What’s your diagnosis?

December 5, 2014

We’ve all gotten some form of the question from a non-medical person:

What’s your diagnosis? What have you got? What is it? What’s wrong with you?

But how often do we have an answer?

For a “healthy” person it seems easy. The answer is usually something well-known and straightforward that requires no explanation, like the flu, a broke leg, a torn rotator cuff, allergies. You give that as your answer and move on.

If you have a chronic illness, though, there’s no simple answer.

Maybe you have one straightforward diagnosis. So you answer: lupus, multiple sclerosis, ulcerative colitis, fibromyalgia, Hashimoto’s disease. You’re even kind enough to give the full name instead of saying MS, UC, fibro, or Hashi’s. Even so, the other person has no idea what that is, so they ask what it is. But do you really want to spend 20 minutes explaining it? Probably not. I usually don’t.

Of course, you might have multiple diagnoses. Maybe you have 2. Maybe you have 12. I always have to stop and think before I list mine, and that confuses people. They don’t understand that the list is ever evolving. A new diagnosis is added, another is changed to something different, and yet another is removed. And the list is long, so I usually just give the few “big ones” and I have to choose which those are at the moment. Besides, the list is long enough that it’s hard to remember. That’s why I always keep an updated list on my phone: so that I can give an accurate list to new doctors. But non-medical folks don’t want the full list, and they don’t understand it. See the previous paragraph. They don’t know what most, maybe any, of my diagnoses are, so they want explanations. But I don’t feel like giving them over and over and over and….

Then again, maybe you don’t have any diagnoses. That’s hard for a lot of people to understand. In their minds, if you’ve gone to the doctor, then you should know what’s wrong with you and you should have a name for that problem. Simple. If they only knew. Medicine is a science that doesn’t have all the answers. So maybe you’ve seen 15 doctors and don’t have a diagnosis yet. Or maybe you have one of those “almost” diagnoses. You know the type. Like my first diagnosis was “Undifferentiated Connective Tissue Disease” which is just a fancy way of saying “We know you have the indicators for a connective tissue disease but we can’t figure out which one, or maybe it hasn’t been discovered yet, so we’ll just give you this label instead.” Try explaining that to someone who doesn’t even know what connective tissue is! Still, I was glad to have that non-diagnosis because at least I had a label to give people. When I had no diagnosis at all for 11 years, too many people (including doctors) thought I was making up my symptoms or that my problem couldn’t really be serious.

On top of all of that, you could have diagnoses you think are wrong. I have a few of those in my records. For example, I don’t think I really have IBS. Irritable bowel syndrome was diagnosed by multiple doctors, but now I think I had undiagnosed Celiac Disease and leaky gut as well as some food intolerances. Now that I’ve addressed all of those issues, my IBS has magically gone away. If you suspect a diagnosis is wrong, should you even bother to mention it?

Of course, you could have a combination of these. Maybe you have one or more diagnoses, but more that haven’t been diagnosed yet and others you don’t believe. That’s especially hard to explain. Sure, I can tell someone I have Hashimoto’s disease, for example, and maybe even explain what that is. Then they think that’s it. When I say there’s something else that we haven’t figure out yet, they’re confused. I have a diagnosis. That should cover everything. How is it possible there’s something else? Well, it’s possible because the human body is complex and, yes, it’s possible for more than one thing to go wrong at a time. Saying I should only have one diagnosis is like saying you can’t have a flat tire and a dead car battery at the same time. Yes, you can. And yes, I can have Hashimoto’s disease and sleep apnea and whatever-the-hell-else all at the same time.

I just got curious. Writing this, I realized that I was only remembering a few of my diagnoses, so I pulled up the list on my phone. The first in the list was one I’d forgotten about as I was writing this: PCOS. That stands for polycystic ovary syndrome. It was diagnosed ages ago, but I’d forgotten. Hence the list. And a perfect example of why these questions are so hard to answer.

Over the last few years I’ve mentioned several diagnoses in this blog, but I’ve never listed them all in one place. I never thought it was important. But I know some of you have been curious, so here’s a short list in no particular order. Of course, this isn’t the same list I would have given when I started this blog back in 2011. Back then, I hadn’t yet received at least 3 of these diagnoses, and I had others that I’ve removed from the list because I know they’re really part of something else. So, as of now, they are:

Hashimoto’s disease, hypothyroid, PCOS, Scoliosis, Raynaud’s disease, tinnitus, undifferentiated connective tissue disease, seasonal affective disorder, upper airway resistance syndrome (UARS), adrenal insufficiency, MTHFR mutation (homozygous A1298C).

