I have a lot of problems right now

So, inevitably, I tapered off prednisone and fainted all over my condo for three days. Then I decided to be brave and try a new treatment: quercetin, a mast cell stabilizer. At first, it felt amazing. My kidney inflammation completely disappeared. Two days later, I lost my vision and feeling in the right side of my body.

After I stopped the quercetin and my vision came back, I lost hearing in my right ear. I have no idea why my mast cells decided to trap a bunch of fluid in my ear. I tried to tough it out, but vertigo forced me to crawl like a baby. Sudafed opened up my ear tubes, but now the decongestant is pissing off my pee tubes.

And no one wants to hear about these problems.

So, here’s another.

A young guy moved into the condo next to me. This is significant because until now I was the token young person in the building. It’s nice to live next to another person with a job and other priorities besides monitoring me, my dogs, and my garden. (Stop looking in my window, Susan!)

As soon as he bought the place, he started tearing down the walls. I think it’s admirable when someone renovates their own place, so I didn’t even mind the noise. Although I did get nervous when my bathtub shook as his sledgehammer blasted the adjoining wall.

The following day, as he continued to work on his bathroom, I learned my shower wall provides practically no sound barrier. Even with my inflamed ear tubes, I could hear every word of his TED Talk podcast… in my living room. Of course, at that moment my pee tubes declared it was time to relieve myself. Reluctantly, I sat down on the toilet. This episode was about gender and genetics. So, he’s a handyman and an intellectual. And yeah, of course, he’s attractive. After all, one does not remodel without muscles!

First impressions are everything, and the sound of my tinkle is reserved for my closest friends. I held my bladder and wished I had to do another 24-hour urine analysis, so I could pee in a bucket in the privacy of my bedroom. Maybe I need to go to the hospital to get my problems sorted out. Or at least until my neighbor puts a bathroom wall up.

Why I only write when I feel like it

“Write every day” is common advice pounded into aspiring writers’ heads. If not every day, writers are encouraged to schedule writing time and stick to weekly routines. The purpose is to train your creative brain to produce a steady stream of writing regardless of inspiration.

I love routines. My perfect morning starts with making my bed, a chai latte, and breakfast for my poodles followed by twenty minutes of reading and a leisurely shower. I love how routines minimize decision making and ensure I focus on my priorities.

However, a routine is a luxury not everyone can sustain. My body is unreliable. My health changes from hour to hour without warning. It does not abide by any clock or calendar, no matter how hard I try to bribe it. As a disabled and chronically ill person, I have given up on routines.

When I first got sick, I thought if I followed a strict routine, I would feel better. I created a conservative schedule of medications, healthy meals, exercise, and sleep. I tried to follow it every day and every day I failed. My routine was destroyed by bouts of dizziness, midday vomiting, and nighttime muscle spasms. Instead of feeling better, I felt worse as I clung to my schedule and ignored my body’s demands.

Five minutes of writing a day may seem like an easy commitment (I have tried it!), but some days I can barely walk or shower. Some days I must choose between eating and resting. Some days brain fog robs me of my words. On a bad day, I don’t need the added disappointment and guilt of a writing routine I can’t maintain.

I am not less of a writer, because I can’t write every day. In fact, my experience with chronic illness and disability enriches my writing. Furthermore, I love writing and doing what I love, at my own pace, is healing. In the end, writing when I feel like it helps me feel like writing much more often.

4 tips for writers with chronic illness (and everyone else)

1.  Set realistic, meaningful goals
I have less energy than most people, so I must choose my goals carefully. A near death experience incited my desire to launch blog. I cannot blog every day or every week, but I strive to post every two weeks. I remind myself that the quality of my posts matters more to me than the quantity. I also decided not to monetize my blog in order to save my energy for writing.

2. Write when you feel good, wherever that may be
Inspiration is extremely elusive when you feel like crap most of the time, so I make every effort to capture it. I’ve trained myself to jot every idea into my phone no matter what I’m doing. I dictated half of this blog post into my phone while sitting in traffic. Notes and outlines help me write when I feel good, but I’m not inspired. I always bring these with me to my medical appointments, where I spend a lot of time waiting.

3. Enjoy less taxing, creative activities when you don’t feel good
I’ve learned how to enjoy myself when my brain feels like mush. Podcasts, books, movies, and coloring are low-energy activities that can be great distractions, while stimulating creativity. You totally have my permission to binge on Netflix. I also recommend networking with other writers on social media. Networking can be as simple as liking someone’s posts and sending goofy memes. The chronic illness and disabled writing communities are awesome.

