Sometimes the bare minimum is plenty

November 13, 2021

I’ve been wanting to write for weeks but it’s just been too much. I’ve been having a really hard time lately.

Thanks to medication changes, my adrenals aren’t being properly supported, so I have both less energy and lower tolerance for handling stress. And in a few days I have a colonoscopy and endoscopy.

Colonoscopies aren’t a big deal for most people. Not that anyone loves getting them, but you just deal, right? Well, thanks to a decades-long history of medical trauma, medical procedures can be triggering for me. And thanks to decades of undiagnosed gastrointestinal symptoms, GI stuff is also triggering for me. So knowing that in two days I’m going to have to drink a formula that will probably make me throw up, and that will induce the kinds of GI symptoms that I’ve struggled with for most of my life, followed by a medical procedure, where I’ll be up close with people during a pandemic…. yeah, my anxiety is at an all-time high.

Logically, I know it will be all be fine. But logic isn’t helping. My therapist gave me some breathing and thought exercises which help, and I’m just trying to make it through this period. It’s rough.

To make it a little easier, I’m doing a few things that I don’t usually do:

  • I cried. I spent a lot of my life learning not to cry because if I did, people thoughtI was just trying to get attention. (Yup, as a 12-year-old with chronic pain, that’s what I was told by several doctors and teachers. Thankfully, my parents never thought that.) Now, I don’t cry easily. For a week I really felt the need to cry, but I couldn’t let it out. Finally, though, I cried. And then I sobbed. And then I sobbed some more. I cried a lot that day, and it helped a lot. I cried a bit yesterday. I’m still having trouble crying as much as I need to, but I’m working on it. It helps to let it all out.
  • I asked for help. I don’t do this often enough. I posted on my Facebook page, asking friends to make phone calls to manufacturers for me. I was trying to find a gluten-free version of the easier colonoscopy prep. I had made a few calls, but it’s so stressful. For one thing, making any of calls for gluten-free stuff is stressful and exhausting and I’m tired of doing it. But then, doing it for this purpose…. it was just too much. A fabulous friend did the research. She called everyplace on my list, then did more research to find more to add to the list. She struck out, but if she hadn’t called for me, then I would have felt like I had to, and I would have been upset with myself for “failing”, thinking that maybe if I’d made the calls it could have been easier.
  • I asked for help again. Several friends had volunteered to help with the calls, so when that friend struck out, I asked for more calls. Since I couldn’t get the easier prep, I wanted to get an anti-nausea pill to help with the one I’ll be doing. Again, I needed something gluten-free. Three people called pharmacies all over my area to ask which manufacturers they used for this med (there are quite a few who make it), and then called those manufacturers to ask if the med was gluten-free. Again, they struck out. But again, if they hadn’t done it then I would have felt like I had to. It was so great of them to make those calls.
  • I asked to borrow a puppy. No, really! I have neighbors with two of the sweetest, most adorable puppies. Both are house-trained and don’t chew on stuff, so they’re not too hard to watch. I asked if I could borrow one, and the timing worked out that I took one for an hour. He cheered me up SO MUCH! Dogs are great medicine. Normally I would have felt silly asking, but I’m glad I did. And they were glad their dogs could help.
  • I’m giving myself a break. My to-do list is short right now. Really short. And even then I know it’s ok if I don’t get most of it done. In a typical week this amount would be easy to do (my list is usually twice as long), but not now. For example, today’s list is: laundry (already in the machine – win!), vacuum (if it doesn’t happen, that’s ok), prepare some work for my volunteer gig (they know I’m struggling and that I may have to cancel tomorrow’s meeting if I can’t get it done, but I think it will be doable), walk (fresh air is good for me), and watch YouTube videos while relaxing with my knitting. My hope is to get everything done before lunch except the last two. That way, I won’t have anything I need to do this afternoon except enjoy a walk and relax on the couch. And honestly, the vacuuming is unlikely. And that’s ok. The rest of my week is even easier than today.
  • I’m avoiding anything emotionally taxing. When a friend brings up a stressful topic that isn’t necessary to discuss, I ask to change the subject. Stressful movies and books are on hold. I’m keeping it as light and easy as possible. Last night I watched an animated Disney movie and that was perfect.

