Saturday, December 3, 2016

Top 5 Things I've learned through the hard way and internet quotes


1) "Nothing in this world worth having comes easy." - Dr. Bob Kelso
      In one of my all time favorite scrubs quotes, Bob Kelso dishes out some serious sass as well as important advice. This has made its way up the list of favorites, especially in the past couple years. Life is precious, but hard. That being said, don't confuse between struggling and a bad life. When I graduated high school, I believed I would go to the college I was accepted to for four years, get my nursing degree, work some long hospital shifts, fall in love, settle down and keep living...just like everyone else. After all, I had gone from elementary school, to middle school, to high school... college was obviously the next step. A year later I went to move into my dorm sophomore year with the friends I made and the dorm I wanted, and a shiny 4.0 GPA (still baffles me) when I got a call from my doctor who strongly recommended I come back home for treatment. Sad, angry, disappointed and confused we packed my stuff back up and moved out (RA was so confused). I finished my vacation with my family then drove back up home with my mom. As we pulled into the driveway I remember wanting to put on my invisibility cloak and run into the house, hiding for the possibility of seeing a confused neighbors look or prodding questions. The next couple weeks I threw a major pity party and honestly felt ashamed and like a failure. All my friends were surely having a great time off at college, living it up carefree. This linear path I had drawn out perfectly straight and parallel had been erased. It took me a year of treatment, online class at community college, and bitterly scrolling through my newsfeed before I drew up a new path: a new school, new friends, and a new major. Then something really cool happened. I started to open up about my struggles, my frustration, and my change in direction, and so did other people around me. Turns out my friend had transferred colleges too and another one decided last minute to work instead. So guys, don't worry... life isn't linear and it sure as hell ain't simple.


2) "Sometimes you never know the value of a moment until it becomes a memory." - Dr. Seuss
        I think all of us at some point in our lives have learned this one the hard way. That time with your grandma you spent with your mind elsewhere and it turned out to be your last. That joy of holiday traditions you no longer do because xyz. That time you ended a relationship over something stupid. Realizing that some of the moments you can cherish forever are smiles on faces or making up crazy animal combos with a friend (schwogfry for life). We are not guaranteed this day, nor this hour. Remind yourself of the beauty and love that surrounds you each and every day.

3) "Be at peace, not in pieces." 
      Despite being an awesome pun, this is one of my go to catchphrases in times of trouble. I like control... most of us do, and whenever I feel I'm losing control this is a solid go to. I come from a long line of very anxious people and believe me when I tell you, it takes its toll. Just remember it's okay to accept your not in control or need help.

4) "Health is a crown that the healthy wear, but only the sick can see." -Imam Shafi'i
     Yes.

5) "Be kind, everyone you know is fighting their own battles." 
     Similar to #1 and I posted about this before but I needed reminders to myself all the time. People are different and that's okay. We grow and expand as humans by beings around people who are different than us. You don't have to agree or concede or even argue. 


Well, my fingers already hate me, I promised my brother I would get back to blogging (taadah!) so I'll be trying to post some more stuff more frequently including a health update because I know a lot of y'all have asked. 

Happy holidays!


Tuesday, September 27, 2016

I'm invisible... You can't see me!

       Lol but actually in case you couldn't tell by the cheeseball title, I plan to ramble on about invisible disabilities because it's invisible disabilities week! It's pretty self explanatory but an invisible disability is any disability that can not be seen and has no major visual manifestations. Examples include: diabetes, depression, EDS, lupus, schizophrenia, anxiety, Lyme etc. Some examples of visible disabilities might include: Down Syndrome, spinal cord injury, amputation, blindness, or muscular dystrophy. 


It can be hard feeling so sick on the inside and looking “fine” on the outside. You also have to deal with people challenging your right to accessible parking spaces, store scooters, and even medical care. Since there is usually no way to tell the difference between someone with an invisible disability (ID) and a faker, I usually go with,”be kind, everyone you know is fighting their own battle”. One in every 5 Americans has a disability and many disabilities are invisible. Many of us get comments that we are faking being sick, when in reality, most of the time we are faking being well. We put on a smile and continue on with our lives despite the lack of energy, the intense pain, and feelings of hopelessness. To those of you who are close to me, you have seen me with my guard down, but for others you may have no idea I am in pain every day of my life. I don't mention this for pity or to complain but more so in attempts to open up a dialogue, even if just an internal one. I want take this post and this week to spread awareness, compassion, and answer people's questions if they have them. The love and support that y'all have given in various ways and modes truly amazes me.


Since I kinda missed EDS awareness in May except a blog post, I'm going to try and make an ID/EDS etc awareness video… Eventually. If I do, I will post the link here. 

Saturday, September 10, 2016

WARNING: Might just be one long rant...