4. Be kind to yourself
Your body is not the enemy. When I’m unable to meet my goals due to my health, I acknowledge that I’ve been busy trying to stay alive. There is no writing pace that guarantees success, but you do need be alive in order to write. Fighting your own body and criticizing your limitations is not productive. Self-care will make you a better writer.

What goes up must come down

When I was seven years old, I took my first plane ride to California. I was technically visiting my aunt, but we all know I was really there for Disneyland. My parents promised me the Happiest Place on Earth and I believed them.

My aunt had the honor of taking me. Holding my hand, she led me around the theme park, as I marveled at the attractions. The first item we bought was an autograph book, commencing the hunt for Disney characters. As the morning progressed, I became braver at approaching princesses. I even procured my own princess hat.

So, when my aunt suggested Splash Mountain, I was excited. I love water. She asked me if I was sure, and I said yes. To be certain, we watched several boats drop down the waterfall, as the photo kiosk captured gleeful riders.

I hopped into the seat next to my aunt and boat continued to glide forward through the towering rock walls. I grasped my aunt’s hand on one side and the handrail on the other. The first dip, a few feet, made me giggle and my hands relaxed. We drifted along the outside of mountain, and re-entered the dark cavern, this time surrounded by ducks, alligators, and bears. At each turn, new creatures sang and danced along to the catchy big band music vibrating throughout the mountain.

I snapped back to vigilance as we approached the first big conveyor belt. The boat tipped backward and I tried to determine how high we were climbing, but it was dark. I simultaneously wanted the rumbling of the boat to stop and to not stop. Finally, a small circle of daylight appeared at the top of the lift.

My aunt squeezed my hand and whispered in my ear, “What goes up must come down.”

I tried to pull my hand away. My aunt snickered. I tried to reckon with her warning. I imagined throwing a ball in the air. The ball fell. I didn’t want to fall. I was only seven years old, but I knew gravity always won. Why would my aunt do this to me?

My panic was interrupted by the sight of the tree line. I’m pretty sure I wasn’t touching the boat as we dropped down side of the mountain. The boat began to climb another conveyor belt and my aunt taunted, “What goes up must come down.”

“I don’t want to go up anymore!” I screamed.

*****

My mast cells are beating up my right kidney again. The pain got so bad I swore I’d never drink water again, but I need water to live, so I decided to try a prednisone burst instead.

I FEEL GREAT!

If you’ve never been on prednisone, it’s sort of like 3 shots of espresso, except the buzz lasts from 8 am to 4 am every day. In fact, I forgot to drink coffee this morning, as if coffee is optional. I was too distracted by overwhelming feelings of hope, determination, and joy. I spent the morning scanning documents, mending clothes, and vacuuming air ducts. I’ve eviscerated every miscellaneous pile lurking in my condo.

From there, I moved on to shopping, online AND in stores. My FitBit battery can barely keep up. I take breaks for eating, of course. Food tastes great and prednisone allows me to digest many MCAS forbidden foods like spaghetti and chocolate. It’s impossible to cook a meal without dancing.

I’ve got my ducks in a row. I’ve got my poodles in a row. I am the best version of myself.

Of course, I wish I could feel this way every day, but prednisone is black magic. The main side effect is total destruction of your body. It eats your muscles and bones, while you swell into a bulbous blob. After a few months, your can-do attitude is offset by atrophy and disfigurement. My body is still recovering from 2015, when I took prednisone for a full year.

I know what’s coming. I have already begun to taper my dose. In a few days, my heart will pound, my head will swirl, and I will struggle to sit up on the couch. I will want to sleep from 8 am to 4 am every day. I will tell my friends I feel like I am dying.

What goes up must come down, but I’m sure as hell going to enjoy this ride while it lasts.

Disneyland

Seven year old me trying to hold it together after a long day at Disneyland.

I did a thing

Do you ever get a strong urge to go somewhere or do something totally out of the ordinary? There’s no apparent explanation for it, but you MUST do the thing.

As soon as the snow melted, I NEEDED to go canoeing. I NEEDED to leave the city and paddle down a river lined with tall, green trees.

Maybe it was an instinctual calling after months of hibernation and mountains of snow? Or maybe it was my body craving a physical challenge as it slowly regained strength? Maybe it was just an excuse to put my dogs in their adorable life vests?

