DWP Appraisal Hell

I’ve not written (speech recognition of course) a blog for a while, mainly because I feel like I’ve had nothing to say, despite having plenty of things I’d like to write about. I got hit by severe depression in mid-October. Things have become better recently, but first a negative event I experienced.

A few days before Christmas I had a DWP appraisal, even though I’m not getting any money from benefits. The whole event was sickening, I don’t just mean metaphorically but also physically. I don’t think giving a detailed narrative is a worthwhile thing for me to do, and I imagine it would not be for anyone to read, but there are few things that stood out.

The first thing that struck me upon arriving at the site was how much like a prison the setup was, with a massive security fence and guards. The building entrance has a bizarre double door system, at least it had automated doors for those people that are really struggling physically, but the short corridor took up valuable room space, since the waiting area is split into two weird and quite small sections. Upon arrival people are informed that they are likely going to be waiting for over an hour, and given how they were already behind yet it was early morning, they could be waiting up to 2 hours. Given the uncomfortable claustrophobic waiting area that was quite unappealing.

bureaucracy

Upon arrival every person seems to be surprised by this information, and several people had to cancel their appointment due to time constraints. The receptionist repeated the same few statements to each person about how the system is not their fault, and that they appreciate that a person may have to leave and schedule a new appointment. A man in a wheelchair arrived and was even informed that his appointment had been cancelled, although no one had actually contacted him to explain this, and the reasons given were classic examples of bureaucratic mismanagement, along with repeated statements by the receptionist that it is not their fault. It is easy to accept/agree that it is not the receptionist’s fault, but the fact that they are acting like a dismissive robot is their fault. I guess this is a learned behaviour given their job, and I can appreciate they may be used to receiving nasty comments, but they should at least wait for some before being so defensive, and dismissive.

Since I had walked a mile to get there I was already feeling the physical impact, and added to this was the fact that I had not slept for over a day due to the usual severe pain. I suppose I could have asked to reschedule, but I didn’t see how the next time would be much different. Sitting for a length of time escalates my pain, and can result in an inability to even sit due to my nervous system demanding that I stop doing the thing that is causing my pain to spike, it’s a weird retracting pain, the urge to move away becomes overwhelming, but obviously I can’t move away from my own body. Standing up or lying down at least changes things for a while until they become deemed to be the enemy.

sleepdepr

Eventually I was seen by a physiotherapist, which was the first sign of trouble, since a key part of my problems, and long-term domino effects is sleep deprivation and thus the psychological impact of that should be considered, not just the physical. The interview proceeded to become a bizarre movie like style of being interrogated by stupid cop, who repeated the same questions, yet lacked any comprehension of what the answers meant. I was asked about my sleeping pattern, since I had written about it in my overview. I explained that I don’t have one due to the constant ongoing pain, which sometimes becomes unbearable and overrides even exhaustion, which over the last year and a half often resulted in missing huge chunks of sleep over the week so that I became so exhausted I could get a few hours sleep, and then probably not sleep for another day even though technically that means I’m down twelve hours. Then after a few weeks of this I would manage to get more sleep for a short-while, before the erratic sleep returned. I had to explain that I have had sleep deprivation problems continually, yet it still didn’t sink in, they then asked me what time I set my alarm for this day I explained I set it for nine but then highlighted that I hadn’t actually slept so they said “so you pattern is normally what nine then?” I genuinely had to resist the urge to scream at this person, instead I managed to yet again explain the situation using simple clear words. It was odd, instead of acknowledging this answer I was asked a bunch of weird questions about my how I use an alarm, and how I use a mobile phone. This then turned into further strange questions, which indicated the person didn’t believe what I was saying about not phoning people. This went on for quite some time, and towards the end I realised how much time jumping they had done in regards to trying to piece together a timeline, even though they had a detailed explanation written out in front of them from the four I had filled in previously.

sleepdep

The thing I take away from this interview is that it very much seemed like I was having to prove that I was innocent of committing fraud, that they were trying to trip me up by asking the same thing repeatedly, that they were desperate to find anything to latch onto to prove I was guilty of lying, such as the bizarre mobile phone questions. And then abruptly the interview ended and I was dismissed, at this stage the person had no interest in any further conversation, and was already trying to herd me out the door. Crucially there had been no questions about my psychological state, which given the symptoms should have been a key part of the interview. As I mentioned above, the gravitas of my situation finally hit me in October, the fact it been well over a year, and at this stage I had been suffering from depression for the last two months; it has been pointed out to me that my idea of depression and other people’s has a scale of difference, being fatalistically optimistic and the fact that I’ve had long-term pain of a different type for twenty years, I view depression as an inconvenience, and what I call depression others would categorise as major depression. Having a degree in psychology I am also academically aware of things, including the difficulty of self-diagnosis, and how our beliefs and biases influence our thoughts. I had been given medication to help with the sleep problem, and to help fight off depression, this was an area highlighted by my doctor; in hindsight I should have emphasised it.

