Monday, July 20, 2015

On Caregiving: A Note From My (Amazingly Supportive) Father

I used to be able to watch those pleas on television for money to feed the starving children in Africa and and be completely devoid of any emotion. You know those commercials, children with distended bellies, flies taking up residence in their eyes and some C-list celebrity trying to guilt you into donating “just a dollar a day.” Barely made an emotional dent. And I have to admit that I did feel just a wee bit guilty for not my lack of empathy, but not enough guilt to distract me from whatever I was watching before that damn commercial interrupted things.


But then we had kids.


Somehow the mere presence of these cuddly, screaming, adorable, sleeping depriving entities unlocked the emotions stashed in the recesses of my brain. Any TV show, movie, or commercial that depicted a child in any sort of distress induced that salty moisture in my eyes that I heretofore had hardly ever experienced.


As any parent will attest, the absolute worst is when your own child is ill or injured. The slightest fever could induce completely irrational fears of childhood leukemia. And don’t even mention the apprehension of flesh-eating bacteria that was induced anytime any sort of skin redness appeared.


Luckily, both of our children made it through the childhood and adolescence relatively physically and emotionally unscathed. Despite our best efforts, it did not appear that we caused and long-lasting damage to either of them. Our daughter graduated from the top fashion school in the country and and secured the job of her dreams in New York City. Our son was off to college as a pre-med with a high ranking GPA. While our arms were a little sore from patting ourselves on the back, we were just beginning to relish and enjoy our time.


And then it happened. February 23, 2013. Our daughter was at an ER in New York with searing pain in her neck and shoulders. Over the next several months, the pain migrated to her back, sides and hips. To make a very long story short, Erica had to quit her job and return home to live with us, exactly what a 24-year old had in mind for a career path. Rather than parties with the fashion gliterrari, she now got to experience leftover spaghetti and meatballs with parents. After months of poking and prodding, Erica was diagnosed with myofascial pain resulting from a genetic disorder, Ehler-Danlos Syndrome.


The worst was those nights when I had to witness Erica literally writhing in pain for hours. At that point, no medication or therapy offered any significant relief. This was, to me, a parent’s worst nightmare. Yes, I know her condition was not life-threatening. She is not confined to a wheelchair and her future still looks bright. These thoughts, though, provided little solace when she was coping with an undiagnosed condition over which we had little control.


As parents, Erica’s condition has provided us with some hard learned life lessons. We had to both learn how to be supportive and to cope with our collective changed circumstances. We wished we could have been more enlightened earlier in the process. In that vein, I would like to share what we learned as caregivers, with full recognition that there are exceptions to everything and what I suggest may not be applicable to all. The additional caveat is that Erica had resources that many lacked, such as generally supportive parents and good insurance. With that said, here is just a short list of what we learned.


1. The Pain is Real.


She’s not faking it. She’s not being dramatic. She’s not simply trying to get attention. She does want to get better. And, most important, it’s not all in her head.


2. Distraction Can be the Best Pain Relief


Most traditional pain medications, at best, did nothing, or at worst, had significant side effects that made Erica feel even worse. What did seem to provide some relief was just sitting with her and watching TV or looking at stupid videos on the internet. Netflix and Amazon were invaluable.


3. The Illness does not Define the Person


Erica desperately did not want to be known as the “chronic pain person.”The problem is that when dealing with a medical issue as all-encompassing as what she was experiencing, it is easy to let to her condition subsume conversation on any other topics. It dominated every interaction, including interactions between my wife and myself. We eventually learned to remind ourselves that we were the same individuals we were before the onset of Erica’s illness, with the same interests and eccentricities. The three of us made a conscious decision to talk about topics other than Erica’s affliction. My wife and I actually would agree not to talk about anything related to Erica’s condition while we went on walks or had dinners out.


4. Avoid Caregiver Fatigue


Recognize your limitations.There is no doubt that caregiving can be more than a full-time job. You can not always take a break when you would like, but you must take one when you can. Stress reduces your effectiveness as a caregiver. In addition, the unspoken truth is that stress can lead to resentment, which in turn leads to guilt. Certainly having a co-caregiver helps.Try to learn to recognize the onset of caregiver fatigue and take the necessary steps. It may be an afternoon nap or time away. Erica and I learned to recognize when my wife was bordering on stress overload. At those times we simply sent her away for the weekend. I recognize this may not be an option for everyone, but you must learn what is realistic and doable for you, And don’t feel guilty about taking a break. It will benefit everyone.


