Milo’s Law: If It Can Go Wrong, It Will Go Wrong.

When I wake up in the morning, I usually spend a while in bed “gathering my strength”. I cuddle with my dogs and check emails on my phone or just lie there, coming into consciousness. It seems to change the way my day unfolds if I take the time to do this. I also try to have a long, slow morning before appointments: have my tea, my supplements, sit in front of my light box, have breakfast, gear up for a shower… This is all to emphasise yesterday’s difficulty of getting up at 8am and leaving the house at 9am to be at an appointment by 9:40am. I am a different person now that I have ME and, just as I couldn’t crash on somebody’s couch overnight or sit in a car for a road trip, I can’t get up and leave the house in an hour without great difficulty. That sort of morning rush takes a giant toll on my body.

But I had to yesterday. I felt okay getting out of bed and taking a shower and then, after being upright for about 20 minutes, I hit a wall. My heart rate was over 115 bpm and wouldn’t calm down. I was shaking so much, I checked my blood sugar to make sure it hadn’t dropped too low. I sat down for a half hour before getting dressed and my whole body sweat the entire time.

We were going to stop and get my prescriptions on the way to my appointment with my GP since we had left 40 minutes for a 20 minute drive, but we heard on the radio that there had been an accident on the highway and it was wreaking havoc, so we decided to head straight for the clinic. We took the back roads ~ avoided the highway ~ and apparently the rest of the city did, too. Nothing was moving. I called the clinic at 9:30am and told them I might be a little late. I called again at 9:50am and told them we were still sitting in the same spot on the road and now I was already 10 minutes late. They told me to come in anyway ~ everyone was running behind because of the traffic. I called my physical therapist, with whom I had an appointment after my GP at 11am, and asked him if he happened to have any open slots later in the day. He made some phone calls, then called me back and said his 1pm patient will swap with me. Wow, who goes to that sort of trouble? Brilliant.

We got to the clinic finally at 10:10am ~ the 20 minute drive took an hour and 10 minutes ~ and my doctor wouldn’t see me. I was too late. I said, “I can stay here and wait until noon if there is a chance she can fit me in… Isn’t everyone else late, too? … My husband took the day off work… it’s really difficult for me to get here…” I wanted to have a meltdown, but I was too tired. The answer was no; I’d have to reschedule. I even asked, “Does she know it’s me?” as if I’m some spoiled rock star (“Do you know who I AM??”), but I thought she would understand what is involved to get me here and find a way to make it happen. But maybe she doesn’t know how difficult getting to the appointment is… Like I said, I haven’t seen her in 6.5 months and I’ve changed.

It was never clearer just how much I’ve changed than when I was walking back to the car in the disabled lot (ie: not far). The parking lot is on an incline. I’ve been going to this clinic for years and I could have NEVER told you this lot was not flat as a pancake because it never registered before. Because it never needed to. Yesterday, the tarmac reared up in front of me like some CGI ground wave in a movie about an earthquake. My vision tunneled ~ honestly, it was like a Hitchcock camera trick ~ all I saw was black parking lot climbing straight upwards in front of me. I had to stop constantly as I walked to the car. It blew me away. I never could have told you there was any slope there. My muscles, my heart, my lungs… they simply don’t work anymore.

To complicate things further, I called my PT back and said, “Actually, I canmake my 11am appointment now, but your other patient is probably already on his way, but if it’s any hardship at all for him, I can swap back, but no need to call me back, I’ll just come at 1pm…” Mutter mutter… Bashful, embarrassed, crawl-into-a-hole voice…

So my husband and I went home again and I lay perfectly still with my eyes closed, deep breathing my frustration away until 12:40pm when it was time to leave again. I rescheduled the appointment for tomorrow week (for all my American readers, that means a week from tomorrow. I really miss being able to use that shorthand (shortspeak?): “Friday week” is so much less cumbersome than “a week from Friday”).

I also spent another two hours on the phone with my insurance company. Being ill is a full-time job.

Gratitude for the day: Thank you to the FIVE people who texted and messaged to wish me luck at the appointment-that-never-happened. You write a post about an upcoming follow up with your GP, not knowing who will read it, and then, suddenly, a friend that you haven’t seen in a year and a friend in a different country and a parent and a sibling and an online CFS blog buddy all send you notes to say good luck and/or how’d it go? You know who you are: THANK YOU. Every day, every time, it helps.

