Skip to content

my feelings

Vigil

I like to be alone. It took me a long time to feel that way. When I was in grad school, I lived in a cheap apartment on the border of a neighborhood that was mostly known for gang wars and being the setting for a documentary called (I swear this is real) “Getting high on crack street.” Once while I was having a party, an episode of COPS happened on the sidewalk I traversed every day to leave my apartment. COPS was filming in Lowell and they literally caught some guy and arrested him on my sidewalk. So basically what I’m saying is my apartment was charming. And cheap. But still charming.

Not that long after the COPS incident, my roommate moved out abruptly. Shocking, I know. I was 23 and generally a person who worried a lot about money at that point because we didn’t have money growing up, I paid my way through school myself, and grad students are stereotyped as living off ramen noodles for a reason. Lowell had the cheapest housing in the state at that point, due in large part to its impressive record of violent crime and also its propensity to flood like it was the Merrimack River’s job.

Living in Lowell, you learned to view the Merrimack as an adversary. A worthy opponent. When a river can rise enough to cover four blocks beyond its banks in a foot of water, you respect that river. My little cousin wanted to see how bad the flooding was one time and we walked a few blocks down closer to the university. We identified partially submerged landmarks and then two white plastic chairs just floated by. You know, just on their way to meet up with their chair friends and all the other debris beside a shuttered ice cream place where the flood deposited all the detritus.

Anyway, my roommate moved out abruptly and I was stressed about money because I was always stressed out about about money. I didn’t sleep for two days and on the third night, I ordered the best, greasiest fake Chinese food and ate it while sitting on my living room floor, watching some crappy horror movie. I slept that night, and the following nights, and eventually decided I didn’t want to deal with roommate stress. I decided to live alone.

I worked two full time jobs while in grad school and was also in grad school so I didn’t have a lot of free time. This was helpful in the beginning. I was so tired when I got home that I usually just went to bed. I put Lord of the Rings in my Playstation 2, turned the volume down on my cathode ray tv, and fell asleep. I wasn’t really experiencing being alone. It wasn’t until later when I had a more normally structured work schedule that I had to learn how to keep myself company.

The funny thing is that once I learned how to be alone, I loved it. It alleviated so much stress. When I went to Scandinavia in 2007, I came home, walked up to my apartment, took off all my clothes in the living room and just left them in a pile while I made coffee. Living alone was fantastic. I haven’t lived with anyone who wasn’t my partner in several years and I prefer it that way. I like having the choice to not talk to anyone and to think about things and make decisions on my own.

Being confident in your ability to take care of yourself and support yourself is very empowering and liberating. But it can be isolating, too. In the years since I lived in my charming apartment in Lowell, I have become progressively sicker. It was pretty obvious to my partner at the time but not to most people, even people I was close to. I looked healthy and still worked and fundraised and volunteered and lived a fairly normal life. It became easy to not let on how unwell I was and most people didn’t know until I crashed super hard and needed major surgery and all that.

In the last few weeks, I have finally gotten my lower GI pain mostly under control. My baseline pain is lower but I am still having colitis attacks about twice a week for 2-3 hours. I don’t know what is triggering the colitis so I can’t stop it. The good news is that most of the time, my pain level is lower. The bad news is that when it’s not controlled, it is unbelievably painful. Like can’t stand up straight, think my intestines might somehow drill through my abdominal wall and enter the outside world Alien-style, painful. It is awful and unpredictable and really frustrating.

This morning after I got off the train near work, I started having bad lower GI pains. I got to work and was stuck there until the attack subsided. I took all relevant meds but these episodes seem to be self limiting and resistant to symptom interventions. I sat at my desk with my legs up and distracted myself from the pain with work.

A coworker and I were chatting and I told her about my abdominal pain which was presently terrible. I don’t know what caused this realization but I realized while we were talking that she had no idea I was in pain before I told her. That really jarred me. I have been in pain for so long that my body has adapted to a neutral affect in response. People not only can’t tell that I’m sick but they also can’t tell when I am in serious pain.

I felt suddenly this swell of loneliness. It was momentary but overwhelming. I made a choice to share my life openly. People read about my pain but something is always lost when you distill emotions and moments into words. Over time, I have developed a complicated and difficult but enriching life and this world exists solely within the confines of my body. My friends and family can visit this place but they can’t stay.

I am alone in this strange place. I know how to be alone. But being alone in this body and this pain and this struggle is a different kind of alone, a solitary vigil in an invisible space.

 

Second life

I feel very much that I have had two lives. My first life stretched from childhood to my late 20s when I became seriously ill. I lived a lot in that first life, even for a few lifetimes. I grew up in Boston and went camping in New Hampshire most weekends in warmer months. I was a good student and read a lot and journaled compulsively. I traveled, went to college and grad school, worked several jobs. I fell in love and had my heart broken and broke some hearts. I had a lot of fun in my first life, a fact for which I am very grateful.

