What doctors learn from us

April 19, 2015

Most of my doctors work at one of Boston’s teaching hospitals, so I sometimes have a student or intern in the room during my appointments. This past year, there was a fellow, Dr. N, working with the doctor who I see for my sleep problems. The fellow has been really great, and I’m sad that he’s leaving in June when the fellowship ends. Before he leaves for an exciting new position, I wanted to tell him how great he’s been. But he beat me to it!

At my last appointment, I pointed out that I probably wouldn’t see him again, and he looked sad and reached out to shake my hand. Then he said, “I’ve learned a lot from you.” I was completely shocked. He was being very sincere. I could tell that he really meant it, that he had learned a lot from me. I was truly touched.

I hadn’t thought much about him learning from me. I had been thinking about all I wanted to say to him about what a great doctor he is. I still told him, and I gave him specific examples. I asked that he try not to lose his enthusiasm and caring over time.* He blushed deeply and said he wouldn’t. I hope what I said sticks with him. What he said sure sticks with me. But in that moment, as I was thinking about what I wanted to say to him, I was caught off guard and didn’t know how to respond to his statement. Now I’ve had some time to consider it.

I try hard to convince doctors to be open-minded and understanding, but I forgot what an impression I might make on doctors who are completely new to the field. With Dr. N, it wasn’t just about open-mindedness and understanding. That was part of it, but I think I showed him what a chronic illness patient really looks like. I’m guessing he hadn’t seen many yet, and probably few like me who are so proactive no-nonsense. He saw my resilience and determination. He also saw my fear and anxiety. He heard me say I was willing to try anything, but push hard to prioritize non-pharmaceutical options. He saw me work incredibly hard and try many options, even the ones I clearly disliked or feared. He received many emails from me as I tried to improve my health, emails that were always short, to the point, and respectful. He saw me struggling to stay awake in appointments while trying to joke and keep the atmosphere friendly. He heard me state my symptoms methodically, without complaining about them. He heard me emphasize the disabling aspect of my symptoms in an effort to be taken seriously, even when no one expressed doubt, and I’d like to think he understood why I felt the need to do that. In a short time, he saw and heard so much.

I don’t know what exactly Dr. N meant when he said he’d learned a lot from me. I can only guess. But I would like to think that at least one new doctor now understands more about what chronic illness patients deal with, and will show them the compassion and understanding that we all deserve.

*Note: Dr. N really was fantastic. He went out of his way to do everything he could to improve my health. On top of his magnificent efforts and attitude, he was also very knowledgeable without being arrogant. I hope he goes on to be the amazing doctor that I suspect he’ll be.

Where are all of the men spoonies?

April 15, 2015

It’s not a surprise that there are more female voices in the social media spoonie world than male voices. After all, many (most?) autoimmune diseases affect many more women than men, some by ratios of 2:1, others 3:1 or even higher. Women in many western cultures are also raised to discuss their feelings and problems while men in those cultures are raised to pretend their problems don’t exist and to hide their feelings. There are probably other contributing factors, too. In the end, it comes down to a predominantly female space. And this is a problem.

It’s a problem because men often feel the same kinds of isolation that women do, but they see no one like them with whom to discuss it, so that leads to more feelings of isolation. It’s a problem because men need to discuss how they feel just like women do. It’s a problem because we often feel invisible, and without male representatives, men probably feel even more invisible.

And yet, we know there are men in the spoonie world. I’ve seen several on Twitter. There are a couple in my in-person support group, though they’re definitely out-numbered by women.  They’re around, but they’re few and far between, it seems.

I wrote once about wanting to participate in this project. As you can see in the description, the author wants a diversity of writers so that all readers can see themselves represented in the book. The author recently mentioned that all of the stories she has received so far are by women. She needs men to contribute. Where are the men? Why aren’t they participating?

