How Physical Health Problems Can Trigger Mental Health Problems

Last week I talked about a recent incident where my mental health, more specifically my eating disorder’s obsession with drinking a lot of water, had a detrimental affect on my physical health and in a hilarious twist of fate and example of bizarre symmetry (and by hilarious I mean literally the most unamusing thing to happen ever), this week I am talking about how the opposite can also be true, and how physical health conditions can end up triggering or making a pre existing mental health problem worse.

So when we last left off, I had explained how I had been admitted to hospital for water intoxication and was being treated for this problem via a strict fluid restriction plan to get all of my electrolytes back to acceptable levels (it is at times like this when I wish I had one of those “previously on” video clips that they show before episodes of various TV dramas…I should really look into that…ooh and a theme tune! I do love a good theme tune!)
Now, after a few days, the fluid restriction, whilst being incredibly annoying for me, seemed to be working, and my sodium levels kept improving until they were back to normal. Really, that should be the end of the story, the problem was solved so I should have been packing my bags and making my merry way home, but alas the story did not end there and developed into what I like to think of as an epic novel of utter ridiculousness.

You see whilst my sodium levels were improving, I wasn’t feeling any better which didn’t make much sense. I had been admitted for a problem that was being successfully treated yet bizarrely, as the days went on, I became more unwell with a pain in my stomach. The doctors couldn’t really make sense of this and before long I was in so much pain that I couldn’t stand or lift my head off the pillow and was in need of all the morphine I could get. A few tests were run but no answers were revealed so a surgeon was sent to have a look at me.

After thumping me in the abdomen with an iron mallet a few times (she said she was only going to “press gently” but trust me from the pain I am pretty sure that woman had a mallet and a vendetta against my stomach region), it was concluded that I might have a swollen appendix. I was told that normally the surgeons would book me in for an operation to whip it out just incase, however due to my already poor physical health from my eating disorder, they wanted to avoid taking me to theatre (alas the operating one and not the version where you get to watch The Sound of Music on stage whilst eating a little pot of ice cream with a spoon that is basically just a mini plank of wood with no resemblance to a spoon whatsoever), because they weren’t sure I would survive an anaesthetic.

Thus it was decided that they would only operate if they were absolutely certain that such a thing was necessary and therefore some more tests were scheduled to try and clear up what was going on. The problem with this was that by leaving time for tests, we were also leaving time for things to go downhill which they did fairly rapidly. Again the surgeon visited and again an operation was suggested but also feared so I was sent to yet another test in the form of a CT scan where I was basically shoved in and out of a tube a few times whilst doctors took photos of my insides (I really hope that my organs put on their best clothes and posed nicely for the occasion…it isn’t every day someone wants to photograph your intestines).

After the CT scan was complete it was around 1am and I was finally allowed to have some more morphine and attempt a snooze, whilst my sister, who had been sitting beside my bed for the past few days, went home. That was until 4am when another surgeon woke me up, to tell me that the scan had shown that things were rather serious and I was scheduled for emergency surgery immediately, my sister being called back in by the nurses having only just left. The next little bit of time is somewhat of a blur but from what I remember I was pumped with anaesthetic and taken to theatre (again, the operating one. I didn’t get so much as a lick of ice cream and I saw no children dancing in curtains. Livid.)
I was so knocked out that it was about 24 hours before I woke up from the procedure, dazed and confused with a tube coming out of my stomach and leading to a bag of some unidentified liquid.

It was then that I was informed that my appendix, in being left for so long, had ended up exploding. (The surgeon told me that I shouldn’t say that it “exploded” because in technical terms you should say that it “ruptured” but damn it I went through a hell of a lot of pain and nonsense because of what happened so if I want to say that my appendix literally exploded like a firework on the 5th of November then I will jolly well do so!)
Consequently my body had been filled with poison, hence the tube and bag scenario coming out of my stomach after the appendix had been removed, to drain the poison out (the poison being the funny liquid in that bag.)

Since then the job has basically been to free my body of poison, recover from the surgery and try to build my body back up after its internal beating, a job that isn’t going too well at the moment because this whole physical health problem extravaganza has triggered the life out of my mental health problems, more specifically my eating disorder.

Admittedly I haven’t been doing particularly well for a while now, but I have been clinging on to some sense of stability by rigidly carrying out the same routine meal plan via some form of repetitive autopilot action. Unfortunately, this event has utterly destroyed my autopilot “just do what you did yesterday” routine.

