I need to get that stuff, you know, it comes in sliced, in packages, you use it for toast?

That is a literal question I asked someone because I couldn’t remember the word “bread”. Brain fog isn’t anything new for me, but the increase in frequency, and severity of the lapses, has started to concern me. My professor thinks I’m slacking because I had things in at the last second, even when it’s something I already had an extension for. I reassured her that I wasn’t procrastinating. For me to actually retain even a few bits of the material, I need to take my time working on the subject matter. If I miss a lecture, which I have, I don’t just play it and write up a generalized summary to meet the requirements. I listen to a few minutes, pause to take notes, then continue on with the lecture.

Notes on a  two hour lecture typically takes me 6-8 hours.

I need those notes for tests, only in this class, test times don’t really allow for you to dig stuff up in notes or on the books. (I take classes online since I can’t make it to campus anymore.) Another reason for taking accurate notes, is that I love the material. It was different in classes I found incredibly boring. It was material I really wouldn’t use again, and I had no interest. In this class I am interested, it’s just also complex, and contains a lot of minute details. If I can’t remember that bread is what you use to make toast, how am I supposed to grasp the ridge counting system and pattern equations you use to fill out a fingerprint card? (Important side note…I had to take a few minutes to remember the word equation. Sometimes I’ll get annoyed and just look up key words I know related to the word I’m forgetting, but this time I’m proud I figured it out eventually.)

My brain and body are screaming at me to just sleep. I’ve gone from embarrassment of needing a wheelchair, to impatience regarding the length of time it will take to get one. I’m still worried I’ll end up single forever, but I also understand that right now the key is staying alive and protecting my brain from my body’s overly active and very confused immune system.

Most of us who are chronically ill, have had someone judge us as lazy, or we’ve been labeled as procrastinators. We’ve seen the eye rolls, or lost friends because we ran late to often, or cancelled plans.

If I have to be somewhere at 6pm, I start getting ready around 3pm, because I know I’ll need breaks. I also go to bed early, and sleep in, the night before.  If I’m sore, I shower more than once, and take baths to get my muscles as relaxed as possible. I longingly will eye my high heeled shoes, before grabbing my sensible flats. Picking an outfit depends on how long the event will be, and how swollen my various body parts are. Since most of my swelling right now is in my lower abdomen, I have to plan for how that looks. Shape wear?  No way. The pain that results from attempting to contain a bulge that is actually my intestines, colon, ulcers, and of course stool, is beyond explanation.

Last night I saw a movie. It was amazing to go out, but the process began the day before. I tried to be cautious about what I ate, as I usually am, but because I’d eaten a bit more than my intestines could handle, I had a very obvious swelling of my lower abdomen. No worries, we can just kind of layer two tops and hope that it isn’t as noticeable. Makeup? Yeah, that’s fun when you’re arms and legs are weak. I need to get a full length mirror so I can sit and do it easier. Right now I have a rigged up way of doing it that allows me to sit in my bathroom sink so I can use the medicine cabinet mirror to do my makeup.

No, I am not joking.

Forget cleaning up any mess that was made while doing my makeup and hair, if I clean it up, I’ll be too tired, and I was already running 15 minutes late. Now the whole trying to get to my friends house. He’s only like a 5-10 minute walk away, and the weather is nice, but I know that the walk would drain me. It used to be something I wouldn’t think twice about. My part of the city has a free ride electric car that goes around, but alas, there were no available drivers. Plan B was a Lyft Line, but the wait was 10+ minutes, and by this point I am so tired, I really need to take some Zofran. Shift to a regular Lyft which costs more, but doesn’t involve a wait.

So I get in the Lyft, and I’m regretting my large purse, but whatever, I can unload things once I get to his place. As much as  I want to see the movie, I’m considering just going back inside and going to bed, and it’s only like 4pm.

This is where things get really important: I didn’t give up.

