Strands 2

One

My new pharmacist is lovely. Yesterday I had a medicine review with him, and he is kind and encouraging. He complemented me not just on my inhaler technique, but also on the effectiveness with which I control my other symptoms. I no longer dread collecting my prescription every month.

Two

Since I began counselling, I have developed a number of new techniques to help me to cope with everyday life. I have a diary to write my thoughts into, so that I don't dwell on them at bedtime. I drink hot chocolate to help me relax. I have a morning schedule and a night-time schedule. I give myself points for every good thing that I do in a day - even something as small as feeding the cats or doing the washing-up. My current high-score is 30.

But most importantly, I have thrown myself into my hobby - crochet. I have started to sell my creations online, and it stops me from feeling useless, even on my bedridden days when nothing else makes sense. There is a book on crochet and depression that I am eager to read when I have the money and the time.

Three

I have started going to gigs again, meeting up with friends and adding old acquaintances on Facebook. I've started to feel that perhaps I may not appear to be such an idiot as I once thought I did. One of my particularly close friends from my university days has a habit of playing Cupid amongst her particular circle of friends, and upon hearing that Leo and I are amicably separated, decided to introduce me to another single friend of hers, believing that we might have a lot in common.

Perhaps unsurprisingly, things did not go well - but not due to my depression or anxiety. He loved the sound of his own voice too much, interrupted me when I finally managed to get a word or two in edgewise, had no regard for my personal space, and seemed genuinely surprised when I wanted neither to kiss him or to go home with him. In fact, the whole experience left me quite upset. Are all men so narcissistic these days?

Leo had been ribbing me for days before the event, but seeing the look on my face upon my return has thankfully silenced him.

Four

In my attempts to re-engage with society, I fear I may have taken on too much. Four blogs, four Facebook pages, two online portals to my crochet business and a social life - inevitably I end up slipping, and neglecting one or more of these duties I have created for myself.  Perhaps I should set up a routine for these things too. I wouldn't want to intimidate myself with an enormous workload, and undo the progress my counsellor and I have made so far.

Strands

One

I love my GP's surgery. It's a five-minute walk around the corner, tucked away inside a community centre, and always immensely peaceful. The most people I've seen in the waiting room at any one time is three - a far cry from the over-subscribed circus Leo and Alba attend.

The GP herself is marvellous. Her bedside manner has struck exactly the right balance between matter-of-fact and sympathetic; too much of either tends to intimidate me. I visited her yesterday for a duplicate medical certificate, an update on my counselling referral, and more medication. She gave me an extension on my certificate without my needing to ask, apologised for the long waiting list for counselling services, and corrected my repeat prescription to show my correct dosage. I was in the surgery less than five minutes. My GP seems to be the exception that proves the rule within the NHS.

I collected my medication from the awful pharmacist, who looked far from pleased to have a customer so close to closing time. Earlier today, the Jobcentre faxed my certificates to head office whilst I waited - taking no risks this time - and later sent me a text message to confirm that my back payments would be released within three working days. I won't feel a sense of relief until the money enters my account, but the promise is there.

Two

Truman has been over several times since I cleaned up his room. Unfortunately, my own hatred of conflict barred me from confronting him about the mess he left, but Leo conveyed the message for me. No apology has been forthcoming yet, but this comes as no surprise.

Meanwhile, Truman is already regretting his hasty decision. Both Poison Ivy and the person in whose flat they are staying - an old enemy of Leo's - are frustrating him to no end. I can happily report that Leo has told him to lie in the bed he's made for himself.

Three

Since writing that I neither have bad dreams nor recurring themes from night to night, I have experienced both. I dreamed that I had killed a monstrous person in self-defence, and was running from two things: the police, and the dark fog slowly covering the city. Despite my overwhelming guilt, the people I met all sympathised with me and hid me from the police, but the fog was awful. It moved slowly, mockingly, in that near-sentient way it does in horror movies. It was inescapable and evil.

The next night, I dreamed I was ill and unable to walk, so I had to be driven everywhere by my family. We left the house in the middle of the day only to confronted with the darkness and the fog again. More horrifying still, the fog was somehow refracting the moonlight so that there appeared to be three full moons overlapping each other in the sky. I've been disconcerted by dreams about planets appearing too large in the night sky before, but combined with the creeping fog from the night before, those three moons absolutely terrified me, even upon waking.

