Debating the line between private and public

April 27, 2019

Today I spent a while editing something I wrote that will be published in a book. Unlike this blog, though, it will be published under my real name. I have gotten so used to writing under Ms. Rants, that I’m feeling a bit confused about this.

In the past seven and a half years I have published 736 posts on this site – yikes! Before I looked it up just now, I guessed it was around 600. That’s a lot of writing, and a lot of posts, during which time I have gotten comfortable sharing a lot. I have spoken about strained relationships, deep fears, and incredibly embarrassing moments. Yes, I know that nothing online is ever completely anonymous, but it’s unlikely that someone will care enough to dig into this tiny little site that doesn’t even make any money to try and find the author, never mind actually make that information public. And if they did, what are the odds anyone would care? This book, on the other hand will be much more widely read, we think. My name will be out there and searchable. And that makes me question, what do I want to share?

This is a question we all make every day in a thousand tiny ways. Today I had to bring my car to the dealer for recall-related repair. What a pain in the butt. They said that at least I would get a voucher for free food from their cafe. This surprised me, and without thinking I said thanks, but that I couldn’t eat anything there because I have Celiac Disease. I didn’t have to say that. I could have said thank you and just left it at that. But I try to bring up Celiac Disease frequently as a way of educating people, and now it’s habit. I want people to hear about it in benign situations, where they don’t feel like “the whole gluten-free thing is blown out of proportion.” That way when they do hear someone requesting gluten-free food, maybe instead of judging that person as being “difficult” they will remember that Celiac is a real problem for real people and instead they might just have some compassion. No, I don’t expect to change minds with throw-away comments, but I figure if they hear it from multiple people, it could have an impact.

I often get asked why I wear knee braces, why I’m limping, or something else that is none of their business. How I answer depends on the person, the way they asked, and my mood. If I don’t feel well, they won’t get a nice answer. If I feel good and have time, and they seem nice and open, maybe I will explain a bit.

But these are all relatively anonymous. The car repair guy knew my name, but that’s just one person, to whom I told one small fact. Now I am considering telling a lot more of my story – my journey through symptoms, diagnosis, shitty doctors, supportive doctors, horrible insurance problems, and all the rest – and telling it to many more people. I don’t mention family or friends in the story, it’s just about me, so it is all my decision.

I always lean towards sharing more. I think we, all of us with chronic illness, will help each other the most by being honest. That is why I made this blog anonymous in the first place. By far the most popular posts on this blog are the ones I thought no one else would care about, and I worried about publishing them because they felt super private, but I did it. Every single time, the response was huge, with people thanking me for sharing because they could relate. So I want to be open and share.

But I am also aware of the world we live in. This is the world where I could get harassed for being on government benefits, put down for eating gluten-free, and generally maligned for being ill.

One day, a friend at my chronic pain support group came up to me and told me she liked my blog. I was confused. It turns out, she had read this site and recognized that it was me. I felt exposed. But this would be different. I would go into it openly, knowingly.

I will share a lot in my story. I will be open about many things. But as I read those words again this morning, I had to ask myself, just how open do I want to be? Because once it’s out there, in a book, there’s no taking it back. And while I want to use my situation to help others, there’s a line. I just wish I knew where it was.

Have any of you had to deal with this decision of how much to make public on a larger scale? How do you decide? Please comment below, because I’d love to know! And if you’ve had to deal with this decision (and I’m sure you have, because we all have!) I would love to hear about that too. How do you decide?

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Normalizing the horrid ways I’ve been treated

April 13, 2019

For seven months my therapist has spoken with a woman who fights hard for her health, who does her own research, fights with insurance companies, argues for the tests she needs, pushes her way in to seeing the best doctors. So it’s no surprise that when I expressed my fear that I might one day just give up the fight, my therapist asked a question to which she thought she knew the answer: “But is there really any chance that you will give up?”

She definitely looked surprised when I said yes, but it was the look on her face when I told her why that surprised me.

