Showing posts with label Journey to Diagnosis. Show all posts
Showing posts with label Journey to Diagnosis. Show all posts

Sunday, October 16, 2011

The Invisibles, a new film by Pixar & Disney

Idea Pitching

A young woman walking with a crutch approaches a heavy-set cigar smoking man at an outdoor cafe setting. The street is busy but the fenced off al freco dining allows her to approach him. His tie costs more than her food budget, but not quite as much as her doctor bills for this month. He's busy thumbing through scripts, chasing each rejected pile of papers with a thrown back sip of scotch, easy, over ice.

She hands him her soon to be discarded pile of paper, the title page reads: The Invisibles.



Unlike The Incredibles, there are no masks or capes or stretchy, lycra suits (now dry-cleanable). But the powers are similar. The hidden identities are similar. Working crappy jobs to get by? Similar again. Mothers, fathers, brothers, sisters, babies. It's all there. But there are no headline winning accolades for The Invisibles.

‎"The Invisibles" are people with Hidden, Silent or Invisible Autoimmune Diseases who do not necessarily look like they have a disability, so they choose to hide their disease. They work as hard, if not harder, than the average healthy person, but their lives are riddled with pain, rejection, uncertainty and the blase attitude aimed at them.

Most people couldn't match a face to an illness, because there is no face for most autoimmune illnesses. The woman with the crutch has MS. But to other people, she's just that lady with the stick. Did she fall and have an accident? Was she drunk? Stupid, careless woman costing us all money. If only she'd...

Helen: Now it's perfectly normal...
Violet: [interrupting] Normal? What do *you* know about normal? What does *anyone* in *this* family know about normal?
Helen: Now wait a minute, young lady...
Violet: We act normal, mom! I want to *be* normal! The only normal one is Jack-Jack, and he's not even toilet trained!
[Jack-Jack bursts out laughing]
Dash: Lucky...
[Violet and Helen look askance at him]
Dash: Uh, I meant about being normal.




So, What Makes it an 'Invisible' Illness? Aren't you just being a bit dramatic here?

"According to The Invisible Disabilities Advocate, an organization dedicated to raising awareness of invisible chronic illnesses and disabilities, more than 125 million Americans have at least one chronic condition, and for more than 40 million, their illnesses limit daily activities...The term invisible illness refers to any medical condition that is not outwardly visible to others, even healthcare professionals. Invisible illnesses encompass a broad range of conditions, including heart disease, diabetes, dementia, psychiatric illness, autoimmune disorders, and even cancer." source

Out of those 40 million sick Americans, "only 7 million use a cane, walker, or wheelchair, making their disabilities visible."

40 million Americans seems like a seriously big number. Can that even be true?

"According to the Centers for Disease Control and Prevention, nearly one in two Americans suffers from at least one chronic disease that affects their daily lives. Diseases such as fibromyalgia, arthritis, and diabetes are often referred to as invisible illnesses because the pain many patients feel is not visually apparent." source

Even scarier, "taken together, autoimmune diseases strike women three times more than men. Some diseases have an even higher incidence in women. In fact, of the 50 million Americans living with autoimmunity, 30 million people are women, some estimates say." source

"While individuals with visible illnesses—those requiring canes or wheelchairs or causing physical manifestations (e.g., hair lost from chemotherapy, tremors and speech irregularities from Parkinson’s disease)—do encounter sociocultural difficulties, their obvious medical conditions typically engender ready support and understanding from others. However, for those with invisible illnesses, such support may not be as forthcoming. And for those with invisible illnesses that remain controversial in the medical community and public eye, support may not come at all." source



What's So Invisible About This Illness?



"Debilitating joint and muscle pain, fatigue, migraines, and other chronic “invisible” symptoms frequently characterize autoimmune and autoimmune-related disorders, such as lupus, rheumatoid arthritis, fibromyalgia (FM), and chronic fatigue syndrome (CFS), which is also called myalgic encephalopathy/encephalomyelitis or chronic fatigue and immune dysfunction syndrome (CFIDS). Although all individuals with autoimmune disorders usually encounter skepticism about their invisible symptoms from others, conditions such as lupus or rheumatoid arthritis are well-established—albeit sometimes difficult—medical diagnoses, and the general public is aware of them as such.

However, individuals with FM or CFS are not so fortunate. 'Not all chronic diseases are equal. Some are more accepted than others,' says Patricia A. Fennell, MSW, LCSW-R, the CEO of Albany Health Management Associates, Inc. 'There are more than 80 autoimmune diseases, and many can be considered invisible,' she says." source

Because autoimmune illnesses seem to be a shared general affliction with women of childbearing years, one could ask if the overall submission of women in previous generations has had anything to do with the tremendous fight for acceptance and treatment for these various autoimmune conditions. "The fact that women have enhanced immune systems compared to men increases women's resistance to many types of infection, but also makes them more susceptible to autoimmune diseases."

Since caregivers and the giving of care has been a female societal role, it makes sense for women to have helped one another through illness without any major media attention via publications or television. It was simply seen as a rite of passage, the role of young woman into caregiver. With more and more caregivers being struck with illness though, and with more attention and equality in medical treatment, more women are actively seeking medical assistance. source

"Even though there is some universally accepted knowledge about autoimmunity, its victims -- mainly women -- have suffered from a lack of focus and a scattered research approach. For example, autoimmunity is known to have a genetic component and tends to cluster in families as different autoimmune diseases. In some families, a mother may have lupus; her son, juvenile diabetes; her sister, antiphospholipid syndrome; and her grandmother, rheumatoid arthritis." source Is the fight for acceptance, treatment and a cure a feminist issue?

Real Life Voice: "As I have metal in my back and am in pain with this I sometimes use a stick, the interesting thing is people are more than happy to let me pass or give there seat up for me. When I don’t have a stick you can forget any help."



The Boogie Monster, or The Evil Genius Behind Illness

"More than 50 million people in the United States suffer from autoimmune diseases due to an abnormal immune reaction called autoimmunity. Autoimmunity is a major cause of many chronic diseases. This number, however, does not include several brain diseases and mental illnesses for which brain autoimmunity has been experimentally demonstrated. For example, a huge population with autism spectrum disorders (ASD), Alzheimer’s disease (AD), Tourette’s syndrome (TS) and obsessive-compulsive disorder (OCD) has been found to have autoimmunity to brain. This patient population is never included in epidemiological studies of the autoimmune diseases." source

People often ask, "Oh, what caused your illness?" and it's a very good question. It's such a good question there are few answers for it. Luck? Genetics? Bad luck? Bad genetics?

When you pose an even heavier question like What Causes Chronic Illness?, you're opening a Pandora's box of opinion, and not many eliciting these opinions are actually getting anywhere near to evolving a solution to the problem.

"Research of autoimmune diseases has not revealed the mechanisms that cause this response. According to A.D.A.M, one theory holds that various microorganisms and drugs somehow "triggers" off the immune response, particularly in those with a genetic predisposition to an autoimmune disease.

Someone can experience more than one autoimmune disease at the same time." source

Google estimates there are about 5,130,000 results for the question. And, in contrast to the myriad of hypothesis to answer the question of the cause of chronic illness, there are only a few path to diagnosis.



Are We There Yet?

One of the most frustrating and emotional aspects of chronic illness is the diagnosis, or the lack of a diagnosis. I know for me personally, it took years and every time I saw someone and paid for the expertise and walked away with nothing was a massive blow.

"Getting a proper diagnosis is sometimes as difficult as living with the disease itself. Victims face problems not only because physicians often don't think of autoimmunity, but also because of who they are, namely, women in the childbearing years. As a rule, this is a time in a woman's life when she looks healthy, though looks can be deceiving. Often, women who suffer from autoimmune diseases are not taken seriously when they first begin consulting their doctors. A woman's symptoms are likely to be vague in the beginning, with a tendency to come and go, and hard to describe accurately to her physician. In a typical scenario, she is often shunted from specialist to specialist and forced to undergo a battery of tests and procedures before a correct diagnosis is made, which can sometimes take years.

According to a 2001 survey by the Autoimmune Diseases Association, over 45 percent of patients with autoimmune diseases have been labeled chronic complainers in the earliest stages of their illness. This can be devastating to a young woman who may then begin to question her sanity as she tries desperately to find out what is wrong. Tragically, many of these patients suffer significant damage to their organs in the meantime and end up carrying this health burden with them for the rest of their lives because of the delay in diagnosis.

If the public, particularly women, and medical practitioners were more aware of the genetic predisposition to develop autoimmune disease, clearly there would be more emphasis on taking a medical history regarding autoimmune diseases within the family when presented by a patient with confusing symptoms. Earlier screening of these diseases could not only prevent significant and lifelong health problems but also actually prevent some autoimmune diseases." source




The Skeptics

Often, simply informing others about a medical condition is not enough explanation. "There are substantial differences in how individuals are viewed culturally and socially, depending on their diagnoses. Diabetes, lupus, heart disease, and cancer may all be considered invisible illnesses, but “no one would ever consider questioning the limitations of an individual who says [he or she has] one of these diseases,” notes Fennell. Yet, this happens frequently for those diagnosed with FM and CFS, she says. According to The CFIDS Association of America, the condition’s name trivializes the illness as little more than tiredness, even though the illness is associated with a “constellation of debilitating symptoms.”

