How to be a Productivity Hedgehog

The other day I read an article entitled How to be a Productivity Unicorn. Just for kicks really, because there’s not much hope of me becoming a Productivity Unicorn any time soon. Don’t get me wrong, the advice in the article was sound, it just wasn’t aimed at people with health problems who need to count spoons and take naps a lot.

But, just because I’m not a Productivity Unicorn doesn’t mean I don’t get stuff done. I move pretty slowly, need to have periods of hibernation between productive times, and occasionally I get overwhelmed and have to stop what I’m doing to curl up in a ball for a while. I’m a Productivity Hedgehog.


Productivity Hedgehog - getting stuff done.

So here’s my guide on how to be a Productivity Hedgehog.

Don’t be too hard on yourself, but don’t let yourself off too easily either

I regularly don’t manage to finish all the tasks on my to-do list for the day, but I realised pretty quickly that beating myself up about this, or feeling guilty, would just leave me feeling defeated and unmotivated. If you don’t manage to get everything done, give yourself a break – with autoimmune disorders, your body is running on overdrive anyway, so you’re doing a lot even if you’re just sitting still. 

However, it can be very easy to slip into a pattern of not getting things done or putting things off. A few years ago, poet Glen Colquhoun came to speak to my writing group. One of the things he said that really stuck with me (highly paraphrased!) was that everyone will be on your case if you drop out of medical school, but no-one really cares if you drop out of writing. The only person who does care is you, and therefore you have to be your own cheerleader and motivator. When you’re living with chronic illness, it can be really easy to start “dropping out” of things, and people are likely not to call you on it because they’re worried about being insensitive. The only person who can truly keep you on track is you. 

For example, I try to write in the mornings. Some days I wake up and know that I’m in too much pain, too nauseated, or just generally not well enough to do it. On those days, I go back to bed, or do whatever it is I need to keep myself well, and forget about writing for that day. On the contrary, some days I wake up and feel uninspired or unmotivated. It would be easy for me to not write on those days either, and just blame it on my illness, but I know that what I really need to do is employ a bit of “bum-glue,” stick myself to my chair and write my way through whatever’s blocking me. As my old school principal used to say “the best way to get motivated about a task is to start doing it.” 

Learning the difference between “I really can’t do this right now, because I’m sick” and “I don’t feel like doing this, but I can if I push myself a bit” can be a huge step towards not only surviving chronic illness but thriving despite it.  

Stop multi-tasking

This might sound counter-intuitive, but I became much more productive when I stopped trying to multi-task. Trying to do too many things at once left me feeling stressed out, and ultimately meant I stopped trying to do anything. I started out simply by making a rule for myself that if the TV was on, the laptop was off and vice versa (full disclosure, I do have the TV on while I’m writing this but that’s just because I got bored with the film I was watching but couldn’t find the remote!) This simple change meant that I was more present in what I was doing, got tasks done in a shorter space of time meaning less energy expenditure, but also got more quality relaxation time in too. 

Add rest, relaxation and fun things to your to-do lists

If you’re someone who feels guilty about taking time for yourself, adding rest and fun things to your to-do lists can be a good way to get over that psychological hurdle – it’s on the list so you have to do it! This is also something that has helped me to build daily routines as, if you’re not working full-time, days can start to stretch out. It’s easy to end up pottering around for hours and not remembering until the end of the day that you’d meant to watch a certain TV programme, bake cookies, or whatever it is that’s a fun thing for you!  

Routines can sound like scary things that involve a lot of boring tasks and early wake up times, but building a routine around what you like doing, when you naturally wake up and go to bed, and what you actually have energy for, can have just as good an effect on your productivity and over-all well-being.

Do the simple tasks now

I try to make a point of not letting any small tasks end up on my to-do list. For example, dealing with pieces of mail that require a response, such as bills or surveys, straight after opening them, rather than putting them aside for later, means a much simpler and less-overwhelming to-do list. When I’m tired which, let’s face it, is pretty much all the time, it can be hard to feel motivated to do these kinds of things. But realistically, they usually take less than five minutes, and completing tasks, even small ones, feels pretty good.

Similarly, finding ways to cut down on miscellaneous daily tasks can also help save energy. For example, I eat home-made food nearly every day, but I don’t have the energy to cook every night. Every time I do cook, I make extra portions, so I have a supply of left overs. Not having to spend time in the kitchen every night leaves me more time and energy for other (hedgehog) tasks. 

Don’t think too much about tasks before you do them

A few weeks ago, I had several weeks where my diary was absolutely packed. I was going from appointment to appointment, and in between I had to fit in all the everyday stuff. In general, I start to feel a bit panicky if I don’t have at least one or two empty days for rest in my week, but this had gone beyond that into I didn’t even have any days where I had less than two things to do. The more I thought about it, the more stressed I felt, so eventually I stopped thinking about anything beyond the task I was doing, or was about to do, and got through the weeks that way.

Though it’s clichéd, “take things one step at a time” is good advice. Being present in what you’re doing, rather than stressing about what you have to do later, is considerably easier to say than to do but attempting to gently redirect your thoughts every time worries start creeping in is worth trying. I would have been shocked to hear myself say this a few years ago, when I was doing everything I could to get out of doing relaxation/meditation, but it really does get easier. 

Thanks for reading,
Little Miss Autoimmune 

This post was cross-posted over at Systemically Connected

Changing Seasons and Blood Pressure

People often ask me whether my symptoms get better in Summer. I think this idea probably comes from the common belief that people with osteo-arthritis only get joint pain in the cold or when it rains. I'm not really sure if there's any truth to this for osteo-arthritis; it certainly isn't true for forms autoimmune arthritis, but still the common belief lives on. My answer to the question varies, depending on how well I know the person asking, and if I think they're really interested or just making conversation. The honest answer? Some things get better in summer, some things get worse, but overall I don't think my condition has ever been stable for long enough for me to say for sure whether it's the season or something else making a difference.

