[speaker001:] There's nothing wrong with those. They're perfect. Absolutely perfect, now
[speaker002:] Why is she
[speaker001:] erm
[speaker002:] getting her
[speaker001:] Well she thinks you're on a high dose, you're not, you're on an okay dose. Now we've had you w That's right. We're we're waiting inn here we we're still on three months so we're alright. So mid October, so we've actually
[speaker002:] Mm.
[speaker001:] got a a a while to go yet before we decide what we're going to do with that. But your levels are perfect, okay, it's got nothing to do with lithium.
[speaker002:] No I I think it's just a really bad case of M E again.
[speaker001:] Yeah, yeah. Well she she told me that your M E type symptoms had got a lot worse and I said that's we had at That's what I chatted with her about the other day but
[speaker002:] I've I've been really housebound for five
[speaker001:] Mm.
[speaker002:] weeks now,
[speaker001:] Yeah.
[speaker002:] and it's driving me mad. I I'm
[speaker001:] Yeah.
[speaker002:] you know I feel just
[speaker001:] Mm.
[speaker002:] dreadful.
[speaker001:] Yeah.
[speaker002:] But it but it is typical M E symptom.
[speaker001:] Well that's right, a sort of low achy, tired, tired
[speaker002:] Yeah.
[speaker001:] and more tired.
[speaker002:] That's right and I'm very depressed.
[speaker001:] Yeah. Are keepi You are I mean obviously you are keeping yourself going cos you're obviously getting out to come here and do bits and bobs but
[speaker002:] Well this is the first time I've been
[speaker001:] Yeah.
[speaker002:] able to come here on my own.
[speaker001:] Yeah.
[speaker002:] Erm and that's not like me, I usually manage to you know.
[speaker001:] [sneeze] Now you're usually okay, aren't you?
[speaker002:] Yeah but er it really has knocked me for six this time.
[speaker001:] Mhm.
[speaker002:] Erm I think it's probably that infection that I had er
[speaker001:] Yes. It may well be.
[speaker002:] That thrush or whatever it was.
[speaker001:] Yeah. Yeah.
[speaker002:] Er it takes very little, well you know yourself
[speaker001:] Mm.
[speaker002:] don't you?
[speaker001:] Yeah.
[speaker002:] I mean I found it in the past, you know any infection what so ever just knocks you for six. And and I'm just, you know, I I think that's probably why Jo was
[speaker001:] Mm.
[speaker002:] c I think I she'd seen me at my worst on Friday
[speaker001:] Yeah.
[speaker002:] And and
[speaker001:] Yeah.
[speaker002:] I think it worried her a bit.
[speaker001:] Yeah. Yeah. But er your Lithium levels are absolutely fine. They're almost exactly the same as you were four weeks ago.
[speaker002:] I thought they were actually cos I I even at that part of
[speaker001:] Yeah.
[speaker002:] it it felt
[speaker001:] Yeah.
[speaker002:] erm
[speaker001:] Yeah. Yeah.
[speaker002:] normal.
[speaker001:] Yeah. Good
[speaker002:] I mean the headaches are I'm reluctant to say [LAUGHTER] better [] [LAUGHTER]
[speaker001:] Yeah, but not so
[speaker002:] But
[speaker001:] bad.
[speaker002:] but they're certainly no not so severe.
[speaker001:] Yeah. Do you find they respond better if you take Dihydrocodeine when they're there as well?
[speaker002:] Yes.
[speaker001:] Yeah.
[speaker002:] Yeah
[speaker001:] exactly what I's expect and you may find they actually sort of are on a down-slope still. And maybe it's a very shallow down-slope but still on a down-slope.
[speaker002:] Mm.
[speaker001:] And that's what I'd
[speaker002:] I do actually feel better. I I eat I don't usually take my first lot of tablets till sort of around dinner time. And I find sort of about an hour or so afterwards I do actually start to feel
[speaker001:] Anyhow we're g we're gonna summarize your Lithium in October of course, that's
[speaker002:] Mhm.
[speaker001:] And that's fine. What I would Apart As far as the levels are concerned I'd check them again in Septem Erm no hang on we've just checked them. I'd probably check them in October again. Two months, cos you seem stable.
[speaker002:] Two months.
[speaker001:] You seem st Unless you get any particular
[speaker002:] Mhm.
