What You Need To Know About Headaches……Part 3

I had hoped to get my migraine series finished before the end of June, which was migraine awareness month. However, sadly I spent most of the last week of June in the hospital with a MIGRAINE. I had dealt with it for over ten days and finally waved the white flag, cried uncle and went to the hospital. I was hoping that I would be able to break the migraine by just getting medications in the ER. But no luck, I had to be admitted for four days. So finishing this treatment section of the migraine series seems appropriate, as I spent the last couple weeks living in this phase of a migraine.

So how do you treat a migraine??? Well, that’s really a hard question to answer. What works for me may not work for you and vice versa.  And I have found it to be more a case of trial and error of what might work. I have tried SO MANY medications and treatment options over the years. Even thought I have been on this migraine journey for over 15 years I am not totally sure that I have found the perfect mix yet. In the early years I only had migraines periodically, it wasn’t until the last three years that they have really become debilitating.  I also didn’t start having the hemiplegic (stroke like) migraines until 2016. One of the big things I can’t stress enough when you are on the search for the best treatment for your migraines is to keep a journal of your symptoms, what you did, what you ate etc on the day of your headaches so you can see if there is something recurring with each migraine. So lets dig in to treatment options.

The most common treatment for migraines are medications. Whether you take over the counter meds, preventative meds or meds for the acute head. Below you will see the each type of medication explained.

  • Over the counter (OTC) medications are medications that can be bought without a prescription on the counter at any pharmacy.
  • Acute medications are used as soon as a migraine is happening. These are also known as abortive medications.
  • Preventative Medications are used on an ongoing or routine bases, in hope that they will prevent or reduce future attacks. These can also be called prophylactic medications.

Over the counter options for acute symptoms include:

  • Excedrin Migraine
  • Ibuprofen which is also known as Advil and Motrin
  • Naproxen which is also known as Aleve
  • Aspirin (you need to check with your physician before taking this medication as it is also a blood thinner)
  • Acetaminophen which is also known as Tylenol

Examples of prescription drugs you might be given to take for acute (when the headache is happening) symptoms include:

  • Triptans are a class of medications that deal with the chemical Serotonin in the brain, which helps to diminish the swelling of the blood vessels that cause the headaches. These drugs are primarily used in the treatment of acute headaches. This method of treatment goes back to the 1950s. Examples: Maxalt & Imitrex.
  • DHE 45 became a treatment for migraines in the 1940s. It is only used to treat migraines in the ACUTE stage and should not be used as a preventative medication. This medication is available as an injection, IV drip and nasal spray.
  • Ergotamine is a medication that is used for a SPECIFIC kind of headache. It is used to treat vascular and tension headaches. The medication works to narrow the widened blood vessels in the head, which in turn reduces the throbbing effects of vascular headaches. This medication is also used only in treatment of acute headaches.

Examples of medications that are given as  preventive or prophylactic prescription medications include:

  • Beta blockers (Use caution with these as they can also lower the blood pressure and heart rate) This group of medication is used as a preventative medication to treat migraines. They work to relax and open up blood flow thus reducing the frequency of headaches.  Examples: Propanolol or Toprolol.
  • Calcium Channel Blockers (Use caution with these as they can lower the heart rate) This group of medication is used because of the way it works, basically the end result is that this group of medications prevent contraction of the muscle wall of the artery.  Examples: Procardia or Verapamil
  • Antidepressants are often used as a preventative medication for headaches because the tricyclic antidepressants also work to treat chronic pain. Thus they work well for migraines.  Example: Elavil
  • Anticonvulsants this group of medication work to calm the hyperactivity in the brain. Example: Depakote, Topamax, Gabapentin

There are also many other options for migraines. One of the most common is the Complementary & Alternative Medicine. This option includes any medicinal products or practices that are not part of modern medicine. Alternative medicine can be defined by its use an an alternative option to traditional modern medicine. Complementary medicine is used in conjunction with traditional medical treatment. These treatments could be things like: any natural remedies like herbal medications or treatments, vitamins, minerals or any kind of supplements. There are many options of herbal medications, which I have tried, the one I personally had the most luck with was feverfew. Other options would include meditation, yoga, biofeedback, acupuncture, tai-chi. Or even body-based practices like chiropractic adjustments or massage therapy. Like always, before starting any new over the counter medication, herb or supplement. Or any increase in physical activity please check with a dr before doing so!

In addition to medications and alternative or complementary therapy, the U.S. Food and Drug Administration (FDA) has now approved two different nerve stimulators that may be helpful for certain people who have not gotten any relief from all other treatment options. The Cerena Transcranial Magnetic Stimulator is a device that has been approved for anyone over the age of 18 who have migraines that are preceded by an aura. This specific device is help to the back of the head and will deliver a pulse of magnetic energy.

There is also a vagus nerve stimulator that has been approved for use in adults with migraines, as well as those who suffer from episodic cluster headaches. This device is hand-held and is placed over the vagus nerve in the neck and it releases a mild electrical stimulation to reduce pain.

In 2010 Botox, previously primarily known for its use by plastic surgeons, was approved for use with chronic migraines. Currently the FDA has only approved Botox use in those with chronic migraines, which means a person must have 15 or more headache days a month. Research shows that the more frequent the headaches the better the Botox result will be. Botox is given as approximately 30 tiny Injections around the head, the injections are given around pain fibers that are involved in headaches. Botox will enter the nerve endings around the injection site and then blocks the release of chemicals involved in pain. This in turn prevents activations of the pain networks of the brain. Patients who receive Botox can only receive injections every 12 weeks. And it generally takes 3-4 treatments at least to begin to fill the full impact it may have. Botox requires pre-authorization by the insurance company before it can be given. Along with very detailed documentation by the doctor regarding the frequency and duration of your headaches.

In early 2018 the FDA approved the first drug of its kind for migraines. It is said to reduce the number of migraines among those who are prone to migraines. Most of the medications currently used for migraines are used to control the symptoms. The new drug, called Aimovig, is designed to reduce the number of migraines among the population who suffer most frequently. One of the largest studies done during the testing stage showed that the number of migraines dropped from eight to fewer than five. This medication is given as an injection, much like insulin, delivered by a pen-like device. The one big downfall for some is that the medication will cost around $6,900 a year, and insurance coverage is not completely decided at this point!!