I'm sure many meteorologists will disagree with this statement, but in my opinion New Zealand only has two seasons. We go straight from winter into summer (then sometimes back again the next day.) In Wellington it's windy all year around, and it's not that uncommon for people to get hayfever all year not just in Summer. 

The worst times for me tend to be the points of season-change. I somehow manage to be surprised by the weather change every year, and find myself completely unprepared. In Summer balancing long sleeves for sun-protection against not getting over-heated, usually leaves me one kind of sick or another, and going into winter I just about always find myself in the middle of Raynaud's or asthma attacks at least once after going out without adequately warm clothing.

A few weeks ago, I "blood pressured" myself by forgetting that when it's hot I need to be a bit more careful about managing my low blood pressure and low electrolytes. I got straight out of bed, reached up to take the clothes peg holding my curtains together down... and woke up on the floor a bit later. It was stupid and totally avoidable, so after a chat to the lovely ambulance staff (yep, had to press the medical alarm) I stuck this up beside my bed: 

This is the first thing I see in the morning, and so far following it is working. I've decided the "official" name for my blood pressure issues is loop-de-loop blood pressure as the problems come from it dropping sharply when I stand up, then over-compensating into the high range after a few seconds, causing short-lived but blinding headaches. Following this routine and taking things slowly helps it to stay a bit more on the level. On bad days, I have to switch tap water for electrolyte water and add in some black coffee (which personally I can't stand!) but all in all the floor and I have managed to keep our distance from each other.

Thanks for reading,

Little Miss Autoimmune

Drunk or sick?

New Zealand is a place with many contradictions. People are friendly and often willing to help out complete strangers - I've blogged many times about the kind, wonderful parts of our culture - but there are some awful parts too. Those of you in New Zealand will likely know what I'm referring to. Everyone has been chipping in their two cents about it. I've been thankful to find that most of the people I interact with in real life, and on social media have perspectives on this issue that I respect and understand.

But of course, that's not the case everywhere. Comments around the theme "Drunk girls get what they deserve" have been popping up, and it made me think of a situation from my own teenage years (don't worry - it's a happy story.)

I'd gone to a party. I wasn't drinking, because I'd just started on a medication for an ovarian cyst, and wasn't sure how it would affect me. I remember having a great time at the start of the night, but after that things get a bit blurry. When I asked people who didn't know the full story about it later, they remembered it as I was very drunk that night. But I hadn't had any alcohol. 

I didn't know it at the time, but I was actually having an allergic reaction to the medication. As the night went on, the reaction got worse and I got "drunker." 

I remember talking to a guy I didn't know, and that he kept asking me if I was okay and how much I'd had to drink. Then after a while he asked if I wanted to be left alone, to which I think I must have said yes.

I pieced together later, that he did leave me, but was concerned enough about the state I was in to go and find the girl who was throwing the party. She knew I hadn't been drinking, so figured out I needed help and called my parents. I don't remember anything beyond this point, but apparently I fell over, then screamed obscenities at several people. A friend carried me down the stairs, because I was too out of it to walk, and the girl left her own party to wait outside with me until my parents arrived. I spent the rest of the weekend in hospital having convulsions as the medication worked it's way out of my system.

The experience left me feeling incredibly lucky that I had good people around me who had looked after me, when I needed help. It makes me sad that this isn't a more common story though. 

Rape culture tells us that "drunk girls get what they deserve." Would I have deserved to be assaulted in this situation? Would anyone who took advantage have not been responsible, because I was out of it? I wasn't drunk, but most of the people there that night genuinely believed I was and, when my behaviour was described to me afterwards, I could certainly see why.

I don't like to think about it too much, but that night could have ended very differently for me. I could have been around people who were indifferent, or worse people who had malicious intentions. I might not have got the medical attention I needed, just as someone who was "just drunk" and had alcohol poisoning might not have got the help they needed.  

There have been a number of times where I've been mistaken for being drunk because of the effects of my illnesses. We've all heard stories of people collapsing with some kind of illness of injury, and people ignoring them because they think they're "just drunk." So what if they didn't ignore them, but assaulted them instead? Would we blame the victim in those instances? I think most people would agree that taking advantage of someone who is seriously ill is absolutely abhorrent, so how can you honestly believe any different for someone who is drunk if the effects can be so similar? 

So my point here really is, if you see someone in trouble then help them if you can, even if you think it's just alcohol induced. My guess is, most of the people who helped me have long forgotten about that night, but I'll be forever grateful to them anyway.

Thanks for reading,

Little Miss Autoimmune

A Guide to Disability Humour

I was mucking around on facebook the other day, and saw I'd been invited to an event that I could tell was going to be far too physically demanding for me (it had the word "Jazzercise" in the title.) I clicked decline, and when it asked for a reason I wrote: "I'm a tad too disabled for this, but I hope it goes well" or something to that effect - can't remember the exact wording. A bit later I was thinking about it, and realised that could probably come across as flippant and insensitive if people reading don't know me. Disability humour can walk a thin line between being funny or offensive, and so much of it depends on context. In this example, people knowing that I am actually disabled and not just being a dick is some pretty big context.

I'm normally pretty happy to laugh at myself and my health problems, and in a lot of cases I'm happy for other people to join in too. But there are some boundaries within that, so here's my Guide to Disability Humour.

It has to be funny
One of the things that can be irritating when it comes to disability humour, is the assumption that if you don't laugh, it's because you're being "over-sensitive" or "too PC". The reality is, your joke may not be offensive, but that doesn't necessarily make it funny either. If the "joke" is basically that you're saying something controversial, it's probably not particularly clever or funny, and the best you're ever going to get is a few nervous laughs.