This urge contradicted every precaution I’ve taken every day for the past three years. I imagined how many ways canoeing could go wrong:

  • The sun could trigger anaphylaxis and I would need an emergency airlift. The helicopter pilot would find me by following the trail of vomit floating down the river.
  • My arms could dislocate or lose all muscle strength. I would lose control of canoe and end up floating into the Mississippi River. Maybe the Gulf of Mexico.
  • A bee or a swarm of mosquitos could attack me and trigger anaphylaxis. Another river of vomit; another airlift.
  • I might fall in, have trouble breathing, and depend on my two toy poodles to swim me to shore. Except they are toy poodles, so obviously we’d end up in the Gulf of Mexico.
  • Everything could go well, but I might lose all energy right before I needed to drive back to the city. I have no idea how much that Uber would cost.

I did not feel confident.

The urge continued to nag, “You really need to update your Facebook photos. Think of how cute your poodles will look!”

So, I texted a friend, “Do you want to go canoeing?”

I waited for her to tell me it’s a horrible idea.

“Sure,” she said, because I have supportive friends that let me test my horrible ideas.

So, I picked a 4-foot-deep river and a cloudy day.

Perched on the bow, I felt a bit more confident, like an explorer, brandishing my paddle. I only dropped it once. The river, aside from a few mild rapids, gently guided us down stream. Basically, we floated the whole two hours. Our only real job was not to make any sudden movements and tip the boat.

My only source of anxiety during the trip was when one of my poodles tried to fight a bald eagle. Quixote, who is 9 pounds and cowers at geese, had no reservations about barking and lunging at a bald eagle swooping increasingly closer to our boat. I imagine the eagle was ultimately dissuaded by his blaze orange life vest, completely validating the hour I spent digging the vest out of storage.

When we reached the landing, I leaped out of the boat and dragged it onto the shore declaring my victory. I was alive. I did the thing. My friend congratulated me on an uneventful voyage, but only I could truly appreciate what I had achieved. I knew my accomplishment could be attributed to luck (the weather was absolutely perfect) as much as determination (months of painful rehabilitation). But most importantly, it was about conquering fear.

And my Facebook photos got so many likes.

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Summer essentials for MCAS and EDS warriors

Minnesotans have a deep appreciation of summer. It is the reward for surviving blizzards and subzero mornings. As soon as the trees begin to bloom, we magnetize to our celebrated lakes for barbeques, swimming, and boating.

Too bad my mast cells hate summer.

Specifically, my mast cells hate the sun, the heat, and humidity. Fifteen minutes in the sun can trigger six hours of fever and vomiting. My mast cells hate the winter too, but that was easier to accept. The only fun aspect of living like a vampire is being able to say you live like a vampire. And to be honest, that hasn’t made me many friends.

This summer, overall my health is more stable, but my joints are not. It seems now that I’m less inflammed, my hypermobility is more noticeable. Like many MCAS patients, I also struggle with Ehlers-Danlos Syndrome (EDS). My mast cells are tolerating a more active lifestyle, but now my joints, especially my ribs, are slipping all over.

This year, I am determined to enjoy my summer anyway, even if that means getting up before sunrise. I’ve even assembled a survival kit of sorts. Here are the top five essentials I rely on to enjoy summer despite MCAS and EDS:

A cute hat

Emphasis on cute, because you should love your hat enough to wear it at all times. I have a huge head, so I’m a fan of straw, bucket hats, but UV protection hats are best. I am also a big fan of having multiple cute hats.

A fanny pack

Fanny packs are back! This is great for two reasons. First, they are perfect for carrying Epi Pens. I no longer fear a severe reaction when I walk my dogs, but I know one pissed off bee could put me in instant danger. Second, fanny packs easier to carry than most bags, meaning less joint problems . I’ve been eyeing this Lululemon bag.

Birkenstock insoles

Everyone has heard of Birkenstocks, but people rarely know about Birkenstock’s insoles. I actually find the insoles more comfortable. They provide both arch and metatarsal support and slide easily into any shoes. I can’t imagine my walks around lakes without them!

Zero gravity chair

When I asked other EDS warriors about patio furniture, the response was unanimous. I got mine from Target and it’s amazing. When my friend tried it, I worried she’d never leave. Perfect for outdoor reading, recovering, or wasting time on Facebook.

Signature (non-alcoholic) cocktail

Okay, it’s not really a cocktail at all, but this summer I’m observing happy hour. Every afternoon, when I slurpy my icy, mast cell stabilizing drink, I feel more summery. Your drink can be whatever you want. Here’s what’s in mine:

  • ½ cup frozen blueberries
  • ¼ cup raspberries
  • ¼ cup pomegranate juice (mast cell stabilizer)
  • ¼ cup lactose free Organic Valley 2% milk (easy to substitute)

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Wishing you an enjoyable summer! What’s your favorite summer essential?

