The Pain Train

It’s been awhile since I have taken the time to write – aside from a few shitty, short poems that are irrelevant to the content of my blog and life.

I’ve been incrediblggi todayy busy this summer. Between managing my health and preparing for my final year of my degree, it’s been difficult to force myself to engage in hobbies which – yes – sometimes become a chore. We can blame the depression typically associated with unending physical pain and illness.

With my irrelevant excuses for my absence out of the way, I’d like to ramble about something that has been eating at me for months.

I’ve become this person who wears a shield of strength for those with disabilities and atypical neurologies. I have crafted this careful, firm and arguably profane voice which challenges preconceived notions and thoughtless ideas about people like me. People with Ehlers-Danlos, or whatever other rare disorder, or whatever. In doing so, I’ve been quite open and candid about my own illness. I’ve openly shared my symptoms, struggles, weaknesses and flaws. I’ve breathed stories of heartbreak and grief. I’ve opened up about my failures; failures to accept, or withstand my disorder, or as I have affectionately named it – my genetic lottery ticket. I let anyone who was willing to listen in about the days when I want to die and the days when the pain and fatigue is simply too much. Also, I’m pretty sure there is an incriminating Facebook post somewhere when I reminded everyone to remember I was a badass, after my first brain surgery. Drugs were involved.

But there is a casualty of war in doing so. I have yet to find any fellow zebra, or chronically ill person, discuss this casualty. I want to talk about it as candidly as I have done all other things.

People in my life have begun to minimize their pain and suffering. I have a wonderful cousin who is struggling to find a diagnosis for her unbearable back pain. She is probably one of the most compassionate and empathetic people I’ve met. She’s so different than I. She has far more patience, than I can bear, for people. She speaks kindly, while I laugh out obscenities. And here she is, when she talks about her pain to me, she says how it in no way compares to mine and she can’t imagine what I must go through, and how she feels she’s whining and complaining.

This is not okay.

I need to get something straight for people. Pain is pain. We all experience it, admittedly, at varying lengths and degrees. My chronic pain isn’t worse than my cousin’s. It’s different. I mean, sure, if we’re going to objectively measure (and objective measurements only really have a place in an ER or trauma ward), her pain is probably worse than that time you stubbed your toe really hard on the side of your desk that juts out awkwardly. It’s probably worse than the time I slammed my elbow into a door frame. Or dropped a hammer on my foot. My pain, on the daily, is probably worse than when your four year old skinned his knee when he fell off his bike.

But I’m not really referencing small, acute moments of our lives when something hurts. I know that time you stubbed your toe really fucking hurt, though. However, there is no badge for who has it worse. Let me be clear – I’m not saying chronically ill people are guilty of intentionally minimizing the pain of those around us. But our rare or rarely diagnosed disorders tend to sort of blot out the sun a bit, and sometimes it’s hard for that light to reach those around us who have different kinds of pain – chronic knee pain, a bad back, or that unending neck pain. My cousin was minimizing her pain. If I had to guess, it’s because I am so open about my pain, surgeries and hospital visits, so she had this clear image of what she thought ‘bad enough’ looked like and her pain effects her in a different way. Somehow, maybe, she felt her pain just didn’t match up to mine. I corrected her every time, if you were wondering. Her pain does. It sucks just as much.

Just because I have a genetic disorder you’ve never heard of, doesn’t mean your chronic back pain doesn’t hurt the same way. You deserve a space with me, with your friends, with your family to talk about that pain, how it effects your daily life. You don’t need some life-altering diagnosis (MS, GP, EDS, blah blah blah) to be a part of the pain train.