How do you feel when someone asks a version of, “What do you have?” How do you answer?


Sharing too much and not enough

November 19, 2014

I get tired of answering the same questions about my health and insurance woes from my family and friends all time, and they feel awkward about constantly asking. It would easy to just have them follow this blog, but I’m keep this blog anonymous, and only a select few know about it. So I send emails.

I don’t send too many emails, and the last one was several months ago. I always find it tricky. I want to include enough information to answer everyone’s questions, but not so much that the email is cumbersome to read. I want to cover everything, without overwhelming anyone. I want to share enough, but not too much.

There’s no guideline for this. There are online tutorials for writing the perfect business-related email. There are tips on writing difficult emails to a friend. But I’ve never heard anyone mention a group email to update friends on a chronic health condition. I try to keep the tone light, but informative. It’s serious, but not too heavy. I only started this a couple years ago, and most of the earlier updates were insurance-related, so it was easy to make fun of the system. It’s harder to make jokes when I’m writing about my health.

And then there’s the audience to consider. Close relatives and less close friends and everyone in between are all on the list. They’re all people with whom I feel comfortable sharing this info, so privacy isn’t a concern, but their knowledge is. The people who I’m closer to know a lot more about my health conditions in general and often the specifics that I’m dealing with at any given time. A good friend who I speak to less often won’t know these things. I know I need to include enough details for the latter to understand, but I don’t want to bore the former.

Now let’s say I find a balance for all of that. There’s still the issue of my own shyness around this stuff. I’m happy to answer questions, but feels so self-centered of me to send out these emails, as if everyone wants to know this stuff. I know that’s irrational. I know that they want to know – most of them get this email because they asked to be kept in the loop. I guess I’ve just never been good at being the center of attention for any reason.

I’ve been meaning to write this latest email for over a month. I’ve thought about it from time to time, but I just never got around to it. Today’s the day. I’m going to write it right now. I just wish I knew what I was going to say.


More things your doctor doesn’t tell you: temporary handicapped parking permits

October 31, 2014

I can’t believe how many times I’ve had different versions of the same conversation. First there was this one:Handicapped Parking

Me: There is absolutely no excuse for parking in a handicapped parking space without a permit.

Him: Well, maybe there are some.

Me: No. None. There’s just no excuse at all. If you need the space, get a permit.

Him: What do you think about pregnant women using those spaces?

Me: I have had plenty of pregnant friends who could walk around just fine up to the time they delivered. They sure did better than me!

Him: Well, my sister had some complications.

Me: Then she should have gotten a temporary permit from her doctor.

Him: Oh, I didn’t know those existed!

Then came this one:

Me: There is absolutely no excuse for parking in a handicapped parking space without a permit.

Her: I totally agree. Usually. I mean, I did park in them last month when my foot was healing. But that was different. I needed it.

Me: If you really needed it then you should have gotten a temporary permit from your doctor.

Her: Oh, I didn’t know those existed!

And there have been others. Why is it so hard to understand that there is no excuse whatsoever for parking in a handicapped parking space without a permit? Why don’t people realize that if they have a legitimate need then they should get a temporary permit? Oh, that’s right, because doctors never offer them! Shouldn’t a doctor suggest to a patient with a broken foot or some other temporary condition that they get a temporary permit? I don’t know if temporary permits are available in every state, but they definitely are in Massachusetts. (If you want proof, check out #6 on this site.) But the average ambulatory person does not know this. Why would they?

Doctors should know it, though. They should know it, and they should tell their patients. I am not suggesting that these temporary permits be handed out like candy on Halloween. However, like so many other issues in the world of illness, education will help everyone. People who need temporary permits would be helped so much if they could actually get them. And people with a legitimate need to park in those spaces would be helped by people not assuming it’s ok to park there if they themselves judge their own need to be worthy.

So I will continue to say this to people, and I hope you do, too:

It’s not up to you to decide if you “need” or “deserve” to park in those spaces. If you have a legitimate need, get a permit. Otherwise, leave those spaces for people who really do need them!

