Thursday, October 29, 2020

"Pain is an old friend" - Doctor Strange

October 29, 2020

Warning: This post is a book. A literal book. But I was writing it in my head all night and was with me when I woke up this morning, so it is being written. It doesn't need to be read, but I do need to write it.

Every day begins with  pain. Every. Single. Day.

It wasn't always like this. Until my youngest son was born, I woke up like everyone else. Some days refreshed, some days still tired, but blissfully unaware of the miracle of waking up without pain.


Chapter 1: First to go are the feet...

I don't remember the day it started, but I remember that it never went away.

My youngest son was born when I was 42. He was the youngest of my four and I was healthy and it was an uneventful pregnancy - if you don't count the kidney stone attack that landed me in the hospital when I was 8 months pregnant. His birth was completely fine - normal with pain and uncertainty - but nothing to distinguish it from my other three uncomplicated vaginal deliveries. I was extremely blessed. Tired, but blessed.

I remember the night I couldn't walk to his nursery for a feeding because of the pain in my feet. I had no pain until I set my feet on the floor, then it felt like my feet were encased in a bubble...a bubble full of nails. They felt so swollen and the pain from trying to stand was so bad that I literally crawled to my son's crib to nurse him that evening. Or morning. I can't recall, because he nursed round the clock at first. I thought it was something related to postpartum. I had no idea what was wrong and I didn't know who to ask. I just know that from that day to this, every time I put my feet on the floor after I wake up, it is excruciating. 

...then the hands...

A year later,  my mother passed away from non-Hodgkin's lymphoma after a battle of several years. The stress of her death along with dealing with my babies took its toll. A few months later, my hands went wonky. The base of my thumb joint hurt so bad I couldn't take my wallet out of my purse. It was scary, but I remembered that I had a great aunt on my mother's side that had disfiguring rheumatoid arthritis, so I thought it might be related.

...now throw in everything else...

And somewhere along the way, I began to have a fatigue I had never experienced. Like having the flu...the joint aches and pains and tiredness and sometimes a low grade fever. Tiredness down to my bones that sleep didn't help. So tired that I wasn't sleeping but had to lay completely still and could only listen to the TV. It took too much effort to open my eyelids or raise my head. I couldn't. I just couldn't. On those days,  my husband was a saint and took over taking care of the boys. There were days I was just "gone". I didn't dream, I didn't sleep. I wasn't depressed. I wasn't thinking or feeling anything. They are just lost days. I've told more than one person that I am convinced that is how it feels to die. I feel like I am dying. And I am not being dramatic. 

So...not surprisingly...off to the doctor I went.

But surprisingly, I didn't have rheumatoid arthritis. I had markers in my blood for lupus. Damn. That was the beginning of my life with a rheumatologist. A wonderful doctor, thank the Lord, but a rheumatologist at 43? I was always the youngest one in the waiting room. I didn't have quite enough markers and symptoms to get a full Lupus diagnosis, so I got the unpronounceable diagnosis of Undifferentiated Connective Tissue Disease. Or UCTD for shortness and for sanity. (I also found out I have hypermobility syndrome...we'll circle around to that later.) It was real. I was put on treatment. It helped with the pain and fatigue and my life went back to normal... for while. 


Chapter 2: Next in line is my back

I don't remember much about my hands and feet after that because when my youngest was three, my oldest grandchild was born. It's a crazy story for another time, but suffice it to say I loved her and her mom - my oldest - dearly and it was a blessing. I started babysitting her when she was 7 weeks old. I was 45 and raising 3 and 5 year old boys and a newborn granddaughter.

My body starting yelling at me. I had always been blessed with a strong body that didn't reveal my age and I was fully convinced I would never really age. At 45, my husband and I finally decided that we didn't want to have anymore children...but I could have and would have, if we had wanted. I felt invincible. 

