Category Archives: Chronic Illness

This Old House (The Body Edition)

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I spent much of the day yesterday on a train to New York (because obviously the only thing more sane than moving three days before Christmas and becoming displaced for three weeks is squeezing in a last minute business trip the day before said move, but it was well worth it. When have I ever been known to do things in any sort of logical, tempered manner, anyway?)

I was wading through some research for a project I’m working on, but despite how interesting I found Kleinman’s theory of sociosomatic illness (and I really did), I couldn’t string together two coherent sentences on it. For one, my body was achy and tired from packing boxes, stacking them, and packing some more. My brain was whirring with logistical details—movers, lat minute requests from our buyers, Christmas gifts that needed purchasing—that kept creeping into my highlighting and note-taking routine.

But more than anything, the New England coastline makes for a pleasant distraction. The only thing I found more enjoyable than looking at the icy waves and scenic vistas was looking at all the different types of homes that dotted the shoreline.

True, I have moving on the brain, but I have always been fairly obsessed with old houses. This train ride gave me plenty of chances to feed my fervor. Really, is it surprising that the structurally defective girl likes houses with wonky hardwood floors, sloping corners, and squeaky joists? No sparkling new boxy Neo-Colonials with their pristine, virgin floors and sensible open floor plans for me. If there aren’t systematic idiosyncrasies—or what I prefer to consider charm–I’m not interested.

Part of this is situational. I grew up spending the summers on Cape Cod in a neighborhood where most of the houses were grand rambling affairs, circa the 1700 and 1800s. Most of the places I’ve lived in the city have been old—in Boston, this comes with the territory—with crooked angles, oddly shaped windows, and steep staircases.

One of my goals in life is to someday own a house with a turret. As long as the turret is accompanied by a creaky old front porch for Scrabble playing, my husband is on board with this. But besides the geographical aspect, I think I just have a more finely attuned appreciation for large-scale quirkiness.

My middle fingers have broken so many times that sometimes they just get stuck in the bent position and it is impossible to wrench them straight again. When I am fading, apparently my left eye doesn’t open as much as my right one, a bizarre little factoid my husband uses to gauge my energy level. I routinely get high fevers for no obvious reason. I can predict changes in the weather by the thickness of my lung secretions, and I’ve been known to grow bacteria not normally found, oh, say, in North America.

And when it’s humid out, my curly hair actually grows more horizontal by the minute (I have witnesses), just like a real, live Chia pet. Good times.

I’d like to say that like the old houses I adore I have good bones; however, we all know that would be an outrageous lie. But like an antique Cape coming out of a long, stormy winter, I like to keep things…interesting.

Thank goodness my husband likes long-term maintenance projects.

And turrets.

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In all of the holiday madness, don’t forget to swing by Medgadget to cast nominations for the annual Medical Blog Awards.

’Tis the Season…?

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I’m spending the day in the hospital, waiting for someone I love to get out of a long surgery. I came prepared—laptop, headphones, research I should be doing, and of course, several glossy magazines. (What can I say? Distraction is the best antidote for worry). I noticed a definite theme running through all of the magazines—this is the season for stress. There were tips on stress-free shopping, stress-free entertaining, stress-free family functions, and stress-free travel.

It made me think of a recent post I wrote about stress and illness and the tenuous relationship between the two.

Just in case I haven’t already hit you over the head with it (let’s be serious, if you’ve read the other post, you know my position), I believe in the distinction between stress causing illness and stress exacerbating illness. As in, stress did not cause the genetic respiratory condition responsible for so many hospitalizations—my suspect genes did. As in, stress did not make me cough for 17 hours straight and go into respiratory failure, but 20+ years of the wrong treatment for the wrong disease certainly contributed.

Did stress play a role in making the infections and recovery worse? Sure it did. Stress takes energy away from recovery. I’ve seen stress make diabetic blood sugars skyrocket, I’ve seen stress make arthritic joints ache with more severity, I know this relationship is a strong one.

