Wednesday, June 4, 2008

"Sick Girl"


I apologize in advance for the fact that this is an extremely long post. But there was a lot in “Sick Girl” by Amy Silverstein that I identified with.

Some of the books I’ve talked about are certainly more current.

This is the first book in a while I’ve been able to get into. Let that tell you what it will…
*****
“Staying alive in this body has become an obligation for me that continually raises the question of why. Why continue in a perpetual lifesaving marathon when there is no possibility of a happy, healthy end? The answer to this question appears to me only in blurry glimpses from time to time – mostly in the calm short breaks between illnesses” (3).

Is this what Doctor C meant by saying I could lead a “fairly” normal life? That a few months out of the year I will feel practically normal again and then the rest of the year I’ll suffer through all of the symptoms of my illnesses?

I know that we’re still trying to work out the kinks of this treatment plan. Yet, every time I think something is working well and might do the trick, it stops working.

Unfortunately, I’d be lying if I said that the above quote from “Sick Girl” didn’t resonate with me. Because it does. There have been and continue to be days of pain and fatigue that make me stop and think, What’s the point?

But then I think about the fact that I’m young and have way too many unfinished things that I have yet to do. But it’s really hard when you’re trying to make an invisible illness visible, trying to make those around you understand:

Do you know what it’s like to expend energy you don’t have to expend?

To be so tired everyday that you want to curl up in a ball and cry?

To have your body feel like your bones are crushing in on your organs and to be told that for you, this is the new “normal”?

You know, I realize what’s happening to “us,” isn’t taking place in a vacuum. Even when our friends and family don’t acknowledge it, it’s having an effect on them, too. Obviously, there are some people in our lives that refuse to acknowledge what’s going on.

Sometimes I want to tell people that I’m worried about myself, that I don’t know how long I can stand to go on like this, that I don’t like doctors or relying on other people and that all of this really sucks!

But I don’t.

I stand back, resolute or stupid – take your pick. I pretend like life is normal and everything is fine. But I’m reminded constantly that it’s not.

How many times do I have to list these symptoms until all of this becomes real? This is really happening to me…

And I think that’s what scares me the most. That this will take over and a “sick girl” is all I’ll become...

“Only in retrospect would I recognize that it was youth, coupled with the absence of serious childhood illness, that could dull down the medical danger radar in a girl to the point where peril hardly registered at all. Add to this an obliging physician with the same defective detection system, plus a penchant for the jolly, and what you’ve got is a recipe for massive denial that cooks up into a ticking time bomb” (15).

Man, oh man, does this sound familiar?

At some point I have to let myself off the hook about letting others dictate to me that what was happening to my body was nothing more than a little stress and constipation. Constipation in my muscles and bones? I don’t think so. Until it spiraled out of control and my body hammered it into me that something was definitely very wrong.

But then there’s a part of me that thinks, How could I have been so damn stupid?

Again and again we are told to trust doctors and do what they tell us. And yet, we are also told to ask questions, seek second opinions, and not stop until we are satisfied with the answers we receive.

You know, I was living truly on my own for the first time. No way was I going to admit that, for whatever reason, that I couldn’t handle life.

“Smart, savvy patients are not born; they are made – sometimes unwillingly” (48).

So true. You either become a passive actor in your medical care, and therefore, your life; or you attempt to walk in step with your doctors, even though one of you will always remain ahead or behind.

“I realized from the earliest stages of my illness that the people around me responded better when I stayed strong and kept all the ugly details to myself” (50)”

This is true, too! What else can I say about it? It seems to me that the people around us are better spared the gory details, even though we have to live with them every single day. It doesn’t really make any sense.

But I think that people are content to think of me in a very different light than I see myself.

“I was a scary story, no doubt. My illness had made me into one of those people who serves as the protagonist in the kind of thank-god-it’s-not-me tale that will run through entire communities and even through young doctors’ minds’” (59).

Okay, so my situation is NOT that bad. But my mind keeps coming back to the fact that for my rheumatologist, I’m sort of an anomaly. It probably gives Doctor C great pleasure to occasionally see someone under the age of 60. In fact, I sometimes worry that Doctor C might be getting too much pleasure out of it. Like there’s some sick fascination. Or maybe Doctor C doesn’t really think about my case at all. While we’d all like to think that we are the only patient our doctors’ have or that our doctors are so intent on helping us that they lie awake at night thinking about us, we all know that’s not quite true.