Somewhere in late 2008, when my youngest was 4, I started having back pain. Of course, I had had normal low back pain for years from lifting two large toddler boys and adding a grandbaby with a car seat aggravated it..but this was something different. When I moved into certain positions, I would get a new, electric and searing pain down my left leg. It was a new and disabling pain...so I got a new doctor. A "sports and spine medicine " physician ..and shortly after that, a neurosurgeon. Migrating lumbar vertebra. No trauma, no reason except normal wear and tear ..and they were moving and pinching my spinal cord. I did regular scans through the now-familiar coffin-like MRI machine - and my vertebra kept moving. Because of my hypermobility syndrome, my vertebra were LITERALLY falling off my spine. Did you know they can do that?!?!  It continued to get so bad that I spent most of my waking hours off my feet in a recliner, on pain meds, and unable to care for my baby granddaughter. I had to fix it or I'd end up bedridden.

I had a spinal fusion with stabilization. Seven hours on the operating table, fileted down the back like a fish. It was a miracle. I was left with some nerve damage on my calf and foot on my right side with a little foot drop on the side, but I count that as a welcome trade-off from the disabling pain I had. 

The heartbreak of it all is that it can't be fixed. It can only be stabilized from going further. So my back will never be "fixed", I'll never be able to stand or walk without some form of discomfort and after 30 minutes or so of standing still, I MUST sit down  or move because the pressure of my vertebra on my spinal cord just cuts me down. And sitting? If I sit too long, it puts pressure on my lumbar surgery site and the pain just magnifies until I lay down or medicate.

I put in time in physical therapy, adjusted my routines and learned to accept help from people - a skill I desperately need to learn and thankful that God gave me the opportunity to do. But I did mourn...I would never be able to do things that came so easily before. My entire life I had been flexible and strong and could run and dance and bend effortlessly. Now I can't touch my toes without serious effort and I wasn't able to run at all until almost 10 years after the surgery. Thankfully, I can still do some types of dance...but that's a happy story for another time.


Chapter 3: Just because it's secondary, doesn't mean it's not Fibromyalgia

Two years after I began taking medication for my UCTD (ironically the "miracle drug" that Trump touted for COVID was a miracle for me for a couple of years for this lol), I started having a weird problem. My knees started "dislocating". 

Now, this is weird because knees aren't a joint, so technically they can't dislocate. But that was the only word I could find that describes the sudden, overwhelming feeling of my lower leg bone being twisted apart from my upper leg bone. It happens when I bend my leg to the side, like sitting crosslegged or crossing my legs with my ankle on my knee. Sudden. Unbelievably painful. My first visceral reaction is always a very loud scream, usually involving the F word. As in WTF? Only straightening it and hopefully having someone pull the leg straight again seems to stop it.

None of my doctors knew what this could be. I resorted to doing something I would do many times over the next few years...googling my symptoms. And I came across something surprising. One of the rare side effects of Plaquenil are "muscle weakness in the lower extremities together with diminished tendon reflexes". That was the only thing I read that could explain it. My rheumatologist thought I was crazy, but I went off the medication..and my knees improved. They've never gone back to the same strength they were, but they improved enough so I could stop worrying about inadvertently cursing in public. But there go the meds for the joint aches and debilitating fatigue. 

I still miss them.

Now I am left with what is termed "secondary fibromyalgia" caused by my initial UCTD. Ironically, my blood levels normalized a couple of years after my initial diagnosis and I am technically "in remission" from the connective tissue disease, but it has left me with it's evil twin, fibromyalgia.

Fibromyalgia is technically "is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues." In short, it sucks. The good news is that it is becoming an accepted diagnosis in the medical community. There bad news is that there is no "test" for fibromyalgia. It is determined by process of elimination and lucky me won the elimination lottery. I thank God regularly for my rheumatologist who validates me on this and reminds me that there is also no test for migraines, but we acknowledge them, so we should do the same for this. Bless his heart. 

There is also no "cure" for FM. The experts don't know what causes it, don't understand it and don't agree on how to treat it. We mainly treat the symptoms and hope for the best. And learn to renegotiate our life and lower our expectations.

We know we can't do what we used to do.

We know that our pain is everywhere and has no cause.

We know we get tired after doing one or two "normal" things a day.

We know rest won't help us.

