“39 year old woman, looks like shit and in apparent hell.”

Today I read a post on a CFS forum titled “disappointed reaction from sister-in-law” which had me fired up in a way that is a rarity since I left my job. This woman had told her family she would not be able to attend a baptism on December 23rd and also be able to come over on Christmas Day to participate in all the festivities. Her sister-in-law asked, “Why? Are you sick?” and then, seemingly fed up with the CFS/ME/FM “excuse”, the sister-in-law decided to educate her on what the disease is and why she should be able to attend family functions. Why? Are you sick? My pulse is racing just typing that. It is utterly reprehensible that this disease is called chronic fatigue syndrome and that it is characterized by “post-exertional malaise” and that all medical tests are relatively normal and that we don’t look as sick as we are. It’s such an unbearable injustice to add this insult to injury.

It’s not just friends and family. I have given up talking to doctors after I realise they have zeroed in on my type-A personality or obsessive tendencies or the sleep problems I’ve had my whole life or the fear of getting sicker. It happens every time. I had a visit with a new sleep doctor today and I talked about my night sweats and then about how I’ve always been a light sleeper. I joked (kinda) that, even in sleep, I wanted to be sure I heard an intruder. Her next questions were about sexual abuse and anxiety and I realised I’d said too much. As a patient, you can’t really be 100% honest – because they’re DOCTORS, their job is to see what you don’t. However, I think the majority of the time patients are pretty self-aware. I had to steer her back. No, no, no, these night sweats aren’t from anxiety – they’re from death taking over my insides so all the fluid in my body is squeezed out of my pores over the course of eight hours. You can’t imagine how much fluid there is in a body. And my sleep problems now can’t be equated to my lifelong insomnia and lack of deep sleep – this year, I am tortured, thrashing, contorting in pain, in muscle spasms, constantly waking, never peaceful. Luckily, in the last three or four moths, I’ve gotten a handle on the sickly night sweats – by realising they were caused by over-exertion and took everything down to the “housebound” notch. But, my point was, I realised there wasn’t much point in recounting my story to this new doctor. She wouldn’t be able to shed any new light and, in fact, it was the opposite: it was a long appointment, it was difficult to tell her everything from the beginning, it was disheartening that she didn’t really say anything about my sleep – which is why I was there – and, in the end, she said she was leaving the practice at the end of the week. Wow. More wasted time, wasted energy, wasted money. But I had to go for insurance to cover my cpap machine. That’s the deal. That’s the racket.

I got off track: Why? Are you sick?

I used to say that I thought everyone in the world should work one week in a restaurant. That it should be mandatory in high school or college for each student to put in a minimum of 50 hours, rotating positions so that you have some concept of what it is all about. I usually would declare this after some moron degraded me or tried to pinch my ass or ordered something without looking at me, without saying please or thank you. And I mean ordered it – as in, gave me an order. I was an actor, so I’d smile through it. But really what I was thinking in my head was, you won’t get to me because I’m smarter than you, I make more money than you and I guarantee I’m happier than you. It worked for a long time. Until, one day, there was no amount of money that would have made me give one more performance.

Fast forward ten years and now I think everyone should spend one week in my house. Or the house of anyone with M.E. Actually, I wish we could all spend a week in a thousand different homes in a hundred different countries, expanding our understanding, knowledge and compassion…. But, this is what I know right now: this house, this disease. I wish the doctors and the friends and the employers and that lady’s sister-in-law could all live with this for a week. And I don’t even mean live with M.E. – I just mean live in the house with the person with M.E.

