off these meds immediately – this is a really serious and abnormal reaction!’.

I explained to her the reason why I was on the treatment in the first place and why I was finding it hard to ‘just stop taking the meds’, and this young doctor was absolutely brilliant. She sat back and listened to me carefully and then took the time to make five or six phone calls – while I was still in the room – to get hold of an ENT registrar to find out what the implications of stopping the treatment would be for my hearing, so that we’d be able to make an informed decision. The ENT registrar told her that as treatment had been delayed by several months already [Urgent NHS referral, remember?] it was unlikely that my hearing would improve, that the specialist who prescribed the steroids probably felt it was worth a shot – even if it was a shot in the dark – because sometimes people do respond, even with delayed treatment. But, the registrar concluded, in light of the extreme reaction I was having it certainly wasn’t worth staying on the meds, as the odds of success were so small.

I felt really reassured in that moment that I wouldn’t be missing out if I ended treatment prematurely, because the odds of any improvement were so small. It made complete sense to stop taking the meds.

But, then I got home, and I was still hyper and there was so much in me saying that firstly I was already dealing with the adverse effects of this medication [the GP had explained that it would more than likely be a few days, maybe even a week, before the chemicals in my body would stop messing with my brain].. and it was only a few more days to go.. and what’s to say that I couldn’t have an equally abnormal positive reaction to these meds..? After all, my body is clearly highly sensitive to small chemical changes..

So, the next morning I took the third dose, against medical advice. This time it wasn’t manic compulsion that made me do it, but that part of me that just needed to hold on to hope, that simply couldn’t give up, even though everyone around me felt this was a very bad decision, indeed.

I spent time in my session with P. that day, exploring why it was so terribly hard for me to stop taking the tablets, even though the rational part of me knew that the chance of a positive outcome was incredibly slim – and that was really helpful, even with the chaos raging in my head.

I also had a good chat with K. that afternoon. She was characteristically open, direct and honest with me both about her anger and her disappointment that I had carried on taking the medication in spite of what the doctor had told me, and in spite of the fact that I had felt completely reassured at that point that I wasn’t missing out. I told her that I would think very carefully about handing the meds in to P. the next day, but I was also clear that I wasn’t prepared to make any definite promises, because I simply didn’t feel that I could. So much of me felt out of control and I just couldn’t say that I’d be able to do that, come morning.

Oddly, the thing that made me realise just how out of control I really was wasn’t the fact that I had cut myself so badly, but the fact that I found myself at a McDonald’s having a Big Mac.. I’ve been a vegetarian for something like twenty years, and I keep sort-of-kosher, so for me to sit down and eat something like that goes against so much of what I believe in. It is something I simply wouldn’t ever do, if I were in control of my actions..

I did end up giving P. the tablets the following day, but not before having taken a fourth dose that morning, this time – again – in a very compulsive manner. There was no reasoning whatsoever, just acting: I simply couldn’t not take them. This made me realise that I really needed to view the tablets in the same way I did my scalpels and cords [all of which I had handed in to P. two days earlier, feeling too out of control to be safe with them]; while I was still having this strange reaction I just couldn’t manage the tablets responsibly.

It took a good while after that final dose before I felt completely back to my normal in-control self, and I carried on working with the crisis resolution team through the weekend and most of the following week, just to be safe.

I am really glad that I had as much support available to me as I did during this time, because it was incredibly frightening to be so out of control. The experience was very different to other times when I have felt out of control. Whilst what came out in the midst of this whole ordeal – feelings, thoughts etc – were things that were almost certainly already brewing inside, it was – at least the way I look at it – triggered by outside factors. And that’s quite a scary thing.

All the very best,

xx

Consequences Of One’s Actions

A lot has been going on in the last few weeks [or is it months?] since my last proper post. There have been some serious ups and downs, and I don’t quite know where to start.. So, I’ll just start with what’s on my mind right in this moment: my hearing. Or, rather, the lack thereof.

I’ve not really written about this before, because up until about a year ago, it’s not really been too much of an issue, or at least it has been an issue I have had the luxury of being able to ignore.

As my long standing friends will know I lost a big chunk of my hearing many many years ago, when I was about twenty. I was doing voluntary work at an orphanage in a village outside a village outside another village, in the Middle Of Nowhere, India. It was Diwali, the Hindu festival of light, and as a special treat for the children we had bought fireworks and penny crackers, which they were allowed to set off. All was going great, big bright smiles all around, lots of happy dancing and singing.