My second life is the one I often write about here. It’s the one that started when I became too sick to work and could no longer function. It’s the life I’m still living right now. A life that started with me being so sick that I just wished it would be over, that I would just close my eyes and transcend to an oblivion where I wasn’t puking and in pain all the time. A life that saw me through those times and carried me here. A life that brought me to Hong Kong and Beijing, to a challenging job, to bright red hair.

And to Water Country.

Water Country is a New England institution, complete with an iconic and maddeningly catchy jingle that everyone from New England reading this just sang in their head. It’s a water park with slides and a wave pool and a lazy river. I went as a kid for several summers. My mom and her friends would pack coolers and beach bags and all the kids and mothers would pile into my aunt’s unbelievably large and hideous brown van. The kids mostly sat on the floor in the way back like you would do in a station wagon. No seatbelts. Very early 90’s vibe. I think I was 12 the last year we went.

I think 2013 will go down resoundingly as the worst year of my life. I was super sick, had a resection and colostomy, broke up very shortly after my ostomy placement, moved, and generally had an awful time. I had worked so hard to shape this second life into a place where I could feel happy and fulfilled. And then it was just gone. I called my best friend in the middle of the night after we broke up, sobbing. “I had this whole life,” I said in between the deep whistling hiccups of genuine despair. “I know,” Alli said. “You lost a lot.” And she was right.

Late in the summer of 2013, the two of us decided to go to Water Country. I don’t even remember the conversation that led to the decision. In the last week of August, when the NH kids were back in school, we drove up to Water Country. It was warm but not terribly hot. There was almost no one in the park. We ran up three flights of wet wooden stairs, went down the slide, and then ran back up to do it again because there was no line. It was fantastic.

We made the poor decision to try a slide that you went down on your stomach on a mat. Nothing bad happened, it was just so ridiculously difficult. I had a colostomy bag and abdominal pain and she had ulcerative colitis and a knee that had been operated on and still didn’t work well. We were on the mats on our stomachs and just could not push ourselves down the slide. It took several minutes and was not even that good of a ride. Water slide fail for two. Then we went on a bunch of other slides and drove home with the smell of chlorine and conditioned air in the car.

We go to Water Country every year. Water Country is a place that I solidly place in my second life. This was a tradition I started in my second life and that means that there was no comparing it to before I got sick. Even when things go well and I don’t react, there is an inherent discomfort in doing things in this life that I did in my old one. A lot of the time, there is an inherent discomfort in relationships with people who knew us before. It is a reminder of the differences and the space between who I used to be and who I’m not now. It isn’t something that makes me angry anymore but it is something that I don’t think will ever stop. There are some things that you hide deep in your heart you just never get over and when you are in these situations, you feel a twinge when they are hidden inside.

I don’t feel that twinge on Water Country day. It’s like a holiday for me, a testament to the fact that this second life is so much harder and scarier than my first one but that it’s still a good life. It’s hard and messy but that doesn’t mean I’m unhappy. I can be sick and happy at the same time. Every year, that day proves it.

I wish that I had never gotten sick and that my existence would never have split along this fault line, opened a chasm between who I used to be and who I am now. But it did. And most of the time, this second life isn’t really so bad.

Lucky day

The nights are getting cooler and the wind is no longer warm. Darkness descends earlier. Fall is close. I walk a lot but especially at night when it is just a little cool. I listen to music and look at the moon with a dog in tow. Life seems less antagonistic when you look at the ocean.

Last week on just such a night, I took Astoria for a walk to the water. It wasn’t late but the town was quiet. About a mile from home, as we walked down the block to the ocean, a man ran past us and almost bumped me. I turned to steady myself just in time to get coated in pesticide that was being sprayed from the back of a pickup truck.

I just stood there for several seconds because I couldn’t believe what had just happened. I was stunned. Astoria has saddlebags with her treats, water, bowl and bags on one side, and my epipen, IV meds, and emergency protocol in the other. My immediate reaction was to take benadryl but I was afraid I would contaminate the line with pesticides if I used it. We were close enough to my apartment that hurrying home would get me there faster than calling someone to pick me up and bring me to my place. I took the epipen out of the case and walked home as fast as I could with it in my hand.

I was home in under ten minutes. I took off all my clothes and threw them into the washer with Astoria’s collar, harness, leash and pack. I rinsed myself off so I could use IV meds and got benadryl and pepcid onboard. I took 50mg oral prednisone and gave Astoria a bath.