It has to actually make sense
This should be obvious, but jokes that don't make sense are just stupid. For example, a stranger on the street once stopped me and asked me where my parrot was. I stared at him blankly, trying to work out if he'd mistaken me for some other parrot-owning-person, until he muttered something along the lines of "it was just a joke". I eventually worked out that he was referencing Molly Stick, and I guess suggesting if you walk with a stick you're a pirate? I don't know. It wasn't offensive, but it didn't really make sense either, and I was just left confused rather than amused.

There are things I can say that you can't
This is one that really confuses people. I get why this is hard, I really do. People see me joking and laughing about my health problems, and they think "Hey, this is cool, we can make jokes about it too." And mostly that's true, but sometimes it isn't. 

• There are some things that are okay for anyone to joke about. 
• There are things that I find funny when other people with disabilities say them, but would be really offensive if an able-bodied person were to say them. 
• There are things that I can say about myself, that would make me feel really awful if anyone else - disability or not - said them. 
• Even more confusing, there are things that I might be okay with joking about that someone else with a disability may not be and vice versa. For example, I know some people are okay with calling themselves and/or others "cripples" in a joking manner, but after that word was yelled at me as an insult a couple of time, it makes me really uncomfortable whatever the context.

Figuring out where these lines are can be a difficult process, but I think one of the important things to remember is that if you accidentally cross one of them, it's really better to just back off and remember it for next time. Insisting that you weren't being offensive, or that you "should" be able to say something because someone else did will just make the situation more uncomfortable.

The disability may not be the offensive part
Basically, just because someone's given the okay for disability humour, it doesn't mean you get a free pass on being generally offensive. For example, a racist or sexist disability joke is still racist or sexist. I don't think I really need to explain why that's not okay!

Timing is everything
Like any kind of humour, there is a time and a place. I sometimes say to people if I fall down or anything like that, they're welcome to laugh and I'll probably join them, but only AFTER they've helped me up. As I'm writing this, a similar conversation just came up on the radio, and New Hot Guy from ZM's advice was: "If someone falls down, you have to wait for their reaction. Because if you laugh and they're really hurt, then you're an a**hole." Pretty much sums it up! I think as a general rule, it's fair to say that if someone is in need of assistance, or if they are in some kind of physical or mental distress, it's probably not the best time for jokes.

This is by no means a definitive guide, and I'm sure other people may have boundaries in different places. If there are any others you think should be on the list, feel free to add them in the comments.

Thanks for reading,
Little Miss Autoimmune

Being Strong

I was searching through some papers the other day, and came across my old essays and assessments from when I was at drama school. A ridiculous amount of nostalgia took over, and I abandoned my search in order to read them.

I was 19 when I was at drama school. I was pretty ill, though I didn’t know what with yet, and each day it was getting worse. I read the assessments, and comments on the essays, with a certain level of trepidation. My memory of them was that they were pretty negative, especially in regards to the growing health problems.

As I read through, there was definitely a theme – every tutor had made mention of my illness, but with some distance I was able to see the comments more clearly. Reading these comments, aged 19 with a serious illness looming over me, I discounted all the positive things focusing only on the negatives and qualifying statements. I saw every time my health was mentioned as discounting anything complimentary said before i.e. “She might have the potential to be good, but she’s sick so she can’t possibly be good at anything.”

Reading over them now, I can see that yes, some of the statements were questioning whether I would be able to push through the health problems enough to make it in a tough industry, and others were indeed qualifiers to positive statements made. But many of the comments about my health were actually intensifying the positives. The gist was that it’s not actually that easy to do well in a demanding course anyway, but when you add an illness into that mix working hard to do well is even more of an achievement.

I always feel like a bit of a fraud when people tell me I’m strong, or brave. I often have to bite down on comments about how I’m actually just treading water through most days in the hopes that I can get through them. Sometimes I feel like telling people the only reason I seem strong is that I have my exhausted fall-apart meltdowns in private before I leave the house or after I get home, so I can pretend to be brave while I’m out. I feel like if people saw how I am when they’re not around, they’d think I was weak and pathetic.  

These last few weeks, as the pain and swelling in my hands has gotten worse, it’s been especially easy to slip into thinking of myself as weak. A few weeks ago, I found myself locked out of my apartment, not because I didn’t have my keys with me but because I couldn’t manage to turn them in the lock. A few days later, I spilt a cup of boiling water down myself, because my grip wasn’t strong enough to keep hold of it. Both instances left me feeling anything but strong, but with a bit of distance I realised I was adding in more negatives than there really were. Loosing function in a part of your body is hardly something that’s generally associated with being strong. But getting up and carrying on with life even though that function is gone, and things are getting harder, does take strength. A lot of it. I might feel pathetic for loosing the strength in my hands, but I wonder how many people reading this are thinking “I’ve spilt boiling water on myself before, and I don’t even have bung hands.”

Participating in real life is hard – not just if you have an illness but always. Life is complicated, and confusing and exhausting. It would be easy to check out, and say “I’m ill and I don’t want to.” I know I for one consider it often. Having an illness doesn’t make you strong. The fact that you keep trying, despite the fact that it’s hard, does.

Thanks for reading,

Little Miss Autoimmune

Nothing is ever simple

I went to see my GP on Monday, as there were several issues I felt were starting to get out of control – the weird bulge growing on my forearm, the even weirder red painful dots on my skin, and the ridiculous number of coldsores I’ve had recently.

