The Emotional Toll

Some days I completely forget I’m sick. Other days it’s all I can think about. A few times in the last few months I’ve broken down crying in the hematologist’s office. Sometimes when I’m stuck on a thought, the nurses and doctors at the center tell me I’m lucky and it could have been much worse. While that may be true, is that supposed to be comforting? Does hearing that ever actually make anyone feel better? Why are we so quick to compare other people’s tragedies with “the big picture”? All it does is trivialize what the person is thinking and feeling and going through. Doctors seem to think that as long as a patient isn’t terminal, they’re “lucky”. I certainly don’t feel lucky.

Beyond medical personnel, some people have been quick to downplay my diagnosis and suggest causes for my immune system failure – diet, exercise, stress, genetics, etc. All I can figure is that no one wants to believe they could just wake up tomorrow to discover their immune system is shutting down and destroying itself without any cause or warning. So they trivialize. And make excuses. And rationalize the situation so as not to worry themselves. But that’s the reality of what happened to me. And trivializing it leaves me feeling guilty about something completely out of my control. This happened TO me, not BECAUSE OF me. Even still, I’m supposed to be able to trust my body to work properly and instead my immune system literally turned against me overnight.

Why can’t medical personnel hear bad news and just say “I’m so sorry this happened to you” or “that sucks” or “nobody deserves that”? Why are we so quick to write someone off just because things “could have been worse”? That hardly changes the fact that they could have been infinitely better – I could not be sick at all. It might just be me, but hearing how much worse something could have been isn’t comforting. It focuses on “if/when” scenarios, which my mother always taught me to avoid. Growing up, she wouldn’t even answer or acknowledge a question my sister or I had if it started with “if” or “when”. She didn’t want us living in hypotheticals. At the time it was extremely frustrating, but now I find realism to be a comfort. Blind optimism makes it THAT much harder to cope when something does go wrong. And spending time focused on the hypothetical only serves to distract me from the real problem at hand. So while I appreciate that the nurses are saying whatever they think will make me feel better, I really wish they would stop telling me I’m lucky.

I believe everyone has their own breaking point – their own tolerance for pain, destruction, heartbreak, etc. I hit mine years ago. So who am I to tell someone what they should be feeling? Even if I’ve been in their shoes, the way people handle bad news varies greatly from person to person. It’s based on past life experiences in relation to the current situation. Just because two people handle information and bad news differently, doesn’t mean either person is wrong. We can’t compare ourselves to others. We all have a basic human need to feel validated. I need to know it’s okay to be upset. My diagnosis is devastating for ME and that should be all that matters.

In general, people often tell me to put things into perspective. In other words, “there are people dying in Africa – this isn’t that bad”. I wish humanity would stop generalizing these things. Putting things into “perspective” means relative to my own experiences. Comparing a chronic diagnosis with starvation and disease in Africa makes no logical sense to me because it’s too hard to relate to. It’s like comparing apples to oranges. I can only compare my diagnosis to the other things I have been through in MY life. And while I have fought my way through some crappy situations, they were one-time occurrences. The hardest part was healing emotionally, but time was on my side. As the years went by, emotions were easier to control and memories began to fade. Therapy helped to make things easier to understand and I learned valuable ways to cope with the painful memories. Ultimately, though, the painful thing was just that – a memory. It was in the past. My only responsibility going forward was to heal.

This diagnosis though is nothing like that. It is a constant work in progress. It isn’t going to “go away in time”. It isn’t going to become some distant memory as I get older. My treatments and appointments will become less frequent when I’m in remission and I will hopefully be able to go years without treatment, but there is no “cure”. There is no end date. No one can definitively say how long remission will last or when my next hospital stay will be. The unpredicability and uncertainty terrifies me. The best I can hope is that time will make the emotional impact this has had on me easier to handle. “Time heals all wounds”, but time will not heal this

The Confusion & Memory Loss

Today was strange and a bit frightening.  I started my morning by working from home.  Around 10:30 AM I started to get a headache.  I knew that that Prednisone taper would eventually catch up to me!  I called my husband to tell him about my headache and it was like my mind completely went blank.  I barely remember calling him at all.  All I remember is that I was having a great deal of trouble forming thoughts and sentences and I felt very confused, overwhelmed, and dizzy.  I think I freaked him out.  To be honest, though, I freaked myself out.  I kept stammering and restarting the same sentence over and over again.  It felt almost like an out-of-body experience.  I figured the best thing to do was to sleep it off.

