Please don’t take away my physical therapy

January 25, 2018

For most of my life, my posture has been lousy. My shoulders hunch forward, I never sit with my legs down properly (in large part because I’m very short, and I can’t comfortably sit that way, since my feet won’t be flat on the floor), and of course, there’s the scoliosis. Two different forms for scoliosis, actually. Thanks to all of that, and a doctor who majorly screwed up (she measured my legs wrong, and for years I wore a lift on the WRONG FOOT!) I have a lot of neck and back pain. And that’s even before you consider my mis-aligned kneecaps, which have worn away most of the cartiladge on the outer sides of my knees.

So you won’t be surprised to learn that I have been in physical therapy for neck and back pain a bunch of times over the years. I’m doing it now, too. But this time it’s really helping. Probably because I’m not getting cut off after a few short months, like all of the previous times.

If you’ve ever done physical therapy, I’m guessing this will sound familiar. I would go in 1-2 times per week for a few months, be given exercises to do at home each time, and then at the end, told that if I go home and do the exercises, I’ll be fine. And when I wasn’t fine, when I came back for more help, I was treated like I failed.

And yes, I admit that I wasn’t as consistent with the exercises as I should have been. But even so, it felt like something else was going on.

That brings us to 2017 when, for the first time in my life, I went to physical therapy appointments for the entire year. Sometimes I would go 2 or 3 weeks in a row. Sometimes I would miss 2-3 weeks. But always, I went back. In between, I did my exercises at home. Sometimes I was consistent and sometimes I wasn’t, but I always tried.

And it helped. A lot! So you can imagine my disappointment when I went to physical therapy yesterday to be told that Medicare has lowered its coverage limit.

Oh boy.

On the bright side, this might not effect me. She had checked and last year I would have just squeaked by under the 2018 limit. Still, it’s disconcerting. We will need to be careful.

We talked about having me come in less often. Or maybe skipping a few weeks here and there. Or maybe coming in for shorter appointments, since the limit is on the dollar amount covered, not the number of visits.

Not for the first time (not even the only time that day!) I came up against the problem of having to manage my health in the face of insurance limits.

On the one hand, this is totally fair. After all, they need to set limits, right? On the other hand, this is my health, and isn’t the whole point of paying into the system so that it will cover me when I need it to? What good is it if it won’t. I’m not the cheapest person on the insurance’s rolls, but I’m far from the most expensive. And damn it, I want my physical therapy! Without physical therapy, my pain and posture will get worse and that will harm me in a lot of other ways, limiting my ability to work, meaning I will need even more benefits.

After all, I am losing a bunch of my benefits this year (yeah, that’s a topic for another post) because I earned more last year. Don’t they want to keep me off those benefits? They should want me to be healthy, if only for financial reasons. They should consider that more physical therapy will actually save the system money in the long run.

But no one worries about that. They certainly don’t worry about the human being behind the numbers. The human being who simply wants to be in less pain, who wants to stick with the thing that works, who tries so hard to feel better every single day.

My physical therapist warned me that Medicare changes its limits every year, and she implied that future changes would not be in my favor. I am not surprised. But I am horribly, sadly, painfully disappointed.

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Struggling to endure

December 6, 2017

Last week was a really good week. And that made Sunday so much harder to deal with.

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First I took a long walk around beautiful Walden Pond (and took this photo), stopping a bunch of times to admire the view. It was unseasonably warm, and sitting down to watch the water was lovely. I was able to clear my head and figure some things out.

I made plans. I worked through ideas that had been weighing on me. I made some tough decisions about my finances and my health. By the end, I was super excited to get started! I walked about 2 miles total and felt ok afterwards. I rested that evening, but that was it.

A few days later my mom came to visit. After a lovely lunch, we took a walk in a wooded area. The sign said it was a 1 mile loop, and that seemed ok to us. Well, I don’t know what went wrong, but the path never looped. We eventually made it back to the car, but we walked about 4 miles. I was surprised I felt so good afterwards. Tired, but good. Hmm. Maybe this was a new trend?

The next day I hung out with friends and had a wonderful time. I got home later than I expected and was too tired to go out to a friend’s house that night like I had planned. Too bad. I really wanted to go, but I knew that resting was the right move.