If I had ticked the box regarding depression then I am sure I would have been allocated a doctor and not a physiotherapist for the interview, and some of the questions would have been about the psychological impact of my condition. I can at least acknowledge that my involvement is part of the reason why things went the way they did, of course considering I had written about being massively sleep deprived you’d think an assessor would highlight that issue.

Due to how physically demanding the whole event was, and the fact it lasted several hours, my pain levels later that day were a staggering fucking nine for several hours, before dropping back to my normally horrific six or seven. This is on top of the fact that I had not slept for what was approaching two days. Painkillers and alcohol didn’t do anything to the nine rating. I guess my body was flooded with cortisol both from the psychological interrogation as well as the scale of physicality I am not used to.

Miraculously four days later, on Christmas Day, I experienced several hours of a pain level of only one or two! Unfortunately that did not last, and even in to early January I was still probably averaging a six rating.

The shoulder and neck physiotherapy session have ended, I am still carrying out the exercises, and it does seem to have helped a lot. Having started physiotherapy for my stomach, back and hips it seems like the intense pain in my right midsection is starting to reduce a bit.

So once again my thoughts are flooded with daily ponderings about returning to exercise of a more tangible level, and even going back to martial arts in a few weeks, primarily BJJ. Realistically that goal is way off, even if things start improving faster, but it’s nice to have hopeful thoughts and even an anticipation of setting a simple goal. Next time something less depressing.

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When Pathetic is not Pathetic

Since leaving my job due to my health I have felt almost no stress (until I ponder things in the future, so I mostly don’t), and this has helped relax the pain in my neck and shoulder. Doing much of anything is still too much, and doctors have repeatedly emphasised complete rest is the most important thing, continuing my estimation game for when I can do more. Due to this I decided to not even force myself to finish a particular blog. This helpfully allows me to do something I enjoy: starting a whole load of things, mentally being happy with the direction, but not physically finishing them. Whilst I am financially paying for myself to rest, I decided that getting the most rest, to quicken healing, really is still the priority, because then I can return to actually doing some work.

As part of my continuing focus on resting, I have even avoided doing much dictation by speech recognition. I have a massive mental list of blog posts I have pondered writing for a while now:

  • role-playing articles
    • working at KJC Games
    • game design lessons
    • more gaming stories and the lessons I learned
    • my obsession with White Wolf
    • why GURPS is the best thing, yet I’ve never played
    • tidal force role-players
  • the difficulty of doing nothing,
  • energy levels and how to plan around them
  • chronic pain
  • martial arts
    • returning from injury
    • consideration of training partners when you cannot work at your old pace
  • NoobGrind articles
    • Various thoughts about gaming
    • Guild Wars 2
    • Path of Exile

There is an additional reason that I am avoiding finishing any blog posts, since I envisioned graphics that I feel really add to the articles. The problem being, whilst I can make art and graphs to at least an adequate level, they are not areas that I practice much, so it would take me a long-time to get things to a level I am satisfied with. This links to an issue of sitting at a computer for an extended period, I normally have pain in a variety of places, and thus it is not good for my body, nor is it me resting. Pathetic sounding, but it is the reality of my situation.

I’m also aware that my wanting to have graphics for a blog post, it is me entering into the dangerous territory of pushing these partially started articles towards needing to be near perfect. In a way this justifies me not having to do what I can, and then move on.

Graphics Needed
Well, it is still nice to have some graphics.

So I decided to write the above stream of consciousness, at least then I am writing my intent in regards to what I will be blogging about soon, and I don’t need graphics. Whilst I could again use the word pathetic, that should only apply if I was healthy and avoiding doing work. If your best is barely anything, and you are still managing to get bits done, then that is not pathetic.

Health: Cortisone, Writing Motivation

The cortisone injection last week went well, with the doctor successfully injecting the area on the first attempt. The pain of the needle going in was not that bad, I was reading SuperBetter on my Kindle during the process, to help distract me from the pain, it did help a bit. Then as the injection of the fluid occurred the pain skyrocketed, it felt like a large object landing on the area; the doctor said that this could be a good sign, as it indicates that the injection had hit the right area due to how sensitive it was.

