Finding the right prescription

I've just read this interesting post on the ever wonderful The F-Word and it chimed with me. Not because I've gone through what Jane is talking about in her post, but because I've had some experience of the impact that not getting the right treatment, or indeed not getting any treatment at all, can have on one's day to day life.

I have an underactive thyroid. No big deal; 100mcg of levothyroxine a day (for me) and the problem is fixed. The problem is that as I look back over my life I have clearly had an underactive thyroid for at least half my life, and that has affected everything. I've struggled with my weight for years, I've been sleepy when by rights I couldn't possibly be (16hrs sleep and still tired?), and I've struggled to concentrate for even half a sentence of reading let alone a whole chapter (not so good when you are a lifelong student!). But it was more than that: I also had severe anxiety to go with the apathy, which spiralled into agoraphobia when I was also depressed. If I exercised it took me days to recover and I had physical tremors at times of stress. One way or another, I went to the doctor about all of these problems over the course of at least 15 years, and it was not recognised once as a possibility. It was only when they started to investigate for another condition entirely that the thyroid problem was diagnosed.

I still remember vividly the experience of taking the thyroxine for the first time. It felt like the most amazing high, because I actually had energy. After the first few days of bouncing round the room and irritating everyone (especially my boss), I began to get used to this increase in the hormone that should be there naturally. But every day, week, month, everything just got a little easier and I began to realise that everyone didn't feel the way that I always had and that they weren't just managing it better than me. I really wasn't a lazy failure - I just hadn't stood a chance. Now it was all going to be better.

Except gradually it wasn't getting better any more and then it started to get worse. My docs were great about working with me to get my thyroxine dosage right, happy to take my lead as long as my bloods stayed somewhere in the recommended range. But something was not right. And I had to push to be taken seriously, after all my bloods looked fine. What hadn't been checked was my iron levels, and when I finally got it checked, turns out I was right off the bottom of the chart.

So now I take my iron tablets twice a day, as well as the thyroxine, and again I have that feeling of 'oh, THIS is what being a human is supposed to feel like'. When I exercise, my fitness actually increases. When I need to think, my brain actually works. And when there are chores to be done, I have the energy to tear through the list and then keep going.

Now that's quite a ramble through the saga of my health. And I guess the question is how does that relate to the post I linked to above. Well my point is this: for years I was made to feel that everything I struggled with was my fault, that I was lazy, fat and should be ashamed of myself. Every time I went into the doctor's surgery I was told that if I just lost weight it would all be fine, if I just conformed then there would be no problems. Thing is, I was biochemically incapable of conforming. I needed those tiny, almost inconsequential, tablets to function and to feel right in myself. I did not need to be shamed for the consequences of what was physically wrong for me. And I think that perhaps my experience is a very pale shadow of how it must feel for people who are intersex or trans and are looking for help and support.

So yeah, I read a post like the one above and I think about the myriad ways that prescribing is political and the way that the refusal to consider prescribing is also political. I think about the ways in which meds are pushed onto some people (those experiencing mental health problems, for example) and the way that meds are witheld for others. And I think about the ways in which the messages that surround health and the prescription process often vilify and punish the individual who is asking for help.

I don't think it's necessarily a personal message from a particular doctor; I think it's usually the result of policy, whether national or local. But those policies are often deciding who is worthy of treatment, and thus respect, and who is categorically not worthy.

And if you happen to fall outside the boundaries drawn, well it's clearly your own damn fault.