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Annie Storkey

Mania

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Edited by Annie Storkey, Friday, 27 May 2022, 11:53

I have just blogged about my recent depression but now I want to tell you about mania, as I guess most people don’t really understand what it is like.

I consider hypo-mania, that is, low grade mania, a normal part of my every day life. When I am hypomanic, I have constant racing thoughts in my head, like a dialogue with myself (just to be clear, I’m not hearing voices; I’ve never had auditory hallucinations). I have a heightened awareness of my surroundings, of colour and noise, and it is often an enjoyable experience, though the discourse can cause anxiety when you replay conversations and mistakes from 30 years ago.

It is hard to say when hypomania tips into mania, I think it is when I start feeling tipsy and my thoughts become more grandiose. My internal discourse contains grand speeches where I share my words of wisdom with the world and everyone hangs on my every word. I see myself as charming and engaging, with my eyes twinkling like diamonds (and I can understand how someone with psychosis might be deluded enough to imagine they are diamonds). I am excitable, wanting to engage with the world, to run down paths with my arms outstretched. I am lucky that I have a lot of insight and control when in a manic state so I don’t do anything to embarrass myself in public; this is how I manage to continue as high functioning within society. I’m also lucky to have seldom experienced psychosis, though I understand and appreciate the thin line between reality and delusion in mental illness.

I can tell my moods from my shopping habits; I told my GP when my depression started by looking at my PayPal account. When I am manic, I shop more and buy frivolous items or several pairs of identical shoes in different colours. This morning I started browsing for colourful tops for my summer holiday, yellows and corals. My Mad March Mania is very late this year.

If you want to read a book about experiencing bipolar disorder, I recommend Kay Redfield Jamison’s An Unquiet Mind, an autobiography of a manic depressive written by an academic expert on manic depression. I don’t agree with everything she says from a medical perspective but her descriptions of her emotional states and behaviour were very recognisable to me, as well as the vulnerability of academics/medical professionals declaring their mental illness.

Annie


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Annie Storkey

Depression

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Edited by Annie Storkey, Friday, 23 Sep 2022, 12:08

I haven’t blogged for a while as I have had a major bout of depression and didn’t want it to be a distraction for my students (though I did record it in my research journal). But EMAs are done so it is time to talk about it.

I always have a bout of depression in February and have recorded about it previously in my blog. Like many people with bipolar disorder, I also get seasonal affective disorder and this usually means a couple of weeks when I am down followed by a seasonal burst of mania in March (mad March amongst manic depressives is a common phenomenon). But this year my depression hit the same week as war broke out in Ukraine and I already had a sort of post-pandemic malaise. Consequently, my depression was deeper than normal and accompanied by a severe worsening of my generalised anxiety, ranging from being convinced that my office floor would give way due to the heavy shelves, to an overwhelming fear of my sons being sent to war and our world being destroyed by imminent nuclear strikes. For the first time in over 20 years, I made contact with my GP to discuss my mental health. The GP clearly knew less than me about mental health and appropriate treatments (she spoke to a psychiatrist who recommended fluoxetine, which the GP didn’t know was Prozac. Prozac is not an appropriate medication for someone who has mania). I still haven’t got an appointment to see the psychiatrist. But I also contacted NHS psychological and wellbeing services who were quick to assess me for low grade CBT, which I will start next week.

My depression lasted nearly 3 months and has gradually improved over the last few weeks. During that time, I have kept up with a heavy marking load and teaching commitments but this has meant increased tiredness and my research has been a bit neglected, though obviously the practice part of my action research has continued. I had wanted to start data analysis in February but that was not possible with my mental state which continued into March and April, when I also had my methodology chapter assignment and NVivo training to do. April is, of course, an intensive marking month. So here I am in May, familiarising myself with my transcripts ready to start coding next week.

I have felt ‘normal’ for a couple of weeks now, though normal is a somewhat loose concept for a manic depressive. 

Annie


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Annie Storkey

The highs and lows

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I had a bout of depression for a week or so after Christmas. This is not unusual, in fact, it is a feature of the Christmas holiday for me. But I thought I would unpack it a little.

The most obvious reason for depression during December is seasonal affective disorder (SAD). Like many manic depressive, I do have SAD. As well as the lack of happy inducing sunlight, with the resultant low vitamin D levels, I am very responsive to changes in mood and routine and the changes in the seasons are a cycle of this. Mania will come in Mad March, as it always does. But it is more than SAD, over Christmas my routine is altered in many ways and this impacts on my moods.

