Saturday Submissions – With Dr. Liam Farrell

It’s a day late, I know, I know, I’m sorry – (It will be worth it, promise!) I haven’t been well in the last few weeks, I completely forgot all about Saturday Submissions last week and then I do it a day late this week, oh dear! I can do better than this, surely!!

________________________________

This week I speak to Dr. Liam Farrell, yes, a real doctor, or at least used to be a family GP, now better known as an award winning columnist and broadcaster. You can find Liam over on Twitter as @drlfarrell.

 

Why presentations are best served rare

We are doctors; we do terrible things to people. They come into the surgery like healthy folk and go out as patients. If they’re really unlucky we confine them to an institution where the occupants are routinely left immobile, deprived of sleep, fed a diet that is tasteless and nutritionally marginal, and experience the de-humanizing indignity of being half-naked all the time.

‏The average age of a patient in general practice is 75 years old.. Many have multiple diagnoses, and their care is incredibly complex, and above all requires more of our time. But our time is in increasingly short supply, so much of it wasted on the worried well and on health promotion. If we reckon on 15 mins per consultation, a family doctor with 2500 patients would spend 7.4 hours per day to deliver all recommended preventive care and 10.6 hrs per day to deliver all recommended chronic care.

‏This leaves a generous 6 hours every day for those pesky acutely ill patients, sick certs, insurance and passport and DLA forms, paperwork, eating, sleeping, banging our heads against the wall in sheer frustration, toileting and reproducing. But what is never understood, by patients, the general public, the media, bureaucrats, managers or politicians, is the huge numbers of people family doctors see who aren’t sick, and who have nothing wrong with them; this really can’t be comprehended unless you sit in with a family doctor for a whole surgery. A huge part of our job is telling people what they don’t have. Unfortunately, ‘nothing wrong with you’ is a retrospective diagnosis and can only be made after the consultation.

As the threshold for attending healthcare services grows ever lower, there are more and more worried well, too much screening and over-treatment. It becomes harder and harder to pick out the really sick person from amongst the ranks of the worried well; when you are looking for a needle in a haystack, the last thing you need is more hay. There is consequently not enough time and resources to the really sick; so everyone loses, especially those with hard to recognise rare diseases.

As The Fat Man said in The House of God, when a medical student hears hoof-beats outside a window, he thinks it’s a zebra.

Which might be true, of course, in certain circumstances – if you were in practice in the Serengeti, for example (curiously, I was once in the Serengeti, heard hoof-beats outside my window, peered through the early morning mist and saw only an old cow).
A medical axiom used to be that common things are common and uncommon presentations of common diseases are more common than common presentations of uncommon diseases. But this is now known to be misleading. Taken all together, rare diseases, and rare variants of common diseases, are not uncommon. And diagnosing rare diseases is very difficult; it’s not as if there is a are disease specialist we can refer patients to.

I do have some hard-earned experience. As an intern, I saw a young lad in casualty. He had fainted at a disco (yes, it was that long ago, Saturday Night Fever was quite fashionable. Old age is creeping up on me, not sure why but fairly sure it’s up to no good) and he had a few unusual skin lesions and a labile BP.

These days, I doubt if I would be able to recognise a phaeochromocytoma ( a rare tumour of the adrenal glands) if one walked up and assaulted me with a blunt speculum (I’ve been flogged into apathy by too many URTIs and sick certs, rare and interesting diseases only present to other doctors), but I was young then, fresh and sharp and so hip, I could hardly see over my pelvis.

I wrote ‘possible neurofibromatosis?’, ‘possible phaeo?’ on the chart and admitted the young man to the ward. I was too green to realise the importance of hoarding unusual cases to myself, for my own advancement, and sure enough, the rumour spread around the hospital as fast as an epidemic of flaming gonorrhoea.

Later, when I went to check up on my patient, I found him buried under a tide of medical students, SHOs and research registrars, all keen for a piece of the glory, all ordering 24-hour urines, all dreaming of a case report for the peer-reviewed journals and another notch on their CVs.

‘Help me, doc,’ he said, desperately, ‘they’re suffocating me.’ I whipped away the students, but the others were far above me in the hierarchy and I could offer little succour.

‘Sorry, pal,’ I said. ‘It’s a common complication of uncommon diseases.’

______________________________________________________________________________

Thank you so very much to Liam for providing todays Saturday Submissions!
What did you think of his post?
Do you relate as a medical Zebra?

Please leave a comment and let Liam know what you think, be sure to check out his Twitter Link and make a new connection!

——— Wanna Be Part of Saturday Submissions?———-

All you have to do is tell us a little about yourself and write a blog post (Any Wordcount) in relation to your chronic illness, or how a relation/friend/patient with an illness affects or interacts with you, etc. all welcome!

You can include photos (preferably your own, if found online be sure to add links to where you found them)

Be sure to add links to your social media accounts so people can link back to you OR You can write it anonymously if you like just be sure to put your details in the email so I can respond to you personally 

You can send your submissions to: irishpotsies@gmail.com

Ambulance Time Once Again!

On August tenth we had to call an ambulance yet again!
I had been in bed for weeks at that stage nursing a savage pain on the right side of my abdomen. This wasn’t the first time it has happened, and probably wont be the last! It got to a stage where I was trying to manage the pain myself at home, trying to avoid going into hospital, but I had to face facts and call it as it got too bad to manage on our own this time.

The Ambulance arrived promptly and began to tend to me. They were a crew of two, Male and female, and were excellent. Friendly, Professional, funny easing the mood when needed and seemed to take a genuine interest in what both Keith and I had to say and contribute.

Unlike the last few ambulance calls, this visit from them wasn’t rushed. It was calm, sedate and gave us time to properly prepare to go into A&E. While they took their time trying to locate a vein on my foot, Keith ran upstairs to the computer, got ready and printed off an A4 sheet with simple information on it about me and my condition, highlighting the main issues I present with, medication I am on and what would be needed when first admitted like fluids, Pain control and Catheterisation, etc.

The reason for this sheet was because through previous experience we have found to be constantly repeating ourselves while giving out my information to different people and yet only parts of the overall story get heard by all different people and nobody has the full story! This time we  said we would try getting this sheet in as a common denominator of information in my files so that everyone will be literally be on the same page regarding my care and see what happens. It was worth a try at least.

After getting a vein in my foot and administering some morphine for pain relief, we were eventually ready to go to the hospital and the ambulance crew were brilliant with everything as well as taking on the information sheet, which they said they thought it was a fantastic idea and wished more people were that organised!