“Medical emergencies – I would learn on that day – do not cause the more ordinary aspects of life to disappear; not even for a moment. For very sick people like me, the unimaginable gets played out right alongside the completely familiar. And sometimes it is the memory of the small benign details, rather than the scary big picture, that has staying power” (63-4).

I too, know what it’s like to try and make the invisible visible. That is sometimes far more painful than the pain we are trying to make people see.

And she’s right. You think that when something life changing like this happens, all of the little crap falls away. Not so. It almost becomes more amplified, like it has become twice as important, because you might miss something, let something slide.

“Because I thought too much. And thinking too much leads to knowing too much. And knowing to much would make it impossible for me to live in carefree denial” (143).

That’s me. I read too much, know too much. And you know what, my doctors don’t like it. I know they don’t. But what choice do I have, when they give me information selectively?

“…those who face serious illness early in life, and those who avoid medical tragedy straight into old age. At some point, it seemed, everyone would have their body stolen from them – and, with it, the ability to set themselves apart from medical misfortune. But timing is everything; the longer this loss can be delayed, the better. Being able to hold on to ones easy health, I came to believe, was the mark of true good fortune. The very lucky get hit later, simple as that” (182).

If you have your health, be thankful. It’s pretty crazy when you think you have your whole life ahead of you to dodge bullets. And then you find out that you don’t. This is an understatement, but it’s a pretty big disappointment.

“I was here – sorting through my life. Looking for reasons to put medicine in my mouth, and finding enough of them to be able to swallow” (291).

I think the thing for me that is the scariest right now is the fact that this is my body… on drugs. Without them, I don’t want to imagine what life would be like. I’ve been there, done that, and it wasn’t pretty. And while this is a fairly imperfect existence, it’s better than not existing at all (well, I can say that today – it seems like it’s going to be a good one).

*****

While “Sick Girl” got some pretty bad reviews, I thought it was pretty good. There was a lot that I identified with, as a young woman dealing with illness. Silverstein’s panic about prednisone – What if I get fat? – I’ve been there. Unlike her, I didn’t fight my doctor tooth and nail about it – I took it – but I also didn’t get billed a “fragile” and “noncompliant” patient, either. My fragile noncompliance gets played out here, rather than in my doctors’ offices.

A lot of people have said that this book is an overly negative one. I firmly believe however, that everyone has their own way of coping and dealing with things. If you want a happy book about organ transplant or illness, this is not your story.

This is one of the reasons I believe that books about illness that include only one story are not the most useful.

Silverstein tells the story of her parents leaving her in the backseat of a cab, after she is told that she might eventually need a heart transplant. I had to question whether to believe this story. It seemed so mean, so cruel to me, especially coming from parents. But I guess we have to believe her story, every part of it, because we’ve got nothing else to go on...

She also talks about her stepmother who only cares about whether she’ll be able to play golf or not.

As a question I posed in an earlier post, Silverstein is writing her story the way she sees it. And this is the fatal flaw with all of our stories. Those who we deem as villains or heroes may not see themselves the same way we do. As I’ve suggested before, I have a feeling that any of my doctors would find my story skewed. I’m sure that the way I’ve written them is not the way they would have written themselves.

Aside from the above criticisms, I was struck by the fact that very early on in her story, she is guided by, supported by, the love of a man, who despite it all, becomes her husband. Her portrayal of Scott really frustrated me.

If I had someone like she did, there from the very beginning, I would treasure that, hold on to it, and never let it go. I don’t have the companionship of someone telling me I’m beautiful, even when I’m bloated from the prednisone and feeling like crap, don’t have any makeup on, and am wearing the requisite sweatpants and t-shirt, what has become my uniform these days. Even the effort to look like crap is often too much.

I guess that’s it. I’m done with “Sick Girl”.
*****
(Silverstein, Amy. Sick Girl. New York: Grove Atlantic, 2007)

Tuesday, June 3, 2008

Subtle Changes

I used to walk at least five paces ahead of my mom. Now we walk in step.