As firmly entrenched in my position as I am, my husband said something the other night that gave me pause. In speaking with someone else about my health, he mentioned that I was much more stable the past few years because of the lifestyle changes I’ve made. “Your schedule in college would have made the healthiest person run down and sick,” he said.

He had a point. In college I worked anywhere between 30-40 hours a week on the campus newspaper (usually from 5pm till the middle of the night), got up early to fit in five courses a semester, interned another 15-20 hours a week, and did lots of other random stuff. I was either running around on 3 hrs of sleep and heavily over-committed, or I was an inpatient.

For three years now, I’ve proudly asserted that the reason I am in the hospital less often and for shorter periods of time is because I finally have the right diagnoses for several of my health problems. I’m getting the right kind of preventative treatment (daily chest PT), I’m on the right medicines, I’m seeing a doctor who specializes in what I have. I’ve stopped the vicious cycle, and better understand how to cater to my persnickety lungs and deficient immune system. I firmly believe if I hadn’t gotten this diagnosis and wasn’t doing all these things, I’d still be making trips to the ICU. It surprised me that my husband hadn’t factored this into his conversation. To me, it is all the difference in the world.

And yet, I have made a lot of lifestyle changes. I don’t survive on three hours of sleep per night (adrenal failure makes that one pretty impossible). I am not so desperate to prove I am not sick by taking on too much. I’ve made sacrifices and compromises both financially and professionally to ensure I am not in that vicious cycle again. I’m trying to set myself up now for a future that while promising, is not as certain as the present.

So there is some truth to what he said, certainly. I’m not sure I would have made those changes, would have matured in the same way, if I hadn’t had the diagnostic breakthroughs. But I also believe 100 percent that if I were still living my life the way I used to, I would be sicker. I’d be more run down so infections would hit me even harder. This is not wisdom or enlightenment so much as it is common sense, and I think it applies to anyone, regardless of health status.

(And yet if I were to run into a certain doctor from my past today, the tiniest part of me would want to tell him: It’s the holiday season. My grades are due in two days, and two huge freelance projects were due this week. I just sold one house and bought another (its own unique brand of home inspection-acquired stress) and my life is half-packed, the boxes stacked and ready to move three days before Christmas (good timing, much?). My computer died in the midst of the major deadlines, I’ve had the plague since sometime in July, and someone I love is having invasive surgery as I type. If I were to pick a stressful couple of weeks, it would be these.

And yet I am breathing just fine, thank you. Stress, huh.)

But of course I wouldn’t say it. I would nod a hello and go on my way, my indignance tempered by gratitude that at least I now know what’s wrong, and I know what choices I should make to keep me well.

Anatomy Lesson

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Various things I’ve learned recently:

That if someone cannot walk two steps on their toes or heels without trembling or falling, something is seriously wrong with their back. (Seriously.)

That if someone’s spine is crooked, fluid-filled, and riddled with bone spurs and if their disks have slid far enough in the wrong places, the pain can radiate not only down their legs and into their feet, but it can also inch up towards their head. (It’s equal opportunity!)

That when crawling seems like a reasonable option, probably that person’s quality of life could improve. (A modest request, really.)

That it is possible for the body to have learned to tolerate far too much pain for far too long. (And the rest of us are wimps, no matter what we’d like to believe.)

That even if someone takes the right medications, does the right exercises, and makes many accommodations, the body is a sneaky, shifty thing that does not bend to mere wishes. (And MRIs do not lie.)

That when doctors talk about removing parts of someone’s vertebrae and fusing other parts of the spine together, they intend to do so with pieces of that person’s own bone. (Because at first we thought it could be some random person’s bone, and that seemed sort of gross.)

That even though someone can look so small and vulnerable on the exam table and their shoulders might even quiver a bit, their eyes can still be fierce with a strength few people possess. (I mean fierce.)

That watching someone you love in excruciating pain makes you feel incredibly frustrated and completely helpless. (But then you compare your discomfort with their pain, and you realize it isn’t about you.)

Later as you stretch, or when you bend down to pick something up, or walk from the bus on your own two feet, and you don’t feel a tingle, not at ounce of searing pain you know exists for someone else, you cannot help but think, I am lucky.

