How sick is sick enough for you?

October 7, 2012

When I was a kid and my symptoms first started, a lot of people said that it was all in my head.  Doctors, nurses, teachers, friends, and family all expressed doubts at one point or another.  My mother was the only one who never doubted me.  I heard it so much that even I started to wonder myself.

After 11 years of symptoms, it was a relief to finally have a blood test as proof.  “Look world, it’s not in my head, it’s a real thing!”

Now I’m fighting the same fight again.  Only this time, instead of saying the pain isn’t real, people are saying it isn’t bad enough.  I keep wondering, how sick is sick enough?  What’s the limit?  What’s the definition?  My boss clearly didn’t think I was too sick to work.  Or maybe that was just wishful thinking on her part.  The long term disability insurance folks have said that they don’t think I’m too sick to work.  I’ve been spending months preparing the materials, bit by bit, to prove otherwise.  Now, I just found out that the MassHealth folks (our state medicaid system) also don’t think I’m too sick to work.  Now I have to figure out how to prove otherwise to them, too.  Of course, I’m expecting to get denied by the SSDI folks, since almost everyone is denied on their first try.  I just applied, but I’m pretty sure I’ll have to work on an appeal.  I got dumped by a doctor who’s tired of dealing with my expensive tests and extensive paperwork, and who was unwilling to state for the record that I’m too sick to work (even though he said it off the record many times.)  He told me to have another doctor do it.

Being this sick is the worst thing in my life.  Being unable to work is demoralizing and scary.  So what’s happening?  Instead of focusing on the positive parts of my life and trying to work through this crap, I’m forced to focus on the worst parts of this crap and explain and define it over and over again for all of the doubters.  I’m forced to examine and then reexamine the most negative parts of my life and lay them bare for strangers to judge me.  And they certainly do judge me.

I’m not the first person to go through this and I won’t be the last.  But at this moment, I may be the most irritated.  I just want to yell at all of those idiots, “If you don’t think I’m sick enough, then just how sick do you think I need to be?  How sick is sick enough?  How sick would you have to be to not be able to do your job?  How sick would your kid/parent/sibling/best friend need to be to not be able to work?”  Not that I think it would do any good.  I’m just tired of being judged.


Why medical records stress me out

October 4, 2012

How many of your own medical records do you have?  Really think about that.  These are pieces of paper (or maybe electronic files, if you’re lucky) that delve into various aspects of your health from the day you were born.  They are from every practitioner you’ve ever seen.  How many do you really have?  And how do you find any particular piece of information within them?

It bothers me sometimes that I have so few of my medical records.  Of course, I don’t know how to quantify this, but I know I’m missing a lot.  There are the many doctors I only saw once or twice.  There are a few doctors who I saw a bit more.  And I no longer remember who any of them are!  There’s just no way to get those records now.

Then, for each practitioner, there’s the matter of getting my hands on every record from the time I started seeing them.  For the practitioners I am still seeing, this means constantly asking for new copies of records once or twice a year.  For many people, this costs money. I can get some of my records for free, but I pay for others.  Frustratingly, I can arrange for specialists to send copies to my PCP for free, but I have to pay to get copies for myself.  Why is this?  I think it’s wonderful that the law (at least in Massachusetts) requires that PCPs receive all medical records at no charge.  This is important to maintaining patients’ health.  At the same time, though, I think that patients need to be responsible for their own care, and that those who want to be responsible for their own care should have free access to their own records.  There should not be any roadblocks to this.

Asking for medical records is frustrating, but I am completely mystified that I can not get copies of any lab work without going through my doctor’s office.  I get some testing done through the doctor’s office’s lab, but some of it is done through an independent lab.  I called that independent lab to ask for a copy of my test results recently, and they said that they were not allowed by law to give me those results.  This was my blood that they tested.  This is my health they checked.  But I can’t know the results?  Really?  I understand that they don’t want uneducated people to panic when they get abnormal results, but what about those of us who are educated about our conditions and who want to take charge of our own healthcare?  I should not have to wait an extra week to get my doctor on the phone, or maybe even have to go into the office and pay an extra copay (if I’m lucky enough to have insurance, which I don’t have the moment) just to find out that my TSH levels have changed.  That’s absurd.

And having copies of my medical records isn’t handy for just my own use and knowledge.  Every time I see a new doctor, it helps to bring my own records instead of waiting weeks or months to have another practitioner send them over.  With the insurance appeal, SSDI application, and Medicaid application, having my own records speeds up the process by weeks or more.  Not having the records slows down these already-painful processes.

Of course, let’s assume you actually have all of your medical records.  What do you do with them?  I stopped counting a long time ago, but I know that I have many hundreds of pages of records.  It could easily be over one thousand pages.  Yes, 1000 pieces of paper containing both important and unimportant information.  (The picture above shows some, but not all, of my records.)  While almost all of my records exist in computers at doctors’ offices, I am not able to receive electronic files.  At one point I considered going through my records and entering all of the information into a searchable spreadsheet, but it was just too overwhelming.  Then I figured I would do the same thing for only my current records, but I couldn’t figure out how to set it up in a way that would actually be useful.  Analysis paralysis.  Shoot.

This stresses me out!  I know that there are important tidbits in those pages.  I know that it would help to have access to every record of mine that exists, and to have it in some useful format.  I just don’t know how to make that happen.