It’s not just my cousin. I’ve caught my husband minimizing his pains and aches. I’ve caught friends online doing it. I know this comes from a place of love. These people are trying to express they understand the severity of Ehlers-Danlos and what I experience. I do appreciate that sentiment. I appreciate the love and care. It’s just not healthy though – for them or me – or let’s be fucking real here – anyone. We can experience pain together and commiserate together. Don’t hide in the shadow of my illness because you feel your pain doesn’t meet the metric for shitty enough. It does. I want to be there to hold your hand. I want to be with you, in that sea of shit and pain, when it keeps you up at night, when it makes you cry, when you just don’t know if you can handle it anymore – I want to be the person you come to because I get it.

We need to do better to make space so our friends and family know that, while our illnesses consume our lives and dominate our dinner-table conversation, their pain is just as valid and there is no need to minimize it. We don’t own the patent on the fuckery that is pain. It isn’t exclusive to our weird diagnoses. It’s the shitty side of the human experience, and we all deal with it. This planet is fucking huge. I think there is enough space for everyone’s suffering.

This post is dedicated to Katelynn.

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Stuff and things.

I’m too tired to think of a clever slug for this particular post – but I have thoughts I really want to get out. It has been a pretty busy couple of weeks, for a lot of reasons.

I am attending college and since we recently moved (again) I lost credits. It’s been nothing but an uphill battle to get my freaking B.S. but, it finally seems like I will get to finish. Between financial difficulties, being in the awkward place between ‘poor’ and ‘middle class’ where you can’t afford to pay your way (and you know, still eat), but you apparently make too much to get aide, my health and other factors, it’s been fucking ridiculous.

You see, in high school we were told a degree only takes 3-4 years, but most people take 5 years. I was like “I’m not going to be that person! I’ll do it in 4!”

I was that person.

But not because I was indecisive, or unmotivated. But that life literally threw everything it had at me. My freshmen year I attended full-time, worked 2 hours below full-time at Walmart to pay for school, and chemotherapy for liver disease. After my first semester, I got married and moved to Alaska with my husband. I started back up the next fall and struggled with increasing pain, incompetence from doctors and ensuing depression related to the fact that I was a 20 something in inordinate, inexplicable pain. In 2012, I attempted suicide because I was in so much physical pain and I had been told by various physicians it was in my head – I wanted to die. Society had failed me. And living in pain without answers was not something I was ready to do. Somehow though, my husband managed to literally and figuratively save me. All this time, I was attending school in Alaska. It was still a constant battle with physicians and my own feelings of failure, inadequacy, grief and anger. I did my part though. I went to therapy. I got help. I kept fighting. In 2014, I was diagnosed with a rarely diagnosed brain condition – and I was dismissed as a patient by my neurologist because she was misinformed and incompetent to the nature of my condition. Puzzle pieces began falling into place. A physical therapist noticed my extreme range of motion and the words ‘Ehlers-Danlos Syndrome’ were uttered for the first time.

But then my husband was restationed back state-side in Virginia. I continued school, worked part-time at a child development center to earn some money so we could move, and put my health on hold. I still attended even during my move to Virginia. And unfortunately, because I had worked, I lost most of my financial aid and was only able to attend half-time this last year (which worked out semi-okay). So I started at my third university and in my first semester here in VA, underwent my brain and neck surgery last November.

This most recent semester has been a whirlwind with recovery, doctors appointments and decisions. Now, it’s almost the end of the term, I’ve managed to sort my financials for my final year of school (five years later, dammit) and now… I have big decisions to make. You see, I’ve wanted more than anything to get to go to graduate school. I’ve looked into PhD programs that grant assistantships and waive tuition.

But yesterday, I had an appointment with my new neurosurgeon – I have two, I’m such a lucky duck – and learned my MRV (magnetic resonance venogram) revealed I have narrowing of the blood vessels in my brain. This explains the new pressure headaches, vision loss, and other array of horrible symptoms I’ve had. Sadly, this is pretty common for patients with Ehlers-Danlos Syndrome. EDS effects literally every system in the body, including our blood vessels. Mine are narrowing due to faulty collagen. This can lead to a number of things and the scarier, and more uncertain things: strokes and transient ischemic attacks. So, now, it’s the waiting game for my angiogram to get a better look at the vessels in my brain before we decide if I should get a stent to relieve pressure and help prevent further narrowing and/or blocking.