I don't think people mean to be hurtful or ignorant about medical conditions, especially long-term painful ones. I think they just assume there's an answer to the question.

Take 2 of these and call me in the morning, went the saying. An aspirin a day keeps the doctor away. Lots of older people have mantras to health. In my day we smoked and drank and nobody got cancer.

Well, we know that's not true. You just didn't know you had cancer.

And it's the same for chronic illnesses. You didn't know you had it. You had it, and empirically we can look back and diagnose people with illnesses, it's just that you didn't know you had it. So you weren't expecting anything more than what was thrown at you.

Today, we can tell how many micrograms of iron you're lacking with a simple test done in 15 minutes.

Another helpful source of contention for our skeptics are the number of doctors and health related shows on tv. Someone is always handing out an answer and there's always a nifty little ending, endearing and heart-warming, all wrapped up in a 42 minute episode. If Dr. House can cure FMF, surely ANYONE can now that we've watched it on tv!!

When the FMF episode aired, I received a lot of emails and a few phone calls from overseas. Oh, they'd announce, almost ecstatic, there's this drug called COLCHICINE! And it cured them!!

And I'd have to break it to them that well, yeah, colchicine is effective in a lot of symptoms, but mostly it helps with the kidneys and doesn't do a lot else. And there's no cure. It's a lifetime sentence. Oh, and it makes you poo a lot.

So, when someone hears that you've got some chest pains and ongoing inflammation in your joints, they think back to an episode of The Doctors in which we were all told how fish oil helps to STOP inflammation. Or Dr. Oz told us that arthritis really only affects those 65 and over. And, if you're lucky, someone will hand you some colchicine because it helps cure diseases.

It doesn't forgive them for the stupid things they say, but they truly don't mean it. They're suffering from a bad case of Misinformation. Unless they have hearts of concrete, which a lot of them do, and they do honestly delight in younger people than themselves being sick, miserable and almost dying. I like to call them ogres, or trolls depending on the day.

Deborah Barrett, PhD, MSW, agrees: “For many invisible illnesses, there has been more understanding, attention, and validation from the medical community...in terms of public awareness and acceptance." source

Skeptics also seem to take issue when a sick patient rejoices in a diagnosis. See, she's managed to make herself sick enough to trick a doctor. She just wanted the attention. How can you be HAPPY to be so sick?

Dr. Elvira Aletta responds: "There may be a difference in how we respond to a diagnosis if the onset of the illness is sudden as opposed to insidiously appearing over months, if not years. It is common to hear from people who have lived with painful symptoms without a diagnosis to actually feel celebratory when they are finally given one. It would be understandable if that were not the reaction of someone who suddenly, 'out of the blue', discovers they have serious heart disease or cancer." source



How Did You Get So Sick? or What Did You Do to Deserve This?

In my time as a chronically sick person, I've run into people who have posed some interesting questions. One of my least favourite experiences in life was meeting with a woman who, when finding out my twin loss was *only* a first trimester loss, she proceeded to rip me a new arsehole. Because a real loss is after 22 weeks. And, she finished, aren't I lucky I don't have cancer.

Now, this particular day sticks in my head because it was one of the first full outings I did to get veggies and fruit from a local farmer's market. I had been preparing myself by doing 10 minute walks 3 times a day to gain the endurance to do this Farmer's Market trip.

And she cornered me in front of the chicken man, who sold farm fresh eggs and chicken. Hence the name, Chicken Man.

He looked embarrassed, ashamed that this woman was yelling at me for having the GALL to feel sadness around my twin loss and for telling people I was sick. After all, I could have cancer, you know, a REAL sickness.

We were at the farmer's market with friends and their baby boy, and when I sat down and told them what had happened, no one moved. I desperately wanted someone to go up to her and tell her to fuck off and die, but no one did. Instead, they all just murmured about illness and people not understanding.

That moment proved to me that there are people who *get* pregnancy loss and chronic illness and there are people who really don't deserve more than the shit on their shoes.

And since that moment, I really have very little time for people peddling me crap ideas.

I once had a woman selling Ganoderma mushroom paste ask me if I believed I made myself sick.

And I told her honestly, No. No I don't believe I made myself sick. Now, I'll be the first to tell you I'm not an optimist. I'm a realist. A pessimist in a nice, nifty new coat.

I had a bad upbringing. I suffered through miscarriage and infertility. There was a period where I didn't conceive for a year and a bit, followed by a string of miscarriages. I had a bad birth. And I lost more babies. I got sick. I'm still sick.

Nope, not much to feel joyous about, but I wouldn't relegate myself to the 'causes illness to happen' thinking. Personally, I think that's a bunch of garbage created to sell products and prey on people's fear, insecurity and sadness.

Yes, we've all met that person who is so negative despite all the good in their lives. And conversely, we've met the person who is so happy despite all the shit that rains.

Even more so, we've all met that person who said, oh, I can't do it and they didn't. Or prayed for help and they did do it, well.

Yes, there is a mental aspect of it. We are living, breathing organisms that are complex. Our brain is as much tied into our physicality as it is our mental thoughts and our emotional feelings.

If you're having a bad day, you're probably going to feel more sore, or anxious or helpless. Just as, if you're having a good day, you tend to sort of 'forget' a few of those niggles.

However, you didn't CAUSE this disease. You didn't bring it on yourself by having a Big Mac every Friday for a month. You didn't wish for a lifetime of pain and hardship by hoping that horrible bitch at work got a flat tire.

While we are beings in the infantismal flow of life, let's face it, we're not that powerful. Really, we're just some mould that got lucky in the evolution stakes and we managed to learn behaviours that enabled us to grow, mate and evolve.

To say that I am so powerful as to genetically alter my DNA for bad purposes is to say that I may as well go outside and end the droughts in Africa.

I believe there is a lot to the physiological malfunction of the body and the connection to poor physical form. That's why massage feels so good and how a chiropractor can relieve a headache or a backache. I think we have moved a lot from our natural, normal positioning by sitting and reclining. You can learn a lot by reading about proper physical functioning on some really good blogs. Investing in taking care of your body can relieve lots of pain, but it can become a long-term costly facet of care.

However, all that mental blaming is detrimental and whether you are or are not at the root of your own illness has very little to do with autoimmune disease and autoimmune arthritis or chronic muscle burning. There are a lot of people out there peddling products and services to help you overcome the problems you've caused yourself, or so they say.

Yes, let's be forthright with it. We're sick and we've all had a bad day or so. Maybe it's made it worse and maybe it hasn't. But, it does not give anyone a right to prey on someone's fears and insecurities. And it gives NO ONE the right to blame you for being sick.

Coping mentally and emotionally is going to be one of the best ways for you to have better physical days. Having better physical days is going to be one of the best ways for you have better mental and emotional days. It's a circle. It can't be broken off or segmented away. There is no room for BLAME in healing.

Coping With Chronic Illness by Dr. JoAnn LeMaistre is a very important article to read.

This is a fantastic article by by Mark Grant, MA.



Don't You Have a Doctor for That?

The best system of care is in which the patient feels understood. If the patient has pain, but has a doctor who acknowledges the pain, who sympathises, the patient goes away with a better feeling and understanding of the pain, the limitation in 'curing' or stopping the pain and an overall better prognosis.

The doctor-patient relationship is as important as a husband-wife relationship in the long-term care of a patient. That's why if your doctor is crap, you dismiss him/her and you seek someone else. In a system in which this model of care, turning to your GP for every path of guidance, is the rule, finding a good doctor is almost as difficult as finding ancient coins washed into the sand at the beach.

For me, in order to see a specialist, I must get a referral. And my referral is to either a public doctor or a private doctor. Because I have insurance, I often go private. Well, actually, to tell the truth, I've never gone public. For anything, other than birth. And that didn't go so well.

My relationship with my GP is paramount in regards to my care. This is a doctor who sees more files on me than I actually wish, but knows the ins and outs of my health almost as much as I do. It's taken years to find someone I trust so much. However, I wish it wasn't so doctor centric. I wish the health care model allowed me to nominate a physiotherapist as part of my initial response team, so as to get the quality recovery and joint protect I need.

In addition to the doctor-patient care model, there should always be the so-called "fringe treatments" that make up the core of your care: Physical care, Mental Care, Emotional Care. Music, craft, friends, family, photography, sewing, animals, stretching, yoga, sleep, vitamins, minerals, talk therapy. You need to combine the allopathic with the natural, with the alternative, with anything that matters a lot to you.

There are ways to ensure you have a better health picture overall, despite your constellation of symptoms, no matter how maddening.

If you can openly grieve, name your anger, vent in a safe and finite way, actively and physically challenge yourself and emotionally support yourself, you will feel better. And that involves a lot of people. Talk therapists, a physio, group supports, social activities, friends, family, pets.

It's almost too exhausting to try and create a better health for myself.



It's All in Your Head.

