In a totally last ditch effort, I called the woman who’s managing my social security disability claim in the hopes that, I don’t know, maybe she can push my claim through so I can at least get state insurance again.
We were on state insurance, but the annual income requirements changed and now we’re just a few hundred dollars over the limit. We no longer qualify, no exceptions. Because I can’t work outside the home, we can’t afford any of the state market plans or even my husband’s company’s plan. We wouldn’t be able to afford rent.
Without insurance, though, I can’t continue treatment, which means I’ll never be able to work outside the home. I was doing better with treatment. Soon I’ll run out of my medications.
Disability usually takes a long time to be approved. Sometimes you’re denied even after appealing. I’ve already been denied once; my hope was that I could appeal and eventually be approved.
That doesn’t help me now, though.
I don’t know what to do. I’m scared, to be honest. I’m already flaring with treatment. My rheumatologist thinks I need to add on a medication or two. I know that without any treatment, I’ll be bedridden again; before I started treatment, I was bedridden and needed Mike’s help just getting dressed. I couldn’t work from home at all.
I hate getting caught up in grief, but this wasn’t my life at all before I got sick. I worked three jobs. I had a lucrative career. I went hiking and bowling. I played softball. Then I got mono from the Epstein-Barr Virus, and I never got better. It triggered my UCTD, which stole my life. I don’t go hiking. I can’t even play video games anymore, because using the controller hurts my hands. We’re struggling financially. Mike is my husband but also my caregiver, and he’s got his own health issues that need caring. (Yet he still stubbornly insists on doing things for me.) I have family who help when they can, but they’re struggling too.
Honestly, I went back to school not only to help me with marketing my books, but also so that, after I found the right medication combination, I could return to the workforce. I need to feel useful. Now I’m scared that I’m just earning this degree to feed my pride, meanwhile racking up more debt I won’t be able to pay off.
This illness stole all of my hopes and dreams. I wanted to have a family. Now I just pretend that I never want to have kids. I don’t know if my body could tolerate pregnancy and parenting. It can barely tolerate cooking a meal. Lately I’ve been in so much pain and buried under so much brain fog, I can barely focus on my school work. The material is difficult as it is. (Why do they make accounting and macroeconomics so hard? I mean, seriously.)
I want to fight for the future. I’m not finished yet, damn it. But people like me live in a limbo.
One of my greatest fears is falling. It’s not the height that scares me. It’s the fast lack of grip, the surge to the bottom. I don’t like being out of control.
Ironically, a recurring theme in my life is losing control. I never learn to let go and enjoy the fall, see where it takes me.
For the past four months, I’ve been fighting to keep my health insurance plan. My state changed the minimum annual income requirement back in March, and we’re now $400 over the mark. $400 is far from enough to cover the cost of a yearly deductible and monthly premium, plus co-pays and prescriptions. Yet in the state’s eyes, we should be able to afford it no problem. They don’t account for rent and heat. They don’t even look at your income after taxes.
We looked at my husband’s company’s insurance plan, too. Even though it’s a bit cheaper than one of the state market’s plans, we still can’t afford it.
We’re already struggling.
I’m really grateful that we had state insurance these past few years. Because of it, I was able to get a diagnosis and start treatment for my UCTD. Still, we can’t afford another plan, and we definitely can’t afford my treatment and monitoring without insurance.
I looked into several avenues, but they all came down to one thing: soon I’d be out of medicine.
Once I run out of medicine, my disease becomes aggressive. It isn’t long before I’m bedridden again and I’m unable to care for myself. To write. To live.
I felt myself spinning out of control. One of my other greatest fears is my disease. I’ve worked hard to get to where I am. I’ll be damned if I go back.
The fear is suffocating. My rheumatologist and I have determined that Plaquenil isn’t enough, that I need to add other medicines. Plaquenil has been so very therapeutic for me, but it’s not a magic bullet. I still have pain and stiffness, fatigue and brain fog, and other symptoms that may be related but definitely need further testing.
It doesn’t help that someone I love with an even more severe condition is losing her insurance, too. Chronically ill people rely on social services, but those programs are always the first to go when states need to make budget cuts.
I’m too scared to feel angry.
I have one last thing I can try. It’s a long shot, and I’m only going to have a small window. If I’m successful, it’ll be the net that catches me at the bottom. If I fail, well… I guess I’ll have to finally learn to let go.
It’s only been six days since Trump was sworn in as President. I knew things would start happening, and that it’d be fast, but I couldn’t have imagined how quickly.