I really like the excitement of Christmas. I love buying people presents, planning and making the food, decorating the tree and making people happy. And I start my Christmas planning early as my anxiety does not like last minute rushes. But, of course, after Christmas this winds down and it is then the depression comes. This mirrors my normal bipolar cycle; after a period of mania I have a short period of depression. It reminds me how important a regular routine is to maintain my mental equilibrium.

This week my depression has lifted. I am back into my work routine and, despite my husband having been away on business in the US for 10 days from New Year, I have managed to keep everything at home running like clockwork. Today I went for my morning walk in the cold frosty morning with a clear blue sky and saw buds appearing on some trees. Spring will soon be with us.

Annie

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OU Mental Health and wellbeing Conference

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Edited by Annie Storkey, Wednesday, 12 Jan 2022, 10:32

Wednesday and Thursday I was at the the OU Mental Health and wellbeing Conference and what an amazing event it was. There was a wide range of interesting speakers with different perspectives, some great opportunities to share ideas with colleagues and the atmosphere warm and supportive. It is so encouraging to see hundreds of colleagues getting together to discuss how we can improve the health and wellbeing of staff and students. I really enjoyed attending and hope this event becomes an annual one. Many thanks to the organisers, speakers and participants for making it an enjoyable and worthwhile event.

However, 2 days of discussing mental health, with the anxiety of presenting my own work, has left me exhausted and hypomanic, with racing thoughts. This is hardly surprising after such intense activity. So I decided to opt out of the AL conference today and tomorrow (I knew this was a risk when signing up) to give my brain a chance to settle down and I might skip the mental health workshop next Tuesday. You can have too much of a good thing.

Annie

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Presenting at conferences

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Last week I was accepted to present at the OU’s Mental Health and Wellbeing Conference and this led me to reflect on how much my confidence in presenting my ideas has increased over the last 2 years. Presenting at conferences was part of my development plan in year 1 and was quite apprehensive as I have social anxiety as part of my bipolar disorder.

Some people misunderstand how social anxiety can present and assume that I am a confident speaker because they think I am an extrovert, when I am actually a sociable introvert with hypomania. I don’t like being the focus of attention; during my nursing training I actually failed practical assignments because of anxiety with being watched.

Unusually, the pandemic has played to my advantage here as conferences were moved online. I’ve been teaching in online rooms for almost a decade so this is a comfortable environment for me and the screen interface means I feel less in the spotlight. Consequently, I have presented my research  at internal post-graduate research conferences and at the annual AdvanceHE Teaching and Learning Conference in 2021, where I also did a Q and A. So, although I still have anxiety at presenting at the conference, I am now much more confident in my voice when speaking about the subject I am passionate about; supporting students with mental health challenges. I look forward to the conference in December.

Annie


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Draft methodology chapter

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This week I submitted assignment 7, a draft methodology chapter. It is a month early but November is a busy month for me as I have marking from all my modules, one of them twice, so I have planned ahead with my doctorate workload. I actually wrote this draft chapter in September, just adding the practical bits about final sampling this week. 

I'm pleased with what I've written and can see it coming together but it is slightly frustrating to draft the methodology chapter before you've finished the data collection phase as it is necessarily incomplete; there may still be adaptations to my methodology as I progress. I've also got ideas for including personal reflection at various points but I think that is hard to do before the chapter is finalised. The personal reflection is an exciting development as I can see my practice already transforming as I interview students about their support needs.

But for now my mind needs to be on recruitment and interviewing and how this can be developed further, alongside providing the support my students need to fulfil their potential.

Annie

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Transcription

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:28

This week I transcribed my first research interview and I found it quite a profound experience. Obviously, I was apprehensive about starting the process, that’s normal for me, but once I began I found it fascinating and I felt like I really got to know my participant. Listening again to the conversation highlighted things I hadn’t registered during our discussion and I began to understand the student experience in more depth. Listening to the participant talk and recording their words made me reflect on my current practice and prompted me to make changes in some of my communications this week. I can see why Braun and Clarke (2006) recommend that researchers immerse themselves in the data by listening to each audio recording before manually transcribing the data, giving a verbatim account, including all verbal and non-verbal utterances with appropriate punctuation and pauses. The process is very active and I’m glad I took this route rather than using an automated transcription service. It was time consuming (10 minutes typing for every 1 minute of speech, plus reviewing and editing) but very much worth it for the intensity of experience and understanding.

Annie


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The joy of like minds

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:28

I realise that my last few blogging attempts might have given the impression that I am currently dwelling in a well of despond but really, nothing could be further from the truth. I want my reflections to be accurate accounts of my feelings about my research studies and consequently they can seem to be focused on how I might overcome challenges. But my research is actually something that brings me fulfilment and satisfaction, as I discover more aspects about a subject I feel passionate about; student mental health.