I hope each of you enjoyed this series on migraines and that maybe you learned something you didn’t know. I know I learned a LOT while doing the research for this series. Migraines are so complex and I could have probably written a five part series or even more. There are so many options of medications available along with many more non-medicinal treatments available, than in years past. And so much research is being done to find the best treatment available for migraines. I didn’t cover Botox in much detail and there is a lot of information I could share. If you are interested in learning more about Botox or the new medication Aimovig leave me a comment and let me know. Also, if you have a condition that you would like me to do a series of posts on let me know and I will dig in and start my research. This has been pretty popular so I am looking forward to doing more multi-part series in the future.

With Love,

Amber

The Day I was Treated Like A Drug Seeker

* This is about my personal experience not a topic to be debated about the use of narcotics.

I went to my local ER last week because I had been dealing with a migraine for almost two weeks. Sadly, is not uncommon for me to end up in the ER for a migraine. In fact that usually happens at least a handful of times every year. Unfortunately I generally end up being admitted for said migraine at least a couple times a year. So I know how things work in this ER and Hospital. Especially since I actually worked as an RN in this hospital for 9 years. But this time was different.  I had the worst experience I have ever had in that hospital. I have NEVER been treated as poorly by as many medical professionals in such a short time span as I did that visit. And that’s saying something because over the last five years I have been there MANY times and have been cared for by MANY nurses, physicians and other providers. Due to the fact that I am no stranger to the hospital, and the fact that I have MULTIPLE invisible illnesses I am not unfamiliar with being looked at like I am drug seeker.  But this visit took that to a WHOLE NEW LEVEL.

I had barely made it into the room in the Emergency Room when this male who I assumed was a nurse came in and without telling me who he was or anything his first words were “I see you take X & Y at home for pain did you try either of those?” Okay, fair question. I calmly explained that they can cause rebound headaches so I don’t always try them for headaches. He proceeded to tell me that I wasn’t going to be receiving any narcotics while I was in the ER that day.  He then went on to ask me what has worked on my migraines in the past. My mom answered that question as I was not totally able to think straight after that long with a migraine. She told him that a low dose of Ketamine has worked for me really well for me in the last. Continuing on to tell him the last time I received it the nurse had never heard of it being used for migraines either so the Doctor took him aside and showed him literature on the studies that have been done. Those studies show that Ketamine at a low dose works well for migraines. And before she finished her sentence the nurse shot that down and said there was “NO WAY” I would be getting that today because its a sedative and not for migraines.. At this point I didn’t know what to even think. Honestly, I was ready to leave and say forget it.  But that wasn’t the last run in with that nurse I would have before I was admitted.

I had a port placed three years ago due to the fact that I don’t have good veins anyway and then I took years of high dose steroids which killed the veins I did have.  So I always request that my port be accessed. He REFUSED. He said I had great veins and placed a peripheral.  I wasn’t in any condition to argue. Because he was so asinine I ended up with five sticks which should have been one.  But I did enjoy when the ER doctor put him in his place and let him know that he would in fact be giving me Ketamine for my migraine. HA!!!

I was really hoping that the Ketamine would work like it had in the past and I would be able to go home. But it didn’t……. So they called a hospitalist to come in and see me so I could be admitted to the hospital.  As he walks in the room he introduces himself and announces “I DO NOT GIVE NARCOTICS FOR HEADACHES, JUST SO YOU KNOW! Again, that word had not come out of my mouth since I arrived. He like the nurse was making an assumption of why I was there based on what he saw on the chart, without actually seeing or talking to the person behind the medical record. I really hadn’t even thought about asking for any narcotics because I know that it can actually make a headache worse. He asks me a few questions and says he won’t be admitting me its a neurology issues, and leaves. The nurse I loved so much comes back a few minutes later to tell me that they were taking me upstairs. When I asked who the admitting doctor was they told me it was Dr. Pleasant Pants that I had just seen. I was less than thrilled.

Once I was taken upstairs and settled into my room, a neurology doctor who I didn’t know showed up to see me. And AGAIN for the THIRD time in less than three hours, this doctor identifies herself and before I can say anything she says “I DO NOT GIVE NARCOTICS FOR MIGRAINES, JUST SO YOU KNOW.”  Yet again I had never asked for an narcotics or even actually thought about asking for one.  Like the two before her she was also making an assumption about why I was there and what I wanted before even seeing me. By this point in the day I had nothing to say I was so blown away that I just looked at her. I didn’t have anything to say I just agreed with her plan of care and went on with it. At that point I would have tried anything to get the headache to go away. And anything I would have said in that moment to this doctor would not have been nice or helped my case in any way.

Sadly, during my entire four day stay in the hospital there was only one nurse that would actually give me my home pain meds. In fact she actually brought them to me without me even having to ask for them. The other nurses didn’t think I needed them because I was getting “the migraine cocktail!” And that is true, I didn’t need my home meds for the headache, I needed them for the rest of my body. All the other parts that hurt besides my head.

I know, everyone is all in an uproar by the new changes that may be coming with narcotics and the doctors are being more careful with what they prescribe and to who. But anyone could look at my record if they really took the time and see that there is more than enough reason for one or even both of the medications I take. And if they looked more closely they would also see that my scripts last me on average 45 days rather than 30 because I don’t take them as often as they are prescribed. If they took time to look further than the med list they would see a person. A person who believe it or doesn’t really care for the way pain medicine makes me feel. I don’t enjoy being nauseated and itchy when I am already itchy all the time from my illness.

It just frustrates me to no end that the people in the world who have abused the drugs have totally messed things up for those of us who need them. Because people choose to take narcotics to get high it is becoming increasingly hard to get pain meds for people who really truly need them. Many of us need something to be able to get out of bed in the morning. Or to take a shower, or to do any daily task. But because of those idiots many are being refused. And sadly there have been a number of suicides in the chronic illness community due to the fact that they were refused the pain meds they relied on.