Here’s the thing about depression and chronic illness. It’s not depression if you are adjusting to a major loss. That’s called grief. Grief needs time to process. Allow yourself that time to mourn, to be angry and sad about what you’ve lost. You need time to accept the new reality.

But at some point, grief can morph into depression and that can make your physical illness worse.
-- Dr. Elvira Aletta

I usually laugh when someone suggests my illness is all in my head. I don't hear much of it now, but I did. And I heard it even more from doctors, so called 'specialists' about my daughter. Now, I even find myself laughing when I hear someone lament that a doctor told them that it was 'all in your head'.

We must remember that people thought women were hysterical monsters, fit for nothing more than the sanitarium, during their periods. This hierarchical stigma of the male diagnostics of women is centuries old. And, when your symptoms don't fit their nice, neat tucked away manual, well, you're nothing more than that hysterical woman in need of a straight jacket and to be tucked away, nice and neat, away from causing them concern.

But, we do need to accept that there ARE mental symptoms in conjunction with physical symptoms. Of course there are! We are living, breathing organisms. We cannot simply turn off the brain in regards to physical symptoms, in as much as we cannot turn off our emotions when we feel pain.

Depression, and let's just clear the water, is commonly found as a co-morbid symptom of any ongoing illness. How can it not be? People become depressed over once in a lifetime changes. This is an ongoing, chronic, every day for the rest of your life issue. It's OK to say you have been or you are depressed in conjunction with your illness.

"Dr. Elvira Aletta suggests that one or a combination of the following factors can affect the emotional and psychological well being of those diagnosed with a chronic illness, and contribute to depression.

The situation. Loss. Grief.
Changes in appearance, mobility, independence.
The illness itself may have depression as a symptom.
Pain and fatigue.
Side effects of medication and other treatments.
Social pressure to appear okay especially hard if there’s no diagnosis." source

The role of denial cannot be ignored either. When you spend your entire day pretending there is nothing wrong, despite there actually being something hugely wrong, the mental, emotional and physical toll is exhausting.

There are a lot of treatments out there that can attempt to curb both the mental distress as well as reduce some of the physical symptoms of ongoing illness. I know quite a few people who use antidepressants for muscle control as well as anxiety or depression. Lots of people have had success getting outside and back into society, despite their illness, once they've successfully mastered antidepressants.


It's probably the most personal facet of your care and it's ok to ask for help.

Real Life Voice: "I try to pretend this hasn’t happened. My attempts to restore equilibrium lead me to think some moments or even hours that I do not have this disease. I pretend. My family pretends. Then I seem to have to start all over with my family, my friends, my life, again experiencing the shock, the uncertainty, the disruption, the striving and the acceptance."



The Silence

While numerous and highly visible campaigns have worked hard to educate the public about the plight of those with invisible illnesses, there will always be a hesitancy about it all.

If you know I'm sick, will you still treat me like you did before you knew?

_____Will our friendship change?

_________Will you want to date me?

____________Or will you think less of me?

_______________Will I become an inevitable burden to you?

That feeling of being a burden, to you, to life, to society, to my family, to my friends, to my children, to future generations is what keeps me, and countless others, quiet. If I complain, will you think I am not grateful for the help I receive?

If I complain, will you tell me all the things I *should* be grateful for? Will you decide not to help me for fear I might complain about needing help?

If I am quiet, and don't complain, and then you tell me I should have said something, who is helping whom?

It's profoundly complicated.

There was a very black time in my journey when I didn't want to get out of bed. I couldn't. It hurt. I couldn't eat. The medication was making me sick. I hated freely and I didn't care who I hurt. All I wanted was the permission to die. I had broken it down into 2 reasons. One, I didn't want to live if living hurt so much and because I felt like such a burden.

I hadn't dreamed that I'd get married and have children and become a huge, physical, mental, financial burden to them. That wasn't what I signed up for. That certainly isn't what they signed up for. And the cost was escalating out of control. There was no help available.

As a society, we are raised to become self-sufficient. I was told it was the goal of a good parent: To create a self-sufficient 18 year old who could go out and fend for himself.

Some societies and governments work to provide for those less sufficient. I'm lucky to live in one such society where the bulk of my medical care is provided by the taxpayer. And I hope it's something that catches on globally. But there is a great and paradoxical disgust of people using these services.

"None of us struggling with chronic illnesses want to appear visibly disabled to our friends, family or co-workers (or for that matter to total strangers). So, we learn to adapt and become adept at fooling onlookers, along with keeping helping hands at arm's length. Its a hollow victory though.

Sooner or later we all need a helping hand even if we are reluctant to admit it. It is not always easy relying on the kindness of others." -- source

Real Life Voice: "My Social Security Disability application was approved. I’ve been told that only 30% of first-time requests are granted disability payments. I’m obviously relieved and grateful to qualify for social security. My initial reaction to all this news was something like … “Great, I’m approved for disability!”; followed by … “Crap, I’m approved for disability!”



Give Me a Call if You Need Anything

If you are wanting to help a friend or family member with aspects of their ongoing illness, I ask that you read this open letter so that you can understand some aspects of living with an ongoing illness.



“Friendship is born at that moment when one person says to another: "What! You too? I thought I was the only one.”
― C.S. Lewis

One of the things that heals the wounds is time. And what makes time so worthwhile are the people we spend it with. I feel so tremendously grateful for the friends I have had, over time, and hope to keep. It doesn't mean they've always done or said the right things, but they care.

When a woman loses a pregnancy, a baby or an infant, one of the things we like to educate people to say is very simple. I'm sorry. I'm sorry for your loss.

And, if you don't know what to say, you simply say: I don't know what to say right now, but I am so sorry for your loss.

And it's the same with most loss. You verbalising that I have had a loss is what is most important. You accepting my loss with me. I know you don't understand it fully. But I know you care.

We have a habit of wanting to quickly rush in and fix it all. Smooth it all over. Remove the pain. Curb the inconsistencies. Flush out all that is wrong with the world today. And you can't do that with chronic illness.

I will still be sick tomorrow. My house will still be a mess. My bills won't be paid. I won't have extra funds. My yard will look like a primitive jungle and to be honest, I don't have the time, the energy or the consideration to really care. It bothers me, oh it gets under my skin like you wouldn't believe, but I want to spend my time and my energy and my consideration on what is important to me.

Once, when I was part of an early childhood setting, a mother had an unsettled baby. I offered to come over after lunch and play with her older child or the baby while she slept. She scoffed very loudly: You?! Of all people, you!!

I think that did more to ruin bits of me than anything else at the time. I had been working so hard to have energy and stamina and it would mean a lot TO me to help. It also would have meant my daughter would have had a playmate for the afternoon and I would get to hold a baby, something my heart yearns for.

But no. All she could see if that this sick woman was offering to help. How bad a situation must she be in for a SICK woman to offer to help. At that moment I wasn't actually a human being. I was a subject of her pity. No, no, no. She wasn't going to be having a SICK person helping her, she wasn't that desperate! I was the desperate one, what with being sick and all.

What she didn't know is that I'm quite good at settling unsettled babies, as I've had one myself. And that it would have done us both a world of good.

I'm not saying to let disabled people come into your life just because you feel bad for them, but don't write someone off just because they physically aren't perfect. I'm still a mother. I'm still an academic.

Don't be put off when I tell you about my illness. I'm letting you know, ahead of time, for what's going to happen to me. It, however, doesn't lessen WHO I am.

So, to help me, is to let me back into life. Don't try and protect me from failing. I already know I'm not going to be perfect or that I'm going to flounder. But so do other people. Let me back into life.



* Rest Ministries has an excellent article on things TO say and things NOT to say. They also have a great article on how to help your friend or loved one.

* 50 ways to help a chronically ill friend

* Reach Out Australia has some good ideas too.

Seriously, the two best websites on Chronic Illness are But You Don't Look Sick and the Invisible Illness Awareness Week blog.

Your Illness Is Not Your Fault by Tamara Staples here

Five Simple Words to Keep Chronic Illness at Bay by Madeleine Parishhere

For more information, and support, like the Invisible Illness Awareness Week Facebook Page.

5 Rules for Living Well with a Chronic Illness -- source

Monday, October 3, 2011

The Roulette Wheel of Diagnosis

Dear body, I'd reeeeally like to go to the library today. Could you please stop hurting? Please? (The short answer was no.)


Part of living with something no one understands is that you don't understand it either. You probably 'get' it more than others, but because there is no standard rule, no benchmark to gauge your own normalcy, you always find yourself questioning it. If I hear about Vasculitis, I immediately go re-google it to make sure I don't secretly have it and my rheum missed it.

(PS. If you or someone you love has vasculitis, the John Hopkins vasculitis resource online is AMAZING.)

It's like diagnosis is a roulette wheel. Every time you hear of something, maybe, truly this is it! You race online to see what the symptoms are. Oh hey, that sorta kinda sounds like me. Maaaaybe this is it!!

Nope. No. It isn't. Ok. Next!

House, MD was truly epic for me because people would watch an episode and send me an email. Oh Jen, have you tried Wegener’s Granulomatosis? they'd ask. If I had I'd reply yes, and if not, I'd add it to the list of other possible diseases I'd take to the rheum.

