Pain relief a diagnostic torture

 

In the end of October I visited the pain relief doctor. Nice word for Scrabble or gallows I just thought of. I was scheduled at the end of the afternoon and, as an expert by experience, I know that after a half-hour walk out you get a painful butt from sitting on the wrongly designed chairs which are specially designed for modern waiting rooms. When I am finally called in later I will be offered a cup of coffee immediately I hope (to ease the pain of waiting?) That hospital humor has never really suited me and I also think it is just schadenfreude really. The pain relief doctor has already explained at the consultation what the intention is. I will get a ultrasound guided Nerve Intercostal Block . I also went through this whole process in 2008 and the treatment is not very exciting although there are some risks of hitting a lung.

Back to the call and pain relief consultation for a moment. I was called if I could be at the hospital in half an hour and have a physical examination. Yes no problem I live ten minutes from the hospital so hop in the car and report. The doctor introduced herself and immediately started to write down my appearance (statuesque man, just a little too fat and pain on the left rib and of course), as it should be, a round of psychological questions was done. This is done to check that it is not imaginary pain. Quite a few "healthy" people seem to suffer from this these days. (I too use the Internet to look these things up).

The psychological examination was completed and we moved on to the physical. After explaining where the pain areas are located, they check pretty hard where exactly it hurts. I could cry and felt like I was about to go completely out of the conscious world. And no I am not very squeamish. I was seemingly able to convince the doctor quickly enough that I was going through hell and the examination was stopped for a while. It was moved on to the back to see if something could be wrong here. A number of suggestions for treatment were made and I had already indicated myself to have it treated as soon as possible. For this I will be referred to the pharmacy for pain relief medication to get through the coming time and some so-called blocking will be done on the rib on the left side at the end of the month. Once I left the hospital, I almost choked with pain in the car and we drove home. I could cry.

And then of course you have to keep eating, after eating a plate of macaroni, I vomited it out into the toilet bowl within 2 minutes under heartfelt apologies. The all-consuming pain couldn't even keep my stomach contents in place. Like being stabbed and the wound just wanted to remind you.

If that pain alone can be cut in half then I am already happy. After so many years I am quite used to it, I must say, and I have always told myself that my environment should not be a victim of my problems. But God Almighty what a pain.

 

 

And finally yesterday we had our adventure at the pain clinic and I must say it is just a strange idea, that for once it doesn't hurt anymore like it did for more than a while. It remains to be seen because at the moment there is still residual pain because the syringes have been inserted and this gives a more severe pain than before but as a reasonable positive guy I am hopeful again, after a week I should be able to do everything again. And then soon I will finally be able to throw myself into some light housework again without complaints afterwards.

I have been sweeping the room whistling a song again that did not happen for many years. And that's quite an amazing sensation when you've had to put the brakes on yourself for so long. I feel like a full person again although I will remain a "cripple" to the rest of the world. But yes, I can only rejoice and put on my old-fashioned bad boy costume again. I am going to do lots of naughty things again. The doctor did warn me not to overestimate myself now, and that it is not certain until the prednisone wears off. It is and remains junk but yes if it makes life less painful. (In the physical sense.) Now to deal with the aftermath of the pain which will be there for about a week as they stick a big needle in you which will give some pain as they shoot in some anti-inflamatorial meds and after this my life will be a big party again. Mentally seen there will be some party poopers and of course the medical bills will not be very small luckily we are insured for this. Anyway there will be those other pen licking ass- #@#$&@@#$ like the tax authorities for example have to cooperate a bit. So there will be some challenges during the holidays.

To give a bit of a picture of what the treatment is here is a link to a You Tube movie:

 https://www.youtube.com/watch?v=m--qyUUzH5U

 

The Old Sailor,

Workplace bullying might end up as Complex PTSD

 

Dear Bloggers,

As some of you might know that my wife is suffering from Complex PTSD caused by her managers over a period of three years and then something in her brain just snapped. Since this event she has been in therapy and until today there is no way to cure her fully. This means that there are no opportunities for her to do any kind of job. As there are to many triggers out there and she might be harmful towards other people. Instead of working she is going two mornings in a week to a farm with care for people with mental challenges and she is learning to do some light tasks and learns to ride a horse.

