I went back to the docs today for the results of my first post Ursofalk blood tests. I've been on the Ursofalk for 4 weeks.
The difference was amazing - the alp and ggt are way way down - the dip in the graph is something to behold. I was really pleased with that but very frustrated that there is zero change in the symptoms (except if you count the 'getting worse' aspects of some of my symptoms)
So we talked about it. I told him that the tiredness is overwhelming and that I can't get beyond 11am without needing a sleep. If I fight the sleep, I can't string a sentence together. I told him that I can't read and process information and even if I do manage to read something, I can't remember what I have read about an hour later. I told him that I have been getting very itchy - to the point where I have big scratch marks on my legs.
I haven't the energy to do anything at all - including wee bits of cleaning, socialising walking and if I push myself to do it - and even if I really enjoy it at the time - it wipes me out for days after.
I also mentioned that I have 'new' pain - especially in my bones and joints. I said too that my liver area feels as if it has been beaten with a baseball bat and is bruised.
I told him that what I worry about most is the memory/ concentration/ reading because they are the things that have such a huge impact on me. Until I got ill, I read compulsively and I studied for pleasure. My memory was pretty good - mostly because I love the learning process. I really enjoyed writing assignments and reports and I enjoyed writing outside the study and work environment too. My ambition was to complete a PhD and maybe go on to do social research.
Now though, I can't do any of that because I can't do the reading, processing, thinking and understanding that is involved in constructing an argument. And even if I could construct the argument, I wouldn't be able to remember the argument to be able to construct it. It is the strangest thing - i was never particularly good with numbers though I could blag it or do what i needed to do. But a verbal or written report, even if it was challenging, would have been the source of great pleasure for me. All that is gone.
So the doctor wrote all the symptoms down looked at them and said ' In a list like that, do you know what it looks like? Depression'
My job involves working with people who would be very vulnerable to depression and because it is something that has cast it's shadow over my family more than once. So i am familiar with the signs and symptoms of depression. And I had to agree with him, that when you look at the list, it does look very like depression.
BUT - and I think that it is a big 'but' - I do not feel depressed. I have been there in the past, for a brief time, and this does not feel like depression. In fact, apart from the obvious (and I think quite rational) health concerns related to PBC and the future, I don't think I have ever been happier. My mood is generally good - I have bad days like everyone else but they don't usually last long. I would admit to frustration because I want to have my brain back. I want to be able to go back to work and function in a way that makes me an asset rather than a liability. I do worry that if I don't get my head sorted out that my work will sack me - either because I have been off for so long or, if I go back now, because I can't do the things that are expected of me. But I think that is a worry rather than depression.
I just don't think that I have depression! I think that I feel tired all the time, sore, itchy and stupid. But in spite of that, i feel ok - if you know what I mean.
I should say here that I really like my GP - he is a good listener and not a bit condescending or patronising. He even owns up when he is wrong. I trust his judgement absolutely. I know that if he doesn't know the answer, he won't fob me off - he will check and get back to me. I know that he is going by what is in front of him which at the moment is a list of the symptoms of depression. So I have said that, because I am willing to try anything - and I mean ANYTHING - I will take the prescription for antidepressants and I will go back to him in 2 weeks.
If there is a question in this it is: is depression a common symptom in PBC? OR is it just an 'easy' way to explain away and medicate other symptoms?
Now that I have got to the end of this - I think it was a rant more than a question!