Let me narrate to you how I feel in the morning, the inventory I take of my body, the pain in my bones as I get up and dress. Let me talk to you about my food choices – what will cause me the least distress, what will help the nausea, what will be the least likely to aggravate the IBS, what I can make (or ask my husband to make) with no grains, dairy, gluten, legumes, or eggs. I will show you how I decide whether I have the energy to shower (involves standing up) or do laundry (involves going downstairs and leaning over) or empty the dish washer (reaching down and reaching up multiple times) or walk in the yard (involves boots, coat, cold, taking steps). I will tell you all day, every day how badly my head hurts and how much my hands ache and how broken my back is. You’ll be able to watch me grimace every time a dog barks and close my eyes when I walk into a room that doesn’t have a dimmer switch and massage my neck endlessly, have trouble getting out of my chair, walk like I’m crippled, cover my ears when the ads come on the tv, begging you to mute it. I can explain how every day I weigh the pros and cons of medications: Will this take care of the pain or give me vicious bounce-back headaches? Is it worth taking so much of this knowing the liver problems it can cause? Will I be able to tolerate the nausea, dizziness and insomnia of this long enough to let the good kick in? Will this help me sleep but not give me a hangover? Will this help my muscles enough that it justifies the bowel intolerance? Is this helping enough to justify the $60 price tag? Is this worth trying even though it suppresses my immune system? You’ll see how carefully I go to different areas of the house, how every trip is calculated: never, ever go from one room to another without taking something that needs to go there, too. No wasted movements. You’ll see how I plan phone calls on my calendar: no more than one a day and none on the days that I have doctor appointments. No wasted energy. And you’ll see how often I have to lie down in the dark and how early I go to bed and how quiet I’ve become. It’s very understandable why doctors would think I am depressed – my hair isn’t brushed, make up doesn’t exist in my life anymore, I have no energy for chipperness and no need to form connections by chit chatting. No wasted words.

Worse than doctors seeing the wrong thing, though, is doctors not seeing anything. I read my records from an appointment earlier this year – in the very sick, dark days – the notes said, “39 year old woman, well groomed and in no apparent distress.” All the fight just drained down my body, out of my feet and into the earth. I felt defeated and limp. I get it, this is how they describe their patients… certain terminology is used… But, if I wasn’t in apparent distress, then… Well, then, he needs to come live with me for a week. Maybe I’ll make him dinner and then we’ll walk around the block and have a lengthy, animated discussion …and then he can watch what happens the next day. He’ll be able to see how I curl up in a ball weeping from pain, unable to speak, unable to move, unable to eat. And maybe he’ll think, Distress is too small of a word. In fact, malaise doesn’t really cut it – and neither does fatigue. How about chronic persecution syndrome? How about post-exertional perdition?

Are we sick? Yes. We’d rather not have to plan every hour and foresee every hurdle. We’d rather not isolate ourselves and lose contact with those we love. We’d rather be at every baptism and birthday and Christmas celebration and dinner date. In fact, given the chance, I’d guess that people with ME/CFS as a whole, would be the life of every party. We’d be the ones dancing, singing, eating and drinking until the wee hours of the morning. Wasting as much energy and as many movements and words as possible. 39 year old woman, dressed to kill and apparently having a ball.

…and I will hug him and pet him and squeeze him…

I don’t think I have the energy to write much because I have big plans today like making a few phone calls and washing my cpap. I’m also determined to do my stretches today, which I haven’t been able to do for ages. I had 19 very bad days. The worst day of all was two days ago. My brother, a pilot, was in town overnight and I wasn’t able to see him. I haven’t seen him since August, 2011 ~ two months before I got sick. I kept thinking, I manage to get to a doctor appointment and talk for 45 minutes, but I’m not able to meet my brother for breakfast? But he has another layover here in two weeks, so I get a second chance.

Then, right after that horrible day, miraculously, yesterday I felt better. Not great, but better. I wish I could adequately describe the difference between a bad-but-not-horrible day and a good-but-not-great day. They are worlds apart. Instead of getting out of a chair like a crippled, arthritic 90 year old, I get up like a typical 39 year old who is in pain. Instead of walking up the stairs to the bathroom delicately, with difficulty, concentrating on each baby step and clutching at the walls, I walk up slowly, heavily, but without much thought. Instead of watching tv as still as a statue, unable to smile, needing to block my ears at loud noises, but having a hard time holding my hands up to my head, I can laugh and operate the remote control. Instead of unhappily eating an apple or drinking an Ensure to pad my stomach for the pills I have to take, I am hungry and look forward to eating a (really boring) meal.

I looked in the mirror yesterday and there was pink in my cheeks, but not in a feverish way. I had been ashen for weeks ~ grey skin, dull yellow eyes ~ and overnight it looked like I had taken a walk outside. It feels like the Monster, who has been crushing you in both hands for weeks on end, had to scratch his nose or something and, with one of his hands not pressing in on you, you are suddenly able to take a breath… to have a conversation without sweating and shaking… you are able to pet your dogs and hug your husband and make granola. And the whole time you are thinking, thank you thank you thank you. That is when I can see a tiny seed of hope. I have to remember in the despairing, dark days of pain, that there will be another day in the future when the Monster has to let go to answer the phone or smoke a cigarette or whatever… and you will be able to move a little easier.