        Okay... so I wanted to touch on a bunch of different things that don't have another home. I'm feeling very brain foggy/disorganized so if none of this makes sense... then it'll probably at least be entertaining.
#1: How long it takes to get anything done in the medical world
      Let me preface this with I ABSOLUTELY know this is not all on the medical professionals. There's shit with insurance, documentation guidelines, hospital rules and regulations, and just overweighted caseload that influence this issue. But seriously, it gets ridiculous.
Some examples:

  • I met with a new GI July 22nd. He seemed on top of his game, familiar with my conditions, and agreed that action needs to be taken to get by nutrition etc back on track. He had lots of medical history, former testing, current summary... everything he needed. He ordered a SmartPill test (camera pill you swallow and it takes pictures and does testing as it goes through your GI tract... pretty cool) and an upper and lower scope (sticking cameras up your arse and down your throat...yum). I had already had a gastric emptying test to diagnose gastroparesis (delayed stomach emptying), but we had no idea the motility of my intestines or if they absorb any of the nutrients. Fast forward 4 weeks until my scheduled SmartPill test swallow. I had to go off all GI meds for a week (which means not only more of the daily yuck but near constant acid coming up my throat), get a ride to the hospital, fast beforehand, take off work etc etc. I get there and they're (nurses) doing the pre-procedure checklist. They get to question #3 "do you have any implanted devices?"... "yes... but the doc knows about it... we talked about it"  "Let me give him a call"  *comes back 10 minutes later* "I'm sorry, the implant disqualifies you from doing this test, I have to cancel it... the doctor will give you a call (lol jk)". Okay, so waste of time. I messaged my doc later (shock and awe... he never called) and asked if we could schedule the only other test one can do to get the same data as the SmartPill. His response: we will talk about it next appointment. So you're thinking aight... that's okay. Wrong. Not only is his first available not until mid-November, but his office won't schedule any follow-up appointment until after I complete, and get the results back from the scope scheduled for September 14. So basically I'm SOL until at least December timeframe.... assuming that visit won't just mean going over EGD results and him ordering the same test I asked him about months earlier. Don't worry guys...it's only nutrition. 
  • It took my PT 3 weeks to write and sign a sentence saying "patient needs new custom wheelchair back to maintain posture and for support". 
  • It has taken my doc 5+ weeks (he was on vacation for one but still) to write and sign a prescription, note, and LOMN saying "patient needs custom bilateral AFOS". 
  • I've been waiting for records from one doctor for 13 months despite several verbal and written reminders to him and his staff.
#2: My two cents on the Epipen bull:
          As someone who is literally allergic to life (sunlight, heat, cold, stress, talking, meds etc) and must always have Epi on my person and has unfortunately had many uses of the autoinjectors I am pissed. But not just by Mylan (jerk face mcugly butts) jacking up the price of Epipens (500%), but the fact that I have multiple friends who have to make the choice between life-saving medicine, therapy, and treatments and feeding themselves or their kids. 
And we aren't even talking about those without insurance. Most of my friends are lucky enough to have some form of health insurance (even if its crappy) and are still drowning in bills and medical debt. There is not a single day that there isn't a medical bill arriving at my house and that is just ERs, hospitals, and doctor's bills. Plus medicine, devices, PT, testing, surgery, and prolotherapy (not covered by any insurance as it is "experimental"). I have been incredibly blessed with kick-ass insurance (although still a PITA) and to be able to stay afloat in the bills. Despite all kinds of preventative and prophylactic treatments, there is still only so much you can do to keep ahead of things and emergencies still happen. Epipens also only are viable for a year. They come in a 2 pack but most need more to keep one at school, one in the car, and one on your person. For most, it is now cheaper to go to the ER for anaphylaxis treatment than to use their Epipens. Honestly, all I got is "fuck you Mylan". No excuses, epinephrine is cheap, autoinjectors are relatively cheap. Not to mention their tax evasion strategies. 

#3: Depression
Since the people who 1) even read this blog and 2) read all the way til now and aren't asleep from boredom are probably the people who care, I saved this one for last. As some of you have noticed, I've been dipping into another depressive phase. Depression and me are buddies now so it's cool. It is also normal and a big part of chronic illness so don't go panic on me. So don't be alarmed if I'm a) super clingy and annoying or b) super avoidant and grumpy gills ... that's kinda just how it goes. See previous post RE: things you can do to help.  



Aight. That's all for now....

Sunday, August 21, 2016

What Can I Do To Help?