Specialists, Specialists Everywhere, But for the Little Things, Not a Doc to Spare

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The last time I had any sort of primary care doctor was when I was in first grade, up until the pediatrician who referred me as a baby to the ENT and immunology doctors handed me off to them altogether. It appeared I wasn’t exactly an ideal candidate for generalized care. Considering the strep that sent most little kids to the doctor’s office for a quick swab test and some meds ended up spewing from my ears and lodged in my knees, I can’t really argue with his logic.

For most of my childhood and young adulthood, I rotated among specialists for a confounding array of ailments: an asthma/allergy doctor for my lungs (and we all know how well that went); an immunologist for my IGg deficiency disease, an ENT doc for the ever-present (and sometimes life-threatening) infections and surgeries, a rheumatologist for the joint inflammation that began in my lower back at age 10. There was also the orthopedic surgeon who fixed my ankles and diagnosed my knee problems, the specialist who dealt with my enlarged liver and spleen, the urologist, the endocrinologist, and many others.

No wonder my genial suburban pediatrician looked at me and secretly wanted to run in the opposite direction. (And can you just picture what it was like when I was asked to supply copies of my entire medical record? I think upwards of six hospitals had a piece of me.)

It was (and is) a precarious position to be in, and I cannot help but think of the overused analogy of the quarterback: I had lots and lots of team players responsible for different things, but I had no one coordinating all the moving parts.

I still don’t. I have my lung doctor, who is amazing. I actually have to suppress the urge to tell him he’s a rock star when we communicate via e-mail because I do not want to sound like a crazed fan or something. I have a scarily smart rheumatologist who oversees various infusions and inflammations and serves as my de facto primary care doc, but her office is busy and isn’t made to handle acute (but minor) things that aren’t technically related to rheumatology. I still have a handful of other specialists who deal with isolated problems and body systems, and I see them and undergo their suggested tests.

I am not arguing against specialized medicine. I would be foolish to do so. If it weren’t for advanced, sub-specialized care, I never would have received diagnoses for rare respiratory diseases, diagnoses that have changed my life. I depend on the cutting-edge research into ridiculously niche problems my specialists conduct to maintain my quality of life and hopefully change the future outcomes of progressive diseases like mine.

That’s no small order.

But whom do I turn to when I have a nagging headache that persists for weeks? I know (because after 20 surgeries, you just know these things) it isn’t sinus related, and my eye prescription is current. What about the fleeting dizzy spells and intermittent fog that is different from the chronic fatigue or adrenal depletion? Do I start with the ENT doc and move outwards after that? Call up the rheumatologist and see if she’ll take a crack at it?

And what about all the normal things other people get checked for during physicals? I can’t remember the last time I had a physical. I know that many, many important things in my body are monitored regularly, but for all the sophisticated tests and labs I have, are there smaller routine things no one is checking because everyone is looking at something different?

I’ll figure it out, I know. I have a lot of weird issues that necessitate a lot of doctors and I can’t argue against that.

But when niggling things manifest, I’m not sure any of them are appropriate people for me to bother. I’m thinking of taking the plunge and getting a certified primary care doc. I hear they’re something of an endangered species, and I fear people like me are largely responsible for that. But if they’ll have me, I just might like one of them….

September Lessons

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I’ve always loved fall. Some of my reasons are more typical ones: I love the vibrant colors of the leaves, the smell of burning leaves, the cool days where I can wear a sweater and not be too hot or too cold, the abundance of root-vegetable inspired dishes. I love the way the nutmeg and cinnamon-scented candles I use to replace the flowery smells of summer fill my living room, and the way the smoky aroma of grilled meat at football tailgates lingers in the air.

Plus, I am huge dork. Fall has always been synonymous with “Back to School,” and for dorks like me, this is a big event. When I was little, I would start planning my back to school shopping in July—not the clothes, mind you, because I wore a uniform from first grade through high school. No, much to my brothers’ horror, I was focused on such weighty issues as Trapper Keeper versus regular folders, erasable pen versus regular pens, and whether I wanted standard or college-rule lined paper.