So today I would like to share how wonderful it was to attend a workshop yesterday looking at emotional resilience in students as part of current research focused on exploring how students might be supported when studying emotive and sensitive content. I won't discuss the research itself as it is still a work in progress but what was heartening was to see colleagues (and some students) from a variety of disciplines coming together to share ideas on a subject which is much neglected and urgently needs addressing. The fact that emotional resilience in online learning is a neglected territory has parallels with my own research into the support needs of online students with mental health challenges, and I found hearing about this research personally encouraging and it made me think about my own investigations; I will need to follow up this study when it is completed. I think this research study is one of the most important in educational research in the last few years and I was left feeling very positive at the end of the workshop about the future of learner support.

Annie

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Stepping back

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:29

I decided this week to take a step back from the research and wait and watch patiently. Doing research can overwhelm you and start to invade your every thought, and this is especially so when it overlaps with your practice. The first few weeks of the data collection was intensive, with sampling and invitation emails, planning and testing interview procedures and doing my first data collection, alongside my usual work commitments which included online tutorials, so I needed to make some space to reflect on what was happening. Besides which, my regular students need my help to settle into their modules and they are my priority. So I spent the week absorbed in forum discussions and communicating with students in tutorials and via email.

I'm happy about this. I am up to date with my teaching workload and feel that I am beginning to establish good relationships with my students. I have a clear and achievable plan of what needs to be done over the next few weeks, both from a work and research perspective. Next week I will review my recruitment approach and look at how I can make my research as flexible and inclusive as possible for my students with mental health challenges.

Annie

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Anxiety

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:29

I was quite unnecessarily anxious about doing my first interview, despite having been doing telephone tutorials for 14 years. As a manic-depressive, I am often anxious about new experiences but I also get anxiety prior to regular intense occurrences, like when I give an online tutorial (which I have also been doing for years) or start a batch of marking. This anxiety expressed itself in many ways, for instance, rechecking recording equipment to make sure it works and revising and practising my questions repeatedly. On the day it showed in a mild depression during my morning walk, a feeling of nausea and fear, and pacing around the house. I am used to managing anxiety on a daily basis so lots of deep breathing, CBT and positive thoughts and no attempt to avoid or delay the inevitable.

What I experienced can be similar to what students experience when invited for a telephone tutorial, with the anxiety of not knowing the person calling or what to expect, and the anticipation of the event. Some will overcome this and welcome the opportunity to share their experiences and support needs with their tutor whilst others will find the barrier more difficult to climb. What is important, then, is that tutors work to establish positive relationships with their students at the beginning of the module and that they keep that door open for communication. I think regular communication from a tutor is vital in this process, especially early in the module, and communication is one of the things I will be exploring in my research on how students with mental health challenges can be supported to reach their potential. This includes proactive support that intervenes before crisis point so that students are supported when they are at their most vulnerable.

These issues also have implications for my research study in that I am inviting participants to have telephone interviews and not everyone will be comfortable with this, especially at the beginning of the module. I hope that as my students get to know me better, several will have the confidence to come forward and volunteer so that their voices will be heard.

Annie


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Want to know more about my research?

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:29

A couple of students have enquired about my research so I thought I would share what it is about and what it will mean for my students.

I am currently doing a Professional Doctorate in Education, exploring how students with mental health challenges can be empowered to be independent learners in the online learning environment. My choice of investigation was prompted by reading the research of Richardson (2015) which found that distance learning students with mental health challenges were significantly less likely to complete and pass their modules than other students. This concerned me as an Associate Lecturer who wanted all her students to reach their full potential, but also as someone who has bipolar disorder; I, too, dropped out of my first degree when I had a mental health crisis 25 years ago. I want to understand the barriers these students face and how they might be overcome so that I can support my students in their learning journeys.

Whilst there is some research into the barriers faced by these students, there is also an assumption that it is up to academics to decide how to overcome the challenges. But my knowledge of health and social care tells me that we need to go to the service user for their expertise on their needs. I am doing emancipatory action research study with an emphasis on student voice to explore the lived experience of students with mental health challenges, using case study interviews to plan, implement, evaluate and reflect on the support needs of these students, alongside data analytics to identify students at risk and intervene as necesary. It uses the affirmative model of disability, an inclusive and collective approach emphasising positive social identities, to develop relationships and deliver individual and proactive support. Participants are offered an initial telephone interview to discuss their experiences of studying with mental health challenges, the barriers they face, the resilience they bring and to negotiate the support they would like to receive from their tutor. The follow up interview happens at the end of the module when we evaluate and reflect on the experience of studying and being supported.