Astoria can be a lot of work sometimes but one thing that is never a problem anymore is bathing her. She loves water. She loves the hose. If I am trying to spray something with the hose, she would prefer what I’m spraying to be her face and will jump back and forth to body block whatever I am aiming at. If I wash dishes, she stands close to the sink so I can spray her with the little nozzle. She knows all about the bathtub and that the water lives there. When I get home from work and open the bathroom door, she ferries her toys from the bedroom to the bathroom one at a time, piling them on the bath mat. When she has all the toys she wants, she picks up her favorite dinosaur and gets in the tub. Just hanging out in the tub so she doesn’t miss bath time. If she is dirty (or not), she will actually get into the bathtub and look at me plaintively until I wash her. She is a ridiculous creature.

Well, it was her lucky day because after getting covered in pesticides, we had a long bath. She was pumped. I shampooed her all over and rinsed her really thoroughly while she repeatedly slapped me in the face with her tail. She shook off all over the bathroom because why not at this point and let me aggressively towel dry her, which meant she was at most 70% dry.

Since I was now covered in water, fur, dog shampoo and probably pesticides that I just washed off her, I took another shower. Fifteen minutes later, after I wiped down every last surface in the bathroom because they were somehow all coated in fur, Astoria started coughing. So she got another bath. More shampoo. More water. More shaking. More towel drying. More cleaning every single thing in my bathroom. She is having her best day ever.

As I’m changing over the laundry and loading a truly impressive amount of used towels into the washer, she is running in and out of the bathroom with her tail going so fast that she is knocking things off the coffee table. LOOK MOM THIS IS MY DINO. More wagging. More wiggling. She is at a cool 97 on the excitement scale if 100 is the point at which you actually detonate from euphoria. LET’S DO THE THING WHERE I WANT YOU TO PLAY TUG WITH A STUFFED ANIMAL THAT ISN’T BIG ENOUGH TO GET A GOOD GRIP ON. LET’S DO IT.

But I still need to shower myself again so I put some peanut butter in her kong for her to play with and I climb back into the shower. I am listening to music and trying to calm down as I scrub myself again. In the next room, Astoria finishes up with her kong and comes looking for me and then lets herself right into my shower. She is now 100% wet instead the 30% I was settling for earlier. She is slapping bottles of shampoo and body wash off the shelves with her tail. I have two towels left and it takes 1 ½ to dry her off. At this point, the dog has been washed and buffed dry three times in two hours. Her coat is so shiny, I can’t look directly at her without sunglasses. I’m bright red and developing my own cough so I take IV steroids and just plan to never sleep again.

My town was spraying for mosquitos that night, which is how all this happened. I have a landline for calls like the one I expect for spraying. I didn’t get a call. I usually do and realize that this was just an unfortunate glitch. I don’t think anyone is to blame for this situation. I didn’t make any mistakes and this still happened. You can plan and prepare but there is always an unknown element. The world is not entirely predictable and that means that there is always the chance that some unlikely thing will happen. I had my meds, I had epi if I needed it. I was responsible. I understood that I can’t always control my disease or my environment so I had to be ready to respond. A large part of learning to function with mast cell disease is understanding that you will never be able to completely control your exposure to triggers.

A completely different situation that also happened last week confronted me with a separate but related reality: that people often think that people with disabilities are just not doing it right. By which I mean being disabled and living with a disability. It is omnipresent and so frustrating and degrading. When we say that someone gave us trouble for parking in a disabled spot for which we have a placard, they say that if they were disabled, they wouldn’t park there because it’s not fair for people who have worse mobility.When we say that we are scared about not being able to get medication for chronic pain, they say that if they were disabled, they would meditate and rub themselves in [insert herbal remedy] and push through the pain by virtue of their willpower. When we say that we are worried about how changes in healthcare policy will affect disability payments, they say that if they were disabled, they would never allow themselves to need disability payments because they would continue to work fulltime. When we say that we can’t pay for our meds and copays, they say that if they were disabled, they would manage their money better. When we say that our insurance won’t pay for a medication that we absolutely need and should have, they say that if they were disabled, they would never let that happen to them, that they would just be so forceful and smart that no insurance would be able to deny them anything. (I just made a Michael Phelps face as I typed that last sentence. This point is a bit more sore than I thought.)

I realize that this response derives mostly from two things: ignorance, and to a larger extent, fear. It is terrifying to confront the fact that we live in a society where people can just refuse to provide you with things you need to function or even to stay alive. It is scary to think that you can become so sick overnight that your old life will never be manageable again and that you will need so much help to do anything. It is scary to think that providers and government agencies and pharmacies can refuse to alleviate your serious pain. It is much easier to think that disabled people are just doing it wrong than it is to realize how vulnerable we all are in so many ways. Few things are scarier than impotence. Maybe nothing is.