5. Nurture Your own Relationships


Caring for a child with a chronic condition can stress a relationship with a partner. When possible take time off together. As much as you feel to the contrary, you don’t have to include your child in every activity.


6. Timing is Everything


While your child is in the midst of a serious pain episode is not the time to try to resolve serious issues. It is not beneficial to discuss treatment options, simmering personal disputes, or future life choices in the midst of severe pain. When your child is suffering, her focus is not what job options she should pursue. Someone in distress does not have the desire, ability or inclination to deal with major issues. We have found that discussions on “big” issues were consistently unproductive at these times.


7. Adjust Expectations

Your child may not be able to do everything you think she should. Forcing someone to do something when they’re experiencing significant pain does not constitute good parental discipline. It merely exacerbates the pain. While there may have been times that I felt like I was being manipulated, I eventually that learned providing reasonable assistance was not synonymous with coddling. Instead, it helped Erica’s recovery and generally enabled her to take on more activity at a later time. While I am disappointed when Erica has to cancel a gym session, I realized that she is the best judge of her body. She has learned the hard way what she can do and when she can do it without adverse effects.





Thursday, July 16, 2015

Travel Tips For Chronic Pain I've Come Across Prepping for London

I'm starting to compile a large list of "hacks" for traveling/moving abroad with chronic pain. More will be added to this list, but again, after exhausting Google, I have found no go-to site with a list how to make traveling easier.



Here is a compiled list of a ideas.

GENERAL:

  • Plan ahead: don't try to do everything on your trip, get plenty of rest a week or so ahead of time, prioritize the things you want to see, include time for rest each day and the first few days to combat jet lag
  • Talk to your doctor: I had discussed with my doctor writing several lists (one for my disability advisor, one to receive a "disability room" at my housing, one for my flight, one for loans and one for the other specialists I will have there). Specifically for your letter to new specialists, it is a good idea for your doctor to detail your current meds, your allergies (especially drug related allergies) and a basic synopsis of your diagnoses and prognoses.
  • Buy travel insurance: This is a given. If you are too sick or in too big a flare to go, things always need to be cancelled every so often and you'll want your money back when it does. (This may also require a note from your doctor.) 
  • Don't change meds and/or therapies a few weeks before leaving.


FLYING:



  • When booking your flight, get accommodations. Just do it. It'll make your life easier. The key is to spend as little energy as possible on your flight so you can enjoy your vacation/new place of residence. Get wheelchair service in the airport--you will be able to skip lines to board, check in, etc. Ask for aisle bulk head seating (the seats in the front of each class with more leg room). See if they can give you an upgrade--I got one for business class. 

  • Medication: ALL medication you are bringing should be packed in a carry on. If you are going for 15 months like I am, you will most likely need a carry for just your drugs. At this point, you can use your doctor's note and call the airline's medical clearance to get more carry ons and check in bags for medical equipment, drugs, etc. Get all your drugs from a place like CVS Caremark that can give you all of them in advance. According to British Airways, customers and TSA will not have problems with me bringing a carry on bag of drugs and equipment like a TENS-Unit (as long as I also have the manual). 
  • Take breaks to walk up and down the aisles so you're not sitting constantly. Lay on the floor if need be. (I asked.) 

  • Get a direct flight. Seriously, going budget is not worth the pain. Avoid layovers. 
  • Drink lots of water! Bring an empty water bottle to fill up once you are at your gate. 
  • Try to reduce stimulation and bring comfort items. Noise canceling headphones are a godsend. Sunglasses, a blanket, a really nice neck pillow, etc. 
  • Pre-medicate before your flight. You will be happy you came prepared!
  • Dress comfy and wear lots of layers.
  • Give yourself LOTS of extra time at the airport (added breaks).