Heart Center.

I have an appointment with my GP tomorrow. It’s at 9:30am, which is about 2 hours earlier than I usually schedule appointments so that I am a functioning human being. I don’t even know if it’s worth it to see her. I basically made the appointment because I haven’t seen her in 6.5 months. I am a different person now. Last time I saw her, I still didn’t quite understand how the medical system works. I still sort of thought that doctors would search and help and communicate and dig until they figured out what was wrong with a patient. I still didn’t realise how specialists operate. Even after the first infectious disease doctor said, “You don’t have an active infection” and then, in no uncertain terms, gave me a permanent goodbye. Even after the second infectious disease doctor said, “You have chronic fatigue syndrome and, from here on out, you should work on treating the symptoms.” In other words, See ya! Even when the chronic fatigue expert spent ten minutes with me after I waited 8 months for an appointment and sent me on my way with directions to exercise read a book about pain, and try Cymbalta. It wasn’t until my second visit to the rheumatologist, that it finally clicked. He had treated me so well at my first appointment. I will never forget he said, “There is something wrong with you. It is not your job to figure it out, it’s ours.” It felt validating and I almost wept. Someone would finally take the burden of this search off my shoulders and figure out why I felt like I’m dying… But that’s not the way it works. When I went to see him again a year later, the first thing he said was, “Why are you here? Chronic fatigue syndrome is an infectious disease.” Ah. Click. Finally I see. Dr. House is only on a tv show, stupid! Specialists spend 15 minutes max listening to your story, run the standard tests, and you’re done. If the tests are negative, you will never hear from them again. And, even if the tests are positive ~ like the time they found two toxic goiters on my thyroid and had to kill the whole lot with radioiodine and I had to figure out from a pamphlet and a bunch of inquiries that were shuffled from one person to another how to get my synthetic hormones and whether I should have follow-up visits with someone ~ sometimes you won’t hear from them then, either.

I had a yearly check-up with my GP 9 days before I was hit by ME. I distinctly remember saying to her that day, “My biggest problem is my neck” ~ meaning the degenerative disc problems in my cervical spine that have plagued me since my early 30s. We talked a lot about my job. I was having difficulty sitting at a desk all day after years of being on my feet. She thought, because of the stress involved, that it might not be the job for me. I remember her saying exactly that: “Are you sure this is the right job for you?” I shrugged and thought, Maybe not. But I still love it. In some ways, I think that sentiment has coloured the treatment I received once I came down with ME. I think a lot of us (my doctor, my boss, my family, and I) thought my problem was caused by job-related stress and lack of sleep.

That is another way I am a different person now than when I saw her 6+ months ago. Now, my awareness of my body and physical sensations are extremely fine-tuned. It is laughable to me (and tragically sad) that, in my confusion during that first year, I was almost persuaded that my sickness could have been caused by 1) bowel problems, 2) vasovagal reactions, 3) stress and anxiety, 4) my pain killers, 5) my birth control pills. When you are scared and in foreign territory, you want to latch on to ANY explanation that is said in a rational way from an expert authority. I suddenly understand how false confessions are coerced out of murder suspects. Maybe you’re right, Dr. E, maybe it’s just IBS. Phew! Even though I had had my share of health problems in my life, I was completely naive about how this medical journey would unfold itself. It is tragically sad and not so laughable that I didn’t trust myself 100%. I was SO SICK. My bowels? Stress? No, not this. Sleeping normally, then swimming in sweat. Running a little cold, then incapacitated by bone-wracking chills. Steady, then dizzy. Confident, then fearful. Strong, then shaky, then weak. Memory like a steel trap, then uncertainty about all details. Aches in my neck, then deep body-wide pain. Occasional headache, then 24-hours-a-day migraine for months. Able to bound up and down stairs, then legs not working. Energy, then none. Working, then housebound. Well… then sick. Don’t doubt yourselves, ever.