Complex PTSD is a traumatic experience due to workplace bullying or sexual abuse. But as more attention is paid to these kinds of experiences and exactly what they can do to victims, we are beginning to understand more about this condition. And this increased understanding should, in turn, give hope to the hundreds of people who find themselves subjected to workplace bullying every day.

Because the victims of C-PTSD do exhibit some of the same symptoms seen in standard PTSD, it can easily be misdiagnosed. But C-PTSD sufferers also exhibit some other symptoms that are more specific to the condition. These can include difficulties regulating emotions such as prolonged sadness, inability to control your temper or inhibited temper, and even suicidal thoughts. My wife became a victim of workplace bullying by her manager.

Other symptoms of complex PTSD include either forgetting or consistently reliving traumatic events; feeling detached from your own body and thoughts; overwhelming feelings of helplessness, shame, guilt or stigma; a distorted perception of the bully. Workplace bullying is so much more than just making your job more difficult. It is a very real form of abuse that can undermine a person’s entire sense of well-being.

By understanding the realities of C-PTSD, we can begin to break through the wall that surrounds workplace bullying and begin to let victims know that they are not alone and healing is very much possible. It will not work after three years of constant abuse at the certain point you might just snap.

Just an example of what you encounter with a partner with C-PTSD

All of a sudden a loud scream and she is sitting straight up in our bed her heart is pounding, I am fully awake at 2 am. She is totally panic-stricken and consumed with terror in her eyes. And mumbles: “He is throwing me out of a window”.

Our bedroom is quiet. There are no intruders, only our faithful hairy friends Fedde and Heiko are standing on the other side of the bedroom door.

I wonder if her loud screaming has scared any of our children.

After 5 minutes, maybe 10 minutes as I lie in a snoozing mode again, I feel her and she is terrified in our darkened room. I try to decide if I should call a doctor to give her something to calm her down… perhaps I’m having it wrong and is it only just a bad dream. I am both afraid and confused. I know that it is safe in our bedroom, that there is no immediate threat, but her body and emotions are hijacked, and without my consent I find her immersed in past horrifying events.

Thankfully I do know now, from more than 8 years of experience, that a panic attack will eventually pass.

It feels like it’s going to kill her, but it won’t. but her body and emotions are hijacked, and without my consent I find her immersed in past horrifying events. I have to wait it out.

PTSD is typically the result of a specific, horrifying event, Complex PTSD is the consequence of numerous traumatic events, over a longer period of time. CPTSD is frequently caused by childhood abuse and neglect or, in my wife’s case, being trapped for many years in a very abusive workplace.

Complex PTSD and PTSD share symptoms, but there are some symptoms unique to CPTSD. If you are interested in a somewhat detailed list of symptoms for both PTSD and CPTSD, you can scroll to end of this post.

When I look objectively at the symptoms of PTSD and Complex PTSD, I can check off 99% of them (anger isn’t a symptom for her and also low self esteem has never been an issue) but still she tries to live in denial that she has CPTSD… until she is triggered and panicking so badly that she is struggling to speak’

Every morning she is waking up and begins her day with limited emotional energy. Our children are priority so she does everything to work around her limitations with PTSD to be available for them. She carefully plans her day tasks and she is trying to avoid crowds when she has to go to the shop.

One crowded, overwhelming event can sideline her for several days afterwards, so she is choosing her activities carefully, mindful of the probable fallout.

Still, 8 1/2 years after escaping her abusive managers, she still has nightmares and panic attacks. She is having huge gaps in her memories of the past years.

CPTSD is basically an emotional injury ~ an invisible illness. Since it isn’t as tangible as a broken bone I frequently have to remind her that living so much of her life being on “high alert” and in “panic mode” is both emotionally and physically exhausting.

According to my wife: “For me, being triggered causes a level of overwhelm that is very difficult to describe. Research done by PTSD patients has shown that when someone with PTSD is triggered and panics, the right half of the brain “takes over” and the logical, thinking left side of the brain is sometimes almost totally “shuts down.” When this happens to me it becomes almost impossible for me to speak and I can’t think. All I am aware of is the panic and a desperate need to hide. If I were walking with someone else, we would have to stop talking until the truck has passed because there would be no way to hear each other over the noise of the truck. For the minutes that the truck is roaring past, there is only the truck. I am totally consumed by the noise and vibrations of the passing truck. 