PACKING: 


  • Start early. Since you need to rest the week or so before leaving, I have started slowly packing now, a month or so before my vacation. I know this may sound silly to some, but it makes me feel less stressed, since I am leaving for a year and still need to get a lot of things.
  • Make a giant list and check things off as you go through so you don't forget. 
  • If you can afford to, bring creature comforts from home like a good pillow, equipment used for pain management, splints, circulation socks,pain salve (depending on size), icy hot packs, eye mask, etc. 
ONCE YOU'RE THERE (IF YOU'RE MOVING):



  • Find all the things you'll need around you, who and what delivers, and how much. I know all the closest grocery stores, dry cleaners, pharmacies, hospitals, etc. I've also looked up where to find caretakers if I would ever need them.
  • Get all your new doctors' appointments set up before you go so you can get settled right when you get there. 

  • In London, there is Amazon UK Prime. I plan on ordering all my medical equipment to arrive perfectly the day after I move in so it's less work I have to do later. (I've made a Pinterest secret board with links to all the things I'll need to buy when I move.) 



Like I said, I haven't done the trip yet so I will change/add/delete accordingly as time goes on. 

Tuesday, July 14, 2015

15 Things No One Tells You About Chronic Pain As A 20-Something

Syndicated from Huffington Post.

This was originally published on The Mighty, a site that finds the strength, joy and beauty in disability and disease.

1. Sometimes you feel like a lab rat/medical experiment gone awry.

"House M.D." doesn't even begin to cover all the weird treatments and experiments you've undergone to aid your health. Your "medical team" becomes the people you know and hear from most.

2. The idea of going out and maintaining a normal 20-something social life is laughable.


Think you're going out for a few drinks tonight? Oh wait, you can't because of your specific diet, medications you're on, etc. Friends may be disappointed. You may be bored (really bored). Netflix will be your bestie, don't worry.

3. Some people are really open and kind about your chronic pain. Some are just the worst.
Explaining your chronic illness truly becomes an art. You read their body language and take their past experience and personality into consideration before divulging your illness. Then, usually, it's a game of 21 questions.

4. There are good days and bad days.


Good days and bad days depend on a lot of the perpetuating factors you may have. Some days, I'm good enough to take a day trip to go shopping and other days, showering is a legitimate goal if you can make it out of bed.

5. You become your own doctor/pharmacist/advocate.

Doctors can make mistakes sometimes. I double-check all of the interactions of my drugs when I'm prescribed new drugs to make sure I'm not going to accidentally kill myself. Do your research. Many of the things that work for me now consisted of a series of trial-and-error combinations of medicine and therapies.

6. With chronic pain comes new and different priorities and limitations.

The way I best describe any given day is that my life is like an iPhone battery, and I'm on energy-saving mode. Everything from cooking, to getting dressed, to going out to eat, to working take a little (or a lot) of battery. Some things I used to love to do are just not worth it anymore.

7. Chronic pain is a full-time job.


I'm not kidding. If I could show you my calendar, between all my specialists, I have on average about four doctor's appointments weekly. Half of them are usually out of town -- meaning they're out of state. I also, on a monthly basis, get acupuncture, chiropractic work, Reiki, massage, trigger point injections and see a personal trainer (who specializes in chronic pain) twice a week to weight train. If something pops up out of nowhere and everything needs to be rescheduled, I'm on the phone for sometimes hours rearranging appointments.

8. Certain foods become your best friends.

When my pain was at its worst about a year ago and I had no medication to help my pain, all that could comfort me was mashed potatoes and ice cream. Turns out, mashed potatoes and ice cream are not a cute look for my body and with my physical limitations, cooking healthy food for myself and exercising is much more challenging.

9. Sleep, above all, is key.

Seriously, if I get no sleep the night before, my whole day and body goes to sh**. Getting enough sleep is worth it.

10. Maintaining a love life? LOL.



I haven't even begun to crack the chronic pain code on this one. I have no answers here.

11. Get a pain guru.

Having someone close who's been through the ringer with everything you're dealing with is so helpful. Anytime I call her frustrated about something, she has five to 10 different solutions I never thought of. My pain guru happens to breed puppies. Speaking of which, puppies are just about the best therapy you can have, so get those, too. Nothing feels better than lying in a pile of puppies.