And summer reading? I’d have finished it all within the first couple of weeks of summer and would count on the diligent notes I’d taken to refresh my memory in late August.

Obviously the older I got the less critical things like Trapper Keepers and erasable pens became, but fall (and September in particular) continue to have meaning for me, and my reasons for this are less typical.

For starters, the simple act of breathing is easier. True, my temperamental lungs never handle the change in seasons too well, but once we’re firmly entrenched in fall weather and I can say goodbye to the humidity that suffocates me, I am happy. I don’t mind the infections as much if in between them I can actually inhale and exhale without feeling like I will never get enough soupy air.

But beyond pragmatic changes like the weather and going back to school, for as long as I can remember fall has also been synonymous with this thought: “Maybe this year will be my year.” The clean slate I’ve been waiting for, the fresh start every student gets, the year no major calamities occur.

When I was little, “my year” would have looked something like this: No surgeries to accompany almost every holiday and long weekend. No weeks’ long absences. No streams of blood gushing from my ears, ruining my pillowcases and making me hesitant to sleepover friends’ houses. No missing birthday parties and ballet recitals and skating shows because I was too sick. No broken bones and casts with classmates’ signatures, no missing the bus because I needed another nebulizer treatment. No sitting on the sidelines at Field Day every May, watching everyone else run and compete.

In college, “my year” would have looked something like this: No missing weeks of classes each semester due to hospitalizations. No needing my friends to take me to the hospital or visit me during my longer stays. No needing to ask to borrow notes or make up more essays, no needing to conference call the campus newspaper from my hospital bed, oxygen mask and all. No needing to worry my parents with late night calls from the ICU, no getting worse and worse despite the more medication I took. No more feeling like all I did was put my life on hold for illness, and no more feeling like however much I gave up for illness, it would never be enough to make me feel better.

It was a vicious cycle of disappointment I set up for myself. Obviously I never got a year like that, and the more I wished for one and counted on that fresh, clean slate to feel normal, the harder it was when it never happened.

I still get excited for September, and I still get anxious to go back to school. I enjoy my writing students and their work, and I like the structure and routine of semesters. But I no longer count on each September to herald in “my year” and I am much happier because of that.

Don’t get me wrong, it is not that I have become resigned to crises and medical issues, or that I have given up hope that an uncomplicated medical life exists somewhere out there, and I am happy to say that the crises aren’t as pronounced as they used to be. But I’ve stopped setting up expectations that are counterproductive. It’s not about starting over each September with a clean slate or getting back to normal (whatever that normal is); it is about accepting that where I am, disruptions and all, is what is important.

So What About the Healthy One?

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I started a line of thought in my most recent post that warrants its own entry: the reason no illness is ever truly invisible is because the people who love us can decipher the many signs and symptoms of illness no one else can. I think it’s important to explore what it’s like for our partners or spouses when a shared illness is invisible, because it isn’t easy. It isn’t fun, or glamorous, or fleeting.

And it certainly isn’t fair.

I mentioned previously that my husband can tell from the single word “hello” if I am having a bad day. The reason he is so attuned to me is because he has spent our entire relationship doing things for me and because of me that no one ever sees:

Performing my chest PT when I need an extra treatment. Racing to hook up my nebulizer when I can’t get it myself. Picking up my prescriptions and accompanying me to doctor appointments when I am too weak to get there on my own. Eating outlandish food that does not contain wheat, poring over recipe books to make my limited diet more interesting. Wiping my forward when I am clammy, holding my hand when I have palpitations. Taking me to the ER and spending nights wide awake next to my hospital bed. Rubbing my back when I cannot stop coughing and knowing when to thrust the spit cup under my mouth. Staying nonplussed when steroids make me moody and unpredictable, carrying things for me and doing all the shopping and housework and lugging when I cannot help him at all. Understanding when we have to cancel long-awaited plans, miss outings and trips, or have to leave early because I am not feeling well.

(Loving me when I am at my lowest, loving me when I cannot recognize myself.)