I think when you have an eating disorder, eating your meals is kind of like a recovering alcoholic avoiding the pub.
If you force yourself to eat the same meal plan every day, you get into a sort of rhythm, a rather bumpy and unpleasant rhythm that you can’t lead a good conga to, but a rhythm all the same. Missing one meal however is like an alcoholic downing one mouthful of vodka after a few months sober and then suddenly finding it impossible to stop.

Knowing that missing one meal will always make the next one harder is the reason that I fight so hard to complete my meal plan even on the bad days because I know that not doing so will make it harder for me in the long run, but in this whole “my organs are exploding” situation, missing a meal wasn’t something I had any control over.
For the first day of the hospital admission, eating was mentally impossible because I was in a different place with different foods. This problem was somewhat solved when family and friends hauled bags upon bags of my safe foods to my bedside, but by that point I was physically in too much pain to lift my head let alone grab a spoon to chomp down on some cornflakes. During all of these pain days I was also constantly being wheeled in and out of various tests that doctors were telling me I wasn’t allowed to eat before, and incase I was going to need emergency surgery after some of these tests, my stomach also had to be kept empty on the off chance that people would be whipping the scalpels out (apparently it is significantly harder to operate when one has just demolished a peanut butter sandwich…or any kind of sandwich…not that there is any other sandwich worth mentioning).

Post surgery I was finally allowed and encouraged to eat to regain my strength and I genuinely tried, but again there were hurdles. Firstly the combination of anaesthetic/poison/million medications made me extremely nauseas, and I was being sick multiple times a day. My taste buds had also suddenly gone haywire and for some reason I could not tolerate sweet foods which for someone who always picks sweet over savoury and who lives off sweet things like porridge and cereal, this was somewhat of a problem. Even the flavour in toothpaste made me throw up (all over my toothbrush I might add…suffice it to say my breath was not minty fresh), and shock of all shocks, I started to be repulsed by peanut butter. Me. Repulsed by peanut butter aka the food that was previously the holiest substance on earth? Who am I? I think I am going through some kind of identity crisis. You might as well start calling me Malcolm.

Therefore I was trying to find new foods that I could both mentally and physically tolerate, family and friends bringing in new groceries every day (including my parents who had had to cut their holiday short and catch an emergency flight back to the UK with fears that they might not get “back in time”…safe to say their relaxing trip to Malaysia was somewhat of a disaster this year..).

Excitingly, a new safe food that I could physically and mentally tolerate was discovered in the form of mashed potato, but by this point it had been so long since I had eaten properly even that was a struggle. I felt sick at every meal time and I could never be sure why. On one hand it could have been the “genuinely physically ill with poison and anaesthetic” sick that I shouldn’t have forced myself to fight as nothing I ate would be kept down anyway, or it could have been the simply sick with anxiety and fear of food sick that I really should have been challenging to prevent it getting any worse. Sometimes food would arrive and I would feel so ill that I wouldn’t risk a mouthful only for the food to be taken away, the sickness to go and me to realise that all that nausea had been anxiety as apposed to anything related to physical complications.

After multiple meetings with my eating disorder services who visited me a lot on the medical ward, it was decided that I would be discharged home incase eating became easier there due to familiar surroundings. Armed with a ridiculous amount of mashed potato, I really tried but a few days in found that I was struggling to swallow. Again I assumed this must be that whole “throat closing up with anxiety” thing, so I persevered, but then after finding some weird white nonsense all over my tongue and throat and a trip to the doctor, it was discovered that life had thrown yet another curve ball and in my weakened post surgery state, had given me tonsillitis and oral thrush, conditions that make swallowing rather difficult and would therefore interfere with anyone’s ability to eat…Oral thrush? I didn’t even know that was a thing? WHAT THE HELL IS GOING ON WITH MY BODY.

Now I am three weeks post surgery (happy no appendix anniversary to me!) and in positive news, the nausea from anaesthetic and poison is practically gone. Having started another lot of antibiotics and some weird throat drops I have also regained the ability to swallow but after so many physical preventions to eating, I am now mentally more terrified than ever at the prospect. I have been to my eating disorder unit and the scales say that I have lost weight yet somehow I feel bigger.
Doctors are telling me that I have to get back to my old meal plan immediately so that we can add new things in to regain all that I have lost but it feels impossible. I cannot comprehend how the hell I was managing to eat before, despite the fact I was doing it only a few weeks ago, because now such an ability has become alien and frightening. I am tied up in a bundle of fear over food, throwing up, weight gain, trying to eat whilst being laid up in bed unable to carry out my usual exercise routines and consequently recovery from surgery isn’t going very well because I don’t have the energy to recover. Both the physical affects and mental health problems are feeding off each other like my body is an all you can eat buffet, and ironically the one person not getting fed in this situation is me. I have been on the edge of collapse for months now, clinging to the edge of stability with all the strength I can muster, but this has thrown me. I have fallen off the cliff. I am spiralling.