I’ve been fortunate to have some wonderful commenters on this site. Of course, I have no way of knowing the gender of the people who read this blog and who don’t comment. Often the commenters’ genders are clear, though. So far, they’re almost all women. Occasionally someone emails me, and they have been almost entirely women. I sometimes get tweets. Those are mostly from women. Where are the men? Why aren’t they participating here? Yes, a couple times I have written about periods and other things than cisgender men can’t relate to. But the majority of what I write, while it comes from a female perspective, can also be relevant to men. Just like what I write comes from the perspective of someone short, bisexual, and sarcastic, but people who are tall, gay, straight, asexual, and not sarcastic can probably relate to a lot of it. So where are the men?

I don’t know exactly why I see and hear so little from men in the spoonie world, but I’m saying right now that you’re welcome in this space. I suspect you’re welcome in many others, too, but I can only speak for my own. So welcome! I hope you stick around and leave some comments so we can get to know each other. You’re an important part of the spoonie community. I hope you find your place in it.

How chronic illness didn’t cause my anxiety

April 9, 2015

Two years ago I was sitting in a support group meeting when one member said, “Everyone with a chronic illness has PTSD.” The way he said it was so matter-of-fact that I was really surprised. It was the first time I had considered the possibility. After a moment, I decided I didn’t agree. I knew I didn’t have PTSD. I still don’t. But I understand much better why he said it.

Today I was emailing with a close friend about some anxieties I have. They all have to do with my health issues. Even the anxieties that don’t seem to be about my health issues, like anything job-related, can be traced to the lack of security I now feel because of my health issues. She asked if I might have PTSD. I’d thought about that before, so I know I don’t have it. I had checked the diagnostic criteria and while I have lesser versions of many of the symptoms, I wouldn’t get that diagnosis. I’m sure of it. So what do I have?

I have years of pain, exhaustion, nausea, diarrhea, and other symptoms. I have inexplicable symptoms that pop up at very inconvenient and completely unexpected times. I have years of the fear of not knowing what caused any of it. I guess that’s all to be expected.

But I also have anxieties that were completely preventable, the ones caused by society. I have years of disrespect, disbelief, and condescension behind me, not only from friends, coworkers, and acquaintances, but also from doctors. I had doctors mistreat me both emotionally and physically. I was a terrified teen who was falsely assured it would all be ok. Even then I knew the adults didn’t really know that. I was a scared young adult whose fears weren’t acknowledged at all. I worry about my health, my present, and my future every day, sometimes a lot and sometimes just a little, and I hear nothing more than platitudes from medical professionals, if that.

I have lost people close to me. I’ve missed out on more life experiences than I care to think about. My friendships, romantic relationships, and career have all been altered. My health has affected where I live, how I spend my free time, and even my ability to get a dog. There is no part of me that has been untouched by this.

And yet I’m one of the lucky ones, because my anxieties aren’t nearly as severe as they could be.

Still, I’m aware of them. I’ve been noticing them more and more lately. I don’t think they’ve gotten worse. I think that as my physical conditions have stabilized, for the first time I have the capacity to acknowledge the emotional toll this has rung. And while there’s the occasional larger symptom, mostly I notice small things. Talking to a friend about tattoos is fine as long as we’re talking about body parts where I haven’t had much pain, but when we talked about one particular popular spot, one where I’ve had my worst and longest pain, one that has involved the most mistreatment by doctors… even just typing this out my heart is beating more and I feel tense. Talking to my friend about tattoos there gave me a feeling that was completely unfamiliar. Being touched in certain places upsets me horribly. If a doctor touches my shoulder, my thigh, my back, I’m fine. But if they touch my wrist I just about jump through the roof. The pain there isn’t so horrible anymore, but the memories are. The memories of doctors asking if pressing certain areas would hurt, and when I said yes and asked them not to, they did it anyway just to see my reaction. The memories of doctors intentionally dislocating my wrist because they saw in my chart that it was possible and they were curious. The memories of me asking them not to, of me telling them how horribly painful it was, and of them doing it anyway. Who would do that to a scared 17-year-old? But they did. More than once. The memories of a doctor telling me I should stop complaining because others had it worse, and me leaving the office in tears.