Dear Super Awesome Friend,
        Loving someone is hard, loving someone with chronic pain and chronic illnesses can add some uncharted territory. This is my attempt to help some friends out who have been struggling with the answer "I don't know" to the amazingly beautiful question of, "what can I do to help?"        
         First, know that while unsatisfying for your drive to be useful, fix the world, and get home in time for dinner, your presence and attention mean more than you might ever realize. Illness is lonely, isolating, and unpredictable. Waking up after a night of pain and other fun NSFW wonders to random memes, emojis, or stories can make a shift from bad day mode to good day mode (ze mind is a powerful thing you know). Obligated to text me every day and respond to everything I text you? Nope, Chuck Testa! While I hate saying no and canceling plans, I would almost always rather be invited (unless it's a chocolate festival in which case all self control will be throw to waste and the gastroparesis gods will reign down their mighty wrath). While each of you can probably call to memory many times where I have no taken care of myself or made bad choices, for the most part I know my limitations all too well.
       Here are some FAQ on this topic:
What are some things that are easy for you to do?

  1. All the time: laugh, watch netflix, talk about what I watch on netflix, watching disney movies, fix things, cards or board games, singing disney songs in rediculous voices
  2. Most of the time: all of the above, car rides, rolls near water (parks, creeks etc), going to movies, swimming, vidja games
  3. I HAVE SO MANY SPOONS AND GOT MORE THAN 3 HOURS OF SLEEP: rock climbing, nature, camping, amusement parks, museums,  and frisbee
What are some things that you don't like doing?
  1. Going to loud, busy or bright places or flashing lights
  2. Meeting multiple new people at once 
  3. Anything that requires long periods of focus (ie watching a pot boil, watching a fast paced subtitles movie)
  4. Games I can't win at (just kidding...kind of)
  5. Going out with multiple stops (chair loading and unloading is tiring yo)
When is it best to give you space?
  1. When I'm being a brat for no reason (fight me...I dare you)
  2. When I've been in a spoon drought (see above)
You haven't texted me back, did I do something wrong? Do you hate me?
Probably, most of you are terrible people. But actually no, usually it is one of the following:
  1. I'm low on spoons
  2. I'm having vision problems
  3. I read it, swore to the unicorns I responded but actually didn't, and found it three weeks later...
  4. I can't form coherent sentences in English
  5. I physically don't have my phone
I feel like a bad friend for not knowing how to help/what to do/what to say....
The fact you feel that way actually means you are a good friend and just not a psychic or a unicorn... we all can't be awesome ya know. But actually this one is a tough one because so far none of the answers I have given people have been reviewed as 5 star customer service. I guess all I can say is that I hear you and I understand and view nothing more or less of you measly humans. 

Am I supposed to laugh at your twisted jokes about death and illness or is that in bad taste?
You can laugh if you want.

I'm scared but I don't want you to know or worry about me because apparently there is some precedent for supposedly being able to tolerate scary diseases and pain and suffering of a close friend and I have to hold myself to that standard.... oh or I could accidentally kill you...
It is okay to be scared, I'm scared too. Give yourself time. 

I hope this helped someone but if not at least I got a few more memes into play. 
Love you fools,
Julie






Tuesday, May 31, 2016

But You Are So Young...

          But you are so young... words that pierce a hole right through my sternum. Yes, I am young but unfortunately chronic illnesses don't ask for ID. Yes, I am young but I know kids, young adults, adults, and seniors with chronic illnesses. Nobody tells a diabetic kid they can't be sick because they're too young! Yet we (spoonies of various illnesses) get it all the time. My passport and birth certificate concur that I am 21. I am young but anyone who has heard the snaps and cracks of putting my joints back in place before I get out of bed each morning would swear that I am 80. I am young but take more medication and supplements than my grandparents. I am young but I wake up each morning to face a monster that knows my name, my fears, and my limits. I am young but my calendar is that of a retiree: volunteering with doctors appointments and physical therapy to fill in the gaps. I am young but I have friends my age and younger fighting for their lives and few that lost their battle already. I may not look sick, or I may, but I feel sick. I feel these disease nestle into every nook and cranny of my body. I put on a smile to mask the pain and refuse to slow down for the fear that I will be eaten whole by the flames. As Plato said, "be kind, everyone you know is fighting a hard battle". While many of these comments aren't said with ill intent, they can be destructive to someone not quite back up on their feet. I suggest going with a complement not related to pain, illness, or weight for the general population. My heart broke the other day when a fellow friend with gastroparesis (stomach paralysis) told me (after losing a lot of weight do to sickness and malnourishment) her mom had told her she looks better "lighter" after she had just been talking to her mom about how she's really struggling with her GP. Pro-tip: Try crawling around in our bodies in your mind. If you were in constant pain and feeling defeated, would you want someone to tell you "you don't look sick!"? Even if with good intentions the answer would probably be no. You can always ask instead how we are doing or if we have seen any good movies recently (chances are if it is a spoonie the answer is YES...we watch a lot of Netflix... ;) ).