And these are just the physical things, the actions and reactions precipitated by symptoms and medications and infections. I cannot leave out all the other realities of his life with me: The enormous medical expenses that will never go away. The financial ramifications of the career choices I have made in the interest of my health. The fact that in some ways, we are limited by my illnesses in ways that have nothing to do with stamina, oxygen stats, or infection rates. The fact that no matter what, progressive diseases mean things will never be uncomplicated and there will always be nagging fear.

“You’re sure you know what you’re getting into, right?” I asked him during our engagement, only half-kidding. But the man who was not scared by IV bruises the night we met, who did not mind spending part of our honeymoon scouting out a Walgreens and playing Scrabble while I used my neb, does not seem daunted.

(He’s crazy, I think to myself. And I’m lucky.)

Acquaintances are surprised if they find out I am sick, and friends who do know often do not realize it is in any way life-defining. This is because I look healthy when we split bottles of wine and pore over appetizers; this is because they do not see me on any sort of day other than a good one (and lucky for both of us, there are so many more good days than there used to be). So aside from my immediate family, I do not think many people realize the cost of invisible illness for him, for anyone who chooses to spend their lives with people who will have good days but will never be healthy.

I do not think my husband spends much time thinking about this, or wishing people understood the pressure and responsibility of illness. But from my perspective, I think it would be hard for anyone in his position. Because for as many people there are who ask me how I am doing and how I am feeling, far fewer stop to ask him how he’s doing with all of this, how he’s feeling. I am the patient, so I am afforded the empathy and the queries.

And so in the background stands the person most responsible for all the days when I can safely tuck my illness away underneath invisibility, and no matter what I can hide from outside eyes, it will always be visible to him.

(Even when I wish it wasn’t.)

Individual symptoms and diseases are less important than the fact that whatever is wrong with someone directly influences the people in his or her life. With that in mind, and all the other healthy people involved in relationships with patients of any chronic illness, I want to point out that the Well Spouse Association’s 19th Annual Conference is happening this October. For more information, click here.

Seeing the Scope of Invisible Illness

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Today kicks off National Invisible Chronic Illness Awareness Week, making it the perfect time to tackle the realities of living with illnesses that aren’t obvious to the naked eye. This year’s theme is “Living with an Invisible Illness Feels Like a Roller Coaster—Help a Friend Hold On!”

As someone with many different invisible illnesses, I find this theme compelling. On the one hand, it implies that this kind of life can be difficult and that patients need support and understanding—very true. Yet it isn’t as simple as that. The roller coaster metaphor immediately conjures of memories of white-knuckled ascents up steep hills and the rush of relief that follows. These highs and lows, the white-knuckled anxiety and the carefree moments, they are all part of invisible illness.

But You Don’t Look Sick
You knew I was going to start here, didn’t you? That’s because of all the issues tangled up in this discussion, this is the most obvious and probably most relevant. Why even bother having a National Invisible Illness Awareness Week? Because when you’re sick and there are valid reasons why you can’t do something the way you want to or are worn out or need help and you look otherwise healthy, that disconnect can cause big problems.

If I don’t look sick, then I must not be sick. If I don’t look sick, then I shouldn’t need to take the elevator when I am carrying a heavy bag and four flights of stairs seems like it would take way more oxygen than I can get. If I don’t look sick, then I shouldn’t have to re-arrange plans to accommodate chest PT sessions, or quietly leave the dinner table so I can cough without making a scene.

Duh.

Similarly, people with serious illnesses who do not “look” disabled shouldn’t need handicapped parking placards, or people who are young and dress well and wear make-up couldn’t possibly have a life-threatening or life-altering disease because truly sick people are only found in hospital beds, wearing faded johnnies and cracking wan smiles, and they certainly don’t look like normal people. I know enough people with enough invisible illnesses to know that this kind of thinking happens all the time.

This is the frustrating, anger-inducing part of the roller coaster metaphor, the one that quickens my pulse and flushes my face. I’m not asking for or expecting understanding from these people. I don’t really need it, and I’m not expecting miracles here. But there are times when I just want them to keep their preconceived notions of what sick looks like and their judgmental indignation to themselves.