I relaxed a bit at his place, he got food (I watched him eat it because that’s what I do now haha), and he was nice and got us a Lyft to the movie theater. Usually it would have been a walk, but I wanted to enjoy the movie. The mall had several flights of stairs that I needed to climb to get up to the theater. The elevator on the side we were on was broken. (Of course…) So we go up stairs, stairs I’ve climbed dozens of times. My legs hurt, parts go numb, I’m starting to wonder if I should just sit down, but I don’t want to make a scene. I start moving slower and slower, but eventually we get to the top. I’m in pain, but we’re there. After enjoying the movie, I remind myself that I need to make it back to see Star Wars, but that perhaps I’ll go alone so I can use the stairs or my walker.

After the movie I did a really dumb thing. We were walking around looking for a specific shop, but we couldn’t find it. We walked and walked and eventually we were almost back at his apartment. So he asked if I was cool with just finishing the walk and I said I was.

But I wasn’t.

Today, I am paying a price. Brain fog is extremely intense, the urge to just keep sleeping is preventing me from doing a decent job on my homework. Have you ever worked out really hard, and you have really sore muscles the next day, where even lifting your spoon is painful? That’s where I’m at. I was having muscle and joint pain before, but pushing myself beyond my limits was just plain stupid.

Lesson: regardless of what you think other people with think of you for using assistive devices, or refusing to walk when the distance is considered walkable, listen to your logical brain. 

I could go to bed right now, and it’s only 5:40pm. I have homework to do, so I can’t just sleep. I could take a bath to ease the pain, but eventually I’ll have to get out. Plus the hot water is a dangerous scenario with my autonomic nervous system being such a bastard lately. Plan is to take a lot of homework breaks, think as much as I can about the homework topics, and if I really need to sleep, then I will let my body sleep.

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I need to get that stuff, you know, it comes in sliced, in packages, you use it for toast?

To Port or Not to Port…and how to ask the question!

During Rituxan, my nurses had noted that my veins were incredibly difficult to work with. This wan’t news to me. Every time I would go in for blood work, it would take multiple sticks before they accessed a vein. The only veins that work for me, are the veins in my hand. There are two exceptions, but neither is practical for every procedure or blood draw. The first exception is whatever sorcery the EMT’s and paramedics use. The only thing I can think of is that while I’m unconscious, or actively seizing, my veins become more prominent due to muscle contractions, and an elevated heart rate and blood pressure. They usually have to stick me at least four times, though, so it isn’t a total win even though they can get that one pesky arm vein. The second exception was what happened during this past hospital stay. After one nurse missed twice, and a second missed once, they asked for a doctor to help. The  doctor missed twice with an ultrasound machine as guidance. This was extra fun because of how deep the needle was during the process. I’d also been given nausea pills that hadn’t really worked, and no pain medications or fluids because, duh, no IV. They were drawing up IM medications when the special IV team arrived. They used another ultrasound machine, and even they struggled, but managed to get it in to a deep vein in my forearm. Luckily they used lidocaine that time, so it didn’t hurt nearly as much.

When I told the doctor that we were in the process of beginning IVIG, she said that it would be a good idea to get a port. I agreed with her, but admitted I was worried. Port maintenance isn’t a huge pain, but I do have vasculitis. I guess my fear is that the existence of a port, potentially increases my risk of blood clotting. (Granted you use heparin to prevent clots from forming, but still, terrifying.) I’m also afraid to ask my doctor.

If I had a port I’d have the option of administering IV Zofran and Phenergan, which would be an enormous help. Right now I’m using medical marijuana way more than I want to be using it. Having to use it multiple times, per day, just to function, is no way to live. I process nausea drugs quickly, so having a fall back option, like marijuana, is the only way I can be sure to avoid vomiting, and is the only way I’m able to consume anything at all. We could also talk with GI about home IV fluids, including banana bags to supplement all the vitamins and whatnot that I’m not getting due to my dietary restrictions.

Previously my doctor made it clear she doesn’t order ports for her patients, as most issues are temporary. I went through chemo, without a port, and it was hell on me and the nurses. Multiple nurses stated multiple times that I should have had a port placed. I was also not allowed to schedule any of the last spots of the day, as it took a good 20-30 minutes each time to find a useable vein. They couldn’t use hand veins, so we always used this same vein on the side of my thumb. It got really aggravated by the end of the six months, but could still be used. As an IV placement, it sucks though. It’s blown several times, and curves over 45 degrees.