Before Inauguration Day, Congress voted on their annual budget, which is normal. However, they re-allocated the ACA budget to miscellaneous. In Trump’s six days of office, he’s signed executive orders to:
give power to agency and executive department heads to “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the [Affordable Care Act]” while he works on repealing it
pull federal funding from women’s affordable healthcare organizations that provide abortions, ignoring the fact that these same organizations also provide cancer treatment and other healthcare to low-income women, men, and teens
resume and speed up the Dakota and Keystone Oil pipeline projects, continuing to route them through Standing Rock despite environmental concerns, land treaties, and President Obama’s executive order to halt the DAPL and look for alternative routes
pull the U.S. out of the United Nations
withdraw the U.S. from the Trans-Pacific Partnership
ban refugees from entering the U.S., begin deportations, give police officers power to act as immigration officers, and block federal funding from sanctuary cities
allow torture of political prisoners, which breaks the Geneva Convention
begin building a wall between the U.S. and Mexico, which Mexico has refused to pay for; I suspect the ACA’s re-allocated funds will be paying for its materials, and political prisoners will be used for slave labor to build it
You know what solves it? When the economy crashes, when the country goes to total hell and everything is a disaster. Then you’ll have a [chuckles], you know, you’ll have riots to go back to where we used to be when we were great.
“Lenin,” he answered, “wanted to destroy the state, and that’s my goal too. I want to bring everything crashing down, and destroy all of today’s establishment.”
Trump has been leveraging our social, political, and working class issues, instigating the blame of our problems on disabled people, black people, Latinxs, and Muslims. He insists that the ACA is being taken advantage of by lazy people who don’t work. People who rely on the ACA and Medicaid for healthcare are veterans, single parents, people with disabilities, cancer patients, retired people, and low-income families. No statistical evidence suggests that any large percentage of people covered through the ACA are “lazy people.”
There’s a lot to do. I advise working locally. Know your community. Pick an issue or two you care about and commit for the long haul. And understand that as horrifying as this all is, millions stand with you. Find common ground, stand up for others—and know the enemy.
Shit is real here in the U.S., my home. Most of the people I know are either completely oblivious, in denial. They don’t see how dire things are. I’ve been following all of this and urging family and friends to pay attention. They won’t. I think, honestly, most of them just can’t believe anything like this can happen. They believe that our Constitution and government will protect us. The Constitution can only protect us if our government upholds it. Right now, our government is fighting amongst themselves. There’s little opposition from the Democrats against the Republicans and Trump’s Cabinet.
It’s possible that we mere peons cannot even begin to understand what’s happening to us. We just know that we don’t want it and we don’t deserve it.
I’m at a loss here myself. I read each executive order with growing cynicism and horror. To be honest, I didn’t want to believe Kendzior’s and others’ apocalyptic predictions before and around Election Day. I thought that by urging electors to vote against Trump would be enough, but now it seems that we were fighting the wrong battle. We should’ve been urging our senators and representatives to pass legislation to block all of the things that Trump promised during his campaign, protecting all of the people that Trump is trying to harm.
It might be too late.
I’m not giving up. I’m terrified, to be perfectly honest. With every executive order that I read, I find it harder and harder to focus on anything; writing and working as normal seems pointless in the face of what’s happening. When this has happened in other countries, millions of people died. It seems like a cleansing has begun: women, disabled people, non-white people, queer people, Muslims.
I still believe in fighting for our freedom. I come from a family of veterans and I will never dishonor their sacrifice and memory by giving up those freedoms. I will keep writing. I will send letters to the White House. I will put aside my phone anxiety and call my state Senator and Representative, and ask them to fight. I will start attending town meetings and make my concerns heard.
And by “bitches,” I mean “dear friends who help me with things.”
This weekend, I finally upgraded my pathetically outdated iPhone 4. Not even the 4S—the 4, you guys. It was years old and turtle slow. It did make calls, which is pretty much the point of a phone, but in my out-in-the-country apartment, I barely have service. Texting is my main method of communication—that and FaceTime. I’ve long been eligible for an upgrade, but money’s been tighter than tight. Sprint.com had a deal: a free iPhone 5S with a two-year contract renewal. Um, hello!
I’d been using Siri on the iPad, which we got secondhand in December 2015—and it radically changed my life. When it’s plugged in, you can use the “Hey Siri” feature, which is pretty handy. For example, if I’m cooking dinner and the iPad is on the counter playing a podcast, I can plunk my sore body down and say, “Hey Siri… Set a timer for 20 minutes.” Hands-free, which my achy fingers and wrists really appreciate. I don’t have to walk across the kitchen to reach the iPad, which my hip and lower back also appreciate.
Since activating my new phone, I’ve used Siri mostly for texting. I’ve been having a hard time with texting lately, because my thumbs and wrists are so stiff and sore. The simplest messages take me forever, and it’s almost guaranteed that I’ll goof them up somehow. It’s really amazing to hit that button and say “Read my texts” or “Text so-and-so…”
While the tech itself is cool and I nerd out a lot about it, I’m all about the accessibility. If Siri has been helpful to me, imagine how helpful it is for others!