I napped for a few hours and then apparently spoke to my husband on the phone again.  This is yet another conversation I don’t remember having.  When he got home from work, he had to physically show me on his phone’s call log that we had a five minute conversation this afternoon.  I feel fine now as I’m writing this, but I’m still a little freaked out from earlier.  Confusion is one thing – I’ve been having moments of confusion and times I haven’t been able to concentrate for weeks, but memory loss?!  Hopefully that doesn’t happen again.

The First Day Back in the Office

This morning my husband dropped me off at the PATH train and I headed into work.  I was a little nervous about the commute, but the morning ride wasn’t too bad.  The train was crowded and I was scared someone was going to elbow me or shove me, but I managed to find a spot to stand that wasn’t too cramped.  Luckily, the air conditioning was blasting in my train car, so I didn’t have to worry about having a hot flash or sweating too much.  When I got to my stop, I waited for the crowd to disperse before going down the stairs.  I didn’t want to feel rushed with everyone around me hustling to catch the next subway train or to get to their office.  Once I made it through the turnstile and up the stairs to subway-level, I paused for a few minutes to catch my breath.  I’d rather take a dramatically long time getting from the train to my office than rush it and have an episode.  Once I felt ready, I headed up the steps to street-level and then into the office.  I always knew I was lucky that my office building is essentially right at the top of the subway/PATH steps, but today that was beyond convenient.

I got on the elevator and headed up to the office.  In case I haven’t mentioned it enough, let me be very clear – I am extremely blessed to work where I work.  I have some of the greatest coworkers you could ask for.  When I got back to the accounting office, I was the first one in so I unlocked the door and headed to my desk.  On my desk was a beautiful bouquet of hydrangeas, roses, and daisies from my team!  Waiting for me was also a bobble-head of our company mascot and a pen from our latest conference giveaway.  I set down my purse and headed out to the main area to see everybody.  I was greeted with hugs and excited squeals welcoming me back.  I missed human interaction so much!  It makes the work day go by faster and it is a lot easier to answer questions in person.  The morning went by fairly quickly.

Every Wednesday our office has a catered lunch.  Usually, a large group of us grabs our food and heads to a conference room to eat together and converse.  I love our Wednesday lunches.  It is probably my favorite part of the week and the part I missed the most.  My coworkers kept telling me how Wednesday lunches weren’t the same without me, but I assumed that was just something they were saying to make me feel missed.  I now know they weren’t just saying that.  I definitely talk the most, but no one seems to mind.  They seem entertained.

The afternoon flew by.  I left a little early to try to avoid some of the train congestion during rush hour.  I accidentally ended up in a train car that had no air conditioning.  Normally I would have switched cars at the next stop, but I had a seat and I wasn’t willing to give up my seat.  Getting a seat on the train is like winning the lottery.  As more and more people crowded into the train car at each stop, the lack of air conditioning grew painfully apparent.  By the time I made it back to NJ I was in the midst of one of my worst hot flashes ever.  I don’t know how one can physically sweat so much in such a short period of time, but I managed to find a way.  It was awful.  After getting off the train, I had to walk up a long, winding, sloped ramp to get to the escalators to street-level.  I should have stopped occasionally on my way up to catch my breath, but I was so sweaty that I just wanted to get to the car.  By the time I got to the car, my heart rate was through the roof.  I suppose that was probably my fault… Oops!

Based on the way my afternoon commute went, I am definitely working from home tomorrow.  It is too much stress on my body trying to get into the city each day.  I think I will take management’s advice and ease back into things.  In other words, I will likely start by working a couple days a week from home.  Next week, for instance, I plan to work Monday/Thursday in the office since I have appointments in the city those days anyways, but I will likely work Tuesday/Friday from home.  I am not sure about Wednesday yet.