Choose your own (mis)adventure

“You and YOU ALONE are in charge of what happens in this story.”

This is the ominous warning given at the beginning of each Choose Your Own Adventure book, the popular 1980s children’s series. I used to check these books out of my elementary school’s library by the armful, enticed by the idea of being in charge. I carefully weighed the potential risks and rewards of each option at the end of a chapter, imagining my fate. Do I run for the nearest escape or defend myself? Should I ask the sorceress for help? Morocco or Boston?

The authors punished greedy and cautious readers alike. This pissed off my impulsive younger brother, who inevitably succumbed to flipping through the books in search of the most appealing outcomes. Then he would back track, memorize the best choices, and declare himself the winner.

To my disappointment, adult life is a lot less adventurous, aside from an occasional vacation and professionally led excursions. Instead, I am in charge of mundane misadventures. There are no new planets or ancient jewels. Basically, I’m just trying to stay alive and support my Etsy shopping habit.

My recent misadventure in healthcare reminded of these books and their valuable lessons: life is illogical and totally unfair. Oftentimes, health decisions are a gamble. Some options end up being a huge waste of time and money, returning you back to the original situation. Other times, all of the choices suck. To demonstrate what I mean, I present to you…

Choose your own (mis)adventure: Abdominal pain

You can no longer ignore the pain in your upper right abdomen. It has throbbed with increasing ferocity over the last two weeks, but you cannot recall any new changes to your diet or exercise routine. The Internet suggests it could be your gallbladder and upon inquiry, it seems like everyone you know has had their gallbladder removed. One friend warns you of the possibility of a gallbladder rupture. You wonder if this is related to your mast cell disease. Your back begins to spasm.

If you hope the pain can wait until you see can your primary care doctor, click here.

If you go to the emergency room, click here.


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Emergency room

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You check into the emergency room. Forty minutes later, you are ushered into a room and describe your pain to a doctor. The doctor orders an ultrasound and it looks normal. Blood and urine tests are normal, too. The nurse administers mast cell medications, but they have no effect on the pain. The doctor recommends following up with your primary care doctor. Although it cost you $100, at least you’ve confirmed you’re not dying. Right?

Click here to go to your primary care doctor.


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Primary care appointment

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In the clinic, your primary care doctor examines your abdomen and agrees your gallbladder is the likely culprit. She orders a HIDA scan to measure your gallbladder’s functionality. You drink 20 ounces of a milky sludge and lay still in a narrow tube for an hour. The HIDA scan is normal. You pay the $100 imaging deductible.

Meanwhile, the pain is affecting your ability to work and move. You research mast cell related gallbladder issues and discover half of MCAS patients feel better after gallbladder removal. Half of patients feel worse. Your primary care doctor recommends you consult a surgeon.

If you schedule a surgery consultation, click here.
If you decide to give up, click here.


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Surgery consult

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The surgeon acknowledges all your test results are normal, but agrees to remove your gallbladder with the recommendation of a gastroenterologist. You know two things to be certain: surgeons love removing organs, and this was a waste of time and $25.

If you schedule an appointment with gastroenterology, click here.

If you follow up with your primary care doctor in hopes of non-surgical solutions, click here.


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Emergency room 2

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The pain is shooting up to your shoulder and your back is spasming. Near tears, you hurry to the emergency room before the pain renders you unable to walk. The doctor reviews your chart. Blood and urine tests are normal again. The nurse administers pain medication and you have some relief, but no answers. Another $100 emergency room copay.

If you schedule a surgery consultation as recommended by your primary care doctor, click here.
If you get a second option in gastroenterology, click here.


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Primary care follow up

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Your primary care doctor examines your abdomen again. You break out in hives when she pushes in the center of your belly. She reassures you it is not a hernia, but suspects a muscle spasm. She says sometimes Botox injections can help muscle spasms in the abdomen. You hate needles and have no idea if you’re allergic to Botox.

If you give up and accept a life of pain, click here.
If you decided to try Botox in the stomach, click here.


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Gastroenterology

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The gastroenterologist tells you your gallbladder is fine and he doesn’t want to treat you because you have mast cell disease. He informs you that the clinic has hired a gastroenterology psychologist. He suggests she may be able to help you to learn how “food affects your mood.” You just wasted $25 and two hours of vacation time to be referred to a poop shrink. Your current psychologist agrees.

If you give up and accept a life of pain, click here.
If you follow up with your primary care doctor in hopes of a non-surgical solution, click here.