Doing research with my own students brings up ethical dilemmas that needed addressing. For instance, my research needs to be fair to all my students so I am careful to reassure that any student can have an interview about their support needs; they don’t have to take part in my research to be supported in their studies and whether they take part or not will not influence their assessment. My sample of students also needed approving by the Student Research Project Panel to ensure that students who have opted out of research invitations or have recently been invited to take part in research were removed from the sample. This means that not all my students will have received an invitation to take part. Taking part is voluntary and all students who participate are provided with information about the study and are required to sign a consent form detailing the purpose of the research and the use of data. The issue of consent is revisited throughout the research.

What I hope to achieve from my research is a greater understanding of the experiences of students with mental health challenges and the support they would like in achieving their learning goals. This is an exciting opportunity to influence how student support is provided and I look forward to working with my participants in developing new knowledge.

Annie


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Research sample

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:29

Last week I got authorisation for my research sample and it was surprisingly straightforward, if somewhat nerve-racking.

To do research with OU students you need permission from the Student Research Project Panel (SRPP) and they will authorise a sample of participants. In many cases they will produce the original sample for the researcher but some researchers will request to draw their own sample, which needs approving. The latter is my situation as I want to research my own students so last Thursday I submitted a prospective sample for approval.

This process is necessary as some students may have opted out of contact about research and others would have already been involved in recent projects or even multiple studies. But it is anxiety inducing for the researcher when your initial sample is already very limited in scope. As it was, the process reduced my sample by a third. But I am glad to say that my response was positive and practical; the process is necessary and ethically right, and this is my sample and I am going to work with it. It is so nice to finally be contacting potential participants and to have the opportunity for 2 years of work to finally bear fruit.

Annie


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Welcome video

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Edited by Annie Storkey, Friday, 1 Oct 2021, 12:51

Today’s reflection is on how I welcome students. I’ve always sent out fairly lengthy welcome letters which include a biography, details on tutorials and forums, and how to stay in contact. These are necessarily sent addressed to ‘student’ not individually named students as I use the university group mail system to send emails to nearly 100 students. I also send out individually named emails to disabled students, enquiring about their needs and offering support. This can be time consuming as up to a third of my students might have a disability but I think it is worthwhile as establishing early positive contact is good for relationship building and addressing any challenges early is beneficial. I wanted to build on my general welcome messaging this year and decided a welcome message in Adobe Connect might be the way to go so that students might be able to hear and see me at the beginning of the module. So I planned and delivered 10 minute welcome videos for my K219 and K220 groups (KE322 have a welcome tutorial already timetabled in). The videos included an overview of the module and website, staying mentally healthy during studies and study skills tips.

I found the process strangely anxiety-inducing, considering I am an experienced online lecturer, but I guess that is my bipolar talking as it dislikes new experiences. I needed 2 takes of my first video due to not enabling my mic (a hazard of presenting by yourself without an audience). What I did discover in that first take is that I hated the webcam and found it distracting; I am an animated speaker and my head bobbing around was not helpful. But once I got rid of the webcam all went well, though I stumbled over a few words at the beginning. I think it was a worthwhile addition to my ‘welcome’ -  and I have already had some positive feedback. It also won’t be too time consuming to repeat in future presentations. I really didn’t like the webcam though and didn’t find it helpful.

Going forward, I will be repeating the video on future presentations as I think it is an easy thing to incorporate into my ‘welcome’ and beneficial for relationship building. I now have a greater idea of what works for me and that means no webcam. On some of my tutorials I have a photo of me on one of my introductory slides and in future presentations I will add this to my 'welcome' slides.

Annie


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Nose in a good book

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:30

This week I started reading Action Research in Teaching and Learning by Lin Norton. I’ve read a lot of books recently on action research and most have been very informative and provided helpful and stimulating advice that made me reflect on the theory and practice of my own research. Norton’s book is no exception but what I am really enjoying is the emphasis on reflective practice in, for want of a better word, ‘practical’ terms. For instance, Norton discusses including participants in reflective practice and the pitfalls of using reflective journals. I have had several people suggest that I should get my participants to keep reflective journals about their support needs and this approach was a key focus of my research when I first applied for my doctorate course. But I decided not to use this approach as I know that many students struggle with reflective writing and I did not want to put pressure on my participants to fulfil my expectations at the risk of them feeling inadequate; my research is about empowering students with mental health challenges not confining them. Reflective journals will be mentioned as a study aid (they are a component of one module I teach) but there will be no pressure from the perspective of my research. I want my student participants to explore what study approaches they think is helpful not what academics think they should do, and I will be using my regular email contact to encourage reflection with all my students as part of my proactive motivational support. Norton recognises that practitioner researcher needs to be aware of their students’ own experiences of learning.