I’m just anxious about asking. I’m also anxious about people looking at me weirdly. It’s easier to hide than a wheelchair, obviously, but it’ll still be there, and people may still ask. What will people I date think? How will I even be able to date? I could show up to most dates without a wheelchair, unless they wanted to go for a stroll afterwards. What happens when the time comes for them to see more of me, and this lump is right there by my collar bone?

It’s all hypothetical, of course, and I doubt my doctor will even okay the port…but I anticipate it is going to be necessary if and when we do IVIG. I just don’t have a good vein for it, and if we’re going to be doing it every 4-6 weeks, and if there is blood work like I’ve been getting, it’s time. Every ER doctor and nurse, has wondered why I don’t have a port. I’ve never had a valid answer other than, my doctor doesn’t think I need one.

I know myself. I’ll be anxious if it happens, and anxious if it doesn’t. If I do get one, I’ll be self conscious for a while, then snap out of it. The same goes for the chair. Maybe I wanted one with normal wheels instead of a power chair, but anything is better than my current situation, and I can always make it my own, make it unique.

Also, I’m 1/4 of the way to my goal on You Caring. I can’t wait to reach my goal, keep insurance, and kick some major Behcet’s booty!

To Port or Not to Port…and how to ask the question!

Wheelchair Evaluation

Today was my wheelchair evaluation, and it went well. They definitely didn’t do anything I thought they would do, we just sat down and discussed why I needed a wheelchair, what I’d be doing with it, etc. I was bummed that the smart drive wasn’t an option for me. Insurance already takes 2-3 months to furnish patients with a chair, and usually denies Smart Drive, or other power assist options. Basically you have to be sick enough for a fully powered wheelchair, or you get a straight manual one. I was pretty convinced that meant I’d be getting a manual one, but the evaluator told me that it definitely wasn’t an option for me. My diagnosis codes meant I was eligible for a powered chair, so that would be what I was getting.

The poor man was showing me color options, and I realized I was crying. I should have been embracing my impending independence…but instead I was suddenly realizing I’d be that person. I’ve never looked at someone in a wheelchair and thought anything negative, but I recognize the stereotype that exists. People wondering what happened, or why someone so young is in a chair.

I’ve worked on my attitude. The chair may stick out, but I don’t have to use it all of the time, which is something I’m lucky for. I can participate in events again, and stop being in so much pain when I do something on a day when I’m not up for it.

I’ll keep whomever actually reads this blog aware of the rest of the process. The next step is having a full evaluation by a physical therapist.

Wheelchair Evaluation

Wheelchair Evaluation and Fundraising

First and foremost, my wheelchair evaluation is in exactly 10 hours! My apartment is nowhere near ready for it, but it’s as good as it’s going to get for right now. One of the aggravating parts about any chronic illness, is having a list of things to do, and only enough energy to do a few things. The kicker is never knowing which things will drain you. I thought for sure I could at least fold and organize my clothes. Instead I ended up with clothes in boxes and baskets. It’s chaos, but at least my space is open for the mobility advisor.

Unfortunately the kitchen and living room are an unusable mess. I try my best to take care of my own messes, but I’ve run out of energy to keep up with my roommate. I know I need to follow through with my promises to do cleaning in lieu of utilities, however, it is just too much. When I was nightly cleaning, I would often end up having him fry something after it was all clean. It just felt futile.

People have been saying, “You walk fine,” and rolling their eyes when it comes to the wheelchair. They don’t seem to appreciate how much effort it takes to walk “fine”. I am constantly reminding my body where things are, and even the constant tension of my muscles can’t always prevent a fall. I used to walk blocks to take the dog to the grassy area. Now going around the block is nearly impossible. There tons of places and things I’d love to do, but I know my body isn’t capable of the walking required.

I am getting a wheelchair because I have ataxia. I am not coordinated, and it is worsening. I also have tremors. A few steps for me, equals a whole lot for someone else. Toss in my difficulty get adequate nutrition, and you have my life.