We quickly made it to the hospital, after getting more Morphine on the Ambulance, I was brought straight into the A&E main area, Thankfully I wasn’t rushed into Resus at any stage this time, it was calm and sedate and a far better visit this time round.

I was delighted to hear back from the Female paramedic that she passed on the sheet Keith had given her, to the triage nurse and that the nurse also commented on what a good idea it was to have all the main things highlighted on one page where everyone can see it. She said she would put it in my file so that all the doctors would see it too. So far so good for our little A4 sheet!

While waiting around for a short while, waiting on the triage nurse to find a place to put me as it was busy in A&E that day, The Paramedics were chatting to me and told me they knew some student and new paramedics who were doing papers based on me for some exam that was due the next week! Morto! I found it funny that they would pick me based on my rare or under diagnosed EDS condition or as I like to call it, ‘my awkwardness!’ :p

I once again had terrible trouble getting veins in me, doctor after nurse after doctor tried and failed and it started getting really sore. The vein the Ambulance crew had gotten was already failing just a few hours after it was put in, my foot swelled up  and they were worried as they really wanted to administer fluids and iv meds so they wanted a vein soon. Throughout the following week while in the hospital, this continued. a vein would be gotten and it would fail almost immediately until in the end the anaesthetics team had to be called and they had no trouble getting a vein and thankfully now a note has been put in my file to say that only anaesthetics are to place a cannula on me and no one else, so hopefully all the prodding and poking will come to an end now.

After spending no more 24hours in A&E this time around, I was admitted to the surgical ward. While in the A&E I had all the usual tests, xrays, scopes, exams, the usual trouble of about 50 different doctors trying to get a vein after a brief moment of being cocky and saying something like, “Oh I’m good at this, don’t you worry”, or,”Oh really? Bad veins, huh? well, I like a challenge!” and then just end up being unsuccessful anyway! That always provides me with a giggle especially towards the cocky ones who think I wont post a problem, cha! Say that to me after 20 mins of trying hopelessly! :p Being admitted after 24hours was quick though, considering that I have often had to wait over 46hours before.

I always like being admitted to the surgical ward. Not only does everything seem to be more up to date and cleaner, but Compared to the medical wards, The mood on the ward is generally brighter both from the staff and the patients. The Nurses seem to genuinely care, are not as dismissive as others I have encountered on the medical wards. They get upset when you get upset, they don’t like to see you in pain or discomfort and as much as they are able, they won’t keep you in pain for long and will treat you asap when they are asked to, a lot of the time, they don’t even need to be asked, they will notice themselves and will get you what you need to help ease your discomfort. Also, the electric beds are well cool! :p

I saw My Surgical team the next morning bright and early and they took the situation serious when they saw I had lost over 3.5 stone with the nausea, vomiting and general pain and discomfort I have been having with my gut issues.

As well  as my pain team to cover my Occipital and Sacroilliac joint Nerve Blocks which were due once again, They called in a dietician, a tissue viability nurse to talk about any difficulties I may be having with the chair, thankfully theres nothing serious going on there but she wanted to refer me to a Dermatologist for a small bit of irritation caused by the chair that was easily sorted with some long term antibiotics (starting with an 8 week course and if it needs to continue after that it could go up to 16 weeks), will just have to wait and see how it works. Then they wanted to get a serious OT assessment for me as my own local OT never properly assessed me for manual chair or a bed, given my situation, these are the two basic things my surgical team wanted to be covered while I was admitted.

The Dietician was concerned for my weight loss compared to my height and prescribed a high fiber, high calorie diet as well as Fortisip Calorie drinks to take twice a day along with my usual daily food intake to help at least maintain my current weight if not try to increase it. Sshe also prescribed a new tummy med to take with the other ones I am on to try and help with the nausea and vomiting as well as to try and increase appetite. So I have now started these and I was thinking of doing quick video reviews of the different drink flavours on offer, if you are interested that is! Let me know and I will do it if you like 🙂

Throughout there was non stop testing to find out what was causing the pain in the right side. Xrays, Ultrasounds, CAT and MRI scans, Scopes, blood tests, you name it, it was done.

In the Ultrasound Room!

One outcome is that they have ruled out any Gallbladder issues. There definitely seems to be Sphincter of Oddi, Severe Gut Dysmotility and Neurogenic Bladder Dysfunction problems, as well as a large and painful Lymph node on the inside of my right hip which is causing a lot of pain too and is currently under investigation, all these are contributing to the pain as well as the Ehlers Danlos Pain itself, but they have ruled out Gallbladder and Appendix issues, which is good!

I had 2 major cardiac events while I was in, though I had been battling low Bp all week, these events were the opposite, they came out of nowhere in the middle of the night, they were raging high bp and very fast heartrate, the ecg showed some abnormalities but thankfully they didn’t stay long (about 2 or 3 hours) and after they administered some medication to lower my bp and hr, I seemed to return to my regular low bp self, they were scary though as the pain in my chest when it happened was frightening and I was soaked through with a tempreture. The nurses seemed concerned as Long story  events came out of nowhere. Thankfully though after a few hours I returned to normal and could get some sleep.

Long story short, I got to see everyone that was called for me except OT. The final team was the pain team with the good professor who loves to give injections and this time was no different! He administered my usual Occipital and Sacroiliac joint nerve blocks under ultrasound which he did at my ward bed, he had a little portable ultrasound machine or at least that’s what it looked like and he went for it there and then. The pain team in conjunction with the anestetic team said that I may have chronic piritonitis ( information or even tearing of the abdominal lining that holds your organs) this is still being investigated and will continue as an outpatient appointment along with all the other teams I had to meet while I was in.

The surgical team try everything they can and they are so good to want to learn but they still are not sure exactly what is causing the severe pain and weight loss. I had mentioned to them about a Gastroenterologist specialist in Cork university hospital who is very well up on EDS and speaks regularly as well as trained under Prof Aziz over in London whom I hope to see as soon as i am able to travel. They said go to see him, just to see if he can help and my surgical team said they would be delighted to consult with both him and Aziz going forward as they are of the mind that more on the overall team to help me then the better!

In the meantime my team wanted to bring my case up at an EGM (emergency general meeting) where the head consultants and specialists of a department get together and discus special cases at a count table meeting so that other people’s views and suggestions can be taken on board, then once they have news they  will call me for a new outpatient appointment or send me for further tests if required.

