How chronic illness didn’t cause my anxiety

April 9, 2015

Two years ago I was sitting in a support group meeting when one member said, “Everyone with a chronic illness has PTSD.” The way he said it was so matter-of-fact that I was really surprised. It was the first time I had considered the possibility. After a moment, I decided I didn’t agree. I knew I didn’t have PTSD. I still don’t. But I understand much better why he said it.

Today I was emailing with a close friend about some anxieties I have. They all have to do with my health issues. Even the anxieties that don’t seem to be about my health issues, like anything job-related, can be traced to the lack of security I now feel because of my health issues. She asked if I might have PTSD. I’d thought about that before, so I know I don’t have it. I had checked the diagnostic criteria and while I have lesser versions of many of the symptoms, I wouldn’t get that diagnosis. I’m sure of it. So what do I have?

I have years of pain, exhaustion, nausea, diarrhea, and other symptoms. I have inexplicable symptoms that pop up at very inconvenient and completely unexpected times. I have years of the fear of not knowing what caused any of it. I guess that’s all to be expected.

But I also have anxieties that were completely preventable, the ones caused by society. I have years of disrespect, disbelief, and condescension behind me, not only from friends, coworkers, and acquaintances, but also from doctors. I had doctors mistreat me both emotionally and physically. I was a terrified teen who was falsely assured it would all be ok. Even then I knew the adults didn’t really know that. I was a scared young adult whose fears weren’t acknowledged at all. I worry about my health, my present, and my future every day, sometimes a lot and sometimes just a little, and I hear nothing more than platitudes from medical professionals, if that.

I have lost people close to me. I’ve missed out on more life experiences than I care to think about. My friendships, romantic relationships, and career have all been altered. My health has affected where I live, how I spend my free time, and even my ability to get a dog. There is no part of me that has been untouched by this.

And yet I’m one of the lucky ones, because my anxieties aren’t nearly as severe as they could be.

Still, I’m aware of them. I’ve been noticing them more and more lately. I don’t think they’ve gotten worse. I think that as my physical conditions have stabilized, for the first time I have the capacity to acknowledge the emotional toll this has rung. And while there’s the occasional larger symptom, mostly I notice small things. Talking to a friend about tattoos is fine as long as we’re talking about body parts where I haven’t had much pain, but when we talked about one particular popular spot, one where I’ve had my worst and longest pain, one that has involved the most mistreatment by doctors… even just typing this out my heart is beating more and I feel tense. Talking to my friend about tattoos there gave me a feeling that was completely unfamiliar. Being touched in certain places upsets me horribly. If a doctor touches my shoulder, my thigh, my back, I’m fine. But if they touch my wrist I just about jump through the roof. The pain there isn’t so horrible anymore, but the memories are. The memories of doctors asking if pressing certain areas would hurt, and when I said yes and asked them not to, they did it anyway just to see my reaction. The memories of doctors intentionally dislocating my wrist because they saw in my chart that it was possible and they were curious. The memories of me asking them not to, of me telling them how horribly painful it was, and of them doing it anyway. Who would do that to a scared 17-year-old? But they did. More than once. The memories of a doctor telling me I should stop complaining because others had it worse, and me leaving the office in tears.

When I see a new doctor I steel myself. I walk in with my medical history, my list of medications, and my questions for them. I’m all business as I interview them. But inside I’m quaking. I ask them specific questions and it appears I’m checking their abilities, but it’s more than that. I need to find out how they’ll treat me and I listen closely for the answers. I try so hard to figure out if they will respect me. Will they listen to my opinions about my own body? Will they take me seriously? Will they read research articles that I bring them? Will they scoff at my chosen treatment methods? Sometimes I get it wrong, but I try so hard to figure it out at that first meeting. I refuse to be treated badly any more, so at the very least, I try to make that much clear. I suffered through that for more than 20 years and I won’t do it again.

Sometimes I think about it all and I wonder, how could I possibly have come out of all of that without being somewhat scarred? And yet, I did ok for so long. Somehow, I managed it all. It was just the last few years that pushed me over the edge. It was getting so much sicker. It was having the doctors say there was nothing more they could do for me. It was doing my own research and having doctors tell me I was wrong, when I knew in my gut I was right (and if you’re a regular reader, you know that I was.)

And it was years of fighting with insurance companies and the social security agency to “prove” that I was really sick, to fight for the benefits to which I was entitled. That might have been the most scarring of all. It was stupid and unnecessary and hurtful, and I will never forgive any of the people involved in the creation of that process for treating sick people like criminals.

I’m generally a happy person, but sometimes I hear things coming out of my mouth (or being typed here on this screen), and I’m shocked at how angry and bitter I am. I don’t mean to sound that way, but I just can’t help it. And really, can you blame me?

It’s important to remember that anxiety can be a condition of its own. You can have anxiety without any physical illnesses. It’s also quite possible to have both, but have them be unrelated. It just so happens that I’m focused on my own type. I know that any anxieties I have are related to my chronic illnesses. It just so happens that the illnesses themselves aren’t what traumatized me the most. It’s the way people treated me because of them.

