Living Life My Way

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I last left the house was on 26th November last year. Actually, November was a remarkable month because I went out twice. Both for medical appointments; the effort of which exacerbated my symptoms owing to my systemic inability to tolerate exertion. This core feature of my illness has been recognised in bold neon headlights by the Institute of Medicine in the USA. Indeed, it has recommended that the universally derided term Chronic Fatigue Syndrome be re-named Systemic Exertion Intolerance Disease. The debate is raging currently both about the proposed name and diagnostic criteria:

SEID Criteria

My gut reaction was to welcome the criteria as they fit most closely with my particular experience (especially orthostatic intolerance) but I recognise that naming a disease after its symptoms is problematic. Only time will tell where this will go but there are some promising signs that the seriousness and degree of devastation of this illness are being recognised.

Although I can’t do very much without suffering the consequences, I make it my mission to purposely enjoy what I do have and can do. I’d like to share a few of the things that brighten my days. Firstly, I’m blessed indeed with having an ever-changing spectacular view from my bedroom window. Here are a few snaps I’ve taken recently:

 

Another joy in my life is reading. My condition has to be at its most severe before I am unable to read or comprehend. I spread my reading among social media, books and articles on health or for sheer enjoyment and, occasionally, to broaden my knowledge and horizons. Among the books I’ve read lately:

The Medicinal Chef Healthy Every Day by Dale Pinnock

As the title suggests this is all about eating good, unprocessed, healthy food every day. I love it! I can’t do a lot with it though as it involves standing to prepare and cook. I have managed a couple of recipes though: chicken curry, seafood one pot (although I did eschew the squid in favour of more prawns) and a mackerel salad. Quinoa features quite a bit. Tried it; prefer rice.

Eating well so as not to stress our bodies with processed food is a good thing to do. This book has some excellent recipes to try. I just wish it came with a personal chef 🙂

Silent Pain: How Stress and Trauma may lead to Chronic Fatigue Syndrome by Helen Germanos

This is Helen’s story of her illness, soul-searching, investigation, therapies and recovery. I was attracted to reading it because it is based on Polyvagal Theory, about which I wrote a post last year. It is a hugely interesting book and Helen’s three-tiered approach to recovery has given me much food for thought. I consider it a most valuable addition to my store of resources about holistic medicine. I also want to thank Helen who has been hugely kind and generous in answering my questions, sharing her knowledge and wisdom, and directing me to sources of help.

The Last King of Lydia and The King and the Slave by Tim Leach

I love historical fiction. I read Wolf Hall and Bring up the Bodies recently, Hilary Mantell’s award-winning books about Thomas Cromwell. To be honest I found both very ponderous and tough going in places. She was rather harsh on Thomas More too which I didn’t altogether appreciate! It was therefore a delight to encounter these two books which follow the fortunes of King Croesus from king of unimaginable wealth to slave. Exquisitely written and a joy to read. The standout man of the books for me is Isocrates, a fellow slave, who gets all the best lines and wisdom.

The Girl on the Pier by Paul Tomkins

I didn’t know who Paul was or anything about him until I read an article tweeted by the ME Association which, very probably, is the best article I will ever read about ME. I then learned that he was a football writer and had penned a novel. So I decided to give it a go, having no real knowledge of what it was about but expecting it to be well written. Oh boy! It knocks your eyes out and takes a good rummage round your psyche, poking sharp elbows in tender spots. It defies categorisation somehow, possibly psychological mystery comes somewhere near. That Paul managed to write a book of this quality while trapped in the ME divers’ suit is remarkable. A fantastic read!

