But did it help?

September 25, 2018

I go to so many medical appointments, sometimes I just take for granted that I have to go. But last week, after I wrote about having 13 appointments in just one month, I also mentioned it to a friend, and she asked me something that shocked me: were they helping?

It shocked me because I hadn’t thought to ask this myself! You would think that of course I’d be evaluating each appointment to see if it was worthwhile, but at some point, I just stopped doing that. I have gotten all too used to “follow up” appointments where the doctor reviews my symptoms, nods, and then tells me to come back in 4-6 months without suggesting any changes to what I’m doing. And often this is fine, because I feel like I’m on a decent course. Or because I know the treatments come with bad side effects that I want to avoid. Still, it’s worth taking a step back every now and then to ask,

Is this working?

Is this worthwhile?

I’m glad to say that in the case of this hectic September, the answer is a resounding, YES! The hand therapy has been making a huge difference. My sleep doctor suggested one small change that has had a big positive effect. My naturopath offered me some hopefully changes. I haven’t seen any changes from my new therapist, but it’s early, and there’s nothing negative, so I’ll give it some time.

This means that what I’m doing is working and it’s worth it. At least for now.

Still, 13 appointments in one month means very little time to relax, to deal with household chores, or to have fun with friends. And it’s really getting to me. I’m looking forward to one day soon actually being able to do those things again!

In the meantime, take a step back and ask yourself, are all of those appointments helping? I hope the answer is yes but if it’s not, it might be time to ask yourself how to change that answer. (Obviously I’m not a medical professional and I’m not suggesting you stop seeing your doctors even if you’re not seeing positive results right now. Use your own good judgement!)

Advertisements

Too. Many. Appointments.

September 17, 2018

I laugh whenever a benefits form asks if I’ve had any medical appointments in the past 6 months. Are you kidding?!? Of course, some months are busier than others. When I only have 1-3 appointments in a month, it’s freeing! I can do more things for fun, see friends, get stuff done around the house. And then are months like this one. By the end of September I will have had 13 appointments. THIRTEEN! This is not cool.

Some of it is coincidence. I only see my naturopath every 3-4 months and I’m seeing her this month. I only see my sleep specialist twice a year, and I saw him this month. There’s also the problem that I’m currently in hand therapy twice a week for painful tendonitis. We had to skip a week and a half for scheduling reasons, but that’s still a whole lot of appointments.

On top of that, I started seeing a therapist once a week. After a bit that will change to every other week, but it hasn’t yet. The idea was that hand therapy would end in August, so September was the right time to finally try seeing a therapist. And then hand therapy got extended by another month. Oops!

calendar-1990453_1920

Physical therapy got put on hold due to my PT moving to a new home and a new office at the same time, followed quickly by a planned heart surgery for her husband. It was good timing for me in terms of my hand therapy and other appointments, but I’ve been feeling my scoliosis acting up, among other issues, so I have an appointment to start seeing her next week, now that she’s scheduling patients again. I haven’t seen my dentist in about a year (oops!) so that will be next week also.

These are all important. They’re also TOO MUCH!

I’m exhausted and overwhelmed. I try to make plans with friends, but can’t manage anything on a day that I have an appointment, and that means we never get to hang out. Running errands, cooking, and laundry all have to be scheduled around these appointments, too. Benefits forms aren’t getting filled out and craft projects are being abandoned. You haven’t even seen me here on this blog lately!

For now I am just trying to hold on. I only have 1 appointment in October so far. All of the doctors I see only once every X months have been scheduled for other months. I haven’t scheduled therapy or PT for next month yet, so those will happen. Still, with any luck hand therapy will have ended and I might have only 5-8 appointments next month. I can hope!

People ask, “What do you do all day since you’re not working?” Little do they know how much work it is to take care of my health! This month is worse than usual, but still, appointments, benefits forms, pills, special food prep…. it all adds up in a big way.

I’m looking forward to having some more breathing room soon. In the mean time, I hope that you all are doing better on the appointment front than I am!


Wishing someone would tell me what to do

August 20, 2018

When I was a kid and I didn’t feel well, my mother would bring me a cool cloth for my forehead, some children’s Tylenol, juice, and toast. She took care of me. She told me to rest, to watch tv, to read a book. She told me if it was severe enough to go to the doctor. I didn’t have to think.