I have not shared this earlier because it took me awhile to process it. To really think about how it made me feel and how I could share this best to get my point across without sounding like I was whining. I just wish medical providers would look further than a med list. Or even the list of diagnoses. Behind those things there are people, people who never asked for these life altering diseases, people who didn’t ever do anything to deserve the fact that we are living in chronic pain. Many of us who really need the pain meds would not be able to function or have any semblance of a normal life. And if it comes to the point when none of us have access to those meds a lot of us wont be able to get out of bed, much less work and be a productive member of society. Many of us would gladly trade every last pain pill for the ability to go back to the life we had before we got sick. If i could turn in my pain meds and magically be healed i would be the first in line. Sadly, that doesn’t happen! I can’t speak for all of the people with chronic pain due to a chronic illness, but personally I have tried all other methods of pain relief. I have tried meditation, acupuncture, massage, physical therapy, water therapy, over the counter meds, pain rubs, heat, ice. You name it, I have probably tried and it just doesn’t work the same way that pain medicine does.

At this point the only thing I think we can really do is to start writing letters. Letters to those who represent us in our local, state and federal government.  I am not a political person and I normally don’t include things like this in my blog but I think this is all we have left. I think its time for a CALL TO ACTION for all of us who suffer from chronic pain. We have to be proactive and start writing letters, telling our stories and getting them out there. If we don’t share them, who will ever know what we really live through on a daily basis. They need to know that we are being treated the same as drug seekers, the same as drug addicts or not being treated at all. They need to know that we didn’t choose this life but it has happened and we are doing out best to make the best out of the hand we were dealt and having out pain medications taken away is not the way to do it.

I know in the past people have probably assumed I was drug seeking because when you present to the ER, for a migraine or back pain or a lupus flare that causes pain all over the body they can’t see it. They don’t see our pain on a lab test or an X-ray so they just assume that we are just there for the meds.  When it reality we just want to do whatever it takes to get the pain away even if that’s just a shot of steroid. Healthcare workers have sadly become so jaded by the “opioid crisis” that they can’t see past it. I know from many years of experience as a nurse that it is easy to assume that drug seeking is occurring when someone asks for pain medicine without asking any further questions.  We have to start advocating for ourselves, as I always say if we don’t advocate for ourselves no one else will.  Sadly, I did not do a good job of doing that this time around  because I felt so bad. But I wont stand to be treated like this again.

I am lucky to have a multiple people who act as advocates for me for, will stand up and fight for me when I can’t. My Mom has become my biggest advocate as she has sat in the ER waiting rooms and at my bedside hours in end without complaint. Just to make sure that i get what I need. Many times she is my voice when I can’t speak up for myself. If you are in a situation where you don’t feel as though you can stand up for yourself take someone with you. If you can, take a family member or a friend with you to the ER or to the Dr to help make sure you get the treatment and care that deserve.

If you need any help writing letters to your representatives or finding who your representatives are please let me know and I will be more than happy to help you however I can

Please take the time to also share this story in your communities. We have to get our stories out there, we have to find a way to be heard.

With Love,

Amber

Confessions of the Chronically Ill

Co-Written by myself & contributor Amy Nora

When you have a chronic illness like Lupus there are going to be some thing’s that you hold true. Things that you don’t share with most people, things that you know most people don’t want to know, or simply wouldn’t understand. Things that you feel people who aren’t sick would never understand. So as we have come to an end of the 2018 Lupus Awareness Month, I want to share some confessions from the chronically ill. Remember they might not be true for all chronically ill. This is based of the experiences/issues we have and deal with.

1. I often feel guilty — Some of you are probably wondering why we would feel guilty. Well, there are a MILLION different reasons. We may feel guilty that we can’t contribute to our families like we want to. Or we might feel guilty because we feel like we are a burden to our family and friends. Or because of the constants needs or help for basic daily life we need to ask of others. There are a million reasons why we might feel guilty.

2. I feel like I’m alone — Again you may be wondering how we could feel alone when we have friends and family all around us. Well, that’s simple, we may have people around us but they don’t know the struggles we face everyday. So it’s not so much that we may feel alone physically, it’s more mentally and emotionally. Because most family and friends don’t know what it’s like to live our lives, and they can never truly understand our world.  We try and protect them from what we go through, because as much as what we deal with, we also know that they feel a stress.  This can intensify a lonliness.  It creates a vicious cycle.

3. I often experience some level of anxiety and depression — There are so many reasons we may feel this way. We could be anxious because we aren’t feeling well and there’s nothing we can do about. Or because there is something coming up that we aren’t sure we have the energy or stamina for. On the other hand we could be depressed because we had to cancel ANOTHER date with a friend or our spouse. We might also be down because we feel terrible and have for awhile. That takes a toll on your mental health.  The very nature of having a chronic illness creates a constant mental battle that is medically known to alter brain chemistry.

4. I am almost always in pain — Even though you know I have pain medicine and have taken it. I am generally always hurting somewhere. NO, it’s not searing, burning level 10 pain. It’s more like a constant nagging annoying pain. Like a level 3 Pain. But it’s usually constant. And chances are I won’t say a word, and will often say “I’m fine” when asked.  Just remember, your fine and my fine are not the same.  Sometime ask, “No, how are you really doing today?  I want to know.  What can I do that would help you?”  When in pain and tired, these words are a balm physically and mentally.

5. Every good day is truly a gift —Sadly, we don’t always have a LOT of GOOD days. So when I do I may need help remembering that this day is a gift and I should take full advantage of it.  Do not make me feel guilty for having a good day, do not take my joy for this good day.  I may have to pay for this good day for a week to come or a few days in bed or on the couch with pain, fatigue, or any combo of problems including infections.

6. I don’t look sick — Nine Times out of ten you wouldn’t know by looking at us that we are sick. That our bodies are constantly at war with itself. We just look like average people on the outside, but inside we may be a disaster. Going out in public knowing that others can’t see our illness can lead to feeling alone, or being anxious.