I wish you, dear reader, the best of luck with your own situation. I sincerely hope you are treated better, while I sadly realize that many of you are not, and many are treated even worse. I hope so much that one day these preventable anxieties are actually prevented.

(And since you might be wondering, no, I’m not in therapy. I would like to be, but I can’t see a private practitioner with my health insurance and I do not want to go to the major hospitals for personal reasons. So until I get different insurance or can afford to pay myself, I won’t be going. But again, I’m one of the lucky ones, because I’m functioning ok. And I’m very thankful for that.)


Thanks a lot, hormones!

April 5, 2015

It’s easy to forget how much of an effect hormones have on our physical, mental, cognitive, and emotional health until they get all fucked up.

Now, before I continue, let me say that, yes, I will be talking about my period. Oh heavens! Some of you have already IMG_20140312_153843closed the browser screen. Others are squirming uncomfortably. Tough. This is what I talk about on this site: health issues. And that includes periods. Have questions? Read this post from last year.

As I’ve mentioned before, I have PCOS. That’s polycystic ovary syndrome. It’s not uncommon, but it affects different people in different ways, so we have to be careful not to generalize when it comes to PCOS. For me, it means I’ve never in my life had a “regular” period. I won’t bother to describe the horror that was my so-called menstrual cycle when I was a teenager. Let’s skip ahead to last year.

After many years on a few different birth control pills and other hormones, I suddenly stopped getting my period. I’d had some off months before, but this time was different. My doctor had me go off the pills to see if I’d get a period naturally. I didn’t. So he ordered an ultrasound. Now don’t get me wrong, I was thrilled to not be getting a period. It was one less thing to deal with from a body that gave me enough to deal with. And I wasn’t looking to get pregnant, so that wasn’t an issue. But there were 2 likely reasons for the lack of a period, and we needed to know which it was. Birth control pills can lean to a thinned endometrial lining, and that can mean no blood. Or maybe I wasn’t ovulating, so that’s why there was no blood. Maybe it was both. Unfortunately, the ultrasound showed that my endometrial lining was building up. It wasn’t at dangerous levels yet, but it was getting close. That’s not good.

So my doctor put me back on a birth control pill. And it’s not been good. First came the brain fog. Then the moodiness, ravenous appetite, and increased pain. Then the fatigue. I eventually realized I’d become hypothyroid again. Estrogen can bind thyroid receptors (thank goodness I’d done my own research!) My doctor ran blood tests, and while I waited for the results I went on the placebo week (many birth control pills have this: you take the pill for three weeks, then nothing or a placebo for a week.) I got my period (yay!) and felt SO. MUCH. BETTER! All those new symptoms were gone!

The blood tests came back and my doctor increased my thyroid med when I started the next birth control cycle. The symptoms all improved, but didn’t go away completely. The fatigue is still bad. I became nauseated frequently. I had occasional disturbing thoughts. The other day I was just going about my business, thinking about how lousy I felt, and suddenly thought that it might be best to die. Then I wouldn’t have to deal with the health stuff. Hmm, that’s not good. I wasn’t feeling depressed or suicidal. The thought only lasted a moment. But it was a moment too long. I’m usually a happy person, but I’d been in a bitchy mood for the past week. I’m not liking me these days.

Yesterday I’d had it. I was sick of the nausea. I worked too hard to fix my diet to be dealing with this bullshit now! And the fatigue was too much. I worked too hard to fix that, too. And don’t get me started on my mood. I just couldn’t stand it anymore.

So today I made a change. Sure, I probably should have checked with my doctors. But I didn’t. I know what I’m doing is safe in the short term. We’ll worry about the long term at my next appointment in a few weeks. So what did I do? I went off the birth control pills and I went back to my old dose of thyroid med – exactly what I was doing before this whole mess. I’m only 1 week into the cycle. I don’t know if I’ll get my period, but I do think I’ll be feeling better in another day or two, and that’s the important part.

I will need to do something to make sure I get my period at least a few times a year. There are other options. This was the option that we thought would have the fewest side effects. Back to the drawing board! Maybe I need a different estrogen pill. Maybe I need progesterone instead. Maybe I need both (which is what I had before last year.) Maybe I needed to raise my thyroid med more. That’s very possible, and I probably should have done it today, but I just felt too lousy.

Very likely, I will need to try this whole thing again in a few weeks. And I will go through this same misery when I do. But for now, I’m hoping my hormones will calm down a bit and allow me at least a few days of feeling my usual level of lousy, instead of this new level!


I miss my friends

March 30, 2015

The other day I wrote about my many medical appointments this month. There was a time when I’d squeeze an appointment in before work, or go during an extra-long lunch break (which I’d have to make up for after work hours.) Those days are long gone. Now I don’t have to worry about missing work, but I do have to worry about missing life.

As I’ve been feeling better lately, I’ve been spending more time with friends. What a treat that’s been! I do better during the day, so I don’t go out much on weeknights. But I see many friends on weekends, and I have a lot of new friends who also don’t work due to chronic illness, so I hang out with them on weekdays. Seeing one or two friends on weekdays each week has been wonderful! Unfortunately, with so many medical appointments, I just can’t manage it.