I am considering starting to write a dream diary to help with analysis. Perhaps it would be useful.

Asthma

I was born with eczema. The family photo albums are devoid of baby Cambria; future generations will probably be led to believe that I sprang into existence around my first birthday, once my skin and hair had grown back. My earliest childhood memories are of itching, itching and more itching; of teachers horrified by the state of my skin; of my baby sister getting into mortal trouble for painting the bedroom with handprints of my precious E45 emollient cream.

The summer I was seven, I developed hayfever. If I had been bored at school before, I was positively distracted now. I could scratch my itchy skin, but I couldn't itch behind my eyes or inside my nose. Every successive summer from then on brought its own brand of antihistamine - my body seemed to develop a resistance to each one as it came along.

Skip ahead a few years, and grown-up Cambria moves to the big city. Neither eczema (except on very cold days) nor hayfever (except in spring when tree pollen season begins) has plagued me with anything like the ferocity it did when I was small, and my skin and sinuses are grateful. Still, I've never shaken the habit of biting my fingernails. The decision to have either beautiful manicures or skin to hold oneself together makes itself, and to risk one for the other is something I'll probably never be able to do.

For those first few years in the city, I counted myself lucky. My health was better than it ever had been, and unlike several of my relatives, I showed no signs of developing "the full package" - the triple threat of eczema, hayfever and asthma. Then the coughing started. Then it persisted. Then the chest infections started and kept coming, one after the other, mere weeks apart, relentless and mysterious and exhausting. Finally, on Halloween 2010, I had my first trip to A&E with an asthma attack. Unfortunately it took another two attacks before I was officially diagnosed and treatment began, and by then the physical and psychological damage had been done.

It killed off my career before it started, you see.

*

Yesterday I wrote about my awful pharmacist. I admit: I was psyching myself up to collect my prescription, and a little expression of my frustrations was in order. However, it turned out to be a beautiful day, and I collected a list of errands together in order to go outside, but for as short a time as possible. (Sadly, sunshine alone does not cure anxiety.) One of these other errands was the booking of my bi-annual asthma review, so I visited the doctor to make my appointment on my way to the pharmacy.

Any therapeutic effect the writing of yesterday's entry had on me was obliterated for two reasons.

He asked if I would like to take a test to gauge how well my asthma is currently controlled, by measuring my inhalation with a sort of reverse version of a peak flow meter. Apparently I failed at this; he berated my technique at length, and made no attempt to explain how to improve. Having berated him myself at similar length not more than three hours earlier, I listened with a smirk on my face, before meekly responding:

"But my asthma nurse says my technique is perfect. In fact, my next asthma review is tomorrow afternoon. Perhaps she can speak to you about it afterwards?"

His shitty grin turned to fury. "You do that," he snarled.

This time, I didn't wait for the door to close behind me before loudly proclaiming "wanker."

So imagine my horror at his having the last laugh, when I discovered at home that he had only provided me with half my monthly dose of antidepressants.

*

"Ooh, aren't you easy!" said the nurse as she found a fresh filter for her peak flow meter. "We'll be done in no time!"

It's true that my asthma hasn't bothered me at all lately. With the unseasonably warm weather, I haven't needed to use my Ventolin inhaler. My BMI is normal (which I knew), my blood pressure is spot-on (which is a surprise, given how my mood has been lately) and I don't smoke (I was loath to inform her about the amount of secondary smoke I'm exposed to).

My peak flow was a consistent 400, which is below my target of 435 but pleased my asthma nurse to no end regardless.

"Have you brought your inhalers with you today?"

I produced both Ventolin and Qvar.

"Show me how you use your blue one, please."

I shook the inhaler and expelled all the air from my lungs, right down to my diaphragm, just as I was taught in singing classes. Then I removed the cap, held it to my mouth, and activated the spray simultaneously with a deep breath inward. I held my breath for five seconds, then exhaled slowly.

"Excellent," said the nurse. "Perfect technique. Your asthma is well under control."

Pharmacist

In a city full of unfriendly people, it's surprised me to discover that one of the least friendly is my local pharmacist. Besuited and obnoxious, smug and surly by turns, he regards the people that walk through his door as cows to be milked. If he can't drag you into a monetary transaction, he treats you with the same disdain as one might treat the soil found on one's shoes.