Then, I'd open my speech by saying, "I'm sure you've considered Wegener’s Granulomatosis, but can you tell me why this disease doesn't fit my symptom?"

If it was my trusted Rheum, he'd take a breath, brain going through a million neural file cabinets and comparing my notes to his stored data files. Sometimes he'd actually hold his breath while thinking. I don't enjoy this patient induced torture, truly, but it does make me pleased to have a smart doctor.

Generally, everything comes down to my brain MRI and my lung x-rays and that incredible LACK of elevated anything in my labs.

MRI of brain with TRaPs:




Me:




Depending on who I'm having my appointment with, I can be quite forward and say, "So, let's say this is an atypical presentation of xyz, what is the treatment?"

And believe it or not, the majority of treatments are the same.

Weight loss
Light physiotherapy
NSAIDs
Steroids
Plaquinel
Immunosuppressives
And, if you're lucky, injectable biologics.



Occasionally, like with Familial Mediterranean Fever, you might stumble on success with Colchicine, but it's very rare for a single drug to be SO effective for a disease.



When House did an episode with a father and daughter having Familial Mediterranean Fever, my diagnosis at the time, I received so many emails about it! We didn't see the episode for at least a year, but it was frustratingly amazing that the show featured FMF.



Of course, the father and daughter make a 100% recovery of symptoms after being treated with IV colchicine.

When I saw the episode, I swore off the show for the season. It was so demoralizing that a chronic, incurable condition was waved off with a magic wand of a day of IV drugs. IV colchicine is a last resort, and most patients will still have symptoms of the disease after the acute treatment. They are STILL sick, every day, because it is a Genetic condition. Not a once in a lifetime acute illness.



This is the daily battle of life with a genetic illness. There is often no reprieve from the symptoms, but like everyone else, there are good days and bad days.

At the moment, I am severely fatigued. There just is not enough oomph to force these muscles to work. It's definently a Spoon Theory day for me.

Aside from the fatigue, my muscles are burning all over. In my arms, in my legs, in my chest. I've got that heavy band feeling at the back of my head. I want to be up and active. I want to do so much more. But the burning is practically crippling at times. And then, oddly enough, it abates for a few hours only to come back.

I'm making cottage pie for tea tonight. I love any excuse to have mashed potatoes. However, there is a lot of chopping involve. I've broken it into chunks, approximately 90 minutes apart. You'd think it was a military operation, but no. That's life living with chronic impairments.

I'm feeling quite disappointed with myself in regards to my weight. Last year I felt so healthy and alive and lost about 14kg. My physio kept warning me that strenuous exercise can actually trigger inflammation in chronic illness, especially inflammatory illnesses. But, I didn't listen.

And spent months battling chronic inflammation in my gallbladder.


Mine isn't nearly as cute. However, if you're like me and you'd love to remember your organ as sweet, not painful, then try I Heart Guts.

I've never regained that mobility or freedom since. And, all those 14kg are back. High dose steroids for the gallbladder, fatigue and general, often overwhelming, fear of re-triggering all that inflammation has brought it all back.



I've made a goal of getting 50,000 steps on my stepper before xmas. I need to increase my cardio and try to get back some of my mobility. I'd also like to not feel like a beluga whale in a swimsuit.

Actual Photo of Me This Summer:

Saturday, March 12, 2011

Catching Up

I need to find the time in my life to write.

So much has been happening and there are so many emotions surrounding it.

I saw the Rheum registrar, a young Indian man, who seemed very nervous and slightly with the deer-in-headlights appearance. It's the one part of my illness I absolutely hate. I just simply can't relate to people who treat you without that essential human connection. I guess if I came across someone who was really extraordinary and something I've always wanted to see in real life, I'd be excited too, but, as a patient, it sucks.

Basically, I've been denied my requests for funding for Anakinra. And they want to take away my diagnosis. That really unsettled me for a few weeks. I started having nightmares again. I simply am running out of options and it makes me feel I need to find another Rheum. Someone who will take these dead ends and DO something. Be proactive. I can't live my life waiting for someone to have the time for me. I've already done that in my personal life with poor results.

Miss S saw the Paed Rheum who IS proactive and has some pretty big friends at London's Children's Hospital where they will do her genetic testing. However, she has some FIRSTS that have to happen. 1) We have to have blood test proof of an elevated inflammation marker, something we have NEVER been able to document in me, save for the gallbladder thing.

We also have to do some testing on Soph, though, at this stage, we're not sure what it will be. It might just be xrays but it could involve explorative surgery. No mother looks forwards to that decision.

School has been a major source of anxiety for us all, to the point of insomnia. Lots to talk about there. The bottom line is the teacher is unhappy with Sophie having time out 2 or 3 times a day for a rest, for her ongoing fatigue. I don't want this to become a permanent source of anxiety for us. She is showing ongoing fatigue signs, she's not coping with the heat and it should be a simple solution.

Instead, it's become a 'We just pulled our kid out of school because of 1 teacher'.

I attempted a 7 day Colchicine trial, suggested by the Registrar as part of proving my 'need' for funded drugs. I made it 5 days and can't do more. Everything burns. It hurts to move. The nausea and stomach symptoms are horrendous. I felt like crawling into a hole and being left for dead earlier today.

Summer has come and gone. It makes me melancholic to see Autumn arriving. It makes me sad it's March. It makes me sad it will be 4 years in 9 days.

Soph has been home for 2 weeks and that's 2 weeks I haven't been going in for my voluntary role. That leaves me with tremendous guilt, given we've just had mega need there due to the displacement of Canterbury residents following the earthquake in Christchurch.

I feel like I'm holding things together with some sort of dissolving threading. It's going to give at some point.

To get me through, I've been taking about 6 kids vitamins every day. It does seem to be providing wonders of energy and health. I remember it was my tonic when Spph was born and we weren't sleeping.

I've been thinking of adding Water kefir to my list of crazy things to try and get well. Must try to find some in nz to get started.

My head is just killing me but I can't lie down because of the colchicine induced nausea.

Friday, February 18, 2011

A little more Badger

I'm always hesitant when the phone rings. I don't know if it's a general phone avoidance or phone phobia, but I get this internal cringe when the phone rings. It's not like I've had many horrible phone experiences in my life, but I am, decidedly, anti-phone these days.

It takes a lot of effort to remove oneself from a comfy couch and walk to the phone. You'd think, being in the company of one who loves emerging technology, we'd have a portable phone but pshh. Seriously, who uses those things? We have 1 phone jack and an antiquated non-cordless phone.

When the phone rings, it takes a lot to answer it. It's either someone confirming an appointment or someone changing an appointment or someone trying to change my power company. No one ever rings to offer me a million dollars or a chat. Not that I'd be keen on a chat. I'd have to sit on the stairs and that's really uncomfy.

And I'm exactly the same way with my mobile. It's more likely to run out of batteries than be used, though I am trying to get better at texting people. I just enjoy socialising when it's my own decision.

I spent some time this morning trying to pass on and receive messages with my gastro. He's been quite a find, after the first gastro was a complete waste, so I look forward to hearing from him. He is genuinely interested in the TRAPS disease and wants to know more. He also, genuinely, wants to help.

So when he mentioned that he'd try to see me ASAP when symptoms started forming a pattern, I leapt on that. Are you sure?? I asked, aghast that someone was actually taking me seriously. Really? And in my head I'm thinking, pinch me! Pinch me! I'm dreaming!

Last Friday morning, thursday night I guess, I noticed a pinching feeling in the area surrounding my right kidney. It was enough to wake me several times. Ow, I thought. That's not good. But I went on into 'work' and dutifully ignored it.

Saturday morning it was more than a pinch and more than an occasional Ow. It was more of a sustained owwwww but still only coming in periodic waves.

Today, now a week on, it's more of the 'why do I need a kidney and for the love of G-d would you stop' sensation. I rang my GP's office on Monday looking for an appointment. 'You need to ring a week in advance' the woman tells me curtly (as though I plan these things, as you would a teeth cleaning). He can see you 3:15 next Monday. Oh, I say. That's quite a ways away. Take it or leave it she tells me. Yikes! Drives a hard bargain, these headphone equipped women.

So, here we are. It's Friday. It hurts and I see the doctor on Monday. Options available to me are the 'after hours' or accident/emergency variety of doctor. The emergency room (seems a bit OTT, you know?) or wait.

So I rang the Gastro, thinking of his offer. I get put onto his PA, a wonderful and lovely and patient girl. Oh, she says, are you the TRAPS lady? I hate to call you that, she says.

Oh no, I butt in. I've been called worse. It is me and I've got these symptoms and he said he wanted to know when it was happening. Tell him that it's mild now but it's going to get worse and I thought he ought to know.

I like how you're so calm, she says. Like you know it's going to get worse and yet you're so calm.

Well, I think to myself. I've done the panic and cry thing in the past and all I did was upset everyone around me. Besides, it's not going to kill me...yet.