We know that only those who have this "get" it.

We know this isn't fair ..and it doesn't matter.

We know it's not just in our heads, because if we didn't have it, we could do all the things we love to do ..that we can't do now.


Chapter 4: Migraines are not just a headache

I never had many headaches in my life. I hardly needed Advil unless I had a hangover or the flu. Then these started when I was in my late 40s, right around when perimenopause was rearing it's ugly head. 

I remember the first time I vomited from a headache. The pain was ungodly, then the dizziness and vertigo ...and then I just had to heave. It didn't really help the headache, either. It truly is hell. I couldn't keep any pain meds down and I was blessed that a friend with migraines had an extra suppository I could use. Which saved the day. But it wasn't the last one.

So now I have migraines. I don't have auras and I don't know what triggers them yet. I have theories. They hit on days the weather is changing. I hate stormfronts. Lately I found that rolling my neck forward releases the tension in my neck that begins the migraine, so I'm starting to think I have cervicogenic headache, which would go right along with my other spinal issues. Yay.

The worst is waking up with one...the day is lost. I am so thankful that Sumatriptan works on my migraines, but I usually don't get to them early enough. Every time I'm optimistic that this isn't a migraine headache, but sinus or stress, and and medicate and treat for that first. Heating pads, yoga, Advil, hot compresses. Then and only then I resort to the Sumatriptan. And when that doesn't work, I briefly understand why people with disabling headaches sometimes shoot themselves in the head. I do. It's not a life. 

The only good part of disabling pain is the moment the pain retreats and you are left with a new and beloved appreciation of life without pain. For the moment. And you're incredulous that you didn't appreciate it when you had it all the time.


Chapter 5: Lyme disease? Really?

Had a bad spring in 2019. Got bloodwork back that said I had been infected with Lyme disease previously. Took the prescribed antibiotics. Still feel crappy. Enough said. Just add it to the list.


Chapter 6: Mental illness is not just in your head

Mental challenges run in my family. My brother had bipolar disorder and my youngest daughter has some type of disorder that was tentatively diagnosed as either bipolar or borderline personality disorder. My maternal grandmother had worries..today she would be diagnosed with generalized anxiety disorder. My youngest son was just recently diagnosed with that.

That's what I have. I also have felt depressed on and off since I was a teenager. I think I survived without official treatment most of the time because my anxiety would pull me out of my depression lows and my depression would kick in when my anxiety was off the charts. I don't react to alcohol or recreational drugs well, so I am thankful at least these crazy mechanisms kept me from reeling out of control and I just zigzagged through life until now I'm too tired to zig very much :)

Since I have had to accept that medications make my life manageable, I've tried countless types of antidepressants and mood stabilizers. They've all ended with giving me side effects from high blood pressure, insomnia, and weight gain to hallucinations (Cymbalta made me think the room was going to eat me). No dice on those. The only thing I can use at this point is an antianxiety medication when my nerves are cranked up to 11. They bring me back to normal and I can function again. I thought they were silly when I was in my 30s and now I can't imagine what my life would be if I didn't have them when I needed them.

I can't take any medications daily. After a few weeks, I have every side effect in the book. One doctor told me I may have a metabolism that processes the medications so slowly that in effect I end up with an overdose when I take it daily. I think that may truly be my problem. So for now, I don't take anything but the essentials when I need them. 


Chapter 7: Menopause is not for Sissies

I finally finished this year. It sucks. My body is no longer open for any babymaking business and I'm glad, because at 59, it had no business being in that business anymore.

It's been 10 years of hot flashes and migraines and craziness. Most of it has eased up except I don't know if I'll ever be in charge of my body temperature again. I may have to dress in layers and accept feeling like a furnace is spontaneously burning inside me for the rest of my life. I miss having skin that didn't look and feel like crepe paper. But I made it through and came out the other side. 

Nuff said.


Chapter 8: Taking care of it all

I have reached the point where I could go to a different doctor every week and just rotate them and never be done. I have incidental issues like kidney stones with back pain and bleeding  or stomach aches and intestinal issues which need be taken care of and tested ...