So, why am I even going back to my GP? I want to talk about my application for disability. She has known me for years and she should know that, even though I mostly saw her when I had chest infections, I have always been an upbeat, energetic person and ME caused an abrupt and permanent change. I must stay unemotional. The day last year that a few tears dropped in her office sealed my fate as someone that needed therapy and an antidepressant. My chart note says “Stress reaction, emotional.” I did what she said and started seeing a therapist, but 15 months of weekly visits later and nothing has changed. Nothing except I’ve spent 50 minutes each week crying about how I don’t know how to accept this new life and I don’t know how to stay hopeful and calm when my symptoms flare. Which is always.

I’ve cried more in the last year than I have in the 39 years before. I get overwhelmed sometimes with the surety that my husband will reach a breaking point and leave me. Or that I will somehow have to find the strength to leave him so he can have a life and I can be freed from the unrelenting guilt that I carry. The other night, my husband said, “I’m not going anywhere. I love you deeply.” I sobbed: “But you didn’t fall in love with this.” I spat out the word “this”. I said it with a grimace of distaste, as if I were talking about a maggot-infested, rabid rat that was sitting on my chest. And I actually flinched at the knowledge that the revulsion was about myself. I try to stop my brain from doing this. I try to remind myself that I still have value, even sick. But it’s hard now that I have very little interaction with the outside world. I can tell myself a thousand times that I am not the disease and my self is not sick ~ my core is still the same ~ but I don’t really believe it. I sure feel sick at the core. Or, at least, that there are many, many layers of sick surrounding that central self, which is still the me I know and love. But, if those layers rule the body, who really cares what’s in the center? If it can’t express itself or figure out a way to thrive, what’s the point? How do I enrich the world when I rarely laugh, can’t talk for more than an hour each day, have nothing interesting to say…? And how oh how do I find joy in my own life when everything I enjoy takes energy that I simply don’t have? I have to find joyful activities that can be done lying down with my eyes closed, day after day?

Anyway, my husband pointed to my heart and said, “I fell in love with what’s in there and that hasn’t changed.”

I thought, Yeah, it has. But, I admit, I felt another renewed resolve to fight. If not for myself, then for my husband and the person with whom he fell in love.

sarah and dave 5

ME/CFS Alert videos ~ I think you should watch them!

Friends and Family, I watched the following ME/CFS Alert videos today and I highly recommend them for anyone who is interested in learning or understanding more about this disease. They are only about 10 minutes long.

The first video is an interview with Dr. Staci Stevens, exercise physiologist at the Workwell Foundation (formerly the Pacific Fatigue Lab). She explains post-exertional malaise ~ in my opinion, the number one most debilitating and cruel symptom of this disease ~ from a clinician’s point of view. Here is an article by Cort Johnson about Dr. Stevens’s protocol, which uses empirical testing to establish the (very low) anaerobic thresholds of ME patients. Cort says, “So emerged the ‘Stevens Protocol’ – the  only test that actually documents post-exertional  fatigue, and documents it so well that failing the test is virtually a slam-dunk for a disability evaluation.”

This interview with Dr. Kenny de Merlier, an ME/CFS expert from Belgium, is very interesting (it is listed as Episode 42, but when the video actually starts playing, it says Episode 41, fyi). Dr. de Merlier believes that in every case of ME, an infectious disease triggers an autoimmune response. I, for one, have great faith in his knowledge and the work he does. Again, I encourage everyone to watch this interview (and Episode 43, which is also with Dr. de Merlier) to get a better understanding of this baffling illness from a clinician’s viewpoint.

Here is an interview with Dr. Dan Peterson, one of the world’s foremost experts in ME/CFS. Dr. Peterson has been seeing patients for 25 years and now heads Simmeron Research in Incline Village, Nevada. The depressing reality here is he says, in his 25-year career, he has never seen a full and total recovery, he doubts he will ever see a cure, and getting governmental monetary funding or political support for Ampligen research/treatment has been “an exercise in futility” (also, he says many of his patients have developed lymphoma, which in itself is scary).

While you’re at it, you might as well watch this video interview with a patient of Dr. Peterson. She has been sick for 25 years and is now on Ampligen.

Thanks for taking the time to educate yourselves.

General Update

I feel like it has been a while since I gave a proper update. This may be a bit disjointed as I hit the important points from the past few months.