Is this all enough to make me feel great? No, of course not. But it’s enough to make me not feel worse, and that’s a win. I’ll keep spending time with dogs, watching easy movies, doing my crafts. I’ll keep my to-do list short. I’ll ask for help. I’ll spend time with dogs. (Oh, did I say that twice?)

In a few days, after the colonoscopy, I’ll feel better. Once my medication is back to working properly, I’ll feel even better. (I tried to time things so that it would be back before the colonoscopy, but my doctors were really slow to get back to me about how to proceed after we got the test results.) This isn’t the post I planned to write. That one has to wait. And again, that’s ok. But it’s one that felt right to write. We all have times where we’re struggling more than usual, and it’s ok to do the bare minimum for a while. That’s definitely my plan for now.


Choosing an arm: a simple decision?

October 16, 2021

“Which arm do you want for your flu shot?” It’s such an easy question, right? Well, not really.

In the car on the way to the pharmacy, I debated. I usually have a sore arm for a bit. (For context, I have chronic pain in many areas of my body, and my right wrist is one of the worst spots.) My left arm is stronger and has less pain, which means I can tolerate it there more, so I should get it in my left arm. Then again, maybe I should get the shot in my weaker arm, so I still have one strong-ish arm. So I should get it in my right arm. The soreness can mess up my sleep for a night or two. I sleep on my left, so I should get the shot in my right arm. But do I really want more pain in my right arm? No I don’t, so I should get it in my left arm. I reach for things with my left (I’m right-handed, but with extra pain that wrist, I have to do more with my left) so I should get it in my right arm. I use my left more when I drive, so I should get it in my right arm. But I want to have at least some function in my right when I drive, so I should get it in my left arm.

I went back and forth for a bit. Finally, I decided: the left. The deciding factor was simple: I can push through the arm soreness in my left to crochet and knit, two of my favorite hobbies which I do to relax. I can not necessarily push through the soreness to do those things if it’s in my right arm. And if I’m feeling lousy, which I have been lately (that’s a story for a different day) then I’ll want to do my yarn crafts more than ever.

These are the kinds of issues that I don’t think “healthy” people deal with. They simply pick an arm, probably their non-dominant one, and move on with their day. But for someone like me, whose non-dominant arm is needed to compensate for the pain and weakness in what is my naturally dominant arm, there’s no easy answer.

If you’re struggling with similar issues, related to your flu shot or anything else, please know that you’re not alone. Sometimes these supposedly-easy decisions are actually very difficult.

P.S. I’m happy to say that the soreness was much milder this year, and only disrupted my sleep for one night.

P.P.S. My brain fog is much worse than usual this week. I hope this post makes sense and that I caught the worst of the typos but, well, it is what it is.


Losing the best doctor

September 1, 2021

I just had a long talk with my fabulous primary care physician. The talk about my health issues went fine, but when we talked about his upcoming retirement, I cried. I’m pretty certain I have never before cried when I lost a doctor. I have felt upset. I’ve been nervous. I have simply not cared. But this is different.

Not only is Dr. P my PCP, but he prescribes my thyroid and adrenal medications. Both are medications that are rarely prescribed. (Hypothyroidism is commonly treated, but not with this particular medication.) Yes, other doctors do this, but they are few and far between. Plus, many doctors treat one condition or the other, but I need someone who does both, because of the way the two impact each other. And Too many doctors provide these treatments without fully knowing what they’re talking about. But Dr. P knows.

It’s more than that, though. Yes, he’s smart and he’s up-to-date on the research. But he also knows when to pay attention to patient outcomes more than to research. He is smart, caring, and, unlike so many other doctors I have seen, not condescending or patronizing. He does not put his ego first. Today he explained a course of action he wants to take to address some symptoms I have had recently, and he explained WHY. He took time to answer my questions. When I asked why we would do X test and not Y test, he thought about it, admitted that Y could make sense, thought some more, and then said that he’d still prefer X and told me why. I agreed completely, because his reason makes sense.