monster

I saw the Good Doctor on Monday and she is adamant that I stay away from dairy, gluten and grains still. I am also back on all the same supplements as before, plus berberine to combat yeast and magnesium to help pain and sleep (note to those that may not know: magnesium glycinate is the form that should not mess with your bowels. Other forms can help you poop or cause diarrhea, depending on how much you take). I’m thrilled. After months of stagnation, I have forward momentum. I told her, “I don’t care what we do, but I have to do something. If you don’t want me back on the supplements yet, I’m going to start the Chinese herbs.” After much research online into ME/CFS experts’ protocols, I was bolstered to see many of the same supplements that the Good Doc has me on (CoQ10, fish oil, acetyl-L-carntine etc.). I started them again on Monday and I wonder if they contributed to the uptick on Thursday. Placebo effect doesn’t really work with this disease in me, as much as I wish it would. It might make me feel a little lighter or more hopeful, but the placebo effect cannot cause the difference between practically bedbound and able to walk and talk. It’s more likely the fact that I slept fairly well Wednesday night ~ 8.5 hours. My plan is to start Cymbalta on Monday or whenever the initial nausea from the supplements wears off… so I can deal with the initial nausea of the Cymbalta. Joy.

Here’s my daily regimen:

 daily pills

An Update on my day-to-day…

Here is an update for those of you that have tried to contact me. I’m okay. Not great, but okay. After the Worst Headache, I had an up-swing for two weeks, feeling like I had more energy, less pain, more mobility and JOY. Today is day 14 of the subsequent down-swing. I have been struggling. I’m in constant pain, which gets worse in the evening. I have a headache and sore throat every day, my neck and my lower back are stiff, inflamed, screaming. There are jolts up and down my spine. My hands ache, my jaw is tender and I don’t even recognise my eyes anymore. Sunken and puffy, swollen, red, dry and circled with purple. I’ve had a hard time getting out of bed in the morning, I’ve only been able to do my stretches every other day, I’ve only been able to do 2 to 6 laps of the house, I’ve been walking somewhere between 1,000 and 2,000 steps each day. I haven’t been sleeping very well and my deep sleep keeps dwindling (according to the Zeo). However, I’m still walking, I’m still talking, I’m still sitting at a computer, I’m still bathing myself and making my way around the house. I’m still breathing. Focus on the positive!

I continue to use the CPAP, but I’m still having difficulty. The nose pillows-with-tape-over-my-mouth routine allows me to move around in my sleep and rest my head on its side, but I wake constantly from the air inflating my cheeks or traveling around my gums. It is the weirdest thing. I will wake up because there is a worm of air crawling its way along the outside of my bottom teeth. It will journey along my gum line in the front of my mouth and find a tiny outlet between my lips to whistle its way out. Or, I will awaken with one cheek suddenly puffed out, ballooned with air. Or, my whole mouth will inflate so I look like a chipmunk ~ with a mask plugging my nose and tape over my mouth, I expect my ears and eyes to bulge out like those squeezy rubber dolls we played with as kids.

Also, the tape is wreaking havoc on the skin around my mouth and the inside of my nose is raw and sore. None of that happens with the full face mask, but I can’t turn on my side without it moving, air escaping and me waking. Unbelievably,  the former situation is the lesser of two evils. Far fewer mask parts to wash, too. The washing of the CPAP parts is a huge ordeal for someone with ME. It is not an easy chore and almost negates the better sleep I am meant to be getting. The dental device that my father recommended costs $600 – $800, which I would spend if I could be guaranteed it would work. For right now, I just don’t have the energy to tackle a new appointment with a new dentist to get a new device.

The last few nights I have awakened in the throes of the full-body flex that I have talked about before. It’s as if there is an arc of electricity going through my body: back arched, toes curled, arms and legs rigid, hands in fists. I have thrown my neck out this way before. I now wonder if a muscle relaxant taken before bed is the answer for this. I’ve taken 1mg of melatonin a few nights this last week and I think it might help a little (or maybe it’s the placebo effect), but not enough. I should have taken my GP up on the offer for Ambien or Traxodone or Flexeril, but I’m such a scaredy-cat. It has to stop, though. I don’t think I’ll improve without pharmaceutical intervention. I’ve been taking tylenol with codeine every day the last few weeks and it’s not very effective at the low doses I like to take ~ plus, it gives me a kind of hangover. On Monday, I start Cymbalta. Duh duh duuuhhhhh….. Please don’t let me chicken out. I need to try something. My doctor said to expect to feel crappy for the first few weeks. But, in theory, it should help with the chronic pain, sleep and anxiety.