7. I am often afraid to work, make plans or have a life — I know this one sounds silly. Why would anyone be afraid of those things? It’s simply because we never know what our body is going to do. I may feel fine at 8am, but at 11am I may feel like I was hit by a bus. Our bodies change so quickly and often without reason. So we never know if we make a dinner plan for next Wednesday how we will feel.  Every plan is made with the caveat of, “If I feel okay,” and buying tickets for an event is a terrifying exercise in wasting money and letting friends down.

8. Not all doctors understand — Sadly, this is the case a lot of the time. I don’t know how many times I’ve seen a doctor who’s not my own and they know nothing about Lupus or how it impacts a person’s life, body & health.  The American Medical Association even acknowledges that auto-immune diseases are one of the most under taught areas in medical school because of their complexity.  More times then not, as the patient you are educating the provider when you are already ill.  At best, they believe you and do some additional research quickly to understand.  At the worst, they do not listen and make medical decisions that do not help you are your condition because they do not understand fully how Lupus impacts you.  Remember, Lupus effects each patient differently.This is just a few confessions of the chronically ill. I could probably write a book on things we feel but never share. We don’t want pity so we often keep our issues to ourselves. We don’t want to be judged or looked down upon because of our health.  What we do want is for people to understand.  Just this week, Toni Braxton tweeted a picture of herself, and people were quick to make a judgement that she had plastic surgery.  No, she is on steroids for her Lupus.  Know Lupus.  Know that we deal with our body attacking us on a daily basis, and that no two cases are the same.  Know that we keep our secrets to protect you, but know those come at a cost.  So today…. We let a few cats out of the bag.

With Love,

Amber & Amy

The Ugly Truth About Chronic Illness

The ugly truth…… the lives of people who are chronically ill are often not what you may think. Most suffer a lot more than they are willing to share. We fight something everyday, whether it’s pain or fatigue or just feeling bad overall. And naturally we don’t want to seem like we are always negative. We don’t want to appear like there is nothing good in our life, so often times we hide all the bad and just talk about the good.  But after awhile this gets old and too hard to keep up the lies. So we just stop talking to people and start shutting people out because if we don’t see them or talk to them you don’t have to lie about what is really going on. For a good majority of people with chronic illness even on the days when we “look and sound good,” we are still fighting some part of our disease process. There are very few days where we feel “normal.”

I recently read a statistic that said that 80% of people with chronic pain/illness will hide their pain and symptoms from friends and love ones. At first I thought this was a crazy statistic but the more I thought about it I really believe that’s true. We don’t want looks of pity or for people to feel sorry for us and by keeping things to ourselves this is less likely to happen. If we don’t share we don’t have to worry about what others will think or say about us.

It is really easy to pass judgement on someone you don’t know who looks fine. You see a overweight young women getting out of a her car that is parked in a handicapped spot, and think there’s nothing wrong with her she’s just fat! Almost all of us have all done this at some point, myself included. But we should all really think twice about spewing judgement! By just assuming something about someone you don’t know at all or someone that you are close to you make them feel badly about themselves, and make them not want to go out to do things. Just because they look fine doesn’t mean they are not fighting something on the inside. I know for me it’s easier to just not say anything about the amount of pain I live with. Simply because people will want to pass judgement on my pain, my lifestyle or how I treat my pain. But honestly it’s no one else’s business.

If you see a young person limping or parking in a handicap spot don’t always assume they are jut lazy or overweight. They could have any number of health problems that you could never see. Heart disease, lung issues like asthma or COPD, cancer, Lupus, RA etc. Same goes for anyone really, not just those that are young. I read somewhere that 80% of older people have one chronic illness, while 50% have at least two! I know how easy it is to place judgement, but until you have walked in their shoes you will never know what’s really going on in their life.

The ugly truth is that most people with chronic illness have very few really good days. Often times the bad days outweigh the good. That being said you may not know this because they don’t tell you. But it’s just the truth. Most people with chronic pain won’t ever tell anyone just how bad their pain is and how much it impacts them daily because they don’t want the judgement. In these days people hear chronic pain and automatically think druggie. What you don’t know is that many of us would rather do anything than take pain meds. If we could work a full time job and be a truly functioning member of society we would! For me personally I would give basically anything to be able to go back to working as a Nurse. I miss it ALL the time and often reminisce about the days when I was able to work. I never wanted to end up like I have. But it happens. Anyone can experience a life changing illness or accident. It’s not just a certain kind of person who these things happen to. So be mindful of that. Be mindful before you pass judgement and before you say hateful things to someone. You probably know next to NOTHING about what their life on a daily basis is like.

The Spoon Theory, How Spoonies Get Through a Day

When you are sick and really feeling terrible, there is nothing that can be more irritating than when someone says to you, “At least you don’t loo sick!” While they may not mean this as anything but a compliment. In general it is NOT how most with an invisible (chronic) illness will take it. To hear you don’t look sick when you have an illness where your body is attacking itself on the inside but can’t be seen on the outside is very very frustrating. So much so that fellow Spoonie Christine Miserandino developed a way to explain how we are feeling. Her piece is called The Spoon Theory. If you aren’t familiar with this theory you need to be.

Christine decided that she needed to find a way to explain how well or poorly she was feeling to her best friend and roommate. Her roommate was the person who went to doctors appts with her, saw her sick and saw her cry. She stated that if she couldn’t effectively explain it to this person, how could she explain it to anyone. She thought about it for awhile and decided using spoons would make the most sense. And at this point The Spoon Theory was born. And stated, “At that moment, the spoon theory was born. I quickly grabbed every spoon on the table; hell I grabbed spoons off of the other tables. I looked at her in the eyes and said “Here you go, you have Lupus”. She looked at me slightly confused, as anyone would when they are being handed a bouquet of spoons. The cold metal spoons clanked in my hands, as I grouped them together and shoved them into her hands.”

Christine went on to explain that the difference between a healthy person and someone with a unhealthy person is that someone with a chronic illness has to make a choice and choose what they do or don’t do every day! When a normal healthy person does not have to make that choice.