 Unfortunately the OT never turned up and there were questions as to wether she would turn up anyway as she usually only sees Stroke and Neurology patients so my surgical team along with the head nurse on the ward rang her boss as well as had to write a letter in order to argue the case as to why they felt I was a special enough case for her to make an exception and come and see me, alas I was left waiting all over the weekend just to see her and she never turned up so my team decided to send me home at this stage with some new meds and a ton of outpatient appointments and they would follow up with her to get me a much needed appointment as my local OT isn’t really doing what she is supposed to do. 

In the meantime I have made a new appointment to see that Gastro specialist in Cork, his name is Akbar and I have heard great things so I really hope he can help. That appointment is on the 20th of this month (September) and of course I’ll fill you in on how that and any subsequent appointments go.

For now, I’ll just chill and try to recover 🙂

Thank you as always for taking the time to read.

Lette ( the fainting goat!)

Made The Longlist of The Irish Blog Awards 2016!

 

WOO!! So not only did the Blog make the long list finalists for Best Health and Lifestyle Blog in The Irish Blog Awards 2016, but also one of my blog posts, ‘The Good, The Bad and the Emergency‘, made it onto the the long list for Best Blog Post!!

I am delighted and I have you all to thank for adding your entries for the blog! I cannot tell you how much I appreciate it 🙂 From here on, as far as I know, The blogs will now be judged by a panel and then those who make it onto the shortlist may need to get votes for the remainder of the judging so if I ever even make it that far, I may be back to ask for some votes! :p

For now, Thank You all once again and I will keep you posted on how everything goes 🙂 ❤

Lette (Fainting Goat)

Neurogenic Bladder Dysfunction

Yup, I have yet another diagnosis!
This time I have confirmed Neurogenic Bladder Dysfunction. Though I have had some of these problems in the past, I first started having acute symptoms and was admitted to hospital last December (2015) and it was later confirmed after a Urodynamics Test showed little to zero activity in my Bladder on the 15th of March this year.

My first symptom was Urinary Retention. I would get the feeling to go and then couldn’t, it was awkward and then went 3 whole days without going. Lets just say it got more than a little uncomfortable with pressure, Sharp pain, severe nausea and I probably should have went to the hospital with it sooner as it can be very dangerous not being able to pee!

_____________________

According to the Wiki:

Signs and symptoms:

Urinary retention is characterised by poor urinary stream with intermittent flow, straining, a sense of incomplete voiding, and hesitancy (a delay between trying to urinate and the flow actually beginning). As the bladder remains full, it may lead to incontinence, nocturia (need to urinate at night), and high frequency. Acute retention, causing complete anuria, is a medical emergency, as the bladder can stretch to an enormous size, and possibly tear if not dealt with quickly. If the bladder distends enough, it becomes painful. In such a case, there may be suprapubic constant, dull, pain. The increase in bladder pressure can also prevent urine from entering the ureters or even cause urine to pass back up the ureters and get into the kidneys, causing hydronephrosis, and possibly pyonephrosis, kidney failure, and sepsis. A person should go straight to an emergency department or A&E service as soon as possible if unable to urinate with a painfully full bladder. – Wikipedia/UrinaryRetention

_____________________
I rang my doc for advice and he told me to go straight to A&E, he explained that urinary retention is considered a medical emergency and that I should be seen straight away if I go in. So I got my things together and went  in not really knowing what to expect, but at this stage I was in dire pain and discomfort.

When I got to the A&E I was surprised to find that they did treat it as an emergency and took me straight in, catheterised me to relieve the discomfort (that felt amazing, eventually, though it took an hour or more for the discomfort to subside only a bit, but it was enough to get a bit of comfort!)

Lots of blood tests and scans later they decided to admit me for more tests and observation.
I was in hospital for over a week as they needed to flush my system with antibiotics and fluids as there was blood found in my urine and an infection in my bladder and kidneys. A urology nurse had to come to show and explain to me that I had the option of using the full time Foley Indwelling Cathater that they had me on in the hospital, which is pretty intrusive to be honest, or I could use these small intermittent catathers that almost look like little lipstick tubes or even tampons, but small enough to fit in a purse and look rather inconspicuous.  I can use these whenever I need them and I wont have anything attachment to me full time.

_____________________

According to the Wiki:

Advantages: 
People with neurogenic bladder disorders like spinal cord injury, spina bifida or multiple sclerosis, and non-neurogenic bladder disorders like obstruction due to prostate enlargement, urethral strictures or post-operative urinary retention, need to be continuously catheterised to empty their urinary bladders. But such continuous catheterisation can lead to problems like urinary tract infections (UTI), urethral strictures or male infertility. Intermittent catheterisation at regular intervals avoids such negative effects of continuous long term catheterisation, but maintaining a low bladder pressure throughout the day. – Wikipedia/IntermittantCathaterisation

_____________________

Near the end of my stay the Urology team came to me with a ‘gift’!!! 🙂

My bag of intermittent cathaters! I actually smiled when I saw it. It was actually a cute set up! it came in a lovely stripy bag with instructions, Cathaters, Alcohol Hand Sanitation Gel, Sanitation Wipes and A Mirror to help you see where to put the cathater… like you didn’t know where to put it like, come on folks! but its a handy Mirror! :p

    

Once I got the knack of using them, and they tested my bladder to see how full it was after I went, to make sure I was voiding properly, and once that was all clear I could go home.

Over the next few months I needed to continue to use the intermittent cathaters daily and, despite a few small nicks here and there, I got very used to them.

I eventually was called for a Urodynamics Test on the 15th of March and after a dead performance from my bladder, they conformed Neurogenic Bladder Dysfunction.

It’s actually ok to deal with but people with this can be more prone to developing infections of the Urinary Tract, the Bladder and even can lead to kidney failure, so I am now being monitored to keep an eye on my kidney function and I need to come back in to do an updated urodynamics test and a kidney scan once every 6 months. Which I am very happy with considering the amount of medication I also take daily, I do worry about my kidneys and other organs being affected from long term use.

My next appointment for this test is in September and I will update you once I know about that 🙂

Chat soon, Lette (Fainting Goat!)