Harper Lee

Tuesday, May 3, 2016

May is EDS Awareness Month

Alright, it would be silly if I didn't post something EDS Awareness related because it is awareness month so here goes.
Here are some FAQ about Ehlers-Danlos Syndrome

  • What is Ehlers-Danlos Syndrome (EDS)?
    • EDS is a group of genetic connective tissue disorders (CTD) that affect your bodies ability to produce collagen. Collagen is a protein in connective tissues that acts as a glue for your body. People with EDS produce weak, faulty collagen which affects our joints, organs, blood vessels, ligaments, tendons, you get the jist. There are different subtypes based on which type of collagen the mutation is on. All types share joint laxity, easy bruising, and soft skin. There are currently six different types of EDS (newly revised): Classical, Hypermobility, Vascular, Kyphoscoliosis, Arthrochalasia, Dermatosparaxis, and Other. It is possible to have crossover, AKA more than one type (lucky duck...).
  • How is EDS diagnosed?
    • Excellent question self, EDS is a clinical diagnosis that can be confirmed with genetic testing in all but the hypermobility type. The clinical diagnosis comes in two components: the Beighton Score (asses joint hypermobility), and the newer Brighton score. (I know, it's stupidly similar names)
BRIGHTON CRITERIA
BEIGHTON SCORE (out of 9)



  • Is there a cure?
    • Major womp here. Not yet. But, in Baltimore they started the first EVER EDS Clinic and Research Center out of GBMC!
  • What are some conditions that are comorbid (related to and commonly occur together) with EDS ?
  • What was the point of that?
    • Because collagen is everywhere in your body, EDS effects everything. 
  • What's with the zebra?
    • The zebra is the mascot for rare diseases based off an old medical saying from the 1940's Dr. Theodore Woodward, "when you hear hoofbeats, think horses not zebras". This saying is used to remind medical students that it is often not a rare diagnosis. The problem is that medical zebras do exist, and it can be hard to remember that at times. The average time from start of symptoms to correct EDS diagnosis is 8-15 years. 


Some Facts About EDS!
  1. 50% of EDSers can touch their tongue to their nose! 
  2. EDS is currently estimated to effect 1 in every 5000 births world wide.
  3. It is likely that most contortionist have EDS or another connective tissue disorder.
  4. Professor Rodney Grahame, a British Rheumatologist in the field, says, "no other disease in the history of modern medicine, has been neglected in such as way as Ehlers-Danlos Syndrome.
  5. Characteristics of EDS were first described in 400 BC by Hippocrates, but the syndrome was named after Edvard Ehlers of Denmark in 1901 and Henri-Alexandre Danlos of France in 1908. 
  6. EDS is considered an invisible illness, even though it can have visible manifestations (extreme bruising, atrophic scarring, joint hypermobility, etc).
  7. Due to the lack of resources, research, and awareness there is no cure, few treatment options and is largely based on palliative care.
  8. Actress Cherylee Houston has Ehlers-Danlos Syndrome.
  9. Some breeds of cats, dogs, and horses can have EDS.
  10. Gary "Stretch" Turner, the man with the world's stretchiest skin has EDS. (likely did many contortionists and circus performers)

Congrats! That's all for today folks, feel free to comment if you have any questions, I'll do my best to answer them!
Jkjk...I hope :)




    Wednesday, April 20, 2016

    "Falling Behind"

    I'm a junior in college.
    Actually, well, I should be a junior in college.
    I'm actually a sophomore in college by credits, junior by age and semesters.
    But I'm catching up!
              No, actually I'm not. Still chugging away at what feels like a cruise controlled speed. Chugging away at the arbitrary set number of hours you must sit in school until deemed "educated". And I'm readily becoming more and more frustrated trying to arrange class schedules, accumulate credits in any way possible, and get a good enough grade so that I can move on. GMU has this nifty program called Degree Works that takes your credits and tells you what you still need to graduate, which classes fill that requirement, which classes have qualifiers, ya get the drift. According to Degree Works, after almost 9 semesters now, I am officially half way.
              College is not friendly towards students with chronic illnesses. Despite many universities attempts to bridge the gap with programs like disability services, the odds are still stacked against you. Many classes will drop you if you have too many absences (sometimes even 1), regardless of your ability to keep up with the work. College is also a breeding ground for germs, poor eating and sleep habits, and stress. Being physically able to get out of bed is one thing, going to class another, and then absorbing it? How about homework? Most homework either involves reading, computer use, studying, or essay writing. Most of those tasks are near impossible when eye strain, fatigue, migraines, photo sensitivity, concentration issues, and other fun cognitive issues plague your daily life. Reading that may take most people 30 minutes takes an hour for me. While most college students become sleep deprived zombies around finals too, finals for students with chronic illness can be especially challenging. Most people get sick during finals but because the pressure is on, non-chronically ill students are more likely to go to class, despite being sick and often times, contagious. This puts those of us with weaker immune systems at risk for getting very sick during finals when we are already probably pushing our limits.
               All of this and more makes me look at that half way mark and want to cry, but not tears of joy. Finishing college seems impossible (all my family out there chill, I know its not impossible and I'm not dropping out). It makes me sad because before I got sick I was so excited about college. About life beyond school. About making a difference. Now I feel like that motivation and joy of education is being slowly stripped from me. I don't want it to be this way. I want college to matter, to be something I enjoy rather than just another constant struggle. I'm scared this fog in my brain will never clear. I'm okay with "falling behind" but I'm not okay with staying behind.


