An inconvenient wheeze

“Will it kill me?” I ask, fed up with the obfuscation that’s going on, staring him straight in the eye.

“Er … no,“ he replies, eyes focused, consultant-like, into the space above my head. 

Yay, I’m not in danger of carking it any time soon. At least, not from this. Great news, even though I do wish the man would volunteer some information instead of me having to drag it out of him like a mother trying to understand how their teenager’s school day went. Nodding to the squadron of pigs primed for take-off on the grass outside the window, I persevere with the list of questions I’ve prepared in advance.

“Will it get worse as I get older?” 

“No evidence that it will. You need to get flu jabs and stay away from people with colds,” is the best he can do after a lengthy contemplation of the inside of his eyelids. Interestingly, no mention of Covid implications. Well, I guess there’s no community outbreak currently, so I’ll give him a pass on that.

Silence descends on the room after this burst of conversational brio, and we stare at each-others’ shoes like a pair of accountants at a party, wondering who’s going to be brave enough to speak first.

What is it about medical consultants? They may be brilliant in their fields, but the ones I’ve experienced share a startling inability to communicate on any level that could remotely be called human. 

Many people believe that our stresses and emotional issues manifest in physical ways. I tend to agree with this as I’ve had minor respiratory problems for as long as I remember. My breathing kit is like a litmus test of my emotional equilibrium. When I get stressed, my voice gets all husky and breathless — think Marlyn Monroe singing happy birthday to JFK — and I get mild symptoms of a cold. As it’s always been short-lived, I’ve never really thought too much about it.  

At some point a couple of years ago, it stopped being an occasional thing. I reached some sort of tipping point where I’m coughing a lot — a worrying amount. The first year of joined-up-coughing, it stops for the summer. The second-year, it doesn’t. I’m not over-concerned as many people in New Zealand have coughs bestowed by our high pollen count from all the horticulture and similar. By mid-2019, it’s bad enough that I figure a visit to my GP is in order. Having put me through some rudimentary tests, she fobbed me off – somewhat predictably — with antihistamines. Pointless waste of time. Cough, cough, cough. Time passes, I box on. It’s my new norm. I just assume I’m stuck with it. 

By August last year, I’m notably worse and wheezing has long since entered the frame. So, I go back to see said GP, who finally accepts something is wrong, and I’m in front of a respiratory specialist faster than you can say Chronic Constructive Pulmonary Disease. The speed is courtesy of my eye-wateringly expensive private health care policy, which I’m deeply grateful I have kept going when handed the bill. It turns out, and this will likely surprise no-one — it certainly didn’t surprise me – that I have severe Asthma. However, this diagnosis was off the back of a lot of tests, and I was seriously relieved it wasn’t something much worse.

Just as an aside, try being a severe Asthmatic in the time of Covid — talk about an inconvenient wheeze. Convincing scared people that you’ve been hacking your lungs up since long before Covid-19 was even a blob on a laboratory microscope is tricky. They don’t tend to hang around long enough to appreciate the finer points of a dry cough (Covid) versus a wheezy damp one (Asthma). Forget social distancing; we’re talking crossing the street, making the sign of the ‘evil eye’ in their scramble to put as much distance as possible between them and you. And believe me, you do not want to have a coughing fit in the supermarket queue. The one benefit of coughing as if you have a 60-a-day fag habit? People stay the Hell away from you so are out of range of any ‘aerosols’ they might otherwise generously share.

But back to our action-packed story.

“I think the meds are making me worse,” I say somewhat confrontationally.

This elicits no response if you ignore the facial tick that’s starting to manifest.

“So, what happens if I stop taking them?”

“Why don’t you stop until they’ve cleared your system and then start again to see if there is any difference?” he says after another interminable silence.

This seems like quite a good wheeze if you’ll forgive the pun.

“How long will that take?”

“Couple of months.”

And that pretty much wraps it up. I sense we’re in the throes of a break-up. By this time, we have seen quite a bit of each other, and I have become accustomed to his face like Henry Higgins in My Fair Lady. Leaving for the final time, I feel a little aggrieved that he’s just booting me out into the wide world without even the safety net of a six-month callback. Doesn’t he care? Haven’t we gone to Hell and back together? This little pity party lasts as long as it takes to get out of the building. Then I think, “So what? I’ve been on my own before. I can do it. Anyway, who wants to go on stuffing their system with pharmaceuticals when there are other fun options like hypnotherapy to explore?”

Of course, I’m exaggerating in the interests of a good story, and I do my specialist a disservice. He tried hard. As we worked our way through the tools in his toolbox searching for a panacea, he visibly deflated as each failed to be The One. I think he saw me as the proverbial riddle, wrapped in a mystery inside an enigma that he was a bit peeved not to be able to solve. Damn it, why wasn’t I responding to the pharmacopoeia of Symbicort Turbohalers et al. on offer? I was pretty peeved myself. For a person whose favourite activities include singing and bushwalking, I’d hoped for better. Cough, cough, cough. Wheeze, wheeze, wheeze.

The trouble was, his toolbox was limited to the range of available medications, and there was no thought to try and identify the underlying causes or discuss this as an alternative to consider. These days, medication is generally the treatment of first resort, whatever the condition. Many things can trigger Asthma, but I do not doubt that mine resulted from a layering of traumatic events over several years, which caused no end of stress and sleepless nights. Then came a pandemic which didn’t exactly diminish the anxiety levels. 

Even though the medical outcome was disappointing — I badly wanted a quick, easy fix — I also didn’t want to be on large doses of inhaled whatever for the rest of my life and I stopped. Three weeks later, I’m sure you’ll be happy to know, I’m still here and none the worse for wear. If anything, I’m a bit better. The whole episode has helped me think differently about many things that I probably wouldn’t have if the meds had worked. As a result, I’m feeling happier and more in control, hopefully building a virtuous circle of improving lung function. 