The discussions on professionalism on career development have also been very useful and have given me ideas on developing my research career, including thoughts on how my current research might be expended in the future to look at specific interventions such as how I manage my tutor group forum in relation to mental health and wellbeing support. The book acknowledges that action research can be ‘messy’ and I’m looking forward to reading more.

Annie


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Getting back into a routine

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Edited by Annie Storkey, Friday, 17 Sep 2021, 13:45

I always find it exciting when new academic year beckons, and not just because of the interesting students I will be meeting and the new challenges ahead. I also look forward to getting back into a routine again.

I have high functioning bipolar disorder and hypo-mania is pretty much part of my daily life experience. I manage my bipolar disorder and the inevitable ups and downs using cognitive behavioural techniques and an organised routine is very important to me as it helps to manage expectations and brings much needed structure to the day. Like most associate lecturers I am not employed by the university over the summer, at least not until the new contract comes in, and my teaching responsibilities are mainly in term-time. My doctorate also has term-based deadlines, though there is plenty of reading to do over the summer. As much as I love having a nice long break from the day job from mid-June to mid-September, I can sometimes feel unsettled and disorientated with the lack of structure to my day. Obviously, my doctorate is helpful at the moment for giving me something to focus on but I decided that I needed to establish a firm routine early before the new term starts to help the transition back to work.

So, on the first of September I got back at my desk and organised myself. As I have some tight deadlines this year (it’s my research data collection this year, alongside my usual teaching, and I also have draft chapters of my thesis to write) I gave myself writing deadlines and planned ahead with my studies. This has really paid off; I am back to my regular routine of a walk in the morning then at my desk at 9.30 to check the emails before setting into the day’s work. It’s been very productive due to the lack of interruptions; I’ve re-drafted two thesis chapters, done my annual admin and research planning, as well as some mentoring work and writing teaching resources. Getting all this done early has made me feel more confident and relaxed about the new term starting and I’ve also been able to reflect on what I want to achieve in the year ahead. It’s going to be a great year.

Annie


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The power of positive contact

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Pro-active motivational support is one of the grounding principles of my work as an Associate Lecturer and regular, continuous contact is one of the ways I do this. I send out weekly emails to my students to maintain contact and build relationships; the emails usually consist of the introducing the study aims of the week with appropriate guidance and pointers. I see this contact as a positive interaction with students to help motivate them but I have previously underestimated its positive impact on my own wellbeing.
I enjoy receiving replies to these emails from students as distance teaching can be just as isolating for the tutor as the student, and getting feedback from others is encouraging, whether the student is asking for support and guidance or just acknowledging your contact.
I am absolutely delighted when students ask about my mental health (I have bipolar disorder) as this signifies to me a world where barriers are breaking down, and disability is acknowledged as a part of identity, not a stigma or tragedy.
So my wish in the coming year is the building of positive, supportive relationships within the university setting, with openness and acceptance of difference.
Annie
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Why am I doing this to myself?

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:30

Yesterday it hit me after several intense days of writing; I guess it comes to all doctoral students at some point and those of us doing professional doctorates alongside our day jobs probably experience it more than most. I'm talking about the desperate question of 'Why am I doing this to myself?'.

It's a natural question to ask, after all, I work 32 hours a week as an Associate Lecturer (AL) and the professional doctorate is a four year programme so little different to a more conventional full time doctorate schedule in terms of deadlines and completion. It is very much full on and has to be done alongside my other commitments which also have firm deadlines (I marked nearly 100 assignments in November at approximately 20-25 hours a week).

I don't need to study for a doctorate. I've been an Associate Lecture for 13 years and have no immediate plans to change that as working flexibly from home suits me and I enjoy the contact with students that such a role has. There has never been any pressure from the university for me to study for a doctorate either; it was all my own idea. I've never been one enamoured of status so that is not a consideration. So why bother?

Three of the modules I teach start with an assignment which relates to goal setting or reflective learning, and with very good reason. Having a goal in mind helps to build our resilience when times are hard and gives us a focus for the future, motivating us to overcome the obstacles that occur on the way. I am doing my doctorate because it is a subject that I am passionate about and a story that needs to be told. My research into supporting students with mental health challenges has the power to change lives for the better and that is what spurs me to strive towards the goal.

So how did I overcome yesterday's mental obstacle? Well, I took a break from study for the day. I went for a nice long walk, had a cup of tea and did some AL work instead. Today I'm coming back for a couple of hours work with a clearer, less stressed, mind and some new ideas for my assignment. Every day is a new day.

Have a good weekend.

Annie


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A new academic year

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Edited by Annie Storkey, Wednesday, 16 Sep 2020, 11:01

I just posted my story in a module forum but I thought I'd post it here to encourage new students who are a little nervous about the coming year.