My body had an immediate reaction to the amount of pain, I started sweating a lot and nearly passed out. However, the experience sorting out my damaged right ear was far worse, so to anyone reading this due to worrying about their own cortisone injection I’d say yes it will be painful, but you will handle it. The pain experienced for the next two days was more like how the shoulder pain had been a few weeks ago, so not a big deal in the grand scheme of things.

6-TR07 FIGURE 4
Example of shoulder injection

Writing & Motivation

Whilst things had improved a little bit I have still lacked motivation to do much, as well as still needing to prioritise doing nothing. So despite receiving positive feedback about the Kaizo Trap and Cyberpunk articles in particular, I have not finished any articles for a few weeks, and I had planned follow-ups on those previous articles. At least I have had time to think about them, but after making a few notes, I then don’t have the urge to continue. Considering I could ramble on using speech recognition whilst in bed it would seem easy enough, but I just didn’t want to, until today when I got so frustrated I decided to ramble a bit.

One of my coping mechanisms whilst resting up has been watching all sorts of videos, I have written a NoobGrind article about Gaming and Disability: Value of Video, which as per normal for me turned into a thousand word piece. I hope to be able to maintain motivation and get back to writing articles about role-playing games and my professional experiences.

What’s Next?

I have another doctor’s appointment today, and I will need a further sicknote extension for hopefully just a week or two, and then maybe the injection will prove to have been effective. As mobility has improved I have been at least able to do a tiny amount of yoga and tai chi, and I hope that this progress will help trigger further strengthening without interfering with the current healing by re-aggravating something. I am still having to hold off at attempting anything Brazilian Jiu Jitsu related.

As pain reduces and health improves, I expect (hope) motivation will return. I guess if things don’t improve then I will have to change mental gears anyway. SuperBetter is helping, but I will write about that another time.

superbetter-toolkit
SuperBetter by Jane McGonigal

Cortisone, Future Health & Physiotherapy

At the time of writing this I am a few hours away from having a cortisone injection in my left shoulder. The swelling from last year finally started to reduce a few weeks ago, and has nearly gone. The constant pain from the left shoulder, to back of the left shoulder blade, and then up my neck has only reduced a little bit. Although doing more than nothing still quickly increases this pain.

I received whiplash a few weeks ago during an emergency brake, even though it was not a particularly dramatic incident. It just shows how susceptible a person with a weakness is to injury.

My current sick-note is due to expire next Monday. It is hard to estimate whether the cortisone injection will give such a rapid improvement in 6 days, but hopefully it will.

I expect the injection to hurt, and whilst it may not help, I think it is worth trying at this stage. A few weeks ago I read a few articles and research papers on the subject, for example:  http://overhaultraining.com/cortisone-injections/

One of the things I kept reading was how key physiotherapy is, regardless of having cortisone or not. Since I desperately want to be able to exercise again, partly because I miss Brazilian Jiu Jitsu, and partly because I have put quite a lot of weight on, the sooner I can start exercising a lot more the better. I have been doing some very simple exercises, small shoulder and neck movements, as well as short works of a mile or two. However, I was advised by three doctors that doing more than this currently is not advised.

The trouble is determining when can I start to do more? Sensibly a few more weeks of basic movement is what I should stick to, and at the moment I am considering re-joining a local gym to get access to the swimming pool, sauna and spa. I am aware it is better to be sensible then do too much and quickly aggravate the injured area again.

40th Birthday

I recently celebrated my 40th birthday, which despite the chronic pain was still an enjoyable day, and it’s nice to write about something positive. I do not put any particular emphasis on specific days, since I try to treat every day as special, but I appreciate that some days are more special than others. I had a small family get-together; we enjoyed a tasty collection of Chinese food and a bit of cake. Technically this had been my breakfast since I had been up the previous night and slept most of the day, as once again my sleep cycle was out of sync.

Whilst I don’t expect presents from friends or family I do very much appreciate gifts. Although I am not much of an alcohol drink normally I have recently been using it for medicinal reasons, roughly one or two units a day, so it was nice to receive several different drinks. The wife bought me an amusing present, a collection of treats in a bin; I have mentioned needing a small bin for my new room. The nice secondary joke being that a large collection of sweets is rubbish for my diet, but at least I’m generally good at rationing out treats.

