Approaching Zero

The dark wonder drug lies in the drawer.  In there, behind the socks, are the massed heaps of green and white boxes containing my collection of as yet untaken prednisolone.  Open the drawer a crack and they sort of shimmer.  5mg tabs.   Full of fatness, sleeplessness, reflux and fear.  Taking these back at the beginning  the world was a desperately dark place. 

Up at the clinic, once the diagnosis had been confirmed, and the pain had magically lifted, they told me I might be on these things for a time.  There’ll be side effects, some worse than others.  You might get a moon face, a fat neck and a humped back.  Weight could hang onto you like sliding lard.  I looked up photographs of sufferers and saw them.  There was something defective and old about the way they represented themselves.  They didn’t want themselves photographed.  They smiled painfully from somewhere deep in their disability.  They were how the world was back in the 1950s only this was now.

I gave up eating, almost, and went to the gym as often as I could.  This weight won’t get me I told myself  and neither did it, miraculously.  Instead I was overtaken by a sort of paranoia, a fear of company, a dislike for being anywhere crowds were.  Didn’t do readings, didn’t go out much,  I stayed at home.

Tapering was the buzz word.  The dose would slide down the scale in a sloping line.  I began on 40 mg daily with a whole armful of additional drugs to counteract the side effects of the first.  Stuff to fix the calcium drain from my  bones, to stop the stomach acids roaring up my throat, to fix my blood.  Might take 18 months, advised the GP, to get down to zero.  In the background was the vague suggestions that for some people zero never actually came.  I read about it.  Patients who’d become sufferers in middle age and were still full of prednisolone fear when they were 80. 

But as the taper sloped, ever so gradually, the fear began to dissipate.  The nose bleeds stopped.  The sleepless nights slowed down.  The pain which had taken over all my major muscles never returned.   I got down to 10 and then 5 and then 1.  I stopped carrying boxes of the drug around with me as a bulwark against missing a dose.   Now I’m in new territory, facing days where prednisolone does not feature.  I’m through the sound barrier in a place where anything can happen.   Yesterday I took nothing.  Today a single tablet.  Tomorrow I’ll take nothing again.

Out there are prednisolone free skies.  Ones where there is no polymyalgia and no paranoia.  It’s taken three years.  What will I write about now?  How shall I continue to observe medical practise and report on the NHS?  But, given my age, I’m sure something will shortly be along.

Down, Down, Down

Now at home, sitting in the study, it’s all very different. The Polymyalgia, the PMR, might be in retreat but in its stead hang the dark clouds of prednisolone. I’d been warned. Like the market things can go up and they can also go down. Past achievement is no indicator of future performance. Depression. Have I been here before?

For those who’ve never sat under such dismal skies the word depression no doubt suggests feelings of mild discomfort, of vague unhappiness, of dissatisfaction with the way things currently are. You’ll be okay. Just shake yourself. Get up and face the world. Get out and have a breath of fresh air. Come on. You can do it.

The reality is different. You can’t. As anxiety gives way to caves of dark the head, that part of it that carries conscious thought, seems to switch itself off. The fog arrives. The mind slows beneath its blanket of desperation. The author Horatio Clare quotes Gerard Manley Hopkins as describing just how this is: “I wake and feel the fell of dark not day.” That too is how it is for me.

The blanket wont lift. Dark fallen on it. It lies.

Your friends, your loved-ones, and those around you all say they understand. But they don’t. They really can’t. Unless they are there with you, in the midst of the somnambulant and unmoving smog, where sparks don’t light and nothing sounds.

Back at the doctor’s the GP suggests that my own basic underlying anxiety about Polymyalgia and what I’m going through may be contributing as much as the Prednisolone chemicals themselves. She might be right. It matters little. The fog is still real and the blankets don’t change.

I return home and write some of the most dismal poems I’ve ever managed. Will I put any of these in my next collection? Will there be a next collection? Doubt on both counts.

But there is a part of me, somewhere above the dreary layers, that’s taking note. And that’s a good sign. I work out that the depressions rarely arrive arbitrarily during the day. They are either there when I wake or they are not. And often by the time we’ve moved on to the day following they’ve gone It’s also possible to get the blanket to lift, just a little, by going out there into the bright world and walking vigorously about. I take to cycling the three miles to the top of Roath Park Lake and back, to walking at speed round Waterloo Gardens, and, once, to putting my running shoes on and jogging slowly along the lane. Not a brilliant success, that. Too early in the process. But other and milder forms of exercise seem to work. Just a bit.

Listen to your body is the standard advice. I’ve listened to mine and right now it’s not saying much.

But as the Prednisolone dose tapers the incidence of depression should reduce. That’s the hope.