Hope you’re having a great summer.

 

Astoria has a bath

 

 

Astoria has a life jacket

 

 

Astoria has a bathtub

Unshakeable: An update on Kristina

On Father’s Day in 2008, my father had a massive heart attack. My mother, sister and I were passengers in the car he was driving to a restaurant for dinner when he suffered a full cardiac arrest. I know all of the facts about what happened because I have recited them so many times, but I don’t truly “remember” most of what happened. I remember performing CPR in the middle of the street and worrying that I was not being forceful enough with compressions immediately before I cracked his sternum. I also remember calling my uncle from the ambulance and thinking at the hospital that this was one of those moments that would divide my life into periods of before and after.

There have been a few other moments and I mostly recognize them when they are happening. I did not realize that the week spanning the end of September and beginning of October in 2015 would be one of those. I spend a lot of time reassuring people about their health, including myself, to the point that it is almost a reflex. I assume things will be fine until I am shown incontrovertible evidence that they will not. I trick my body into thinking it’s not scared by donning the physicality of confidence and busy my mind with other things.

I have a practiced eye and I should have been able to see the impending storm last year. On the other side of the horizon, a darkness gathered, spinning and spinning into a fury. But I didn’t. None of us did. I think about it every single day.

Last week, a friend commented that Naples is not too far from where Kristina lives. It’s lucky that she did because I had no idea. Kristina is a mast cell patient and mom of a mast cell baby. She is my friend and part of a group that included me and six other masto moms or patients who shared everything. Kristina suffered a brainstem stroke last October and suffers from locked in syndrome. She is aware and understands everything happening but is unable to control her body or speak.

I visited Kristina yesterday at home with her family. She is still Kristina. She laughed at my sarcasm and bad jokes. I asked her if I could give an update for everyone thinking of her and praying for her. She said I could.

The last ten months have been very challenging for her and her family because she lost all functionality but very limited eye movement in the stroke. Additionally, she is a mast cell patient, which complicates her management and treatment. Her team is aggressively working to teach her brain to make new pathways to control movement, especially in her face, arms and fingers. She is working on sitting upright and spent some time in a wheelchair while I was there.

She has regained some movement in her face and neck. She can turn her head from side to side. She can control her eye movement better, including blinking. She can move some other muscles in her face, including above her eyes and near her mouth. Kristina communicates currently by eye movement and answers yes/no questions or spells words by blinking when the alphabet is recited to her.

Kristina is able to breathe on her own with a tracheostomy, which allows extra assistance to help clear secretions and cough if needed. Her speech therapist tried a new valve on her trach while I was there and for the first time in ten months, I heard Kristina’s voice.

It is not in my nature to be hopeless, even when things are grim. In 2008, my father was in a coma after his heart attack long enough that we were approached about giving him a trach to keep him ventilated long term. We were given a target date for this procedure since he was not expected to wake from the coma before then. Instead, the vent was removed and he woke up on my parents’ 25th wedding anniversary. It has been eight years since that day and I am still grateful for that every day. The fact that my father survived has given me the unshakeable understanding that sometimes, even when it seems hopeless, and even when we can’t explain it, people get better.

Kristina is a tenacious, intelligent and eminently capable person. Her family is amazing. They are so dedicated to her recovery. Getting to hug Kristina, and her mom, husband and son, was easily the highlight of my year. I don’t know what will happen but I am hopeful. I told her that we love her and that so many people think about her and ask about her often. I told her that I was glad to see how well she was adapting to being home and that she was making gains and that I had an unshakeable belief that she would get better, too.

Thank you for keeping Kristina and her family in your thoughts and prayers.

An uncommon gift

Rare disease patients often have little in common but their disease.
We speak different languages.
We are of different races.
We live in different countries.
We have different families.
We have different ages
And politics
And religions.
We laugh differently
And love differently
And cry differently
But when you are in the moment, it all feels the same.
And because we are so different
We might never have been friends otherwise
But that doesn’t matter
Because we are.
And sometimes our differences make our friendships messy.
And sometimes our closeness despite our differences feels like cheating
Like getting a gift in celebration of something
We shouldn’t be celebrating.

Today I visited a dear friend
Who was a gift from this disease
And I sat with her
And rubbed her hands
And told funny stories
And reminisced
About the hard days
Before the hardest days came.
And thought to myself
That I will never be able to put this feeling into words.
To put this connection
Into words.
To describe
How one day
A long time ago
This woman told me about her son
And that she was scared
And when she did
The fear in my heart saw hers
But it saw the courage too
And hearts are always more courageous
When they don’t beat alone.
I will never be able to put into words
What happened inside me
When she lost her voice
And things seemed hopeless
And she was scared
And I was scared
But my heart mustered some courage
So that her heart would see it.
And we don’t know what will happen
But the only way to overcome these hardest days
Is by opening our eyes
Even when we don’t want to
And laughing
Even when it makes it hard to breathe
And remembering
Even when it twists your insides
To know
That none of us saw this coming
And that we are scared
That we won’t overcome this.