…And on that jolly note, that is pretty much my explanation of how a physical illness can go on to affect/cause/trigger a relapse in a pre existing mental illness. As with a lot of my blog posts, it hasn’t been a particular barrel of laughs as far as topics go, but it is the honest truth, and as always, that is what I am determined to put out there in terms of raising awareness of mental health problems.
Now after all this typing, I think I am very much in need of a nap and then maybe I will give some more mashed potato another go. Eating food is the last thing I want to do right now and my stomach is already full from terror, but I promise, I really am trying.

Take care everyone x

AppendixExplode

Why Familiar Surroundings Are Important When You Suffer With OCD

The original title of the blog I was planning to write today was “Tips on staying away from home when you have mental health problems”. You see, my parents were jetting off to Malaysia and seeing as I am not well enough to manage by myself at the moment, the plan was for me to go and stay with their friends in this lovely little house out in the countryside.
We have been planning it for months, I had visited the house and felt OK about it seeing how nice my bedroom, personal office AND personal bathroom were going to be. There was even a cat called Pingu. A cat. Named after my favourite childhood penguin. Ideal right?

Well I thought so, but was still worried about managing my mental health with new carers who do not know me as well as my parents, so I came up with a list of coping strategies and ways to manage it. Consequently I decided to write a blog sharing my oh so helpful tips incase anyone else out there was in a similar situation, but then…well…I went to the house where I was due to stay for two weeks, lasted approximately four hours and then was driven home in hysterics at midnight with my parents due to fly the next day despite having still not packed so much as a flip flop, because we have been spending weeks packing for me to go away (if you want to imagine how many things and bags it was, think of the average stuffed car that people often drive off to uni in, double it and chuck a penguin on top for good measure. Oh and a Christmas elf. One must never travel without one’s cuddly Christmas elf. Oh there we go! I did give a travel tip! YAY ME.)

Clearly then, I am in no place to be giving tips about staying away from home right now BUT over the course of this traumatic experience, I have been reminded of a valuable lesson about mental health problems, so I thought I would share that with you today instead.

Having been mentally ill and having been in therapy for over a decade, I would say I understand my conditions and myself rather well, which is why I felt that I could make a plan about an approaching situation in advance without running into any unforeseen issues.
Trying to do my same rituals in a different place however, really reminded me of something a lot of people might not realise: that being that sometimes with OCD, it is not just about carrying out a specific behaviour like a shower routine, it is about carrying out a very specific shower routine in a very specific shower.

I always knew that because of OCD and anorexia, I have a LOT of routines, rituals and specific ways of doing things. I eat out of certain bowls with a certain spoon, I drink tea out of a certain mug at certain times of the day and I wash my hands, shower and get dressed in very specific ways. As rigid as these and a number of different actions in my day are, logically you could assume that I could carry them out in a different place so long as I had the correct equipment. There was a shower where I was going to stay so of course I could do my shower routine, there was a sink so of course I could wash my hands and I was taking all of my cutlery/crockery so obviously I would be able to eat all in my usual ways.

Even I can admit that years ago, though still having OCD, I was able to do these fixed ritual things in other places with other sinks and showers. I have been on holiday since my diagnoses, have stayed in a hospital and went to university (kind of…), always carrying out the same actions just in different locations. Therefore I tried to do that this time going to a strange house but, with things how they are at the moment, as hard as I tried and as good as my intentions were at the time I attempted it, it isn’t possible (at least to a manageable realistic degree that doesn’t involve hysterics 24/7 for a fortnight which is less “a good challenge” and more cruel torture. I am all for accepting challenges and trying things out of my comfort zone but sometimes you need to eat a few mini muffins before you are up to demolishing an entire five tier wedding cake by yourself).

I was truly shocked as I sort of hadn’t realised how bad things have got again.
The descent has been a gradual process, little slips that in the end add up to a sky diver height of a fall. It is like what they say about if you put a frog in boiling hot water it will hop out but if you put it in warm water and gradually turn the heat up it will boil to death before it realises (that is what they say isn’t it? Who are these people? Please dear readers, do not go putting frogs in boiling water. If you really want to see some green bubbling in a pan just whack in a bag of frozen peas, far more humane AND one of your five a day).