I’ve been told repeatedly that in many ways my situation was (and continues to be) somewhat extreme and unique. I am still struggling and doing little steps forward.”

There’s no way around it: PTSD sucks. There are ways that she has improved a lot in the past 8 years though. I can now write about it here on my blog. As horrible as CPTSD is, I want you to know this: there is still joy in the midst of the struggle.

I still laugh with my children. We have so much fun together. Our girls love to make us laugh… it’s become a bit of a competition between them to see who can show the funniest memes each day.

I have been blessed with two Shetland Sheepdogs, one of them is being a service dog for me. They bring all of us so much joy. Truthfully, I am not sure that She’ll ever will totally “conquer” her CPTSD but she is slowly but surely learning to manage it.

Instead of actively working she is trying to learn new ways to heal and better manage the symptoms of PTSD while she embraces her weakness and struggles. Many people do recover from PTSD and even CPTSD. There are numerous healing resources to explore. Perhaps you are also in the thick of PTSD or CPTSD.

CPTSD is a more severe form of Post-traumatic stress disorder. It is delineated from this better known trauma syndrome by five of its most common and troublesome features: emotional flashbacks, toxic shame, self-abandonment, a vicious inner critic and social anxiety.

• CPTSD emotional flashbacks do not typically have a visual component. Emotional flashbacks are sudden and often prolonged regressions to the overwhelming feelings of past abuse/abandonment.
• Fatigue with symptoms of or similar to Chronic Fatigue Syndrome
• Numbness, both physical (toes, fingertips, and lips) and emotional (inability to feel love and joy)
• Clumsiness
• Hyperawareness and an acute sense of time passing, seasons changing, and distances travelled
• Feelings of worthlessness, rejection, a sense of being unwanted, unlikeable and unlovable
• Social isolation, avoidance of relationships
• night terrors, chronic insomnia
• Variations in consciousness, including forgetting traumatic events (i.e. Psychogenic amnesia), reliving experiences (either in the form of intrusive PTSD symptoms or in ruminative preoccupation), or having episodes of dissociation.
• explosive or extremely inhibited anger (may alternate)
• Changes in self-perception, such as a chronic and pervasive sense of helplessness, paralysis of initiative, shame, guilt, self-blame, a sense of defilement or stigma, and a sense of being completely different from other human beings

 

If I could share one thing with you it would be this: please be gentle and take care of  yourself.

The Old Sailor,

Being a Homeowner is not always easy

 

Dear Bloggers,

 

We have lived in our house for almost five years and my wife wants to move back to the little village on the lake were we once started as homeowners. The lack of houses is making the market going wild and it got overheated. Although homeowners that want to sell have to bring their prices down as the energy market has become impossible for many Dutch families. Something to consider for the coming years. So we need to hold our horses for a while until they realize that we are not going to buy that far over budget.

new and old situation

How to budget for a new home so You don’t end up house poor.

Before buying a home, figure out how much house you can truly afford, including a budget for maintenance and repairs.

I have discovered that I was house poor soon after we bought this house in 2018.

When I put 10% down on the 300 -square-meters property with a  111-square-meters house in the city of Sneek, Friesland in the Netherlands, a district on the outside of Sneek, I was surprised to find out what we had to pay, which initially was €162.000 on mortgage.

Above the new situation as the hedge was a fire hazard and the garden was fully out of shape.

Heating the poorly insulated home was also more expensive than we thought it would be. To make ends meet, the budget had to be extended as 52-year-old  we had to take out a home equity line of credit.

“I quickly found that I was spending at least half of my small €46,000 income at the time on being a homeowner,” I never tried this before. “It turned into the home owning me, as opposed to me owning the home.”

While buying a home can be a sound investment, it can also become a financial burden. Here’s how to think about your housing budget so that doesn’t happen to you.