I have been contemplating upgrading my PC for a few years, and have received money towards this. Thankfully I have a powerful enough PC, and I have not needed to upgrade my CPU, memory, or motherboard for years. As the requirements for high-end PC games have lessened over the last few years, in part due to so many games being made for consoles, the hasn’t been a need to upgrade; yes there are games that demand more resources but I don’t particularly care about playing Crysis in maximum specs. Due to resting and avoiding computer use I don’t particularly need a more powerful system, but speech recognition software like Dragon NaturallySpeaking does benefit from having more system resources, so have recently been looking at a more powerful system.

To PC or not to PC.

About a year ago I had been contemplating having a big celebration; my sister had one when she turned forty, and that was a fun evening. I had pondered the idea of asking to use the ITC gym (Sukata), since a lot of the people I would have been inviting train martial arts there, in particular Brazilian jiu-jitsu (BJJ). Although I was not one of the club superstars, I do like to think that when I was healthier I was a good training partner, which is an invaluable asset for the more talented, healthier and dedicated practitioners. Hopefully I will be back training and healthy for my 41st birthday, and if so I can have a large party then.

Although I have read dismissive comments about how irrelevant or pathetic a Facebook or email message saying “Happy Birthday” is, I disagree. Even a short message takes time and effort for somebody to do, and whilst it is possible to set up a script to automate sending emails to people on the birthday, it is not something that the general person would do. This is why I appreciate the effort.

This blog post nearly ended up being about the placebo effect, but I decided to separate that information for a future post. In the end was more a collection of thoughts about how my life is not all bad.

This was written (dictated to) listening to the splendid new track by Leslie Wai, a cover of Modern Love but with some great tweaks. He is the wizard behind the Kaizo Trap music. I have blogged about Kaizo Trap before, and I wrote an article for NoobGrind about it.

Music: pain management and mental health

Due to being bed ridden I have been listening to more than I normally do, and I normally listened to a lot! But before I get to the science, music and my love of all things Anathema, first an update:

The ongoing chronic pain in my left shoulder and neck resulted in me losing two of my major passions months ago: martial arts and computer gaming. For months my thoughts have been dominated by pain, and any attempts to estimate when I can return to these two hobbies is impossible to compute, further frustrating my current mind-set. Like so many other people facing major injuries/illness, looking forward to things improving is an important part of maintaining morale; not being able to do so is horrid.

I have already experienced having to make a difficult life changing decision due to the development of permanent repetitive strain injuries in my wrists. Years ago I had to stop playing competitive real-time strategy (RTS) or first person shooter (FPS) games due to the intense twitch-based requirement to compete.

It is accepted that general exercise can help regulate mood, and active distractions such as electronic gaming can greatly help in pain management. 1

I am trying to spend as much time in bed as possible doing nothing, to limit aggravating my injury, and so I will heal faster; I’m barely even walking. So in addition to losing two of my hobbies, they are additionally things that would have generally good physical and mental health beneficial effects.

Fortunately I at least have music listen to, and this still provides a distraction from pain2; whether this is due the power of imagination with the music taking the listener on a virtual journey, or due to specialised brain regions triggering dopamine release, it is not understood currently.

It is commonly accepted that music has a powerful impact upon our mood, as well as being a crucial aspect of society. Since music is so personal it is tempting to think that our individual relationship with music, or the musicians, is unique. I appreciate the reality that our own experience is specifically unique, but in general not rare given how many people there are on the planet. I think this is a more grounded way to view things, especially when you hear about people who hijack everything about a song and even argue with a musician about what a particular track actually means, telling the musician they are wrong about their own version!?

I like to consider that I have a broad taste in music, but unsurprisingly I definitely have my preferences. One of my big influences at 16 was Doom Metal bands like Anathema, My Dying Bride and Paradise Lost; an honourable mention to Black Sabbath for their great tracks in this genre previously. The reason for writing about Doom Metal is that I saw the following post:

Doom research

I love so many bands/musicians, but in particular Anathema. If I had to pick they are my joint favourite since I also adore New Model Army with an intensity I find shocking to myself.

I first saw Anathema after the Serenades album came out at my local rock club in Blackpool called The Tache, I think it was in 1993. Most of my night club mates had diverse taste in music, although they preferred the metal scene, so it was no surprise that several of them could be listening to an acid house track one moment, then listen to pop, punk, death metal, etc. without it being a big deal. At the time Doom had the potential to blow up, with Paradise Lost doing great , given that Metallica was suddenly a global giant and Guns N Roses were in the mainstream it seemed oddly possibly Doom could become massive. Never mind the interesting diverse Industrial bands like Ministry Psalm 69 seemed like it was about to be massive, or the quirky but cool G.G.F.H. was being discussed; I recall discussing the potential of a band merging Doom and Industrial sounds.