Have you had similar conversations? Please share some in the comments below!


Why do you judge how I use my food stamps? An open letter to “news” writers

October 29, 2014

Dear Judgmental “News Writer,”

Since I’m too sick to work, my financial situation isn’t so great. So I applied for SNAP, formerly called food stamps. A couple weeks ago I got the letter stating I’d received the benefit. I went to the grocery store and, lo and behold, food stamps covered everything I bought, just like they’re supposed to!

But apparently, this is evil and will destroy our society. Or at least, that’s what you seem to think.

As I mentioned a couple weeks ago, I wasn’t sure what I could buy with food stamps. Toilet paper? Toothpaste? Vitamins? No, no, and no, as it turns out. The SNAP web site answered some of my questions, but not all of them. So I turned to Google and typed in a few search terms. What I found was horrifying.

10-29-2014 10-58-16 AM

This screenshot is from the first page of search results. The first few items were all government web sites. The last one here is a very useful post by a blogger. And the three in between from “news” sources? Oy! I clicked on “11 Things You Didn’t Know You Could Buy With Food Stamps” thinking, oh-so-foolishly, that I’d find some helpful tips. Instead, what I found was an insulting, arrogant, judgmental article about the horrible things people like me buy with food stamps. “5 Surprising Things You Can Buy With Food Stamps” was more of the same. So were several other articles I clicked on. Apparently, it’s everyone else’s business what I buy and what I eat.

I want to pause for a moment to note that “10 Things You Can’t Buy With Food Stamps” is wonderful. It points out that, yes, SNAP benefits are meant for food, but things like toilet paper and toothpaste are necessities that aren’t covered. Take a look when you’re done reading this.

Now, I know that people feel they have a right to say what “their” tax dollars are used for. But that’s not how society works. I don’t get to choose whether “my” tax dollars are used to pay for a war, local schools that I don’t use, or road maintenance that I don’t particularly care about (actually, I do care, but that’s another story.) The idea is that society supports society, and then everyone benefits. So yes, my tax dollars support local schools even though I don’t have children, and that’s ok because one day the children who are educated in those schools will be our police, scientists, doctors, and teachers. You see how that works? Again, we all support each other, and then everyone benefits.

Unless someone is on food stamps or getting social security or receiving some other “benefit,” at which point they’re demonized by society. By you.

Apparently writers like you feel justified in calling out someone who buys a bag of chips or a pastry with their food stamps. Oh the horror! They aren’t being healthy enough! And the “N” in SNAP stands for “Nutrition” so this can’t be allowed! You get that this is sarcasm, right?

So who defines what’s nutritious? Is that sugary cereal you feed your child nutritious? Do you know how much sugar is in a glass of milk? Is there too much salt in a frozen dinner? What about a freshly cooked rotisserie chicken? Oh wait, that chicken isn’t covered by food stamps. Ok, well what about that carton of ice cream you like to dig into after dinner on a hot summer night? Oh, it’s ok when you eat junk food because you pay for it with your hard-earned money, but I can’t eat it because I’m on food stamps? Really? What if you’re a government employee and my taxes pay your salary? Then do I get a say?

And again, who decides which foods are nutritious? Maybe you have hypertension and need to stay off salt, so a mildly salted food is bad for you. But I have hypotension and multiple doctors have told me to increase my salt intake, so for me those foods are better. Then again, sugar is a problem for me, so I need to avoid that, while a small amount of sugar might be ok for you. They say red wine has health benefits, but it’s not covered by food stamps. Maybe that should change. And dark chocolate is good for you so does that mean food stamps should cover chocolate bars? What about chocolate cake? Who draws that line? Should it be you, cocky “news writer”? A doctor? A medical board?

Or, I don’t know, maybe me, the person who is eating this food?

And by the way, what happens when, after years of gorging on unhealthy foods with your hard-earned money and righteous attitude, you get sick? Who will pay for your medical care? Who will support you if you can’t work? And how will you buy food if you can’t work? You better come up with a plan that doesn’t involve any government support or “benefits” because you’ve made it quite clear how you feel about those!

Now if you’ll excuse me, I’m off to have some homemade chicken with apricots, rice, and steamed green beans. Followed by a bag of Cheetos. Because I want them and it’s my choice, not yours.