Bovenkant formulier

Getting ready to buy a home? Hire a financial advisor that does all the math for you and sees into the fact that there might be extra costs on remodeling the house. Constructional things can cost a lot of money.

Total renovated the entrance hall and the staircase has been replaced

Onderkant formulier

What does it mean to be house poor?

Someone who is house poor spends so much of their income on homeownership — such as monthly mortgage payments, property taxes, insurance and maintenance — that there’s very little left in the budget for other important expenses.

Being house poor can limit your ability to build up retirement or other savings, pay off debt, travel or enjoy life. Yes been there, done that and got the T shirt.

“I did not have the money for going out with my friends anymore, going to restaurants, or enjoying time as a 50-something-year-old.” It was an extreme time to survive “I was selling all kinds of stuff on Marktplaats, trying to make the heating bill payment.

A total rebuild of the kitchen required a new electrical system due to induction cooking

In fact, 28% of recent home buyers say making their monthly mortgage payments will be among their biggest money stressors for the next two years.

Budget before you buy

Before shopping for a home, it’s important to figure out how much house you can comfortably afford, which may be a different number from the maximum mortgage you can get approved for.

“A reconstruction calculator is definitely a good starting point for helping to determine your housing budget,” says Gerrit who is a certified financial planner. “However, they also require that you have a strong understanding of your cash flow today — what income is coming in, what expenses are going out and what amount you are saving.”

On the top picture you see the new electric system on the lower picture the old one

One rule of thumb is that you shouldn’t spend more than 28% of your gross monthly income on housing-related costs and 36% on total debts, including your mortgage, credit cards and other loans. This is 64% in total

everyone’s situation is different, and the rule doesn’t take into account the need to leave room in your budget for things like furniture, as well as maintenance and repairs. Plan for upkeep and upgrades

The cost of unexpected home repairs and ongoing maintenance can take you, in particular, by surprise. Even a house that was in very good condition on closing day will inevitably need some big-ticket fixes over the years.

I realized just after moving into this new home that the roof had a leak and the draining system needed some work. So I got a roofer over to fix the problem and this took about €4000 out of my budget for remodeling.

The old living room 

41% of people who have purchased a home in the past 12 months say their biggest money worries in the coming two years will be affording home repairs and maintenance.

The new living room

Saving 1% of the property’s value is a good starting point for maintenance expenses per year.

But, you may need to scale up to 2% of the property’s value based on the age and condition of your home, ours is from 1966, repairs you have already made, and the life expectancy of housing components like the roof or furnace.

Bovenkant formulier

Onderkant formulier

Tips to avoid being house poor

Even if you plan properly for a home, it’s possible to become house poor if a job loss or medical emergency leaves you unable to pay your bills.

Painting the outside of the house

In 2018, when we decided to purchase a home with my wife, I knew we wanted to do things differently. I Thought that we as a couple bought our “dream house” after living so frugally for nine years that we could pay off our debts and save up a 20% down payment. Even so, we took out a smaller mortgage than we could have qualified for. After two years of renovating our house to a home again we ended up in extra costs of about €100.000 We took the electrical wiring down and rewired most of the house. All the draining was renewed and also the water and gas lines. We took the wooden floor out as it was rotten and got a  foam concrete floor with underfloor heating a total new heater with new high efficiency radiator panels upstairs, we placed insulation between the floors and still there is some work left to do in the coming years.

Soon on our house you might see a sign like this

“When you're absolutely sure you want to live somewhere for the long term, buying a home with the proper down payment and an understanding of the true costs of homeownership can be a great experience,” I am having a bit of experience through the years. “I found that with my third round of homeownership.” And we are getting ready to take step four.

 

Someday, sometime and somehow the new adventure will start soon I hope

 

The Old Sailor,

 

You have Osteoarthritis and now what?

 

Dear Bloggers,

A few years back in the summer I first felt it: some painful morning stiffness in my fingers. The first signs of osteoarthritis. I resemble my father in many ways. We both went gray when we were 25. He developed osteoarthritis in his fingers around the age of 50 and had deformed, painful fingers and hands 20 years later. Other joints also gave pain complaints over the years. I am a bus driver now and would like to keep doing this until my last day. So, no arthritis for me.