Serenades

Quite a few of us were really into the Anathema – Serenades album, in part due to the surprisingly diverse nature of the work. The creeping sounds at the start of “Lovelorn Rhapsody” sets the tone for the album well, and builds in to what could be considered a quintessential Doom Metal track; a slow intense almost frustrating build towards something more layered, then reaching a more head-banging worthy pace for the last third.

The much beloved track Sleepless could be badly described as if The Cure made a Doom Metal track, but then got frustrated at their style change, before deciding to fully commit to the project; I mean that as a compliment, it’s a great track, and hints at what Anathema will evolve in to.

The track “J’ai fait une promesse” has a particularly special place for some of the people that were a year or two older than at The Tache, this is because a regular had died of cancer and this track was played at his funeral. I recall this tracks placement in the album was somewhat debated, some finding it to out of place, others loving the difference and the fact that why shouldn’t it be there.

I have offered to help Selim with his project. Between painkillers, alcohol and reminiscing I’ve not felt so bad tonight. For me there is little like listening to Anathema on repeat to make me feel better, but I will write more on them (via speech system) another day.

1. [“Electronic Gaming as Pain Distraction”]
2. [“Superior Analgesic Effect of an Active Distraction versus Pleasant Unfamiliar Sounds and Music: The Influence of Emotion and Cognitive Style”]

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RSI update: Shoulder and Sleeping

My medical situation in November deteriorated quite rapidly and I ended up pretty much bedridden for six weeks; despite my wish to return training as explained in Martial Arts and Disability: my situation. The RSI affecting my left arm had mostly subsided, however due to trying to use my left arm to compensate for the RSI in my right arm I developed RSI in my left shoulder. Due to the damage to my left hip, and the fact I have to sleep face down pinning it into place, this meant that I was also further antagonising my left shoulder. Taking a lot of pain medication did enable me to get sleep, however, as it was masking the problem I would usually wake up after only a few hours in a lot of pain and be unable to get back to sleep for a while. After a short while my neck had an intense pull on the left side, which then escalated as I had to adjust my sleep to my lower back being pulled out of alignment as my left shoulder and hip caused massive sleeping problems.

 

The pain I experienced over the last two months has been the worst in my life. I have had broken bones, the pain was extremely intense for a short duration, but thankfully improved over time. The pain from the RSI in both my arms could be somewhat tolerated by hugging myself, which changed the pressure in the arms. Obviously pain is a very subjective thing; different injuries have different effects, never mind the differences between people. For example the intense burning pain I had in my left arm from elbow damage, followed by a chemical reaction from Witch Hazel that I believe had seeped through a bit of tissue damage via my eczema, but was nothing in comparison to my left shoulder.

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Left elbow June 2015
elbow 20150614 3
Left elbow June 2015 after Witch Hazel
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Left elbow June 2015 after Witch Hazel, massive swelling

 

Over the last few weeks I have radically altered my sleeping setup and managed to find new sleeping positions. The pain has reduced from agonising to the halfway level of ‘bloody annoying’. With the somewhat improved sleep and reduced pain my thinking has cleared up somewhat, and I feel like I can at least attempt things again. I walked a short distance into town tonight, had a meal out at a buffet and then walked home, this pathetic amount of exercise proved to be a bit of a challenge and my left shoulder and lower back particularly hurts at the moment, which is worrying since I returned to work in the morning!

The following pictures show an experiment I tried using a massage table as a bed to help keep my left hip pinned. The idea was that I could help limit spine rotation by lying face down, plus pad the shoulder area. However, they are not comfortable things to lay on for extended periods.

Massage Bed 1
Massage Table experiment 2015

 

Massage Bed 2
Massage Table experiment 2015, screen beneath
Massage Bed 3
Massage Table experiment 2015, underneath showing monitor lying flat aimed at the face hole.

Exercise is going to be a tremendous challenge for the next few months. I have to fight the urge to do anything other than the few very basic physio exercises I have been instructed to do, because I am not even healed at the moment, but I do need to do something to help with the healing. The weight that I lost in 2014 and up until June of 2015 has since been put back on, so I also feel bloated, sluggish and my trousers don’t fit. So it looks like another month of no martial arts, although by the end of the month I should be able to do some sport specific exercises, and hope to do some very light Brazilian jujitsu training in February.

 

At least with my mind clearing my caged frustration can be channelled towards productive things. I will return to BJJ, but as long as I am sensible I can hopefully not have to immediately take another injury break!