The weird bulge in my arm is, as I’d suspected, tendonitis (inflammation in the tendon sheaths.) It’s likely being aggravated by the fact that it’s on the side I use Molly Stick, and I’ve probably been typing/using the mouse a bit too much lately (bring on the voice software!) My GP suggested the best course of action would be to ask my nurse to give me a local steroid injection, to bring down the swelling and to stop it interfering with the function of my hand. I always get significantly worse for the first 24 hours after a cortisone shot, so I’m guessing the days after having it done I won’t be able to use Molly Stick, making life a bit difficult. My nurse is away at the moment, so fingers crossed the tendon will have un-inflamed itself before she gets back and I won’t end up needing it.

My GP also noted that there is some swelling around my joints, in addition to the soft-tissue inflammation I’ve been getting, which may mean my PsA has decided it’s tired of being in remission. That’s kind of upsetting, especially as I can’t take anti-inflammatory meds because I have gastritis (inflammation in the lining of the stomach) but I just keep reminding myself that I was incredibly lucky to go into remission in the first place. 

I’m pretty superstitious, so I was fairly sure that the coldsores were down to a combination of suppressed immune system and the fact that I tempted fate with this facebook status a while back: 

“Tubes of Zovirax are specially designed to disappear somewhere in your house, in between coldsores. Someday I will find their secret hiding place, but on that day I will probably not have a coldsore.” 

I’ve been getting them once or twice a week ever since then. My GP agreed that it is most likely down to the immuno-suppresant effect of the medications, and said I’ll need to contact my nurse to find out what I can and can’t do to support my immune system without it becoming counter-productive. It is in a round about way a good thing, because it means the meds are having an effect. But a little frustrating to find that my immune system is still over-achieving when it comes to attacking healthy cells and yet simultaneously becoming incompetent when it comes to fighting actual diseases.

When it came to the red dots, she said she honestly had no idea, other than to say it definitely wasn’t hives, shingles, an infection, or vasculitis (inflammation of the blood vessels.) All good to know, but it didn’t really get us any closer to what it was, so she got on the phone to my dermatologist. My dermatologist quickly added “a complication of the coldsore virus” and “a reaction to medications” to the list of things it wasn’t, but unfortunately, by the time I got in to see her, the red dots had all passed the point of being biopsy-able, so she couldn't give me a firm diagnosis of what it was. She did say, however, it’s likely folliculitis (inflammation of the hair follicles.) From what she told me (and a quick google search) there are a few different types of folliculitis, ranging from mild irritations to much more serious. The type I have is not caused by an infection or ingrown hairs, but by inflammation from the autoimmune diseases. To make things more complicated, the medication used to treat this kind can’t be used in people who have a positive ANA blood test, which I do (ironic when the fact that I am ANA+ is likely the cause of the inflammation in the first place!) Fortunately my dermatologist was able to give me a topical treatment instead, which should hopefully help to settle it down. 

When I mentioned the coldsores, she said that I may need to go on tablets for a year to eradicate the virus. I’m a little reluctant to do that, as I’m already on so many medications as it is, so I’ve said I will wait a while to see if they calm down on their own first.

So all in all, I’m feeling a tad –itisy at the moment. It feels at the moment like I’m not only fighting all of these diseases, but that they’re fighting each other, either making each other worse or complicating treatment options. I’ve never been a particularly zen person, but I do know that thinking like this, or getting upset and frustrated about it is just going to make things worse. So the other day I decided that any time a medical profession uses the words “Because you’re complicated...” I will mentally replace them with the words “Because you’re awesome...” Because I am.

Thanks for reading, 
Little Miss Autoimmune

The Hippos Have Been Fed

It's a bit of a good news bad news sandwich today:

Good News: My waiting game/hungry hungry hippos playing is over. My cortisol level came back slightly elevated, rather than low, so we can rule out Addison's Disease. My electrolytes and blood pressure are still low, but my GP says that it's unlikely to be anything too serious causing it.

Bad News: I have a rather yucky respiratory infection, which has made my asthma flare, and I feel like there is a giant cat sitting on my chest, squishing my lungs. I can't take normal cough syrup, and my blue inhaler makes my muscle spasms really, really bad.

Good News: My GP is awesome. I have a treatment plan that seems to be helping, and I found some gluten-free liquorice, and Irish Moss cough syrup, both of which taste really good. Plus my couch is comfy, and my teddy bear is pretty good company.

All in all, the bad stuff will pass, and I'm so relieved about the Addison's Disease, I can't be too unhappy about the infection. Just imagine me doing the most sedentary happy dance ever :-) 

Thanks for reading
Little Miss Autoimmune

Disability Chic

After living on my own for a year and half, and periodically have to call my dad to come rescue me after I fall down, I’ve finally bit the bullet and got a medical alarm installed. I’ve delayed up until now, because there was still a part of me that wasn’t ready to admit I needed one. Even so I was totally confused when both my doctor and the lady who came around to install it, told me very firmly “But you must actually wear it!” Why would I go to the trouble of getting one, if I wasn’t going to wear it? And then I realised what they meant. All the time, not just at home when I’m alone. All the time, out in public.

Wasn’t it bad enough that I’d swapped pretty bracelets for a medic-alert; high heels for crocs; and already had a number of “disability accessories” like Molly Stick and wrist splints? Now I had to add a giant hunk of plastic hanging around my neck as well?

I get why it’s necessary to wear it all the time, and after a moment of feeling sorry for myself I put away my vanity and got over it. I even started coming up with jokes about it, for if anyone asked what it was. But then I wondered if that was the right response.

A few weeks ago, I found myself crying over some posts about crocs made on a public page. I was really annoyed at myself, partly because it was such a shallow thing for me to get upset about, but also because I’m usually pretty good at ignoring silly comments on the internet. I’ve posted before about my reactions to the irrational amount of rage and nastiness directed towards crocs, but this time it was a bit different. The gist of the posts this time: No one will ever find you attractive if you wear crocs; you must have given up on ever having sex; you make other people feel nauseous. It was honestly like having someone take the worst things I’ve ever felt about myself, in my darkest moments, and post them on facebook for me to read.