When I cross the street every day, I think, Wow, either the cars are moving faster or drivers have gotten a lot more impatient. But maybe it’s none of the above. Maybe I’ve gotten slower.

I’ve discovered in me a wry sense of humor that sometime borders on being offensive.

It took 3 days of steroids to finally put a smile back on my face, a smile that had been erased by months and months of pain. A smile that I'm not sure will stay on my face without the help of medication that makes the physical pain not gone, but bearable.

I used to be one of those people that had a list of 15 things to do in a day. I did 25. Now I’m lucky to make it ¾ of the way through my list. Things are constantly getting bumped back, plans rescheduled, schedules rearranged.

To most people, these are imperceptible changes. They aren’t even a blip on the radar. But to me, these are the things that make the drugs and the illness suck. The things that make me look in the mirror and not recognize the person that I see. I see empty eyes that lead to a hurt soul and a broken body.

Where did I go?

Where did I go wrong?

"Another Day (That Time Forgot)

I’m not a huge Neil Diamond fan, but I am absolutely addicted to the song, “Another Day (That Time Forgot)”:

“Another sunny afternoon
Tonight is the worried look that’s on my face
Connected through the years
It somehow took us both in separate ways
Was on a day that time forgot
Another day that time forgot oh no oh no
Should have held you till the storm went by
But we had nothing left to hang on to
Too many words you said
But not the words connecting me to you
Just another day that time forgot
Another day that time forgot oh no oh no
The two of us we both just let it lie
Didn’t see it leave
Didn’t even try
I only knew that we were moving on
Suddenly it’s gone
Never knowing why oh no oh no
Don’t have a reason I can give
At least not one that I can understand
Just somehow disappeared
It slipped beneath the fingers of my hand
Was on a day that time forgot
Another day that time forgot oh no oh no
We had it once but we just let it fall
Should have held it close
Could have had it all
I’m thinking ‘bout the life we could have made
Lost the one we had
Somewhere along the way oh no oh no
I woke up all alone again
A half remembered dream inside my head
You took me through the day
Followed me at night into my bed
Was on day that time forgot
Another day that time forgot oh no oh no
Oh no oh no…”

From the album, “Home Before Dark”

I'm Gonna Say It Again...

You’ve got to have friends.

I saw the “Sex and the City” movie and I LOVED IT!!!

It was one of those movies that made me laugh and cry. And there was something comforting about the familiar – Carrie, Charlotte, Miranda, and Samantha. We all have friends who are those girls. We are those girls…

One thing that surprised me was that despite the toned bodies, the faces of the characters had aged. I guess I had sort of expected them to have plastic-y, worked-on faces. But they didn’t. And you know what? It made me kind of happy. Even the characters who remain forever young in our minds age. Time withers them, too.

But, if there’s one thing to be taken away from the movie, it’s that you’ve got to have friends.

Not just any kind of friends.

The kind that will be there to save you from failed relationships.

To make you laugh during even your darkest hour.

And sometimes, they even save you from yourself.

Monday, June 2, 2008

This Is Becoming A Theme...

I'm exhausted... Painfully So...

You've Got To Have Friends

It was so nice for a change to act like a 22 year old, to have 22-year-old worries and concerns, to gossip about boys, and laugh at jokes that only those present could understand. I think it’s these times that I’ve become most thankful for over the past year. No matter how hard things get, I am, at some point, still able to laugh.

There’s nothing like a night out of Mexican food at the end of a long first week of work and a weekend with friends. I can’t exactly say I'm coming back refreshed, as I’m still exhausted, but that's only to be expected, right?

Part Of That World

This past weekend I took the train to visit a friend.

On the way home, I cried there on the train, like an idiot. I had spent a few days in someone else’s world. Now I was back to my own. And no one was waiting for me. Just me. Sure, there’s my cute, cozy apartment filled with my stuff. And for the most part, it is stuff that I treasure. But it isn’t the stuff that matters. It’s the people in your life that do.

For a few days I was able to see how “normal” people my age live, with worries about major milestones, like marriages, anniversaries, and new houses.

Not trips to Meijer that knock you out. Or a life that is lived doctors appointment to doctors appointment, blood work series to blood work series.