I would’ve been completely satisfied with my Siri, but my aunt got us an Echo Dot for Christmas. Now my little gang is complete with Siri and Alexa.
At first, back when Alexa first launched, I thought it was a tad bit creepy that Alexa is always listening. You don’t press any buttons. You just say “Alexa,” and then whatever command. It was also kind of buggy when it first launched; it didn’t understand a lot of things and often played the wrong songs, etc. But Amazon seems to have ironed out some serious kinks. However, Alexa doesn’t seem to understand my husband. Maybe it’s because he spent its first night home completely torturing it: “Alexa, what drugs do you do?” Now Alexa ignores him completely. (I can’t really say I blame it.)
In the morning, I’m supposed to take my Plaquenil, Prednisone, and one of my two Tramadol for the day with some food. I’ve been having trouble with Plaquenil and dairy, though, so if I have any dairy in my breakfast, I wait before taking my meds. Being that I’m so stiff in the morning and my mobility isn’t the greatest until Prednisone kicks in, I’ve already settled into a rhythm with Alexa. When I finish eating, I say “Alexa, set a timer for 20 minutes.” It can hear me from across the room and starts the timer right away. I can even ask it, “Alexa, how much time is left on my timer?” I don’t have to get up or push any buttons. For me, this is a dream. When the timer goes off, I say “Alexa, stop,” and take my meds with water.
I’m sure I’ll find more uses for Alexa and Siri. I’m trying to figure out how I can have Alexa read my manuscripts to me while I’m editing; it can read Kindle books, but I don’t know if I’d have to format my WIP as a .mobi first or if it’d work just fine if I just load it into my account as a .doc. This would help me catch more errors in early passes.
Siri can also take dictation; I’m planning on setting aside some time to play around with writing by dictating to Siri on my Mac. I know a lot of authors love Dragon, but I just don’t have the budget for it. Dictating my novels—if I can get the hang of writing out loud—would really take some strain off my wrists.
I know a lot of people are kind of weirded out by voice-commanded tech. It seems futuristic and slightly creepy. My dad, for example, wants nothing to do with it. I completely agree that there are certain lines you just don’t cross. I wouldn’t load all of my payment and banking information into Apple Wallet, for example. That’s just asking for trouble—or at least, it seems that way to me. But Alexa can order things off Amazon for you, and you can even set a voice code so that it can’t be abused. I don’t often feel well enough to run errands, and Mike is usually exhausted and raring for a nap after work, so it would be pretty handy to say “Alexa, order some paper towels” or whatever when we’re running low. They’d be delivered straight to my door, saving both of us some time.
You can even connect certain home objects to your Alexa. It’d be so rad to say “Alexa, turn down the thermostat” or “Alexa, turn on the bedroom light.” I can easily imagine mornings, when it’s hard to get out of bed, made a bit easier by my girls: “Alexa, read Let’s Get Visible.” I could still be productive.
I do feel kind of weird “bossing” Alexa and Siri around. I can’t help but think of The Matrix and even Dollhouse. It brings up some interesting questions. Does AI have feelings? What makes us human? Sometimes I say “please” or just tell them they rock. I can easily imagine a future where voice-commanded AI is super useful or completely and totally abused—or abusing us! It’s definitely an intriguing avenue to explore in fiction. My Amarie in the f/f companion novel to Just One More Minute always says “please” to Alexa and Siri, because she doesn’t want to hurt their feelings. (Amarie is so sweet, and I can’t wait for you to meet her!)
Security and ethics aside, I welcome our robot overlords. As long as you’re smart about how you use them, they can be extremely beneficial to those of us with limited mobility. I’m even envisioning a future where, instead of the Life Alert lanyard, elderly people have an Echo Dot or something similar in their home; if they fall, they can say “Alexa, call 911” or even “Alexa, call my daughter.”
There are so many fantastic uses for Alexa, Siri, and future iterations. I’m eager to see how this technology progresses!
Do Alexa and Siri creep you out? How would you utilize them in your everyday life? Let me know in the comments!
I never followed up on my last health update (the one where I found out I was once again looking at a Lupus diagnosis). Since that post, I’ve gone into a full-throttle, super nasty flareup.
My pain has been steadily at 10/10 (8/10 at the lowest, with medication). I thought I had it under control after breaking up my Tramadol dose. Usually I take 100mg at bedtime, but I started taking 50mg in the morning and another 50mg at lunch instead, using my herbal medicine before bed to get me through the night. I got the idea to split my Tramadol from a friend, whose pain management doctor told her that Tramadol isn’t great for treating pain; you have to take it ahead of the pain—which I’ve long suspected. The downside to all of this Tramadol? TMI alert: I’ve been a little constipated, which I’m pretty sure is making my back pain worse.