Today (Monday) I’m doing things around my apartment that need doing. They really need to be done, but I’m also resting. I have an appointment early tomorrow that I need energy for. And one of the things I have to do today is to prepare for tomorrow’s appointment: I need to prepare all sorts of notes so I don’t forget anything when I’m in the office. Tomorrow I doubt I’ll do anything besides that appointment. Wednesday I hope to do some clothes shopping. I don’t have any bathing suits that fit and summer is right around the corner. I’d like to see friends, but I know I won’t have the emotional energy for it after Tuesday’s appointment. Still, shopping drains my physical strength and causes extra pain, so I always need a full day to recover afterwards. That’s what Thursday will be: a recovery day. And at some point Thursday (or sooner) I need to prepare notes for Friday’s medical appointment. After Friday’s medical appointment I’m going to a Passover sedar with my family. I’m not religious, but it means a lot to them, so I go. I’ll probably have to go directly from the medical appointment. Saturday is a nephew’s birthday party, so as you can imagine, Sunday will be another day to rest. And BOOM! The week is gone!

Last week was pretty similar, and I think the following week will be, too. And of course, I know I’m lucky – a year ago I wouldn’t have been able to manage so much in a week. This is huge for me! Still, I miss hanging out with friends. I miss socializing. I like having quiet time to myself. I don’t get bored easily. I can happily spend a day reading and puttering around. But like many humans, I’m a social creature. I live alone, so on the days I don’t leave the house, I don’t see another human being. Days like yesterday, I might go out and see strangers in passing, but I don’t have any real conversations with anyone.

March is a gray month in Boston. As I write this, the skies are dark and there are some light snowflakes coming down from the sky. I have no desire to go for a walk (which I’ll have to do anyway) or to go outside. Yet, a little company would be lovely.

Like I weather, I know my current social situation is temporary. So I’m trying to make some plans with friends for a few weeks from now. At least that way I’ll have something to look forward to when this ridiculous string of medical appointments is over. And I’m just grateful everyone understands why I’ve disappeared for a bit.


Playing Musical Doctors

March 23, 2015

There’s a child’s game that’s really quite simple called Musical Chairs. The children gather in a circle around a bunch of chairs. Music plays, and the children march in a circle around those chairs. When the music stops suddenly in the middle of a song, everyone rushes to sit in a chair. The catch is, there are fewer chairs than children, and whoever doesn’t get a chair is out of the game. (Each time someone leaves the game, more chairs are removed from the circle.) So you always wonder who will get a chair and who will be left standing.

That’s how my calendar went with doctor appointments last week. I called it Musical Doctors.

When you see many specialists, and each require multiple checkups and followups each year, sooner or later this kind of thing is bound to happen. For me, the game started this time when I needed to make an appointment. A few days before I’d been thinking thinking about how nice it was not to have any doctor appointments lately, how much less stressful it felt, how much more time and energy I had. Then I tried to make an appointment and discovered why I’d been enjoying a blissful break in the doctor hecticness: they were all piled up in March and April! In 3 weeks I had 5 appointments scheduled, with 2 more a couple weeks after that. I often have appointments grouped together coincidentally, but 5 in 3 weeks is a lot, even for me! And suddenly I was scheduling a sixth! It wasn’t easy fitting that sixth one into my schedule, but I made it work.

I was dreading the 6 appointments in 3 weeks. It was overwhelming just thinking about it! But then I took a closer look at my calendar and realized I had an unfortunate conflict. The appointment with the hardest doctor to schedule, Dr. T, happened to conflict with a support group I’m in that means a lot to me. Not only that, but this was a special meeting of the group. It had taken me 6 months to get this appointment. The last time it took me 8 months to get an appointment. Still, I called the office and asked to be put on the cancellation list, just in case.

But I wasn’t putting all my eggs in that basket! I emailed Dr. T and explained the situation. I was clear that I would keep this appointment if I had to, but if it was at all possible to move the appointment, even if it meant waiting a few more weeks, I’d really like to do that. A few days later, I got a call from his office. They offered me another time slot, and I was so excited. But when I pulled out my calendar, I saw that I already had an appointment that day. This was the only day they could offer me. The other doctor, Dr. C, is also hard to schedule, but not as hard as Dr. T. Technically I had time to do both the same day, but I knew I would haven’t have the energy for both. I figured I’d take my chances. I took the new appointment. Now I could go to my support group!

Ok, it was time to call Dr. C. She was booking into July (and this was mid-March.) I could wait if I had to, but it wasn’t ideal. But wait, they’d had a cancellation later in April! This would mean seeing Dr. C the day before seeing another doctor, Dr. H, and each involves a lot of driving. Still, it seemed like the best possible option. I took it.

It was an odd set of coincidences, but somehow it seems to have worked out. My biannual dental appointment, my quarterly rheumatology checkup, my annual determatology checkup, and several followups all just happened to fall in the same 3 weeks. Such is life when you have multiple chronic illnesses.

After some juggling, each doctor is now in a time slot. And who’s “out” like in the game? I’m not sure, but I think it’s me.