This would be a second brain surgery, although an endovascular type of surgery, still has it risks and still weighs heavily. I’m not scared about the surgery itself, but rather the looming uncertainty and consequence of the larger picture – the surgeon yesterday said something profound and sad.

“I can see you’re still very much in the beginning of your Ehlers-Danlos journey.”

No he wasn’t saying that about my diagnosis. He wasn’t talking about the pain and struggle I’ve already faced. He was talking about the fact that comparatively, I am still very well off and the deterioration, once it starts it is going to snowball so fucking fast, I will blink and suddenly, it won’t be quite so. I am a walking time-bomb. My body is waiting to blow. There is no question about if. It’s all about when. I could have years before my GI system shits out and I end up on a feeding tube. Maybe I don’t need another corrective craniectomy for ten years, but it will probably happen. Maybe it only takes until I’m thirty to need that cervical fusion that is likely in my future.

Until yesterday, I had no doubts about trying to get into a PhD program. But then after finally getting some sleep, I woke up so tired and the magnitude of those words washed over me. Is it a good idea to keep going? Do I need to be thinking of my health instead? Will I be able to handle it? What if I need another surgery during the post-doctoral program?

Goddamit. Now I am doubting everything.

I know my husband would support me no matter what. But that’s the problem. This man would carry me up our three flights of stairs if I asked, even if it hurt his back, or made his knees ache for days.

I just don’t want to live my life regretting my wasted potential. And I don’t know how to make myself accept that. Of all the limitations I know I have, this is one that I am just not emotionally or mentally prepared to accept.

Fuck.

To every nurse ever.

Dear register nurses, CNAs, and triage staff:

This piece is dedicated to you. You see, while you may not be doctors, you will have the power to make or break a hospital visit for a chronically ill person. You have the power to impact someone like me forever, whether it is in a positive or a negative way – that will be up to you ultimately.

I’ve been struggling to put this into words for a few months now. You see only three weeks after my brain and neck surgery, I ended up in the ER (this was in December). This was perhaps the most terrifying day of my entire life. I thought I was going to die.

I woke up with a throbbing headache. It was pretty bad but I assumed that maybe it was because I had missed my last dose of pain medicine. So, I took my medicine and managed to get some water down, before camping out on the couch. I was pretty miserable. I turned on Netflix and drifted in and out of sleep for a few hours. When I woke up, my headache was just as bad, and I began vomiting. Okay. So, it was pretty bad. But it was probably just the percocet causing nausea? Right? Wrong. I was stupid. I knew there was something wrong. But instead of just going immediately to the emergency room, I waited. I waited and it got much worse. I went down hill as the hours passed. Soon the vomiting was becoming non-stop. I couldn’t eat or drink. The pain was inching from an eight to a nine, something I had rarely experienced in my life. Moving hurt. Opening my eyelids hurt. Everything hurt. I felt like my brain was going to leak out of my ears. Finally, we hit the the twelve hour mark. I couldn’t even keep my medicine down to manage the pain. I was throwing up every few minutes. I start choking on my own vomit and my husband saw me turning blue, somehow I manage to get it down and gasp for breath. At this point, he’s like, “hospital now”.

It still hurts unlike anything but I am scared to go to the ER. You see, I’m scared because I’ve been mistreated in hospitals before. I beg my husband just to take me to urgent care instead and call my neurosurgeon who is one state away. He concedes and takes me to an urgent care clinic only five minutes from our house. They get us in pretty immediately. But my heart rate is through the roof around 120ish, I can’t stop throwing up, and I’m curled up on the table in the fetal position. And it’s pretty clear they do not have the equipment to care for me. As soon as the doctor sees me, she says I need to go down the street to the emergency room and she won’t charge us for the visit. She kindly gives me a vomit bag and hurries us out.

