It's hard to write a proper update on the Condition without doing some more tedious "thinking out loud", but there's progress.
I expected to be back at work within the next few days, but this idea was squashed during a very long -- and even longer awaited -- meeting which lasted late into the evening.
Dr T., who's an extremely busy psychiatrist, largely agreed with the gut specialist, Dr de P, in his surprisingly holistic four-strand assessment of the Condition, giving me the clearest explanation of its psychosomatic aspect I've had.
She thought that it would be preferable to stay off work for another month until the treatments now in hand kick in, then agreed that three weeks may be enough provided I rapidly get an appointment with somebody else she reckons I need to see, who specialises in psychosomatic medicine. This I've since done, for next week.
Until tonight, Dr T had no idea what happened to me over the past five months, but knows me well: I've seen her on and off since a spell in hospital in mid-1997, but ceased to be one of her priority patients about four years ago.
The further insights she gave me (in an appointment I'd been preparing for a couple of days, notes on paper) built on a suggestion the generalist, Dr Yang, came up with in September -- one I've hitherto dismissed because it didn't make any sense to me.
Followers of this clinical saga will know I found it hard to accept the idea that the Condition, with its several undeniable, measurable physical symptoms surrounding the collapse of my digestive apparatus, could be a case of mind over matter.
The complete test results forced me to do so, acknowledging the role stress and other mental factors had played in triggering it all. While earlier this month, Dr de P blew my premature (and bitter-tasting) "it's all in your head" conclusion out of the water, he helped me begin to understand the brain-body interaction (viz. my Oct 17 entry on 'treatment in mind' and notes on neuro-transmitters).
The surprising hypothesis from blog-hero Yang -- the one that made no sense to me -- was that the Condition could have struck in reflection of a serious depression.
Well!
When my insides turned into leaky pipes in May, I didn't feel depressed.
I was in excellent, often relaxed spirits throughout much of the summer, even when the trouble was at its worst, the diarrhoea appalling, the headaches frequent and the white blood cell count three times what it should be. There was no point in worrying ahead of time that the examinations would come up with something serious. I was peeved only during the periods the diagnostic process seemed to be bogged down or going in circles.
Manic-depression (in the proper, clinical sense of that term) is a genetic inheritance of mine. I've described how it afflicts my mother in four-monthly cycles, with no relation to the seasons, and has proved hard to treat. And expressed my hope that I haven't passed it on to the Kid.
Dr T knows that I've been spared this. But she long ago diagnosed my cyclothymia -- whose monthly cycles are quite apparent even in this 'blog, the gaps coinciding with the period around the new moon. She also regards me as one of those people who is hyper-sensitive to light (the more we get, the better). There, I'm far more affected by the seasons than my Mum.
I told Dr T what Yang had said after she volunteered her own twin hypothesis.
If I followed correctly, the cyclothymia is to some extent a defensive deviation I've developed to avoid the kind of more serious illness that my mother and others have to endure. And in May, she suggested, rather than "undo all that has been achieved" since I came out of hospital in '97 by going into a real and deep depression, I unconsciously transferred the battle on to by far the most vulnerable part of my body, the ever-dodgy guts...
These notions shed light on what Yang suggested. Dr T's line of argument led me to ask questions like "You mean somebody can be really depressed without knowing it?" and so on, to which the answers were "yes and no".
More to the point, it dropped another big chunk of puzzle into place and made the strongest intuitive sense. Her hypothesis felt right, just as Rainer's out-of-the-blue alert from Brazil on serotonin levels (Oct 15 entry) rang a loud bell, to be swiftly echoed by Dr de P.
It suffices properly to consider my motives even for starting this log, before the "experiment" took all the shapes it has since February, to realise that I needed a creative outlet for things too long repressed in my Factory career.
Incidentally, I've also been given confirmation of a statement made by someone who'd better be nameless. This was another doctor, who should have known a damned sight better than to start to reel off names of journalists I'm acquainted with who were badly affected, one way or another, by the problems inherent in trying to provide good and honest coverage of the military campaign in Iraq and its aftermath. (I told the person to shut up with the list and came out of that meeting dumbfounded by the breach of medical ethics...)
Those of the Loyal 4 ¾ who were reading this in the early days may recall the anti-"coalition" views I vented well before the first attack was launched -- opinions that had no place in my work at AFP. While avoiding details here which could identify people I was far angrier with early this year than I'd been ready to admit, let's just say that Dr T has helped me understand my unconscious reaction to things happening then.
The outcome?
It's simply a development of the "recovery strategy" I've been thinking about since the physical diagnosis. Changes of lifestyle and diet, and an anti-stress programme, to which Dr T has added a couple of alterations in brain chemistry treatment.
I won't say what quite simply because prescriptions vary too much from one person to another, even for similar conditions, but she went along completely with my refusal to take the "sledgehammer drugs", as I described Xanax, Prozac & Co.
She also agrees that, to start with at least, I'm better off turning down proposals to resume work on a part-time basis, which I'd rather not do. That has yet to be fully discussed with AFP, but I suspect it would suit neither me nor the Factory and the leeway the place gives the Desk chief in replacing me.
So, all being well with the treatment, particularly measures to alleviate the fatigue (Dr T also told me why she thinks I've still been getting so tired so fast, which nobody else could), I'll be back working with other people's stories from around November 18, three weeks from today.
Tony's right, though he retired quite a while back. Once you've been a journalist for long enough, life without any real deadlines is no fun!
[Entry revised for an update and clarity, 29/10/2003.]
11:51:15 PM link 
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