Joint pain is symmetric, meaning both sides hurt. So both of my thumbs are painful and stiff, both knees, both elbows, etc. Oddly, my right side hurts more than the left in some cases; my right big toe, right hip, and right thumb have consistently been more swollen and painful than the left side. I suspect these joints all have bone spurs (Dr. Memet said she thought my toe did [both in the toe joint itself and the other nearby joints]—, my hip x-rays showed bone spurs, and my thumb feels exactly the same as the other joints do).
The pain is a hot ache and it radiates. But it also feels… bruised? There’s almost a throbbing, too; I can feel my joints swelling. It’s really hard to explain. Regardless, it feels fucking horrible.
My lower back is equally painful on each side, and very stiff. This morning Mike had to help me get dressed and put my slippers on. He had to help me sit and stand up multiple times. And every time I need to get something from one of our cabinets, he’s had to do it for me (our cabinets are underneath our counter—no overhead ones).
The pain wakes me up at night, multiple times. There have been a few nights where I couldn’t get comfortable and so didn’t sleep at all.
On top of the pain, I’m drained—no matter how much sleep I get. I’m not usually a napper, but I’ve been caving and taking naps. I’ve also been chugging Emergen-C like it’s my job. Neither that or coffee really help, though, so I’ve mostly been drinking plain water.
The only place I’m truly comfortable is on the couch. It curves nicely against my back and reclines, so I can get the pressure off my hips and knees too.
I need my cane while out and about—if I’m even up to leaving. I stayed home instead of going to a wedding reception this weekend. Today I basically haven’t moved from the couch, because walking and standing are sucky.
Since my last post, I found out that my anti-dsDNA was positive and pretty freakin’ high. A positive anti-dsDNA means:
there’s definitely something autoimmune going on
there’s a pretty good chance it’s Lupus
the immune system is attacking the DNA
the person is currently or about to be in a flareup
the higher the levels, the worse the flareup
My rheumatologist’s lab measures anything over a 10 as positive; my anti-dsDNA measured a 24. That’s more than double the normal level.
My rheumatologist said he doesn’t want to diagnose without a positive ANA, but I’ve found several medical journal articles that said doctors don’t need more than a positive anti-dsDNA to diagnose Lupus—especially with presenting symptoms. My rheumatologist said he was calling in Plaquenil, though—or so I thought. When I went to pick it up at my pharmacy, it wasn’t in. I checked the pharmacy several times, and they even checked other locations. No dice.
Honestly I’ve been so exhausted, not to mention tired of the medical merry-go-round, I haven’t called my rheumatologist’s office yet to see what happened with the ‘script. I was on the phone multiple times with them before and after my blood work came back, trying to resolve my bad appointment. I’m just sick of having to do all of this.
I have, however, been reading up on the anti-dsDNA, Lupus, and some other things.
What Arthritis Pain Feels Like—It’s possible that I have both OA and RA (or Lupus). Dr. M told me I have bone spurs in multiple joints. However, some articles indicate that bone spurs can be caused by RA/autoimmune. It really depends on the author, as rheumatologists all have different opinions. Either way, this article describes my pain to a T.
New Findings with Eppstein Barr Virus—I know one thing for sure: this all started after I had mono, which is caused by EBV. I thought this article was interesting, because even though it didn’t mention Lupus, it did mention some findings. For example, researchers believe that a healthy zinc level may keep chronic active EBV disease at bay. I’m wondering if my EBV is slowly evolving into Lupus. If so, could taking some of these supplements help keep flareups away? Or maybe it’s CAEBV? Chronic Fatigue Syndrome? Rheumatoid Arthritis? Lupus? Some combination of multiple or all of these? Can someone please get me some answers before I lose my mind? 😜
Anti-DsDNA is more specific to lupus than ANA and can be very valuable in making a diagnosis of lupus. […] If the anti-DsDNA levels are high, the disease is more likely to be active. There is either a current flare or a flare may be imminent.
I’ve long been complaining about Connecticut healthcare. Recently I found another spoonie living in CT who, after years of getting nowhere, went to see a rheumatologist in Boston. Within a single office visit, he diagnosed her and began treatment. I’m starting to think it’s time to get an out-of-state opinion.
She also has a post all about filing for disability, which really gave me hope because I thought after being rejected that there was no way I could get it. I know many people get rejected the first time and have to try again, try again, but I thought since I lost my diagnosis, I definitely didn’t have a chance. But it seems like, as long as you can prove your illness is affecting your ability to work—which it is—you can get disability.