It had been such a fabulous week. I exercised, got fresh air, got clear on a new mindset, spent time with friends.

And then it all changed. I spent all day Sunday feeling run down. I never left my apartment. I cancelled all of my plans for the day. This sucks, but it isn’t unheard of. And I did a lot this week, so I couldn’t complain, right? I trudged through the day, mostly reading a novel and wishing I could do more.

That would have been ok. It would have been disappointing but totally fine. If only that was it.

Sunday night I got really nauseated. Sometimes I know what causes the nausea, but usually I don’t. I tried Pepto Bismol, which usually helps, but this time it didn’t. I tried medical marijuana, which usually helps, but this time it didn’t. The nausea was really bad. My pulse was racing (114 while I was still sitting) and I felt bad all over.

Over the years, nausea has because an emotional trigger for me. I don’t know why it has, when the pain hasn’t, but it just has. So as usual, I started thinking about how horrible this is, and when will it end, and why won’t it ever go away. Yes, I have these episodes a lot less often now that I’m off gluten, corn, and a couple others triggers.

But why does it still happen? Was it something I ate? Something I did? A delayed reaction to the 4 mile walk 2 days before? How will I handle another 50+ years of this? Why did I bother to make plans? Obviously it was stupid to think I could ever get off of benefits and support myself. I should just stop trying. Then I started thinking about how it might be easier to just kill myself and end this. Except that would be very upsetting to my family and friends. I couldn’t do that to them.

I started having those thoughts a few years ago. I know it’s temporary. I’m not too worried, because I only have them when I’m curled in a ball on the floor, too nauseated to do more than stagger to the toilet occasionally. I have never gotten to the point of really wanting to kill myself but even if I did, I wouldn’t be able to until the worst of it had passed, and I never think about wanting to die except when I’m in the worst of it.

So all these thoughts were floating around in my head, and then something strange happened: I started to cry. And cry. And cry. Before I knew it, I was sobbing. Big, ugly sobs. I couldn’t stop crying. I thought I should call someone. (If you’re new to this blog, I live alone.) I ran through a mental list of awesome people in my life, and finally decided to call a friend who lives in my apartment complex. I asked him to come right over and he did. I didn’t explain, but he must have heard it in my voice, because he showed up with his dog, saying the dog was for therapy.

The dog, of course, immediately started to nuzzle me and lick me. He’s that kind of dog. Very sweet. But what I really needed was a hug and some understanding, and I got that.

We sat on the floor while I cried and talked. I always sit on the floor during these spells – for some reason, it just works for me. I cried myself out and we just sat there for a while. Then for some reason, I started crying again. Still, having someone there was extremely comforting.

Eventually I wore myself out. My friend and his dog left (he mentioned leaving the dog, but I was too weak to care for him.) I fell asleep on the couch to an old movie that I often watch when I don’t feel well. I woke up less than an hour later and found the nausea had subsided enough that I could drink a little water. Lots of diarrhea and lots of crying can really dehydrate a person. Then I stumbled to bed. I slept fitfully, but got through the night.

Monday was a bust. I cancelled plans and ate almost nothing. But it didn’t get that bad again. Tuesday was better, and I even left the apartment. And today is better still (though it’s after noon and I’m still in my pajamas, so it’s not fantastic – I try to get dressed by noon every day when I can.)

So why am I sharing this? I’m sharing it for a few reasons. For one, amongst my friends with chronic illness, I’m often seen as the strong one. Strangers online (both through this anonymous blog and under my real name) say that I’m a role model. I have my shit together. I’ve got a good handle on all of this. I work my butt off to take care of my health, research new treatments, find the best doctors and practitioners. That’s all true. But that doesn’t mean I don’t have really bad times, too. I think we all need to remember that the people who seem to be great probably have bad times behind closed doors where we can’t see them. It’s important not to idealize people, but to see them as they are.

It’s a reminder that we all have our struggles. We struggle, and then hopefully we have better days, too. We don’t need to assume someone is perfect in order to have them as a role model.

I’m not perfect. I’m still continuing to fight every day for the best health possible. I want to believe that one day those episodes will end. Until then, I will just keep on trying. Because what else can I do?