“Most people start the day with unlimited amount of possibilities, and energy to do whatever they desire, especially young people. For the most part, they do not need to worry about the effects of their actions. So for my explanation, I used spoons to convey this point. I wanted something for her to actually hold, for me to then take away, since most people who get sick feel a “loss” of a life they once knew. If I was in control of taking away the spoons, then she would know what it feels like to have someone or something else, in this case Lupus, being in control.”

Christine goes on to talk about how at the beginning of the day the chronically ill start with X amount of spoons and that’s how many you get. No more, no less. And through the day EVERY SINGLE ACTIVITY that you do costs you X amount of spoon. That’s everything, including getting dressed, taking a shower, putting on makeup etc. All activities that most would be thinking that are simple and easy things that shouldn’t be a problem. However, activities like that are the ones most people will take for granted and do without a second thought. That being said, those who have a chronic illness may have to forgo those activities, or others, like drying their hair and putting on makeup (simple as they may seem). Those things may definitely be skipped if there is an activity later in the day that they know will take more spoons and they really want to take part in or attend. Even if we may be able to do those simple tasks like those what were mentioned above it make take use 5 times as long as it used to. Simply because we don’t have the energy to get them all done at once like we once did and may require frequent breaks through the getting ready process so that we don’t risk exhaustion before whatever it is we are doing! Those of us with chronic illness have to do what we can to conserve spoons so we can make it through the day.

Let me give you an idea of what a work day looked like for me before and after my Lupus diagnosis.When I was working as an RN, right out of school before I was my first life changing diagnosis, my mornings were very different then they are now! 7-10 years ago every morning I would get up and get dressed, do the normal tasks like deodorant and brushing my teeth as well as doing my hair, which could consist of being in a pony tail/bun or down and curling it! I would put on my makeup almost every day and eat breakfast at home before leaving. I would always leave for work with enough time that I could ensure that I would arrive on the nursing floor a full 30 minutes before I started my shift so I could fully prepare for my day. I would work a full 12.5 hour shift, most of which I was on my feet and going, going, going for the whole shift. I would sit very little usually only to chart and long enough to eat a quick lunch maybe 15 minutes, if I was lucky. At the end of my day I would arrive in the room where we gave report, right on time because I was usually busy until it was time to give report and leave. Once I left work, I would often go out to dinner or even out to the bar for a fun night out after work. I could easily survive on 5-6 hours of sleep and do okay. During part of that time I was also in school for my bachelors degree, so I also had to work on studying, writing papers and going to classes online and on the computer, as well as spending time in lab or clinical.

The previous scenario is so different then what it’s like now (most recently). When I was working as a hospice nurse in the field last year, I would wake up maybe 20 minutes before I had to leave, if I was lucky! Leaving just enough time to drink a yogurt shake or maybe something as i was driving, jump in some clothes, put on deodorant and perfume and brush my teeth. (Much different than the way I did before) Most days I would work anywhere from 4-8 hours a day depending on what my day was like, and how far i had to drive. By the time I got home I was in so much pain and so stiff I could hardly get out of my car and walk into my house. And most days I would shower and fall into bed. Even if i has only worked 4 hours. And this is where I would stay until the next day. I wouldn’t sleep that whole time most days, but I didn’t have energy to do anything else. And my spoons were totally and completely gone. There was no more meeting with friends for dinner after work or going out for drinks on a work night. And most nights I require no less then 8 hours of sleep, more likely 10-12 hours. And many times on my days off I would spend resting because I was tired from the day before and knew I need to rest up for the next work day.

When I came across Christine’s Spoon Theory, I found it to be the perfect way to explain my days and how I pick and choose what I do and don’t do. Over the last 6 years I have used this very theory many many times to explain what is going on with me and why I may cancel plans from time to time. When anyone new comes into my life I often times will send this to them so they can get a bit of an idea of what I have to deal with on a daily basis. And I suggest that all of you do the same. This works for all chronic issues. Not just Lupus and Fibromyalgia. It can be used to explain the energy conservation requirement of any condition that causes chronic pain and chronic illness. So since I could not show you Christine’s complete theory, I want to provide the link for you. The Spoon Theory in its entirety can be found by clicking that link. I recommend all of you read it even if you have read it before. I also recommend that you keep the link so you can send the theory to any friends or family who you feel needs a better understanding of what you deal with all day every day. I also hope that those who you share this with will have a little bit better understanding. And will maybe refrain from using those awful 5 words we all hate so much to hear, “But you don’t look sick!” If you are a friend or family member of someone with a chronic illness please take time and read Christine’s whole piece. It would honestly mean so much to the person in your life who is a Spoonie!!

Please share this post with anyone you might know who is dealing with a chronic illness either as the chronically ill, or as family or friend of the chronically ill, and you feel that they could benefit from it!

With Love,

Amber

I also want to send a shout out to Christine Miserandino for allowing me to quote her writing in this post!

Reference:https://butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/

What’s In My Hospital Bag- Spoonie Edition

Sadly over the last three years I have spent many days and nights in the hospital. I even took a trip to Mayo for a week and have had a couple overnight trips for treatment. That being said I have what I need in my bag for the hospital down to a science. In fact when I get home from the hospital, I wash the dirty things in the bag and repack it. That way it’s always ready and I don’t have to rely on my family to try and pack it in a rush. So let’s just jump right into what’s in my hospital bag.

1. Pajamas/yoga pants- I always have at least one or two full sets of pajamas packed in my bag. Whether I am able to wear them or not I want to have them. And I generally have sets for summer and winter. Because you never know if you will be in a room with a roommate who keeps it at 60 or 80 degree. I also keep usually two sets of yoga type pants and a pair of shorts in the bag, in case I’m on a ward where I can’t wear anything but a gown. You just have to have bottoms on, no matter what kind. For me personally I don’t feel comfortable wearing only a gown.

2. T-shirts/Tank Tops- I always pack a T-shirt or two (usually short sleeved, maybe one long sleeve) & several tank tops in case they will let me wear them. Most of the time I am on a floor with a heart monitor so I have to wear a gown so they can reach it. But I always keep a couple just in case because to me they are much more comfortable than those darn hospital gowns.