 

The Blog Awards Ireland 2016 – Nominations Now Open

Hi all,

I am delighted to say that Irish Dysautonomia Awareness has been entered into this years “Health & Well Being” – Personal Blog – Category in the blog awards nominations and hopefully will make the long list at least, that’s where it got last year so to make that again would be really nice! 🙂

If YOU would (Please) like to Nominate this blog Please click HERE (Give it a minute to load, it can be slow!) or click the image below and follow the instructions. I would greatly appreciate your input, THANK YOU! You need to register with the site but you can do so quickly and easily  by signing in with your Facebook and you can control what information you give them.

Please enter The Title of the blog: Irish Dysautonomia Awareness,
Also pop in the URL of this Blog which is: https://irishdysautonomia.wordpress.com
also please be sure to enter it into the ‘Health & Well Being’ – Personal Blog – Category.
Thank you ever so much!

Please click here and enter the info to Nominate this blog! – THANK YOU!

This year there is also an entry to nominate your favorite Blog Post from the blog here. In the last number of months the post that has raised most interest seems to be this one:
‘The Good, The Bad & The Emergency – Part 1’

I would also greatly appreciate if you have the time, to maybe nominate that blog post Please and thank you most kindly! as far as I can figure, there’s no harm in trying! 🙂

It is the same process as the first, please click Here:
Hit ‘Nominate a Blog’ – Enter the ‘Blog Post’ Title as: The Good, The Bad & The Emergency – Part 1

The Blog Post link is : https://irishdysautonomia.wordpress.com/2016/04/05/the-good-the-bad-and-the-emergency-part-1/

The Category is ‘Best Blog Post’ – Personal Blog

Please Click Here and Enter ‘Blog Post’ Details (As I have laid out above) for Nomination – Thank You

Thank you so very much for you time in doing this each and every year, I may be back to you for more support if we make it to the ‘public vote’ part but even if it doesn’t get anywhere, a few more people will view the blog as a result of just entering and further our much needed awareness, even just a teeny bit.

Thank you once again,

Lette – Fainting Goat!

The Good, The Bad and The Emergency! – Part 1

*Please Find Part 2 of this post ‘HERE’

WOW!

It has been a long while, so sorry about that, so much has happened and I needed time to recover and get myself straight again before I decided to update.

Harolds Cross happened, and it was great!… while it lasted! Of course, we all know, nothing goes straight forward for me so yeah, there’s a bit of a story to go with it!
The day before I went up, I got my hair cut… It was A DISASTER! No, seriously, Look…

Me pulling the pissiest face ever! Never go to a cheap hairdressers! Jeebus! Lesson learned!

Then on March 15th I also got another new diagnosis (Neurogenic Bladder Dysfunction!)…yeay!
Lets just get straight into it shall we?

Harolds Cross – Rheumatic and Musculoskeletal Disease Unit (RMDU)

I’ll start with Harold’s Cross.

I got called up there for 2 weeks at the start of February, not really knowing what to expect, I had asked for other peoples experiences of the place in some of the Facebook support groups and I got very mixed reactions. Some people loved the place and couldn’t praise it high enough, yet at the same time, there were just as many negative replies from people who didn’t find it any good for them, at all.

I made up my mind that everyone is different and I wouldn’t know how I feel about the place until I gave it a good go myself!

Up early and ready to rock!

Up I went on the Monday morning. It was freezing hard and we had to be on the road leaving Limerick very early in order to arrive up in Dublin for 9am. We met no less than three car accidents on the way out of Limerick because of the state of the roads but thankfully it eased off passed Tipperary and then we were well on our way.

Icy roads at sunrise

Of course, I got us lost on the way through Dublin and that was with a SatNav, I know, it takes talent to get lost using one of those but there ya go!! We did finally arrive and in I went.

Harolds Cross is very large, with lots of different areas to cater for different medical needs, everything from inpatient palliative end of life care to week stays and day cases for varying degrees of physical disability and the individual treatments involved.

I was immediately struck by how clean and bright the place was and how very friendly the staff were. As soon as anyone saw the chair I was asked if I needed help with anything.

Once I was all signed in, I was escorted upstairs to my ward for the week, The ‘Sacred Heart’ ward and I was assigned to bed 13 under the consultant Prof. V.

13 seems to be my lucky number! I have gotten this bed number, 4 or 5 times already during hospital stays!

 

As soon as I was in the ward I was delighted to see it was spacious and open with two separate units, the first had three beds with men in them, then through an opening in the centre of the ward you come through to a bigger area of six beds, all women and this is where I was. The ladies all introduced themselves and everyone was so friendly, I was made feel very welcome and even more delighted to know there were another two EDS patients in the unit with me! One on my ward and another in the ward upstairs.

I was assigned a wonderfully kind young nurse with an English accent and she sat down for ages with me taking all my details and full medical history, telling me everything that I will experience going forward, what will happen, what is available and where to find everything. Everything sounded great so far.

I was to meet with the consultant first, he would come to see me on the wednesday of each week. Then the Doctor and nurses would look after my needs in between. the pharmacist would review my meds, and make sure everything was up to date and OK to see if anything needed to be added or taken away etc. I would be assigned an EDS aware physiotherapist to work with my individual needs on a daily basis and an occupational therapist to cover everything else like home needs, medical aids and equipment, pain management etc. other services included Podiatry, a specialist foot care clinic that could fit you for orthotics, a social worker who gave advice on social welfare, back to work or college needs as well as a stand in as a bit of a psychologist if you needed to vent! There were relaxation classes and specialist talks on various weeks covering things like pain management and the like.

I was utterly delighted to find out that they had Therapy Dogs that come and visit the centre regularly and I was lucky enough to get to meet ‘Rian’ one day on the first week, a beautiful, great big, gentle, golden retriever that I spent time giving rubs and loves to! 🙂
On the ward then, as well as handing out and sorting your medication, food (which was mostly fresh or freshly made that morning as well as doing what they could to cater for special diets and allergies!) and some other needs, you could also request hot or cold packs if you needed to sooth sore, achy joints and muscles. I thought that was a lovely touch to be honest and I wish it was available in all hospitals. Hot packs, for me anyway, bring another level of comfort that cant be touched by conventional medicine.

The food, staff and facilities were really great and they did what they could to cater to special dietary needs!

They have a hydrotherapy pool also so this should have been part of my treatment while I was up there, however, they were in the middle of renovations and unfortunately a couple of weeks prior to my going up, one of the building machines ended up bursting a water pipe and put the pool out of use for the time I was there. This was a huge pity as I feel the water would have helped hugely in the exercise and also in helping the muscles to relax and recover while there, but it was not to be this time anyway!