Feeling moody from pain

July 19, 2017

There’s an emotion toll to chronic pain that’s easy to miss if you have only ever experienced short term pain.

A banged finger will heal soon enough. A sprained ankle will cause frustration. Even a broken bone rarely leads to anything permanent, and so you just wait it out. But the chronicness of chronic pain means that you need to handle it long term, and that comes with a lot of emotions.

Over the years I have had many feelings about my pain. Working through them has helped me to deal with my feels now, and yet, I still struggle.

I have new pain. Just 2 short months ago my thumbs weren’t even on my radar. I used them without thought. Now, everything hurts. I cringe when I realize I have to go to the bathroom, because I know I will feel extreme pain when I pull down my shorts. Picking up a plate is difficult and painful. I wonder how long it will be before I break and drop something not from clumsiness, but because of the pain or weakness. [Side note: I say my thumbs hurt throughout this post, but more specifically, it is the joint that connects each thumb to my hand. Thankfully the rest of each thumb is ok…. for now. Since every movement affects that joint, I can’t use my thumbs without feeling the pain, though.]

I’m scared. This pain could be permanent. I might literally have it every day for the rest of my life. Or it could go away. Or it could go away and then come back at random times. There’s no way to know.

I’m frustrated. When I feel horrible, I spend some time on the couch watching tv and crocheting. That makes me feel better. But I was in too much pain to crochet. I always fidget, always need to keep my hands busy and my fingers moving. But now any type of fidgeting I do is painful, because I use my thumbs, or I use other fingers and that pulls at the muscles that connect to the thumbs. What on earth will I do if I can’t crochet or fidget? I can’t even begin to imagine.

I’m sad. So very sad. Because I know that my thumbs will probably never be the same. And because I know there are other joints in my body that I am taking for granted now in the same way I took my thumbs for granted two months ago. I want to appreciate everything now, while I can. I even want to appreciate my thumbs because I know all too well, from 26 years of joint pain, that things will probably get even worse and that I will look back on this time and wonder with amazement at how I didn’t realize how good I really had it, despite the pain.

I’m overwhelmed. My head swirls. Did the onset of summer cause this or exacerbate it? If so, maybe things will be better in the fall? The increased dose of my anti-inflammatory supplement, from 1/day to 4/day, hasn’t helped. I really hoped it would. When I started with 1/day last year it changed everything and made me feel so much better, but it seems no match for my pain-filled thumb joints. Or maybe it’s disease progression, and I need to go back to taking Plaquenil. I don’t want to, for many reasons, but I can’t deny that it has helped a lot in the past. I’m in so much pain that I almost want to try it now, but should I wait to see if things get better in the fall? Then again, what if they get worse? What if waiting just leads to more damage and makes it impossible to halt things? No one can make these decisions but me. I could see my doctors, but would they say anything I don’t already know? Besides, I just saw my rheumatologist a couple months ago and I have another appointment to see her in a month. It seems silly to move that up so soon. We can discuss it all then. But when every day is such a struggle, a month feels very far away.

I feel trapped. I feel trapped in my body, which is so filled with pain. And I feel trapped in my apartment, because the evil humid air outside makes my symptoms worse. I know that even a walk to my car will increase my pain and fatigue and will bring on nausea and diarrhea. I can’t go out there. But I need to move, to be distracted, to do something.

I feel cut off. Texting has slowly become a primary form of communication amongst my friends and the new person I’m dating. But texting is far too painful. I dictate messages into my phone, but I find that frustrating. And even just navigating to my messenger app is painful. I can do it, but it hurts. I am SO GRATEFUL that typing on my laptop isn’t too painful yet. But what happens when it is? I lived through that 20 years ago, but computers weren’t as vital for communication then.

Yesterday my neighbor stopped by for a visit with her puppy. I hadn’t left the apartment all day, thanks to the weather and my pain. Even just opening the door and feeling that wall of thick, muggy air for a few seconds wasn’t good. Having a visitor felt so good! And the puppy was a darling! Petting him hurt, but it was worth it. They left all too soon. I wish there was a visiting puppy program for the sick.

I am so fortunate. I have a lovely home, a caring family, wonderful friends, and enough food and medicine. But the emotions still engulf me at times.