Then there is the fundraiser. I started a fundraiser to help me keep insurance once my divorce is finalized. It will be hard to continue living where I am living regardless, but if I cannot come up with insurance funds, I’m not sure where I would go or what I would do. There was sone resistance since I did a fundraiser to get to NYU a year or two ago, but that was under different circumstances. My divorce settlement has shifted, and the shift leaves me without insurance, or a way to pay for insurance.

I hate asking for help, but sometimes it has to be done.

Just a short update tonight. I’m quite tired, and I have to be awake earlier than usual!

Wheelchair Evaluation and Fundraising

My Absence Explained

On Sunday, December 7th, I spoke with my rheumatologist via email. My symptoms are at an all time high, and my will to keep fighting had dwindled. I knew I needed someone to take care of me. I couldn’t care for myself. She recommended going to the ER, getting admitted, and seeing the GI team to sort out what could be done to help with my current symptoms.

Too bad that isn’t how things work.

The ER nurses were genuinely worried about me. After several failed IV starts, including two done using ultrasound guidance, the IV team was called in. They numbed me up, and managed to get a deeper vein. Everyone involved asked why I didn’t have a port. I just had to shrug. It isn’t something I’ve pushed for, or wanted, but now It seems like it’s something I may just have to accept. We were talking up jugular lines again, PICC lines, it was just a mess.

The ER doctor agreed with what I suspected (without me telling her what I thought was going on.) She felt that the inflammation from Behcet’s was causing ulcers in my colon, ascending and descending. Sure enough, she pushed on my upper abdomen, and I had horrendous pain in my lower left. The pain was shooting to my right shoulder. At one point they came in because my heart rate was going insane (from around the high 50’s all the way up to the high 180’s), and this was on dilaudid. The ER doctor felt confident that they would try and sort out the severity of the situation, and an appropriate diet to help with symptoms.

Nope.

The night I made it up to my room, I just slept off the Dilaudid. I don’t like pain medications at all. When I woke up it was time to take all of my PM medications. Instead of giving me my Keppra by IV, they opted to give it to me via liquid.

Yes, you heard that right folks…they opted to give the woman who was so nauseas she didn’t know if she could swallow her pills with water, 1750mg of Keppra, in a nasty oral concoction. 

I was okay briefly, if I didn’t move. Then the panic set in. I knew I was going to throw up. I didn’t know when, but it was going to happen. My default in these situations is to lay on a nice cold bathroom floor…but they wouldn’t let me. They kept saying because of the fall policy they couldn’t let me lay on the floor. Logically I knew why, but in that panicked state, I just wanted what I knew. Eventually I made use of the lovely green emesis bags they provide.

Still not sure if it was a gastroparesis vomit, or a reaction to the liquid Keppra, but it was definitely not pleasant. It never is.

When I left Saturday morning, I still felt sick, and I’ve been basically sleeping ever since. I started a fundraiser to help me raise funds to keep my insurance. My next treatment option is super expensive, and I’m hardly getting by as it is. With the disability wait, it’s just so hard. Medical Marijuana is so expensive, and works better for me than most of the prescription drugs (minus IV Zofran, but I don’t have a port so I only get that in the ER). I can’t exactly ask friends and family to send me money for weed, but at least if I can keep insurance I can possibly get a port and some better IV options.

The Saturday doctor basically stated that my blood levels didn’t warrant an admission. Excuse me? Are you acknowledging that I do have an issue, but refusing to offer me treatment options? Rheumatology wanted me admitted and watched, but she didn’t have a say. Two of the lines they tried to place they had to use ultrasound, the third was a higher tech ultrasound and a nurse on the vein team had to numb the area before going super deep to get the vein.

When someone is having classic signs of colitis, including referred pain, and such severe pain that they have significant elevations in blood pressure and heart rate…you at least have GI look in on them at some point. Nope. Since I only vomited once…even though I refused anything to eat or drink unless I was taking my pills (which is why I vomited), and because my inflammatory markers weren’t high enough, I was sent home.