"It's not unusual for students on K102 to not have studied for a few years or to not have gone to college. Let me encourage you with my own story.

I left school after my O' levels to go on a Youth Training Scheme (YTS) scheme in a care home. But this wasn't the career I wanted as a child; I'd always wanted to be an English teacher. But such a job was completely out of reach for someone from a rough council estate in Luton in the 1980s. Whilst I wanted to be a teacher it was something I knew was out of my league, it was an impossible dream. I didn't know anyone who worked in a professional job; my father worked in a dairy factory, my mother was a canteen cook, and all my family worked in either factories, shops or child care. I didn't know anyone with a degree and my friends and boyfriend went on to do apprenticeships, even the ones with A' levels. Besides, my parents wanted me to get a job and pay rent so it was the YTS scheme for me. I lacked the social and cultural capital to make my dream come true.

So how did I get here, an academic working in Cambridge for the Open University? Well, my YTS placement was in a small private residential home owned by a lovely pair of best friends, a nurse and a home economist who had previous taught teenage mums, who saw in me a potential for reaching higher. Their support and influence enabled me to successfully apply for nurse training in my local hospital, which was an apprenticeship not a degree in those days. After qualifying a nurse I started an Open University module on research methodology, which then led to a degree and nurse lecturing.  I now have two degrees, a Masters in Education and am currently doing a doctorate alongside teaching health and social care undergraduates.

So, I've gone from leaving school with o'levels to studying for a doctorate. Studying for a degree with the OU can change your life smile

Have a great year of learning.

Annie"


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Ups and downs

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:39

Well, I'm now 15 weeks post-covid and I still have the post-viral symptoms of Postural Orthostatic Tachycardia Syndrome (POTS). But my pulse is noticably improving, I am regularly walking two miles in the morning with a normal walking pulse. A brisk walking pulse should be around 110 and I am generally below that; if it creeps higher I stand still and it immediately goes down again which seems to me a healthy response (POTS symptoms tend towards pulse rates being stubborn at returning to normal). My standing pulse is also much better and I can go whole days with a normal pulse.

Absurdly, as my pulse has got better the lightheadedness has got worse. I am no longer having to take gasps of breath when seated as I was a few weeks ago but I definitely lightheaded more often and have 'brain fog', and more prone to morning headaches than before. Ironically, lightheadedness in POTS occurs mainly in a seated position and it is presumed to be due to pooling of blood in the lower legs at rest. The solution is to get up regularly and keep the legs moving while sitting. Good job my standing pulse has improved! I actually find it helpful to work while feeling like this as it distracts me, even if I am not as productive as usual.

I'm hoping all this is just a lag in my system as it gets used to me no longer having as much tachycardia. I'm going to increase the cardio exercise to see if this will stimulate my venous return more. I've also started on low dose rehydration tablets. When I developed POTS I increased my fluids dramatically as per the recommended regime but did not increase my salt intake alongside this as I appear to have a slightly raised blood pressure (BP) post-covid. But my GP is unconcerned about my BP and I'm wondering if my electrolytes are now out of kilter and if I would feel better with extra salt and minerals, as well as retain fluids better.

Anyway, the improvement in pulse rate seems like a positive step forward in recovery.

Annie

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When postural tachycardia really is postural

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:38

It's been over 12 weeks now since I developed Covid-19 and although I recovered from the infection in just over 2 weeks I still have the post-viral complication of presumed postural orthostatic tachycardia syndrome (POTS). I've blogged already about some of my symptoms (as a lecturer in health I'm somewhat fascinated by how the body behaves!) but today I thought I'd focus on something I've only recently noticed - the affect of posture.

I noticed several weeks ago that I occasionally got mild air hunger (large intake of breath) when sitting at my computer, and that this apparently was common in POTS. It's a very odd symptom, given the condition, as the tachycardia occurs to improve oxygenation when standing. Clearly both responses are to improve oxygenation but they are very different.

But last week when I took a break from work/study, I found myself sitting at the kitchen table hunched over my iPad and getting increasingly lightheaded and gasping for breath. It was quite distressing as it felt like my breathing was deteriorating, when until then I had only noticed it getting better. I then realised that it improved with better posture, which would explain why I had it then but not sat on the sofa with the iPad in my hand. Interesting that it's positional, I thought, and carried on with life.

Then on Tuesday I did my yoga class. Until recently my post-covid fitness levels haven't allowed me to do a whole session without tachycardia but I'm now walking several miles a day and feel much fitter. I was pleased to do a whole class of mainly standing poses and have no tachycardia. But wait, I have postural tachycardia and can get a fast pulse just from lifting my arms up -why was it okay to do standing yoga? I suspected that the strict yoga posture was the answer and reflected on my walking tachycardia. I had noticed recently that my tachycardia when out for a walk is better when I'm thinking about it but my pulse starts galloping when my mind wanders, only that day it had suddenly leapt from 104 to 135 for no apparent reason. Was it because my posture dropped?