The first day was all about settling in and finding my feet around the place, after the traveling up and all the new sights to take in, I was tired and ready to rest. The very next morning I met the consultant.

Sleepy time in Bed 13!

He was friendly, had clearly read through my file and extensive medical history and went through all that with me. He was clued in about EDS, but just generally I found. Anything he said to me, wasn’t new, it didn’t blow me out of the water by any means but he knew what needed to be done to help, he was reasonable and didn’t pretend to know more than what he did, which I appreciate in any doctor.

With his advice my treatment was about to begin properly, the doctor and pharmacist went through my medications and it was determined that, because of the issues in my gut and the fast weight loss I experienced, I was more than likely not eating enough calories most days, and on the days I was eating enough, I seemed to be not retaining the nutrients and calories and as such, continue to lose weight and energy. They tried me on a few different types of nutrient drinks to help me along and wow… they all tasted rancid! I cant have lactose or wheat so I could only chose from a handful of watery, metallic tasting ickiness!!

Forti-yuck!

However, I was there for treatment, and I was going to give it a good go so I drank them but as I was particularly nauseous that week, a lot of what I ate and drink didn’t stay down.

The next big chunk of treatment, probably the biggest was physiotherapy. My assigned lady, lets call her, ‘A’, she was a gem! She really took her time during our first assessment together where she examined my body, all the problem areas and even finding problem areas that I didn’t even know were problem areas!!

I found her to be very good, very clued in about EDS and was extremely careful not to push the areas that caused most trouble. She understood that ‘feeling’ the muscles and joints being used was ok, but there should be no pain.  She was all about increasing mobility out of the wheelchair but she never dismissed the chair and it was always there for when I needed it as of course I would need it continuously going forward. She understood that EDS isn’t curable but that exercise would help better define the weak muscles and as such they would help keep the joints tighter and better hold them in place, preventing further subluxes and dislocations. Other than that, bringing up my general fitness was another priority that would only benefit me going forward.

Once the assessment was all done, she had a printed, individualised exercise program ready for me to follow on a daily basis which included a simple warm up on a bike, starting at 2 to 3 mins with no resistance, if I could even reach that, hopefully as I continue the week, ill be able to increase that time by tiny amounts. From there I had floor exercises to follow that concentrated on my lower body problem joint and muscle areas. After these I had some standing exercises to concentrate on problem upper areas of my body, followed finally by some work on the parallel bars to help practice walking short distances, resistance band exercises and finished with a cool down, simple stretches to some areas and lastly relaxation on a physio bed with heat packs.

My constant companion in the physio room!

 

Though I had been very ill the first week with vomiting, it had still gone amazingly well.  I arrived on the tuesday and found everything to be excellently run at the center. The staff, the food, the facilities everything had been really good and before I knew it it was friday evening and time to be coming home again for the weekend rest before going back up the following Monday morning. This was both a welcome and a tormenting touch to the whole stay.

Getting up and down from Dublin to Limerick was not easy, there were early starts, long journeys in the car which are tough with chronic illness at the best of times and no sooner you get settled back home for the weekend, you are getting ready to drag everything back up to Dublin again. Going by train wasn’t really an option, even with free travel, traveling with chronic illness is unfriendly to other passengers when I need to vomit after 20mins of vibration! Getting from the train station to Harolds cross with bag and baggage wasn’t really feasible either, needing to travel with a wheelchair and carrying crutches, other medical aids and a ton of medication wouldn’t have been easy, so driving straight there and back in our own car, at our own leisure was a more comfortable option for us.

I also found seeing my hubby so briefly for the weekend was a lovely treat in the middle of my treatment but saying goodbye again can be horribly tough. I understand not everyone who is sick has a partner or ‘better half’, but I think this goes for any family members you may come home to including parents, siblings, close friends, carers etc. Seeing anyone you care about for such a short time and then saying goodbye to them again is never easy, no matter who you are!

I know Dublin is only ‘Up the road’ by some peoples standards but it’s still a good 3 hours travel time to and from the place and that takes a massive chunk out of your day. It doesn’t make the 2 hours visiting hours seem worth it when traveling up takes so long around it!
It also costs a lot on petrol so we decided to drive up and back but to leave visiting during the week as it wouldn’t be worth coming all the way up when the visiting hours are so short. Thankfully Skype made this a whole lot easier and I spent a lot of time on video chat home to himself and the pup!

As I had been very sick during the first week in Harolds Cross, vomiting almost daily down on top of the increased activity it turned out I had lost over 2 kilos after just 4 days. By the time I got home during the weekend I was in excellent spirits and couldn’t wait to get back up but I was very low on energy and spent most of the weekend sleeping to catch up on my energy reserves for the next week. This had my husband slightly worried and he wondered if I should return back up at all. I decided to give it a go anyway. I wasn’t going to be given this chance lightly again so I really wanted to give it my best shot.

Back up bright and early on Monday, I was launched into everything again straight away, Physio, OT appointments, I was to meet with the pharmacist this week too as well as the foot care clinic to get fitted for Orthotics for my very flat feet, a busy week planned, I was excited for it, but I was so very tired…

I got through Monday, but the pain and nausea started to get very bad by bed time. I had been vomiting on and off throughout the day, found it very hard to eat, even to stomach taking a drink of water. The back of my lower head and upper neck were beginning to sear with pain, I had very little sleep, was extremely uncomfortable and by Tuesday morning I started getting visual auras.

The staff were excellent. I informed them of the symptoms and they kept a close eye on me throughout my stay while I was unwell but especially this day. They kept track of my hydration and food levels, taking note of what volume I had gotten sick etc. My head was terribly heavy and my stomach was very sick. All I could do for a lot of the morning and afternoon was try and sleep.

By 2pm, I felt one of the nurses touch my shoulder and gently wake me to say,

“Lette you’re due down in physio, ‘A’ wants to know if you are going to go down or leave it today? It’s entirely up to you, take a few minutes to wake up and see what you want to do.”

I had been asleep for over an hour at this stage and had been resting all morning. I woke feeling tired but not as sick as I had been so I decided I would go down and try to do a small bit at least.

When I arrived at the physio room, ‘A’ greeted me and I told her I had been feeling very unwell. She understood and told me to take my own time, not to push myself too much and if I needed to stop at any stage to just do so.