The closest ER, much to my chagrin, is a Catholic hospital. Great. Catholic hospitals are notorious for providing bad care, especially for women, but we can’t really afford to make the trek 20 minutes across town to the military ER. We get to the hospital and the receptionist is pretty nice, but she seemed a bit irritated that I was loudly vomiting into a bag. We barely get a chance to sit down and they bring us back into triage.

The triage nurse asks with an irritated tone why I’m there, and if I had consumed an energy drink in the last hours, because my heart rate was still about 120 and my BP was 150/90ish.

All right dude. We just told you I had brain surgery three weeks ago and I’m experiencing the most excruciating headache I have ever had in my life, and you wanna know if I’ve been pounding down energy drinks? Did you miss the part where I said I haven’t been able to keep anything, water included, down? How about the non-stop vomiting? As a nurse, please tell me they taught you what intractable pain was?

This is when I notice the intake room is fucking filthy. My stomach sinks measurably. I already regret my decision to come to this hospital, but I’m here and I know I need help. The triage nurse takes me back and gives me a gown to change into. My husband helps me in the bathroom change. I put it on backwards, intentionally, because he said he was going to hook me up to an EKG. I’m trying to make his job as easy as possible.

This nurse has the audacity to give me shit for putting it on wrong, like I’m too stupid to put it on right and it was uncomfortable to see my breasts, and I explain I was trying to make his job easier to attach all the wires. I have never been made to feel ashamed of having breasts by a healthcare professional ever in my life. I’ve been through some pretty humiliating procedures too and no nurse, male or female, has ever made me feel as this man did for my breasts being partially exposed. I’m sorry – but you’re a nurse. You cannot seriously expect not to be exposed to the bodies of human beings, including those of the opposite sex ever, even if you do work at a Catholic hospital. I think my husband can sense I’m regretting coming to the hospital now. The triage nurse hooks up the EKG and thankfully leaves. A new nurse enters the room and starts prepping an IV so she can give me zofran and two doctors enter with her. The doctors ask what’s going on and we explain I just had a craniectomy, C1 laminectomy, C2 laminoplasty, dural graft and cerebellar tonsil resection and I’m experiencing an excruciating headache, etc etc. The doctors leave to call my neurosurgeon for recommendations.

My new nurse is this sweet young woman with red hair. She warns me the dilaudid is going to make me feel like someone is sitting on my chest and that it’s going to hurt initially. This sweet woman holds my hand as she gives me the pain meds. Then she explains they are going to keep me for a bit while they figure out what to do. Finally sweet relief. I am finally not vomiting non-stop and she turns the light off as she leaves. She returns with the doctors after a little while, explaining they are going to get a CT to make sure I didn’t spring a leak, but that it was probably rebound from my steroids. The nurse sticks around for a few minutes chatting with my husband and I, pleasantly cracking jokes with me, and asking if I need anything. She treats me completely different than the triage nurse – with empathy, kindness and dignity.

I eventually a CT, and the CT technician makes me change my gown right way, because he also is made greatly uncomfortable by having the gown tied in front. I feel pretty gross and ashamed by this point. And I am starting to get nauseated again. After my CT, my vomiting starts back up, and it’s becoming uncontrollable pretty quickly. Thankfully, my nurse comes back and sees this. She has already given me the max dose of zofran but I ask her if she can get the doctor to give me more, because the vomiting is greatly aggravating my headache and it looks like we’ll be waiting for a bit longer. She gets the doctor to prescribe another dose and manages to get my vomiting controlled again. After awhile, the doctor reappears to let me know my CT looks great and that they spoke again with my NS, he said I was experiencing rebound and they prescribed a med-pack to deal with it. Finally, we’re approaching discharge.

When we got home, I asked my husband if he thought I was overreacting to how the triage nurse and CT technician treated me. He agreed that they acted very disrespectfully by shaming me, and agreed that the other nurse who took care of me was the absolute sweetest. I wish I had remembered her name, I would have sent her a damn fruit basket. Nonetheless, we decided we’re never going to that ER ever again.