    Tuesday, March 22, 2016

    #Wheelchairproblems

           In honor of Bertha's retirement (my current chair), and the arrival of my new chair (name TBD) I thought I would make a post about some of the pros and cons of being a wheelchair users along with some illustrious stories and bits-o-wisdom.
    RIP Bertha Unkown-2016
    Bertha fixed with 6 washers and a screw
       
        Thanks are also due to Bertha for she has taken me places that otherwise would have been out of reach, and allowed me to get one step closer to being a normal college student.
         A couple of days ago me and the boyfriend attempted to go visit the Air and Space Museum in DC. We drove and parked at the metro and metroed into DC. Someplace in the literal TWO blocks between the station and the museum, the screw that holds one of the small front wheels in disappeared. This means that the pin that goes through the wheel (essentially the axel) was not held in place. #howdoesthisevenhappen  (by the way this was Sunday....when it was snowing in March and cold as shit)  We had to call a Lyft driver, hope that they would have a car big enough to fit my chair, and get a ride to a hardware store a couple miles away (second time this has happened). Upon loading the chair, one of the spacers must have fallen out too. Thankfully the fellas at ACE Hardware in NW were happy to help us out. That being said, by the time this whole ordeal was over, the museum was closed so we headed back to VA. #wheelchairprobs

    Pros:

    1. Good parking spots
    2. Nobody looks at your butt...nobody can see your butt
    3. Your shoes stay clean and nice for way longer
    4. You can get places really fast (as long as its downhill/flat)
    5. People all of a sudden become more chivalrous 
    Cons:
    1. You're lower than everyone else
    2. You can't always reach top shelves in stores 
    3. Molehills really are mountains
    4. Sometimes even accessible places are stupidly unaccessible
    5. Clothes are not designed for the sitting figure

    Wednesday, March 16, 2016

    The EDS Bible

    Finally it's back in stock! This book is really the EDS Bible. It is written by Dr. Brad Tinkle who is largely considered one of the fathers of EDS and is very well respected in the EDS community.
    http://www.amazon.com/Hypermobility-Handbook--Management-Ehlers-Danlos-Syndrome/dp/098257715X/ref=sr_1_1?ie=UTF8&qid=1458184415&sr=8-1&keywords=joint+hypermobility+handbook
               I have been waiting for months for the book to come back in stock (no idea why) and it is finally here! I did my first breeze through it and it looks amazing. It not only details EDS, the many conditions that are comorbid (come along with), and research but also treatment plans, PT options, medication and supplement suggestions and much more! Highly recommend for EDSers and caregivers as well as medical persons who want to learn more about EDS. I will post again later once I have read more.

    Saturday, March 12, 2016

    On Memories of Easier Days

         I was looking through pictures on my computer desperately searching for this one picture I needed for a project. After a couple of minutes I found the picture and immediately quit the application, hoping I had escaped in time. A sharp pain starts in my chest. I remember climbing mountains, and going on adventures. I remember not having to plan my life around medications, doctors, and energy fluctuations. Spontaneity. Freedom.  Carefree. Worry-free solitude. I have always been some degree of sick, in some degree of pain, and had some restrictions, but nothing compared to this. I live with constant anxiety about flare-ups, falls, canceling plans, and being alone when needing help. It's exhausting. My 21st birthday is rapidly approaching and planning the celebration has been yet another reminder of limitations. Sure, you can break those limitations: eat whatever you want, do something physically demanding, or go to a new place where you are unsure of what you might encounter but theres a catch. Breaking rules and limitations with my body can sometimes leave me dealing with the aftermath for days or weeks following. It can mean anything waking up in the ER with no memory of what happened to simply being unable to get out of bed for days. So, is it worth it?
            For many people a 21st birthday includes hanging out with friends and family, and having their first (legal) alcoholic drinks. Alcohol is definitely out of the question because of the potential for serious medication interactions (RIP Julie). In my family, tradition is to have a family dinner at the restaurant of your choosing and then desert and presents afterwards at home. For me currently, eating causes pain, nausea, vomiting, and other TMI GI issues. I could go out and eat something I've missed and spend days 2-6 of year 21 dealing with the repercussions, or I could plan something not food, alcohol, or high energy centered. Some 21st eh?

    I miss not having to worry about spoons, building accessibility, supervision, and germs. Those were easier days.
       