The doctor treated me like I was insane. I sat there, nauseas, unable to even walk a few steps without wanting to sleep, in horrible pain, and yet I felt like the crazy one. I was told my gait looked fine as I held onto the IV pole for dear life. The judgment was there, and it was as if I were back at the beginning, before I had a diagnosis. How could I, this woman with normal lab values, possibly be worthy of taking up a bed at the hospital.

Reality is, I needed that bed. I still should probably be in that bed being evaluated for lower GI issues, gastroparesis, and the horrific heaviness, fatigue, and joint pain. I should be in that bed being prepped for my first round of IVIG.

Now rheumatology is pulling in the lifeline. I’m being told that, because the primary symptoms at this point are gastrointestinal, that IVIG should be put off until GI can weigh in on the approach.

Are you kidding me?

I was having issues, skin and neurological, during this flare. IVIG was discussed when GI symptoms were minimal. Now they’re worsening, and that somehow takes IVIG off of the table? Does anyone in the medical field realize how hard it is to get an appointment with certain specialists? As of right now I can’t even see a general GI doctor until the end of February. That’s just the general doctor…it’ll take several more months, and rounds of testing, before I’ll even be allowed to make an appointment with the motility doctor.

This is one of the things “sick” people get that “healthy” people don’t. We don’t run to the doctor the second we have symptoms because we’re weak. We run to the doctor as soon as possible because we know the potential waiting game for any given symptom, and we know how much worse it will get between the onset of symptoms, and the appointment to see our specialist(s).

I’m about to write NYU. I’m about to beg that they do something to me so that I don’t have to feel this pain and exhaustion anymore. I am okay with being chronically ill. I am not okay with being chronically unable to leave my room.

My Absence Explained

So Much Sleep

Every single doctor wants to put me on a steroid taper. I was just on a steroid taper. The issue is that the dose of steroids I need to feel relief, is a whole lot higher than what one can maintain long term. The other issue is that it’s just a stop gap measure. We can keep decreasing flare symptoms for a few days at a time, but we aren’t really doing anything for me overall.

Tomorrow I’ll be calling my rheumatologist, but she’s pretty set on me waiting until January to move forward with IVIG. One of the biggest struggles lately has been how much I’m sleeping! Literally fell asleep in the bathroom because I thought I was going to throw up, didn’t, and ended up waking up on the floor. (Now that I’m thinking about it, my jaw hurts, so it is possible I fainted.) Still, I literally slept for at least 12 hours last night. I got up, made it to the couch, and somehow fell asleep again for a couple of hours. Walked my friend’s foster dog, hung out with the friend for a bit, then somehow managed to fall asleep again. Not sure for how long, at least an hour, maybe longer, but my friend woke me up and asked if I was okay.

My memory has been horrid, and I want to watch shows, but I keep falling asleep. At this point I just put things on that I’ve seen before.

One amusing result was me spending several hours convinced my phone was broken. I kept lowering the volume, and was convinced it would stop just before going to mute. I reset my phone. I updated everything. Then I remembered, to put it on mute, I had to use the little toggle button on the side.

I mute my phone regularly…but today, I forgot how to mute my phone. 

While a lot of people would find this alarming, I just a accept it for what it is. I am in a flare, and all my symptoms are heightened because of it. New symptoms are related to old symptoms, and even fully new symptoms seem to be minor compared to established symptoms.

If you have a chronic illness, and you need more sleep than usual, talk to your doctor, and then sleep! 

For a long time I had a lot of shame about how much sleep I needed just to barely function, but now I (for the most part) accept it. Yes, there are days when it aggravates me, but right now I’m just embracing it. Normally my nebulizer would make me jittery, but it didn’t, so that makes me happy! I also don’t explain it to people, at least not in an apologetic way. My automatic response to, “Are you okay,” has become to just say that I am, or even ask why they’re asking. I don’t even think twice because I’ve just accepted how things are…for now.

I will not give up hope. I will have a better quality of life. Maybe I’ll never be in remission, but I will achieve things in this life.

You have a purpose, even if you’re ill…you just have to find it. I’m still digging around for mine, but I will find it. Right now I’m just trying to share my story, and make people who struggle with their illnesses, hopeful.