But we are part of this world
A world that gave us
Sunshine
And warm breezes
And the night sky.
That gave us
Swimming
And family
And friends
To remind us
That there is good here.
That gave us
Terror and pain
So that we would understand joy
Desperation
So that would know peace.
This disease
So that we could find each other.
These hardest days
So that we can overcome
And so that nothing
Will ever
Seem hard
Again.

Indiscretion

I am not terribly discreet about my health and the accompanying body differences. It is not in my nature. When I was growing up, I would get dressed for school in the living room in front of a window that provided an unobstructed view for anyone passing by. It took me a year to put up blinds in my current apartment because I just couldn’t be bothered. The idea that someone could see me naked is really not something that I particularly care about.

This lack of concern has extended to my day to day management of my health. This means that my health issues are pretty visible, even to people who don’t know me. My port is accessed all the time and I don’t usually wear clothes that hide it. When I had a PICC, I never wore long sleeves for the express purpose of covering the line. While many people didn’t know what I had under my clothes, they could certainly see that there was a bulge on my abdomen where the ostomy bag was. I take medication in front of other people all the time, including IV meds, sometimes in public. I sometimes need to infuse fluids during the day and so then I am walking around with a backpack holding a pump and an IV bag trailing a line connected to my port.

Also, my hair is bright red and I have distinctive glasses and dress like a 60’s housewife. Blending into a crowd is not really something that is going to happen for me.

I made a decision a long time ago to be as transparent about my health as possible in all areas of my life. During the years before diagnosis, and for about a year after, my friends and family understood in a general way that my health was not great. I was fairly functional and at that point didn’t require a lot of help to manage my day to day life.

In the winter of 2013, that changed. I crashed so hard that in the span of a few weeks I ended up unable to stand for very long, or exercise, or eat most foods, or clean my apartment, or run errands. After a couple of episodes in which I got out of bed and literally fell on my face from low blood pressure, it became obvious that I could not manage my life on my own. I was mostly unable to leave my apartment.

So I told everyone. I told my family and friends and work and pretty much everyone else I interacted with. By doing so, I was able to create an insular environment that was largely safe for me. Venturing outside of that bubble was inherently dangerous for me.

In the last couple of years, I have gradually gained more stability and more independence. I travel a lot now. In the last two years, I have been to Seattle, Colorado, Florida, California, Maine, Hong Kong, Beijing, Colorado, Maine again and Florida again. I’m currently in Naples, Florida.

Travel was a big part of my life and identity in my adult life. When I got sick, it was easily the thing I missed the most. It wasn’t even really that I wanted to go somewhere as much as I wanted to be able to go somewhere if I decided. The anxiety associated with being unable to just book a trip and go created a weird sensation of claustrophobia. I was trapped. And by traveling now, I am no longer trapped, but I am less safe.

I have written a lot about the difficulties encountered while I travel. I actually didn’t even realize how often I have written about this until yesterday when I was reading through old posts on the blog and on Facebook. I pretty much always run into trouble getting my boarding pass, despite many attempts to mitigate this ongoing problem. I sometimes have trouble even getting an airline to let me onboard the plane because some employee made a decision that I don’t look healthy enough to fly. Onboard, I often encounter trouble because I have to keep a bag with meds and an infusion pump with me at all times because the IV bag and pump are attached to my body.

And then of course there are the people who just don’t like that I’m sick. You know the people. The ones that don’t actually know you, but who make snide comments or stare.

I flew to Florida on Saturday. For the duration of that flight, I was connected to an infusion pump. The woman next to me was staring and rolling her eyes pointedly which seems awfully stupid since she could just ask me what it was if she wanted to. Two hours into the flight, I diluted a med using a needle. She finally said, “You know, it makes me uncomfortable that you’re doing that.”

I responded, “You’re going to be a lot more uncomfortable if I start going into shock,” and then pushed the med and reconnected my fluids.

Any time I venture outside of this bubble I built for myself, I accept the risk associated with a naïve and sometimes hostile environment. I find it incredible that in 2016 these issues are still present. I am clearly dedicated to educating people about mast cell disease and seize the opportunity to do so when it presents itself. But situations like this have really driven home for me that often people have already decided how they feel about what I am doing or what I look like before we even interact. In some instances, teaching them about my disease won’t help. And sometimes, it makes things worse.

