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On Illness, Both Mental And Physical

posted on 3rd Aug 2010

My health hasn't been all that good the past 3 years. Up until 4-5 months ago I was suffering from a mental illness. And now I have a physical illness which is technically even worse than what I had before. Oddly enough though I've been quite open about the physical illness and fairly quiet about the mental illness. This blog post will change all that and give details about them both, what they are, how they affect me and how you can get help if you need it

Physical: Testicular Cancer

About 6 months ago I noticed that one of my testicles was larger than the other. I simply put this down to never noticing before and apparently it can be natural. However, about 6 weeks ago I started suffering pain and swelling in the same testicle. Pain which also extended up into my abdomen and made me feel ill. The following day I went to see the GP.

I couldn't get in to see one of my regular GPs, one was fully booked and the other was away, so I saw a stand in GP. She examined me and determined it was most likely an infection and gave me a course of antibiotics. Unfortunately after I finished the antibiotics I was still in pain and the swelling hadn't gone down, so I went back to the GP. It was the same GP and she said that the swelling could take 2 weeks to go down.

So about a week and a half later I'm still aching and the swelling hasn't gone down one bit, so I go back to my GP. This time the GP that was away has returned so I go and see him. After I explain the story so far and he does a quick examination he refers me to a consultant urologist to find out the cause. This is where one of the NHS targets kicks in (one of the ones backed by medical suggestion): they will aim to have you seen by a consultant within 2 weeks of referral if cancer is suspected.

The following week I go and see the consultant, he examines me and then sends me for blood tests and an Xray. The following week I go back and am informed that they suspect it might be cancer and want to perform surgery to remove the testicle. I'm also sent for a CT scan to check if it has spread in ways the Xray didn't show (let me just say the the contrast dye they put in you for a CT scan is one of the weirdest things).

So the next week I'm booked in for surgery to have the testicle removed. It's only a day surgery, I arrived at 7:30am and was out around noon. In place of the testicle I had a silicon replacement put in. Such a thing had never occurred to me as existing until they told me about it, but if they can offer a silicon implant for women who have had a mastectomy it is only logical the same exists for men who have had an orchiectomy.

So they take the testicle out, both as a precaution but also to test it, as trying to get a biopsy of part of the testicle could cause cancer cells to spill out. One of the good things about testicular cancer is the main tumour is nicely contained in a relatively non vital organ that can easily be removed with little side effects.

And so we arrive at last week. On the Tuesday I went to have another blood test. The tests look for specific chemical markers given off by tumours. The test from before the surgery showed high levels of these markers, but in theory subsequent tests should show these markers dropping over time.

On Thursday I had another meeting with the Urologist. I was informed that it was indeed cancer and that it looked like a mixture of the two types of testicular cancer, which they said wasn't uncommon. However, I was also informed that my blood test from earlier that week showed a drop in the marker levels and my CT scan was clear, barring a few swollen lymph nodes. Now this can be a sign of the cancer having spread, but it can also be a sign that I've had an infection or many other relatively benign causes.

On Friday I went for my first meeting with the Oncologist. She also took a look at the CT scan and said that it is nothing to worry about at the moment. I was informed that at this stage I don't need any extra treatment, but I will be under observation for the next 2 years, with checkups every 4 weeks for the first year and every 8 weeks for the second year. The reason for this is that there is still a chance the cancer will return, requiring additional treatment. I've got more diagnostic tests to go through over the next few weeks to double check those lymph nodes and make sure my markers are coming down as expected.

My Reaction

My reaction to all this has been a mixture of humour, curiosity and indifference. Some people when informed they have cancer would break down, and for some cancers this is perfectly understandable. Testicular cancer though is about the "best" cancer to have, given its high survival rates. I've seen figures of 95-99% survival rates. You may think "but there's still a 1-5% chance of dying of it" but consider this: the Spanish Flu epidemic of 1918 had a survival rate of around 97.5%. This form of cancer today, is to a degree no more deadly than the flu 90 years ago.

The other factor in my reaction is how much it has affected me. I've had a bit of aching pain prior to surgery, pain and swelling after the surgery and a load of needles put into me for various things. But in terms of affecting my life it has been relatively minimal. I've had colds that have affected me worse.

My Advice

My advice is the same as all the medical advice. Check yourselves regularly, and if you find any abnormal lumps of swelling or you feel any pain then go see your GP immediately. Statistically it is more likely to be a benign cyst or an infection. Both of which are easily treatable. But on the off chance that it is cancer, it isn't worth the risk. The sooner it is caught the better, as it can potentially spread to your lungs and brain. If it is advance stage though it is by no means fatal. It is this advanced stage of testicular cancer that a certain Lance Armstrong had and he recovered.

Mental: Anxiety, Panic Attacks and Agoraphobia

I haven't really talked publicly about this before. In my first year of university, around my first exam period, I caught a rather bad stomach virus. The evening before my first exam I was throwing up. I managed to make it to my first exam despite feeling ill but my second exam at the end of the week was a no go. I went round to my friends and was weak, shaking and retching. I managed to make my way to the doctors to get a sick note and was told to go back to bed.