..and I'm just too tired to do it now. I'm still working half time and after that,  I'm too tired to have the mental energy to organize all the appointments and tests and treatments. Not to mention two teenage boys still living at home that need care and treatment for their issues and maintenance (dental cleaning is not at the top of my list, but needs to be done, right?)

I think that's the scariest part. Being too exhausted and pained to figure out how to treat the exhaustion and pain. That's where I'm at now.


Epilogue

Thanks. I'm done. This is all that's in my head today. I don't know if anyone will  make it this far and that's ok. I do hope that after I'm gone my family might find this  because they were with me every step of the way and I couldn't have done it without them. They are my everything and I would have given up long before now without them.





Tuesday, October 20, 2020

An Extraordinary Time

October 20, 2020

An Extraordinary Time.

We hear that every day these days on most channels. The year of 2020 will go down in history for multiple reasons as being the Shit Show of the century. I am reminded everywhere that we are the only generation that will probably experience what has happened this year - apart from the centegenarians who are still here from the Spanish Flu of 1918. THAT generation had it so  much worse than ours....but there was so much they were spared because they didn't have global news feeds 24/7. So here is the beginning of my take on the GREAT YEAR OF 2020....


   COVID 19

    We have been hearing about the coronavirus since it hit China last fall. Pictures of the Chinese people wearing masks were not taken very seriously..don't they wear masks for their awful air pollution, too? There was low grade rumbling because the government didn't really address it and blew it off...waiting for something...information, reality, deaths? I'm not sure.
   
    MARCH

     March 5th  - Governor Hogan declares a State of Emergency. March hit us hard in Maryland starting this day. The scare alarms went off. People starting contracting it and the nursing homes became hotbeds of death.  We went from 3 cases to 1660 cases (18 deaths) before the month ended.

     March 12th - The Port of Baltimore is closed to cruise vessels. Shit. Looks like our planned Senior cruise for Danny on the Fantasy out of Port Canaveral in April will get cancelled.
 
     March 13th - Toilet paper, paper towels, disinfectant wipes and hand sanitizer begin disappearing from store shelves and online delivery. This is the last day I see toilet paper at any store (and one day I visited 11 different stores to find some) until George sends a photo home on a grocery visit...on May 30th....we resort to getting pre-orders for TP through Walmart that take 2 weeks to deliver. And you can only order one pack at a time. I'm glad I'm the only girl in the house....

     March 16th - Public schools close indefinitely. No real instruction available, just sit and wait. I gave a little "homeschool mom" work, but really didn't know what to instruct. Got a little housework out of the boys, though :) I really miss those Homeschool Living Skills classes for this!

     March 30th - Governor Hogan issues an official Stay-At-Home order and the long quarantine begins. Masks are required for essential travel (grocery store, doctor visits, etc). All other restaurants and retails stores close immediately, although many continue to offer takeout and all other businesses that can start providing take out, delivery and curbside pickup. Masks are mandatory.
                           Roads, shopping centers and parking lots are empty..like a ghost town.
                           All employees of any non-essential service are not able to work. Restaurant and salon workers are quickly unemployed. Erin is out of work. She, along with millions of others, will attempt to file for emergency unemployment.
                          I have not had a haircut since February..and won't end up being able to get one until May 30th. I picked a bad time to have a really short haircut....
                         George and I feel really blessed right now. Both of our jobs are already fulltime at home (George gets permission to not go in for his Tuesday meetings) and the boys are used to homeschooling, plus they are internet nerds. Our lives are pretty much untouched. I feel grateful and worried at the same time.

     APRIL

     April 17 -  HCPSS schools closed until May 15

     April 13-18 - Our Spring Break cruise has cancelled and we optimistically reschedule for the end of July. We our hopeful and keep our fingers crossed.