There is also this sticking point: that despite the fact that I don’t try to hide my health issues, I still have a right to privacy. I don’t mind discussing my port or why I’m bright red if people ask, but I have a choice. There should not be an expectation that I disclose my private health information just because I don’t look like everyone else.

Our stories as patients are our greatest weapons against ignorance and fear about our diseases. They are our greatest assets in making the world safer for us and people like us.

But they are still your stories. And telling them is a choice.

From the deep

In early June, I went to visit my nieces in southern NH for the weekend. It was a fun weekend. Being Auntie Lisa is the best thing about me. I’m a good mix of “let’s make a big mess and clean up real quick before your mom gets home” and “DANGEROUS! TOO DANGEROUS!” I travel with a heated blanket for my joint and muscle pain. My nieces love me, but the “hot blanket” definitely ups my stock.

I think everyone who has ever seen my name at this point likely knows that my lower GI tract is a disaster. I have massive nerve damage and a colon that is prone to herniation and bleeding. I have had many scopes, biopsies and surgeries. I had an ostomy and resections and may eventually end up with another ostomy. My colon is shorter and there isn’t a ton of rectum left.

Last year, I had surgery to take down the ostomy and reconnect the higher colon to the rectum. The process of trying to nail down what would work and what was best for me was fraught with frustration, anger and grief. There was a general feeling that the colon should not be removed in its entirety because “if they were wrong, they couldn’t put it back.” There really isn’t any case literature to look to here; we were figuring this out as we went along.

My biggest concern with leaving part of the colon in was that it would not be short enough to reasonably prevent impaction. I was worried it could land me right back where I was before the ostomy, when I needed to literally bowel prep myself in order to pass any stool. My abdomen was always swollen and hard, my abdominal pain was serious and my rectal pain was really bad. It was an awful time. This was also before I understood mast cell disease well and a lot of what I was eating and doing made the pain and swelling worse. It was truly miserable.

Last month, while I was in NH being Auntie Lisa, I realized that my rectum was really hurting and something was wrong.

I will spare you (and me) the gory details but it took me seven hours of actively trying to stool. Seven hours of pain so bad that at points, I was literally screaming. My lower GI tract was very, very swollen. And in that seven hour period, I realized my colon had herniated again.

It has been six weeks since that day. Swelling has gone down and bleeding isn’t awful. But it is definitely herniated. The pain is bad.

It’s funny how fast you forget how bad something hurts. I’ve had persistent abdominal pain and bone pain for years. But it wasn’t this pain. My mind walled off the memory. I remember what happened. I just didn’t remember how bad it hurt.

I saw my GI doctor today. We talked about my symptoms and then about my rectum for a while. In the middle of the conversation, I started crying. “If this pain would just stop, my life would be so good,” I sobbed. I cried because I was in so much pain and have been in so much pain and also because when pain is this bad, you can’t think about anything else.  You can be grateful for things but you can’t appreciate them.  There just isn’t enough energy left.  The pain takes everything.

I manage the pain as well as I can but really I am still in quite a lot of pain. It was only in relating this aloud to someone who has seen me at my very worst that the enormity became evident to me. This is such a big thing.

And there is this other peculiar thing: that when I’m in pain, no matter why, it makes me think of all the other things that cause me pain, too. Every fear and worry and regret becomes vivid once more, all together. Those wounds open again, like air hungry mouths that finally surface from the deep. And then it’s not just my bone pain and my abdominal pain and my rectal pain and my stomach burning. It’s also that I never went to medical school and haven’t had kids and that my dog is old and that people can become memories so, so fast.

I have tried to tell myself that I can live like this because the alternatives are unpalatable. But I don’t think I can. I will have to do something about this and the very thought of it makes me shudder.

The normal

In the spring of 2009, I realized I wasn’t hearing as well in my left ear. Shortly after that, I started having balance issues. Literally would just be walking and would tip over. I went back to see the same ENT and got a hearing test that confirmed that I had some hearing loss in my left ear. I was referred to a specialty hospital and diagnosed with Meniere’s Disease. They prescribed a blood pressure medication to decrease the pressure in my inner ear.

In September, I got another hearing test. My hearing loss was worse and now noticeable in both ears. I was rediagnosed with autoimmune inner ear disease which is a real thing but they very poorly understood. I tried several meds, including high dose steroids. By November, I was getting steroids injected into my eardrums and could no longer understand speech.

The panic was immediate and fierce. I obsessed over my hearing and what I could and couldn’t hear. The world became strange and threatening. I had never understood how much we use sound for. We use it to tell how far away things are. If they are moving. How fast they are moving. If someone is upset. How hot water is coming out of the tap. The size and structure of space.