Here in Massachusetts, there’s a large doctor network (Harvard Vanguard now, previously called Harvard Community Health Plan for you local folks) where the doctors refer patients within the network, read each other’s notes about patients, see each other’s patient test results, etc. These days this isn’t so unusual, but back in the 80s and 90s it was. Going to these doctors seemed like a good thing, because they communicated with each other. I spent my entire childhood and my early adulthood there.

When my therapist asked if I might really give up I said yes, because it’s so exhausting to keep fighting. And who knows if getting better is even an option? Sometimes I really want to just give up, to say that this as good as it’s going to get and I’ll maintain what I have, but there’s no point in trying for more. And then I do it anyway. Even though it’s exhausting and all-consuming and overwhelming. But maybe one day I won’t. After all, I gave up once before.

I’m not talking about taking short breaks, while knowing I will resume the fight again in a few weeks or a few months. I’m talking about actually giving up, choosing to stop trying altogether. After all, it’s what the doctor told me to do.

I had been undiagnosed for around 7 or 8 years. I had seen many doctors and even had exploratory surgery which yielded no answers but did manage to permanently increase the pain. Sadly, one downside of that doctor network is that I only saw the doctors that I was referred to, and I was referred to the ones who could properly diagnose me, like a rheumatologist. That would have been very helpful. Instead I saw surgeons, orthopedists, and other specialists who didn’t have any answers. Of course, I was also sent to a psychologist, but that didn’t help the pain for now-obvious reasons.

I will never forget the day, almost 20 years ago now, when I saw yet another doctor for yet another opinion, endured yet another painful examination, and was told to stop coming in. She didn’t mean I should stop coming to her office, but to the entire network of doctors. She made that very clear. And since the other doctors hadn’t been able to help, had been condescending when I suggested that perhaps my different symptoms were related (it was years later that I found out they were in fact related, and earlier treatment could have helped a lot,) and generally hadn’t tried to help me if there was no immediately obvious problem they could name, I gave up. I was done.

For a couple of years I stopped seeing doctors for anything more than annual checkups and acute situations. I didn’t even consider attempting to get better. I would simply be in horrible pain every minute of every day for the rest of my life.

Obviously that didn’t last forever and one day, practically out of the blue, I decided to take advantage of my ability to see a doctor without a referral for the first time in my life. I found a rheumatologist and was diagnosed within a week of that visit with an autoimmune condition. It was my first correct diagnosis. But before that, I had given up.

You would think my point in telling you this would be to show the value of self-advocacy, doing our own research, etc. That’s not my point today. That has been my point in many other posts and it will be in many more to come, but today my focus is on how I have normalized that horrible incident with the uncompassionate doctor. When I casually mentioned that the doctor had said I should stop coming in, I saw the look of horror on my therapist’s face. She’s not naive. She has worked in the medical system for many years. She knows this kind of things happens, but she hasn’t normalized it like I have.

That’s not to say I think it’s ok. And if someone dared say that to me again, I would react very differently now, that’s for sure. I certainly wouldn’t stand for anyone saying that to someone I care about. But back then, I was scared and shy and tired of trying, so I accepted it. And over the years I have seen and experienced so many forms of terrible treatment by medical professions and by the systems that are meant to support our health that I am no longer stunned. I am sickened and angry, but no surprised.

I don’t like that I have become so jaded, but I guess that is what 27 years of chronic illness does, at least in the U.S. medical and benefits systems. And what I find even sadder is, I know I’m not the only one.

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“Don’t let the hormones make you think that you’re crazy”

April 8, 2019

I’m an over-thinker. I always have been, I just didn’t realize it was possible to be any other way. In more recent years, as I have had a lot more time to think and a lot less ability to do other things, I have found myself thinking things through even more. This can be incredibly useful, and has allowed me to research my health condition, for example. But it can also lead to trouble, like when I worry about what certain things mean.

I read a lot, too. I read books, blogs, news articles, Facebook posts. I read about chronic illness. This reading means that I find useful information, but I also learned about things I would probably be better off not knowing. I often wish I could unlearn things.