3.Underwear & Bras – I will usually pack at least 6 days worth of underwear because that is the longest I have been in the hospital to date. As far as bras go if I think there is a possibility I will be admitted by my PCP, or that the ER will decide to admit me I will go in with a sports bra on! Then I generally try to pack 1-2 sports bras in my bag. That way I can change every couple days. Sadly, I have to wear a bra. It’s uncomfortable feeling for me not to and can be awkward for the nurses if I don’t!

4. Personal Care Items- I have a bag within my bag that keeps all of my personal care items in them. I always have deodorant, body soap, shampoo, lotion, toothpaste, toothbrush, and a hair brush!! I also keep some hair ties, and headbands in my bag as well so I don’t have to deal with my hair in my face.

5. Slippers or Flip-flops- This isn’t so much a comfort thing for me as much as a way to prevent walking on dirty hospital floor. Hospital/Hotel floors aren’t really known for being clean. So I never leave my bed without something on my feet. And most hospitals won’t let you walk in the room barefoot due to bare feet being a fall risk! I also always try to shower in flip flops! But obviously that’s just a preference for me, and may not be something you need on your list!

6. Entertainment – Most of the time when I’m in the hospital I am in with a Migraine. That being said the TV is often to loud and to bright for me. So I always have my phone, and usually my IPad. Because I have those things with me I always have chargers for both and earbuds. There is also usually a book in my bag in case I’m in with something besides a migraine and feel like reading.

7. Comfort- I’ve been in the hospital enough times to know that I will find little comfort in their beds. Because of that I always have my own pillow and a small fleece blanket to help me get more comfortable so I can rest more easily.

8. Miscellaneous Items- These are items I don’t always have with me for each admission, but are on my list for packing a bag. My CPAP generally doesn’t come with me. But if you are in a hospital the expects you to, you should make sure that it is on your list of items to take. This may seem funny but I HATE wearing socks. So I generally keep a pair or two in my bag just in case I have a roommate that keeps the trim like an iceberg! A pair of cheap sunglasses are almost always in my purse or my hospital bag. This is because I generally end up in the hospital with a migraine. And I’m very light sensitive. So I try to always keep a pair in my bag. The last thing I keep in my bag is an old Walmart bag or unused trash bag, to put my dirty clothes in. Finally, one of the most important things I MUST have is an eye mask!

These are only items that I pack for me. Obvious everyone is going to have a different list for themselves. While preparing to write this I polled my friends who also have recently spent time in the hospital for their must haves. This is their list.

9. My fellow spoonies MUST haves: chapstick, Makeup wipes, fill-it-in book, crossword puzzle books, ink pen, maxi pads/tampons (just in case it sneaks up on you while you are in the hospital), cottonel wipes, cup for dentures, glasses and glasses case, contact solution and case if you wear contacts, coloring book and something to color with, a heating pad or rice bag that can be heated up. One friend also said if she is feeling like eating she will sometimes pack some snacks that won’t need to be refrigerated.

I hope my sharing this list will help you to figure out what you need in your bag. Even if you don’t keep one packed I would highly make a list of the things you would put in your bag should you need one. If you do choose to take some comfort items from home it will make you feel a little less like you are in a sterile environment. Having a list will also make it easier for your family if they should ever have to pack a bag for you. To be honest that was a big reason why I started keeping a bag always packed. It was just to difficult to tell my family exactly where things were that I wanted. And this way the don’t have to be digging through my stuff!! That being said, packing a bag or making a list of what you would want in said bag, will make being admitted much less stressful or scary in the future!

With Love,

Amber

Special Thanks to Missy and Christall for sharing your personal lists with me!!

Dear World….

Hello world! This one is for YOU!!

No matter how hard we try there are always going to be some level of judgement within. But most of us keep that judgement to ourselves, and don’t stare people down or make comments when we think they shouldn’t be using that wheelchair, or parking in a handicapped spot or even just wearing a mask out in public. That being said many people don’t keep those judgments to them self and they make the rudest comments. Today this post is directed to those who can’t keep their judgments to themselves.

Yes, I know what you are thinking when you see me get out of the car that I just parked in a handicap spot. You look me up and down and then proceed to think, “There’s nothing wrong with her why would she park there!” And some will even glare or make comments. By looking at me all you see is what looks like a healthy lady in her thirties who’s only issue is that she is overweight! However, you CAN’T see my Illness! It’s INVISIBLE!! Meaning you may not be able to tell I have anything wrong by seeing me or even talking with me, unless I’m wearing a mask, or limping or even wearing sunglasses inside or using a cane or wheelchair. Otherwise there is no physical manifestation you will see!

You don’t know that even getting out of bed is hard. Getting dressed and ready is exhausting. And could take several hours just to get to point of walking out the door. Due to needing to take multiple periods of rest! By the time we finally make it to wherever we are going, whether it be a restaurant or a place to shop, we have no energy or spoons left AT ALL! You can’t see that it’s hard to breath, and my heart is beating way faster than it should. You can’t see the HORRIBLE migraine I am suffering from. Or know that the lights in the store or from the sun are making my head hurt that much worse. Or that the urge to vomit from said headache gets stronger with every step and movement!! But yet you continue to whisper and make comments and stare me down.

You don’t know that I woke up with a pain level of 8 and even after taking my prescribed dose of medication. I am still at a 7. You can’t see that every step is agony and every time I have to grab the cart to push it in the grocery store, that pain radiates through all my fingers, hands and up my arm! You can’t see the pain that is in my back and pulsating with every movement. Yet you still continue to stare and make comments and judgements.

You also don’t understand pain meds. You don’t understand that we would all rather do anything else than take pain meds. And NO most of us are not addicts and should not be treated like we are. If 99% of you were in our shoes you couldn’t do half of what we do. Because we have gotten used to the pain and know that I can’t stay home in bed just because I hurt. Because, if I did that I would never leave the house!!