Aside from the medication schedule, done in silence, behind closed doors, everything appears normal. Don’t let it fool you. It’s just a façade.

If there isn’t physical pain, there is emotional pain to take its place.

Welcome to my world…

Hang on tight…

It’s going to be a bumpy ride…

Nightmare

Two nights ago I had a nightmare. It was one of those nightmares that are so real, you fight to wake up from it to make sure that it’s not real.

My fingers were deformed.

That was the nightmare.

All twisted and crippled and unusable.

I’ve never had a nightmare of this kind before.

I’ve had thoughts in my head during the day while I was awake, early on, about what it would be like to lose my autonomy.

But this was far worse. I woke up at 4 a.m. and pulled my hand from beneath the blanket. It looked normal enough in the sleep-laden darkness.

And again, when I got up just before 8 a.m. to take my first round of medication, I held my hand straight in front of my face, in the light of morning. I felt it to make sure that the normal looking hand in front of me was real.

All this illness stuff is getting to me. I must be going crazy.

There was another part to this dream. I was wearing a hospital mask. One of those that severely immune-compromised people are supposed to wear.

What could this possibly mean?

And then I look at my toes, which have always been slightly curled.

Do my already genetically defunct toes looks more genetically defunct than normal?

Really, truly, this is getting kind of ridiculous.

We Have To Talk/The Truth Takes Time

Something big happened on Friday. Something that I’ve needed to do for about, oh, eight months or so now.

Unfortunately, I was far too tired to write about it then. So I am writing about it now.

I told my boss about my health issues. I was worried that the story would be met with the same lack of understanding and skeptical glances that so many others have met it with. But I was pleasantly surprised.

I didn’t think it was fair, the way I’ve been feeling for the past few days, to not say something about it. When I applied for the internship, things were so crazy and all over the place that it didn’t make sense to mention anything about it. So, I prepared a script in my head so that I would know what I wanted to say. This is uncharted territory for me:

So, I’ve been having some health issues recently. And I never realized how much this job was going to take out of me. I don’t really want to cut back on hours, but I was wondering if I could come in earlier in the morning and leave earlier in the afternoon/evening, take a lunch somedays/somedays not, and take a bit of a longer break if I need to. I’m totally willing to make up any hours that I miss. I don’t want you to think that I’m trying to get out of doing work. That’s not it at all. I just want to make sure that when I am working, I’m as productive as possible.

This was met with a very sympathetic response. I was told that I could work my schedule as I needed to, work from home when I needed to, and do work either at the office or at home on the weekends to makeup for any time I miss during the week.

What I haven’t quite learned yet is that if someone is telling me that this is all okay, and I’m getting the work done, even if it isn’t exactly in the confines of a nine to five office job, I shouldn’t feel guilty about it.

But then, later in the afternoon on Friday, my boss came into my office and told me that I could leave. It was 3:30. You’re tired, my boss said. Now see, this is precisely what I didn’t want. My boss doesn’t know my body. I know my body. I don’t need to be told when I’m tired. I didn’t want to be pigeonholed, viewed as a “sick person.”

I think that compared to some others in my life, this person was, overall, incredibly responsive. I don’t want to be one of those people who are never satisfied. And I can’t fight “city hall.” But I guess this wasn’t exactly what I was hoping for.

If there’s one thing I’ve learned this year, though, it’s that I have to take care of myself. Look what happened when I thought I was taking care of myself. Now there’s no excuse not to. That said, my body and sleep schedule still haven’t caught up with work and my body is still apparently stuck on the schedule that involved me sleeping for at least an hour every afternoon and then being awake until around 11 or 12, until I got tired again.

Now I’m just plain tired all the time, but can’t seem to sleep, even when that’s all I want to do. Before I couldn’t fight sleep off, now it can’t come quickly enough.

We have to talk…

I hate that phrase. It seems to me that whatever comes after that is never good.

But now that I’ve had that conversation with my boss, I think that was the first step to having conversations with others in my life that I’ve been putting off.

The truth takes time…

Clearly this is evidenced by how long it took me to finally make the commitment to really sitting someone down and making them aware of my illness. This wasn’t easy by any means, and there were times that I wanted to chicken out. I’m not sure I was 100% successful in this endeavor, but you have to start somewhere, right?