I started my warm up on the bike and though I had managed to increase my warm up the previous week to nearly 6 mins, today I could only manage 3 minutes and it felt like the longest 3 mins of my life. Once this was done I had my floor exercises to do so grabbed my crutches and slowly hobbled my way over to the matted area with my printed program in my hand. Got down onto the mat to start my leg exercises and started to feel very strange. I slowly finished what needed to be done and I sat up to try and gather my head. ‘A’ came over and I told her I started to feel very odd. She got a chair for me and brought it over next to me. I tried to get up onto the chair and did so with massive difficulty. I felt like I was moving through treacle and my vision was begining to go black. I told her I couldnt see properly and she helped me into the chair, told me to take a quick breather and that she would be right back.

At this stage I actually couldn’t see properly at all, everything was going in and out of oily blackness alternating with swimming milky white blobs. I felt pressure build in the back of my head and push forward through my sinuses and out my ears.

I leaned forward resting my elbows on my knees, feeling a trickle of sweat tickle as it ran down my forehead, over the bridge of my nose and felt it drip off the end. Everything happened in slow motion.

The sound stopped all around me, everything now pitch black, the pressure in my head was immense, burning nausea rising in my throat which felt like it was now closing up, breathing hard, heartbeat flying…

 

heartbeat…

breath…

 

 

 

the last thing I remember was falling forward…

 

 

 

 

 

 

*Part 2 – NOW HERE!

A Year Today!

Can you believe it is a year today since I took my first trip over to London to meet with Prof. Rodney Grahame at the Hospital of St. John and St. Elizabeth?

While I was there, I had some tests and I received a confirmed diagnosis of EDS (Ehlers Danlos Syndrome) Hypermobility type with Gastro issues. You can read the full blog post I did about that experience Here.

The diagnosis and treatment plan I got there proved invaluable to me here in Ireland to help my Doctors treat me and even still, I am still waiting for my Harolds Cross appointment to help me get back walking!

I was due to go back over to London for further tests and much needed treatment but I have been too unwell and practically housbound when I am not in hospital over the past year to plan anything. I have been admitted to hospital 5 times since my visit over and I also have been diagnosed with Gastroparesis in that time.

However, things are getting worse especially in the Gastroparesis area of things and I still need to get back for the treatment as soon as I am well enough to travel and make plans.

The Medical fund is always open if anyone would still like to contribute or even just to share the link, I would greatly appreciate it, because without it, it would be impossible for me to pursue the correct course of treatment as there are no EDS specialists anywhere in Ireland and traveling abroad is not fully supported at all under the HSE travel abroad scheme.

I would just like to take this opportunity to say Thank you to everyone who has helped so far, to my family and friends and especially my amazing husband Keith. You have all been so supportive and helpful and I couldn’t have done it without you 🙂

Thank you,
Fainting Goat (Lette)

Oh Dear! Spare a Few Likes!

Hehehe! As you can see we are stuck on a funny number of likes over on the Facebook Page! If you have a moment, please click in and give us a like, Thank you! 🙂

While you are at it, check us out at these following links, I would love to hear from you 🙂

Facebook
Twitter
Youtube
Spreadshirt
Email

Sleep Paralysis, Sleep Fainting and How Your Brain Can Frighten You!

This will be a bit of a long post, but bear with me… you may have experienced this too! 🙂

…it started when I was 15.

It was late in the night, about 4 or 5am. I found myself lying in my bed on the flat of my back. The room was dark but crepuscular light seeped in through the unlined curtains. The light of the hall outside leaking in under the door… Semi asleep, semi awake… a pressure on my chest, a looming, shapeless, black, figure crawling up my body.

I could feel its pressure on my body, I tried to move and I couldn’t. Emotionally heightened terror filled my solar plexus. My mind was racing, I was completely paralyzed by fear. My eyes were open, I felt wide awake, I had full control of my thoughts. I could see around my room, but somehow… I was still in my dream. The dream was being acted out in my room, shadowy dark figures were floating and moving eerily around my room. my sister snored gently in her bed, while I tried desperately inside myself to scream and call anyone for help…

A strange sound began to fill my ears… Behind low whispering voices, children laughing and strange music I had never heard before.

The looming, heavy dark figure was now up on my chest… I could feel its ghostly hands tighten around my neck. It didn’t make a sound. Breathing became a struggle as I could feel this creatures weight lying on top of me, fear choked me, I tried so hard to scream…

what was that sound??

Like a moan, it was high pitched, it varied in frequency and sounded for all the world how you would imagine a banshee would cry out and whail!!

I soon realized this sound was coming from me… I was trying to scream in my paralyzed state and it emitted from my throat a weak, eerie sound that sounded nothing like a scream, but in my dream I was screaming as forcefully as I could.

It’s hands closed over my mouth, it’s face right in front of mine, but it didn’t have a face… it was just a dark, heavy shadow with holes for eyes… it opened its hollow mouth and engulfed my face… My heart was pounding, I was sweating, I couldn’t breath, the distorted world around me was fading and just as I felt life was leaving me…

“LETTE!”

“LETTE!! Wake up your FREAKING ME THE HELL OUT!”

My eyes snapped open, and I was now properly awake, in my bed, my sister sitting up looking petrified at me with her knees up tight and her quilt pulled up to her chin!.

My weak, strange moan that was a scream in my dream had woken her… I scared the crap out of her and I was terrified beyond belief!

I decided I needed to know what this experience was, I am rational and I do not believe in the supernatural – only as an interest, I am fascinated by it, but thankfully I found a rational explanation.

I had just experienced Sleep paralysis.

Sleep paralysis is a phenomenon in which people, either when falling asleep or wakening, temporarily experience an inability to move. More formally, it is a transition state between wakefulness and rest characterized by complete muscle atonia (muscle weakness). It can occur at sleep onset or upon awakening, and it is often associated with terrifying visions (e.g. an intruder in the room), to which one is unable to react due to paralysis. It is believed a result of disrupted REM sleep, which is normally characterized by complete muscle atonia that prevents individuals from acting out their dreams. Sleep paralysis has been linked to disorders such as narcolepsy, migraines, anxiety disorders, andobstructive sleep apnea; however, it can also occur in isolation.^[1][2] When linked to another disorder, sleep paralysis commonly occurs in association with the neurological sleep disorder narcolepsy.^{[2] – Wikipedia}

I now get this 3 to 4 times a month. Sometimes I wake up with the strange moaning thing, which has frightened my husband so many times! Sometimes I just feel something touching me and the feeling of fear just makes me jump awake and there is nobody there. Sometimes I hear voices or music or strange sounds, its freaky!