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Botox

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You died from Botox, but at least your stomach isn’t wrinkly. You didn’t leave a will for your poodles.

(Author’s note: It is unlikely you would die from Botox, but you really chose the worst option. Click here to give up and endure instead.)


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Give up and endure

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You swear off all doctors. You can’t afford them anyway. You self medicate with baths, HBO, and ready-bake chocolate chip cookies. If you could just figure out how to never move again, you would be pain free.

Four months later, a friend with MCAS recommends a chiropractor. You decide to go, because the pain is now causing your ribs to subluxate. The chiropractor adjusts your ribs, and you mention the pain in your abdomen. She palpates the pain and tells you its an adhesion. You wince and grit your teeth, as she massages the tender area. When she stops, the pain is gone. Forever.

The End.

(Based on a true story. What the hell.)

Mac and cheese and other drugs: why ingredients matter

Macaroni and cheese is my one true love. It always has been.

When I was seven and it was socially acceptable for me to eat neon noodles every day for lunch, I’d stick my head in laundry chute and yell, “DAAAAAAAAD!”

“What?” he’d shout from the basement. (We use cell phones these days.)

“I’m so hungrryyyyy. I’m starrrrrrving. Feed me. Feed me. Feed me,” I’d chant, while stomping on the floor until I heard him coming up the stairs.

In the kitchen, I’d hand my dad the box of pasta and assume my supervisory chair at the table. I imagined the best thing about being an adult was knowing how to make macaroni and cheese. I had tried on my own, of course, but noodles, water, and the magic powder were surprisingly disappointing. I watched my dad carefully, trying to learn, but the counter was too high. I begged him to teach me.

“What comes next?” I asked, while he poured the cooked noodles back into the steaming pot.

“It’s top secret,” he said.

“Tell me!” I cried.

“Secret ingredients. That’s why it tastes better than mom’s,” he said. (Years later, I would learn mom skimped on the butter, but I would never understand why.)

“C’mon!” I demanded.

“All of your favorite things,” he said.

“Like what?” I asked.

“Peanut butter, “ he said.

“You’re lying,” I accused him. It didn’t taste like peanut butter.

“Well, what do you think makes it taste so good?” he replied.

I didn’t have an answer. I stood on my chair, trying to see for myself.

“Now the ice cream,” he said.

“Stop lying!” I cried. “Tell me how to make it!”

He went to the refrigerator, retrieved a half of gallon of vanilla ice cream, and set it on the counter next to the noodles. Turning his back to me, I saw him scoop the ice cream. I contemplated everything I knew about food. I had never tried this. Maybe he was right. My mouth watered imagining the peanut butter and ice cream mixing together.

“How much ice cream?” I asked hesitantly.

“Two cups,” he said.

I believed him.

*****

Fours years later, I finally was old enough to babysit. I was certified by the Red Cross, and eager to earn money. Unfortunately, my parents still hadn’t taught me the most important skill of babysitting: how to make macaroni and cheese.

“Do you know how to make macaroni and cheese?” my first client asked.

“I think so,” I said. “You mix the box with peanut butter.”

And yet they still let me watch their child.

*****

Today, my macaroni and cheese is no longer neon orange. I buy organic, although still boxed, and use lactose free milk. Making it whenever I want is one of the best things about being an adult.

Gone are the days of blissful unawareness of the ingredients in my food and medicine. As digestion became increasingly painful in my 20s, I began vigilantly reading labels in grocery stores. However, I never thought to read the all ingredients in my medications.

One of the first lessons my mast cell specialist taught me was many patients react to the inactive ingredients in medications. These ingredients (also called excipients) can include fillers, dyes, binders, and preservatives – not the actual medicine itself. I used to think brand name and generic drugs were the same, yet I had awful experiences when my pharmacy changed my prescription. While the active ingredients are the same, the inactive ingredients can vary greatly. Now I only use dye free medications, and have memorized a list of manufacturers my body tolerates.

The same applies to supplements. I learned this the hard way two years ago when I tried quercetin, a mast cell stabilizer. The brand I chose used the least ingredients: just quercetin and cellulose, a common binder made from plants. I even checked it out on their website: “hypoallergenic plant cellulose.” Sounds great, right?

Three days of flu-like lethargy and one seizure later, I discovered the plant they used was Southern Pine. Pine is one of my most severe allergies. Why the hell would you put a Christmas tree in medicine?

Know what’s in your pills. It’s not sunshine and happiness. Or peanut butter and ice cream.