Every day I hear from one friend or another something that shows me that I am making strides in their understanding of my situation.

Some days it’s one step forward and two steps back, but that’s the way most, if not all things, in my life are working at the moment.

Schedule Confusion

On Friday I got a call from the hospital, reminding me that I was due for blood work. According to me, after my last two-week stint, they had changed it to every three months. I called them back and left a message to double check that actually I didn’t have to have blood drawn until the beginning of August.

They called me back to tell me that usually their system updates itself, but in my case it didn’t.

This is supposed to fill me with confidence that these people are trying to help me?

I’m the sick person. I’m the one who needs help. And yet I’m the one who has to tell them the way things are?

Genetic Non-Discrimination Act

About a week and a half ago, President Bush signed the Genetic Non-Discrimination Act.

You can read about it here:

http://www.medicalnewstoday.com/articles/108399.php

The reason I bring this up is because several people (not doctors) have suggested that I undergo genetic testing, since it is suspected that autoimmune diseases are highly connected to our genes.
Amongst other things, the law protects against discrimination in insurance and employment based on your genetic makeup, should you decide to find out about it. So, with those factors taken out of the equation, why not do it?

It’s just one of many things that I’m not sure about lately.

Is it a necessity or a necessary evil?

The problem is that even if the veil of discrimination is lifted, there is still the fact that I may find out things that I don’t want to know about and have no control over.

Just like the discussion of whether my sister should be tested for the illnesses that I have, is this a prophylactic measure or a stupid one? Won’t it cause more worry than it’s worth? And since science hasn’t perfected itself to the point of absolute certainty, what do the results tell us anyway?

I’d be happy to hear from people that know more about the issue, as I don’t know too much about it. What are the pros and cons? And do we really want to know?

Thursday, May 29, 2008

How Do We Know When We're Ready To Change?

This, I think, is a very good question and one that really resonates with me right now.

I know that I am going to have to learn to cut myself some slack – that what used to be my 95% is now my 110%.

I was always a go, go, go, and never stop type of person.

But I can’t be that way anymore. Or I’ll crash and burn… fast.

I don’t have any specific orders from my doctors about what I can and can’t do, but I guess if it gets to that point, I’m really in trouble. Well, if you ask me, I’ll always keep going until I can’t anymore. But with the way my life is now, that is not a realistic plan.

So I can think all of this in my head and know that I need to do it. But how do I? How do I know when I’m ready to change? I mean, me calling the shots, not my body forcing me to slow down and take a rest, not other people telling me what to do - me.

But how do you train yourself to let go? To let go of stress, frustration, hurt, anger, the need to be everywhere and do everything. How do you let go of being yourself and yet keeping things the way they are?

Clearly I am still losing this part of the game. I was too tired to workout Tuesday night, but I forced myself to do it last night. By the end of the workout, and still this morning, my hips feel like I am 80 years old.

Needless to say, I’m not too pleased with this. It makes me wonder how smart it was to start a 40-hour a week job a month after steroid infusions. I fear that they may be beginning to wear off…

That said, something in my life needs to change and I need to be the one to change it. But I’m not sure what it is yet.

3mg And Counting...

As of today, I’m down to 3mg of Prednisone for the next two weeks.

Some of you make think this is stupid, but this is really big for me. When all is said and done, I’ll have been on Prednisone for 7 months. And I’ve dealt with all of the lovely side effects that come along with this “wonder” drug.

It has definitely made me feel better in some ways, but as I’ve learned in this game, there are always trade-offs.

When I first started taking Prednisone, I dealt with being hungry all the time, only being able to think about what my next meal was going to be, and the ever iconic “moon face.” I’ve also had and continue to have very bad and painful breakouts. I don’t know what to call them other than alien life forms that take root wherever they plant themselves.

A small price to pay for feeling better – yes. But a price, nonetheless…

Wednesday, May 28, 2008

Black Bean And Brown Rice Casserole


I made this last week, but forgot to post the picture.

Zucchini Bran Muffins



Yes, they are heart shaped. They are kitschy-cute. They are healthy. Need I say more?

How Big Do Foreign Invaders Have To Be To Cause A Reaction From The Immune System?

I mean, are we talking microscopic here or bigger? Or does it all depend on the type of bacteria?