When we pulled up at the house I fully intended on staying for the next two weeks (obviously I did, I had my penguin and my cuddly Christmas elf, I was committed to this trip). Even though I was anxious, by using multiple packets of anti bacterial wipes and with support from my parents, I got through the unpacking and after two hours my room, bathroom and office all looked really nice, filled with familiar things, a comfortable home from home.

It was when I tried to shower that things went so horribly wrong. First there was the issue that the shower was a stand in shower cubicle with a door. At my house our shower head is hanging above the bath, so when I am getting all lathered I can stand out of the flow of water to reach the required bubbliness (I know that this is not the most environmentally friendly way to live my life and that I could just turn the shower off but just know that I am unable to do that at the moment and to be honest when you are focusing on just keeping yourself alive your carbon footprint is not a top priority. At least I am not flying across the globe in an aeroplane to Malaysia like SOME people…).
With this stand in shower however, I was unable to reach the desired bubbliness needed to get through all of my thought routines because before I had time to count to the required numbers the suds had all been washed away.
Then there was a problem that I had to put my soaps in a basket so my lemon shower gel for feet was too close to my banana shower gel for body and far too close to a wall that I couldn’t touch, and the way you turned on the shower made my usual vitally important life saving way impossible.

I took so long to shower that all the hot water ran out and after a while of forcing myself to stand under the cold ice like hail pelting me in the face, I got out though I still didn’t feel clean. I was in a bit of a state but I didn’t want to give up so I persevered and tried to get on regardless but it was one thing after another. I couldn’t wash my hands in the sink because the tap distance to the back of the sink meant holding my arm at 135 degrees rather than 90, I couldn’t step off the towel I had laid on the floor because my bare feet couldn’t touch the tiles and I couldn’t put on the socks that I had brought into the bathroom with me without direct access to trousers and slippers. “You should have taken slippers in and trousers too” I hear you cry but I had thought of that already and couldn’t because there was nowhere safe in the bathroom to put those things at an acceptable distance away from each other. I found myself standing stranded on this towel shivering and blue with cold, so I naturally did what any other person would do in that situation. I cried uncontrollably and screamed in terror for my mother.

Luckily my parents were still there because the unpacking had taken such a long time that they had ended up staying for dinner whilst I showered.
Seafood rice was cooked and eaten and a homemade rhubarb crumble was just being served when the screaming happened and mum came running. She tried to help by offering solutions, one being the ideal “I can go and get the trousers and not let them touch anything”, but I didn’t want to do that. Yes it would have been safe, but I wanted to solve the problem by myself somehow with support.
Mum could have easily gotten my trousers and I could have left the bathroom but what the hell would I do the next day when she was on a beach somewhere in Malaysia? Around this point my “in a bit of a state” descended into full on “out of control don’t know what I am doing dangerous risky chaotic hysterics and panic” and from there things are a bit of a blur. All I know is that I cried for several hours (I tried to talk too but was at that hiccuping crying point so “I don’t know how to manage I want to disappear” came out more like “Hic gasp gulp hic scream”), and my parents and friends frantically tried to decide what to do.
When I was able to talk and sob at the same time I made it clear that I felt it was a challenge too many and that rather than tackling the “parents away and totally different location for all rituals for two weeks” I wanted to attempt the “parents aka usual carers away, in a familiar place” challenge. Losing both was like losing both of my homes, a tortoise rudely ripped from his semi detached terrace house and his shell in the same day leaving a cold naked slug unable to survive in its place.

There were then more hours of discussion before we realised that this really was not a feasible option and then after two hours of packing all of my things back into the bags we had unpacked them from (we didn’t have to pack my elf. He went and got himself back in the car the second he heard the first bout of screaming. He knows me well), we were back in the car driving home in the dark, leaving the abandoned now cold homemade crumble on the dining table. It is a big shame. My parents love rhubarb crumble.

So it was that I ended up back home after my much shorter than planned and somewhat failed “stay away from home with mental health problems”. On the plus side I did manage to get to the house and unpack…I just left two weeks too early.

Clearly then, I think I have proved my point and raised awareness to all the people who might not understand OCD, that when it comes to OCD and other mental health problems with ritualistic behaviours, it isn’t just the rituals that are important to a sufferer but the specific location and circumstances under which those rituals are carried out.

Take care everyone x

Bubbly