There is nothing unexplainable or supernatural about this experience, it is quite literally your brain working overtime, and you happened to wake at the wrong time!

Here is a very basic understanding of how it works from my own experiences and perspective;

When you sleep, your brain releases some chemicals and hormones to literally paralyse your body so that you dont get up and act out your dreams (incase you decide to throw yourself out a window or harm someone while you are dreaming) This is a natural proces to help you recover and repair your brain and body from the day before, by keeping you still and sedated.

If you happen to wake during this process, you experience a transient state where you have muscle atonia (weakness) or paralysis, you cant move, you can open your eyes but the chemicals in your brain are still active… so you can see or hear or even feel your dreams around you in very lucid detail while your eyes are open and you cant move. A feeling of fear is associated with this and a looming shadowy figure is sometimes experienced… this thing is called; ‘The Hag’ appropriately named because of the fear and the pressure on your chest when you see it!

This is a very basic run-through of how this experience feels, Please read in detail HERE how it happens, it really is fascinating and I would love to hear your feedback on your own experiences.

Recently though, I have been experiencing something different… and very frightening from a health and medical point of view. I havent yet spoken to my specialist about this but I feel I may need to going forward.

I think I am fainting in my sleep!

WHAT? but you are already unconscious! how can you fall unconscious when you already are!?

I know, right? but please let me explain! It doesn’t work like the Inception thing! :p I dont fall deeper into my dreams…

I have Postural Orthostatic Tachycardia Syndrome because of my EDS, so I faint on a regular basis while awake. I have become acutely aware of the symptoms and feelings inside me when this happens and just before I faint. I have to be, so that I can try and control it as I sometimes stop breathing when I faint and this is not good for the ould head and brain and has caused nerve damage previously from the lack of oxygen! I have gotten better at noticing a faint coming on but sometimes I have no control and just hit the floor (insert ‘Let The Bodies Hit The Floor’ meme here!)

When I sleep, I dream very lucidly. In full colour and sometimes I can control how the dream plays out, not every time but nearly always in my dreams I chose flying as my method of getting around! (dont laugh, I really do and it feels exhilarating!) I have proper and extreme intense emotional feelings, I can touch and physically feel things, tastes, smells, pain, pleasure and extreme tiredness when I have overworked myself in my dreams!

Isn’t that crazy? If I play or do too much in my dreams, I can physically get wrecked tired and feel how it affects my body exactly like when I am awake, even though I am asleep and lying still. It is almost like in my dreams I have slipped into another me in the dream world!

Further to this, in my dreams I have started to experience fainting, just like I do when I am awake and active!

I feel the pressure in my head build, my temples and behind my eyes start to throb, stars spinning around my head, a dark tunnel seeps in from my peripheral vision making everything slowly go dark. My muscles feel heavy, I feel disgusting hot rising nausea crawl up from the depths of my gut and up into my throat, I begin to sweat but always feel cold, feel like I am going to vomit… A loud wooshing noise grows intensely loud in my ears, like I am falling through air.

While I am dreaming this, sometimes, I experience myoclonic jerking, my husband notices this. and I also can bite my tongue and the inside of my mouth to the point where I wake up with my mouth filled with blood.

The darkness closes in, deeper, deeper, I feel myself fall under into a faint, it literally feels like someone is just turning your ‘lights’ off and you have no control over it, then there is just darkness for a split second and I snap open my eyes and feel utterly dreadful!

When I wake I feel just like I feel after I faint in my waking state. I had been sweating, I am viciously nauseous, my body aches, I am physically weak and feel sore, tired, and confused… I have an urgency to both vomit and pee… I will get up, go to the bathroom, then hit the floor flat with a hard thump.

I have experienced this many times and wondered if I am in fact fainting in my sleep, or at least experiencing the precursor to a faint, then in my weakened state when I get up, I faint properly… it is all very odd but I did do a bit of research and found I am not alone, at all! Thankfully… I was beginning to worry about my own sanity! :p

This is called nocturnal syncope and I found a medical journal explaining a trial for testing this condition. It is an amazing read, HERE!

PATIENT HISTORIES

Patient 1 had her first nocturnal syncopal episode at the age of 40 years. After sleeping for some hours, she awoke and felt nauseous with abdominal discomfort and the urge to defecate. She lost consciousness while lying supine. She sweated profusely but did not bite her tongue. Her husband observed transient myoclonic jerking. After this, similar episodes occurred regularly (at least one a month) and only at night. The syncopal episodes never exceeded one minute and were atraumatic. She was incontinent of urine and faeces once. A tilt test provoked a vasovagal reaction followed by seven seconds of asystole and reproduced her nocturnal symptoms. Because of ongoing symptoms she underwent neurological investigations and a typical nocturnal episode was recorded during continuous electroencephalographic (EEG) and cardiographic monitoring (fig 1​1).). The EEG was judged normal by two independent neurologists. The ECG, however, showed a pronounced bradycardia (36 beats/min) during the episode, with an atrioventricular node escape rhythm. – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768202/

So this one particular lady experienced a lot of the same things as I did during these episodes. I also found other examples HERE and HERE!

A 2004 research publication suggests patients may awaken from sleep with symptoms of forthcoming neurocardiogenic syncope (Krediet, Jardine, Cortelli, Visman & Wieling, 2004). This suggestion may seem to contradict current teachings on this disorder. However, research shows that transient autonomic mechanisms that predispose to vasovagal syncope may occur during sleep (Shneerson, 2000, p. 1-15). – http://www.dinet.org/NCS/ncs.htm

So it’s nice to know im not going nuts, but these are crazy experiences which make some people think it may be a supernatural occurrence  when it is not. Your brain is just messing with you!

The sleep fainting is new though, and though I have found some medical papers on it, it doesnt seem to be extensively written about, so I would love to hear your experiences of Sleep fainting or Sleep paralysis. Please contribute and thank you for reading 🙂

– Lette

Things I find help with POTS Symptoms

I have discovered a few things that really help the symptoms of POTS and thought it would be good to share for others who may not know about them, they are simple but seem to help me a great deal and anything that helps has to be good!!

#1: Firstly and its my savior, I have to say ginger really is a lifesaver!! I get really bad nausea most days, so bad im rendered sobbing into a bucket off the edge of the bed and it really is a pitiful sight! However, the hubby did his research while I was having a bad episode and he really wanted to help. We found that ginger tea works almost instantly in settling nausea and upset stomach. Tastes a bit yuck but I wouldn’t care if it helped and boy does it!