It’s not like that as an adult. Now I have to take care of myself. I have to remember to take the medicine, to rest or not, to buy juice at the store. Of course I miss having my mom take care of me when I’m sick, but mostly I manage those things ok. What I miss the most, though, is someone else telling me what to do. Making the big decisions.

Sure, I still struggle sometimes with when to take the Tylenol when I have a fever, but that’s not such a big deal. The harder piece is choosing which treatment approach to take with my chronic illnesses.

I have a long list of illnesses of course. And just when I think I know where to focus my attention, one of the supposedly not-so-important illnesses taps me on the shoulder, winks, and then pushes me down a flight of metaphorical stairs.

Like my PCOS. Everything seemed to be just fine, and then I got a period so heavy that my doctor told me to go to the emergency room due to the blood loss. Then I became depressed for several weeks as my hormones did wacky things. Not fun. I was already considering trying a new way to manage my PCOS, but that episode made it clear just how necessary a new plan was.

Now I have seen 4 medical practitioners who I trust a lot, and I have 4 potential treatment approaches. And I don’t like any of them. I desperately want someone else to tell me what to do.

You see, most people just take birth control pills and they’re fine. The problem for me is that birth control pills make me incredibly sick. Since those aren’t an option, I need to find something else. (Sometimes Metformin is prescribed. I tried this once and immediately had an allergic reaction, so that’s not an option, either.)

It’s easy to knock out 1 approach right now: the one I’ve already been doing. It worked great for many years but has recently become ineffective, so that has to go. But what about the other 3? They each seem reasonable, but which to try? Each of them has the potential to make me feel incredibly ill, so I’m not anxious to try any of them, but not doing anything isn’t an option. Each doctor makes an excellent case for each approach.

I will try one, and if I don’t immediately have horrible side effects, it will take months to know if it works. So it could take a year or more to find a treatment that works. If any of them do.

I want someone to tell me: do this. Simple. Easy. But that isn’t an option, either. So I will continue to debating, to research, to question. And in the end, maybe I will make the right choice and maybe I won’t.

These decisions are complicated and difficult. Sometimes the choice is obvious (though still not easy) but often it’s not. And no one is going to make it for me.

In case you’re curious, here are my current options (from an endocrinologist, a naturopath, a women’s health nurse practitioner, and a gynecologist – clearly I’m not limiting my sources!):

  1. A progesterone compound. I feel sick when I take it and it no longer works effectively to give me a predictable cycle.
  2. A supplement called Calcium D-Glutarate. It should help balance out estrogen. This appeals as an easy thing to take that can be easily stopped, but I’m concerned about what it does. It lowers estrogen, and the other practitioners say I need to increase progesterone and estrogen and/or lower testosterone, so I’m not sure this is the right approach for me.
  3. Progesterone cream. It’s harder to dose and I have to be careful to not damage my skin. It would hopefully fix my cycle but not the other symptoms so I would have to take spironolactone. This makes me nervous because it’s a blood pressure medication and my blood pressure is already too low.
  4. An IUD. This makes me nervous because if I have a reaction, I can’t quickly remove it myself. Again, I would need to take spironolactone in addition.

If any of you folks with PCOS have tried any of these things, I’d love to hear about your experiences! Maybe you can help me make an informed decision. Because I’m not having much luck so far.


Shining a light on disability-related injustices

June 21, 2018

Yesterday I spoke to a reporter about health-related stuff. This isn’t the first time, and I’m pretty sure it won’t be the last. I’m also sure it won’t be the last time I bring a new (to them) subject to a reporter’s attention.

Speaking to a reporter used to feel like a big, once-in-a-lifetime kind of thing. Not anymore. As I have become more vocal about health- and disability-related issues, mostly on Facebook, friends and friends of friends have connected me with reporters they know who are writing on these topics.

I answer their questions the best that I can. When they plan to use my full name, I’m extra careful. I was clear yesterday that the article – which based on her questions seems to be about the “opioid crisis,” insurance coverage of alternative treatments, and new medications that are about to come on the market – would not be complete without also discussing medical marijuana. I was just as clear that I would not be willing to talk about medical marijuana if she used my full name, but that I would be glad to discuss it in detail without my full name. That’s my comfort level. For other people it’s different.