I didn’t respond to any of the comments on the page, one because people on the internet are crazy, and two because I knew exactly what the response would be. “Geez, it was just a joke!” or “Have a sense of humour.” And if I explained that actually sometimes there are people in my situation, who are allergic to the glue used in shoe production, and/or live with chronic pain and disability, I would get irritated responses that “that’s not what this post is about” and “God, some people have to get offended by everything”.

The thing is, I do have a sense of humour. You have to if you’re in my situation, but I feel like these comments crossed over the line from good-natured teasing to self-esteem destroying. Even when comments don’t cross that line, sometimes I don’t want to have to have sense of humour about how I look. Sometimes I just want to feel like I look “okay” or "nice" even, not “okay, despite...”

When I posted about crocs before, I heard from several women living with chronic pain that they had also been brought to tears by nasty comments made in person about their footwear, or felt shunned by other women in places such as school pick ups because of it. I had a job interview recently and found myself seriously considering which of wearing crocs, or wearing shoes that would make me hobble and want to scratch the entire time, would make a worse first-impression. These comments might be “just a joke” but they have a knock on effect, to people’s self-esteem and to what other people think are appropriate comments and behaviour in real life, not just on the internet.

The day after all this, a complete stranger came up to me and told me she liked my shoes, and I almost dismissed the compliment because I was sure it must be a joke. Then I realised that I have actually had a number of genuine compliments about my shoes in the past. I’ve had people who really dislike crocs comment that bright purple shoes with black tights do look cute, and there were a number of people who said that they wished their feet were small enough for the pink butterfly ones.

The other day, one of my friends commented that she liked my necklace, without knowing it was a medical alarm. So I’m not going to feel bad about having to wear it, and I’m not going to make jokes about it either, because ultimately it feeds into that feeling of having to laugh off: “I would look okay, if it wasn’t for...” The lady who installed the alarm for me told me to make it trendy, and that’s what I’m going to do. If that makes you think no one will ever find me attractive, then for god’s sake keep that to yourself, because that is your issue. Not mine.

Thanks for reading,

Little Miss Autoimmune

Hungry, Hungry Hippos

I think most of my generation in New Zealand grew up watching repeats of Friends and The Simpsons every weeknight. In most situations you can make a reference to either show, and everyone in the room will have seen the episode so many times themselves they instantly get what you mean. Personally every time I hear an oven timer go off, I feel the urge to yell: “My Fajitas!” and when my hair gets particularly curly: “It’s the humidity!” And I know every time one of my friends mentions Hungry, Hungry Hippos that what they’re really playing is the waiting game.

It’s possible another diagnosis may be on the horizon for me. Nothing confirmed yet; it could turn out to be absolutely nothing. I wasn’t going to post about this, until I knew for sure either way but then I realised “the waiting game” is a big part of living with chronic illness. Whether it’s test results, approval for new medications, treatments to start working, or answers to the cause of new symptoms, it feels like we’re always waiting for something.

I went to see my GP to get some forms filled in last Monday, and in the course of the appointment, I asked her to check my blood pressure. I was pretty sure it was low. I’ve been having more and more dizzy spells and headaches lately, especially upon standing up from sitting or lying, and I’ve had a couple of unexplained falls as well. It was, as I suspected, low but we were a little surprised by how low. At the time it was taken, I was feeling fine which suggests it may be dipping even further when I’m having dizzy spells. My GP suggested I should start drinking coffee to raise it, and when I mentioned I’d found drinking water with added electrolytes helped, she checked my blood test results and found my electrolytes levels are also low. I think there are probably a lot of reasons this can happen, but the one that my doctor thinks it could be is Addison’s disease. I don’t know too much about it, and I’m resisting to urge to google anymore because the Wikipedia page freaked me out. From what I have read, I do have all the symptoms, but given that they are all fairly non-specific symptoms and could be attributed to any one of the other conditions I already have, that doesn’t really mean much.

Autoimmune disorders tend to run in packs, so after you’ve been diagnosed with a few it’s not really all that much of a surprise when another one is added. Even so, I have to admit the possibility of this one has unsettled me a little, especially as I hadn’t even considered anything new might be wrong, before my doctor brought it up. My GP said it’s quite hard to diagnose, and she’s on leave for the next month, so for now it’s just extra blood tests, self-monitoring of my blood pressure... and playing the waiting game.

Whenever you’re waiting on something the advice everyone gives is don’t think about it, but as we all know that’s like trying not to think about elephant when someone tells you not to think about elephants. Still, I’m doing my best not to worry about it at least.   

The waiting game sucks. I really need to get Hungry, Hungry Hippos.

Thanks for reading 
Little Miss Autoimmune

Kindness Is The Cure For Everything

I have been struggling lately. Basically everything in my life apart from my health is going really well, however, I’m in more pain than I have been for a while, and have been feeling quite unwell both from symptoms of disease and from medications. The downside of everything else going well is that I am a lot busier than I am used to being. With my health being so good, it means I am tired and emotional most of the time, something which does not fit very well into being busy.

It’s quite hard to talk about this stuff for a lot of reasons. In part it’s that I find it quite uncomfortable to talk seriously about a lot of this stuff. The fact is I do get quite upset and scared by a lot of the random things my body does, but a lot of the time saying that aloud just makes me feel more sad and scared. One of the other reasons is that talking about things like this often makes people feel like they have to offer solutions, try and fix the problem, or reassure me that the problem isn’t really as bad as it seems. Often it’s not really possible to do those things, and that then makes them feel sad and scared too.

