Showing posts with label chronic illness. Show all posts
Showing posts with label chronic illness. Show all posts

Friday, 1 May 2015

A Call to Union

Post written for  Blogging Against Disablism Day 2015, #BADD2015



"Scroungers, cuts, unfair tests", how dare anyone treat us thus, people cry.
"Incapable, unfit, inferior", this is how you make us look, others despair.
"Pain, misery, poverty", why do you refuse to see?, more shout.
"Welfarists, pity seeking, anti inclusion", this is what you have become, some accuse.

"A few" becomes "most".  
"Most" becomes "all".        
Miscommunication, anger, fear. 
Won't anyone stop to listen? 

Fragmented, upset, distrustful,    
We will not have a voice until we do.
Until then "They" laugh and carry on.  
And harm is done to all.



For BADD 2013 I talked about the difficulties we, as disabled people, faced in simultaneously pursuing two goals to fight disablism.
The first was challenging the perception that disabled people are by definition incapable of working, particularly at the highest levels.
The second was challenging the "if you can type you can work" type argument. This meant ensuring that the general public understand that it is possible to be unable to do sustaining paid work and that appropriate support must be in place without social condemnation.

I am sorry to say that we have failed miserably, with unspoken disagreements over which goal to follow and crucially, how to go about it, causing rifts and friction.

What I see around me today are disparate disability "groups" often at odds with one another, unfounded accusations flying back and forth, and increasing stereotyping and disablism, all coming ironically from disabled people ourselves.
Here are just some of the types of things I have heard repeatedly from many different sources.
  • "Disabled people with chronic illnesses feel sorry for themselves and don't want to work"
  • "Disabled people who work look down on those who don't and don't understand what it is like"
  • "All disabled people could work if they really wanted to"
  • "Disabled people with chronic/mental health illnesses who work/go back to work can't have been that sick to start with"
  • "Disabled people with visible impairments have it easy (insert uninformed rant)"
  • "Disabled people with invisible impairments have it easy (insert uninformed rant)"
  • "Disabled people who campaign about welfare have never worked on or know anything about any other issue, and are against true inclusion"
  • "Disabled people who don't directly campaign about welfare issues don't care"
  • "Person A campaigned about Issue B, therefore they think "this" about Issue C!" (argument ensues)
Those of you thinking "but it's true" might want to reconsider the earlier lines "a few becomes most, most becomes all"
A few disabled people -> Most disabled people -> All disabled people
Suddenly one example stereotypes whole segments of disabled people.


This sort of labelling, insults and assumptions would be pounced on and defended against if coming from an outside source. So why are we allowing this to happen?
What is this if not disablism of the very kind we strive so hard to eliminate?

And so, I call for people to pause. To communicate. To try to understand each other's concerns and goals. Most importantly, to unite.
Until we do, we cannot create strong messages and policies which leave no one out, which both enable and support every one of us, whatever our impairments or current situation.

Unless we achieve this, in every sphere of life, be it education, welfare, employment, social care, health, family and social life, access and transport, many new policies will be unfair, unsupportive or even intrinsically disablist.

As a new government is about to be formed, there has never been a better time to get our act together and make our impact felt over the course of the next 5 years.




Post written for  Blogging Against Disablism Day 2015, #BADD2015

Monday, 21 April 2014

My PhD with Chronic Illness

Image description: young woman in blue and maroon PhD graduation gown sits smiling in an electric wheelchair


Chatting and posting on PhDisabled has really made me think back to my days as a PhD student.  Many current sick and disabled PhD students are struggling with issues directly related to disability and illness which have a great impact on their research.

I completed my PhD with both a very visible "disability" and a long term chronic illness.
The disability didn't really impact on my work but, surprisingly was horrifyingly badly accommodated by the university (I have written another entire blog post on the subject!).
My illness on the other hand had a very big impact on how I worked, but luckily I was very well supported by the university.

Adapting to Chronic Illness


The single most important thing was that I had a very good relationship with my supervisor and I made sure that he had a good understanding of my illness. This did mean revealing diagnoses etc. Not everyone would be comfortable doing this, but this was a choice I made and it worked well for me and the supervisor I had.

We had gone over in detail what I could and couldn't do.  He knew in advance that I would NOT be doing a normal working week and that there would be periods of time when I wouldn't do any research.

One thing I soon found is that there is no such thing as "normal" if you are sick.  I needed to forget about what everyone else was doing and concentrate on what worked for me.  It really didn't matter if I did things completely differently to everyone else. Different is never bad per se as long as I get where I need to.  Luckily I had the full support of my supervisor in this regard.