12. You will have haters.

Send donations in their honor to your favorite chronic pain charity.

13. A few people will be inspired by you, a few people may feel too sad to even be around you and a few people may slit your tires when they see you in handicapped parking with a handicapped tag.

The tire thing didn't personally happen to me, but it did happen to someone I know. Don't forget, just because you can't see an illness doesn't mean it's not there! Don't be those people.

14. Silver lining: you get to watch every show you ever missed out on and try a lot of hobbies you never thought you'd have time for.

Hobbies I've started since medical leave: learning French on Rosetta Stone, writing, flower arranging, pottery, painting/sketching, jewelry design, puppy socializing, volunteering at a pit bull rescue, cooking, baking and reading.

15. Chronic pain has forced me to see the world in a different way. It has forced me to embrace all of my vulnerabilities and genuinely be a better person. Ironically, because of my chronic pain, I am now finally able to do exactly what I always dreamed of.


Wednesday, July 1, 2015

Now Officially A HuffPost Blogger!

HuffPost has syndicated my first article via hercampus.com. Please read and share!

Since I was invited to blog for HuffPost, I am able to post whatever and whenever I want. I have plenty of things I would like to write about for them, as well as rewriting old blog posts, but I would also like to use this is a tool to be a voice for other chronic pain sufferers as well. With pain, many voices are not heard or understood.



That being said, if anyone out there with chronic pain has any ideas or suggestions they would like me to write about, please let me know. You can email me under "contact" with the email listed or in the comment section. I've met so many people who have had pain much worse and longer than I have and am always looking for insight.

Working on a big list right now! I have a few other pieces I'm working on for different sites now (plus recovering from this horrible GI virus I still have) but I will come back to this and focus my efforts on HuffPost. (I also have no idea when I became this busy WRITING of all things.)



I feel very humbled to have come this far, to be honest. This blog was just an idea for a long time that took a lot of balls for me to work up the nerve and write. I was honestly expecting mixed reviews. (I know how the internet works--there are always critics.) But I have been overwhelmed with the love and support I've received from the little pipe hole of a project I started a year ago. I'm looking forward to see where this takes me and, more than anything, happy to see that many of you really find it helpful and use it as a resource.

Thanks guys! 

Wednesday, June 24, 2015

What to Pack When You Need to Go to the ER

Last week, I had to go to the ER. I hate the ER. It is always a last resort. That day I woke up with a high fever, nausea, bad GI problems, dizziness, generally feeling like I got hit by three buses, etc. I ended up having probably the worst possible version of whatever shitty virus is going around + my general pain.

Dad: "You look dead. Give me a thumbs up."
I couldn't hold down food, liquids or drugs, so my dad took me to the ER because I was so dehydrated I could barely move.  It took forever for them to bring me back after a lot of drama I caused in the waiting room yelling things like "poor care" and "I need to speak the administration immediately!" in my half comatose, angry state. Obviously the first thing they tried to do was get an IV in me, which seemed like an impossible feat. I think 6-7 nurses AND doctors each tried about 3-4 different times in all different spots, all with their own dumb theories about how to do it. One doctor even used a ultrasound to find veins and ironically, he was the fucking worst one.

The night I got home.
The next day. I've looked like a heroin addict for approximately a week.

I was in a bed in the hallway for several hours and eventually got moved to a bedroom and was able to leave late that night.

Below are a mixture of things I brought and things I wish I had brought. Because, damn, when better to be prepared, right?