When I worked in mental health, we often talked about not trying to fix people’s problems or rescue them from them, but just walking along side them as they work through them themselves. I think this applies not just to mental health, but to physical health and really to most times of stress whatever the situation or cause. The other day I experienced the most amazing example of this being true.

I was walking home from the bus stop, and I started to cry. There wasn’t really anything in particular wrong. I was cold and tired, and in a lot of pain, but that didn’t feel like enough of a reason to cry because it wasn’t anything new or different. It felt stupid and self-indulgent to cry just for that, especially in public. I was trying to hide it and hold it together until I got home, but this woman saw me from where she was sitting and she ran after me to ask if I was okay.

There’s something very odd that happens when someone is nice to you when you’re not feeling good. Though I tried to insist I was fine, I immediately burst into full-on tears, a reaction that would have been more appropriate if she’d been horrible. The woman asked if I had far to go and if she could walk the rest of the way with me. I refused at first. I didn’t feel I could ask her to go out of her way, just because I was not feeling well. It was cold and raining – no one should have to walk out of there way in that! But she insisted, saying it was not a day that anyone should walk alone.

She took my bag from me, and walked with me the rest of the way home. We talked, and I cried some more. When we got to my place, she asked me if she could say a prayer for me. She asked God to be with me and walk beside me, just as she had walked beside me. She then gave me hug and thanked me for giving her the opportunity to let her help me. I was so astounded to hear her thank me. I was stumbling through an attempt to express the immense amount of gratitude I had for her, and she was thanking me?

I was amazed to have a complete stranger show me such kindness and generosity, and that in itself made the things I was dealing with so much easier to face. In the space of a five minute walk, I went from feeling like I wanted to curl up in a hole and forget everything to feeling like perhaps everything was going to work out okay because there are some truly wonderful people in the world, and that fact in itself is enough to make anything easier to bear.

I realised later that this was quite literally an example of what we had talked about, with walking beside people rather than trying to solve their problems. There wasn’t a way for her to make me not be sick or in pain, but to have her be there with me in that moment when it felt too much was the most powerful and amazing thing.

This was such a profound experience for me, but I hesitated at first about sharing it with anyone. I didn’t want it to sound like a silly overly-sentimental story, or like I was trying to convert anyone into something. In the end I decided that it was an unusual and beautiful story, and that made it worth sharing whatever people thought of it. I put the story up on facebook, and I had many people tell me it made them tear up, or that it made their day.

I want to share this story, because kindness should be shared. So many problems can’t be fixed or cured, but there are very few situations that can’t be helped by a little kindness. The best way I can think of to thank Esther – the woman who walked with me – is to pay it forward and pass on her kindness to others. In most cases I probably won’t be able to solve other people’s problems, just as no one can fix mine. But we can be there for each other, and walk together through the rain.

Thanks for reading

Little Miss Autoimmune

Accident-Prone Hormones

The last couple of days have been a bit rough. I knew they were going to be. I realised last week that it was highly likely several factors – work stress, vitamin D being due, PMS, medication changes and side effects – were all going to combine into a flare. So I’d done my best to make sure I could get through it as smoothly as possible. What I wasn’t counting on, was a sudden and dramatic increase in my own accident-prone tendencies. In the last 24 hours I’ve had several mishaps ranging from completely-silly, to came-very-close-to-serious-injury in severity, and it’s left me in a pretty sore state.

I was talking with some friends the other day, about those “facts” that you believe for years because someone you trust told you them. For example, for years I believed my grandmother had stigmata because when we were little my sister told me she did. I don’t think my sister remembers this, so I have no idea whether she really believed it or if she was just messing with me, but at the time I took it as fact and it wasn’t until years later I thought to question it.

When I was a teenager, my mum told me that having PMS interferes with your depth perception. At the time, I took this as fact, not least because when she told me that I’d just opened a door into my own forehead, then misjudged the gap and hit the doorframe on the way through. She told me that she had exactly the same type of accidents herself every month.  

I didn’t question it, at the time. Honestly, I was too relieved to question it. For years I’d felt like I was loosing my mind, when I couldn’t do something as simple as walk through a doorway without injuring myself (just try explaining to someone that you really did get a black eye walking into a door, and see if they believe you) and she has finally offered a seemingly plausible explanation.

Last night after my dad came and rescued me from one of my more nasty accidents, my mum’s explanation popped into my head. For the first time, I wondered if there was any scientific basis to this, or if it was just something Mum had said to make me feel better. My PCOS symptoms have been really out of whack lately, so if it is true that could explain why the number of accidents has been worse, but I’m somewhat suspicious that I’m making connections out of random events.

So here’s my question – does anyone else experience this with PMS? Particularly anyone with PCOS/Endo or anything similar? Also if anyone with a medical background knows if there’s any truth to the idea that hormones have an impact on depth perception, I would love to hear your thoughts.

Thanks for reading

Little Miss Autoimmune

And we’re back to lupus... I think

I had an appointment with my rheumatologist on Thursday. I wasn’t really expecting much to come out of it. I don’t mean that as a criticism of her, just that I was under the impression that I had no treatment options left. I wasn’t expecting that she would be able to do anything for me and I really didn’t think the confusion over the diagnosis was going to change.

Surprisingly, I was okay with this. I blogged a few weeks about the pitfalls of hope when it comes to believing illnesses will get better, and I think the opposite can be true. If your expectations are low, and you find a way to be okay with that, then anything above those expectations happening is a bonus. There were a couple of questions I wanted to get answers to, and I was really hoping that a cortisone injection in one of my fingers was a possibility, but other than that I was okay with nothing really coming out of the appointment.