  • 19 months sick. 1 year unemployed. 9 months on elimination diet. 8 months housebound.
  • The week before Easter, I had the best 4 days since becoming housebound. Starting April 1st, I went downhill and got no respite from the crash for over a month. Each day, I hoped for a new beginning. Each day felt as bad or worse than the day before. I was spending days in bed and, very quickly, my mood tanked. It is very hard to see the light at the end of the tunnel when you get no relief day after day. I am usually quite good at articulating what I’m feeling ~ what is worse, what would help ~ but, there was a point in late April, where I was lying alone in my room and all I could think was. “Help me.” I didn’t know who to call or what I would say. I didn’t know if I could speak ~ I had been crying for days and was at a point of hopelessness that made me mute. I managed to text E. who gave me a little pep talk and made me feel less alone. That’s all anyone can do. Things started to ease up the second week of May. I’m not back to my normal crappy baseline yet (no walking around the garden, no stretches), but my body feels a bit better and my brain feels like I’m a different person: As usual, as soon as I get some space from the symptoms, I bounce right back to someone who can talk and laugh and see a future.
  • Which brings me to what caused that crash: I think I got so much worse because I stopped wearing the cpap. I really didn’t believe it was doing anything except annoying me. The mask was waking me at night, the necessity of washing all the cpap parts was exhausting, the tape over my mouth wasn’t doing my skin any favours… But, it finally dawned on me that I got worse about a week after I stopped using it. And then I started to feel better exactly one week after I started using it again. So, I’m a believer. I may be aware of the cpap mask waking me, but I am not aware of the apnea awakenings and those are the ones that are really affecting my health.
  • Which brings me to my sleep: I am still having a rough time. I intend on writing a post detailing all the information and tips I have gleaned from various sources on how to improve sleep without prescription drugs, so stay tuned for that. For now, suffice it to say I have tried EVERYTHING. As I have mentioned before, I am addicted to reading the New York Times on my phone in bed before I go to sleep ~ but I wear amber-lensed, blue light-blocking glasses after the sun goes down so I am supposedly protected from the way the screen affects my brain. Well, my birthday night, instead of reading the NY Times, I spent far too long looking at Facebook and answering all the wonderful happy birthday posts. I forgot to wear my amber glasses and wound up staying awake until 6am, tossing and turning.
Zeo graph: These lines should be SHORT when I'm sleeping. The "W" at the top means "Wake".

Zeo graph: These lines should be SHORT when I’m sleeping. The “W” at the top means “Wake”.

This is very unusual for me ~ I always fall asleep right away, it’s the waking up throughout the night that is my problem. So, for the last two nights, I made a strict rule of no phone or computer screen of any kind after 8pm and no tv after 9:30pm. My sleep was instantly better. Look at last night:

Proper sleep waves.

Proper sleep waves.

So, like the cpap, I believe I really underestimated what the phone or ipad light does to my brain. The room is black, but when I close my eyes I see lights, colours, moving lines, exploding stars. Basically, if I open my eyes it is darker than if I close my eyes. Someone on Phoenix Rising surmised that I was experiencing hypnagogia, stuck between wake and sleep. Either that or staring at my phone really, REALLY messes with my brain.

  • Which brings me to the supplements I am currently taking for sleep (and all the others, too, plus prescriptions). Here is my daily regimen:

2x Probiotic
2x tsp fiber
100mg Colace
Chinese Herbs (Lightning Pearls, currently 3/day)

2,000mg Acetyl L carnitine (1,000mg 2/day)
1,200mg Alpha Lipoic Acid (400mg 3/day)
4,000mg Borage Oil (960mg GLA) (2,000mg 2/day)
10,000iu Vitamin A
4,000iu Vitamin D3
2,000mg Fish oil (1,000mg EPA, 50mg DHA)
Vitamin B-complex (Thorne #12)
100mg CoQ10
400mg Magnesium glycinate
200mcg Selenium
400mg Riboflavin/B2
5,000mcg Biotin
15mg Zinc sometimes
500mg Vitamin C sometimes

Valerian sometimes
1mg Melatonin
100mg Phosphatidylserine
Tart cherry juice concentrate