My counselor and I have agreed that I enjoy the art of grim and depressing humour. Not in the Hannibal Lecter sort of way, though I do enjoy a nice Chianti. I still have a couple bottles in the cellar and need to check their drink by dates. (What? Didn't you spend your 20s cellaring imported Italian wines? No?)

I don't know what it is about me, but I have a tendency to deflect situations into some macabre, satiric humour. I read once that comedians are funny because they're brutally honest about their pain and they're ok with it. I think of myself as an excellent comedian. It is how I deflect pain. It's how I degrade myself and it's how I am brutally honest with my own limitations.

And I adore making people laugh. Laughter is a nice way of someone saying they accept you. I don't think people expect it when they meet me. Sitting in a doctor's office and dealing with these concepts and walking away with him laughing is a highlight for me. I've had doctors comment that they adore working with me because we get to be so real and so informal. I also enjoy when they curse.

I once had a GP, who I was very fond of, bang his head on his desk when he realised he was completely overwhelmed with being able to help me and said: Frankly, I should just discharge you because you're too hard. But I like you too much.

And maybe that's the thing. I like that people like me, and I like to make things easier for them. Because life is hard. I know how hard it can be. So a light moment for them and for me is pure gold.

My counselor says it's a self-soothing mechanism that I've taught myself over time. That by somehow finding a spark of humour, I've accepted the bleak, decided I'm over the bleak, and can move on to positive things.

See, I AM positive. It's just my positivity isn't rainbows, bunnies and fluffy. It's decidedly dark, meaty and more Philly Cheesesteak than brown rice and miso.

So when the lovely PA responds that I'm calm despite what's going on, to me it's a non-issue. And I actually sort of thought, well, what would you prefer? Me sobbing on the phone and clutching the ground in agony? But then I thought, omg, maybe I am going to die and I should head her warning and, yeah, nah. Not going to happen.

It gives me mental clarity, the grim Jennifer. It lets me get the crap out of the way and get onto business. It also lightens the load. I don't want your sadness, I'm not pitying myself so let's get to the real business of making me better.

I'm finding it hard to curb the habit though. In front of my daughter, I don't want to joke about her health. I'll joke about her high energy, her inability to sleep before 10pm, but this disease, nope. Not funny. Not to me. I'm a real badger about it.

We're not going to dismiss it. I'm not going to allow you to lessen this illness. I'm not going to allow you to replace your discomfort with a blase attitude. And maybe it makes me appear boring and serious and a real stick in the mud.

I started seeing my first specialist, a gyn when I was 13 about the intense pelvic pain I was experiencing. My mother, who never experienced more than 'bad cramps', didn't get what was going on. It felt like a weedwhacker was tearing my uterus apart. I would bleed in excess and pass clots. I would vomit from the pain of the cramping. And yet, it was the 'take 2 tylenol and get over it' attitude I hated the most.

I almost feel sad to admit, but I was a geek. I adored school work and writing essays. Having to miss drama or video production was horror for me. I wanted to be at school for those bits (the other bits like math or science or pe I could happily miss) but I wanted to go to play practice. And yet, it was always, oh Jennifer is an attention seeker and keeping me home was regarded as this generous, excessive and euphoric reward I was being granted and not the kind and caring regard to my pain and my health. There was no humanity in my childhood.

Kids her age don't get pelvic pain. It's growing pains. She'll get over it. She likes the attention and even negative attention is attention.

I didn't get over it. Because there was and is nothing to 'get over'. It's a lifelong commitment, being ill. It will last longer than any friendship, and longer than my own lifetime.

So I saw my first gyn. I was given monthly prescriptions for Vicodin. And it did nothing for me. It was suggested I have a laparoscopy at the age of 14, but my mother said no. I think about the relief I found after my lap in 2003, at the age of 22, and think how much better the previous 8 years could have been.

It wasn't long-lasting, the relief, but it was relief nonetheless. I often question why those of us with adhesions don't get yearly laps, besides the cost and the recovery period.

I had a major kidney infection when I was 15. I had just finished driver's ed and literally, overnight, struck down. The symptoms had been ongoing, but due to the drama caused by me wanting to see a doctor, I ignored it. After 2 ERs, it was found that my right kidney had abscessed.

It took several hours of fluids and kind nurses taking my abuse as they forced the pus from the kidney. That event most likely has paved the way for the recurrent kidney inflammation now. I was in kidney failure.

And I don't want that for my child. Yes, I know how hard it is for you to look at your precious child and imagine the effects of illness. And to admit it to yourself, to other people. I know that people will accuse you of attention seeking, or being mad and off your rocker, but it is worth it to have someone else repeat your fears and worries.

When the paed told me that he suspected that there was arthritis in my daughter's knees, my heart stopped momentarily. I knew what was coming for her. A lifetime of hurt and pain and drugs and sadness. Of limitations and always, always pushing through, but my g-d my heart lifted and I thought, yes! Someone else gets it.

The unresolved pain of my own diagnosis still lingers in me. I think that anger is the force behind my momentum. It powers my satiric nature. It is the power that pushes me through pain, through illness. And I don't want that for her.

I want her force to be fuller. To be brighter. To be of love and confidence and the power of her.

I think, for the most part, the calmness comes because of that simply and easily discarded word: Diagnosis. I got mine. It's my golden ticket. It, all at once, makes me and destroys me. I am finally real. No one can brush me off now. And yet, what an absolutely shitty gift.

I want the same for her. I want her to achieve her golden ticket status early so that we can brush it off and move forward.

I also really want this liver/kidney pain to stop. And knowing that it won't, I open myself up a little more. A little more vulnerable. A little more grey and depressing.

A little more badger.

Saturday, October 23, 2010

The Courage to Be

While I was in hospital, Matt took Soph to the lab to get her bloodwork done.

We had taken Soph to see her regular GP, Rachel, someone who looks amazing for giving birth to her 3rd child a few months ago and is so smart it's hard not to leave jealous. Rachel is a brilliant children's GP. She's aware, she's considerate and, the best point, she doesn't freak out.

We first starting seeing Rachel about Sophie's constipation and when we saw the Paed, we had remarked about the fevers that we had started seeing when Soph was a baby. We told Rachel, ok, it's time. Sophie's teacher has come to us about the fevers, and if someone else is seeing them, it's time.

Ok, Rachel said. Let's move with this. Keep your fever diary (something I have tried and tried to maintain but never seem to get more than a few days into before I fall off the wagon) and we need to get the blood tests done.

When we first started the constipation diagnosis, Soph had some blood tests done for celiac and we did all sorts of stool and urine tests. Soph was barely 4 at the time and was so brave. She winced and cried quietly. They gave her a certificate to colour in and a colour copy for her records. I treated her to a Happy Meal, because, well, it's all I could do at the time.

Rachel wanted the test done with obvious signs of the disease. It's the same for my rheum. They always want you to be able to rush to the lab at the first sign of mega disease and frankly, it's a pipe dream. For one, labs close. For two, most diseases like TRAPS are so unpredictable it's impossible to schedule your lab test around your life and your disease.

However, with a paeds appointment coming up, we want the blood test results. So Matt and I debated. Do we wait until we can catch a 38C fever or do we go with the physical signs: redness, irritability, food refusal, tummy soreness.

For a couple evenings we had been noticing a temp spike over 37.5C but by judging the clock, it always came after 5:30pm and the lab closes at 5pm. So...do we take her one afternoon just before 5? Do we keep her home one morning until we see the signs?

Knowing the ANA and some other autoimmune tests can take up to 3 weeks, well...what do you do? Take a gamble and get it done now or wait and miss the paed appt with blood results?


It hadn't actually been decided when I went into hospital. My phone was quite quiet on Fri morning and I texted to see how school drop off went and got a text back saying they had been to the lab, with big bear as her Whanau support, and they were now at BK having a treat.

My heart dropped. My brave girl! Doing this without her mama!! My heart hurt. This is MY job. I'm supposed to be there to comfort, to arrange and to oversee these things. It did help me realize that her father is completely competent and that as we separate, he will be fine to cope with and do these things.

He tells me they had her on his lap, with his legs holding hers down. He held one arm, they held another. Another girl did the poke and draw. She screamed and cried, as you would when you're 5. She said she doesn't want to do that again until she's 6, or 6.5. My heart breaks.

Matt took her to school and her teacher, the incredible Mrs. Chambers, announced to the class that Sophie had been a brave girl and she held up her Certificate of Bravery and they all clapped. Oh, be still my heart.

We fully expect nothing significant from the tests. Rachel told us to expect nothing, we know from my own experience, to expect nothing. So, if we're to expect nothing, is it worth getting them done at all. Well, yes. Because if it's TRAPS, getting nothing is on par. If it's something like Juvenile Rheumatoid Arthritis, we will see something. If it's going to attack her body, it's at least worth *trying* to find something.

When I first was undergoing diagnosis, I used to be crippled with guilt. The guilt of being a sick mother -- unable to mother to my fullest. The guilt of being an angry, emotional mother -- hurting my child with my inability to control my emotions. The guilt, oh the guilt, of passing this on -- and it still gets to me. If I'm sick, well, that's ok. It's my lot in life. I can cope with it all. After all, I'm an adult and I'm used to things being tough and ironic and hard.