Split Office + Home Working:


My PhD was in Mathematics, so I needed no special equipment and technically could work anywhere. As one of my "disability accommodations", the university allowed me to work from home as much as I liked, even paying for a home printer, laptop and broadband.

When I was "well" or "as good as it gets", I still couldn't work all day. I always felt at my worse in the afternoon and it soon became clear that working at that time was simply inefficient.  Since I was definitely going to have to have time off and there is no official scope for that in a PhD (there is no equivalent to sick leave), I needed to make every single hour count. So I always worked when I felt at my best, regardless of what time it was. Conversely I didn't make myself work when I felt absolutely awful. The quality of the work was generally poor and I just made myself feel sick for longer.

So I started only going into work in the morning and coming home and resting or even sleeping in the afternoons. I would then maybe do a few hours late evening (eg 10pm-1am).
On the other hand I was often up at 3am in pain or with other symptoms. I soon found that that time could be put to surprisingly good use.  I took to jotting down ideas and/or reading "easy" research papers.
As time went on and my illness deteriorated I would alternate days I went to the office. For instance I might go in Mon, Wed, Fri and work fully from home Tues, Thurs.

I asked that most PhD seminars and teaching get timetabled in morning slots. This was mostly done and was of great help to me throughout my time as a PhD student. The location of said seminars was not always so well looked after, but I was very impressed with the way the university accommodated this particular requirement.

Conferences or talks at other universities were extremely difficult for me and I had to rest for long periods after. I worked from home for days after any such event. I went to less conferences and events than my fellow PhD students and as such these were carefully selected to maximise their use and impact.

Housebound: (12 months on and off)


Other times I was housebound but still well enough to do actual research (ie working on my own new original ideas). During those times I plugged away and kept in touch with my supervisor by email and skype.
Roughly 12 months of my PhD were spent this way on and off. These housebound patches were unpredictable. I might be housebound for a week here, a couple of months there and so on and so forth.

The biggest problem here was probably not academic but emotional, mental and social. The lack of contact at the office is obviously very isolating. Throughout my PhD I would always try to go into the office when I could, not really because I needed to for work, but because it was good for me mentally.
Luckily I pretty much lived on campus and was able to get a social life going by inviting people to my flat. This became a regular event with people coming round for lunch and evenings several times a week. This really helped prevent me becoming lonely and disconnected from university life.

Hospital and/or Horribly Sick! (8 months on and off)


There were also times when I was either in hospital or housebound but so ill that original research  just wasn't possible. Those periods were spent doing "background reading". Some of it was even undergraduate or Masters level. If nothing else it kept my brain ticking over. Roughly 4 months of my PhD was spent this way.
This might not have been so bad had it been under my control. The thing is that it happened at unpredictable times: a few weeks there, a month here, a few days there and this was extremely disruptive.

At least 4 months were spent in hospital/recovering and so ill that even background reading was impossible.
I was "lucky" enough to get a very good result (proof of a new mathematical theorem) quite early on in my PhD which meant that my success was pretty much assured from 20 months in. Therefore because things were going so well, my supervisor was happy to let me just rest until I felt well enough to start working again.
Thus I was not required to take a leave of absence, avoiding the bureaucratic and financial difficulties that many sick and disabled PhD students face at precisely the time that they are at their lowest.
I am of course very aware that I was extremely fortunate in that regard and that not everyone would be able to do this.

Success thanks to flexibility but at a cost


Working this way I was able to complete my PhD on time. I think the thing that got me through was easily being able to switch between my 3 different working modes: very sick (home background reading/hospital/recovery), sick (housebound but doing research and in contact via email/skype), "as good as it gets" (research by morning office hours+ home working, + occasional conference/talks).

However I recognise that spending an enforced 8 months doing background reading or even nothing at all, yet still finishing on time will not be possible for everyone. The subject I was doing helped a lot (no lab work + an early "result") and I think this was the deciding factor. I think I would have struggled far more in other subjects, however good I was at them and would have needed time off, with all the financial and administrative issues that entails.

Ideally there would be provision in the system for someone like me who is ill: ability to go part time, extra funding, etc. I would certainly have welcomed it and felt under less pressure. But there isn't. At most you can defer, but are left without funding or support.

Despite the fact that my PhD couldn't have been going any better, I continually felt very much that I was in a "sink or swim" position, and under tremendous pressure to "be well". Ironically this was likely to be counterproductive and make the illness worse. In the later stages of my PhD I had to keep reminding myself that things were going very well and I did have some leeway if I got sicker.