I know I should’ve called both my primary and rheumatologist days ago, because even if they don’t feel like doing anything about it, at least this will be documented. It’s nearly time for a followup visit with my rheumatologist anyway, and I’m scheduled for a followup with my primary for November 17th. (Long story short: My primary wants me to come in every month in order to have my Tramadol refilled.) And my rheumatologist wanted to check my levels again in another month.
I’m out of ink (and can’t afford more right now, sigh); I’d really like to print off these articles as well as a list—my current symptoms, things I’ve tried, goals that I have, etc—and bring them in with me. I’ve started looking for rheumatologists in Boston who take my insurance (spoiler: there aren’t many), and I’m considering picking one and calling to make an appointment. But it’s a three-hour drive there, and we’re barely scraping by—never mind able to afford a trip to Massachusetts and back. I’m really starting to think it’s worth the risk, though.
I also need to get my medical records from Dr. Mongelluzzo (my former primary) and Dr. Greco (my first rheumatologist who retired, which was why I started seeing Dr. M); those records have blood work showing positive anti-dsDNA (and I’m pretty sure a positive ANA, too). I’d like copies for myself, rather than transferring them over. For one, it’s just good to have them. And two, I don’t trust Dr. S to actually read through them (nor do I trust Mongelluzzo’s office to actually fax them over, as I’ve had so many issues with them in the past; they’re very nice but extremely busy). I’d like to make copies of my copies for Dr. S, and highlight things that fit into the puzzle. Basically, I have to be my own detective and advocate.
The problem is, I need to get into Waterbury and sign a release form for each of them (the offices are across the city from each other). This is also a gas money issue. And, I have to pay for copies of my medical records from Dr. Mongelluzzo (I’m not sure about Greco’s office). A friend got copies of hers, and it was something like $2 a page—so I know my records are going to be hefty, since I was there for several years.
So maybe now you can see why I’m so doctor-fatigued. 😂
It’s all got to be done, though, if I’m ever going to get anywhere. I’d really like to start moving forward, because I’ve been in limbo for the past nine years. I mean, I dropped out of the university I was attending for my B.S. in Elementary Education because I was so sick. And I never went back. I’m still paying off those student loans. Even though I really love being an author, it’s not enough. We’re drowning here; I’m frustrated because I can’t work, and Mike is frustrated because his job doesn’t pay enough and he can’t seem to find anything else. It’s kind of funny because we both really want to take care of each other.
He insists that he can handle everything if he finds something better; I insist that, if only I could get better, I could work too and he wouldn’t have to stress it.
I keep hoping that if I work hard enough, write better books, and write enough books, we won’t even have to worry about it anymore. But the reality is, even if I became the best author in the world with the most published books ever, it’s not always possible to make a living. I mean, maybe I’m being cynical and negative, but someone has to be on the low end of the spectrum. Not everyone can be a NYT/USAT bestselling author or even mid-list.
Just One More Minute comes out in 12 days! You can pre-order your copy for only $0.99 here. Books2Read will either automagically detect your favorite retailer, or you can choose from their list.
It’s a beautiful thing indeed.
This month is already proving to be a tough one, so I’m trying to take it easy. Easier said than done, of course. I’m flaring hard, so pacing and resting are important. But I also have a release, which means promotion! And of course I’m writing SOF4 (see my latest update here).
Goals for November
Write at least 50K for Twisted Broken Strings (South of Forever, Book 4). (My total goal is 75K, but I’m taking it slow.)
Release Just One More Minute. Thank goodness for pre-order. I don’t have to lift a finger on release day, other than to change the price to $2.99. I’m also looking for bloggers who’d like to share Chapter 1 sometime this month, and maybe even review an ARC. If that sounds like you, you can sign up here.
Finish beta reading for my CP. She is seriously a doll; I’ve been taking way longer than forever on this and she’s been nothing but patient. The worst part is, I love her novel! Time is not my friend.
There are a lot of other things I’d like to do, but I’ll be grateful if I can accomplish these three. I’ve been scheduling important social media posts so that I don’t have to spend a lot of time on Twitter and Facebook (plus I can get some extra rest). I struggled a lot with doing this—in my silly mind, I felt like scheduling them was disingenuous. But Rachel Thompson and all the wonderful people in #bookmarketingchat assured me that it’s all still me, and that it’ll make my life so much easier. They were totally right.
Speaking of chats, I’d really like to make more of these. Unfortunately, by the time they start I’m usually shot for the day. That’s typically the hour that all I’m good for is curling up in front of the TV and fighting sleep. There are some really good ones, too, so it’s a bummer. If this sounds like you, let’s high five and make matching #TeamTiredAuthor T-shirts.
I’ve slowed way down with my reading. I still have the rest of Claire Contreras’s Hearts series, and my pre-order of J.C. Hannigan’s Rebel Heart came in and I can’t wait to re-read it! Plus I have about a dozen books I’ve bought but have yet to read. Reader/writer problems, am I right?
