Life through the eyes of a 30-something Panda Woman who happens to be Chronically Sick and Disabled.

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On Comorbidities

Chronic Illness Cat - Co-morbidities

In medical terms Co-morbidities are illness and disorders that you have that may or may not be related and/or overlap.

In medicine, co-morbidity is the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder; or the effect of such additional disorders or diseases. The additional disorder may also be a behavioral or mental disorder.

In medicine, the term “co-morbid” can be either medical condition(s) existing simultaneously but independently with another condition; or it can indicate a related medical condition or conditions. In psychiatric diagnoses it has been argued in part that this “‘use of imprecise language may lead to correspondingly imprecise thinking’, [and] this usage of the term ‘co-morbidity’ should probably be avoided.”

In patient terms this means “we are complicated”. For instance I have to see consultants in the following fields:

Gastroenterology For IBD mainly but my Gastro also keeps an eye on my health in general
Neurology For chronic headache and migraines. This should also include Fibromyalgia but my guy isn’t a specialist in that field
Endocrinology Currently looking into Metabolic syndrome, Polycystic Ovaries etc
Bariatrics Because I’m not just Co-morbid, but also morbidly obese
Psychology For bipolar disorder, anxiety etc
Rheumatology The catch-all for everything else. This includes M.E., Ehlers Danlos etc
GP The poor guy that has to keep track of all of this plus my non-specialist stuff like Asthma, Hayfever, allergies etc

So today I saw the Gastroenterologist and he had a medical student with him. As usual he starts explaining my case and asks what the guy knows about “Chronic Fatigue Syndrome“. The student replies talking about fatigue that last longer than 6 months etc, an exclusion syndrome (i.e. only diagnosed by excluding the other options first) yada yada yada. When he’s finished I update him with the latest. That the americans have decided to rename CFS to SEID (Systemic Exertion Intolerance Disease). OK so that kind of explains the symptom set better than Myalgic Encephalomyelitis to the layperson, and the use of the word “disease” is important as it shows that there is a physiological cause rather than simply a set of symptoms. I update the student that there is now a test for M.E. using buspirone (which I’ve only just heard of recently myself). The consultant smiled as the Student looked shocked to have had medical knowledge given to him by a patient. But this is the crux of it. As a patient with co-morbidities the best chance you have of getting the best treatment, management and care is to be an informed patient. To really get to understand and research the basics of medicine and the details of your conditions. Your neurologist may never have had experience in gastroenterology and sometimes they need to know about your other conditions. Sometimes for diagnosis, exclusion, understanding test results etc, but most often when prescribing. A doctor needs to know how the medicine he wishes to put you on may affect your other conditions or interact with your other medications.

A long while ago I reached a point where many of my consultants wished to prescribe medicines to me but were too concerned about the holistic effects they might cause. I ended up having to research all of the medicine options myself, compiling a spreadsheet with interactions, contraindications and potential side effects. There were iirc 40+ medications on this spreadsheet. I then rated them on how willing / unwilling I was to take them, and took this spreadsheet to the GP for him to decide. He was impressed and relieved as his area of medicine does not cover such complicated patients. We do not have diagnosticians in this country (unlike America’s House MD style doctors). Between us we decided upon 4 medications to start the base of my cocktail and over the years we’ve been able to adjust this as appropriate.

To conclude, being co-morbid isn’t just unlucky it’s tricky. Your best bet is to be informed and know yourself. You will know when a new symptom is likely to be linked to an existing condition or when to go and see your doctor.

May the spoons be forever in your favour.

Cubb

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