But her. Not her. Anyone but her. This is the child I fought to bring into the world. The child who struggled so much in her first year. Who has fought so hard to grow, the develop, to be the best and bravest girl she can be despite abdominal pain and these other symptoms.

When Matt first ended the relationship, I was awash with this feeling that I wish I hadn't brought a child into this fucked up situation. Didn't she deserve a family with love and respect and a safe place to fall, especially if she's going to face other troubles in her life?

But I now see that she does have a family with love and respect and she will always have a safe place to fall. It just happens to be a slightly augmented nuclear family and I hope that as we all grow and age that we will continue to be a close and safe and loving family. I think our joint desire to help her through the illness is what unites us as parents.

I still ache inside thinking of the guilt. I ache inside knowing that she is going to have a lifetime of illness and pain. I ache inside knowing that any future children I have will face this as well. I suppose I am steeled by the fact that my own experiences have been much more positive here in Wellington and that I am growing and learning how to handle myself, handle the unknowns of the illness. I am comforted by the fact that the staff at the hospital are so kind, so caring and so professional, and yet maintain that friendly, approachable manner.

I'm sure this confidence is going to falter at some stage as we approach the paed appointment.

But, for now, I'm relieved the lab tests are in the works and the girl bounced back from it all.

Tuesday, October 19, 2010

Writing is my Food

I've been reading some posts on a messageboard lately about 'fatties' and how people who are overweight need to stop feeding their gobs and just exercise. It makes me giggle a bit, because those types of people have never struggled with much. Either by design or pure stupidity.

We all struggle with something. Some people feel too tall; some too fat. Some are poor and some just have really crappy luck.

It did, however, inspire me to question whether I had it in me to get back on the stepper and do some weight training exercises. And the answer is that I do have it in me. The power, the desire, the insanity to challenge my adrenal glands.

My gallbladder is distinctively more sore and angry than before the exercise so I know that today's 750 steps is probably on the high side for someone with biliary colic.

I've been meaning to write about what it feels like to pass on that really crappy luck but my daughter isn't doing too well. She's had a fever for a few days, very sore knees and she's tired, sore and emotionally exhausted. We're off to the GP and I'm going to ask for some blood tests.

I had hoped we'd have 15 years before we saw more aggressive signs. But we're not getting that sort of time.

I'm supposed to be writing through these feelings but it's hard. Isn't it easier to just stuff it down and have another cup of coffee and bake some cupcakes? Some pretty pink cupcakes?

Tomorrow. Today is a challenge enough.

Monday, October 18, 2010

Of Silver Bullets and Bias

When I was a little girl I had a horrible fear, bordering on obsessive phobia, of werewolves. It all stemmed from a single BETA tape. My grandfather had taped Star Wars onto BETA and given it to my parents. Star Wars is the movie that taught me to talk. My parents would proudly announce, to anyone who was listening, that they'd plonk me in front of Star Wars while they got ready in the morning.

From tv saturation with Star Wars to daycare. Rock on 80s parenting.

But before the Star Wars began, there was a preview for a werewolf movie. I would run from the tv and wind myself into the curtains and cry and shake horribly. And when I was sure it was safe, I would return to the tv.

To remember this, it must have been excessively scary. Later, as a child, if it got dark and the curtains hadn't been drawn, I would look outside in fear, worried the werewolves were sitting outside waiting for me to be alone. We had an alley that ran behind us and we often had a problem with dogs roaming. I had hideous anxiety as a child.

I remember though, that in the preview there was something about the Silver Bullet. The single weakness of these beasts. I would dream about silver bullets for years to come. I finally got over the werewolf fear in counseling in my 20s.


When dealing with an overwhelming illness, or trauma of any kind, we all seek that Silver Bullet. Once found, no matter how hard, it will end that horrible monster plaguing your life. It's a desperate search. Because we're all different, because we all have different reactions to illness, because illness is so different for every single person, the search continues for each of us.

And it's a marketers dream! Just have a look at what this search reveals: Arthritis on Trademe

A woman at Playcentre once approached me about my illness. She was very kind and compassionate and listened as I tried to make sense of what had happened to me. She then broke into a spiel about Ganoderma. She pulled out a bright red booklet and told me to take it home and give it a read. She'd ring me that evening and talk to me about the...PRODUCTS.



Yes, it was a marketing scheme (scam?). A multi-level marketing scheme, similar to that of any other pyramid scheme. Amazing claims begin to pour out of the literature. It clears up anything from acne to MS. Multiple Sclerosis? I was stunned. Of course I wanted in on this! A single tube for $22.95 could cure all my woes.

We looked online and there is some interesting research. It's hard to tell what's real and what's not. It's hard to go past personal 'testimonies' about the power of the product. Because we wanted me to be well so much I almost bought a tube. It was when the woman rang that evening and began her talk about how it had cured everything from her cavities to her recurrent vaginal yeast, we put a giant block up and told her we weren't interested as we were trying other forms of alternative therapy.

She tried and tried for weeks and finally got the message. I never did try it, although I have thought about it from time to time.

I spent a lot of time with a homeopath in Nelson. She is beyond brilliant and I adore her for the emotional space and support she gave me. I saw an osteopath, equally brilliant, to help with the pain. I have since seen another homeopath here in Wellington, not quite so brilliant.

I've tried herbal preparations. I've rubbed myself to the point of stench with various poultices, creams, rubs and drunk every sort of herbal tea you can find.

I've gone gluten free, dairy free and lived on raw juices.

Did anything make a difference? Well, actually, the very first homeopathic remedy I tried I think was the most beneficial of anything I've done in 3 and a half years. In agonizing pain, I sent an email to Selene Homeopathics (can't say enough fab things about them) and the homeopath rang me back and talked to me. He sent me a remedy and within a day or so I felt a major improvement. Since then, not so much.




I've spent literally thousands of dollars in treatments. Chiropractors, the crazy lady who waved her hands around me to dispel the energies, yoga, counseling, tablets, greens, dried herbs, liquid herbs, vitamins, oils, books, veggies, crystals, aromatherapies, bee products, etc.

Nothing has been my Silver Bullet. Nothing has ever met the promises on the label. I've often questioned my rights in returning the product, but is it a gamble to purchase the product to begin with? Do you just suck it up and give it away?

Things that have helped: Ibuprofen and Voltaren rubs, discussing anger and the emotional impacts of increased cortisol on the body, heat and sleep.

I met with a herbalist on Friday of last week. I sought him out to help with the gallbladder pain but mentioned the guilt and sadness I feel about the twin loss. I enjoy meeting with alternative practitioners; in fact, I adore them. I enjoy anyone who seeks out the alternative reasoning behind illness.

Because, in my case, my illness lacks so much understanding and no one really knows the *why* of genetic disease, there is often a lack of empathy and support from your specialist. I like when someone looks into my eyes and says, oh you've got a brown spot over your liver, and then delves into the emotional responses.

I guess you get the anatomy and physiology from your specialist but not a lot more. Your GP tends to ride both sides. I think having someone say, oh how are your emotions on the steroid? Are you doing ok? is so, so important. Because no one actually crosses that boundary in real life. No one asks you HOW you are doing in response to drugs, money problems, work issues, child rearing. And if they do, they don't quite know how to respond to the negative.

I've found people either want you to say you're fine and everything is perfect or they want you to be absolutely at the last straw so they can save you. There are a few wonderful people who know how to ride the fence and ask the right questions. Other people, at no fault of their own, don't know HOW to deal with the reality of living a life compromised by illness.

People will say, oh your situation makes me feel so sad and powerless, I can't imagine how you feel. I think that's the thing. I don't know how I feel about it either. If I try too hard to get in touch with my feelings I get overwhelmed and sad and despondent. If I ignore it, I ignore my body's needs and what's going on in my head and my heart as well.

It's hard learning the art of being unwell. Some people get you're having a bad day and some people just can't imagine having a 'bad' day because they often overlook their own feelings and needs. I think we're trained to push past any sort of 'personal weakness' that we just plow through the majority of life, completely unconnected to our body, mind, heart.

I think being too connected to the unpredictable, to the illness, to the weakness and the sadness allows you to be a victim. It's so easy to fall into the victim trap and there are many, many people willing to take advantage of that. I can think of a story of an ill mother who spent thousands of dollars with an 'alternative' gp who sold her a billion products, loads of new-age tests and basically just rode the ride of stripping her of her own confidence and bank balance.

Conversely, being too unconnected to the reality, to support and give empathy and love really does rob the patient. Just because I look well to you doesn't mean I haven't spent the morning in hell trying to get my hands to open up enough so I could feed myself, get my kid dressed and drive her to the playdate we're meeting at.



Because I need to operate on so many levels, including operating heavy machinery (ie, a car), I can't take the pain killers I need to control the pain. So I wait all day until I've completed my list of To Dos and then I take them. I may be in complete agony but have learned it's not ok to show those signs and feelings. I might be completely in my head, counting, using distraction techniques, to control the pain and you see me as aloof or somehow lesser.

I remember wearing a pair of slippers to Playcentre one day and having someone ask me if I was wearing them because I needed them or because I couldn't be bothered getting dressed. What is it about my illness that allows you, gives you complete permission, to be a total asshole?