That was where I think the start of my illness began. The next exams I had I felt ill for. Before the exam and prior to starting the exam, was feeling ill. But once I got into the exam and started it I was fine. I was also fine for the rest of the day. But then it started spreading to over events. I felt ill about going to the cinema and one time while I was in the cinema I felt really ill and so had to come home.

This prompted me to go see the doctor. I mentioned my symptoms of feel nauseas and tired and he put it down to an intestinal problem, possibly caused by both my stomach producing too much acid and my previous illnesses. I was given some tablets and carried on. However, the symptoms didn't go. I just put it down to it being something you can only manage and not really treat. But I didn't really notice too much that the symptoms were happening for more and more events.

Then I started my 3rd year of university. I went back to my student house, settled in and then went to go out to do some shopping. I really struggled to head out. I made it but I felt ill. Then came to lectures and I started heading out to my first lecture but I couldn't make it. Part way there I gave up, went back home and then made a doctors appointment. The following day I went to the doctors, with incredible amount of effort for a journey I'd done many times, especially as the doctors was fairly close to where I had lectures.

I was diagnosed with having panic attacks and given something for the symptoms and referred to a mental health advisor. A few weeks later I was also put on some medication to help control the panic attacks, a mild anti depressant. Over the following 18 months I slowly got better. I discovered that it was simply due to my brain becoming confused, invoking the instinctive "fight or flight" response in situations where there is no danger, and I had to recondition my brain back to normal.

Panic attacks are caused by a downwards spiral of your emotions, your behaviour, your thoughts and your environment. Each affect each other, causing you to associate an event with something bad. Gradually your safe zone reduces, to the point where you can hardly go beyond certain places without panicking. This is agoraphobia. For some people it is even worse, and they can't leave their bedroom without suffering an attack.

The cure is to change break the spiral. This can initially be hard. If you panic as you go outside then stay there for a while. Get past the panic, which will only last 5-15 minutes. Take deep breaths and prove to yourself nothing bad will happen. Then go further and further and further each time. In about 8 months I went from being unable to go outside without panicking to being able to get a train on my own all the way to NSConference.

But as you start to change you notice changes in how you react. My initial reaction was "I can't make it, I'll feel ill and probably throw up on the train, or I'll miss a connecting train due to it being late or me not finding it". What you think is actually very logical, the issue is that your initial assumptions are wrong. Take missing the train due to not finding it. There are two assumptions you can make:

1. You can assume that there will be no signs or porters to point you to where you want to go 2. You can assume that there will be lots of signs and porters to point you where you want to go

Now most people would say that 2 is far more likely than 1, to the point of 1 pretty much never being the case. To that degree it isn't unreasonable to based your logic off assumption 2. The issue is with panic attacks, you start off with assumption 1. That is the reasonable assumption. Same with feeling ill, odds are if you feel ill you won't throw up, but you decide to assume that you will. When you are cured and you look back, you see the logic you go through and you understand it, but you see that your assumptions upon which the logic was based were wrong.

My Reaction

My initial reaction was that I'll be like this for the rest of my life, unable to head outside. Slowly that changed and I was able to see when I'd be able to move around again freely. Agoraphobia and panic attacks are horrible things to have, as they can serious affect your life. They affect your work, your entertainment and your relationships.

My Advice

Go see your GP. If you really cannot head out then arrange for a house visit. You can't cure yourself alone. But that said, you don't need medical advice or drugs to help you. You just need support from others. And surprisingly, it isn't hard to find others who have suffered from this. In the US about 2% of adults suffer from agoraphobia. I follow over 300 people on Twitter, which means that 6 of those people will suffer from agoraphobia at some point. There will likely be more who suffer from general panic attacks. I encountered two friends who I'd known for years, but only found out they also had suffered from panic attacks.

It's also important to point out that panic attacks and agoraphobia, while linked, are not the same thing. A panic attack is your body panicking in a situation. Agoraphobia is the fear of having a panic attack in a certain place. Often this does manifest itself in a fear of open spaces and leaving home, but it doesn't have to be that. You can suffer from Agoraphobia while you feel fine going out and about, but fear having a panic attack when going into a shopping centre.

The other advice is quite simple, but often the hardest. Force yourself to go where you don't want to. If you have a panic attack then start taking deep breaths. But also take it in baby steps, go at a pace that suits you, but make sure that pace is heading forwards not backwards. I'm not cured of panic attacks, but I can control them now, rather than them controlling me.

And a suggestion for those who have read this far, whether you suffer from agoraphobia or panic attacks or not. By chance I met a woman on twitter called Jen Hart. She has been writing a blog about suffering from agoraphobia and her attempts to cure herself. She is also the one who inspired me to write this post.

A lot of her thoughts and emotions match mine when I suffered from it and it also shows some of the strain it can put on relationships. If it helps someone suffering from panic attacks or agoraphobia realise they aren't alone or it helps someone understand what it is like to go through panic attacks and agoraphobia so that they can better help someone who suffers, then it is worth it.

If you would like to send me a comment on this post, send an email to pilky@mcubedsw.com. Alternatively send a tweet to @pilky.