The Prednisone Problems

The Prednisone side effects are getting old – FAST. I just want to take a nice, relaxing, hot shower in peace! That isn’t an option. I didn’t even like showering that much until the steroids ruined shower time for me and now I want it back. I’m sick of short, cold showers. And feeling rushed. And did I mention cold? Using cold water is the only thing that seems to delay the overheating/hot flash/heart palpitations. Ugh.

Today I was getting dressed (putting on my pants, to be more specific) and, without any warning or buildup, my heart rate jumped to 165. It felt like my heart was trying to beat out of my chest and escape. Usually my heart palpitations gradually worsen and it slowly gets harder to breath. This was different, though. I got short of breath very suddenly and it scared me. I had to sit down. Oddly enough, my heart rate and breathing returned to normal almost as quickly as they spiked. It shouldn’t be that terrifying to put on pants. I would hardly call getting dressed a physical activity/exertion, but I guess I’ll add it to the list.

The other strange side effect I’ve been having now that I’ve been on high-dose steroids for six weeks is muscle weakness/tenderness. My husband tried to massage my shoulders earlier and the muscles in my upper back/shoulders were EXTREMELY tender and sensitive. Even though he was barely applying any pressure to the area, it was very painful. This concept is lost on me. There are areas on my lower legs where I have this problem as well. The area is sensitive and, when touched, feels the same way pushing on a painful bruise would feel. The part that concerns me is that there are no bruises there – not on my legs and not on my back. So why is it that these areas feel so bruised and painful? Is this the muscle weakness and destruction sometimes resulting from Prednisone usage? Will this problem reverse itself once I’m off the steroids or is this permanent? One more thing to worry about.

There is good news, though! Since the AIHA was the only one of the two diseases responding to the Prednisone and my hemoglobin went up despite the lower dose, I am fairly confident the doctor will taper my dose again on Monday! The taper will likely have little to no effect on my platelets, so it’s irrelevant in regards to the continued treatment of the ITP. Thank goodness! Get me off these things!

The Paranoid vs The Cautious

This morning my husband and I had to drive into Saratoga so that I could have a blood draw. We had to drive 50 minutes there and 50 minutes back all for a three minute blood draw, but otherwise it went well. I’m not sure how long it will take to get the results. I am much more likely to hear my numbers from the doctor than from the lab. LabCorp said they are going to mail me a copy of the results, but it could take 7-10 business days to receive. I’ll already have my next blood draw (and results) by then, rendering today’s results useless. I’m hoping my hematology center gets the results by Thursday and I can call them and ask for my hemoglobin and platelets. I’m not worried about the platelets, but I’m a little nervous about my hemoglobin. Since the RBCs were responding to the steroids, I’m afraid the taper will have negatively impacted them. I would love to at least be able to maintain a double digit hemoglobin number and triple digit platelets.

I had a lot of trouble with the hot flashes today. It was 80 outside and humid. Being indoors wasn’t enough to beat the heat. I had the fan directly in front of my face and was still dripping sweat. I had to go into the lake to cool down, which did work, but then when I got back up to the cottage my oxygen saturation was at 93 and my heart rate was at 164.

In addition to the heart fluttering and profuse sweating and shortness of breath (only when my heart is racing) I’ve been feeling lately, my stomach hurt earlier. This is the part I hate. The first time my hemoglobin was low I didn’t recognize any of the symptoms as a cause for concern. At the hospital, the nurses and doctors kept saying “at least next time you’ll recognize the symptoms”, but that’s not necessarily true. The reason the symptoms didn’t concern me the first time isn’t because I didn’t notice them happening – it’s because they are such common symptoms. They can be caused by anything. My stomach ache could be because I ate too much or too fast. Back pain could be related to an injury or stressor. These aren’t things that are going to set off any bells in my head. Right now it has the opposite effect though and ALL of these things are setting off bells. My brain keeps thinking any one of these common symptoms could be the sign I’m supposed to recognize or be looking for in terms of a relapse or drop in my numbers.  Am I paranoid or simply being cautious?