When I was first diagnosed, I visited the pharmacy to set up a repeat prescription service. If ever there were an ideal situation for a pharmacy in relation to a residence, this would be it - it lies just around the corner, five minutes' walk away, and directly opposite my doctor's surgery. This little convenience might only have meant one less thing to worry about, but in times like these you're thankful for every convenience you're given.

So there he was, in his too-crisp suit, with his ever-present glare and a badge bearing an oddly feminine name, giving me a lingering first impression that he might have been over-compensating for something. The surgery had already forwarded him details of my medication, so all we had to discuss was how often I would want each item and whether I paid for my prescriptions. My answer clearly disappointed him, and my wallet remained unopened.

Then he offered me a free diabetes test. Sure, why not? My family has a history of type 2 diabetes, so anything to keep it at bay before it has a chance to set in is always welcome. He handed me a form to fill in and asked if I needed help calculating my BMI. I said that I didn't; at this stage I was still playing Wii Fit Plus every day, and I knew that my BMI was within normal levels. He handed me a tape measure to take a waist measurement and headed back into the dispensary for a moment. With my usual lack of common sense, I measured not just around my waist, but around my sweaters and jacket too, thus adding a couple of inches to what is normally a very respectable waistline. My mistake.

The form completed, I handed it back and he looked it over. Scanning down to my waist measurement, I noticed his eyes light up. Alarm bells started to ring. When a disagreeable person gets a gleam in their eye, experience has taught me that the end result is most often an unpleasant mood for me.

He proceeded to try to sell me an entire range of weight-loss products.

I stared at him disbelievingly as he prattled on with his pitch, joyous at the prospect of making a sale and entirely oblivious to the offence he was causing. It's one thing to tell a woman that she's overweight, but what sort of self-respecting medical practitioner tries to convince a woman she's overweight when she's visibly and statistically not? Answer: a salesman. It dawned on me that I wasn't a patient to him; I was merely a punter.

I refused to be drawn, not bothering to disguise the steel in my voice. "I'll discuss it with my doctor before I commit to buying anything." The light in his eyes faded. "Am I at risk of developing diabetes, please?"

He mumbled "no", stood up and strode back into his dispensary, visibly disgusted by how impervious I was to his sales patter. Not for the last time, I left muttering curses under my breath. Whilst it is a sad fact that most marketing techniques rely on making women paranoid about their health and/or appearance, I can happily report that I have no such insecurities. Grimly I wondered whether he would have been so frustrated with his failure to impress had I been male.

*

Several months later, he made another attempt. After delivering my prescription, he ushered me into the interview room for a medication review, which I thought was a little presumptuous of him until I discovered it was standard practice. Choosing to ignore my "weight issues" this time, he zoned in on my other ailments.

"What are you taking codeine phosphate for?"

"I have an old knee injury that flares up in cold weather."

That light switched itself on again. "I see. We sell Tens machines for twelve pounds if you're looking for an alternative to painkillers. Now, your inhalers - do ever get a cold sensation on the back of your throat when you use them?"

"Very rarely," I replied icily.

"Hmm. A cold sensation means that your lungs might not be receiving the full dose when you're inhaling. You should consider using a breath-actuated spacer. They aren't available on prescription, I'm afraid."

"Not interested, sorry."

More peevish mumblings from him, more epithets through gritted teeth from me.

*

Pharmacists have different responsibilities from doctors, this is true. They have to run a business alongside fulfilling NHS prescriptions, and I have no problem with a little promotion here or a whispered recommendation there. But I'm living on benefits, and I haven't paid for a single prescription since Iosing my job last year. If my pharmacist had had anything resembling the bedside manner one expects from a medical professional, he would have realised that I am not in his target market. There are people in this city, increasingly fewer but still in abundance, who earn a wage, who can pay for prescriptions and who can afford to consider alternatives - lucky, lucky people leading normal lives and wielding disposable income, to whom he should be pitching. Marketing entities are, by definition, indiscriminate in their lack of social conscience, but a little common sense never hurt anyone.

Not to mention service with a smile. That's not too much to ask for, surely?