Escape, Sweet Escape
I’ll be honest, there are lots of times when I am glad that whatever is wrong with me is largely undetectable on the outside. Sure, it can be isolating to feel like crap and slog through the day, trying to be “normal” and feeling so far from that. But there is a very real upside to this isolation: Escape.

Remember that rush of relief when the stomach-churning drop is over? That’s what I’m talking about. “Carefree” is not often a word associated with illness, but I’d say “caring much less” is a big part of it.

If no one knows anything is wrong with me, then for a little while, whether it’s at work or out with friends or riding the train, I can suspend reality. Having chronic illnesses is only one part of who I am, but sometimes necessity dictates that it seeps over into the other roles I take on, too. I don’t want to always think about, talk about it, make decisions based on it, or be associated with it.

And luckily, I don’t have to. The public, non-patient persona is really important to me—and, I’d argue, anyone with any type of condition—because, quite simply, it allows me to define myself in so many ways that have nothing to do with illness. Illness is always there, obviously, but it’s in a back-seat role.

And Lastly, the Invisible Made Visible
There’s something else to uncover in this discussion, something that perhaps isn’t as obvious a theme as the first two: To the people who really matter (and the people whose opinions likewise really matter), there is no such thing as “invisible” illness.

My mother can tell just from looking at my eyes (Are they glassy and flat?) if I am having bad day. My husband knows from the tone in my voice from one single word—“hello”—if I am not doing well. Even at a distance, my father can tell from watching me take two steps how I’m feeling. My friends know the subtle difference between the “just me being me” cough and the “hmm, something’s brewing” cough, even if I’m not even coughing all that much or that loudly.

I know how important having that inner sanctum familiarity is. I can see the same signposts in the sick people I am closest to: the slackened gait of exhaustion, the subtle grimace of joint pain, the tempered tone of tiredness. To the people who know us best, there are always telltale signs, ones that no one else would notice. As long as we have people who can see beyond what’s seemingly invisible, we have what counts, and the ride seems so much more manageable.

So Speak Up Already

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An interesting article in Monday’s Boston Globe called “Patient, Protect Thyself” covered ways hospital staff and patients alike can combat a serious and often preventable problem: infectious disease in hospitals. From making sure everyone who enters a patient room washes his or her hands to maintaining vigilance over the amount of time tubes are left in the body, there are all sorts of ways to reduce the threat of infections.

Questions of communicable agents and preventative practices aside, the article touched on a larger theme that resonates with me, the idea that patients not only have the right to question their health care providers but that such queries are an essential part of optimal care.

Perhaps the meaning of “Patient, Protect Thyself” is really “Patient, Assert Thyself.”

This semantic difference isn’t what really concerns me, though. I’m much more interested in why it can be so hard to do that, especially considering it is our health at stake. Maybe some of you aren’t ever plagued with momentary meekness, but I’ve definitely had encounters where I’ve had to double check or question something and before the words are out of my mouth my face is flushing a bit.

I don’t want to be annoying. Or condescending. They are the ones with medical training, not me.

(And do I really want to annoy someone who’s coming at me with a needle?)

I trip over my own words with “I don’t mean to be a pain” and “I just have a quick question” and “I’m not sure, but I think…” when of course, I am pretty sure. I’ve been through the revolving door of hospitals and doctors’ offices my entire life. I’ve learned some things along the way, like where the best veins for IV lines are, how many nebulizer treatments I need to have before they actually start to help, or that one medicine in particular is the only one that stops my nausea after anesthesia.

There are the obvious times when it’s easy to be assertive, like the time I was sent for the wrong test on the wrong body part with the wrong patient ID number (hello, HIPAA!), or the time my doctor ordered chest PT three times a day while I was an inpatient and I hadn’t gotten any. But the less egregious encounters are the awkward ones…which is weird, right? I mean, I don’t have a problem sending back the wrong coffee order, or double-checking that the security tags have been removed from newly purchased clothes, or repeating the take-order over the phone when I sense the person on the other end may have missed something.