Whatever happens from here, my pesky, inconvenient wheeze might just get me bumped up the Covid jabbing-order. Whether this is a silver lining, depends on where you sit on vaccines. I’ll take the win.

Statements of the bleeding obvious #201: Nice doctors really do make a difference!

It’s amazing how many times what’s billed as breakthrough new research really just confirms what we already understand from experience. Stuff like the fact that singing is good for us and can prolong our lives. That dogs and other animals lift the spirits of long-term hospital patients … as well as mostly everyone else. That laughter is infectious. That lovesickness is a genuine state.

OK, so we’re in an era where it’s possible and considered desirable to research esoteric and non-fundamental subjects. I’m cool with that — non-fundamental subjects like these actually make a lot of difference to our daily lives bringing cheer and happiness, often in dark times. So providing evidence that they really do achieve what  we intuitively feel they do is fab … even if the headlines they provoke seem more like statements of the bleeding obvious than radical insights into the  human psyche.

It most definitely is good to know that singing regularly could prolong my life — I do enough of it after all. It’s a bonus to know that, as well as the immediate buzz from   opening your larynx and letting rip, it’s a gift that keeps on giving in the all-of-life context. Also great to know empirically that my love of animals — near obsession it has to be said — is healthy. That bringing animals into hospitals is genuinely therapeutic and can bring comfort to people in pain or despair. Who hasn’t ever listened to a friend break out into a great belly laugh and  been been compelled to laugh too? Laugh and the world laughs with you, cry and you cry alone … so true. And love sickness? Well, it’s been a while since Apollo fired an arrow into my tender  heart and catalysed all the turbulent symptoms I described in an earlier blog You Make Me Sick! But I haven’t forgotten the visceralality of it all — there’s no question in my mind, it’s a lurg just as debilitating as a fluey cold.

At the weekend, I read another about one of these completely unsurprising research findings. Can A Nice Doctor Make Treatments More Effective? Well dear reader, if you were in any doubt on this count, according to new research by Stamford University in the US, having a doctor who is warm and reassuring actually improves your health. REALLY? Who knew? Most of us I would have thought. I found this astonishing non-news in weekly round up of good news from the New York Times. It’s full of great stories and I love it.

Last week comes Romeo the Sehuencas water frog to my inbox. Romeo is a very rare creature. He was thought to be the last of his type. No Juliet to be found anywhere, let alone on ‘yonder balcony’. Day after endless day, sad Romeo croaked out “Juliet, Juliet, wherefore art thou Juliet?” from his home in a Bolivian museum. Actually what he said was, “ribbet, ribbet, ribbet …” but where’s the poetry in that? Cutting to the chase, biologists had pretty much given up their search in the remote and inaccessible areas of Bolivia where said Juliet might have been found. Then behold! There she was. Juliet the miracle frog — a potential mate for our lonesome hero. Being the only two Sequencas water frogs in existence, it was set to be a fine romance and I’d love to be able to say, “and they both lived happily ever after”. But even for a frog with only one possible mate, the chemistry still has to be right. Imagine the pressure! Without mincing words, would you be prepared to shag some random stranger to preserve our species? Fine if it’s George Clooney.  Not so fine if … well, the list is endless. But then again, unlike Romeo, no one I know is faced with the decision to take one for the future of our species and it’s easy to be precious when we’re in no imminent danger of extinction … unless we keep  messing with our natural habitat that is. All joking aside, a lot is riding on our precious frog prince. Let’s hope the chemistry is there and they soon start producing copious numbers of wee froglets to perpetrate their froggy line.

But back to nice doctors. Apparently the simple things a doctor says to you can have an impact on your health outcomes. Even a brief reassurance can relieve symptoms faster. The reassurance is more efficacious when it’s said in a kindly manner rather than barked out as a “you’ll be fine” afterthought when you leave the surgery. You can’t quite get away from the fact that the doctor has to be skilled and competent as well as nice. However, most of us have been on the receiving end of one of those grumpy types whose you mistake me for someone who cares demeanour is more likely to cause you to lose the will to live altogether than get well. Their cool indifference renders you as articulate as … well .. a frog .. when you try to describe the pain that was giving you hell until it magically disappeared nano-seconds after you made the appointment..

Anyway, the conclusion of the research was that doctors who don’t connect with their patients my risk undermining a treatment’s success. Apparently doctor-patient rapport is much more than the sum of it’s feel good parts. It’s a important aspect of medical care that significantly affects a patient’s physical health. Are you kidding me? It really does feel like a statement of the bleeding obvious that someone who is kind and sympathetic as well as good at their job is likely to achieve a better result.

The article ended by questioning what this means in the brave new world of artificial intelligence. AI opens the possibility of not having to go to the doctor for minor health issues. If interacting with a human being and hearing words of encouragement is part of the cure, this begs the wider question of whether our increasing isolation is actively bad for our health. As the opportunities and need for actually connecting with a fellow human in many aspects of our lives become progressively fewer, what collateral damage are we setting ourselves up for. Romeo the frog couldn’t help his plight. We can, and yet we continue to write people out of the script of our lives. When us humans humans actually get together face-to-face is, we open up the possibility for  laughter and  love. For conviviality and banter. We get to share the good and help each other through the bad times. You don’t need to be a Stamford luminary  to recognise that gentle and kind connections with other people — Doctors and the rest — are seriously good for our health and unkind, cruel ones are not. Comforting to know this is now “proven by scientists”.