Still, I told her what I could because I think it’s important that the patient perspective is included. Too often in these discussions we hear from politicians more than anyone else. Sometimes they talk to doctors. But what about the people who are supposed to be benefiting from these medications?

Now here is where it starts to get a bit interesting. You see, we all have superpowers, and my superpower is getting people to open up to me. It happens without me even trying. I guess I inherited this from my great-grandmother. Apparently she would sit next to a stranger on the subway, and by the time she got off the train she knew their entire life story. My grandmother was the same way. So is my mother. I think people are happy to talk to anyone who will earnestly listen and care, which we do.

I also have an insatiable desire for knowledge. I read a lot. I talk to people to learn things. I reach out to others both to learn and because I care about them. And I’m generally sociable. Add that up, and I know a lot of random shit. Including about health and disability issues that don’t directly affect me.

That’s why when the reporter asked me my feelings about new medications containing cannabinoids (active constituents in marijuana), I not only told her my own feelings, but I was able to tell her about the controversy around these new cannabinoid-containing medications to treat children with epileptic seizures. I’m not in that community, and I made it clear she should talk to those folks to get a full, accurate picture. (My understanding is there’s a lot of concern that once these medications are available, they will no longer be able to get medical marijuana for their kids, and if the medications aren’t as effective as medical marijuana – they don’t have to be as effective to be FDA-approved – then they won’t have any good options for their children.) I also offered to connect her to them.

Over the course of our conversation, I told the reporter a bunch of things like this. Like when she asked my views about the problem of primary care physicians prescribing opioids in a one-size-fits-all manner without customizing things to each patient, I corrected her very strongly. I hear that bullshit a lot but, like I told the reporter, I have only ever heard it from politicians. It makes for a good headline, a good soundbite. But I have NEVER experienced that. Neither have my friends. Or the folks who comment on my blog. Or the people in my chronic pain support group. Or the people in the various Facebook groups I’m in. She was surprised and asked a lot of questions about this.

I felt good about correcting these misconceptions. It’s important to correct them for everyone, but especially for a reporter writing an article on this topic in a major newspaper (I won’t mention which newspaper, as part of protecting my anonymity on this blog.)

Now here’s where it gets even more interesting! At the very end, as we were about to say goodbye, I had an epiphany. After writing this post a couple weeks ago, I was able to speak to 2 different lawyers about the SSDI case review. And after we finished, one of them told me some interesting things. This is part of that superpower I mentioned – people just tell me things. And yesterday, I told the reporter.

I told her how the lawyer told me that she (the lawyer) has seen more SSDI case reviews in the last 6 months than in the past several years combined. The reporter sounded shocked. She asked a lot of followup questions.

I also told the reporter that the lawyer told me the number of case denials has increased a lot in the past year. Of course, before mentioning that I first explained how horribly high the denial rate had been before, and the impact it has on many people. Again, she sounded surprised. She asked followup questions. Including, did I think it was related to this current administration. I was clear that while my opinion was yes, that was only my opinion. I hope it’s enough, though, to cause her to dig into this. Because it is shameful that the safety nets we are supposed to rely on aren’t there for us. That’s why I also pointed out that SNAP (food stamps) allotments have gone down while the Section 8 waitlist has gone way up.

It’s possible this conversation will be forgotten in a pile of other upcoming articles the reporter needs to write. Or maybe her editor won’t be interested. Or maybe, just maybe, the reporter and her editor will see the huge impact of these new SSDI case review rates and denial rates, and they will also notice that no one else has been writing about this, so they could scoop the other newspapers. Maybe they will do some research and write it up and bring awareness to their readers that this is happening. And remember how I said this is a major newspaper? Well it’s big enough that if they report on this, all of the others will jump on the bandwagon. And then we might be able to build enough momentum to get the government to stop this fucking bullshit and treat us with the respect and dignity we deserve, by giving us the benefits we already paid for.

Or maybe none of that will happen. But I am trying, and it feels good to try.

Do you guys know of other “hidden” issues like this that we need to shine a light on? Please mention them in the comments or email me at msrants@gmail.com. I’ll do what little I can to publicize these things so they aren’t hidden any more, and I encourage you to do the same!