Surely looking out for my body is more important than latte orders, security tags, or garden salad versus spinach salad?

And that’s exactly the problem—it is so much more important. One could argue that part of the problem is the leftover vestige of the patient-practitioner hierarchy where the patient’s job is to sit still and defer all authority, but I don’t think that explains it. I think deep down it’s a question of vulnerability, too. Despite how much we know and the wisdom we’ve accumulated, in these situations we still need to rely on someone else to do what we need done to feel better. Once you’ve crossed over that very real physical boundary and let someone in, it’s not always easy to admit a lack of confidence in what they’re doing.

* * *

On another note, Grand Rounds is up at Rickety Contrivances of Doing Good, where my post on the role narrative plays in the doctor-patient relationship is featured as the first post. Susan did a great job with a really compelling theme, so be sure to check out the posts.

I’ve Been Told I Need a Bubble….Can I Make that Two?

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After all these years, dear readers, I can safely say I’ve encountered a “first.”

I tore a ligament in my ankle. Sitting still.

Yes, sitting still. Now, I’ve torn, broken, twisted, and battered my knees and ankles many times; I’ve even had the other ankle surgically reconstructed using a tendon from my leg that was strategically drilled into the bone and held in place with pins. But normally, there are reasonable explanations for my injuries: a wrong turn in kickboxing class, a stumble off a sidewalk onto cobble stoned streets while wearing heels, too much wear and tear from figure skating as a child, etc.

Now imagine my sheepishness when I hopped/limped into the ER at 1 am last week and had to answer the inevitable, “So how did this happen?” What else could I do but admit the truth: I am that much of a disaster that even sitting still I somehow manage to injure myself. I mean, I thought I’d reached an all-time low when I broke my finger typing last month (the second time I’ve done it that way), but at least I know I can still surprise myself.

For years, friends and family have half-joked that I need to encase myself in a protective bubble. In fact, even my doctors have said it. Whether it’s a strep infection in my knee, a rare type of bug no one else grows, the time I broke into hives only to be told I’d somehow become allergic to myself (I’m not kidding on that one), or any of the other myriad medical mishaps I’ve encountered, each time the tale borders on the improbable, the response is the same: “You need a bubble.”

Actually, I think I need two.

Allow me to contextualize this most recent escapade. I was sitting on the floor of my parents’ bedroom, legs on the plush rug and back leaning against the bedpost. My dog had her head resting on my left ankle, which was turned outward. After a few minutes, my ankle felt sore but I was reluctant to move it. I remained that way for about an hour and when I finally stood up, I fell over and my eyes smarted with the pain shooting up the side of my ankle, into my heel, and up my leg.

But silly girl, why didn’t you just move your damn foot when it started to hurt?

Ah, but don’t forget, I ordered two bubbles. The other one is for my similarly cursed dog, who was resting her lamp-shaded head on my foot and howling piteously in pain. You see, we’d just gotten back from an emergency animal hospital where she’d had a 4-inch long, 1-inch wide plank of wood removed from her right eye.

Yes, my dog had a plank of wood stuck in her eye. Well, to the side of the eyeball itself, where it sliced through her mucus membranes and sliced all the way back to the bony orbital near her brain, narrowly missing her optic nerve. At one point, we didn’t think she’d even be able to keep the eye, but she did.

It was a hideous sight, opening the back door and finding her sitting there waiting to come in, this huge stick in her eye. It didn’t even look real.

Who was I to move an animal in clear agony? And really, whose feet don’t get uncomfortable in certain positions? Even I couldn’t have guessed I’d actually hurt myself sitting there.

(Side note: she wound up going back to the hospital as an inpatient for four days and is just now starting to make a very slow recovery.) (Side note two: caring for two dogs, one of whom requires constant attention and has more meds than I do, while on crutches and painkillers, is not ideal).

I got a phone call yesterday and the person was surprised to hear me so hoarse.

“Isn’t it your ankle that’s hurt?” she asked.

“Yes, but I’ve been sick with a respiratory infection for five weeks now. I just forgot to mention that with everything else going on,” I said.