If you have real ginger it works best, Ginger and Lemon tea bags are good too but dont work as fast or as strong. What I normally do is get a Ginger and Lemon teabag, brew it and also add a tea spoon of real finely chopped or ground ginger so that its not just the flavour your ingesting but the actual ginger itself and it works almost instantly!! Its a must!!

I am blessed that the better half has packed out the home cooking with ginger too and I have found I am now waking with little or no nausea in the mornings, its great and leads me to the next tip!

 #2: Home Cooking and changing eating habits really help to alleviate the symptoms of POTS. People with POTS have a strange diet change and usually it goes against what every Dr. and Health pro would tell you to do! At the start when I was first diagnosed, I hadnt cut out certain things like: Starchy Carbs, Dairy, Sweets and take away or processed foods or increasing things like Salt (20 grams a day for me but ask your Dr. for individual cases) to increase blood pressure and pulse, black coffee for heart and energy stimulation, All these things have a huge impact on symptoms. As soon as I started to follow this advice I felt great the very next day with only tiredness to battle which is easy without pain and sickness!!

#3: Keep Hydrated, it is soooo important for everyone to keep hydrated but especially people with POTS because of the fluids lost during certain symptoms (I don’t need to gross you out!). I find electrolyte drinks like Powerade excellent but others likeLucozade isotonic drinks give me headaches so you have to find the one that works for you. Electrolyte drinks hydrate faster than water but you should try to get at least 2L of fluids into you a day in the form of water mainly and then these drinks 2nd.

#4: Know how to rest during important times like showering where your body is under stress, Get a shower chair and limit the amount of overhead arm movements as this can trigger syncope/fainting episodes very easily because of the heat of the water and blood pooling in the legs. Reduce the heat of the water to what you can tolerate and before you leave the shower, rinse your legs in cold water to cause your blood vessels to constrict and pump blood back up to the heart and brain.

#4.1: If going from a lying position to standing, sit with your legs down for a few minutes before attempting to stand up, this will allow your body to acclimatise to the change of position and will reduce the risk of fast blood pooling and syncope episodes.

#4.2: If you find you slump or hit a wall in the middle of the day while up and about, take a bed break! I find even as little as an hour snoozing can give me a tiny boost of energy for the rest of the evening, its minimal mind you but you would risk further symptoms triggering if you don’t listen to your own body and take a rest when you need to!

#5: Take Vitamin D, Ask you Dr. first to be sure but its known as the sunshine supplement, this is brilliant as people with POTS may not be very mobile and cant get outside as often as they should. As well as taking all the meds we need to take, Vitamin D is known to help nearly all organ tissues in the body and it has psychological benefits,  as does real sunshine, ever heard of the winter blues? A lot of people get affected by the lack of sunshine in winter and it can actually trigger depression, its all down to the lack of vitamin D. Sometimes its hard not to feel down with an illness so increase this and you will increase happiness as well as organ tissue health! 

 #6: Avoid Stairs on bad days, goes without saying really but putting that pressure on your heart rate when you are already feeling low is a very bad idea and you do not want to faint at the top of a stairs!

#7: This is going to sound cheesy but THINK POSITIVE!!! I have been doing heavy research on POTS and Dysautonomia in general and the amount of what I call ‘Doom & Gloom’ videos online is frightening! Those videos or write up’s of how bad and terrible people have been feeling, Avoid this crap! Really, the power of positive thinking can really float you a long way and I’m no hippy but it works! So concentrate on the things you CAN do and not the things you cant, be happy for what it is you have and not what you haven’t got, thinking like this really does make a difference. Use your time wisely and creatively and share your experience so that others can share alike, you never know, ya might learn something along the way! 

#8: After being advised by my Dr’s in the hospital before leaving, they gave me and told me to get some Compression or Embolism Stockings to help stop the level of blood pooling that happens in my legs. They have proven very helpful and on the days I don’t wear them I usually faint, when I do I can stand for longer and usually get more hours awake during my day so I highly recommend these for other Pots or Dysautonomia sufferers. They can be gotten from any pharmacy or from your local health nurse, also this brand: ‘Jobst‘ are excellent for support stockings of all different colours, shapes and sizes which is great to colour code with clothing and are far prettier than the usual plain white ones you get at the pharmacy! You can get half leg, up to the thigh and tights style stockings so which ever works for you, personally I find the higher the stocking the more support and benefit they are but each to their own and find what works best for you. Not only that but they suck everything in!! Thats gotta be good right?!! :p

 #9: Sunglasses are now a lifesaver! I don’t know which of the tablets are doing it to me (and it is the meds as the Dr. told me it would happen I just cant remember which one does it!) but I have become highly light sensitive and my prescription sunglasses from long before getting diagnosed with Pots are getting more use than ever. If you dont have sunglasses and are finding this with Pots/Dysautonomia meds I recommend a high UV filter in whatever shades you decide to get, dont skimp and get cheapy ones because they will ruin your eyes and have zero UV protection which will damage your eyes in the long run. Pay well once and mind them, it will be well worth it!

 #10: A blood pressure monitor and a heart rate watch are 2 things I have picked up and have started tracking my daily stats. Not only for myself but for my Dr’s as I will be seeing them so infrequently I would rather keep a full history on the days they haven’t seen me. I find them excellent for allowing me to slow down when I need to and for when I know I can push myself that little bit harder too.

 The heart rate watch is pretty cool as it doesnt need a chest strap and I got it on sale at Amazon. Its a Womens Sportline 710 analogue heart rate monitor watch and is very accurate and not as bulky as other heart rate watches. Click on the link there if you want more details but its currently on sale on Amazon for half the price you would buy in stores.

The Blood Pressure monitor is a Sanitas SMB 30 Upper Arm monitor and I picked this little beauty up in Lidl for €17.99!! It works perfect and I didn’t break the bank! Upper arm is considered the most accurate, try and avoid the wrist monitors, they cant give as accurate a reading (apparently, im no expert, just going by reading lots of stuff and what my Dr. said!)

#11: Also for keeping track of my stats, I use my Android phone and have an app called ‘BP Log‘ which has a lovely clean, no nonsense interface and is very simple to use.

Anyhow, that’s all for now until I think of more, if you have any questions or want to take part in the blog or new youtube channel (Where there will only be positive videos, none of the ‘Doom & Gloom’ kind!) please let me know. Thank you for your interest.

Lette (The Fainting Goat!)