[speaker001:] to it I would recheck that in October. And then when we see you then we're going to sort sort of summarize what three months on effected levels of lithium has done for you. To decide whether to continue.
[speaker002:] Is it a drug that you can stay on?
[speaker001:] They've got people who've been on it for years and years.
[speaker002:] Mm.
[speaker001:] You've got to keep checking the level.
[speaker002:] Mm.
[speaker001:] It it's a funny little drug it's related to sodium, old sodium, you've got loads of sodium. You take it it everyday as with salt. Er but i i it can replace sodium in certain systems of the body. In fact that's how it seems to work. But because of that you've got to watch it's effect on the kidneys, on the body biochemistry.
[speaker002:] Mm.
[speaker001:] So that's what we have to check from time to time.
[speaker002:] Mm.
[speaker001:] But it's very very safe provided you keep in within the sort of dosage Like driving on the motorway. It's safe if you st stick to the speed limit.
[speaker002:] Mm.
[speaker001:] Usually.
[speaker002:] Could you give me some more of that hormone cream?
[speaker001:] Yes. I was going to ask how you'd gone with that.
[speaker002:] Well it's better but it's not right.
[speaker001:] Yeah. Yeah. Well you've only
[speaker002:] Mm.
[speaker001:] been on it a fortnight.
[speaker002:] Yeah.
[speaker001:] So er but
[speaker002:] Find I'm down to using it twice a week now.
[speaker001:] Twice a week. Yeah.
[speaker002:] So I haven't
[speaker001:] Yeah.
[speaker002:] used it this week.
[speaker001:] Alright, okay. yeah.
[speaker002:] But it's certainly an improvement
[speaker001:] Yeah.
[speaker002:] to what it was.
[speaker001:] Oh good good. I mean the advantage of that is you get loc You get the local benefits without generalized side-effects.
[speaker002:] Mm.
[speaker001:] Er and that can be a problem with some folk when you try to manipulate the hormones like that. But I'm actually using more and more of this cream, as I realize that er if you direct it towards the right part of the body in the right people,
[speaker002:] Mm.
[speaker001:] it works extremely well.
[speaker002:] As I say it's just erm overall feeling generally
[speaker001:] Well i mean
[speaker002:] horrible. [LAUGHTER]
[speaker001:] And you know to some extent it's just time and keeping yourself ticking over that's going to get that aspect of things better.
[speaker002:] Yeah.
[speaker001:] And that's frustrating for you and it's equally frustrating for me because I know there's absolutely nothing I can do
[speaker002:] That's right.
[speaker001:] to effect that. But it's important we keep other An eye on the other things, keep other things ticking over and things like the hormone cream and the lithium will be a help in that.
[speaker002:] Yeah. I mean sometimes just by resting really er you know puts me back again but er it hasn't
[speaker001:] Yeah yeah. Don't overdo the rest.
[speaker002:] Well I were going to say i can't rest. [LAUGHTER]
[speaker001:] You've got to find a compromise. I mean it's it's always a com I mean the whole of life is a compromise but especially with this. the compromise between resting when you feel very very tired, and keeping yourself going so you don't seize up.
[speaker002:] Mm.
[speaker001:] But you can't overdo the mobility cos you get very very tired.
[speaker002:] Yeah. Well I've been you know, very conscious of that. And I and when you've had it a long time you
[speaker001:] Mm.
[speaker002:] become And I'm not the sort of person to sit around willy nilly any way.
[speaker001:] [cough]
[speaker002:] But my legs [LAUGHTER] My legs are [LAUGHTER] like jelly, my body's like rubber, you know. [] And I sort of Oof. [LAUGHTER]
[speaker001:] [LAUGHTER]
[speaker002:] Ooh I get so mad.
[speaker001:] Keep other bits of you going. Okay?
[speaker002:] When When do you want to see me again?
[speaker001:] Well. All else being equal, I would say October with the lithium level and then we're gonna have our review of lithium. Okay? If anything flares up in between that's fine. There should be enough cream there now for four to six weeks on a twice weekly basis, but if you run out just give a ring in.
[speaker002:] Right.
[speaker001:] That's fine.
[speaker002:] Well I'll need my other tablets
[speaker001:] Yeah. Well of course you'll need those anyway.
[speaker002:] So er [tape change]