  • Noise Cancelling Headphones - You will THANK me for this later. If you're stuck in the hallway with a headache for 1+ hours, all you hear is constant beeping, people screaming, doctors yelling. My body is sensitive to that shit. Even if you don't listen to music. Put 'em on.
  • Medical Wallet ID Card - I need to make one. I had been waiting until I moved to London so I wouldn't have to change all of my information 20,000 times before I moved, assuming I wouldn't have to go to the ER before I moved. Silly me.  Make sure it has your doctor's phone numbers, a list of current meds you're on, diagnoses, emergency contacts, allergies to things, etc. This is crucial, especially if you're too out of it to explain. You can even print them online and laminate them together. 
  • Packet of Medical Info including doctor's notes approving the medication you're on (especially if you're on narcotics), a description of diagnoses and how you're managing them, and a list of all the drugs you've had bad reactions to
  • Change of clothes - In the case you have to stay the night, or something gets vomited on, blood on, etc. Better to have them.
  • Pillow and travel blanket- ER people tend to forget you exist sometimes. Bring your own stuff. From my fever, I had bad chills and had to wait FOREVER to get a blanket. Brought my own pillow, which THANK GOD, but it did get covered in blood. Damn you ultra sound guy.
  • Toiletries, especially Listerine- if you puke, you will wish you could brush your teeth, I would also throw in a brush, some hair ties, tooth brush and tooth paste, some dry shampoo, etc. 
  • Drugs while you wait- You may have to wait awhile. In the mean, I had brought some Ibuprofen for my fever and headache, Zofran for the nausea and my typical pill box of fun pain meds
  • Phone and whatever other chargers you need
  • Snacks- even if you can't eat, your poor, miserable family members will get hungry 
  • iPad- you need to entertain yourself somehow
  • Squeeze Pig (or just something to squeeze)- I use my squeeze pig for injections but I could've totally used him when they were searching for veins for 2 hours. 
  • Wet wipes- Guess who left the hospital covered in blood. We can't all look like animals. 
  • Cool Towel - You wet this thing and snap it, and it stays cool for HOURS. Perfect for fevers. I wish I had mine. 
  • Eye Mask - Zone out, especially if you're sleeping over. (This is my new one.)




Let's hope this never happens again. Ever.

Tuesday, June 16, 2015

What I do for...

It's good to know what your options are when you're in pain and not thinking straight. Now that I'm starting to be able to manage my pain better and perpetuating factors (like IBS, PMS, hypoglycemia, etc.) I am slowly coming up with a good list of how to normalize my body as much as humanly possible. Sometimes when spasms or nausea/dizziness is unbearable and all else fails, I just drug myself enough to sleep through it. Sleep is so important. Do what you have to do to get whatever kind of sleep you need! For me, it's priority numero uno. And keep calm! My pain used to make me panic--now I'm easy breezy and it makes things go a lot smoother (and I make more rational decisions).

...muscle spasms/trigger points

...joint pain
*Something I have started doing now that I have a few drugs that work for me is taking it before if I know I'll have a hard day or the second it comes on. The last few weeks, my pain has been a lot more controlled doing this. Usually I have a mixture of joint pain and spasms, so I take a muscle relaxant like Metaxalone and 800mg Ibuprofen and that has been helping me. I also finally got around to keeping a pill box one me for when I'm out and crisis strikes. Stay ahead of it. 

...vertigo/lightheadedness/nausea
#themoreyouknow



I will add to this list as I think of more things. If anyone has any questions, please message me! 

Monday, June 15, 2015

Wrote A Piece for HerCampus!

Check it out here! And please share.



Here it is:

Her Story: A Chronic Pain Disorder Took Everything Away From Me


On June 20, 2013, the first pain specialist I had ever seen told me, “You are entering the beginning stages of the world of chronic pain.” And I bawled my eyes out.
Backtrack to eight months prior: I had just graduated from the Fashion Institute of Technology in New York City with a degree in International Fashion Merchandising with honors. I was styling for major magazines and celebrities, and I landed my dream job for a major designer doing sourcing, product development and production. I was one of the rare few that genuinely enjoyed my job. I loved what I did and wouldn’t have traded it for the world.
A few months after I began working, I became obsessed with the position. I was a total workaholic, and at some point, I completely stopped taking care of myself. I was no longer eating well, exercising or even sleeping. I got to the point where all I was doing was working, showering and ordering take-out every night. I stopped seeing my friends and tried to nap in my limited spare time. When February 2013 rolled around, it all came to an abrupt halt.
I woke up one Sunday morning in February that I will never forget: I couldn’t move my neck without an excruciating pain radiating down through my shoulders. I was transferred to the Emergency Care Unit of Hospital of Joint Diseases at NYU.
Little happened at the ER, aside from being pumped up with hard painkillers, anti-inflammatories and muscle relaxants. I was still vomiting by the time I was discharged. I was then sent to a myriad of doctors who tried to figure out what was wrong with me. Some had ideas (that were wrong), treated me for their diagnoses and ended up discharging me, telling me I was crazy or that the symptoms were all in my head. This happened several times.  
It got worse. The pain continued to travel down my back, the sides of my spine, through my neck—it was excruciating. To add even more devastation to the pain I was experiencing, I was forced to leave my beloved life in Manhattan. My paid disability leave ran out at my job and the lease on my perfect East Village apartment ended. I had to leave my dream job, pack up my apartment, and say goodbye to all my friends, then move home to Pennsylvania with my parents indefinitely. I was a mess. I was 23 years old and felt like my life was spiraling out of control.
At that point, I couldn’t even sit down for 10 minutes without crying from the pain. If I took a car ride for more than 30 minutes, I had to make a bed in the backseat to lie down. I couldn’t drive. I didn’t have friends at home. I was insanely depressed and was alone most of the time, essentially on house arrest because of the pain for months at a time. Brain fog from pain was so bad that I couldn’t concentrate on anything. I was rapidly gaining weight. I couldn’t cook for myself. I was so poked and prodded from so many blood tests from all of the different doctors that I looked like a drug addict. As I recently learned, I have metabolic issues with most drugs, so trying all of the new meds I was being prescribed by these doctors constantly made me break out in then-unexplainable rashes, vomit, and I’d get dizzy to the point of being unable to stand.
After seeing rheumatologists, GPs, physiatrists, PTs, sports medicine doctors, geneticists, neurologists, pain specialists, endocrinologists, and orthopedic surgeons, I was still not getting anything useful from anyone. I had a posse of residents following me around the hospital and calling me 24/7 to ask me questions. Nurses would make little cracks about “Erica and her entourage.” 
I was in so much pain that I was willing to try anything, including hypnotists and private meditation counselors. But it was finally decided that I had tried enough, and the only step left was to go to Johns Hopkins Hospital. I managed to get an appointment with the top pain specialist in the country, and in July of 2013, he diagnosed me with Chronic Myofascial Pain Syndrome, Hypermobility-Type Ehlers Danlos Syndrome and hypothyroidism. With these diagnoses he told me, as gently as he could, that there was a good chance it would never get better, and that there was a serious possibility I might never work again.
This ignited in me some serious determination. I told myself that I would get better no matter what and that some day, no matter what it took, I would work again. After rounds of new (more effective) drugs, physical therapy and weekly trigger point injections, I started to (finally! miraculously!) make some improvements. It wasn’t an easy feat. This strategy was absurdly taxing, both emotionally and physically. Everything was painful, but I very slowly improved.
I now get trigger point injections every month, and I work with a personal trainer that specializes in chronic pain, massage, reiki, therapy, chiropractic work and acupuncture on a regular basis.
I decided the best way to get my career back on track would be to attend a short masters program to show potential employers that I am still both relevant and capable. I also knew that a masters program would be an easier transition back to work after being mostly immobile for three years. I have always been an all-or-nothing kind of gal, so I decided to apply to a competitive one-year masters program at London College of Fashion to study Fashion Design Management with my focus on sustainability and ethical design practice. I knew it was unlikely, but I also knew I would kick myself for not at least trying to follow my dreams after such a painful and depressing time-out from my beloved career in Manhattan, which felt like a lifetime ago.
To my delight, I was accepted! With the most accessible and generous disability accommodations available, I will be moving to London and attending LCF in the fall and I have to admit, I am pretty damn proud of myself.
Not many people can relate to all of this. The fear, the immaculate planning, the general anxiety, the stuff you have to put up with from doctors and the judgment from people in general. I lost many good friends in this process—even people I thought I was really close to. The last two years have been gruesome, not just physically but psychologically. Watching all of your friends grow in their professions and their relationships—their lives overall, really—is hard to watch from your bed.
The coming year will undoubtedly be full of challenges and obstacles. Sometimes I feel like that’s what my life has become—a constant battle between what my mind wants and the more limited capabilities of my body. Prioritizing the things you want to do with the things you can do can be hard. But I can’t give this up. I will find a way to make it work.