I love when you see my mask and you turn around and go the other way because you are fearful for CATCHING WHAT I HAVE. Well, in this case the JOKES ON YOU!! The situation is actually the opposite. I wear this mask to prevent CATCHING what YOU have! You don’t know and can’t see it, but my immune system is to busy fighting off my body to worry about fighting off any germs i in contact with. What you may think is a just a small cold for you, could potentially put me in the hospital or even kill me! So I have to protect myself from you and the world!

And you will never understand what it’s like to have to stay in your home for weeks on end because the flu is running rampant in your area! What it’s like when you see people on social media and wish you could be out having fun. While instead you are stuck in your home because the flu for someone like me with Lupus could KILL ME!

The public will never understand the invisible illnesses. In general people will forever think that if there is no outward sign of illness, or pain (like a cast on a leg or a person on oxygen) they will most like assume that you are fine…..JUST LAZY! Which couldn’t be further from the truth. That has been the thought process for many many years and it will be hard to change. In general, the public doesn’t understand any illness that they can’t see. And we understand that. What we don’t understand is the need to make hateful and judgemental statements. How does that help in any situation?!?

I’m going to wrap this up with a few statistics for you regarding the invisible illness. And give you something to think about. Approximately 10% of Americans have a medical condition that could be defined as an invisible disability. And 96% of people with chronic medical issues, live with a condition which is INVISIBLE!! And most of those people don’t use a cane or assistive device that would show they are ill.

Perhaps after reading this someone will think before they judge! Hopefully, they will hold their tongue before making a rude and hateful comment. I know that’s wishful thinking, but I would hope that seeing this Information would make them think. If this reaches just ONE person who will change their thoughts about people using handicap spots or a wheelchair than I’ve done my job!!

With Love,

Amber

The Things I Wish Someone Would Have Told Me

Even though I’ve been diagnosed with Lupus, Fibromyalgia, and Endometriosis there are still things I come across that I wish someone would have told me about. You all know what I’m talking about, those little “tricks of the trade” that people who have been dealing with that condition for awhile and no one shares with the newbie. So after having a discussion with several people across several different groups, I have complied a list of things by asking others who have autoimmune illnesses. The list we complied could apply to anyone, not just me, but could change the way you do or look at things!!

-I wish someone would have been honest with me and told me that it may take MONTHS or YEARS to accept the changes brought forth by the illness. If you can ever truly accept the changes.

-I wish someone would have made it more clear that this is not something you can adjust to overnight! It may take a lifetime to fully adjust to the changes in your body, your energy level and your fatigue.

-I wish someone would have mentioned the depression that happens as you start to really accept the changes in your life is real. As well as made it clear that is is okay for you to feel that way! And suggested early on that seeing a counselor might be a good idea. 

-I wish someone would have prepared me for the fact that there is a very good chance that you won’t make a LOT of the plans you schedule, due to your health. Even if it was something you planned and were looking forward to. You just may not make it!! And in most cases your friends will never understand why you can’t just get up and go.

-I wish someone would have prepared me for the fact that not all Rheumatologist’s (or other drs for that matter) know much about Lupus or the way to treat it. And most even if they are familiar may not know the newest meds or what’s really best for each individual patient.

-I wish someone would have reminded me that no one will understand what is happening to me, and no one will stand up for me like I will. I MUST ADVOCATE FOR MYSELF AT ALL TIMES!!! (As do each of you reading this!)

-I wish someone would have told me that anytime I go to the dr or the ER with a pain related issue that I am most likely going to be treated like a DRUG SEEKER!  Whether I am or not. The drs don’t care. They just go off what they see before even talking to the patient!!!

-It would have been great to know that many of my friends and some of my family would turn their back on me and simply walk away! Because they don’t understand the changes in my life or just simply can’t handle it.

-I wish someone would have prepared me for the pain I would feel, not only from Lupus & Fibromyalgia, but also from Interstitial Cystitis and Endometriosis!

-I wish I had been prepared for the fatigue that Lupus brings on. It’s not like any fatigue I have felt before. It can honestly be totally disabling.

-I wish someone would have prepared me for the cost (even after insurance) that I will have to deal with and pay out of pocket.

  -I wish people understood that exercising and eating better will NOT cure my conditions.

  -I wish someone would have prepared me for how hard it is to keep a full time job doing the things you like once you are diagnosed with a life changing disease!

-I wish someone would have prepared me for all the dumb questions I get based on my conditions. I know people mean well, but their delivery could definitely be worked on.

– I wish someone would have prepared me for all the conditions that would come along after lupus. I had no idea that once Lupus came into my life that he would then invite all of his unwanted friend.

This is just a list of things that was combined from a poll Results from a questionnaire in an autoimmune support group, along with my own thoughts. I know many of you feel this way and could contribute many more points to the list. I hope you enjoyed reading this and it made you think about all the things that you have to deal with. Please feel free to share this with friends, family or others who suffer with chronic illness. And always remember YOU ARE NEVER ALONE IN YOUR JOURNEY!! There are always many of us out there willing to help and talk you through any struggle!!

With Love,

Amber

How I Really Feel…….About Chronic Illness & Friendship

So you’ve made plans and were genuinely excited to do whatever it was you planned. But the day comes and you feel like CRAP. You are hurting and battling whatever ailment is most current. And you know there is no way you can make it to said plans. But how do you get out of it without the other person hating you or dealing with the other person judging you? This is a constant battle I think all spoonies fight. Do we follow through with said plans and then spend a week in bed or do we cancel and then deal with the feelings that come from that?!? It’s hard. And it seems like you (or at least I always feel like I am) are always letting someone down. So how do you deal with the situation?

Over the years this is something I’ve gone back and forth with. Do I make up an excuse as to why I can’t go so it doesn’t seem like I’m sick AGAIN?!? Or am I honest, and tell the person how poorly I am feeling and why I really can’t come?!? I’ll be honest, I’ve done both. And neither seem to make it any easier to deal with constantly having to cancel plans. But in the long run I feel that it’s better to just be honest. If you aren’t feeling well just tell your friend/family what’s going on. Then it’s on them. If they want to be mean and hateful about you cancelling plans that’s their issue not yours. You can’t force them to believe that you are sick.