Speaking of football, my last homage to stuff that cheers me is the current fortunes of my beloved Celtic. I’m thrilled that we have signed the cream of Scottish talent in Gary Mackay-Stevens and Stuart Armstrong, both of whom scored (the former within 38 seconds) in the debut game against Partick Thistle the other night. Add to that a hot young Irish talent in the form of Michael Duffy and we’ve had the best transfer window in recent memory. Signing Michael also brought us a new American fan in the shape of Fr Michael Duffy who had never heard of Celtic until he got loads of tweets welcoming him to the club. He knows the history now alright 🙂

I might not be able to attend games now but my passion is undiminished. Presently, we remain in the league (first place naturally) and 3 cup competitions including the Europa. Next week sees us take on Inter Milan in a full house at Celtic Park. The last time I managed to attend and enjoy a Euro tie was against Barcelona on 7th November 2012. We won and the night defies description. It was electric, raucous and magical. I’ll finish this post about some of the joys of my life with a picture of the pre-match display from which I still have my bit of green plastic:

Language and Metaphors

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Consider the following alternatives:

1. I suffer from symptoms of asthma
2. I have asthma
3. I am an asthmatic

Can you see the difference? Does the language with which we describe our illnesses matter? I think it does. Our lives are a story that keeps unfolding. A large part of that story is determined by what we tell ourselves, and others, about ourselves. Whether you feel you suffer symptoms, own an illness or identify closely with it is a personal choice or, perhaps, simply intuitive but it shapes who you are and informs your behaviour and other choices.

As it happens, I do suffer from asthma symptoms (since early childhood) and I’ve noticed that as my condition becomes more easily managed owing to medical advances in treatment , my attachment to it as a facet of my identity has loosened. So you’ll notice my choice of language now where 30 years ago I would have been labelled-and labelled myself-an asthmatic.

I wonder, however, if that choice is as free or intuitive where ME is concerned. Consider the following alternatives:

1. I suffer symptoms associated with ME
2. I have ME
3. I am an ME sufferer

If asked by a stranger, how many of us would opt for the first alternative? If not, why not? One reason might be because not only have there been few medical advances in treatment there is as yet a complete dearth of understanding about what the condition actually is. Accordingly, very, very ill people are forced to raise awareness and plead for sympathy, understanding and support. Shamefully, this often needs to be directed at health professionals. Thus there is a sense of taking on responsibility for promoting just what’s involved: the sheer relentless, devastating, debilitating awfulness and that means identifying very closely with what’s going on in our bodies.

Ideally, I would aim for option 1 as it gives me the hope that at some point I will no longer suffer these symptoms. They will go as they came or will be capable of easy management. I certainly don’t want to own ME and as for it being my identity …..[insert suitable expletive!]

I’ve noticed in a few articles recently fantastic examples of people using language, specifically metaphors, to describe their experience with ME. Paul Tomkins describes it as half a man, one half stolen. You can read more about this here and Marie Curran describes it as her invisible friend here. Both articles are beautifully written and thought-provoking and I’m grateful to Paul and Marie for sharing their insight.

For my part I have long envisaged ME as an uninvited, abusive monster that lives within me and with whom I am forced to co-habit according to his draconian rules. ( Sorry guys, but I very much see ME as male!) More specifically, my ME monster looks like the giant in Jack and the Beanstalk; he’s huge, powerful and I have to tip-toe round about him so as not to wake him up and rouse his ire. He’s also very fickle. One day I might happily potter around with him only grunting in his sleep but on other days the same level of activity will unleash a ferocious backlash.

I’ve found the only way to handle him with any degree of success is to bore him into submission, largely by a process of aggressive resting, as I saw it described recently, living within my capabilities and taking few risks. Not much of a way to live (understatement) but accepting this does bring a measure of ease.

By using such metaphors we are able to try to make sense of our situation, to communicate with ourselves, with other sufferers, and with the wider world with the ultimate aim of getting ME firmly on the scientific research map to deliver treatments so that we (being optimistic) and those who come after us may have a chance at really living.

Over to you, what story do you have to tell?

Is It Really That Simple?

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I asked myself a question: what is it that I do that makes me feel worse/better? Here are the answers:

 

Worse Better

 

    • Standing/walking (physical activity)
    • Relaxation/Meditation session
    • Computer use
    • Reading/dozing
    • Disordered sleep
    • Restorative sleep
    • Emotional upset/worry/stress
    • Love and compassion
    • Eating
    • Drinking water
    • Infections

 

At first glance it seems so very simple. The first category are stressors, the second relievers. Avoid the first and do more of the second and surely recovery is a given?

 

Is it really this simple?

