Physical vs. cognitive: it’s all connected, sometimes

April 10, 2016

I was chatting with a few people about my chronic illness writing when one mentioned a friend with fibromyalgia who also has some cognitive issues. She asked if chronic pain and cognitive problems could be related.

Oh boy, here we go!

Someone else there with chronic pain said that it makes sense to have cognitive issues because the pain can be tiring, but she was a bit vague. I wanted to go deeper.

First, I pointed out that pain can be distracting. I asked, “If I stabbed you with a knife, how well do you think you’d complete a crossword puzzle.” I saw the wheels turning as the others processed that, imagined it. It was graphic, and it got my point across well.

Then, we mentioned how tiring it is to always be in pain. And on top of that kind of tiredness, it’s hard to sleep when you’re in pain, so there’s sleep deprivation, too. I asked how their cognitive abilities are after a few nights of bad sleep. “Now imagine that every night for decades.” Again, they slowly realized.

Finally, I explained how sometimes that thing that causes the pain and also cause cognitive impairs all on its own. In other words, the pain doesn’t cause cognitive problems, the cause of the pain causes those problems. For example, I have Hashimoto’s Disease. Hashimoto’s can have a lot of symptoms including joint pain, digestive issues, cognitive problems, low body temperature, weight gain, hair loss, and more. Notice that one of those symptoms is joint pain. Notice that another of those symptoms is cognitive impairment. Neither causes the other; they’re both caused by Hashimoto’s. Everyone nodded along.

I love that this acquaintance asked these questions and that everyone in the room made the effort to thoughtfully consider what I said. I love that they really tried to understand! Sometimes I hate talking about chronic illness because I just want to forget about it and go have a good time. But sometimes it’s so wonderful to educate people, to help them understand. And now the person who asked will have a slightly better understanding of her friend’s symptoms.

I admit, there are days when I dodge these questions, but today was a good day, so I answered, and I feel great about it. What about you? Do you ever answer these kinds of questions? Do you avoid them? Are you never asked? How do you feel about educating people? Please comment with your thoughts!

When the government forces pain upon us

March 17, 2016

This week there was a difficult statement from the Centers for Disease Control. Well, difficult for people with chronic pain and their doctors.

There has been a lot of discussion around the use of opioids for treating chronic pain. It paints all users are addicts. It suggests that the deaths caused from addiction negate any benefit that might be gained from proper use of the meds. It suggests that there is no such thing as proper use. And so on.

For the record, I do not use opioids. I have tried them and have always found that they helped me very little and that their side effects were terrible. If they worked for me and didn’t have bad side effects then yes, I would use them every day if that meant living with less pain.

Also for the record, many close friends take opioids daily. They are not addicts. They take their medications responsibly. These medications allow them to do heroic tasks like shower, cook, and drive to medical appointments. Occasionally they can even do something fun, like have me over for a visit.

This week the CDC issued a guideline. This is non-binding, but it does usually have an effect on doctors’ practices. I won’t get into the details here, but they’re linked at the bottom of the article below. Suffice it to say, a bunch of people who don’t have chronic pain have decided that those with chronic pain don’t need opioids. Apparently Tylenol and Advil should be sufficient. In other words, they’re completely clueless.

I find this whole thing very upsetting. So on the one hand, I think it’s incredibly important to talk about it. On the other hand, I don’t feel qualified to properly and fully discuss it, and I find it upsetting to even try.

Here are just a few of my thoughts:

  • Lumping together all opioid deaths, including those from heroin use, is hurtful, hateful, and absurd.
  • How can they not be accounting for the increased suicide rate that will result from this? Do they not care, or do they not understand?
  • Do they really think people would take medications with terrible side effects if Tylenol and Advil (which aren’t harmless, by the way!) really worked?
  • Do they have any idea how many different things pain patients try? Do they know how many more things we would try if insurance covered them? I have such a list of things I would do if I only had the money and the energy!
  • Have they not considered that maybe, just maybe, limiting the use of legal drugs will lead to an increase in the use of illegal drugs?
  • If the concern is addition, why not work to prevent and treat addiction? Studies have made it clear that this won’t help.
  • Where is the compassion?