It turns out the joint in my hand is too small for a cortisone shot. I realised afterwards that I wasn’t sure if my rheumy meant this is always the case with finger joints, or it’s just because my hands are unusually small for an adult (they’re the same size as my nine-year students’) but either way it wasn’t going to happen. Instead my nurse gave me an intra-muscular steroid shot. I’d mistakenly thought this wasn’t an option at the moment, as I’d got the time frame wrong as to how often you can have them, so it was a bonus to be able to have something that would quickly get some of my out-of-control symptoms back down to a more manageable level.

I was pleasantly surprised to find I do actually have a couple of other medication option still to try. My rheumy was at great pains to point out that a couple is not many, and as always there are risks with any medication, but given that I thought I had zero options left a couple is good news. I know very well that these may not work and, since I have to wait for some blood tests to come back before I get the go ahead to start, it may turn out not to be possible for me to even try. I’m not allowing myself to get too invested in the idea that these will help but, at the same time, they have more chance than nothing.

Then there was the diagnosis situation. During the appointment, I thought my rheumy had actually come to the conclusion that I didn’t fit any diagnosis clearly. I was pleased to find that I was fine with that. In the past I have unintentionally placed a lot of significance on the diagnosis, and all that has done is left me upset and confused. I cried when I first got the diagnosis of lupus, and I cried when the diagnosis went away again so clearly neither option was going to make me happy.

At the end of the appointment, my rheumy suggested of the medication options available we go with the one that works best for lupus, and she handed me a blood test form which had PsA and SLE (Psoriatic Arthritis and Systemic Lupus Erythematosus) written under clinical details. My nurse explained that sometimes people do have both running concurrently, and that that may explain why I’ve managed to simultaneously get better and worse on certain medications as they work differently with different diseases. I don’t really know if any of that amounts to a diagnosis. It sort of seems like it, but the last time someone actually said to me “yes, it’s definitely lupus” and yet later they were surprised when I thought I had been diagnosed with it, so I’m not making any assumptions.

The thing that I do know for sure, is that I was okay with it either way. I didn’t feel the need to cry, nor did I feel any relief or positive emotion about it either. The strongest thing I felt straight after the appointment was a desire to go buy some chocolate, but I think that was more down to the fact that I had the injection and four vials of blood drawn all within the space of about five minutes.

I think the reason I’ve placed significance on diagnosis in the past is that there was still a little part of me that felt maybe it would change something, and I was in a round about way still looking for that “better.” Of course I would still really really like it if things did get better – I wouldn’t be looking at new medications if I didn’t – but I’m doing my best not to hang everything on that. My new mantra is going to be: “Things are okay now, and anything else is just a bonus” and I’m going to do my best to listen to my own advice.

Thanks for Reading 

Little Miss Autoimmune

Move it... and sometimes lose it anyway.

I think every chronic illness patient has a phrase which they particularly dislike hearing. For some people “You’re too young!” or “But you don’t look sick?” really hit a nerve. Personally I don’t mind those so much. I think they come from a place of misinformation and while it can be irritating to hear them over and over again, it’s the not the person’s fault if they don’t know what they don’t know.

The one that really irritates me is: “Move it or lose it.” I dislike this, because I don’t think people have any idea what it really means, they just like parroting catchphrases and particularly like catchphrases that rhyme. I also dislike the fact that this is offered up as a piece of advice. For one thing, when it comes to autoimmune forms of arthritis yes, absolutely exercise is important, but you may still “lose it” anyway. Last week one of the joints in my finger stopped moving completely and has been locked in place since. It is somewhat swollen, so I’m hoping that maybe if the swelling goes down it will “unlock” but it could very well be stuck permanently from now on. I take pretty good care of my hands. They’re the only joints I consistently do any physio exercises for, and everyday life provides plenty of movement for them, but they are also the area of my body where I have lost the most range of movement and function.

When it comes to degenerative forms of arthritis (for which move it or lose it is most relevant) it’s still just a catchphrase not advice. It doesn’t explain what type of movement is helpful, and doesn’t do anything to address any barriers. When I hear this, the first thing I picture is someone swinging their joint wildly back and forth repetitively – that’s not a way to prevent arthritis; that’s how you give yourself RSI. It really should be “move it or lose it, but don’t forget to plan and pace!” But I guess that isn’t as catchy.

Perhaps you may think I’m being unfair – the phrase is just supposed to be the reminder and motivator not the sum total of the treatment plan. Unfortunately, I know from my mother’s experience that this isn’t always the case. When she began to have severe pain in her fingers and one of her joints kept locking, my mum went to the doctor who told her “It’s osteoarthritis. Move it or lose it.” and no, I’m not paraphrasing, that was word for word all he had to say on the subject. He didn’t even look at her hands. While my mum was at the time at an age where onset of osteoarthritis was more likely than an autoimmune form, I found it astounding that given she also had psoriasis, psoriatic arthritis in a close family member, and the joints affected were DIP joints (the end finger joints; most often affected in PsA.) that he wouldn’t at least investigate. I insisted Mum go back, and at the very least get some clear guidance on what exactly she should be doing. She was again dismissed with “move it or lose it” as her only advice.

Swollen DIP joint

(Distal interphalangeal joint)

Some months later, (after she had decided to retire as she was unable to complete parts of her job without full use of her hands) Mum saw another doctor, who actually looked at her hands, and it turned out she did not have osteoarthritis but a treatable condition. The treatment plan included complete rest of the joint for two weeks, so the “move it or lose it” had in fact been exacerbating the condition.

“Move it or lose it” is not advice, nor is it in itself a treatment plan. It would be like telling someone who has depression to “turn that frown upside down” in place of offering a referral to counseling. If you’re a medical professional, please realise that when it come to exercise it’s not the fact that we need to do it that’s confusing people. It’s the how and what to do that’s the problem. So if you’re still really keen on using rhyming catchphrases, then by all means say “move it or lose it” but follow it up with a referral to physio or at the very least a proper explanation and plan.