I had to laugh a little at the fact that this didn’t surprise her in the least.

So yes, I need two bubbles. One for me since obviously I can’t get out of my own way, and one for my panic-attack prone, anxiety ridden, severe food allergy suffering dog who was doing what she loved best—racing around the fenced-in yard with her best friend—when somehow she practically impaled her own eyeball.

She’s resting her swollen head on a pillow right now, and as I type, I’m elevating my swollen ankle. We definitely deserve each other.

The Tale of How I Got a Clue

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I’m twenty-seven years old. I’m a married woman. I work at a university and write for several publications. I’ve got my life together and the frequent infections and crises that are part of living with illness do not faze me much at this point. And yet when I was sick last week and stuck in my house, my parents insisted on stopping in just to say hello. You know, just to make sure I was still breathing and all. Even though I spend weeks like this every year and I’m always okay in the end.

But I think I’m finally getting it, this whole protective parent thing.

Let me tell you a little story I’m calling “A Tale of Two Dogs.” Fear not, this is not ubiquitous pet-blogging, I am actually going somewhere with this, I promise.

Let’s call Dog #1 Shadow (as in, scared of her own). Shadow didn’t have the easiest start in life. She was bounced from kill shelter to kill shelter as a puppy and was conditioned to think being scared of everything was okay. Even after she found a home, Shadow went through a lot of crises and stress in her young life, and though her owners did everything they could for her, sometimes things happened that were out of their control and they couldn’t make things easier for her. So many things scared her: sounds, things that moved, strangers, voices, even her own darn tail when it hit the French doors by accident. Shadow is a loving, loyal girl. She loves parks and walks, running and chewing bones—that is, when her problems don’t overshadow everything else, when they allow her to do the things she loves.

And then there’s Dog #2, whom we’ll call Bull (as in, in a china shop), despite its gender inaccuracies. Bull is a happy-go-lucky kind of girl. She is fearless and playful, she leaps into life before she’d ever consider looking, and is the rough and tumble sort who enters a room and instantly makes herself at home. She flings herself into pools, she chases balls into walls and bounces off them without skipping a beat, and she wags her tail with such fervor that she knocks herself over in excitement on an hourly basis. It is a nice thing to see, this playful exuberance, this innocence with which she approaches life.

As a friend of mine would say, to boil things down into an executive summary, consider the following example: Bull and Shadow are frolicking in the yard. The sprinkler heads spring to life. Bull bounds toward them with glee, trying to catch the water in her mouth and batting at the spray with her paws. Terrified by the sound and the motion, Shadow lurches herself across the yard and scuttles under the porch, tail between her legs and ears pinned back. On this day, she cannot enjoy the simple acts of living that Bull can.

Bull is the new girl in town. I know that I will love Bull and Shadow equally, that I will appreciate their quirks and talents and funny little ways equally. No question about that. But I will always more about Shadow, will always be that much more protective and alert when it comes to her because we have been through so much and I know that life will always be a little bit harder for her. Bull is a grand girl and will be fine; with love and an endless supply of tennis balls, she’ll find her way in this world. She won’t need me the same way Shadow does. She is lucky in that way.

Maybe it’s a stretch, maybe I spent too much time in rescue shelters this week and the lack of air conditioning and the stench of panting dog and stale urine went to my brain or something, but I can’t help feeling that this must be a tiny little slice of what it’s like to be parents. Parents who have healthy children and sick children, who love them each without limit and love them for the individuals they are—and who will not ever be able to shake that instinctual urge to protect the one they’ve been through the trenches with, the one whose problems (physical or, like Shadow’s, emotional) sometimes make everyday life that much harder. It is not a greater love than they have for anyone else, and it is not a smothering love. But it is a love that speaks of a very different bond, one that cannot be replicated or truncated.

I’m twenty-seven, a married woman with a career and two dogs. And yet my parents flood me with “How are you feeling?” phone calls the minute a fever spikes. You tell me, am I onto something here? If so, maybe I can tone down the exapseration with which I reply, “It’s just an infection. It’s not a big deal.”