I'm wearing clothes, have fed, dressed and brought my child to Playcentre. I've worked at the craft table and cleaned up paint pots and here you are asking me if I couldn't be bothered getting dressed? I quietly replied that my feet were so swollen I couldn't fit them into sneakers. I would have liked to include an F-You and a Piss Off, but I didn't. Because, even if I'm feeling like hell, I am required to be polite and conform to society, but how funny that you aren't.

Because if I respond with the way I am actually feeling and try to educate you, I'm seen as bitter or a victim or an attention whore. I had someone point out that I rarely ever spoke about my illness so no one knew how to approach me. And I responded that it wasn't true -- I actually did talk about it a lot. I let people know my hands were hurting so I'd go to something that didn't require their use. Or that I was tired and needed to sit, so I'd go read stories. Just because you weren't listening, well, that's not MY problem. And yet it is.



When I did openly talk about the fears I had, I was told I reminded one of the elected officers of 'this person' they knew who did nothing but whine and agonize over their own illness. So I'm instantly painted with a brush of your own personal bias? How is that fair? How is this giving the understanding and support Playcentre is so known to show? That humanity has claimed as a separation from the beasts of burden?

When I began referring people to The Spoon Theory PDF download, more and more people began to thank me for helping them to understand what chronic disease is like. Not everyone read the story and some said it was too hard to read so they stopped. Fair enough. I imagine it is terribly hard reading the reality of someone young, stricken at a young age, with the rest of their life as complete unknowns filled with hardship. But it needs to be read. And passed on. And shared with those we love and those we hardly know alike.



* An Open Letter To Those Without Invisible Disability Or Chronic Illness …

Saturday, October 16, 2010

Into the Bitterness

When I first got sick, people were awash with helpful hints and hopeful suggestions. Like I'd wake up well just as easily as I woke up sick. And when that didn't happen, I asked for a referral to a Rheumatologist.

Now, at the time, we were living in a small, wine growing community and my referral was for a doctor in a town over the hill, a 90 minutes drive each way. I held onto hope that walking into this man's office was going to change my life. I should have held onto hope that it would change for the better but I hadn't yet found out that a lot of doctors are total douches.

His office rang and said that to be seen by the public hospital, we'd have to wait 16 weeks whereas, to see him privately on a Wednesday afternoon, we would only have to wait 4 or 5 weeks. Who wouldn't take that deal?

So, in that time, we put our daughter into full-time daycare and my days as a busy mother were quashed. The house was so silent and my ability do anything was completely stalled. I remember getting off the couch and crawling to the toilet. I could get on and off by myself at this stage, but you know, that very private 'wiping' stage was still beyond me. So I learned the art of shift and shake -- no paper required. No shame either.

We were going into winter and I wore just a long leopard print robe. Getting clothes on and off was too hard, too depressing. Matt's grandmother had given us a very large insulated container with a spout on the top for keeping drinks cold in the summer. We found that it kept water hot and we used that as a means of making tea. I slid the cup under the spout, hit the button and the hot water came out. I could then wait for the tea to cool and drink it. And because I couldn't hold the cups, I drank lukewarm tea from a straw.

I spent a lot of time on the couch watching daytime tv and listening to ZM online. I hated silence. I couldn't stand silence. To this day I need some form of noise. Being in a silent house takes me right back to those early days of being unable to move and crying for help for everything.

Because I couldn't eat, I drank a lot of juice. I had gotten into juicing when breastfeeding Soph and going gluten free. So we dug out the juicer and I drank all sorts of combos. Anything I read online that suggested even the slightest hint of help, I drank it.

Asians greens, silverbeet, carrots, beetroot, it didn't matter. The most offending was brussel sprouts and the least offending is Bok Choi. Cucumbers juiced are a little slice of sluggy hell. Just don't go there.



That's purple cabbage and gluten free cookies.

Like I said, I tried it all.

Slowly as I began to relearn movements and train myself in movements that hurt less, I became mobile and apparently learned a funky gait that I've since had to work on. I called and called that Dr's office. I begged, I cried, I did anything I could to get in. But no dice.

Finally the day came. Full of hope and awe we ventured over the hill and into the Dr's office. It was an office in an aged care facility, with houses for the elderly surrounding it. I guess lots of old people need Rheumatologists.

When he introduced himself, I felt ok about it all. He was fairly young, with a 2 year old son and he seemed interested in the case. He was concerned that my ANA was negative, but that's ok he said. Some people never develop a positive ANA. I did some basic physical tests for him and it was agony trying to touch this or that.

Then he sat down and started to eat his lunch during my appointment. He said that because they had 'squeezed' me in that this was his lunch hour. Now I felt bad for being there. He told me it was a case of a mixed connective tissue disease to him and that he didn't much care for the 'Whys' or causes. He just liked to jump into treatment.

I was to continue the steroid at 40mg and start on the Plaquinel. Should clear it all right up.

And that was that. My 15 minutes were done, please pay $120 and take this script and begin taking the drugs.

It was really depressing. That was it!? Imagine waiting 16 weeks for THAT!!

So we drove home, filled the script and I took my first doses of Plaquinel. And within a few hours the side effects kicked in. In short, Plaquinel is quite effective against Malaria. It's also quite effective as a laxative. I am a sensitive sort, I'll admit that. Drugs hit me hard. And my stomach is so sensitive from the drugs that I puke easily. But at this stage in my drug trailing, I was still a strong gut virgin.

I was puking from dawn to dusk. My butt hurt so much. I called the office and begged for advice. Finally I got a phone call. Oh, that does happen to some people. Just stop taking it and I'll call in a script for Methotrexate.

All I knew of MTX, from my time investigating fertility, was that it was used as a cancer drug and to kill off ectopic pregnancies. What on earth was he doing giving it to ME?!

No way, I said. Over my dead body. I began to research the side effects, the risk to future fertility. I told him I'd see if I could tolerate the Plaquinel a bit longer and if not, well, I'd cross that bridge.

In my head I just kept counting down. Ok, another day sick means I'm closer to the end of this. If it's a flare, it'll stop and my life will go back to normal. Any day. Any day. Come on, any day. People were telling me that a positive attitude, visualzing being well, etc was going to make it all better.

And it was naive. I held this hope that I was going to get better and when I got worse or violently ill from a drug reaction, I felt lost. Wasn't I supposed to be getting better? What the hell?

And if I had negative thoughts I was reigned in by well meaning friends. No one knew that what I needed most of all was just unbiased, non-judgemental, silent support. Someone to hug me, to hold me, to let me cry and scream. Holding all of that in poisoned my perception of life.

The pain was so intense at times and uncontrolled pain is akin, in my mind, to torture. Any movement, any sudden slip from total control meant uncontrolled pain for hours. Doctors, some doctors at least, are very quick to give pain relief. Others won't. My GP, thankfully, was quite good but started me very slowly. At first we tried normal Ibuprofen. Then we tried Voltaren. I quickly showed intolerant to it and had my first bowel bleed and a bad case of gastritis. The steroid, it seemed, was making my body so sensitive.

So we tried codeine with and without Tramadol and finally worked up to Oxycodone. I was bloated up like a walrus. I began developing shakes in my arms and speech was very difficult. We rang the Rheum and demanded an emergency appt due to the shakes and the uncontrolled pain.

It took about 10 days but we got there. Again, it was lunchtime, this time was a pie and a very grumpy, inconsiderate demeanour. He was upset that the Plaquinel wasn't working, that my inflammation markers were all normal despite the obvious swelling and pain. He didn't like the neediness and my 'demands' on him. I am, he explained, the only Rheum for 3 regions and I am a very busy man.

I felt guilty, ashamed but also scared. Terrified of the shaking, the inability to form words. He told me it was odd that these symptoms were starting now, very similar to that of Parkinsons or MS. Oh, he said, looking at my chart. You've got a case of Prednisone poisoning! Just drop down to 20mg. You won't be able to tolerate 40mg very long.

How simple for him, how insane for me. That's it?! This drug is controlling my life!

He asked me why I hadn't started the MTX. Because if I was taking it, I wouldn't be hurting now, and silly girl, you should be doing what I'm telling you. But, I told him, what about the risks to fertility etc. He told me I shouldn't be worried about the future when today was such a problem.

He told me it was very strange that none of my tests had yielded an answer and perhaps it wasn't Lupus after all. It was very much like RA with the swellings and the negative ANA. But my RF was negative as was my Lupus factor. Hrrrrrm, he said, eating his pie, crumbs all over my notes. Yes. RA. Start the MTX and see your GP for pain. And, by the way, arthritis shouldn't hurt all the time. If it is, you're just feeling too much.

We left angry. Hopeless. Upset. I cried most of the way home. Why was no one listening to me? Treating me like an actual human being!? Is this the only doctor we can actually see? What. The. Hell.

I saw my GP and explained my pain and my worries and he just shrugged at the inability to offer another Rheum. We could try Christchurch he said and he began digging through a book of referrals. No, I said, it's too far to travel and I can't afford it.