Thanks for reading,

Little Miss Autoimmune

The pitfalls of hope

I wrote this in the middle of the night a few days ago. I wasn't going to post it, because usually things I write in the middle of the night are either incoherent or excessively maudlin, but I read over this tonight and it doesn't seem too bad! Feeling way more positive now either way. 

I am sad.

That seems like a stupid thing to start a post with. My goal has always been to make this a positive place. When I started this blog, I knew I was taking something that was my own personal journey and making it public. I don't think I could have put into words at the time why I wanted to do this. I think I had an idea that perhaps it would help other people, but also the idea that it would help me too. I've always been one of those people who narrates their own life inside their head - I say that like I know for sure that other people do this. I don't really. I guess I just assume that if shows like Scrubs and Grey's Anatomy are anything to go by, there are other people out there with a voice over inside their head trying to make poignant conclusions out of the random things that happen to them. Or at the very least conclusions, without the poignance.

Right now, it's the middle of the night. I got out my computer with the hope of putting my insomnia into productiveness by working on my latest novel project but instead I ended up writing this. Because I am sad and I am frustrated and in the middle of the night there aren't that many people you can say that to.

I read something on someone else's blog recently about how the author felt she may have exaggerated her illness, not to her doctors but to herself. I do this. I think we all do this. In the middle of the night, when the pain is bad, or if my body has become rebellious in some other way, I panic. I feel that this is the end. I have lost the use of that limb, and normal function will never return.

Tonight trying to open a jar of peanut butter, left me screaming in pain. I paced back and forth in the kitchen, clutching my hand and shaking, trying to fight back the nausea and tears the pain had induced. And then I cursed myself for being so melodramatic and laughed a little too, at how ridiculous it would all look if anyone were there to see it. Eventually I managed to open the jar with a pair of scissors, which made me feel a disproportionate amount pride at my own ingenuity.

This isn't why I'm sad. The pain in my wrist eventually eased, and I could laugh at my own panicked belief that it wouldn't. I thought of the icepacks in the freezer, the splint in my bedside drawer, and all the other back up plans that I have in place but that seem so far away in the moments I need them the most.

And I started to feel a little more positive. And I started to let my dark sense of humour construct the event into a funny story I could tell someone later if I chose.

Mostly I am fine with the way things are. I was going to say I hate the fact that I'm sick, but I don't know if that's accurate. Hating something takes energy and I'm not sure I even give it that. I manage being sick. Sometimes I panic. Sometimes I cry. Lots of times I laugh about it. And all in all it's okay.

And then something happens that give me hope, and that kind of messes things around for a while. Don't get me wrong, I have hope all the time. I have hope that I will achieve things despite my illness. I have hope that each day will be a happy one. I have hope that my life will be a good one, whatever it is that that means. But I don't have hope that my illnesses will get better.

To me, having hope that my illnesses will improve or go away means that I put my life on hold. Even if it's not what I intend to do, it's what happens. Why force myself to get out of bed and do something now, while I feel so ill, when I could wait until I am well and do it then? I have to have the belief that this won't get better, because I have to believe this is my life and live it like I'm not going to get another chance.

The reason that I am sad and frustrated is that recently I let the wrong kind of hope sneak in. Even though I tried not to, I let myself believe that in seeing the specialist and having some tests done, there might be an end to my stomach problems even if everything else stayed the same. This wasn't just a naive optimism on my part; at least I don't think it was. I knew very well the tests may not show anything - in fact, I had a strong suspicion they wouldn't. What gave me hope was the assurance from the specialist that even if the initial test showed nothing, there were steps we could take to improve things. Even if the end diagnosis was not one of "disease", but just of "dysfunction without known cause" there would still be a course of action to take.

It sounded so reassuring. I felt relief that I would have a direction at last. Even if it wasn't a cure, and the likelyhood was that it wouldn't be, I would at least know what I was supposed to be doing instead of just fumbling around hoping that I at least wasn't making things worse.

So the tests didn't show anything. I was prepared for that. But I wasn't prepared for the fact that I found this out in a letter, which I didn't totally understand, and did not include the promised plan of action. I wasn't prepared for the letter to talk about "part of the bigger picture" leaving me wondering if this was a reference to my medical issues which I didn't understand, or an pseudo-philosophical comment. I wasn't prepared for the fact that I actually don't know what happens now. And I wasn't prepared for the fact that all this not understanding makes me feel stupid and scared to ask.

This is where I'm at right now. Sad and frustrated. I should say, none of this is really a comment on the specialist in question. I do wish he had phoned me with the test results, as he said he would, rather than sending a letter. I don't think I would be this confused if I had had the opportunity to get clarification, but I would probably still be sad because I had let myself hope for that "better" and that was probably never going to happen.

I do know these feelings will get better. I know I will let go of that hope I was feeling, and I'll go back to feeling okay about how things are and not trying to force them into the picture of something I wish they were. I will laugh about this, and tell stories about this. I will go back to being okay about making my own decisions about how to try and treat my diseases, and stop hoping that someone else will tell me how to handle it.

Perhaps I will post this rant on my blog, or perhaps I won't because I will decide that it's all a bit overdramatic. Either way, writing it has helped me come to an internal-narrator conclusion worthy of Scrubs or Grey's. Maybe reading it would help someone else know that it's okay to not be positive 100% of the time. And that would be another conclusion in itself. For now I will sleep, and all going to plan I will wake tomorrow with the kind of hope that is good for me. The hope that tomorrow will be a happy day, and that I will have a good life. Illness or not.

Thanks for reading,

Little Miss Autoimmune.