I want to say so much, but I don’t have the words. So here are some reactions I want to share. At the bottom of that article is a link to the CDC guidelines.

The chronic pain community put up a good fight and lost this round. But the fight isn’t over. I don’t know what will happen next, but I know that no one will be giving up!

Yes, I’m one of them

December 9, 2015

I was talking to some friends about some tough decisions I need to make about benefits. One of them said, more than once, that I might need them for a while, but those benefits aren’t meant for my “demographic.” They’re not for people like me. But the thing is, they really are.

I understand why she said it. We both grew up in middle class families in the same middle class neighborhood. We both went to college, then graduate school. We both got middle class jobs. We followed all the “rules” and now we’re supposed to have our happy middle class lifestyles. She is a stay at home mom. Her husband earns a very large salary. She has that middle class lifestyle.

I don’t.

There’s an idea that benefits are meant for other people. The people who aren’t middle class. The people who don’t have jobs. Well, as it turns out, that’s me.

Those benefits are for people with physical and mental illness. People who can’t work. Yup, me again.

People think they’re for people who are older. But they aren’t. They’re for people of all ages. Including people in their 30s like me.

My friend means well. She tries to understand. She is one of the only people in my life who knew me before I was sick, and she understands my health problems better than most. But she can’t accept that it’s permanent because she doesn’t want to. It hurts her to think of me in pain. I get that. I feel the same when someone close to me is in pain; I pretend it can’t be serious or permanent, even when it obviously is. That’s how she feels about me.

But it doesn’t change things.

So yes, I’m one of those people. The other ones. The ones who aren’t us. Except sometimes they are. Sometimes they’re one of us. Sometimes we’re one of them. It doesn’t matter if you grew up rich or poor or somewhere in between, whether you got advanced degrees or didn’t finish high school, you can be too sick to work. And when that happens, benefits like food stamps, Medicaid, and section 8 are helpful. Even when we don’t want them, we need them.

Like it or not, we’re one of them.

Cutting out the people who don’t care

October 13, 2015

Her: I’d like to invite you to our house for Thanksgiving.

Me: You’ve probably heard that I might need surgery, so I can’t plan anything until that’s figured out.

Her: I’m sorry to hear about the surgery. I had no idea. Just let me know if you’ll be able to make it or not.

On its face, this seemed ok. She was sorry to hear about the surgery. So that was a good response, right? But I felt like something was missing. It nagged at me. I read the message again. Something still nagged at me, but I didn’t know what.

Hours later, it hit me: she didn’t ask why I needed surgery, if it was a big deal, or anything else!

I’ve been one of the lucky ones. Most of my family and friends have been incredibly supportive. A lot of people lose many of their loved ones when they have a chronic illness. It’s an unfortunate side effect that the doctors don’t tell us about. It’s hard and it hurts and it sucks. But it happens.

For me, it was my sister. I’m sure our problems aren’t all because of my health, but they’re a big part of it. Every now and then, I question if things area really that bad. Maybe I should try to make amends? Maybe she really does care? And then something like this happens.

Apparently our parents hadn’t mentioned my possible surgery to her. I guess there wasn’t anything to mention yet. I was pretty sure I’d need surgery, but I hadn’t gotten the MRI results yet (which is why I haven’t mentioned it to you yet – don’t worry, I’ll tell you all about it when it’s official.) Now, if someone I cared about had said, “As you probably know, I might need surgery,” I’d be upset and worried! I’d ask why, when, if I could do anything to help, etc. Actually, that’s how the few friends I told have responded. They’ve been amazing. They’ve been calling and texting and emailing. They’ve asked questions and offered support. Not my sister. Nope. She didn’t even ask why I would need surgery.