I’ve had it go both ways when I was honest and told my friend I was too sick to make our plans. I’ve had friends be really understanding and offer to bring me soup or ice cream or something I might need. And then I’ve had “friends” interrogate me about being sick. Asking for signs and symptoms and what I’ve taken to feel better etc. I’m sorry did you become my doctor? These are not things you need to know. This is you being nosey and testing me to see just how sick I am. And I have nothing to prove to you!! If you as a friend can’t believe me for what I say I don’t need you in my life.

That’s what it comes down to honestly! If you have friends that can’t take your word and don’t believe when you say you are too ill to leave the house, you don’t need them in your life. Yes, we often have more Infections and have to cancel plans more than most people. But this is not a part of our life we enjoy. If you think we enjoy sitting at home and never getting to go out and have fun you are sadly mistaken. We crave people interaction and having fun just like anyone else. We just don’t get to do as much as we would like. To an extent we are a prisoner to our own bodies. We can’t control what happens from day to day. We just have to deal with what we are thrown and move on. And if that involves having less friends because they can’t understand the life of a person with a chronic illness then that is just the way it has to be.

We have to treasure the friendships with those who care to take the time to understand our lives. Those are the people who we need around us. People who will support us and lift us up even if we have to cancel plans. It sucks enough having to live life with all the illnesses and drs visits that we have. We shouldn’t be questioned and treated poorly when we have to cancel plans. If you aren’t a spoonie but have friends who are please remember that we don’t enjoy cancelling plans and having to stay home. So don’t make us feel even worse by treating us poorly because we have to cancel plans!

Friendship and chronic illness is hard. And it makes me sad to think about the people who have walked out of my life simply because I am sick. People who I loved like family who decided they couldn’t handle my illness. Which seems crazy to me because they are NOT dealing with my illness I am. Yes, things change! I may not want to go out to dinner or to get drinks as often but that doesn’t me that I as a person have changed. I am still the same person who you fell in friendship love with, except my body is not healthy. As many friends as I’ve Lost, I have also gained some of the best friends of my life in the past 5 years. Fellow spoonies who understand what I go through in a week. As well as non-spoonies who are kind and compassionate and understanding. For all the people who stand by me on a daily basis I am so thankful!! I can never express with words how thankful I am to have these people in my life. They help get me through every day and help me to keep a positive outlook. While also being there to listen when I need to vent!! Friendship can be hard but is so worth the fight in the long run.

With Love,

Amber

Friendship and Chronic Illness 

It’s true once you’re diagnosed with a chronic illness or a multitude of chronic illnesses your life changes. Not just simply Your Health either.  Your social changes dramatically.  It seems like your friends start dropping like flies. Some can’t stand the sight or the thought of you being chronically ill. While others can’t be bothered with your “flakiness,” and don’t understand why you can’t make plans in advance or why you will cancel at the last minute.  But with a chronic illness those things are just part of it. I may feel great today and the idea of a concert or a night out in three weeks sounds fantastic, but there is no way for me to know how I will feel that day!  And it’s not that I am being flaky! I just don’t know what my crazy body will do!  

Over the years since diagnosis I, like many just like me, have lost friends. Not all at once. But one by one. People I considered my best friends or thought I would be life long friends with just walked away for reasons unknown or because they couldn’t handle what’s was going on in my life. I get it. It’s hard to see someone change so much and have no control of what their body will do next.  The hardest part of all that for me is that these were the people I neded the most. The people who I leaned on when times were tough. 

I decided to take a survey of a support group on Facebook. I asked them how many of them still have more than three friends from the years pre-diagnosis. Of the 13 who responded only TWO said that this was still the case. The other 11 stated  that they no longer have have three or more friends prior to diagnosis. And the following comments were left:

-It’s true though, it becomes so hard. Although I’ve learned it isn’t all to do with the Lupus anymore. Now I’m *that* friend that is busy every day and every weekend and can’t find time to eat lunch with friends. 
-My husband is my best friend, and literally my only close friend. I tend to lose touch with friends because I’m “flaky” when it comes to plans thanks to Lupus. We don’t really fight, just people tend to stop making plans that will likely fall through.
I don’t know what I would do without my friends, people who have known me since college, we’re talking 30 years. They’ve been with me through everything and now this.
-I have 2 very close friends and some acquaintances. I generally am with my family only and only 1 of my 2 friends. I cannot make plans that are long term because I guarantee that I will be there. My body does not afford me that luxury. I have lost friends due to this. It is difficult and can be lonely. I am so thankful for my family otherwise I would be alone a great deal. I cannot drive anymore so that is further isolating. Chronic diseases have taken a great deal of my social life since I can’t drive and make long-term plans and often cancel plans that I have made. I have multiple autoimmune disorders as do many of us and this makes it even more difficult.
-My really close friends are my husband, my sister in law and a lady that I met on FB after I was diagnosed… I don’t have any friends that I am still close to from before I was diagnosed, because they couldn’t handle my being sick all the time… 😔                                                                           -My closest friends have came after my diagnosis. People that I thought were my best friends before lupus have turned out not to be suck great friends. I have a few that I still talk too, but even with them I feel super guilty when I either won’t make plans or have to cancel 🙁

I do consider myself lucky however as I do have a couple of really awesome friends here locally who are so good to me. They come and visit me in hospital, they check in on me routinely.  And even spend their time taking me to drs appointments, Infusion’s, and spending hours in the ER with me!  I can’t thank them enough. However, some of my best friends are people who I’ve met through my support group!! Not only are they great people but they totally understand what I am going through and don’t make me feel bad for it!  I may never get the chance to meet them in person but I will be forever grateful for their friendship. 

So I guess the takeaway in this is that sadly most people don’t understand chronic illness or don’t want to take the time to. People also will often walk away when things get tough. It seems it is just human nature. Not to generalize but I’ve seen it happen too many times as a nurse. People get sick and their friends and family don’t know how to deal with it. So for them it’s easier to just walk away then it is to deal. I wish it wasn’t that way but it just seems to be that way. I hope for you this is not something you experience. But if it is know you are not alone. And there are a ton of support groups where you can not only find support but friendship in those who understand you and your Life.