However, I’ve started writing morning pages again! I’m beyond broke, so I picked up an $0.88 composition notebook. My pages are not usually in the morning; often I’m scribbling in them just before bed, to try to alleviate my mind. Not to mention it kills my wrist and fingers. But I get those three pages done anyway.
There are a few writing books I’d like to pick up, especially Sean Platt and Johnny B. Truant’s The One with All the Writing Advice. I’m fascinated by the concept of cultural shorthand. I also realized I never finished Larry Brooks’s Story Engineering. I didn’t even make it halfway through, because there was so much to absorb. But I think I’m ready now.
So many books, so little time.
My GoFundMe page for donations and author services to help my husband and me catch up on bills is still up. I was able to pay a couple of bills thanks to your help, but we have a long way to go. We didn’t make our electricity bill, so we now owe that plus next month’s. I’m thinking of coming off the budget plan, because ours is set way higher than what we’re actually using, and keeping up with it is killing us. It’s only in the brutally cold January and February that we go over and it comes in handy. If you’re an author in need of budget-friendly services or would just like to help, you can donate here.
This month What Happens on Tour (South of Forever, Book 3) is part of Kobo’s Black Friday and Cyber Monday weekend sale. It will be $0.99 from November 22nd to 28th, no code required! And the first book in the series, Diving Into Him, is forever free (everywhere). So if you’ve been eyeing the South of Forever series and are a Kobo reader (you can even use their free app), now’s a great time to start. I recommend getting the free Book 1, then the $2.99 Book 2. Then when the sale goes live, pick up Book 3 for only $0.99! Check out the series page on Kobo here.
A lot of people ask me when I’ll have paperbacks in stock again. I have a few on hand in my office that I’m using as rewards for the GoFundMe. Eventually I’d like to get all of my books back in print, but here’s the thing: it’s less budget-friendly than publishing an ebook. If you’d like a paperback, please consider picking up an ebook copy and telling your friends. My hope is, once I get ahead of my bills, I can finally get started on paperbacks.
It’s been over 24 hours since everything went down and I’m still processing it. Everyone processes things differently—even from experience to experience. Sometimes you need to talk, even if you’re relaying the same information over and over. Other times you just need to quietly mull. I’ve found, in this instance, I’ve needed both space to just absorb and room to articulate.
Even though I’ve talked about it a bit on Twitter, written in my journal, ranted (like a hundred times) to my husband, vented to my sister-in-law, and tiredly filled my best friend in, I still keep running through it over and over again. And, even though technically I’m on a weekend-long social media cleanse, I really felt the urge to sit down and blog about it.
So here I am.
Part of me is in shock, enveloped in complete and utter disbelief. And then there’s the wide-eyed anxious part of me that is all, “See, I told you so.” I’ve been through this before, though, so many times. It’s not really surprising. It’s kind of just my norm.
This past summer, I got a sudden letter in the mail from my rheumatologist’s office, telling me that Dr. M was leaving the practice. I had a panic attack while reading the letter. While I’ve had a complicated relationship with this woman—during my first ever appointment with her, she suggested I see a psychiatrist and that was that—I’d made a lot of progress with her. She was listening to me, she’d given me a diagnosis, and she’d started me on a treatment plan. I spent years jumping through hoops trying to prove to her that I am not a drug addict or crazy. And finally, after nearly ten years, I was making progress in my medical journey. I was getting my life back.
I have joint pain. Often it is debilitating. There is radiological evidence of it; I’ve had several x-rays, MRIs, and even a bone scan that showed bone spurs and some other things in my joints. My illness causes marrow-deep fatigue. It flares from time to time, especially during periods of high stress or sudden changes in weather (like winter, rapidly increased humidity, or a drop/rise in barometric pressure). It behaves like an autoimmune disease—which runs in my family. However, my blood work is always inconclusive. I am seronegative for RA and I’ve had borderline results for ANA and double-stranded DNA.
Dr M determined that I have enthesitis-related arthritis, meaning the join pain is caused by inflammation in my tendons, where they connect to my joints. She explained that ERA doesn’t show up in blood work. She told me that she would treat me as if I have Reactive Arthritis, but that it could still be Rheumatoid Arthritis. She started me on a DMARD and, when it helped a little but had some nasty side effects, urged me to give it another shot. If it still gave me headaches and fatigue, she said, we would try something else.
And then I got the letter.
The letter informed me that she was being replaced by Dr. S, some guy I’d never heard of. I was immediately anxious because I’ve had so many specialists—most of them male—over the years who have brushed me off. I’m anxious in general when seeing a new specialist, but the thought of losing Dr. M and having to start over with a stranger was terrifying. Still, I tried to be brave about it.