 

Of course not. So much is outwith our control and we can hardly avoid eating and standing up! What we’re left with is trying to forge a balance, sometimes from moment to moment, depending on what the external world is throwing at us and what our bodies are capable of withstanding. This involves making conscious choices we know will make a difference: choosing the right foods, having a rest instead of being clamped to the computer and so on. And not giving ourselves a hard time if we don’t manage.

 

Also, there’s a world of difference between feeling better and being recovered. But feeling better is a good start!

Ordeal Scale

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I’ve noticed that my degree of recovery (or otherwise) can be gauged roughly according to a scale of how much of an ordeal any action or event creates.

 

For me, an ordeal is defined by any action which creates serious, abnormal and distressing symptoms or where the anticipation of any action or event creates a debilitating sense of anxiety causing physical symptoms.

 

Here’s a highly unscientific scale I’ve devised of activities which might constitute an ordeal:

 

  1. Lying flat
  2. Light, sound, touch, reading or watching tv
  3. Turning over
  4. Being downstairs
  5. Computer interaction
  6. Sitting up
  7. Standing up
  8. Brushing teeth
  9. Standing for increasing periods of time
  10. Shower
  11. Walking/pottering around the house
  12. Light domestic tasks
  13. Having visitors
  14. Making meals
  15. Walking outside for increasing distances
  16. Being driven
  17. Driving
  18. Attending medical appointments
  19. Social visits
  20. Train journeys
  21. Shopping
  22. Attending social events
  23. Days out
  24. Holidays home and abroad
  25. Working full time
  26. Absorbing impact of emotional upset
  27. Managing infection

 

I’ve managed all of these without ordeal during the currency of this illness but since my major relapse in June 2013 I’ve managed only to get to no. 14.

 

One of the principal reasons for recording my thoughts is to try to discern some pattern, some causation that might inform my choices and actions. I confess to a devil that lives in my mind called Major Worry that the deterioration in functionality since 2013 is irreversible and that I may never again get beyond housebound.

 

I have my times of sheer despair when I find myself sliding back down this scale. Two nights ago, I sunk as far as no. 3. I console myself with the thought that my functionality is variable and what can go down can of course go up.

 

My prognosis is uncertain so it seems to me counterproductive to make an assumption that I’m doomed when the reality could quite easily be the opposite. So, perhaps foolishly, I choose to believe that I will, over time and giving myself favourable conditions, climb up that scale, inch by excruciating inch.

 

Today I’m having a visitor. I’m not anxious about it (hooray) and it remains to be seen what effect the interaction will have. Next week I have an important medical appointment which involves me being driven to Glasgow. I am anxious about this but will do it anyway because I anticipate that the long-term benefit will outweigh any potential risks.

 

I wonder just how many of us live with this sort of scale every day?

What I Did On My Holidays

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eilidhh's 128As promised, here’s the lowdown on my break. The first couple of days were hugely relaxing, almost like a weight of responsibility had shifted .Mostly, I slept and read and ate just what I wanted. I glimpsed briefly a possibility of wellbeing. Thereafter, the break resembled a real holiday: gippy tummy and a hangover every morning!

So, what have I learned from this experience?

I missed my interaction on Twitter and Facebook but there is no doubt that without it life was calmer, with more space, and my head was clearer. Physically and mentally.

What else? For the first few days I did stop myself thinking about my health but gradually that thinking returned, not too surprising given the intense pain in my gut. I also found I was checking my heart rate. But I didn’t question myself too much about whether the things I was doing were correct or not. Forgive the pun, but I went with my gut instincts.

I tried to focus on enjoyment but the reality was that felt artificial. Either I lack the necessary imagination or the fact that I was within the same walls, with the same set of limited opportunities, made it impossible to engender any sense of satisfaction.

On the plus side, I did perform a few physical feats–emptied some boxes, made soup and….wait for it, walked to the end of my road (and back) without (so far) setting off a major setback. Might not seem much over the course of 10 days but I know the achievement they represent.

For me, trying to recover is a bit like stumbling about in a dark cave, not knowing the way out or even if there is a way out, with no-one able to guide me except the bright lights of manifold articles, stories and opinions which blind rather than show the way. Perhaps, only by living my own life and own health will I discover how to improve my lot, or, if this isn’t possible, to live as best as possible with it. My former doctor gave me a wonderful piece of advice: don’t fight your own body. Perhaps, for me, that’s the only advice I need right now.