In order to do the test I need to go off of my adrenal medication, which makes me very nervous. He preempted many of my concerns by saying that he doesn’t want me to feel ill, and that if I have minor symptoms like a, b, and c then I should stick it out until after the test, but if I have worse symptoms like d, e, and f, then he doesn’t want me to feel that bad and I should go back up on the medication and there are other things we can do. He outlined the courses of action we might take if the test is negative (uh oh) and other options if it’s positive (which is what we’re hoping for.) So many doctors would have just ordered the test and sent me out the door, but Dr. P really took the time and effort to address my concerns and make sure I was comfortable.

I have had a lot of medical trauma, and so much of it was avoidable. That time I dropped a knife on my foot was an accident, but so much of it has been doctor-induced (an in fact, the way the doctor treated me in the emergency room and again when he took out my stitches was horrible and trauma-inducing, also.) I find it incredibly hard to trust doctors. For most of my life, I have seen doctors on a regular basis, and so much of that time they were unhelpful at best and harmful at worst. I have been poked and prodded unnecessarily. I have been, essentially, assaulted. (It said in my chart that my wrist could easily be dislocated and then put back in place, and more than one doctor “tested” this, even after I asked them not to, and even though it was incredibly painful.) I have been patronized and condescended to. I have been gaslit more times than I can say.

At first I regarded Dr. P with the same skepticism that I had for all doctors, but over the years, I came to trust him. I haven’t always agreed with him, but the way he listens to my concerns, and even debates me, alleviates a lot of my fears. I ask him to run a test. He says it isn’t necessary. I point to some research. He points to some different research. After a conversation like that I may not get what I want, but I feel heard. This should be something we have in every medical appointment, but it’s all too rare.

I got lucky with Dr. P, but also I didn’t. Lucky wasn’t involved. I worked hard to find him. I had many bad doctors before I found him. I researched. I asked in patient groups. I asked other doctors. Finding Dr. P was no accident or coincidence. Still, I have been grateful to have him as my doctor for several years now.

And he is retiring in a few months. I am absolutely devastated.

If you know any doctors in eastern Massachusetts who treat hypothyroidism with both T4 and T3 medications and who have actual knowledge of adrenal fatigue, please please please give me their name! Of course I’ll do my own research into them, but it would be wonderful to have more people to look at.


Is it medical trauma-induced anxiety or rational concern?

August 17, 2021

Heads up: I’ll be talking about my Covid-related anxieties. If this is going to make you anxious, you may want to proceed with caution or skip over this post.

I’m stuck. I’ve been stuck for a long time, but now, suddenly, I’m running out of time to become unstuck. There’s a big event in just over a week and I’m supposed to be there. It was supposed to be last year around this time, but as the pandemic got worse, they decided to move things back by one year. I wondered at the time if one year would be long enough. I’m still wondering.

These folks are so close to me. They’re like family. In some ways, we’re closer than family. Last week she told me that if I come, she’ll pick up food for me the day before when she’s in town to do other last-minute prep, and she told me to double-check the restaurant that she thinks will be safe for me, but that of course I can choose any restaurant in town that I want (it’s a small town, so not a big deal logistically.) How sweet and thoughtful is that? She’s preparing this enormous party (think like a wedding, bat mitzvah, or quinceaƱera), planning every detail, including hiring caterers, and she thought about my food needs! I told her that I planned to bring my own food and she said that she knew I’d be bringing a lot of food for the trip (I’ll be staying in a hotel overnight if I go) and that she didn’t want me to have to worry about bringing Tupperware to the party. I’m telling you this to illustrate how sweet and thoughtful my friend is. Wait, did I say that already? Well, it should be said again, because she is!

We’re close, and we would do anything for each other. But now “anything” is being put to the test. The party will be all outdoors. There will be a formal part, with 150 people sitting in chairs for 2 hours, everyone wearing masks. I will try not to melt in the August heat. Then there will be talking and food. Then back to the hotel to rest for a couple of hours. That night there’s a party with 100 people. Almost no one will be wearing masks at the party. Many of the adults will be vaccinated, but there’s no way to know if they all will be. I don’t know if the teenagers will be. Of course, the kids under 12 (there won’t be many, but at least a half dozen) won’t be vaccinated. People will be eating, talking, and dancing.