It’s hard to accept that sometimes a relationship can’t be salvaged. It’s natural to want to keep people in our lives. It’s especially hard when that relationship isn’t a vague acquaintance or a coworker, but a close friend or a sibling. We don’t have any other siblings. We only have each other. But that doesn’t matter. That’s not enough of a reason to try to be close to someone who obviously doesn’t care about me, or who at the very least tries to distance herself from me.

I know from past experience that I am better off focusing on the positive relationships in my life. So I will go to Thanksgiving dinner to be with other relatives (depending on how I’m feeling,) but until that day, I will put my limited energy into relationships with the people who love me and care about me.

Now if you’ll excuse me, I need to answer some more of my friends’ emails. They’re worried about me.

“Have you tried…..?”

September 28, 2015

We’ve all heard it. A well-meaning friend, a nosy stranger, a nervous relative, a new acquaintance hears about your health problem and asks, “Have you tried X?”

The first time you hear it, you probably think it’s nice they’re trying to help. Maybe they even suggest something you’ve never thought of. The 5th time you hear it, it’s a bit annoying, but at least they want to help, right? The 782nd time you hear it, you’re fed up and trying not to yell at them about their ignorance.

But how do you really respond?

A friend and I were sharing stories about this yesterday. She said how she always wants to say, “Do you really think you’ll suggest anything I haven’t already thought of?” and I said that I do actually say that. She was shocked that I say it. I was shocked that she doesn’t say it.

The thing is, why bother pretending? I’m not mean about it, but I do point out that I’ve had my health issues for more than 20 years. I read the news. I follow health blogs, Facebook groups, and twitter accounts. I read library books and newsletters. I talk to friends with similar health problems. And let’s not forget, I just happen to see many doctors. So do they really think they’re going to suggest anything that I haven’t already thought of or had suggested to me by a professional? I point all that out, nicely, and no one is offended but they do stop offering me advice. Win!

What about you? How do you handle it when someone asks, “Have you tried….?” Please share your approach in the comments. I’d love to know what everyone else does!

Learning it’s ok to cry

September 11, 2015

A couple years ago I wrote about the fact that I don’t cry much about my health situation but I wasn’t sure why. By contrast, I know exactly why I don’t cry from the pain itself, and that’s because it started when I was a kid, and I learned fast that the adults in my life thought that I was just trying to get attention. If I cried, they thought that even more. So I didn’t cry.

Fast forward to my 30s, and I still don’t usually cry from pain, frustration, or fear. I cry for other reasons – a sad book, the death of a loved one, and such and elicit tears, even though health issues rarely do.

In the last year, though, I’ve been making more of an effort to let myself cry when I want to. It’s cathartic, so why not? I do so much to try and help my health, both physical and mental, so shouldn’t I be willing to cry?

I started with simple things: I didn’t try to stop myself a few weeks ago when I was reading a sad scene in a book. Before, I would try to hold back the tears and fail; this time I didn’t try to hold them back. I let a few tears escape when I was dealing with a difficult health decision. It was a good start. And then came the real test.

When I was in the ER last week the pain was horrible, but even worse was the fear. My anxiety around doctors has been getting worse, and I was practically panicked at the idea of a doctor I didn’t know giving me stitches. What if he messed up? What if there was a broken bone they hadn’t noticed on the x-ray? What if he somehow hurt me? On top of that the pain was intense. For a while, I tried not to cry out of habit. Then, finally, I had an epiphany: it was ok to cry! This doctor didn’t know me or my history. I would never see him again. Plus, crying in this situation was not only acceptable, it was expected. I mean, I had a big cut that had been bleeding for hours and the doctor was dabbing at it to get away enough blood that he could see it clearly. Of course it hurt like hell! Why shouldn’t I cry?