I scheduled one last appointment with Dr. M, where she gave me a cortisone shot in my right big toe and explained that she thought I had bone spurs there and in my other big joint in my foot. She said I might possibly have RA and osteoarthritis. And she urged me to give SSZ another shot, even though I asked if I could try another DMARD.
She instructed me to schedule a followup with the new guy for my toe. Cortisone shots don’t always work, and she really wanted me to see a podiatrist if my toe continued to be painful. It was so stiff and hurt so much, I could barely bend it. I couldn’t put weight on it at all and basically had to walk on the ball of my foot—which of course aggravated the pain in my other joints.
I couldn’t schedule my followup yet because the office didn’t know Dr. S’s schedule. This kind of irritated me, but I talked myself down and told myself to give him a chance. I was supposed to call the office to schedule it in a few weeks, but I got super busy with book stuff and it was summer. I always have very minimal pain in the summer, plus the cortisone shot helped and my toe was better. Plus, if I’m going to be honest, I was still super anxious about seeing the new guy. As summer wound down, though, I knew it was time to get back to my health and bite the bullet. So I did it. I was super proud of myself.
In the weeks that passed while I waited for my appointment, my arthritis started flaring. I felt fatigued every day. My joint pain increased. I’d stopped taking the SSZ again because the headaches and other side effects far outweighed the benefits, though it did help a little so I knew we were on the right track. I’d talked to other spoonies with similar diagnoses who’d recommended some DMARDs, so I knew for sure I wanted to try something else.
On the morning of the appointment, I got up early. I was anxious the night before so I didn’t sleep well, but I did sleep. I ate a tiny breakfast even though my nerves were shot. I treated myself to a coffee from Dunkin Donuts. I showered, dressed up—which is special because I’ve mostly been wearing shorts or leggings—and did my makeup. I made a huge effort to make myself feel good. And, I’ll be honest: I also went to great lengths to look like a responsible patient.
Though I’m ashamed to admit it, I’ve been mistreated and accused of drug seeking so many times, I often dress up when I go to the doctor’s—unless it’s someone who is familiar with me and someone I trust. Then I break out the sweats but still rock the makeup. 😉 I want to stress here that I know people who struggle with substance abuse are patients, too—patients who deserve medical care and kindness and respect. So many doctors make assumptions about chronic pain patients, too, which often makes it difficult for us to get those same things that we also deserve. No matter what the patient’s experience, they are a person who should be treated like a person. It’s a messy, outrageous issue that calls for an entire blog post of its own.
I brought a notebook to takes notes in and my agenda so that I could schedule my next appointment. I gave myself a pep talk and even wrangled Mike into coming with me for support, because just his mere presence eases my anxiety. Those blue eyes and the warmth and kindness that he radiates are 100%-natural Ativan, you guys. We arrived a few minutes early. I smoked a cigarette to further calm my nerves. Then we went in.
I checked in as usual and then waited a little longer than normal to get into an exam room. Or maybe it just felt longer because I was so anxious. I’m not sure. Dr. M’s medical assistant was the same woman, which was a huge relief. She took my weight, pulse, and blood pressure, as always. We went over my medications and I let her know that the SSZ wasn’t working out so I’d stopped it. I admitted I was nervous about meeting Dr. S but she assured me that he was very nice.
And he was. He was soft spoken and very gentle during his physical exam. But he completely ignored everything that was in my chart, everything that Dr. M had told me. He brushed aside my questions. He insisted that I couldn’t possibly have arthritis because my blood work is negative. He told me that ERA would also show up in blood work. When I asked him questions and explained that Dr. M had told me otherwise, he brushed me off. He told me that I probably have fibromyalgia—something I’ve heard a thousand times from other specialists who either couldn’t figure out what was wrong or didn’t want to listen. When I explained—patiently—that I’ve been determined negative for fibromyalgia several times because I do not have the tender pressure points, he brushed me off.
I know several people who have fibromyalgia, who have told me that their experiences are completely different from mine. They have muscular and nerve pain, not joint pain. I have joint pain, not muscular or nerve pain. And when I tried Neurontin, a medication for fibromyalgia, I had an extremely adverse reaction to it. I asked Dr. S if fibromyalgia affects your joints, and he gave me a completely hedge-y answer.
He also kept asking about my Tramadol prescription. He asked me like three times where it came from. (My primary care doctor prescribes it, and it is a low dose—only 100mg at bedtime.) Dr. S kept pressing me to consider a pain management clinic.