So Much Sleep

Inhale, Inhaler, Asthma, Weed?!

Disclaimer: The information below is not meant to be medical advice. What works for me, is what works for me. You should consult your physician to get information and guidance on what would be best for you and your situation.      

_______________________________copingwithbehcets________________________________________                       

I’ve gotten a lot of judgment for my use of medical marijuana, so I thought a formal blog addressing it would be a good idea. Today I was reminded that I should address it, because I had to use my nebulizer for a severe breathing attack. I was using the carpet cleaner to clean up my roommate’s dog’s urine. (She has what I like to call “on purposes” because she doesn’t accidentally pee…she just pees.) Anyhow, the spot was quite saturated, and as I got it clean, I started coughing. Really coughing…and then the thick mucous came up.

Have you ever coughed so hard you can’t inhale? You’re coughing and coughing until your body decided maybe vomiting would be easier.

Luckily I didn’t vomit, but it was close. I spent some time on the bathroom floor recovering, but still couldn’t breathe well. I dragged my nebulizer to my room, hooked it up, and instigated the opening of the airways. This meant more coughing, more spitting things up, but ultimately finding oxygen.

Then the steroid jitters kicked in.

The good news was that I was able to finish some of my homework. The bad news was that the shakes continued until the nausea became unbearable. I took the last Zofran tablet in my possession, crossed my fingers that I could get a refill ASASP, and waited for it to kick in.

The thing about severe nausea, especially gastroparesis related nausea, is that staying still and trying not to think about it, doesn’t make it get better. The discomfort grows and grows. 

In the ER I’d beg for IV Zofran immediately…but at home, I don’t have that option. When I hit that wall where I know I can’t go more than a few more moments without vomiting, I reach for the marijuana.

But you said you had asthma?!?!

Yes, I do have breathing difficulties. Perhaps smoking marijuana isn’t the best thing in that situation…but all medications have side effects. First and foremost, I don’t smoke marijuana. It is too harsh, and always causes me to need my inhaler. In a pinch I’ll have someone shotgun me some, but it isn’t the preferred method. I use a vape.

I use a high end vape.

Truth be told, I need to replace the screen, but the biggest thing is that I control the heat, and the filtration is amazing. Within a few minutes my nausea is gone, and I don’t cough, choke, or need to use my inhaler. My doctors who are okay with medical marijuana, are okay with my methodology, though they would prefer I use edibles. The issue with edibles for me, is the same as the Zofran situation. I need the drug to work fast. Plus my digestive system is slow and inefficient in general.

They do sell  ODT Zofran that does act faster, because it dissolves under your tongue.

The reason I don’t use the ODT option is personal, so please don’t assume you’ll have the same issue that I have. Since I am generally dehydrated, my mouth is almost always dry. This isn’t related to vaping marijuana. Even if I haven’t vaped in days, my mouth is like cotton. The ODT therefore takes forever to dissolve. I also can’t tolerate the taste. Most people find it pleasant, but when I’m in a position where I’m going to vomit, the only thing I can tolerate is the taste of peppermint. Usually I pop an Altoid, or put peppermint oil on my lip, after vaping. I really can’t taste anything else when I’m at that level of nausea.

If I had a port, I would smoke a lot less marijuana. I have a nothing against people who use it medically or recreationally. Prior to using it myself, I thought it was stupid, and while I do know folks who have faked medical conditions to get their medical marijuana card, I also have seen folks like myself who do really need it. For the first time in a long time, I learned what it was like to go out, and not have to worry about nausea taking over my evening. If I use the right strain, I can conquer my stomach, and drink water, or work on homework. At the moment the strain I have was cheap, but insanely strong. It works, but it is making me just a bit too relaxed to focus on anything remotely complicated.

So yes, I have asthma, and I use marijuana. I am in no way endorsing this practice, or saying that you should vape if you have marijuana. My current situation makes medicating me difficult. There is no option for my gastroparesis. There is also no real option for my Behcet’s, though we may attempt IVIG. Right now I’m just popping mycophenalate like it’s candy, even though I could never eat actually candy without getting seriously ill.

Inhale, Inhaler, Asthma, Weed?!