The speed with which I stopped understanding speech was staggering. I had no idea how to function in the world with significant hearing loss. I didn’t know about video phones and deaf alarm clocks and doorbells that turn on a lamp when someone rings it. I didn’t know about hearing aids and cochlear implants and a million other things. And I didn’t know how to sign.

As soon as I realized my hearing was never coming back, I focused all my available energy on learning ASL. I learned a lot online and by watching ASL interpretations of music on Youtube. (Warning: A lot of resources labeled as ASL are not ASL. They are other sign languages or poor fabrications. ASL is not a signed code of English, it is actually not even based on English.) I learned about resources for late-deafened adults and groups to practice ASL. I made Deaf friends and learned about Deaf culture.

I got lucky and the injections preserved some hearing in my right ear. My left ear hears nothing. My hearing fluctuates in my right ear, mostly as a function of blood pressure. With normal blood pressure my hearing is not great, but it is much worse with higher blood pressure. This means that my hearing can change rapidly which is both disorienting for me and confusing for people around me. Fluctuating hearing loss is like a fast track to people think you’re making it up.

I had several hearing tests over the years and stopped getting them because I was accused of inventing my hearing loss due to its inconsistency. Less than a month before I was diagnosed with mast cell disease, a neurotologist told me I needed to see a psychiatrist because I was faking. I called her bluff and saw the psychiatrist.

Halfway through the appointment, he said, “I don’t know what you have but you have something. If you’re faking, you’re not doing it right. You’re working and adapting to the world around you.” He wrote a letter and no one ever questioned my hearing loss again. I haven’t had any more hearing tests and I never will. I will never try to get a hearing aid again.

A couple of weeks after that appointment, I was diagnosed with mast cell disease. Mast cells are involved in sensorineural hearing loss, mast cell disease is associated with auditory processing disorders and EDS is associated with conductive hearing loss. My hearing depends on reaction, blood pressure, medication, a million things. The reason it seemed so irregular was because it was. Like everything else that mast cell disease causes. It is less variable now that I am managing my mast cell disease.

It has been six years since I lost most of my hearing. It doesn’t affect my day to day life terribly anymore. There are sounds I haven’t heard in years and will likely never hear again. Music sounds different. Speech sounds different. I can lipread okay if I know what the context is and I can see the face of the person speaking. In the last few years, my hearing has stabilized enough that I can hear on the phone if there is no background noise. I don’t sign every day anymore so I’m not as fluid as I used to be, but my ASL is good enough to be understood and to understand. All my devices have long since been closed captioned. I sit in the corner in public places, my deaf ear to the wall. I sit at the end of the table during meetings so I can look at people when they talk. The white noise that surrounds me when background noise is high is no longer disorienting. It is just part of me.

Losing my hearing was the original wound. It was the first thing I lost that I never got back. Long before I was having pieces of me removed, I went to bed one night and woke up with hearing loss.

Last month, a nurse said to me, “I would have never known you have trouble hearing!” She exclaimed it, eyebrows high, like it was a compliment. It doesn’t feel like a compliment.

There are things about my life that I think I will never get over. I am having some really serious lower GI issues right now that were supposed to be alleviated by the last few surgeries. Just thinking about it is upsetting and scary. Like I can never accept these things as my normal. And if I can’t accept them, this fog of despair will just get closer and closer until it smothers me.

Six years ago, I was struggling to sign and understand speech. I thought I would never be able to accept having severe hearing loss as my normal.

But I did. I sing in ASL while I’m in the shower. This is my normal. I don’t know how yet but I’ll get over everything else. And then that will be my normal, too.

Fear of the dark

I was diagnosed with mast cell disease in 2012. By the time this diagnosis came, I was emotionally numb. I had been sick for years with terrifying and increasingly severe symptoms, had lost most of my hearing and repeatedly tested negative for dozens of things, rare and otherwise.

Less than a month before, a neurotologist who I will never forgive told me that I needed to see a psychiatrist because I was faking my hearing loss. I had stopped taking all my meds two weeks earlier because I was just done. I called my immunologist and told him that I no longer believed that this disease was killing me faster than the variety of risky meds I was on without a firm diagnosis.

I honestly just wanted it to be over. I didn’t want to kill myself and I didn’t want to die. But I wanted it to be over. I was sleeping through entire days, waking dripping with sweat and this acrid smell emanating from my pores, shaking and trying not to fall over when I finally got out of bed. I was in a truly unbelievable amount of pain and sleep was my only respite. I wanted to close my eyes and just…leave.