       
          

    Monday, March 7, 2016

    An Open Letter to my Caregivers and Friends

    Dear lovely humans,
        There are a couple things I want to tell you, remind you, or just share with you. First off, thanks. I know I'm not always easy to be around, or to care for, or to love. Now you may try to make the point that no one is an you would probably be right. It is hard for me to accept help and cope with not being able to do the things I used to or should be able to do at my fruitful age of 20. Its hard to watch my peers doing things that seem so out of reach. Its hard to live in a society that values productivity when your accomplishment of the day is getting out of bed.
         So thank you. Thank you for coming up with ways to make me feel useful even when I can't get out of bed. Thank you staying home with me and watching a movie even though it seems like thats all we every do. Thank you for spending hours researching my conditions just so you can understand my world. Thank you for respecting when I want to be alone. Or when I cancel plans for the 1,000th time. Or when I go into a communication dead-zone. Thank you for sitting with me in the middle of a public place when I get a dizzy spell so I don't look stupid. Thank you for standing up, and speaking up for me when I couldn't. Thank you for spending countless hours in doctors offices, ERs, and hospitals. Thank you for being patient.
          Apologies are also called for. I'm sorry for lashing out when I've had a bad day. I'm sorry for being unpredictable. I'm sorry for the days when the illness takes over. I'm sorry I can't be your partner in crime for hikes or horror movies anymore. I'm sorry for the middle of the night panics, the scary calls from EMS saying they're taking me to the hospital but can't tell you why. I'm sorry for causing you pain when bad things happen. I'm sorry sometimes I live in my own world.
          Thank you for helping me get through the deep valleys of depression and isolation. Thank you for being there to help me celebrate my accomplishments and joys. I am constantly amazed by the unconditional love and support you guys show me (except you mom, that's in your job description).
                                    
    Thanks,
    Julie
      

    When Your Wellbeing Gets Lost in the System

              I have been very fortunate to have a some brilliant minds working to keep me alive and improve my quality of life. Two of my specialists are so good at what they do that people come from all over the world to seek out treatment from there. I merely have to get a 30 minute ride. I honestly don't know where I would be without them. That being said being a patient of these doctors who are at the top of their game and are leaders in their field has some serious downfalls.
    Here are just a few:

    1. Months if not years of wait time for a new patient appointment, if they're even accepting new patients
    2. Long periods of time in between visits after becoming an established patient
    3. They're stupid busy between conferences, surgeries, case load, and teaching
    4. They don't communicate with the rest of your team whether due to their schedule or their ego this can become a big problem
    5. I can't remember the last specialist who was knowledgable about my rare diseases who took insurance
    6. Their offices are usually administrative nightmares
    7. You usually have no one to go to (with cases like mine...rare meets complex and misunderstood) for a second opinion. You're second opinion become Google which can be dangerous.
    8. You will wind up having to try and get urgent medical care from Emergency Departments which are neither equipped to deal with your..."specialness" or too open to the concept of you knowing more than them about your conditions/ treatment needs.
            As great as it is to have some brilliant minds treating you, you wind up bearing a huge load on your own. Anyone with rare/chronic illnesses can relate to the feeling of their care getting lost in the system. I have been utterly dumbfounded by how unequipped our healthcare system is to deal with the chronically ill. According to the CDC, as of 2012 about half of the adult US population had one or more chronic illnesses. Thats roughly 120 million people. One in four Americans have two or more chronic illnesses.
          I wanted to write about this for a couple reasons, but the main reason being in response to an incident that happened a couple of weeks ago. Over the years I have slipped through the gaps in the system here and there but most of the time no major harm resulted in it, just frustration and longer waits. This time was different.
          It started like many incidents nowadays do, I had passed out in the shower and woke up in the ambulance three hours later (it was also 3am) with IVs and monitors galore and a big shrug given when I asked what happened. Upon my arrival to the ER I was fairly quickly assed by a resident and hooked up for monitoring by a nurse and left there. Anyone who has spent enough time in ERs knows that the worst thing that can happen is still being there during shift change. 0600 roles around after a couple of hours staring at the ceiling (I was in a cervical collar and left lying flat on my back) and one tech coming in to take an x-ray I realized there was no way I could fly the coup before shift change. The doctor comes in to tell me my ECG was abnormal and they're waiting on blood work results (which they never drew). He told me my new doctor's name and that he will come in when he gets here and repeat the ECG. If its abnormal again they'll admit me but if it's normal they'll send me home to follow up with my cardiologist. 0900 rolls around, no doc, no repeat ECG, no bloodwork. I call the nurse. She takes the blood seemingly pissed off that I was checking up on things trying to get answers. 1130: nurse comes in and hands me my discharge papers saying she can't find any of my four doctors to talk through them with me but they need the bed so they're discharging me. I ask about the repeat ECG. She shrugs. I get frustrated and leave.
              I call my cardiologist and he agrees to see me later that day. He does an ECG and it was once again abnormal. He reviews my medications and asks me about one that I started the week prior per orders from my GI doctor. "This medication has a blackbox warning for causing a prolonged QT interval which is very dangerous. Your doctor should have never prescribed you this. You should not have been discharged. You need to stop this medication immediately and go see an electrophysiologist."
    Note to self: need to find new GI doctor.
    Note to self: call cardiologist when before taking any new meds
    Note to self: stand up for yourself in the ER
    Note to self: you need to be on your toes, you're health and safety is your responsibility