     April 30 -  Over 21,000 cases in our state, over 1,000 deaths...but the percentage of cases in falling

   
     MAY

     May 13   - Governor Hogan starts Phase I of opening the state

     May 29  -  Remaining Phase I begins: outdoor restaurant seating, hair salons open

     May 31 -   Over 52,000 cases in Md, over 2,400 deaths...but the percentage climb has leveled


     JUNE

     June 1st  - You are Here. Half of the year almost gone. I don't know what day/week/season it is. I only leave the house to sit on the deck or walk through the neighborhood to try to stem the tide of quarantine weight gain. Once a week I go to the store for food/liquor/craft supplies at Michaels. Danny and Ben have both joined me on these (not the liquor store lol)...so it has given us a bit of Mom/son time.

...and just like that, it's...

    OCTOBER

    Six months later. Six months since I started this entry and left it unfinished. Six months since the boys were sent home to virtual school and the world shut down. School and work are still from home and all long distance vacations (Alaska, Disney Cruise) have been cancelled. George and I tentatively scheduled a Royal Caribbean cruise for our 20th anniversary next year.

    Danny graduated virtually from high school over Zoom in June. And started college at HCC online in August (with one oncampus lab once a week). And started his first job at Red Robin in October a couple of nights a week.

    I still haven't found a pack of Clorox wipes since March, although toilet paper and paper towels can be found pretty easily. This month, thanks to our great Governor Hogan and his efforts, we are upgraded the state to stage 3 and most things are open most of the time. Masks are mandatory everywhere.

     This is insane. We all have "pandemic fatigue". Our new normal is who we are now. I think my normal fibromyalgia is being aggravated by all the stress, because I am living with a level of pain and fatigue I haven't had in years. Depression and anxiety are through the roof, for me, anyway. I'm not known for giving up, but when I barely have the energy or will to lift a finger, everything else seems impossible.

     We are two weeks away from the election. I haven't had a good night sleep since the election in 2016 and I've had countless sleepless nights and stomach aches from the horrors of ignorance 45 has inflicted on this country. I have a underlying sense we'll have President Biden soon. I pray we can recover from this. All of us. 

     Every day all my friends have to listen to the latest lie from our President of the United States. Have to hear his whiny voice complain about people who have stood up to him to do the right thing. Complain about having to deal with this unprecedented global pandemic. Enact orders that destroy our democracy or remove previous Presidents' order that were intended to preserve our environment and world. And it's enraging and frustrating and saddening and embarrassing.

    We realize how much we miss being able to travel to beautiful places and relax. We were able to get to Ocean City and Massanutten for a week each this summer, and they were beautiful, but not relaxing. It was weird seeing so many places we used to eat or visit be closed, temporarily or permanently. I've never missed Disney so  much. My happy place is open...but not the same.

    The one thing that has kept George and I sane through the year so far was daily walks outside through the neighborhood. The days are short and sunset is by 6:30 now so we're hoping they'll reopen the inside jogging track at Roger Carter Center again. 

    Halloween in cancelled like all the other holidays this year, so we'll probably just put out candy bowls for whoever is still brave, and eat our own candy while we watch TV..again. I've watched more TV this past six months than I ever have in my life (Thomas the Tank engine excepted lol). 

    No one is looking forward to Thanksgiving or Christmas this year. I'm not even looking forward to New Year's Eve because God help us if 2021 sucks as bad as 2020.

   The only positive thing ...or attempt at positivity...is that we've restarted our dance lessons with Alex at Arthur Murray after 3 years. I don't feel happiness or adrenaline like before, but I'm hoping that it will help pull me out of the depression I'm in these days. George, too. 

   We're all being as brave as we can be, because we are truly blessed. We haven't lost a days pay during all this or missed paying a bill. 

    The only thing that is missing besides normalcy is that Kelly, now Evelyn, still has the girls. Taylor and I have no access to Piper at all and he has little access to Freya and I have none. This Halloween makes a year since I've seen Piper. I've moved through the grief into acceptance and hope that one day, I'll see them both again.  This year was also the year that I finished my menopause...and my childbearing days are truly behind me. So in the last year I've lost 2 granddaughters, a daughter and my childbearing. It's truly soul crushing. I'm on a search for my next purpose for this last stage of my life. It's not fun and I'm not very optimistic, but nevertheless, here we are.

   Until next time...