A big ask from a big community

A few years ago, we were in a dire situation and we reached out for help. Now, we are in an even worse situation and we need help again.

I'm Joe Watkins aka krakjoe: until I became unwell, I was an active member of the PHP core developer community, and was instrumental in helping the PHP foundation get set up. Even if you don't know my name, it's likely that your work relies on mine.

In November 2022, I went into hospital for a minor surgery. They noticed that my blood sugar level was extremely high, but they put me on fluids, so it went back to normal. The operation was a success and when I came round from the anaesthetic, I felt better than I had in years. But, when the anaesthetic wore off, the world began to crush me.

In the 6 months before this surgery, I had lost an enormous amount of weight, 25+kg, I had pain in my legs, I could only sleep in one position, I could only sit in one chair, I couldn't ride my motorbike, I stopped going out. I noticed these things happening, but put it down to stress and getting older. I would take painkillers and do exercises to try to manage it.

Following release from the hospital, I had three episodes of severe diabetic ketoacidosis, all of which almost killed me. I was then diagnosed with type 1 diabetes, I had been living with it, undiagnosed, for years. All the while, the pain didn't go away. I was told that when I got access to insulin and had my blood sugar under control, the pain would go away. I was advised to get myself physically fit, so I bought gym equipment and took it very seriously, I did all I could to try to get myself under control and out of pain. The pain didn't get better, in fact, it continued to get worse and my ability to cope with it was gone. I spent many days crying during this time. Over the following year, my doctor and I worked together, trying every pain relieving regime that she knows of, none were effective. At that point, I wanted to end my own life, my wife was so concerned that she bought a safe to lock away all of my medications, so that I couldn't get to them, I felt that I would be better off dead. I was hospitalised and had to engage the services of a therapist, who helped me great deal, I was prescribed an anti psychotic medication which turned me into a sad wobbly zombie, I was also given very strong anti anxiety medication, which made me sleep a lot, but crying was the main event of my waking hours. My doctor was getting frustrated that no pain relief was helping, she put in many referrals to have tests done, to see specialists and to discuss my pain with the pain clinic. I spent months as the wobbly zombie, before the pain clinic finally had an appointment for me. This was the day that they decided my only real option was fentanyl and referrals for further and more invasive testing.

Any Americans reading this will already know that fentanyl is the worst substance around. It was prescribed to me as a transdermal patch. In any dose, fentanyl dulls the senses, deadens the emotions, prohibits concentration and the ability to think clearly and isn't necessarily therapeutic. Therapeutic doses induce nausea, and with the three day cycle of patch changes, I spend at least one day out of three either nauseated or vomiting. All the while, I have to try to manage my blood sugar, which is a huge challenge because my appetite is gone, I don't sleep regular hours and I struggle to maintain my exercise regime. I have spent many months doing all I can to attempt to get myself into some sort of routine of sleeping, eating and exercising. Convinced that I had managed this, I attempted to go back to work.

For various reasons, that I can't go into right now, this was an unmitigated disaster, and has resulted in our currently parting ways.

I find myself 40 years old, in a foreign country (from UK, living in Spain) with my wife and 2 children, in a rented house, with no prospects of being able to earn money reliably. If I were in the UK still, things may be slightly different, but I have no way to get myself and my family back there, and having lived out of the country for so long, my options there are gone now. In Spain I will have access to the healthcare system for a short while, due to my tax contributions, but when that access runs out, I will no longer have access to the medication that I need to stay alive. My wife and I are unable to determine what our options are, because with no money there are no options. If we can't pay rent we become homeless, if we can't pay into the healthcare system I lose my medications that keep me alive, if we have no money we can't feed our children.

Please help