            Several doctors appointments later and the issue was addressed with relatively few repercussions (lucky compared to what the situation could have been). I now have to get a heart monitoring chip inserted above my heart to collect data and try and figure out if there is another underlying condition.
            It scares me to say I got lucky because that means things could have gone way worse. I'm constantly worried for the day that I won't get as lucky. When will it be? Will I be alone? Will I get to the ER but have it be dismissed?





    Thursday, March 3, 2016

    Backstory

         Hello! My name is Julie. I am, in many ways, your typical  21 year-old college student. I am a junior at George Mason University. I love traveling, languages (learning my 8th now), movies, photography, nature, fixing things, and art. I live in the dorm on campus during the week and on the weekends I stay with my mom and work. During the school year I work part time as a support staff person for kids with special needs in camps and classes. My hope is to become an Occupational Therapist. I love it because it combines the problem solving and MacGyver-esque fixing with helping people and medicine. I also have been volunteering at a local free clinic doing medical interpretation as well as some administrative tasks for almost 8 years now.
    I have an older brother who is now 23 and was my partner in crime throughout childhood. My mom and I are pretty close, we both like similar music, playing card and board games (when I let her win ;) ), and watching movies. As kids, my parents took us on several international trips, but as we got older the traveling radius got smaller and smaller. That is until I caught the travel bug again in 2011. I convinced my mom to go back to Ghana with me. It was the first of many a life changing trips. Now we are all probably familiar with the new fad of “voluntourism”, and going to developing countries to “make a difference”. Well I was young and naïve and I thought I could change the world in the month I was there. Needless to say, I learned an incredibly important lesson about expectations and going with the flow. I think this has helped me in dealing with my illnesses. 

    The next year I received a State Department Scholarship to study Arabic is Muscat, Oman for the summer. First off, I learned that having a severe food allergy to onions in a country whose cuisine is a combo of Middle Eastern and Indian is complicated. 
    The first day of the program in-country I met with the Indian cook for the program, told him about all my allergies and how important it was that I don’t consume anything with ingredients I’m allergic to. The cook responds flabbergasted, “but ma’am, with no onions…no flavor”.  Needless to say having an anaphylactic reaction in the middle of the desert is nerve racking. After graduating high school in 2013, I made my way to Peru to volunteer in a clinic for one last hurrah before college. 

    At the top of Mt. Machu Picchu 
     So that’s the typical young adult part… but who wants to be typical anymore?

     I spent my freshman year studying Nursing at the University of Alabama Birmingham (UAB). Due to my work at the clinic and my good grades I was pre-accepted into the School of Nursing, just as my grandma had done there many years before me. I loved college, I loved my nursing classes, I loved my independence, and I loved the possibilities of what my life could be. Two weeks into school I woke up at 3:00 am in the ER. I didn’t remember getting there, what I was doing before, or going to sleep. I frantically pressed the call button until the nurse came in and explained to me that I had a seizure and have epilepsy. She paged the doctor and he came in, explained that they were going to start me on anti-seizure medication and have me follow up with a neurologist. Epilepsy. The nurse came back with my discharge papers. I laid there frozen for a few minutes till things caught up. I panicked. I remember calling my mom, my aunt, and my friends desperate for someone to pick up the phone in the middle of the night and tell me it was going to be okay. Finally, my uncle, a doctor in Oregon, picked up. He calmed me down and told me to hand the phone to my nurse or doctor. He talked with them and helped me make a plan. I had no idea that this was just the beginning. It was just like that moment in Ghana where I realized things were changing and there was only so much I could do.
                The rest of my freshman year was a battery of tests, hospitalizations, therapy sessions, and doctors visits. They ruled out epilepsy eventually with continuous EEG monitoring and passed me off to a psychiatrist who passed me back to the neurologist who eventually passed me back to the psychiatrist. You get the picture. By the end of the year I felt like I was 89 years old, not 19. After my freshman year ended I had to make one of the toughest choices of the year: drop-out of UAB, leave my friends and nursing school slot and move back to Virginia with my mom for treatment, or to continue trying to balance school (somehow managed a 4.0 my freshman year despite my health continuing to decline) and treatments with no support system within 500 miles. I chose moving back. I enrolled for online classes at my local community college and started making calls to specialists and doing my research. At that point, I was still having seizure like episodes, syncope, digestive issues, more frequent joint dislocations, severe migraines, breathing problems and severe allergies. Nobody could figure me out. 
    I had one friend in the area, very little interaction with the outside world, and lots and lots of interaction with the medical world who gave me diagnoses of things like Munchausens, Conversion Disorder, “Just Anxiety”, Attention Seeking, “Abdominal Pain”, etc. I grew more and more frustrated and sick. Finally, a friend from high school mentioned Ehlers-Danlos Syndrome (EDS) and Dysautonmia/POTS (Postural Orthostatic Tachycardia Syndrome). She had been diagnosed in middle school. Having no idea what she was talking about I started googling the conditions. Things started to make sense. I was a pretty sporty kid, but spent most of the time on the bench due to injuries. A normal scrape for most people took months to heal and always scarred for me. Sitting still caused pain. Standing up made my head spin and I frequently passed out. Eating made my stomach hurt. Even after 2 years of braces and a permanent retainer on my teeth they still shifted right back to where they wanted to be. A shoulder injury in middle school put me in PT for two years with little improvement. Wait…normal people don’t have joints that pop in and out easily? I printed out the information on EDS and POTS and made an appointment with my primary care. I finally felt like I knew what was going on. I wasn’t making this up. This is real. My primary care breezed through the information sheets, looked up at me and told me, “you don’t have EDS, we would have seen it by now”. Seen it… an invisible illness… she didn’t see it. It felt like a dagger in my chest, but I didn’t give up. I made an appointment with the cardiologist my friend sees who is one of those world-renowned types who appears on talk shows and has people who traverse national boundaries to see him.  