Also, the fact that exertion of any kind, no matter how small, completely knocks me on my ass isn’t going to be good. Walking up about 20 stairs from the dock to the cottage caused my heart to beat like crazy. Imagine how my commute to/from work is going to be everyday. That is 52 stairs in the morning and a fairly lengthy walk uphill in the evening. It wasn’t easy or pleasant before and now it’s going to be even worse. Essentially, any time I have an “episode” where my heart starts racing, I have to sit down, relax, drink some water, sit in front of a fan or apply ice packs to my face and neck, and take deep breaths until my heart rate returns to a safe level. That’s going to get old FAST in the mornings. But I’ve already been out of work for nearly six weeks. I’ve been working from home as much as possible, but the last couple of weeks were useless between treatment and the nasty side effects of treatment. I feel guilty because my hematologist keeps pushing back the date in which I will be able to return to work.  At the same time, though, I trust his professional opinion.  The earliest I will be back in the office is Tuesday, July 12th, pending the results of my July 11th appointment and blood work.

I’m not even sure what the game plan for Monday’s appointment is. I’m assuming the discussion will be largely based on my blood counts. I figure if my counts are good, he will taper the Prednisone again and set up an appointment for the following week to check my progress. If my counts dropped, I’m not sure what happens next. I doubt they will have dropped low enough to warrant any kind of immediate action, but he may bump the steroids back up to 100 mg. I highly doubt he will increase the dose because he wants me off the Prednisone as much as I want to be off of it, but there’s always a chance he will choose that option. Regardless of my counts, I’m sure I’ll have weekly blood draws and appointments until I am off of the steroids completely.

Once I’m off the Prednisone, the doctor and I will be able to focus on what caused the sudden AIHA & ITP (ES) and how we are going to treat it long term. In the meantime, things are all still up in the air:

How did this first 25 mg taper affect my numbers? Is it going to affect my platelets too or just my hemoglobin? If my numbers didn’t drop does that mean my immune system fixed itself? Is it possible that this has gone away and will never be a problem again? Will the next taper be more drastic or would we expect to see the same type of results? At what point during the tapering process is relapse most common?

There are so many things I wish I could know before it’s too late. I don’t want to find things out the hard way this time.

The Shower Situation

Last night’s shower at the cottage did not go well. My heart rate by the time I got out and got down to the basement to get dressed was past 160 again. The cottage shower is similar to ours at home in the sense that it’s a standing shower, rather than a tub, and it’s square. Unlike ours at home, the walls aren’t glass and instead of a door there is simply a curtain. I was hoping the curtain would make a difference and allow the steam to escape but it didn’t help much at all. Every time my heart starts racing it becomes SO hard to take a deep breath. I don’t know which scares me more – the fluttering or the difficulty breathing. I also wonder how much my asthma plays into this. My asthma has always been very mild, though, and only really flares up when I have a cold/bronchitis or when I exert myself/exercise. I don’t really consider a shower exercise, though… It never bothered me before the Prednisone. Here’s to hoping this problem reverses itself once I’m off the steroids!  Tonight’s plan is to take a colder, shorter shower and to put a fan in the bathroom window to help with airflow.

The Struggle to Relax

The week is going to be more challenging than I thought – being in the sun caused my heart rate to skyrocket to 166. I was only in the sun for an hour and I spent that hour sitting on a boat – it’s not like I was moving around or exerting myself at all. How am I supposed to last a week at the cottage without going in the sun? All we do is drink and float in the lake. So now that’s two things I can’t really indulge in – the drinking or the floating.

The Inconsiderate Assumption

On our way to the cottage yesterday, my husband and I stopped at a thruway rest stop to use the restroom and grab a snack. As I was washing my hands, the lady at the sink next to me was blatantly staring at the bruises on my arms in horror. She was NOT subtle at all. Judging by the look on her face, I am 99% certain she thinks someone beat me and gave me these bruises. Part of me wanted to yell, “I have low platelets, bitch!” or perhaps a simpler, “I have a medical condition”, but then I realized it’s none of her damn business! I shouldn’t have to explain myself to strangers.