How dare insurance not cover my specialists

March 27, 2018

24 years. If I’m remembering correctly, I have had gastrointestinal problems for 24 years.

First it was ignored. I didn’t think to tell anyone. And I didn’t know that diarrhea wasn’t normal, that not pooping for days at a time wasn’t normal, that nausea and pain weren’t normal. So I suffered in silence.

Then I saw a doctor who wasn’t helpful. I drank prune juice for the constipation and that got me through the worse of it. Sort of.

Another doctor said I had IBS and gave me a prescription.

Years later I went off gluten, then a bunch of other foods. That helped a lot. The episodes that had been coming more frequently backed off. I no longer found myself in the fetal position from gastrointestinal pain 3-5 times a week. Now it was only 1-4 times a month. Only. Hmm.

The problem was, the episodes continued, and my emotional response to them got worse. I found myself thinking more and more often about how I would prefer death. I only thought that way in the middle of the episodes, when I am already in too much pain to seriously consider killing myself anyway, but still, that’s not good.

I never think about death when I have joint pain, even though that pain is much worse. There is something about the nausea that triggers these thoughts now.

Recently I had an episode that was especially bad. I called a friend and neighbor, who came right over. But even his dog, who he kindly brought, wasn’t enough to help me. I sobbed while curled up on the floor, unable to sit up, unable to think clearly, but knowing I needed to not be alone. Eventually the worst of it subsided. But it was enough.

After that, I finally decided to pay the money for the stool test that had been recommended to me. When I saw my doctor the next week, I was shocked to learn that the test was actually covered by insurance! Wow! I took it home, read the instructions, and realized I needed to go off of a couple of my supplements for 2 weeks before I could take the test. So I waited. And waited. And finally it was time, but my joints were acting up and I just didn’t have the mental bandwidth to manage the pain and the test at the same time.

And then, finally, I took the test. For 3 days I scooped poop into a cup. Joy oh joy. But I did it.

It took time for the company to process the test. Then more time for my doctor to get the results, and for the results to be sent to me. But now, finally, months later, I have the results!

And I have no fucking clue what to do with them.

Some aspects of my gut are in balance, others are not. My doctor was honest: there was nothing he could suggest except to take a probiotic (which I already take, but which I had to stop taking for several weeks before the test) and so he wanted me to see someone with more expertise. I appreciate his honesty. That’s why I see him.

There’s just one problem. He recommended 2 different practitioners. And neither are covered by my insurance. At all. Not one penny.

So now I’m considering paying. The one who looks more promising based on her experience is $217 for the first visit and $188 for each followup. I have no idea how many visits I’ll need.

I have the money. And to be honest, if I’m going to spend money, this is a good thing to spend it on. I save as much as I can these days, but really, why am I saving it? To take care of myself. And if I can fix this problem, avoid these episodes from now on, why wouldn’t I do it?

So once again, I am going to pay out of pocket for my healthcare. My insurance is fabulous when it covers my care. But when it doesn’t, I question what is wrong with our system. No one would question that I need help. There is obviously something very wrong. I have limited my diet, tried pills, and followed doctors’ orders. And yet, I still have episodes that have me curled on the floor thinking that death might not be so bad. I need help. And I am so incredibly lucky that I can afford to pay for it.

What if I was one of the ones who couldn’t?


It takes skill to injury yourself the way I do

March 27, 2018

The other day I woke up to find that I had wrenched my shoulder in my sleep. It felt like it was partially dislocated. Sometimes it felt fine, and then I’d try to put on a shirt or reach for something and there’d be searing pain. I didn’t fall. I didn’t pick up something heavy. I slept wrong.

Everyone hurts themselves from time to time. A stubbed toe or a paper cut are the hazards of daily life. No big deal. But then there’s this other level that shows up when your body is out of whack. Being out of whack makes me more prone to these kinds of injuries, and sometimes they make no sense.

Like the time I wiggled my toes and injured a tendon. That was a month ago. It still hurts.

I’m skilled, I tell you. Totally skilled. I mean, it’s not the average person who could give themselves a long term toe tendon injury, with daily pain, just by wiggling their toes!

And do I go to the doctor for any of these injuries? No. Of course not. Because I’d be going All. The. Time!