So the tears came. They poured down my face and I did nothing to stop them. I didn’t make a scene. I didn’t yell or scream or sob loudly. I didn’t exaggerate but I also didn’t hold back. And you know what? It felt so much BETTER to let all of that out!

This is a long process. I need to unlearn more than 20 years of habit, but I know I can do it. I just need to make more of an effort to cry when I feel the need to cry. Wish me luck!

Does this sound familiar? Have you experienced anything similar? Please comment below – I’d love to hear your story!

Even when they’re wrong, it’s still my fault

August 12, 2015

Let’s face it, sometimes customer service representatives aren’t trained all that well. I once had one of those jobs, and I mostly learned what to do through trial and error. I’m sure some callers were annoyed at my inability to immediately solve their problems, but since I was offering technical support on phones, it wasn’t a big deal if something wen8-12-2015 6-10-09 PMt wrong.

Until I got really sick, most of my experience with calling customer support fell into those kinds of non-essential categories. Maybe the cable bill would be screwed up or I wouldn’t have internet access for two days. This was really irritating, but I knew it would eventually be fixed. I also knew that I’d receive reparations for my hassle.

Unfortunately, it doesn’t work that way with government entities. If they get something wrong, it’s still considered my fault. A few weeks ago I wrong about my frustration with SSDI benefits, mostly based on a phone call with a representation at the SSA (Social Security Administration.) I’d read everything, but it’s confusing, so when she corrected me, I assumed she was right. I should have known better. Thankfully, reader StuckInTexas commented and corrected me. But what else are they getting wrong?

I called the SSA 4 times to report earnings from a bit of work I’d done. It was handled 4 different ways, including 1 representative who was so confused, I just gave up and hung up the phone.

Yesterday I called Medicare to ask if a certain treatment was covered. They said yes, but only under certain circumstances. Those circumstances weren’t 100% clear, and when I asked questions, they just reread the same passage. To me it sounds like what I need will be covered, but they wouldn’t confirm that. They were happy to repeat, though, that it’s my responsibility to make sure it’s covered. How is that logical? I can understand that it’s my responsibility to call and check, but if I call and they refuse to confirm, then what? Do they really expect patients to move forward with appointments and treatments without knowing if they’re covered? Obviously that’s sometimes necessary, but often it isn’t.

MassHealth, our state Medicaid, was different. She simply said she couldn’t tell me and then she passed the buck: she said my doctor had to call the provider line. I can only assume the representatives on that line are better trained and will be able to answer the question. When I asked about covering a TENS unit, for example, she didn’t know what it was. When I spelled it, she still didn’t know. Medicare doesn’t cover it, but at least that representative knew what I was talking about. I think. Maybe she didn’t. Maybe they really do cover it. I don’t know!!

Yesterday I got a long form in the mail from the SSA. They want me to fill out all earnings I received since I went on SSDI. This was triggered by the earnings I recently reported, but I thought that only happened if the earnings were $750 or higher in one month. My earnings weren’t over $400! So now what should I do? I don’t want to have to fill out the form, but even more, I don’t want to be put in the category of people they “observe” unnecessarily. I want to call the SSA to check on this, but I’m pretty sure that if I call 5 times and speak to 5 different people, I’ll get 5 different answers! And if I do get 5 different answers, they’ll still say it’s my responsibility to handle this correctly. If I get 1 answer from everyone and it’s wrong, then the SSA will still say it’s my fault, even if I do exactly what they tell me to do. Don’t believe me? Look at what happened to these disabled folks who were on SSI.

I will take responsibility for my own mistakes. But I think these big government entities should do the same. What do they really expect from us? If they can’t manage to properly train their own employees in these complicated rules and regulations, is it reasonable to expect the general population to understand these same complicated rules and regulations? I don’t think so.

Have you encountered anything like this? How do you handle it? And if you’ve had to report income while on SSDI, did you have to fill out tons of paperwork? Please comment below so we can help each other out!

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