When I see a new doctor I steel myself. I walk in with my medical history, my list of medications, and my questions for them. I’m all business as I interview them. But inside I’m quaking. I ask them specific questions and it appears I’m checking their abilities, but it’s more than that. I need to find out how they’ll treat me and I listen closely for the answers. I try so hard to figure out if they will respect me. Will they listen to my opinions about my own body? Will they take me seriously? Will they read research articles that I bring them? Will they scoff at my chosen treatment methods? Sometimes I get it wrong, but I try so hard to figure it out at that first meeting. I refuse to be treated badly any more, so at the very least, I try to make that much clear. I suffered through that for more than 20 years and I won’t do it again.

Sometimes I think about it all and I wonder, how could I possibly have come out of all of that without being somewhat scarred? And yet, I did ok for so long. Somehow, I managed it all. It was just the last few years that pushed me over the edge. It was getting so much sicker. It was having the doctors say there was nothing more they could do for me. It was doing my own research and having doctors tell me I was wrong, when I knew in my gut I was right (and if you’re a regular reader, you know that I was.)

And it was years of fighting with insurance companies and the social security agency to “prove” that I was really sick, to fight for the benefits to which I was entitled. That might have been the most scarring of all. It was stupid and unnecessary and hurtful, and I will never forgive any of the people involved in the creation of that process for treating sick people like criminals.

I’m generally a happy person, but sometimes I hear things coming out of my mouth (or being typed here on this screen), and I’m shocked at how angry and bitter I am. I don’t mean to sound that way, but I just can’t help it. And really, can you blame me?

It’s important to remember that anxiety can be a condition of its own. You can have anxiety without any physical illnesses. It’s also quite possible to have both, but have them be unrelated. It just so happens that I’m focused on my own type. I know that any anxieties I have are related to my chronic illnesses. It just so happens that the illnesses themselves aren’t what traumatized me the most. It’s the way people treated me because of them.

I wish you, dear reader, the best of luck with your own situation. I sincerely hope you are treated better, while I sadly realize that many of you are not, and many are treated even worse. I hope so much that one day these preventable anxieties are actually prevented.

(And since you might be wondering, no, I’m not in therapy. I would like to be, but I can’t see a private practitioner with my health insurance and I do not want to go to the major hospitals for personal reasons. So until I get different insurance or can afford to pay myself, I won’t be going. But again, I’m one of the lucky ones, because I’m functioning ok. And I’m very thankful for that.)

Thanks a lot, hormones!

April 5, 2015

It’s easy to forget how much of an effect hormones have on our physical, mental, cognitive, and emotional health until they get all fucked up.

Now, before I continue, let me say that, yes, I will be talking about my period. Oh heavens! Some of you have already IMG_20140312_153843closed the browser screen. Others are squirming uncomfortably. Tough. This is what I talk about on this site: health issues. And that includes periods. Have questions? Read this post from last year.

As I’ve mentioned before, I have PCOS. That’s polycystic ovary syndrome. It’s not uncommon, but it affects different people in different ways, so we have to be careful not to generalize when it comes to PCOS. For me, it means I’ve never in my life had a “regular” period. I won’t bother to describe the horror that was my so-called menstrual cycle when I was a teenager. Let’s skip ahead to last year.

After many years on a few different birth control pills and other hormones, I suddenly stopped getting my period. I’d had some off months before, but this time was different. My doctor had me go off the pills to see if I’d get a period naturally. I didn’t. So he ordered an ultrasound. Now don’t get me wrong, I was thrilled to not be getting a period. It was one less thing to deal with from a body that gave me enough to deal with. And I wasn’t looking to get pregnant, so that wasn’t an issue. But there were 2 likely reasons for the lack of a period, and we needed to know which it was. Birth control pills can lean to a thinned endometrial lining, and that can mean no blood. Or maybe I wasn’t ovulating, so that’s why there was no blood. Maybe it was both. Unfortunately, the ultrasound showed that my endometrial lining was building up. It wasn’t at dangerous levels yet, but it was getting close. That’s not good.