In practical terms going forward this means:

1. Avoiding articles, stories of recovery, advice and so on and listening only to what my body is telling me.
2. Reduce the length of time spent on the computer. Enjoy quality moments and exchanges.
3. Be careful about my diet. Nothing too drastic but my gut dramas let me know that anything most certainly doesn’t go.
4. Aim for a relaxed approach to any activity; shift permanently the weight of responsibility about recovery that anchors me into a miserable cycle. Stop bloody worrying!
5. Stop feeling that I ought to be more than I am or do more than I can; go with the flow.
6. Keep testing my boundaries without apportioning meaning to any outcomes. Some days will be better than others.That’s true for everyone.
7. Continue to seek out enjoyment without guilt. Similarly, not to become despondent if nothing feels fresh, exciting or rewarding.
8. A recurring theme of this blog: practise gratitude. Make a point of noticing all the good stuff.

So there we have it. No miraculous recovery by trying to do things differently but some useful insight.

A final thought: I think the premise behind my break was right. Efforts to focus on recovery inevitably become a focus on the illness itself. When you focus on something it becomes bigger, stronger and better developed. It takes over. You identify with it to the exclusion, or suppression, of everything else about you and in your life. I think it would be in my interests to find something, ordinary or special, that occupies my attention away from the world of illness and disease, and which can be managed within my limitations. What that might be is as yet a mystery to me.

Holiday

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eilidhh's 271It has dawned on me that I’ve reached a point where my recovery is going nowhere. Since my last day at work, on 6 June 2013, my principal occupation, nay preoccupation, has been to strive to recover a reasonable level of health and functionality. I have treated this as I would have any legal problem: engather and analyse the facts, take expert advice, assess the options, and proceed accordingly. At this point, I feel that the facts are not certain and impossible to establish, and the advice contradictory and confusing. I don’t even know for sure what illness I have: is it ME, Chronic Fatigue Syndrome, Post Viral Fatigue Syndrome, Dysautonomia, Cardiac abnormalities or an illness that is peculiar only to me? I have no definite idea of its causes, its pathology and thus no certainty about what to do for best.

I spend a lot of time seeking out information and advice. Lately, where I would have found inspiration from a recovery story I feel alarm. Typically, they run along the lines of; I was desperately ill, tried everything, limped along, then finally the key element dropped from the sky and now I’m running a marathon. That key element varies enormously from finding sensitivities to mould, diet change, addition of supplements, to psychological or other lifestyle changes. How do I know what my key element is or even if I have one? I’ve found myself questioning the basics. What does pacing actually mean? What am I meant to do? What about diet? Supplements? Sleep? Attempts at activity? How do I know if I’m doing the right thing for me? Worse, am I doing myself any harm? Have I damaged myself irreparably? I’m wracked with indecision and self-doubt and that can’t be good for me of that I’m certain!

From tomorrow, my boys are on holiday from school for the next 10 days so it seems to me that the time is right for me to take a wee holiday, not from the illness itself (I wish!) but from my job of trying to recover. For the next 10 days I’m going to try to forget that I’m ill at all, put aside all my protocols and act as if we were away in a foreign country, cut off from the normal run of things. What will this look like:

• I’m putting aside my computer as if I was leaving the office. I’ll put on an automatic reply to emails and avoid all electronic contact, including my normal social media lifelines.
• I’m taking off my heart rate monitor.
• I will eat what I want and, with the exception of vitamin D and fish oil, ditch all supplements.
• I’ll sleep as long as I want, when I want, where I want.
• My journal will not record any symptoms, thoughts or ideas about illness or recovery.
• I will banish any thoughts about illness or recovery.
• I will focus on enjoying myself, just as if I was on holiday.

By doing this, I hope to return to my ‘job’ relaxed, renewed, with a metaphorical tan prepared to embark on the next stage of my recovery. I will miss my many online friends meantime but, just as with a normal holiday, I’ll be back with my boring photos and tales of what I got up to.