When I was first diagnosed with an autoimmune condition it was a real shock to me.  I had been having symptoms for 11 years at that point, and this seemed to come out of nowhere.  My ANA levels were incredibly high.  At the first appointment, I gave my new doctor a copy of my old medical records.  I can’t imagine how long it took him, but he went through those records and found two previous ANA tests that were high.  I wonder if there were others that he didn’t find in that mess of papers.  The two previous tests weren’t high enough to diagnose me, but they should have been flagged and watched.  Someone should have been continuing to test those levels.  My PCP back then was less than useless, and he never coordinated my care.  No one told me about the tests.  Back then, I didn’t read my own test results, and since no one had mentioned autoimmune conditions to me, I didn’t know what to watch for anyway.  Now imagine if this had been different.  What if some of my other doctors could have easily done a search in an electronic file and seen those high scores?  Or what if I could have done it myself?  I could have been diagnosed years sooner.

There have been a few other times that I have read parts of my medical records for one reason or another, and found surprising notes.  I learned that a doctor thought I was overly emotional, and that was the reason behind my pain.  I learned that something was found during surgery which the doctor never mentioned (and I have witnesses that he didn’t!)  I discovered suspicions that doctors had about my conditions, but which were never tested (and some of them turned out to be right!)

What’s done is done, so I am not dwelling on that.  What I am dwelling on is the fear that it could happen again.  I have dozens of blood tests run every year, plus other tests.  What if I am missing something?  I won’t rely on the doctors anymore.  I need to keep track of it all myself.

What do you do?  How do you keep track of your records?  Do you have copies of everything?  Do you create electronic files? How do you organize it all?  I would love to get ideas from everyone!


Saturday night slump

September 22, 2012

It’s Saturday night and I’m the pathetic “friend” checking status updates on Facebook.  It’s 9pm on a Saturday and I’m at my computer.  I have plans.  Well, I had plans.  There’s a huge, once-a-year event that I love, and this year, for the first time, it’s just a short walk from my apartment!  I really want to go.  But I’m so tired.  And I have to be up early tomorrow.  But I want to go.  But I have to be up early tomorrow.  And I’m tired.  But it’s only once a year.

Sound familiar?  I’m sure most of you have experienced this.  I’ve certainly written about it before.  And a bit more recently, too.  And it still sucks.  I don’t expect to go out every night.  I don’t even expect to go out every Saturday night.  I just want to go out tonight.  I guess that’s asking too much.

Now in fairness, I actually could go out tonight.  I could throw on some halfway-decent clothes, walk five minutes, and hang out with friends and new people.  I could flirt with some cuties (there will be a lot of single people there, and while I’m not in a good place in my life to date now, some flirting could be fun.)  I could have a lovely time, then come home at a reasonable hour and get some sleep.  So why don’t I do this?  Well first, I’m so run down, I don’t know that I have the energy to flirt and chat with people I don’t know.  Plus, I really do have to get up early and be active (active by my standards, at least) tomorrow.  I should have planned that better, but I had forgotten to put tonight’s event in my calendar, so I forgot about it when I made tomorrow’s unchangeable plans.  I went out last night, so it’s not like I’ve been stuck at home for days, which happens sometimes.  But I’m still just frustrated.  I was inside all day yesterday until I went out at night.  Since then, I’ve been inside all day today.  I missed the sunny weather.  I’m missing the fun tonight.  I feel like I’m missing my own life.

I want to think this is temporary.  And let’s be honest: a few months ago I wouldn’t have been able to go out to last night’s thing either, so I’m making huge progress!  And there will be another event next year.  Maybe I should put that in my calendar now.  But then, what if it isn’t temporary?

I feel like I should apologize to you.  I sound like a whiny kid, all upset because I’m only getting some of what I want.  And that’s true.  As we all know, when you’re living with a chronic illness, there’s a lot you don’t get.  Sometimes I can handle it, sometimes I can’t.  Today isn’t one of the better times, but I’ll get through it and life will go on because really, what other choice is there?  So tomorrow I’ll be a happy, mature adult.  But for tonight, I think I’ll indulge in a bit more whining.


The joy and joint pain of autumn

September 18, 2012

I love autumn.  The heat and humidity of summer are gone, and with them a lot of my extra fatigue and other symptoms have gone.  And it’s pretty.  The sky is clear most days, the leaves change colors (they’re just beginning now,) and the air is crisp.  I’m happy every time I look out the window and see the lovely weather.  This picture is from last year, but you get the idea.

Of course, right now we’re in a transitional time.  Right now, summer is mostly over, but not quite.  And it’s mostly autumn, but not entirely.  We haven’t transitioned completely to the cool days yet.  Sometimes I’m hot in a t-shirt and sometimes I need a sweater.  It’s mixed.

And we all know what that means, right?  If you don’t experience worsening symptoms during spring and fall, then you’ve probably heard from others who do.  My rheumatologist says that her phone rings constantly in the spring and fall.

For me, spring is definitely worse.  My body seems to know that bad times are coming, with summer on the way, so it goes haywire.  But autumn isn’t the easiest thing either.  For the last couple of weeks, it seems to have manifested itself as worsening joint pain, especially in my fingers and wrists.  Now, I’ve had pain in these areas for more than 20 years, so it’s not like I can’t handle the pain itself.  What’s bothering me is that no movement causes stiffness, and small movements from fidgeting makes it worse.  Big movements are good, like washing dishes or cooking or sorting through a pile of books (as long as they aren’t too heavy.)  And the problem is that I just don’t have enough of these big movements to keep my joints happy.  I’m home a lot these days, so I’m open to suggestions for things I can do at home to keep my fingers and joints useful without using up too many of my spoons.  Typing on the computer or reading or watching tv all seem to be bad things for my achy hands, and that’s how I usually fill my days, so I’d love some new ideas.

How’s autumn for you?  Is it a rough transition, or is your body just glad to be out of summer?

Good luck during the changing of the seasons CI folks!  At least it’s pretty.