After I was diagnosed, I learned a lot about anaphylaxis and started learning about mast cells. I fixated upon anaphylaxis that occurred while sleeping with an unhealthy intensity. Despite not having serious breathing issues, I became convinced that I would stop breathing and die in my sleep. The oblivion that had been a comfort only a few months ago was now a sinister presence, watching from the dark corners of my bedroom when I turned out the lights. I would lay awake wondering if I would be aware of my death if I died, if I would stop breathing and be forever alone in some infinite darkness, until panic seized me.

A lot has happened in the years since. I have developed new, rational fears, like forgetting one of my medications while traveling (which I have since done), being labeled hysterical/unreliable by doctors, or being served food that I have explicitly stated as unsafe. Mast cell disease is unpredictable and the fact that I can’t always anticipate what will or will not make me react is a wellspring for many of my fears. The fact that something was safe the last hundred times doesn’t mean it will be this time.

Fear is important to self preservation. It is evidence of a primordial necessity of being scared. I was very scared of the dark when I was growing up, long before I knew that the dark could offer sanctuary to any number of terrible things. It is something inherited, a vestige of its utility thousands of years ago. Being fearless with a disease like mine is cavalier and dangerous. Every person, every place, every thing offers the possibility of triggering a reaction.

Fear is also a big reason why so many of us are diagnosed with anxiety or panic disorders before ultimately garnering a mast cell diagnosis. Mast cell mediators can cause a wide array of severe neuropsychiatric symptoms and our body’s response to allergic inflammation, including release of epinephrine, can bolster anxiety or panic. A psychiatrist once asked me what I was so afraid of like the things I was scared of were benign. After I told him, he responded, “Well, I guess I would be scared of those things, too.”

Fear does not ruin my life or control it. I have a complex relationship with fear. I compensate for the unpredictability of this disease by trying to anticipate all possible outcomes of a situation and building redundancies and failsafes into my personal management of this disease. I do a lot of yoga and meditate (less than I should) and walk a lot. I do visualization when I am very anxious, but to be honest, I’m still very high strung. I’m very high strung and I am about half as anxious as I used to be.

We are all of us trying to control a disease that we can’t fully control. That is upsetting and sobering and also liberating. I am getting better about doing things and going places where I can’t control things as much and trying not to compulsively explain to people who don’t know me what to do if I start shocking. I am trying to do things that scare me, like taking on additional responsibilities, taking formal classes and having recurring obligations beyond those that are essential to my life and health. Sometimes things go well and sometimes they don’t. I’m trying to be okay with that. I’m not always okay with that.

I don’t really remember what it was like before, when fear wasn’t a dark horizon in the backdrop of my life. And I’m tempted to say that I’m not scared as much anymore, but I don’t think that’s true. I’m not scared as much at this exact moment while I am writing this post. But tonight, I’ll shut off the lights, and I will still be scared of the dark.

Cloud of uncertainty

Winter is over. That can be hard to call for sure in Boston and I’m a bit superstitious about saying things like that aloud. But I’m ready to commit to the end of winter. Spring is here.

Springtime in Boston is so pleasant and joyful that I think about it in ridiculous hyperbole. The damp dark tones of thawing earth, the stubbornly cheerful flowers, the warm wind rushing around your face in its hurry. The way the moon shines silver on breaking waves and light creeps along the horizon earlier with each passing day. Walking to work in my low yellow heels and a light sweater instead of boots and the bulk of cold weather. The cool clarity of night air through open windows.

It’s a good thing I love all these things because season changes are rough. It is one of the few aspects of mast cell disease that seems universal. We don’t react well to change and so many things change with seasons. Pollen, foods, behaviors, activities, hobbies, temperature, humidity, obligations. I wake up drenched in sour sweat, my eyes burning when I open them in the morning, already nauseous. My neck and chest are cherry red with an occasional hive for variety. I’m having some word finding issues and some obnoxious but fleeting neurologic symptoms. So yea. It’s lucky I really like spring.

It has been a rough few weeks all the way around, work, masto, MastAttack, feelings. I have never been a person who counts days or months; I mark time by seasons. Last spring, I was recovering at home from lower GI surgery after eight days in the hospital. Two springs ago, I was recovering from a several days long anaphylactic episode that landed me in the hospital for five days. Three springs ago, I was starting a new job with a brand new ostomy.

These past several months have been difficult and sad in a way I can’t really articulate. There is a weariness and a sadness and a joy and an optimism that I wield like a weapon, even when I don’t think it will help. It is a physical stability with emotional trauma and pain and regret and living with my choices. It is not terrible. It is just hard. Some days it is so, so hard.

More and more I realize that the reason I have not really found a new normal as my disease progressed is because there is no normal with this disease. There is no consistency so there can be no lasting adaptation. I no longer have expectations for what I will feel like in any moment that isn’t the one I’m currently occupying.

You don’t adapt to unpredictability. You just try not to be consumed by it.

But I’m still glad it’s spring.