I tried it out today and worked really hard on my posture when walking; chest out, shoulders back and down. And my pulse stayed below 110 (normal walking pulse) throughout my 2 mile walk. Now, this might be because I walk slower when concentrating on posture but I've ordered a simple back brace and will explore this further. It might be a breakthrough at managing my pulse rate.

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Annie Storkey

Arm raising

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Edited by Annie Storkey, Friday, 12 Jun 2020, 11:56

Today I walked for 2 miles with a normal walking pulse of below 110. Admittedly I had to slow down in the second half to maintain my pulse but I’m really pleased as this gives me hope that I can manage, or possibly even overcome, the postural tachycardia I developed post-covid. My missing sweating function is returning too (sorry if too much information).

But I have had tachycardia this morning as when I got dressed my pulse went over 120. And this is why postural tachycardia is such a debilitating illness for many people; it is at it’s worse when performing activities of daily living. I fully understand why some people struggle to get out of bed with it.

I first noticed my tachycardia in the second week of my covid symptoms when I had palpitations carrying the laundry downstairs - my pulse was 125. I get the same when hanging out the laundry or chopping vegetables (even in a seated position). Even difficult crochet raises my pulse! My 2 worse episodes of tachycardia have occurred when gardening, that magical combination of heat, exercise and lifting your arms up. The second episode resulted in a subconjunctival haemorrhage so my blood pressure is clearly shooting up too.

Now I’m conquering my venous return in my legs I’m tackling my arms with some Iyengar yoga; cobra and downward dog should be helpful as well as standing poses. My lungs are hating seated twists though.

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Getting better

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:40

Today my postural tachycardia seems much improved. It is normal both standing and pottering around the house and when I went for a walk it was within the normal bounds of light exercise (some rise is expected). What was most significant is that it dropped down to normal immediately on rest, which would seem to me to indicate a normal response to exertion. It even has slightly improved when walking upstairs, though it still doesn't like me raising my arms (getting dressed always causes tachycardia). I've also been less fatigued the last few days, despite walking further, and I managed nearly 2 miles this morning.

Obviously I know this might not last; I got covid nearly 10 weeks ago and know how symptoms vary from day to day. But these are all hopeful signs that my routine of increased fluids and increasing light exercise are helping.

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Postural Orthostatic Tachycardia Syndrome

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:40

My tachycardia is postural, my resting pulse is around 65 and it goes up to 90 when I stand up - when I first noticed it was up to 128 just walking around the house. It is exacerbated by exercise (walking upstairs can raise it to 110, going for a walk to 125, once 150), raising my arms (carrying laundry downstairs or sitting to chop vegetables raises it to 125, even brushing my teeth raises it), heat (gardening on a warm day made it 140), and eating (rise to 90 when seated). Alcohol sometimes exacerbates it, caffeine doesn’t and might well improve it.

The paramedic on my second trip to casualty did a seated and standing pulse and BP and suggested Postural Orthostatic Tachycardia Syndome. I have since researched this (I am an ex-nurse) and it fits my symptoms and circumstances, especially as a post-viral autonomic response. I have instigated suggested lifestyle changes including increased fluid intake, slow transition on rising, wearing light compression running leggings, gentle yoga and taking a daily morning walk with regular rests and water. 

I think water intake has had an enormous effect. Taking water 20 minutes before getting up in the morning has resulted in a normal pulse on rising. I can now, most days, walk around the house without tachycardia as long as I keep my fluid intake up. My morning walk pulse is gradually improving too. Arm raising is still an issue but I am aiming to increase my upper body strength with seated and supine yoga.

I have to avoid fatigue, though. If I push myself too far I can get fatigue for the next few hours or even the next day. The best solution for the tachycardia is to sit on the floor cross legged, that results in an immediate drop in pulse. If I am outside I stand with legs crossed.

Obviously I am in a better state than many people recovering from covid as I was not hospitalised and did not spend my symptomatic two weeks on bed rest so my body is not very deconditioned. I am well enough to do my usual online teaching job and carry out activities of daily living despite my tachycardia. But I thought I would share my experience of dealing with post-covid tachycardia in the hope that it might be useful for other people.

(Hopefully once I’ve beaten the tachycardia I can find a solution to my strange lung pressure issue! I can’t bear high air pressure and get air hunger, especially at rest. I’m hoping increased exercise will lead to greater lung expansion)


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Standing up

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Edited by Annie Storkey, Friday, 12 Jun 2020, 11:58

Today, for the second morning, I got up and did not have postural tachycardia. The key is to drink a glass of water 20 minutes before rising and to get up slowly, keeping the knees bent and slightly leaning forward.