One thing I wish I didn’t know what how much sicker and more disabled some people are than me. Obviously I knew this in an abstract sense, but being involved in the chronic illness community makes it a lot more real. I also see the high rates of mental illness among those with physical chronic illnesses. I worry that one day I could develop some of these issues. I could become more disabled, develop new physical chronic illnesses, develop mental illnesses, or all 3. This isn’t something I worry about all day every day, but it comes to mind a fair amount.

Last week I had a horrible bout of anxiety. I was nervous about the upcoming iron infusion, and the closer it got, the worse I felt. By the evening before, I was a complete wreck. I should have used some medical marijuana, but for some reason that didn’t even occur to me until the next day! I did everything else I could think of: I messaged some close friends, told them I was anxious, and asked for distractions. The kid videos, cat video, stories about their lives, etc. were very helpful. I read the questions my therapist had suggested I ask myself to determine if my anxiety is founded. I ate comforting foods while still having to avoid inflammatory foods, thanks to the food reaction a week earlier. The next day I stayed busy as much as possible. I was annoyed but managed not to panic when I got my period, only 3 weeks after the last one. I had a friend come with me to the infusion. But I was still a wreck.

On the way to the infusion, I told my friend who it would work. It’s a very short thing, but they keep patients around for a while afterwards because there’s a not-insignificant chance of a potentially fatal reaction. “No wonder you’re anxious,” she said. As I responded, “Oh, that has nothing to do with it” I realized how strange that was. I wasn’t worried about a horrible reaction. So why was I so anxious? I couldn’t figure it out.

Several days later I went to my therapy appointment and I immediately brought up the extreme anxiety. It was worse than just about any I’d had before – it rivaled how I felt the night before my food surgery several years ago, and that made no sense! We talked it through for a while. Eventually she pointed out that I have been hypothyroid lately, right? Yes. “Hypothyroid can cause anxiety. In fact, any psychiatrist who has a patient with anxiety will test their thyroid function.” (I pointed out this unfortunately isn’t the case and she said, “If they’re any good, they’ll do it.” Boy do I like her!) Then she pointed out I had unexpectedly gotten my period that morning, and I usually get more emotional a day or two beforehand. Of course, I hadn’t connected the two because I hadn’t known my period was coming. And then she said it:

“I know you worry about developing mental health problems, but don’t let the hormones make you think that you’re crazy.”

And I instantly knew she was right. I worry so much about developing anxiety (yeah, I know, totally counterproductive, right?) or depression but so often, the worst of my anxiety, depression, or other similar feelings are related to my hormones. When I was feeling down last fall it turned out to be a problem with my thyroid medication. When I suddenly feel like crying for no reason at all, it’s always my hormones. At that moment, that was exactly what I needed to hear.

So yes, in this case I would have felt anxious anyway, no doubt about that at all. Medical procedures worry me for a lot of legitimate reasons, and the last time I got iron infusions it didn’t go well, but I wouldn’t have typically felt this anxious by any means. On a scale of 1-10 I would have normally been a 5, not the 8+ I had been experiencing.

I immediately felt better. It was the hormones. That’s all. I have no doubt about that now that I have had some time to think about it (and my period has ended.) It was horrible timing, but there you go.

Could I one day develop horrible anxiety or depression or something else that has nothing to do with a hormone imbalance? Absolutely. Anyone could, but also, my paternal grandmother, father, and sister all had/have depression; my mother and several of her first degree relatives have anxiety. But that also doesn’t mean that every instance I experience is the sign of something chronic. It could just mean that my hormones are temporarily messed up.

Let’s face it, odds are good that I will eventually develop a new chronic illness. It could be physical or mental, and either way, I will have to deal with it. I worry about both, because I feel like I can’t handle anything else, yet I have felt that way before and have somehow managed to handle each new thing. For now, though, all I can do is keep trying to deal with my current health problems the best that I can, while attempting to not worry too much about what may or may not come in the future. And reminding myself that when I find myself feeling overly-emotional, it’s probably due to my hormones.

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Posted by chronicrants