Unfortunately, my mother called last night at the wrong time. When we started speaking everything was fine. But during the call the pain became worse, and by the end, I was moody and bitchy. I was too busy talking to her and feeling sad and frustrated and overwhelmed to take a step back and recognize and work through my feelings of sadness and frustration and overwhelm. So I took it out on her.

And my mom, being the amazing woman that she is, listened, expressed sympathy, and never blamed me for acting like a selfish child. She has chronic pain too, though it’s less disabling, and I think she understood.

Halfway through writing this post, my mom called. She said that she wanted to do something for me and I could not say no. She is going to come to my apartment one day and clean it for me. I can’t clean it myself, and the cleaners I hired didn’t work out, so I have been feeling stuck. She wants to do this to help me.

I have so many negative emotions right now. This thumb pain is upsetting to me in ways I haven’t been able to express to myself yet, much less write down here. But having my mom in my corner definitely helps. Even if sometimes I still get bitchy. After all, I’m only human. And I’m scared.


Can I trust them?

July 11, 2017

Two of my strongest feelings are conflicting with each other, and I’m not sure what to do.

I have a lot of trust issues when it comes to medical professionals. When you look at my history, it’s not hard to see why.

I also have very passionate feelings about medical research. I feel it’s so important to focus more on the “less profitable” health issues. Money should not be the deciding factor! And yes, this is a bit selfish, because I want to see new treatments come to market for conditions that I have, and for conditions that my friends have, too. Not to mention the millions of other folks out there.

There is a group studying the rare form of sleep apnea my father and I have. My doctor wants my father and me to participate. Not only would we each provide useful data on our own, but we’re first degree relatives, which would be very useful for the researchers! My father has already sent in the forms. I have been holding onto them for over a month. I just can’t seem to sign.

The work is legitimate. The researchers are legitimate. I am not worried about giving blood samples or doing sleep studies. There is no logical reason to not do this.

But I can’t seem to sign the papers. I am worried about how the information might be used. What if it’s not kept confidential like they say it will be? Of course, this could be a risk with my regular medical records, too, but those feel more necessary. This is entirely optional.

I should do it. I want to further research. It’s my responsibility. How can I continue to rail against the system when I refuse to participate in it? I want to do this. I honestly do want to do it.

If only I could calm my fears.

What would you do? Have you participated in research at all? If so, how do you feel about it?


Have you called your senator today?

June 29, 2017

HELP!

In the chronic illness community, there seem to be two groups of people:

  • People in the U.S. who are terrified of losing their healthcare or of it becoming completely unaffordable.
  • People outside the U.S. who are wondering what the hell is wrong with us.

These are some scary times.

If you don’t know what’s going on, here’s the basic summary. Our political system has become incredibly divisive. It’s been divisive for a long time, but there are no longer congresspeople working with folks from the other party. Politicians go out of their way to hurt the other part just for the sake of hurting them. Even if politicians from different parties agree with each other in private, they won’t do it in public.

When Obama became president, the Republicans vowed to do whatever it took to prevent him from being reelected. But he was reelected. Still, they could destroy everything he had accomplished. For 7 years they talked about repealed the healthcare plan he put into place. They talked big. And then the day came when they had to actually do what they’d said.

So now here we are with a Republican-majority congress and a Republican president. They have no excuse for not repealing Obama’s healthcare plan. The thing is, they suddenly realized that wasn’t so easy to do. People like it! They use it and rely on it! They need it.

But after talking big, the Republicans can’t just say, “Oops, turns out we can’t come up with something better that will make our richest supporters happy, so we’ll just keep what we’ve got.” No, they have to get rid of it. And the plans they have been coming up with instead are cruel.

Yes, cruel. That’s no exaggeration. The House’s plan would cause 23 million people to lose health insurance. The Senate’s plan would cause 22 million people to lose health insurance. Preexisting conditions could cause your rates to skyrocket. A “preexisting condition” could be anything from cancer to lupus to migraines to pregnancy.

The Senate’s plan would remove access to free birth control, abortions, and maternity coverage. That’s right. So you won’t have any monetary help avoiding pregnancy, ending a pregnancy, or getting medical treatment during a pregnancy, never mind actually giving birth to a baby. Cruel.