You see nurses – you can make the absolute difference in our visits. When I got to that ER, I thought I was dying. I was almost certain I probably had a CSF leak, which is incredibly dangerous. Remember the power you have. Remember you might be the difference between a person choosing to seek help again. Remember to treat your fellow humans with empathy and dignity.

And to the nurses out there who already do that, thank you for everything you do. Thank you for all the blood, shit and piss that stains your clothing, thank you for saving our lives, thank you for holding our hands when we’re in pain, thank you for laughing at our desperate attempts of humor in our darkest hours, thank you for the overwhelming emotional burden you take on and thank you for being you.

 

Recovering, but not really.

It’s been over four months since my complicated brain and neck surgery.

To those of you who have ask ‘are you better?’ or ‘are you cured?’ and to those of you who say ‘wow you look so normal!’, stop, please. Please don’t project your idea of my health for my recovery. I am not angry, or even remotely upset, mostly just frustrated by your ignorance. Let me clarify – ignorance as in you have not been exposed to this situation and therefore there is no reasonable expectation for you to know and understand. I use the term recovery lightly and so does my husband. He often even refers to me as ‘broken’ – in an endearing, unoffensive way.

You see when I signed consent for my surgery, I also agreed that I understood that the biggest issue with the surgery is it can fail – it is a treatment. Not every human will respond to the treatment similarly, and additional factors must be considered.

If you were wondering, it didn’t fail, but it also kinda did. Chiari is sinister like that. I am sure I’ve mentioned before my neurosurgeon compares the condition to wearing a shoe two sizes too small. You’re wearing the shoe for your entire life, but your foot doesn’t really fit right, it hurts and soon you start to lose feeling in your toes. So you go to the doctor and they untie your shoe for you, but two of your toes are necrotic and will need to be removed. You should really thank your lucky stars you didn’t die.

But you still lost the two toes. The damage is done.

Only, instead of your foot, it’s your brain and your head. Instead they remove small portion of your skull bone, they cauterize the portions of your cerebellum, they remove tissue to make room for your brain, but at the end the damage is done. The reduced flow in your brain has been quietly hurting you from day one.

Now, as I said, the surgery didn’t fail but it did. You see, prior to surgery, my pain baseline was a six out of ten. For those unfamiliar with the pain scale, a six isn’t considering life-threatening. It’s four exhausting points from most excruciating pain ever. But it is considered high and tends to interrupt daily life. It prevents you from socializing, it prevents you from going to school, doing chores and tends to get in the way of everything in general. Six is verging on an inhumane quality of life for someone who is expected to be in pain for the entirety of their existence. So, post-surgery, surgical pain aside, I was down to a two. That doesn’t sound so bad, right?

Right. But also, wrong. The two itself isn’t bad. It is the changes that ensued that are bad. About January-ish, I began experiencing a new headache. Instead of at the back of my skull, it now hangs out behind the eyes, and it’s especially bad behind the right eye. So bad, I am actually experiencing more vision symptoms now than I was before such as extreme light sensitivity, blurry vision, auras, etc. At first, I was a two all the time with a minor ache here and there. But now, my baseline is two and sometimes my pain creeps up towards a four or a five. Now it appears I could still be having intracranial hypertension. We’re following up with a vascular neurosurgeon now who is going to look into equipping me with a shunt or a stent, hopefully, to maintain the low baseline and prevent additional damage or escalation.

So, the surgery gave me back my hope. It gave me back my will to fight and to live. There are so many things it gave me. But it wasn’t a resounding success. Life with chronic illness isn’t a sprint. Hell, it’s not even a marathon.

Before I didn’t imagine I could keep living in pain, I didn’t think I could handle a partial or total failure. I didn’t want to feel the despair of losing another fight. It’s amazing how much I’ve adapted and even more what I’m willing to accept now, versus then. I am not cured. I am not better. I am different.