Saturday 3 March 2012

The Rise And Fall Of My Blood Pressure

I have always said that this would not be a blog that was about the steady deterioration in my health, but occasionally things that arise in that area of my life have a wider application.  Regular readers will know the following two details: that I have suffered from Type 1 Diabetes for over twenty years and that I have a real bully of a line manager.  Now, hyper-tension, i.e. high blood pressure is an ever increasing condition among the global population especially in the West.  It has a particular impact for diabetics as it can lead to retinopathy, the swelling and bursting of blood vessels in the eye leading to the eye working less effectively and subsequently scarring and potentially blindness. 

Since about 2002 all diabetics in the UK have been prescribed three tablets in addition to any injected or tablet form insulin they take.  One is a mild aspirin to help with the condition of your heart, one is an anti-cholestrol tablet and one is a tablet to lower blood pressure.  When I was first prescribed the blood pressure tablet it led to me 'zoning out' because after the morning rush my blood pressure fell away anyway, so I was put on a lower dose which I have remained with for almost a decade.

When I joined my current job back in June 2011 the Occupational Health unit was in chaos something which still has not settled down and more than eight months since I started, I am still waiting for my initial assessment.  In the meantime my GP, the nurse at the medical centre and the diabetic clinic at the local hospital have all noted how my blood pressure was running high.  This contrasted with my blood pressure for the previous twenty years, bar two periods of being bullied, first by a colleague in 2003 and by my line manager in 2010.  This time they expected it to fall away now that I was in work after a period of unemployment.  Of course, this line manager has turned out to be incredibly self-centred and pig-headed fussing about how everything appears rather than what is being done.  She will not tell you how she wants something done as she assumes her way is common sense, but if you do it differently you are criticised for hours about how nasty you must be to think that that way was acceptable.  This sense that you do things in a particular way with some malicious intent or are constantly plotting to undermine her is clearly not healthy either for her or for her workforce.  Not surprisingly my blood pressure has not fallen.

The latest incident came around me having to go to the hospital.  When you move into a new health authority area they always like to check you out, this is doubled if you have a long-term health condition as I do.  In addition, in contrast to where I used to be treated, this authority has its various facilities spread over 17Km meaning various trips to reach them.  As I maintained a high blood pressure and within six months had developed Grade 2 retinopathy in one eye and Grade 1 in the other (Grade 1 is the lesser) I was called for more appointments than ever. 

ow, the appointments are always during working hours and I get them scheduled early in the morning or late in the afternoon to reduce the impact on my work.  One day when I had three appointments one at a health centre and two in different parts of the same hospital I actually took leave as my line manager whined so much.  I put all the appointments on to my computer diary to which my line manager has permanent access but she complained that I should not expect her to read this diary though she can check it in seconds.

One morning when I was at the hospital she was stamping around questioning my colleagues about my whereabouts.  I had spoken to her about the appointment just the morning before and outlined where I was going and how long it would take and what time I would be back.  My predicted time of return was only out by 15 minutes and that was due to public transport disruption (you cannot drive when you are going to have treatment on your eyes).   Somehow in the 24 hours between the conversation and me being at the appointment my line manager forgot all that I had told her bar the bare outline that I had something wrong with her eyes.  Thus, I get a forceful email going on about how discourteous I had been not to let her know precisely where I was and when.  Of course, I had done that both on my computer diary and orally but neither format was acceptable to her.  I began leaving her copies of the letters I receive from the hospital but that apparently was unacceptable too 'because of confidentiality'.  Given that it is my confidentiality in question, surely that decision should be down to me.  Finally she said I must send an email precisely seven days before the appointment, with the details I have already put in the computer diary.  When I asked why she could not have told me that weeks earlier and why she had to be so indignant about these little issues, she said all I did was make sustained allegations.  Of course, like many line managers she is untouchable so even a anodyne suggestion of the kind I made can be portrayed as 'inappropriate' and something against which 'measures must be taken'.

It can be no surprise that with such capricious behaviour and the fact that she has to make such a grand fuss about every small issue, with extreme language when a simple suggestion 'please do it this way' would have sufficed, my blood pressure is rising higher.  The only solution given that I cannot get my line manager to modify her behaviour and get no-one at the company to take steps to restrain her, was to have my dosage of blood pressure tablets increased.  This proved to be a matter of less than a minute with my doctor.  The outcome brings us to the nub of today's posting.

Fortunately I did not take the stronger dose blood pressure tablets until the weekend.  I guess I probably needed a x1.3 or x1.5 strength over what I had before rather than the double dose as I woke up on Saturday morning feeling incredibly good, too good in fact.  The fish in the tank were beautiful and I found myself staring at them.  At times my speech would wander off and words would just become very long.  This had a great comic effect for the woman who lives in my house as it appeared as if I was on a narcotic.  In myself I felt very different.  My blood pressure has been so high at times that my girlfriend has been able to feel my heart thumping on the mattress when we lie in bed.  In addition, my limbs have felt very heavy and in my mind's eye their flesh has been dark like aged steak, I guess from me imagining all the blood pulsing into them.  Now however, I see the flesh as a whitey-pink and my limbs feel lifted up by balloons.  The other thing is that my work life is not haunting me right through the weekend in the way it did.  The downside is that I have lost a lot of initiative and it took a lot of will power to get out of bed on the Saturday to do all the chores I have to complete.

It seems incredible that I can have an effect like that from something issued for free (because I am diabetic: prevention is much cheaper than cure in the long run) on the NHS. From when I got diabetes I became conscious that never again could I live without medication and that I was fortunate that I lived in a country where this would be for free and was readily available. I am also worried that my peace of mind has become dependent on a medicine, it seems all too much like 'Brave New World' (1932), 'a gramme is better than a damn' in reference to the drug soma which features in that story.  As an aside, the answer on Ask.com about that quotation is completely wrong.  I want to be able to build my own happiness rather than have it prescribed.  Having spent weeks in counselling as a result of my line manager's behaviour I was able to reduce the worst impacts but clearly not completely free myself of them.

I am glad that I can reduce my blood pressure and hopefully head off serious damage to my eyesight.  However, I am also dismayed that I have not ability to change my working context in order to prevent me facing this kind of pressure simply due to the quirks of a single person who never seems to never have to answer for her actions despite the fact that they cause so much trouble not just for me but a range of staff; a colleague in my department under the same manager has had a heart attack and a stroke most likely provoked if not caused by the manager's treatment of that person.  The consolation is that with these tablets at least my free time is now time off from the burden of working in that context and that, I feel will have a cumulative effect in that I can forget work and really recharge rather than struggling to free my mind of worries about what will be the petty issue my line manager is going to harangue me about for weeks to come.

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