Both plans cut billions – yes, BILLIONS – of dollars from Medicaid. Medicaid is the government-run healthcare program for the poor and disabled. You know, the folks who most need the help.

As for “regular” folks with jobs and steady incomes, they’re safe, right? Not really. Predictions are that their premiums, deductibles, and co-pays will go up, even while the covered services (like contraception, abortion, and maternity care) are reduced.

So who benefits? The rich will get huge tax breaks. Insurance companies will also save money.

Um…. Yeah, I’m usually speechless at this point. For about a minute. Then I start yelling again.

Remember, these bills are hugely unpopular. But they can still pass. Because the Republicans would rather do something unpopular than nothing at all.

As for me, I currently have two different health insurances. My primary insurance covers 80% of each bill and the secondary insurance – Medicaid – covers the other 20%. If any of these bills pass, I will likely be able to keep the primary insurance, but there will be limits placed on it, so it won’t cover as much as it does right now. There aren’t any details yet. I don’t know if it will still cover the CPAP-type machine that I need for my sleep apnea, the many doctors’ visits, the blood tests, or the MRIs.  I would lose the secondary insurance. I might or might have access to other secondary insurances that I could pay for myself. Right now, those cost about $250 per month – money I don’t have available. But that’s right now, and those prices will go up under these new Republican plans. How would I pay for it?

Shit.

This is bad. Horrible. Catastrophic.

Cruel.

So what can you do? I’m so glad you asked! Here’s what you can do:

  • If you are in the U.S., call your Senators! Tell them to vote against these bills! Tell them you want to keep the Affordable Care Act just the way it is. If you can’t call, send an email. Their contact information is right here: https://www.senate.gov/senators/contact/
  • If you are in the U.S., call other Senators! There are many who are on the fence, and we need them with us on this!
  • No matter where you are, ask your friends in the U.S. to call their Senators!
  • Post about this on social media. We need awareness! Too many people don’t realize what’s happening or how it might affect them. And that’s a problem. On the other hand, if the 22 MILLION – that’s 22,000,000 people! – all called their Senators, and each got a friend and/or family member to call also, there’s no way the Senators would vote for this. They wouldn’t want to risk losing the next election, after all.
  • [Edited to add on 7/5/17:] Attend any town halls that you can and make your voice heard! These town halls have a HUGE impact, not only in the media, but on the senators themselves. If they get a lot of feedback at these town halls, they might very well switch their votes to be against this heinous bill.

I’m sure my Facebook friends would be sick of my myriad posts on this subject if so many of them weren’t also concerned. Many are in much worse situations than me. Some are just as disabled, but will lose ALL of their health insurance coverage if this passes, and they don’t have any savings to manage without it.

Remember, 22 million people will lose health insurance if these bills pass. But how many of those 22 million will survive? Because people will die. That is a fact. And while I have no doubt that history will prove me right on this matter, I don’t want to be right. I want to be alive. How about you?

What are you waiting for? If you feel up to it, take 5 minutes RIGHT NOW to call your Senators, call other Senators, ask your family and friends to call Senators, and post on social media. Because unless we take action, millions of people will lose access to healthcare.


The importance of community

June 15, 2017

Last week I saw my primary care doctor for my annual exam. At the end of the visit, he brought up the fact that I was on disability. He said that only 5% of people ever manage to get off of disability benefits. He said that it was important to find activities to keep busy and productive. Then he talked about the isolation that can come when you don’t have a job to get you out of the house, and you don’t feel up to going out a lot. He said it was important to have community, and it’s important to make an effort to create that community.

He’s so right. (And I love that he’s having this conversation with his patients!)

I assured him that I have community. If he only knew.

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I have worked hard to make friends and build community. It doesn’t come easily or naturally to me. I’m an introvert by nature, and my health issues have made me even more of an introvert. Not being able to go out often doesn’t help either. But it’s important to me to have friends and community in my life, so I made it happen.

For me, the key has been to go for quality instead of quantity. I don’t have hundreds of friends, but the ones I have are good ones. Acquaintances are often happy to help me because they see me helping others.