If the word fibromyalgia turns me off, pain management clinic really makes me tense. I’m sure they help a lot of people, just like I know fibromyalgia is a valid chronic pain illness of its own. But I do not want hard painkillers because they are only a temporary solution to my pain. Plus, to be totally honest, they hit me too hard. I can’t function on them. I’ve only ever wanted a DMARD because they are a long-term treatment for my arthritis. I’ve literally never walked into a doctor’s office and asked for pain medication. NEVER. Because not only do too many doctors automatically assume that’s what chronic pain patients are looking for, but because it’s an automatic death sentence if you have a chronic pain illness and want to be taken seriously. In fact, I’ve asked to be taken off both Percocet and dilaudid because I did not like how they made me feel. It scared me, for example, how quickly my oral dilaudid dose stopped working and how I had to increase the dose literally the second time I took it to the prescribed two tablets a day—when one had worked fine the night before. I told my PAC at the time that I just wanted to go back to Tramadol.
But at that point in the visit, I couldn’t articulate any of this to Dr. S. I just sort of froze. Tears were at bay and it was all I could do to not start sobbing in the middle of the exam room. Panic closed in around me and I could barely breathe.
Dr. S said something about running blood work one last time, but that I can’t possibly have arthritis and it’s probably fibromyalgia. He told me that he didn’t want me to take SSZ anymore, that I didn’t need those medications. And he again recommended a pain management clinic.
I couldn’t get out of there fast enough.
Tears were rolling down my cheeks as I hurried out of the office. Running down the stairs, I focused on sucking down the rest of my iced coffee because it helped hold the tears in. By the time I hit the parking lot, though, I ran out of coffee and was sobbing. I was walking so fast, my body so pumped with flight adrenaline, that I couldn’t even feel my normal joint pain—and Mike could barely catch up. I tried really hard to keep it together, but I could barely get the words out to ask for a cigarette. As I lit it, I completely broke down. Mascara lines down my face and everything.
Hello, full blown panic attack.
Once it was over, this weird calm numbness washed over me. I’ve never experienced that before. It would be super cool if panic attacks could always end that way. I focused on helping a much-loved family member with her own doctor appointment. In a way, it was kind of good that we had back to back appointments in separate towns. In my numb state, I was calm enough to be there for her and it also took my mind off things.
But of course, it didn’t last.
Wave after wave of anxiety hit me once Mike and I got home, even though I’d taken pain medicine, which always helps relax me in both body and mind. It didn’t this time. I’d had a headache all day because I was nervous, but it intensified as the day went on. I’m pretty sure it was a mixed tension migraine because by 10pm, I was nauseous and had light sensitivity, plus my neck and shoulders hurt. Even though I tried not to, I kept bursting into tears, which of course made the throbbing pain in my head worse. And my joint pain was also sassy.
Between that and my mind racing, still trying to process everything, I didn’t sleep. I felt completely lost and even though I didn’t want to give up, couldn’t see any other option. I’ve exhausted every resource. I’ve seen every specialist possible. I’ve literally tried everything.
I spent most of today in a numb stupor. Mostly out of fatigue but also because I couldn’t wrap my head around it. Mostly I focused on helping my family, which also ended up being a huge help to me because I couldn’t wallow.
By later this afternoon, though, I started to feel incredulous. Indignant. Completely fucking pissed. I realized that I deserve better. That, just because Dr. S is a doctor, I don’t have to take his word as gospel. And it is not at all okay that within minutes he undid everything Dr. M did for me—everything I’ve worked for over the last decade. I’d really started to make progress with Dr. M and DMARDs were helping me get my life back. How dare he waltz in and take that away from me.
I decided that I wasn’t going to let him.
As I drove to pick up Mike from work, I realized that I needed to go to bat for myself. I was not going to let this doctor make me feel this way. He might be a great doctor, but he clearly wasn’t the right doctor for me. I decided, as soon as I pulled into the parking lot of Mike’s job, I was going to call the office and complain. Make my voice heard. Insist that I start seeing one of the other rheumatologists in the practice. Make them understand that it was not okay for him to treat me like that.
I was so proud of myself. More and more lately I am rediscovering my voice—and using it to advocate for myself. Not rudely, but loudly. Strong. Steady. Calmly. I was so excited when I slid into a parking spot. I grabbed my phone and speed dialed the office number. It rang and their normal announcements began.
“You’ve reached the offices of Dr. C, Dr. P, and Dr. M. The office is now closed. Please listen carefully as our menu options have changed…”
I felt my heart sink. I’ve never felt so deflated so fast. It wasn’t even 4pm yet, and their office hours have always been 8am to 5pm, Monday through Friday. It felt like someone’s sick joke.
I’m still angry, but I’m also exhausted. These last couple weeks—and especially the last couple of days—have drained me physically, emotionally, and mentally. I’m so grateful that the weekend is here, that I can unplug from social media and just relax. Cleanse. Give myself love.
And then, first thing Monday, I’m making that phone call again.