Don’t get me wrong. I do take big things seriously. When I dropped a chef’s knife on my foot a couple years ago, I went to the emergency room for stitches, and later had surgery.

But no, I don’t see a doctor for every injury. Just like I don’t see a doctor for every new gastrointestinal symptom or new pain or new type of fatigue. What’s the point?

So I’m waiting these out, hoping they’ll eventually go away on their own. They often do. Like the time I finally went to the doctor for the unmistakable nerve pain, to be told I had a pinched nerve and should go to physical therapy. I didn’t have time. I asked if not going would cause long term damage. She said no. So I didn’t go. Eventually it fixed itself. If it hadn’t, I’d have gone.

So many of us have far too many medical issues already, so we try to ignore the little ones. But it sure would be easier to ignore them if we weren’t so skilled at creating new ones constantly!


The things we do for our health

February 26, 2018

As I sat on the bathroom floor scooping poop into a plastic cup with a wooden stick 2 hours ago, I thought about how some people can go their entire lives without ever having to do this. Lucky them. I’m not so lucky.

I really really really didn’t want to do a stool test, but much more than that, I really really really couldn’t stand to keep having these episodes. I can handle the gas, the bloating, the constipation, and the diarrhea. I don’t love them, but I can handle them. But I can’t handle the nausea. It just does me in emotionally.

I have had these kinds of episodes since my teens. When I removed gluten and corn from my diet in my early 30s, they became much less frequent. Instead of 2-4 times a week they were *only* 2-4 times per month. Still, that’s far too often. The symptoms changed, too. Some got worse and some got better. And over time, I accepted it, to a certain degree. At least it was less often, right?

The thing is, the nausea, the fatigue, the rest of the symptoms all come on together. I never know when it will happen. Is it my diet? One night I feel fine and another I’m a mess, even when I ate the same thing both times. Maybe it’s something else? I have tried diets, so it’s time for the next step.

Someone suggested this particular test to me. I asked my doctor and was shocked to learn that insurance will actually cover the cost (a rarity for many of the tests I ask for.) His office gave me the kit, and I put it off.

First I needed to do an adrenal test – the fatigue was a more concerning symptom. Mentally and emotionally, I could only handle doing one at a time. It took a few weeks before I could schedule that test, since I had to change some things about my medications to prepare for it.

I gave myself a week, then decided to do the stool test. I read the instructions and learned I had to be off probiotics for 2 weeks before the test. I stopped taking probiotics. 2 weeks later, I was sick. I waited. I finally felt better but my schedule was a bit busy. I knew I needed to be home and not rushed for this. My schedule cleared and I went to take the test. I read the instructions again and saw that I had to be off another of my supplements for 2 days. I went off those. I felt sick again. Then if I did the test, I would finish on a Saturday, and it has to be mailed Monday-Friday, within 24 hours of finishing. I waited a couple more days.

FINALLY it was time! I was nervous and not wanting to do it, but I did it. Because I had to. Because I need answers. Because each time I have one of those episodes, I start to wonder if I would be better off dead. The only times I feel at all suicidal are doing those episodes. I don’t know why. They last for hours that feel like weeks, but never more than a few hours. The pain can be so much worse and last for so much longer, but it never makes me feel that way. These episodes have to stop.

So I did the test. It was a 3 day test. For 3 nights I had stress dreams about the test. The first day I realized it wasn’t fun, but not nearly as bad as I’d expected. But still, I had the dreams. They woke me up at 5:15am today. I want to believe it was worth it.

I finished the test just a couple hours ago. The samples are sitting in my refrigerator (carefully packaged, of course) and ready to be mailed when go out this afternoon. And then I wait. And wait. And wait. It will only take a few weeks to get the results, but it will feel like so much longer.

After many months of procrastination, then another 6 weeks of mostly legitimate delays after I received the kit, I finally feel SO CLOSE to potentially having some answers. I don’t want to hear I have parasites or infections to deal with, but those might be better than a lifetime of these episodes that make me literally want to die, that I can’t predict, and that continue to get worse over time.

So yes, I scooped my own poop into plastic containers multiple times. That’s something most people never even consider doing. But maybe, hopefully, it was worth it.

 


%d bloggers like this: