Wednesday, May 21, 2014

Thinking to the future after Arsenal's FA Cup win

Moments after the dust has settled on Arsenal's (very nerve racking) FA Cup final win over Hull City, I'm already looking towards next season and how the Gunners can improved. The side could have won the Premier League season, after leading the table in February. Yet the team capitulated in the second half of the campaign, with the lack of recruitment and injuries seriously affecting our results.

Some of the current players will not be at the training ground in July. Emiliano Viviano, the Italian national goalkeeper, will return to his parent club Palermo after a season on loan, warming the bench. Kim Kallstrom will return to his original club Spartak Moscow. 

Other players will leave as free agents after not being offered or turning down new contracts. Lukasz Fabianski seems to be tired playing second fiddle to Wojclech Szczesny and decided to move on. Bacary Sagna doesn't seem to like his new contract terms and seems destined to join Manchester City. Niklas Bendtner has finally broken Arsene Wenger's patience and will be finding a new club this summer.

Other players need to be cleared out. Park Ju Young and Johan Djourou should be let go. Younger players such as Ryo Miyaichi and Thomas Eisfeld need to go out on loan, while others such as Serge Gnabry need to be played more. The only player I can't decide on is Abou Diaby. He just keeps getting injured and it is harsh to just eject a player just because of that. He has the ability to be a great box to box midfielder like Patrick Vieira but I honestly don't see it happening. 

So there are plenty of places need to be filled. A back up goalkeeper is required, even though we have Damian Martinez returning from Sheffield Wednesday. A right back is required, but one that will not stifle the development of Carl Jenkinson. I wouldn't mind seeing Micah Richards at Arsenal, although he did burn a few bridges by ridiculing Szczesny for posting a selfie after a win over Tottenham. Richards would also help cover the centre back position, which is another area the Gooners need to invest in.

I would like to get a specialist defensive midfielder in, as Mikel Arteta and Mathieu Flamini seem a bit lightweight. Gareth Barry and Esteban Cambiasso are available on a free, so they could be options. Another player that has been touted is Bayern Munich's Javi Martinez, who is out of favour with Guardiola.

A pacy winger is required, as shown by the lack of options after Walcott and Oxlade-Chamberlain got injured. Jérémy Ménez and Angel di Maria are touted as possibilities.

Finally Wenger needs to get two strikers. Not just one but two. After Giroud, there is nobody we can count on. Sanogo is either crap or hasn't reached his potential. I have longed for Karim Benzema to come to the Emirates Stadium, as he can play out wide as well. Other strikers that haven been mentioned include Antoine Griezmann, Mario Mandzukic and Loic Remy,

Arsene Wenger has also been looking further ahead in time, with Rosicky and Arteta getting on. Lars Bender and Julian Draxler seem destined to come to Arsenal but they are not immediate priorities.

Wenger will have that kind of money that is required to spend on the 6-7 players he requires. It just depends if he is willing to spend it.

Sunday, May 18, 2014

After the depression, now comes the anxiety

After seventeen years, with twelve years on medication, I thought I had my depression under control. I would assume I could just take my drugs every night and that would be it until I die. I might not be totally elated or delirious with happiness but at least I would be stable and not moribund all the time.

In recent months, a new dark cloud has been raining down on me. I can't remember when the situation started but I noticed I have been suffering from anxiety symptoms. The main feeling is my heart racing but other symptoms have been occurring. There has been chest discomfort, difficulty breathing and the aching of my arm muscles. I used to suffer these intermittently when I was depressed but the physical complaints usually came with the feeling of being sad. Now I feel anxious and scared.

Some of these symptoms have been low lying throughout the whole day but they become more prominent when I go to work and just before I see patients. There is no logical reason for this relationship. Like 90% of people, work is just inevitable part of life to pay the bills. All of us don't want to go to work but I don't actively despise it, trying to use as much sick leave to avoid going into the clinic.

Neither have I had any major problems with my patients. Most of the people that consult me can be handled quite easily. I do have problems with explaining things to some of my patients, due to insufficient Cantonese skills, but I can get by. As with any other doctor, I have patients who are difficult or are dissatisfied with the level of care. I do get disappointed with patients who don't take my advice about medical care but I have to remind themselves it is their decision, their own health they are risking and not to take it personally.

"Is it the added pressure of being a higher trainee in family medicine?" I have asked myself. I had to see more patients per session but I can still see all of my consultations in time. I have been putting off a number of issues that I need to sort out, including applying for a postgraduate diploma course in dermatology and starting my clinical audit. I do suffer those anxiety symptoms I have been writing about when I think about doing these tasks but I eventually get round to doing it, even if it is slowly.

The anxiety symptoms do abate when I get to see patients, as I think I distract myself from the symptoms just by focussing on doing something else. Yet I'm at loggerheads why I still suffer from these symptoms.

It got worse when I came back from holiday. My USA trip was 19 days - the longest period I have been away since I started working. I had given myself one day to recover from jet lag, then I went back into work the next day. I was fine with the first day back at work. When it came to the second day, with being on night clinic duty, I was starting to have anxiety symptoms and I honestly thought I was having a panic attack. At one point I thought I was going to freak out and pass out. However I managed to get to the end of the day in one piece mentally

The most worrying thing is not knowing why this is happening. Like most patients, I do want to know why this is happening to me. Most doctors will tell you what you don't want to hear - the truth - that we simply don't know. I know my anxiety symptoms are depression related and psychosomatic. I know I'm not entirely happy with work, dreading waking up, waking up later and later, always looking forward to 5 p.m. and Saturdays but we all deal with that. I have been thinking about going part-time or emigrating after I have finished my training. Yet I don't know if my depression / anxiety would improve by doing this.

For now, I just have to tell myself it is psychosomatic and focus on something different.