Additionally I was always playing "catch up".  I would be on target and then have a period of bad health and feel that I was behind again. My trick in the end was to try always to be slightly ahead if possible, (as long as I didn't make myself sick in doing so).

This came at a big cost. Although I did have time for a few social evenings as long as they took place at my own flat, most of the time every "useful" waking hour was spent working. The rest of the time I was resting or simply really sick. So although I was successful in the end, it was at great expense, sacrificing nearly all of my leisure time. I imagine this is something a lot of my fellow chronically ill PhD students can identify with.
I think these mental, emotional and physical burdens for sick PhD students cannot be emphasised enough. It is a huge addition to an already difficult task.

After my PhD, when I got my funding for my first research fellowship I did, in fact, go 75% part time. This finally took some of the pressure off at the times when I was very ill and unable to work at all. I also had some time to enjoy a more balanced lifestyle. Emotionally and mentally things became much easier.

If more people with chronic illnesses are to succeed then more part time work and study and the ability to flexibly slip between them should become available. This IS possible and the best example I know of is the one offered in the Dorothy Hodgkin Fellowships. I would love to see more research councils and universities offer similar schemes in the future.


Saturday, 12 May 2012

Long in the tooth

I think I'm going to lose a tooth, or maybe two.

My only chance to avoid this will be to drag myself to the dentist on Monday. Unfortunately I have started a flare and have been flat on my back in bed for the past 5 days. I can't sit up for more than a few minutes, am in horrible amounts of pain, even shakier than usual and other symptoms are playing up which I don't care to mention here. Right now I can barely get to the toilet, let alone out the front door.

Another thing to consider is that dental work is far from easy for me. I have to go to the hospital for it because in the words of my last "real" dentist: "we can't do any treatment on you here because we don't have resuss equipment". This hasn't bolstered my confidence much. Furthermore I have to increase my steroids before even routine treatment such as fillings and regularly have flares afterwards. I am supposed only to have treatment if I am feeling "well" (this is a very relative term).

But overriding these considerations is the inescapable fact that I have 2 teeth which now need urgent treatment.

I already had to cancel my hospital appointment with my consultant gastroenterologist last Friday. I had been on a 4 month waiting list. I will now have to wait a further 5 months to see him. This of course is dependent on me not being in the middle of a flare at the time of that next appointment, otherwise I will have to wait another 4 to 5 months.

I am in the same situation with my teeth. Monday's appointment (May 14th) is actually a cancellation from back in January, which itself was a cancellation from November. In the mean time the holes in both teeth requiring work are getting noticeably larger.

You see, the NHS has a policy whereby any patient who "wilfully" cancels an appointment goes straight back to the back of the waiting list, no matter what the reason. I have pleaded with doctors, consultants, managers and receptionists but to no avail.

The net result of this policy is that the very sickest patients, those who may well, ironically, be too sick to go to hospital, face sitting through the waiting list not once but twice or even three times. By the time they see the doctor the problem is far more advanced and they are even sicker. It is a vicious cycle. Some of the permanent symptoms I have today are due to these delays.

I don't have to lose these teeth. Under a good system I would have been given an appointment when my November flare ended and would have been seen in December. They would have been fixed by now. Instead I face completely avoidable bad dental health.

Likewise I could have been offered an appointment with the gastroenterologist when this flare ended. rather than a 5 month wait. Who knows how much worse things will get in that time or whether irreversible damage will be done?

While I understand that missed appointments cost the NHS a lot of money, penalising chronically ill patients must equally cost the NHS a lot of money in the long run and that is without considering the human cost. I know for a fact that while waiting for one of these delayed appointments, the health problem has reached crisis point and I have ended up being dramatically hospitalised complete with blue flashing light ambulances (although most annoyingly I have always been unconscious at that point and would like to register my profound disapproval of missing such an exciting event).

Surely it shouldn't be difficult to identify those who might miss appointments due to genuine serious last minute health issues. Those patients should become high priority and offered appointments as soon as possible. This would avoid further deterioration of already precarious health.

In the mean time I worry about Monday and the future of my teeth if I don't go and my general health if I do. It is a catch 22 with absolutely no way out.

EDIT: It is now Sunday morning and I am (*whisper*) feeling tentatively a little better (ie I was able to stand up without immediately falling over and I have made it into the daybed in the lounge rather than stuck in the bedroom). I doubled my steroids 3 days ago in the desperate hope that in a fight against time and illness flare the meds might win. Please keep fingers crossed and cheer on the steroids!