So my doctor put me back on a birth control pill. And it’s not been good. First came the brain fog. Then the moodiness, ravenous appetite, and increased pain. Then the fatigue. I eventually realized I’d become hypothyroid again. Estrogen can bind thyroid receptors (thank goodness I’d done my own research!) My doctor ran blood tests, and while I waited for the results I went on the placebo week (many birth control pills have this: you take the pill for three weeks, then nothing or a placebo for a week.) I got my period (yay!) and felt SO. MUCH. BETTER! All those new symptoms were gone!

The blood tests came back and my doctor increased my thyroid med when I started the next birth control cycle. The symptoms all improved, but didn’t go away completely. The fatigue is still bad. I became nauseated frequently. I had occasional disturbing thoughts. The other day I was just going about my business, thinking about how lousy I felt, and suddenly thought that it might be best to die. Then I wouldn’t have to deal with the health stuff. Hmm, that’s not good. I wasn’t feeling depressed or suicidal. The thought only lasted a moment. But it was a moment too long. I’m usually a happy person, but I’d been in a bitchy mood for the past week. I’m not liking me these days.

Yesterday I’d had it. I was sick of the nausea. I worked too hard to fix my diet to be dealing with this bullshit now! And the fatigue was too much. I worked too hard to fix that, too. And don’t get me started on my mood. I just couldn’t stand it anymore.

So today I made a change. Sure, I probably should have checked with my doctors. But I didn’t. I know what I’m doing is safe in the short term. We’ll worry about the long term at my next appointment in a few weeks. So what did I do? I went off the birth control pills and I went back to my old dose of thyroid med – exactly what I was doing before this whole mess. I’m only 1 week into the cycle. I don’t know if I’ll get my period, but I do think I’ll be feeling better in another day or two, and that’s the important part.

I will need to do something to make sure I get my period at least a few times a year. There are other options. This was the option that we thought would have the fewest side effects. Back to the drawing board! Maybe I need a different estrogen pill. Maybe I need progesterone instead. Maybe I need both (which is what I had before last year.) Maybe I needed to raise my thyroid med more. That’s very possible, and I probably should have done it today, but I just felt too lousy.

Very likely, I will need to try this whole thing again in a few weeks. And I will go through this same misery when I do. But for now, I’m hoping my hormones will calm down a bit and allow me at least a few days of feeling my usual level of lousy, instead of this new level!

Thank you – I’m touched!

April 1, 2015

I just want to say a quick thank you to Tamara, Jackie, and whoever else nominated me for this award! I can’t tell you how much it means to me. I didn’t want to say anything during voting because I’m not thanking you in order to get extra attention. I just honestly don’t know how best to reach the anonymous person who nominated me. So thank you!

I miss my friends

March 30, 2015

The other day I wrote about my many medical appointments this month. There was a time when I’d squeeze an appointment in before work, or go during an extra-long lunch break (which I’d have to make up for after work hours.) Those days are long gone. Now I don’t have to worry about missing work, but I do have to worry about missing life.

As I’ve been feeling better lately, I’ve been spending more time with friends. What a treat that’s been! I do better during the day, so I don’t go out much on weeknights. But I see many friends on weekends, and I have a lot of new friends who also don’t work due to chronic illness, so I hang out with them on weekdays. Seeing one or two friends on weekdays each week has been wonderful! Unfortunately, with so many medical appointments, I just can’t manage it.

Today (Monday) I’m doing things around my apartment that need doing. They really need to be done, but I’m also resting. I have an appointment early tomorrow that I need energy for. And one of the things I have to do today is to prepare for tomorrow’s appointment: I need to prepare all sorts of notes so I don’t forget anything when I’m in the office. Tomorrow I doubt I’ll do anything besides that appointment. Wednesday I hope to do some clothes shopping. I don’t have any bathing suits that fit and summer is right around the corner. I’d like to see friends, but I know I won’t have the emotional energy for it after Tuesday’s appointment. Still, shopping drains my physical strength and causes extra pain, so I always need a full day to recover afterwards. That’s what Thursday will be: a recovery day. And at some point Thursday (or sooner) I need to prepare notes for Friday’s medical appointment. After Friday’s medical appointment I’m going to a Passover sedar with my family. I’m not religious, but it means a lot to them, so I go. I’ll probably have to go directly from the medical appointment. Saturday is a nephew’s birthday party, so as you can imagine, Sunday will be another day to rest. And BOOM! The week is gone!