You have to learn to live with osteoarthritis, GPs say and 15 years ago I went to the hospital and the Rheumatologist said it must be Fibromyalgia as there is nothing to find in your blood and you are still young. To keep performing in my job at sea. I had to try things out. They gave me a device that gave electric shocks to ease the pain. After a while it didn’t work out. So, I was getting pain medication and through the years I was on the highest possible dose. This summer the pain was getting back to me, and I became ill of it.

I went to my doctor about it. I thought I knew what he'll say: "There's little you can do about it, just learn to live with it." I have heard from many people around me that this is the message they came home with. Or I'm on the doorstep with drugs that won't address the cause. On sites such as the rheumatoid arthritis fund, osteoarthritis is referred to as “this chronic disease” and the treatment consists of drugs such as painkillers and anti-inflammatories, which the doctors have to prescribe for you according to their protocol. To my surprise, I was immediately referred to the Rheumatologist Dr Baudoin in Lelystad. This doctor is not in favor of numbing people with painkillers and other drugs. This is better than just getting a diagnosis in which you are immediately labeled as a "patient" and the "cure" turns out to be an expensive medical treatment that is not yet available. I don't enjoy these kinds of things. First thing I had to do he said was stopping the painkillers and go back to Panadol and solve the hardest moments. My body was totally in distress as it needed to go back to work again. I have been sick of it for three weeks getting fever and diarrhea and as my immune system was totally on the floor. Surprise surprise I ended up with a pneumonia. Isn’t life wonderful.

No one is responsible for my body. That's just me. I have the task of taking care of this as best as possible and that starts with informing myself well. Fortunately, we live in a time when you can keep yourself well informed. I started researching osteoarthritis and what I could do myself to ensure that I can still do my favorite job somewhat decently at 65. Then what I read made me happy and I want to share this with you.

Osteoarthritis is a disease of joints. These can be fingers, but also knees, elbows or hips. It is a form of inflammation that usually ends in wear and tear. It is therefore important to be there early before the wear occurs. This usually only happens after the age of 40, but it is very common. Women are ten times more likely to develop osteoarthritis than men. Wear and tear occurs in the cartilage of the joints, making the cartilage less elastic. The bone outgrowths, together with muscles and tendons, compensate for this reduced function of the cartilage. This is what causes stiffness at first and pain later. Overloading the joint (sports) can also lead to (extra) wear and tear.

Osteoarthritis says something about your overall health

Osteoarthritis seems to be a local condition, but it says something about the health of your entire body. This has to do with that inflammation that it starts with. Osteoarthritis is in fact a signal that the body is deficient in nutrients. The body uses the nutrients present for your essential organs such as your heart and liver. Just like in a panic situation your heart and muscles get blood to take action instead of your stomach which "only" has to take care of digestion. That is equally less important in a panic state. Your joints are “low” on your body's priority list, as are your skin and hair. You can survive just fine with some wear and tear on skin, hair and joints. So they get less nutrients. Osteoarthritis has everything to do with how you feed yourself. Like almost all chronic diseases, by the way. It is therefore important to ensure good nutrition and therefore sufficient nutrients. This is not to say that it is always preventable.

As we age, we become more prone to inflammation. It is therefore important to delay this process as much as possible. Osteoarthritis also has to do with the balance between free radicals and antioxidants in your body, or the oxidation process. This too cannot be prevented, but it can be kept in balance. Eating like our ancestors did before agriculture and livestock were invented is the best thing you can do to fight inflammation like osteoarthritis. In particular, a good balance between omega 6 (vegetable fats) and omega 3 fatty acids (oily fish) is important. Not too much omega 6 but plenty of omega 3 is the advice. Bit of trouble when you are allergic to seafood like me.

Dairy, bread and too many fast carbohydrates can also cause joint problems, so it is important to reduce them. This also applies to red meat.

Soon I am starting together with my wife on a program where they learn us hopefully more to live a happier and healthier lifestyle. I will suffer from pains as I will go to gym again and having a few muscles being not in the best shape. The best is yet to come and the holiday season is on it’s way.

I will try to blog a bit more again although it is painful to my wrists and fingers.

The Old Sailor,