Until one of the kids threw a firecracker up in the air and it exploded right next to my left ear. My whole world went silent in an instant. It was one of the most terrifying experiences of my life, that sudden and complete absence of sound. I remember screaming, but not being able to hear the sound of my own voice.

Over the next hours and days some hearing in my right ear did come back, but the hearing in my left ear was almost entirely gone. I managed to see a doctor when I went into town a few days later. He very carefully examined my ear and hearing and confirmed the damage with a simple “This is not good” and a slow, sad shake of his head.

And that’s pretty much how it’s been until recently. I knew I could probably be helped by wearing a hearing aid, but I simply wasn’t ready for it, and since I was able to use the remaining hearing in my right ear well enough to compensate for the loss in the left, I just left it at that. Something was broken, but not enough to bother fixing it.. There has been a lot of “If you want me to hear you, you’ll need to walk on my right – if you’re only going to talk rubbish, stay on the left” going on over the years, but all in all, through a combination of lip reading, context deduction and plain ol’ guesswork, I’ve been able to fake hearing pretty darn well. It’s amazing how easy it is to just laugh when everyone else laughs at the end of a joke you haven’t even heard, or to cover up giving the wrong answer to a question..

However, a bit over a year ago I started noticing that I was no longer as able to compensate with my ‘good’ ear as I used to be, and – being fifteen odd years older – I decided that it was kind of silly to routinely pretend being able to hear when I couldn’t, and that I should really do something about it. So, I went to have a test.

The results were shocking; not only was the hearing in my left ear really poor, my right ear was also significantly worse than I had thought. I was advised that I was a prime candidate for double hearing aids, and that I should get my GP to sort out a referral [private hearing aids are horrendously expensive].

A number of months later I was finally given an appointment at an NHS hospital. Only by the time I had that second round of hearing tests there had been a distinct further drop in my hearing, particularly in my right ear, and as this wasn’t normal I needed to be seen by an ENT specialist. The audiologist told me that this kind of drop could quite possibly be down to an acoustic neuroma – a fancy way of saying that I might have a brain tumour affecting my hearing. Consequently, an Urgent Referral to an ENT specialist was made. For those of you who don’t know, an Urgent Referral in NHS/ENT terms means ‘probably around three months’. Thus, I spent three months trying to not give myself cancer by worrying about this possible tumour, while not being able to hear what people were saying, since hearing aids can’t be issued while you are still under investigation.

The three months passed and I very nervously went for my appointment, having absolutely no idea what to expect. It turns out that in those three months since my last appointment a second drop in hearing had occurred. More bad news. On some level I kind of knew this, but I had talked myself into believing that the drop was ‘just in my head’, that it was simply down to a higher awareness of my hearing loss, having now stopped pretending to be able to hear when I can’t – but – the audiogram clearly showed that this was a genuine drop, and not something I had imagined.

The ENT specialist sat me down and took an extremely detailed medical history, after which he concluded that it was exceedingly unlikely to be an acoustic neuroma, as only 13 people in 1,000,000 have them, and that my sudden sensorineural hearing loss [SSNHL] was far more likely to have been caused by my two most recent overdoses, as the drops follow that pattern precisely, and the chemical I had taken is well known to cause hearing loss in those who survive the overdose.

Needless to say, to me, this was quite a powerful emotional bombshell. I had been medically cleared after those overdoses and there had seemed to be no lasting damage.. But, clearly, this was not so, and I was now seeing the consequences of my actions in black and white.

The ENT person said that it was possible that the SSNHL might not be permanent, and that a short, high dose, course of steroids might jump start some hearing cells in my ear, partially reversing some of the loss. Ideally this kind of treatment is given within days of the hearing loss occurring, rather than months later, so it was in no way certain that the treatment would work, but he felt that it was definitely worth giving it a go, because whilst there wasn’t really anything to be done about the hearing loss caused by the initial blast trauma, there was still a slim chance that the more recent drop could be helped. I’d still need hearing aids, he told me, but I might be able to avoid cochlear implants further down the line.

I’m going to end this update here, simply because this is already a massively long post, but, I will write more about what happened with the steroid treatment and my hearing in the next few days.

I feel very aware that I haven’t really talked about the emotional impact of not being able to hear, or the fact that part of my hearing loss may have been caused by my own actions, and I hope that I will be able to touch more on that in the second part of this saga, because – of course – this is a big deal.

Until then, do be kind to your Selfs.

xx

PS. I’ve yet to sort my PC out, so I do apologise if the formatting of this post is a bit rubbish; it was all typed on an iDevice, and that’s a lot fiddlier than one might imagine..