Though I find it rude, strangers have every right to stare, but they have no right to know my personal business. I shouldn’t have to feel self-conscious washing my hands in the restroom. If you’re going to make assumptions or judge me, fine, but please at least be subtle about it. It would be different if her face showed concern, but it was just disgust. I’m sure she went back to her car and told her husband or friend or driving companion some crazy story about the bruised woman in the bathroom. Speculate all you want, lady, I’ll just be over here trying to find a long sleeve shirt to wear all week in the eighty degree weather. So, thanks for that. I know I shouldn’t let other people’s looks or judgments bother me, but it’s hard to ignore the looks.

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Fade, bruises, fade!

The Huge Improvement

Today was leaps and bounds better than the past few days. First and foremost, I woke up without a headache for the first time in almost a week. Second, I was able to get up and walk around the apartment. I had spent the last four days almost completely bedridden. Today I woke up, took a shower, ate breakfast at the table with my sister and her roommate, and then helped them get ready and make plans for the day. It was so nice spending time with them!  I finished packing some miscellaneous stuff for the cottage and then my husband and I started the trip upstate. Luckily, I survived the four hour car ride without a hitch!  I never would have made it if we had stuck to the original plan and gone up last night. It was definitely worth waiting.

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The cottage is relaxing, as always. It doesn’t hurt that we have WiFi here now, too. As I write this I’m sitting by the fire, listening to a live band across the lake, and other lake goers are setting off some fireworks. It’s so nice to be around other people and to be able to relax. It’s nice not having to worry about the noise of the music or sparklers giving me a headache or the bright light of the fire bothering my eyes.  Hell, it’s nice even just sitting up in a chair without feeling shaky. I’ll leave you with a picture of my current view.

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The Surprise Visitors

My little sister and her roommate were supposed to fly to Denver, CO last night for vacation, but due to flash flooding, all flights from Chicago to Denver were grounded and the airline couldn’t get them on a flight until Saturday night. Since they already had the days off of work and their bags were packed, they decided to take a spontaneous trip to NYC to stay at our apartment while we’re at the cottage. I’m excited that my sister got to see my apartment, but I’m even more excited that we overlap for about a day and a half, meaning that I got to see my sister today!  It doesn’t make up for the Chicago trip I had to miss last weekend, but it’s still ten times better than not seeing her at all!  I knew I missed her, but I forgot how much until I got to hug her.

In terms of my side effects, today was certainly better than the past few days. I still didn’t leave bed much and my appetite this morning and early afternoon was practically non-existent, but by dinner I was able to eat a real meal and sit up in bed for a little bit. For some reason, even though it makes me extremely overheated, laying on my husband’s shoulder makes my headache better. It might just be psychological, but I’ll take it!  Also, the makeshift blackout curtains that my husband hung make a huge difference.  My eyes have been super sensitive to the light.

The one thing that hasn’t improved at all is showering. Last night’s shower was rough. I think I was finally able to pinpoint the exact cause of the shortness of breath, though. The problem is the steam. Since our new apartment’s master bathroom has a small, square, glassed-in standing shower, the steam accumulates fairly quickly. Don’t get me wrong, I love having a glass shower, but I wish it was a little bigger so the steam had somewhere to go. The only way to obtain any relief was to periodically open the shower door to let some steam out and some cold air in. Basically anytime I wasn’t under the water (ex. soaping up or shampooing my hair) I had to leave the glass door open. Again, not ideal, but at least it was a workaround. Hopefully this won’t be a problem forever.

The only other update is that my foot cramps are back. That is definitely due to the Prednisone, though, so hopefully it won’t be a problem within a few weeks. I’ll just have to deal with it until then.

I’m finally all packed for the cottage and we’re hoping to leave tomorrow afternoon. Fingers crossed!  Last time we headed to the cottage was Memorial Day Weekend and that didn’t end well, so here’s to hoping we finally get the relaxing week away that we want/need. My husband has been such a trooper taking care of me and waiting on me for over a month at this point – he deserves the chance to relax!  Hopefully my Percocet/Oxycodone will keep the headache at bay long enough for me to relax this week, as well!  Or at least long enough for me to survive the four hour drive upstate!