5ml Zyrtec
Thyroid hormones
(T3 and T4)
Pantanase nasal spray
Clindamycin topical lotion
Miralax as needed
Albuterol inhaler as needed

  • The magnesium (for muscles), melatonin (for sleep onset), valerian (for relaxation), tart cherry juice (for pain and melatonin) and phosphatidylserine (to decrease nighttime cortisol) are specifically for sleep (I tried the Seriphos ~which is phosphorylated serine~ for a few weeks, but it seemed to keep me awake. The Good Doctor switched me to the new one). The other new additions to my protocol are biotin (the dermatologist told me to take this for the vertical ridges in my fingernails and hair loss) and the Chinese herbs. I stopped these for a week while I was feeling really terrible and thought I might be getting a cold, but it never materalised, so I started them again, increasing the dose much more slowly than I had originally.
  • My diet is still the same (no gluten, grains, dairy, legumes, tomatoes, potatoes, or eggs), but I think I am going to add rice any day now… I’ve just been waiting until I have a more predictable day-to-day baseline so I don’t blame crippling muscle pain (which happened on the 17th for one day only from head to toe for no apparent reason) or the disappearance of sleep or an extreme headache on a rice cake.

I want to write about my recent doctor visits and some of the amazing presents I got for my birthday, but not today. Just know that I am flying high with all the love and generosity that was showered on me. I keep saying it, but one more time: I am one lucky lady. I have the most compassionate and caring family and friends imaginable. I thought I always knew that, but I am truly humbled today. NOTHING matters but loved ones! In the end, they’re all we have.

Happy Birthday To Me!

Today, I turn 40 years of age. We have a big day planned. We’re going to the beach with the dogs. We’re going to throw the ball and walk in the sand and let them chase birds. They haven’t been to the beach since last summer when E. was visiting and I still had some energy.

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I’m not going to go to bed afterward. Instead, I’m going to stop by the grocery store and buy all the fixin’s for a fry tomorrow morning: eggs, bacon, sausages, bread, tomato, proper cow’s milk for proper tea… I might even look for decent baked beans and black pudding. Then, this evening, I am going to take a shower, wash my hair and put on make up for the first time in 9 months (gasp!). I am going to put on a dress ~ it is beautiful and still fits me and I feel sexy ~ and some very high heels ~ I’m able to walk in them properly, without shuffling, and they don’t hurt my back. We’re going into town for dinner, meeting up with friends and family. It’s going to be a long 5-course indulgence and I’m going to ignore all my diet rules. I am going to rip apart fresh-baked bread, taking the time to inhale its aroma before slathering on creamy butter and savouring every bite. I am going to close my eyes every time I take a bite of pasta ~ I don’t care what kind it is ~ and be fully present in that moment, witnessing every chew with all my senses on full-alert. I am going to order the most decadent dessert, something with pastry and chocolate ~ eggs, sugar, flour, butter ~ and revel in every single mouthful: no guilt, no worry, no blood sugar issues, no inflammation issues, no intolerances or allergies or leaky gut or bowel dysbiosis or nausea. There better be a cheese plate involved at some stage and I might even have some wine. Dry red wine. A whole bottle. Maybe I’ll sneak outside to share a cigarette with someone. We’re all going to talk over each other and laugh hysterically and the noise won’t bother me. I won’t be confused and overloaded by too many conversations at once. I won’t think about pain or exhaustion or how I will sleep tonight or how I will feel tomorrow. Because I will feel fine. I will feel tired and happy and full and grateful. Oh, and tomorrow morning, while eating that lovely breakfast, I will realise I’ve won the $600 million lotto.

Well, a girl can dream, right?

No, unfortunately, today will be like every other day. It’ll be a little bit worse than the norm because my sleep vanished this week and I’m crippled with new muscle pain on top of the old stiff exhaustion. But, it’ll be a little bit better than the norm because my sister is coming over and my husband isn’t working. Three people and three dogs? It’ll be a carnival compared to my usual still, silent days.

Goodbye 30s, you actually were literally the best of times and the worst of times. I have three birthday wishes for this new decade: Continued good health for those I love, better health for me and relief from suffering for all people and animals on this earth. That’s not too much to ask, is it? 🙂

sarah in incubator 001

May 18th, 1973