I continue my no-dairy-no-gluten-no-eggs-no-most-grains diet. I enjoyed starchy veg and popcorn over the last week, but, starting today, I am removing them from my diet again. I might be removing rice and/or oats, too. I am going to talk to the Good Doctor about that on Monday. After a lecture from my husband about what systemic yeast overgrowth might look/feel like, I am also going to try a little more diligently to cut down on sugar in all forms ~ fruit juice, dried fruit, Theo chocolate bars, agave syrup in my granola, cane sugar in my almond milk etc.

I sit here looking out the window at my husband in the garden, pruning our plum tree. He is tireless. Even when he has no work, he never stops working. He rakes leaves and mows the lawn and scoops poop. He shuttles me to and from appointments, does the shopping, cooks dinner. He washes dishes, hoovers, puts on sheets. In the past few years, he has rewired the house, replumbed the house, put in under-floor heating, cleaned out the rat shit and reinsulated the attic, built a second bathroom, expanded the first, built a shed for a new water heater and installed it himself. He landscaped our whole garden with an expertise that knew what it would look like in years to come ~ if he planted certain shrubs, trees and flowers in certain places at certain times of the year, given time, it would be a masterpiece. He built and tends the vegetable garden, he repaired our chimney and built me a porch with a little heater so I could get some daylight in the winter. He deals with his own physical problems and health issues and never complains. My brother called him a saint. My mother called him a hero. I call him a life saver. Without a shadaw of a doubt, I wouldn’t still be here without him. Gratitude is too small of a word.

The ME/CFS Blog Community

Honestly, when I started this blog, I’d never read a blog before. I knew what they were, but I had never looked one up or come across one. I didn’t have time to check my personal email account or read my magazine subscriptions, let alone peruse blogs for fun.

It never occurred to me that there would be so many people with ME/CFS writing blogs. That never crossed my mind. I didn’t get sick and start looking for personal stories of survival on blogs. I got sick and started researching the CDC and WHO and MedScape and the Mayo Clinic. As I continued to write, I would get a comment here and there and think, “Wow, there’s someone else writing a blog about this very same hell in Australia.” It’s like Twitter ~ if you’re not part of that world (and I’m not), you just don’t really get it. I’m discovering how vast this community is and it amazes me. There are so many of us, housebound, bedbound, reaching out in one of the only ways we can. How is it that most people don’t know all about this disease??

I started writing because I wanted to track my days on low-dose naltrexone. I quickly realised what a relief it was to answer friends’ and family members’ questions with my posts rather than trying to keep up with emails or tackle phone calls, which exhausted me even when I wasn’t sick. Then this blog became therapeutic and it became invaluable for me to witness my own trajectory. But, I am gobsmacked at how many blogs I come across that write the exact same things that I have: How my illness began. What has helped. What I wish I had known. How the medical community has failed me. We may start to tell our stories in isolation, but, the more you look, the more you realise that this community is conducting its own researching, being our own doctors. We are all out here, figuring it out ourselves, informing one another through forums and websites and blogs. You know those drug print-outs that you get from the pharmacy? We do that for each other: You might want to try this drug. Start at this dose. Look for these side effects. Try these two things in combination. Try taking this one at night. Here are the Safe Doctors… Hundreds of us, thousands. And there are millions more out there not connected to these resources, suffering in silence.

What keeps nagging at me is, if someone gathered all these blog sites together and sent them all to someone and that someone spent a week reading these uncannily similar stories, that they would drop everything and make something happen. I know that’s a lot of  “someone”s and “something”s. I don’t really know what I mean. Maybe the president drops everything and makes ME/CFS a huge research priority. Maybe an amazing doctor with lots of connections and endless time who lives very close to me decides to stop everything she is doing and focus all her efforts on mastering this disease. Maybe Bill Gates or somebody else very rich puts together an elite superhero team of scientific minds that he pays forever to do nothing but figure out a cure. Or maybe the money goes towards helping every patient afford their mortgage, food, home care, medicine… If somebody powerful/influential/rich read all of our stories, I am sure they would stop doing whatever they do in life and dedicate all their resources to doing something to help us. Right?

On the right-hand side of her site, No Poster Girl has a Blogroll: a list of ME/CFS blogs. I haven’t read any of them and I thought I’d read a lot.