I have also managed to walk around the house without getting tachycardia, there's a small rise in pulse going upstairs but within normal limits. As long as I keep my fluids up I feel I'm winning the battle. Going for walks is proving more of a challenge, I'm trying to keep the pulse below 110 (for a gentle amble) and this is fine for the first 5 minutes; I slow and drink water when it starts heading for 110. It can suddenly jump to 120 and I stop and cross my legs over, as I know if it sustains at 120 it will trigger fatigue. It is so unpredictable, it can be 120 and then drop to 85 on standing still and then stays at 95. There seems to be no rhyme or reason. I'm guessing variations of fluid levels alter it. Last night it suddenly shot to 150 while walking despite me not feeling any different. I'm hoping that, just like my standing pulse has improved, my walking pulse will also get better over time as my venous return improves.

Then it will be upper body I need to work on. I currently get a rise in pulse every time I raise my arms, even brushing my teeth gives a slight rise and getting dressed also triggers it, let alone doing the laundry or sitting to chop vegetables. But I figure upper body strength will be helped by Iyengar yoga and I need to practice getting back to standing poses to get the full benefit. At the moment at home when I get tachycardia I sit crossed legged on the floor and it returns to normal - I managed to play boules sitting down at the weekend smile

Annie

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Post-covid recovery

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Edited by Annie Storkey, Friday, 29 Oct 2021, 16:41

This morning I stood up and did not have tachycardia. I even managed to walk to the bathroom with a normal pulse. Admittedly it did increase when I brushed my teeth (and more so when I got dressed). But this is quite a development. Let me explain.

On the 17th March 2020, a couple of days before lockdown, my 15 year old developed a cough. Just a mild occasional one, not a hacking cough, but the warning signs were there and we went into isolation. He never developed more than this mild cough, though it went on for at least 6 weeks. Several of his friends also had it and apparently a parent of a fellow pupil had a positive covid diagnosis.

The next day I had a cough and sore throat so called in sick. I had mild fatigue but never developed a fever. I felt better after a few days and told my manager I would be back after a week and I duly returned to work. Later that evening I developed shortness of breath and chest tightness. This later developed into a central chest pressure where it felt I might stop breathing, exacerbated by exercise. But on day 16 I felt better. On day 17 I even phoned a student and a work colleague, with just mild shortness of breath.

On day 18 it all changed. I was overcome with extreme fatigue and shortness of breath on exertion. Over the next few days I developed anxiety and panic attacks. Then the fog lifted and I realised that what I really had was tachycardia. I had tachycardia when standing up and moving around and it seemed to be getting worse. It appeared to be autonomic, as I also developed a severe aversion to food which was clearly not gastric; I had to do breathing exercises in order to eat. Eventually I could stand it no more and went to casualty.

After a thorough check up all they could find was sinus tachycardia with a mild rise in blood pressure. The doctor suggested maybe a mild myocarditis which would improve on bed rest. As one of my bloods was slightly raised I was started on anti-coagulants and would have a lung scan to check for a clot on Monday.

The next day I felt awful, presumable due to the anti-coagulants. I spent the day in bed (where, incidentally, my pulse stayed in the 60s) but got up in the evening. I had a massive surge in pulse with chest pain and resultant panic attack and ended up in casualty again. Here an x-ray was taken and the doctor reassured me that he did not think there was anything wrong with my heart or lungs (I think he thought I was just an anxious patient, a common problem for tachycardia patients but I am also bipolar which colours perceptions). 

The lung scan was normal and the doctor in the acute admissions clinic sympathetic and interested. I’m on a waiting list for a 24 hour ECG and echocardiogram.

The paramedic earlier had told me he thought I had Postural Orthostatic Tachycardia Syndrome (POTS) and I looked it up; it fitted everything I was experiencing. The tachycardia on standing and moving around, exacerbated by lifting my arms (chopping vegetables gives me a pulse of 125!), the shortness of breath and chest pain, even the panic attacks. Over the next few weeks I recognised other symptoms such as tachycardia after eating, heat intolerance (my record tachycardia was 140 on the VE bank holiday due to gardening in the sun) and air hunger when sitting and concentrating. It is now 8 1/2 weeks since I developed my assumed covid symptoms yet I’m still recovering from the experience. The prognosis for POTS due to a post-viral Dysautonomia is generally good and I instigated rehabilitative techniques early, an advantage of being an ex-nurse who uses cognitive behavioural therapy daily to manage mental health. But I’ll discuss that in another thread.

Annie


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