I can try to sit at the edge for that first part. Drag a chair away from the crowd and wear an N95. I can stay away from the people talking and eating in the afternoon, and eat my lunch in the car or back at the hotel, if I’m willing to wait that long. At night, I can try to keep my distance as much as possible, again wearing an N95 (can I wear the same one again or do I need a new one?) I’ll need to avoid getting close to people I would typically be hugging. I wouldn’t dance, even during the culturally traditional dances during which I may no longer back to dance fully, but I would typically at least stand at the edge and clap and wiggle a bit. Instead, if I go, I’ll be pretty far from the action. I can keep my mask on when others eat, and eat my own food afterwards. It’s all doable. But I’m anxious about it.

(Side note: I know that this entire event would take a huge toll on me. I would need time to recover for all of my usual health reasons. No part of this would be easy, even if Covid weren’t a consideration. It’s just that those other parts wouldn’t stop me. I already decided that it’s worth feeling bad for a few days or more in order to be there. It’s Covid that’s the issue now.)

The problem is, I can argue both sides of this really well. I know that the odds of me getting Covid are really really small. My state (where the party will be) has one of highest vaccination rates in the country. Everything will be outdoors. I will take every precaution. I’ll wear N95 masks. I will socialize only with 2 friends, both of whom are as careful as I am (and who, as of today, are still planning to attend.) We will eat together, away from the others. At the hotel, we will check in and go straight to our room, and stay there until it’s time to head out to the afternoon party. In the morning, we will head home. It will be good for me to get out of town. It will be good for me to be around people I love. I want to support my friend and her entire family.

Now for the flip side. The Delta variant is pervasive. Yes, we have a high vaccination rate, but it’s still too low for herd immunity. Vaccinated people can transmit the virus. I have plenty of reasons to think that if I get Covid, I’m at risk for a more severe case. I got the vaccine, but I have reason to believe it could be less effective for me than for others. People will be talking and dancing, which will expel more air. There will be few masks. There’s a tent, so even though it’s outside, air can’t travel up. During the first part, we’ll be spending 2 hours sitting in chairs. I’ll try to be on the edge of everyone, but I’ll probably still be near others. We’ll be outside, but still, the proximity will bother me.

I could go on and on. And I have. Several months ago I didn’t think I’d go, but I was hoping that might change. Last month I was pretty sure I’d go, and I felt good about that decision. That’s when my friend and I booked a hotel room. We were ready! Then Delta surged and case counts skyrocketed. And now I’m in hell. My therapist this morning actually said that (well, she called it “purgatory”.) She feels that if I don’t go to this party, it will be due to anxiety, not legitimate Covid concerns. Her reason: I’m so careful because of my anxiety that that itself means I’m incredibly unlikely to get Covid. She’s probably right.

But still, I’m anxious. I keep thinking about all of the potential ways this could go wrong. Every time I think about missing this event, my heart breaks a little bit. This is a major life milestone for people I love and I want to be there. Our friendship will survive if I don’t go. She knows how much I want to be there and how much I’m trying to make it work out. She knows that if I stay home, it won’t be a decision that I make lightly. But I want to be there. I should be there.

The thing is, after 30 years of health problems, it’s hard to shake off the feeling that I’d be walking into the lion’s den. I’ve experienced medical trauma after medical trauma after medical trauma during those years. I have been scolded, gaslighted, and maltreated by doctors. I have been sickened, ignored, and abandoned by healthcare systems. I have lost relationships with people close to me. There’s some part of people that thinks, “It will all work itself out just fine.” I don’t believe that. I’m not sure that I ever have.

Maybe a few weeks from now I’ll tell you that I skipped the event and I’m glad I did. Or maybe I’ll be filled with regrets, as we find that no one got sick and I could have safely been there. Or maybe I’ll go and be glad that I did. Or I could go and get sick and regret it, even though I know that last one is incredibly unlikely. But for now, I have a few more days before my self-imposed deadline to decide. I sure wish I knew what I was going to do.

I welcome your input. I feel stuck, and I’d really like to get unstuck. Two days ago I was pretty sure I was going. Yesterday I was pretty sure that I wasn’t. Today I think that I might. Can you offer me anything useful here to help me sort out how much of my concern is reasonable and how much of it is the result of past medical trauma that has no bearing on this decision?


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