So I filled the MTX script and waited. Waited for a day when the pain was so intense I questioned my sanity and took photos of the drug. How could something so innocent looking have the potential to kill cancer and render one infertile?







So I swallowed my six tablets and waited.

I didn't actually have many side effects to the drug. I had a weird burning sensation at times but nothing more. I also didn't have any effects that it was working. It takes a few weeks everyone kept saying. So, I kept taking the drug. And waiting.

Being sick and on the diagnosis roller coaster is a giant case of hurry up and wait. You do your bit, all you can, and you wait. For other people, for drugs, for chemical reactions, for signs of life and hope.

And nothing.

The pain was intense and horrible. I remember taking a red marker and having Matt put an X everywhere on my body it hurt. I walked into my GPs office and showed him. He just put his head in his hands and said he didn't know. He had started training as a Rheumatologist but stopped because it was simply too hard. It was that scenario all over again. He told me he'd give me the highest dose of Oxycodone he could prescribe and that he'd do some reading.

When I saw him a few days later, he told me he thought Still's Disease was the answer. It often has completely normal blood panels and doesn't respond to modifying drugs. We were progressing into Spring and he warned me not to take the sun lightly. Being on MTX was going to change everything.

I'm normally cold all the time anyways so long sleeves didn't bother me. I got a big hat and put sunscreen on my hands and my face.

One Sunday after the farmer's market we joined our osteo friend and his wife and daughters for lunch at a lovely little restaurant in the Mudhouse. I began to feel very faint and sick to my stomach. We were very aware of the sun but wanted me to get some air. I was sitting at a picnic table under a tree in the shade. But I didn't feel any better.

When we got home and I peeled my top off, I noticed I was sunburnt all over my chest. Despite wearing a winter top, in the shade, I had been burnt. We saw a pharamcist as he was still open and he gasped and said it was at least a second degree burn.

He packed it with gauze and gave us some sesame seed oil that was being used on Bali burn victims to reduce their scarring. It was horrible. I had to go to my GP's nurse and get the darn thing repacked. The pain was horrible but at least I didn't focus on my joints as much.

Because the risk of infection was so high I had to drop the steroid from 20mg and try to cope. It healed beautifully, thanks to the sesame seed oil, and it hasn't left much of a scar. I stopped taking the MTX and went up North with my daughter to stay with my MIL and FIL. Life was simply too hard dealing with the stress of Matt's work and being sick and guilt and coming up to my due date.


A Very Bloated Jen

I spent my due date in bed crying. What had happened to me?

I went to bed one night a very tired, busy mum of one and look at me now? Bloated, sore, unable to move much and filled with so much anger, hostility and infinite sadness. What had I done? Why was I being punished? Why did G-d hate me so much?

My MIL was very supportive but I think it was a very foreign concept for her, all of it. I don't think anyone had anything they could say to reach me. I had gone too far into myself and I hated the world. And I didn't care who I hurt in the meantime. No one's pain could match mine, so why did it matter if what I did upset them briefly?

I bought some Christmas angels from Trade Aid after my last Rheum appointment. I held onto them in bed, clutching them. Trying desperately to form some sense out of the events of the previous few months.

What happened? Was it ever going to get better? Just what the hell was going on?

Thursday, October 14, 2010

About The Author

Every good blog has a good blog author. Not to say I'm a good blog author, but I will try to write about my journey with all the heart and honesty I can provide. Some days the words come, some days the brain fog, well, fogs.

I'm Jen. I'm not yet 30 and I'm blogging about living with an incurable illness. It's taken a while to get to the stage mentally and emotionally to write the words incurable illness and to decide to take the step of writing my story.

It was only after some nudging that I decided to do so, though I'm not new to blogging. I had an infertility blog in my earlier days. Infertility in your 20s? Why yes, but then we had no idea what was going to emerge.

I was always the sicker child. I missed my own birthday and party one year after getting the chicken pox. Then I got chicken pox again a few weeks later. I was always getting ear infections and had my tonsils out after 6 bouts of tonsillitis in one year. I had Mono and missed a lot of school. I had recurrent kidney and bladder infections. I've had a kidney abscess from infection.

I developed acid reflux (GERD) when I was a teen. I was always tired and suffered from depression and anxiety. Insomnia was common.

I began to get deep chest pains that at first was suspected asthma but I never had asthma symptoms and didn't really respond to the inhalers.

My legs began to ache at night and my knee would swell up madly.

Soon I had trouble walking the distance from the house to the university, 2 blocks away. The fatigue and inability to sleep were maddening. I had suspected appendicitis at least 3 times in one year. I began dropping dishes because my hands would simply 'let go' from the clasp motion. I started questioning my sanity because I was sensing so much change in my life and comparing myself to my peers. What was wrong with me?

Then I began having miscarriages. For a young girl in her 20s who was otherwise healthy, it was a bit bizarre.

My clotting panels all came back normally so...it was bad luck?

I was diagnosed with PCOS because of a high testerone level and I was found to have scar tissue in and on my uterus, similar to that of pelvic inflammatory disease.

It was after one miscarriage in August 2004 that things started getting strange. I developed horrible joint pain, my muscles ached, my body was swollen, I had a high fever but no signs of infection. My chest hurt, my lungs hurt, my stomach hurt. I saw a GP who told me she thought I had Lupus 'for sure' and when my ANA came back normal told me I had a 'monster virus' and suggested I get some form of body emotion therapy.

It was after my daughter was born that things got stranger. The very same response happened. Only this time I had an infant with reflux who was failure to thrive, was breastfeeding and had a c-section. I was told I was supposed to be feeling like hell. But it didn't explain the swollen joints or the fever, did it?

I began to experience severe symptoms of depression and anxiety because deep down I knew something MORE was wrong with my baby and my body was just not bouncing back the way other people were.

The joint pain was becoming more severe. A lactation consultant told me to go dairy free and gluten free. I lost a lot of weight and my milk almost dried up and still nothing got better.

I pushed through it all and was feeling mildly better in Feb 2007 when I lost a twin pregnancy.

I had 3 successive D&Cs from March 21 to April 11 and after that developed what we thought was a kidney infection. I was given antibiotics I was clearly marked as allergic to and I had a seizure. I saw a bright white light, felt a huge electric shock all over my body and began to seize.

I went to the hospital where I was told I was hyperventilating because I was tired and it was after that I can't remember much. I woke up to a body that was not mine. I couldn't move. Everything hurt. My head was foggy, my abdomen was stiff and every single movement felt like fire in my joints.

The hospital told me it was a gynae issue. Gynae came and saw me and told me it was a Rheumatology issue. Rheumatology told me I couldn't be seen for 4 days and to lie in the hospital bed and get better.

I checked myself out of the hospital against medical orders and saw my family GP the next day.

He broke the news to me: Jen, he said. You have Lupus. We're ordering tests now but every fibre in my body is saying Lupus.

No, I said. I can't have LUPUS! People with Lupus can die!!

He pointed out I couldn't uncurl my hands. They were frozen, turned in, to my body. I couldn't lift my arms, walk or toilet myself. I hadn't eaten for days and was drinking water from a straw. It felt like shattered glass was being crunched every time I moved, from the little trial movement to a full-on sneeze or sob.

He started me on 40mg of Prednisone and I was wheeled out of the room to the car. I went up north to stay with my MIL and daughter.

After 2 weeks I felt fantastic and so we stopped the Prednisone. Immediately every symptom came back. I have never regained that same vitality or health since. I returned home unable to walk, unable to lift a mug to my lips, and unable to cope with what was happening.

And that began the journey to diagnosis, beginning in April 2007 and ending in July 2010.

In that time I was diagnosed with Lupus, Rheumatoid Arthritis, Still's Disease, Familial Mediterranean Fever and finally Traps, or Tumour Necrosis Factor-alpha Receptor Periodic Syndrome. I have also been tested for Lyme Disease, Hyper IgD, and Porphyria.

In that time I have tried Prednisone, Hydrochloroquinine, Methotrexate, Azathioprine, Colchicine, Paracetemol, Ibuprofen, Voltaren, Codeine, Oxycodone, Morphine, Citalopram and Quetiapine. I've had 2 bowel bleeds, allergic reactions to Azathioprine and antibiotics, a 2nd degree burn from the MTX. I've lost my hair, gained weight, developed major outbreaks of acne, lost and gained muscle tone, found and lost my faith in G-d, and became a victim with serious rage and depression.

In that time I've been told I've made it all up, couldn't possibly have a rare disorder, had Lupus and was being a 'woman' about it all, to harden up, to get on with it, that arthritis doesn't really hurt all the time, that no one knows what to do with me, that I'm going to be a guinea pig and not complain about it and that men don't stay with fat women.

In that time I've had 2 incredible GPS, 3 rheumatologists, including the same one who dumped me and later took me back, 2 rounds of genetic testing, and finally 1 answer.

In that time I have experienced bouts of Pleurisy, Pericarditis, numerous kidney infections and inflammations, gallbladder inflammation and stones, migraines, abdominal pain, anxiety, depression, anger, grief, thoughts of suicide and a divorce.

I'm Jen, and this is my story.