    Three months later after even more tests, he looks at me and says, “you definitely have POTS and EDS and a complicated case of it. I also think you have Mast Cell Activation Disorder and Cranio-cervical Instability (CCI). EDS and POTS have no cure but we will do our best to help you manage your symptoms.” I felt relieved and somewhat happy. Someone finally believed me. Ehlers- Danlos Syndrome is a group of connective tissue disorders in which the body produces weak and faulty collagen which is the “glue” that holds your body together. All of my joints dislocate very easily. I am extremely hypermobile. I bleed, bruise, and scar very easily. Additionally, my veins and organs are prone to rupture. I am in constant, severe pain. Since collagen is everywhere in your body, it effects so all body systems. POTS, MCAD, CCI, Gastroparesis, Arnold-Chiari Malformation, Migraines, Depression, and Anxiety (all of which I have) are just a few of common comorbid conditions that piggyback off EDS. POTS is a condition that affects my autonomic nervous system which controls heart rate and blood pressure. Normally, when a person stands, gravity pulls blood to the lower extremities. The nervous system senses this and sends a message to the blood vessels to constrict, sending more blood back to the heart and head. With POTS, this message to constrict does not get sent. Therefore, instead of the heart rate increasing by a normal 10 to 15 bpm upon standing, it can increase by more than 30 and can even double. By affecting circulation, it also affects cerebral blood flow. Symptoms include orthostatic intolerance (dizziness), chest pain, headaches, GI cramps, inability to focus and concentrate for long periods of time, inability to read due to blurred vision, difficulty with recall, extreme fatigue, nausea, gastroparesis (paralyzed stomach), tremulousness, insomnia, loss of consciousness due to loud noises/ flashing lights and much more. It can also present with seizure like episodes from extreme adrenaline rushes and hypoxia. At last, the real answer behind my non-epileptic seizures. MCAD causes hyperactive mast cells which release histamine bursts causing reactions such as hives, flushing, difficulty breathing, and anaphylaxis. I can react to just about anything (even heat and cold), and what I react to can change. I was newly diagnosed with Long QT Syndrome which can cause heart arrhythmias, syncope, and seizures. I have an implanted cardiac monitor that continuously monitors my heart for 3 years.

    Fall of 2015, I started school at GMU and have enjoyed it. It allows me to have a part-time college experience close to home, and close to my medical team. I use a manual wheelchair with a portable power assist wheel to get around. I work 3-4 hours each weekend and in my free time I go to doctor’s appointments, color (when my fingers don’t dislocate too much), watch movies, go for rolls if the weather is nice, and hang out with my friends. On a good day, I can tackle the world. On bad days I need help with mundane tasks and can’t get out of bed. Did I mention my conditions fluctuate? Living with several rare diseases is like having Latin be your first and primary language. The language you operate in, think in, dream in. Now you know English too, but at times English seems so foreign. Naturally, those who understand you best as you would be those who also have Latin as their first language. They understand your struggles in trying to communicate your experiences to others, they understand that you're basically operating on a dead language. If you want to talk to the pope, you're set. Rare diseases and chronic illness can be isolating and overwhelming. They influence my life and can control it, but I refuse to let them define it. After all, I am a professional patient.