Last week was pretty similar, and I think the following week will be, too. And of course, I know I’m lucky – a year ago I wouldn’t have been able to manage so much in a week. This is huge for me! Still, I miss hanging out with friends. I miss socializing. I like having quiet time to myself. I don’t get bored easily. I can happily spend a day reading and puttering around. But like many humans, I’m a social creature. I live alone, so on the days I don’t leave the house, I don’t see another human being. Days like yesterday, I might go out and see strangers in passing, but I don’t have any real conversations with anyone.

March is a gray month in Boston. As I write this, the skies are dark and there are some light snowflakes coming down from the sky. I have no desire to go for a walk (which I’ll have to do anyway) or to go outside. Yet, a little company would be lovely.

Like I weather, I know my current social situation is temporary. So I’m trying to make some plans with friends for a few weeks from now. At least that way I’ll have something to look forward to when this ridiculous string of medical appointments is over. And I’m just grateful everyone understands why I’ve disappeared for a bit.

Always rethinking goals

March 27, 2015

I had a plan. Then I got sick.

But then, you know what they say about the best laid plans.

This morning I was talking with a friend. Sometimes I do some budget consulting. I don’t have the energy to do much of 3-27-2015 4-01-42 PMit, but I love it, and do it when I can. I always begin with discussing the person’s/couple’s goals. These goals can be anything: buying a house, buying a smart phone, getting a dog, having children, traveling the world, starting a business, retiring young…. there are endless possibilities.

Today I happened to be working with a friend, so it was more casual than when I get paid by strangers to consult for them. After we’d gone through her goals, her spending, her debt, her income, and her savings, we talked some more about goals. And she asked me about mine.

Most people assume my goal is to get healthy, but it’s actually not. I know I’ll never be completely healthy, and I also know I want more than that.

We all had plans that were different when we were healthier. Some got derailed because of health, some got derailed for other reasons, and some were achieved. After my friend left, I thought again about my goals. I think the most unusual thing about them is how often I think about them and change them. Most people, I would guess, hardly ever step back to look at the bigger picture. They assume they’ll do the things society tells them to do, like get a job, get married, buy a house, and have children, probably in that order. But they don’t think beyond that. I know I didn’t. In fact, that’s about what my life plan looked like.

Just before I got sick, I started thinking about leaving my 9-5 job and starting my own business. I didn’t know what that would be. I thought I might try to earn a living off of blogging (spoiler alert: this blog is 4 years old and earns nothing, so that won’t be how I earn my fortune.) I considered some other options. I dated and looked for Mr. or Ms. Right. And mostly I put one foot in front of the other.

Since I’ve been out of work, I am constantly thinking about the present and the future, about what I want and how to achieve it. I change it constantly, as my health and moods change. I’ve come up with several potential ways to work for myself from home part time. I know that I want a dog. I want to improve my health as much as possible while not being obsessed with it. I want a dog. I would love to find a life partner, but I’m also currently content with being single. I want to live someplace quiet and peaceful, preferably near the water. I want to exercise regularly, including physical therapy. I want to be financially stable. I want to spend less time home alone and more time with people I love. And did I mention that I want a dog?

Most people don’t think about their goals often, if at all. Having a chronic illness doesn’t necessarily change that. For some people, it might make them think about their goals less. I happen to go the opposite way. I need something to reach for. I need a happy place to aim for. It gives me a reason to try. Let’s face it, living with chronic illness is work! Reaching for my goals gives me a bit of incentive not to give up on that work.

What about you? Do you spend a lot of time thinking about your goals? Do you avoid them? Do you change your goals over time? What’s one thing on your list?

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