I awoke from a nightmare last night; I was dreaming somebody was giving me a gastroscopy and the sedation hadn’t worked despite me making sure all of it went into my veins. I guess this was an unexpected dream since I haven’t any procedures lined up at the moment but I am not surprised that I am anxious. Sleeping didn’t go well anyway last night and the nightmare just added a layer of desperation I suppose. I went to bed in pain last night. There is nothing too significant going on but more an accumulation of pain that is getting me down. The worst pain is caused by a couple of ulcers on my tongue.

The ulcers have formed (not sure that is the correct word) from where my tongue lies against some sharper teeth. This means that whenever my tongue moves the ulcers are irritated and pain ensues. I try to hold my tongue still, but even standard swallowing becomes painful. Things like ulcers and boils (makes me sound so medieval) are not unusual for me because I take immunosuppressants, it is just a fact of life for me but I guess what grates is the way they interrupt the flow of life. I have found that the best way to get rid of ulcers (on my tongue) is to forget about them. Somehow forgetting about them let’s them heal and disappear but that is difficult when they cause pain when I talk, swallow, or eat. I can anaesthise them for a bit by using a mouthwash or gel but apart from easing my mind, I’m not convinced they heal any quicker this way. It may make it worse with the pain dulled, I am now more liking to move my tongue.

Having a persistent pain like this tends to lower my resistance to other irritants too. As I lay awake this morning the psoriasis plaques on my ankles seemed to be particularly sensitive. I suspect this is due to be uncomfortable and moving about in bed, which in turn rubs the plaques and inflames them. Lying there I could feel other plaques calling out for a scratch; this is the worst thing I would do to my psoriasis in my experience. The list goes on though. There is my right knee that is painful if I rest it on it side, there is the ring finger on my right hand possibily inflamed and swollen with arthritis or an inflamed tendon, and the side muscle I pulled doing bunny hops on my bike yesterday.

Alone, these things are irritating together though, the slowly ratchet up my anxiety levels such that finding the bliss of sleep becomes fleeting and shallow. The type of sleep where dreams seem to be more real.

I am going to see my hepatologist tomorrow to talk about medication that could help me swallow better and avoid food getting stuck in my oesophagus. I am trying to keep an open mind, but I really don’t want to be taking any more pills and having to face they side effects, plus I can’t see how such a pill might work. If it bolsters my peristaltic action then it suggests to me that is makes the action stronger somehow. If it makes the action stronger in my upper GI tract what will it do with my lower part? The other side of not taking anything to help my swallowing is that I will need to have another gastroscopy at some point which is perhaps where my nightmare comes from.

My anxiety isn’t just around how well I can swallow though. My last communication which my consultant as by email where I asked for his help for looking into a case of a friend who seemed to be having an extremely difficult time getting any treatment for a liver related condition he had. I was unsure about whether the write the email but felt that if I could help his situation I should in conscience try. The email didn’t go down well and it was interpreted as me asking my consultant to be unethical; an interpretation I don’t think is correct but not one easily solved.

My consultant’s opinion of me is important for some reason I can’t quite put my finger on. Logically I don’t think there is anything to worry about for my appointment, my doctor will be professional and friendly as always, but emotionally I fear I have lost his respect and that matters a great deal. Maybe he will be able to be more open in person than he was in an email but then again maybe he won’t mention it at all. If he doesn’t mention it then should I to do it to clear my mind? I suspect that having a standard ordinary discussion about pills will be enough to calm my fears and reset my relationship; I just need it to happen.

Another fear I have is that it won’t be my consultant but another hepatologist I get to see. I’ll try not to take that as a bad sign. In the meantime, I suspect I will need to work on my answer to “how are you” to find a few sentances suitable for the occasion.