Why do I ask?

Well, ever since my “diagnosis,” I’ve developed a pathological fear that I am going to get sick. If someone coughs, I am going to get a cold. If someone throws up, I am going to get the flu. That is, if they are sick when they are around me. I don’t just hear that someone is sick and think I am going to get sick.

There are several reasons for this:
1) All of this started, or domino-ed, from a few innocent Strep throat infections.
2) My immune system is already compromised from my illness.
3) My immunosuppressive medications further compromise my already compromised immune system.

What’s a girl to do? Stay at home and become a hermit? Where a mask? Hope for the best?

Who's The Villian In Your Story?

Yes, I’ve been watching too much “Grey’s Anatomy.” But sometimes these candy pop shows can be surprisingly insightful.

As I’ve been talking about a lot lately, I’m beginning to realize that it’s important to filter the people who come through your life. They’re not all going to make the “best friend” list. Then again, they might not make any list at all. And it doesn’t make you or me a horrible person for making that decision.

You know, there was a time when I was really picky about my friends, but in a different way than I am now. Now, for me, it’s about the people who I know I can count on. I hope those out there whom I call my friends know that they can always count on me.

Obviously, whether to include/keep someone in your life isn’t a snap decision that you make on a whim. It’s a decision that comes after a lot of thought and soul searching.

I’ve been wondering whether it’s easier to remember those who are the antagonists in our lives or the protagonists. As I said before, sometimes the simplest gestures mean the most. Then again, I feel like a lot of times I come back to the hurt that others have caused (and some continue to do).

But I guess as with anything in life, we have to take the good with the bad, and that includes people, too!

Work Day 2

Well, I’m tired, which is no surprise, but I’m alive, so that’s a good thing.

I never realized how exhausting it is to put in 8-hour days before.

Today was better than yesterday in terms of tiredness, but when I got home, I had no power. Now, I’m trying to learn to let things go and not stress about the little things, but the lack of power sort of put a damper on the things on my to-do list that I didn’t get done yesterday and had planned to get done today.

So, what’s a girl to do? Make a dozen and a half zucchini muffins, of course! Isn’t that what any girl with a gas stove and some time on her hands would do?

Tuesday, May 27, 2008

New Job + Exhaustion = Insurmountable Worry

I started my research internship today. It went fine, but, needless to say, I’m completely exhausted. I haven’t done this much activity in a long time. By the time I got home, I felt like my body was going to shatter into a million pieces.

I’ve realized that I can work through the pain. It’s the exhausti0n that is really debilitating. Well, actually, whether I can handle the pain vacillates on what seems like a daily basis. Today it was the fatigue that was really the problem.

And my advisor wants me to take a class. The class would be during work time, which is fine. But it meets everyday and I’m really worried about getting the work done, especially if I come home exhausted from work every night.

This brings me to the old question – who do I tell what? Do I admit that I’m worried about taking a class and explain everything that has been going on or do I attempt it and hope for the best?

It seems that every time I attempt to push myself to the limits (or what used to be my 95%), my body pushes back and reminds me that I’m no longer in control.

Career enrichment-wise, the class would be helpful, but body-wise, probably not so good. Today I felt the most stressed that I have in a long time and this was a relatively easy day.

And also, I’m trying to figure out when to pick up my prescriptions. It’s a matter of coordinating my work schedule and walking/bus/transportation, along with making sure that I actually get my medication before it runs out.

Not a big deal, but sort of.

I guess it’s not as simple as picking up and going. I can have the most ironclad plans, but that doesn’t mean that my pain or fatigue isn’t going to interfere with those plans.

Early this morning I was intending to stop by the grocery store to pick something up on my way home, but in the end, I was far too exhausted to make the effort.

And all I can keeping thinking is that every time I fail myself by not following through on something, even as small as going to the grocery store, inevitably, at some point, I will end up failing someone other than myself. And lately I’ve come accustomed to failing myself, but failing others is NOT who I am.

Thursday, May 22, 2008

New Title, Same Blog

I had contemplated using this title originally and now it’s seeming more appropriate than ever. While there was some significance to Jumbo Shrimp, I think this title holds more meaning. It doesn't seem quite as frivolous...