That’s why when I needed to borrow a wheelchair recently, I had 3 offers to lend me one, plus 2 other folks suggested local organizations that lend out medical equipment for free. When I needed someone to push that wheelchair, I was able to post on Facebook and get some offers from friends and also from acquaintances I barely know. Because I have that community.

Sometimes it’s hard. I put myself out there, which means I’m often asked for help and I need to say no. Thankfully, most people understand my limitations. And they appreciate it all the more when I volunteer. A friend is going out of town and leaving her dog at home, with the dog walker coming by many times each day to walk him. It’s not perfect, but it’s the best they can do. I said that if she gives me her key (which I am getting today), I’ll pop in to visit him a couple times, just so he has someone to cuddle with. She was amazed. To me, this is just a nice thing to do for a friend. I won’t go by every day, but on the days I’m in the neighborhood, I’ll bring a book and read while her dog gets some important snuggles. It won’t be the first time I’ve done this for a traveling friend. (And let’s be honest, while it’s an inconvenience, I certainly won’t hate doggie snuggles!)

I belong to a chronic pain support group. Having people who really understand the struggle makes such a difference. It was one of those members who ultimately lent me her wheelchair, and even put it in the car for me because I couldn’t. I do a lot for that group, too. I created and run a Facebook group so we can communicate easily between meetings. I do other behind-the-scenes tasks, too. It doesn’t take much time, but it helps people. And they notice, and want to help me in return.

It’s so easy to become self-involved these days, and more so if you’re in pain or fatigued or dealing with other symptoms all day every day. Believe me, I know. And so many people lose their friends and their families when they become sick. So I am hugely grateful for the incredible people in my life. My parents and other relatives are super supportive, my childhood friends have stood by me and help when they can, and newer friends are ready to step up and help. Acquaintances do more than I would have expected. Even strangers offer to help, thanks to all of my work in the chronic illness community online (both this anonymous blog and a lot of work under my real name.) I am so fortunate that I began building that community long before I needed it, and that I still have it.

I think we all need to heed my doctor’s words and find a way to build community. It will look different for everyone. Some people will reach out to friends, others will go to events through meetup.com (I’ve built some great community that way, too!) and others will do it all online. Whatever it looks like for you, I hope you are able to build the community that you need and that will support you, just as you will support them whenever you can.

What about you? How do you build community? Please share in the comments so we can learn from each other!


One thing we can do to save healthcare

May 19, 2017

I’m keeping this short, because today is a recovery day. It’s a recovery day for many reasons, and one of those is because I spent a lot of energy talking to a senator’s aide yesterday about the state of healthcare in our country and where it’s headed.

Obviously, this is a hard topic to discuss. It’s complicated and scary and very personal. He said a lot of things that I found unhelpful and uninteresting. But then he said some other things that could make a difference. One of those is this: senators’ staffs track all phone calls. Even from out-of-staters.

Some record them and list them all out. Others don’t. But even the ones who don’t know how many calls they’re getting and which way people are leaning.

This aide said they’re getting thousands of calls about healthcare, and not all from people in our state. Hmm.

So we should all call. State our case. We don’t have to say where we’re from up front. Say it at the end, so they listen to our content before they judge. It can be as simple as, “Hi, my name is ____ and I’m calling to ask you to vote against the AHCA. The Affordable Care Act allows me to keep my insurance (or whatever other benefit it provides to you) which keeps me alive (or any other benefit you receive.) Please vote to keep and improve the ACA. Do not repeal or replace it. I am from _____. Thank you.”

Or instead of talking about your personal experience, you can simply say that it will cost millions of people their healthcare, and that you don’t believe that is in the best interests of our country.

Easy. Simple. Fast.

Not sure who to call? There are 100 senators – 2 from every state. Start with the 2 in your state. Even if they are voting the way you want them to, they could use your support! You never know when a flood of calls from the other side might alter things, so please call and voice your support. Then work your way through the list. If you have friends or family in a state where the senator is on the fence or voting the other way, ask them to call, too.

You can find contact information for all of the senators here: https://www.senate.gov/senators/contact/

Here are some senators in particular to call and encourage to vote against the AHCA.

The loss of healthcare is a difficult, scary, horrifying prospect. Let’s do all we can to make sure it doesn’t happen. Please take a moment to share this. You never know whose phone call might be the one to tip the scales.


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