An update on my Lyme journey

It’s been two years since I was diagnosed with Lyme disease and it feels like a good time to write an update on how things are going. Apologies for the long post; there’s a lot to say.

Lyme disease treatment

For those who don’t know, I have been having treatment for Lyme and coinfections at a specialist Lyme disease clinic in Washington DC. The decision to go abroad was a very big one and, obviously, the costs involved in that are pretty huge. But, as everyone in the Lyme disease community knows, there is an unthinkable lack of disease knowledge and awareness in the UK, particularly in the NHS, but even to a lesser extent in the private sector. Receiving treatment in the UK, certainly with antibiotics, is pretty much impossible unless you see the tick, present with a bullseye rash and flu symptoms and have a positive NHS test, and even then, treatment is by no means a given. I had been ill for years with an array of weird symptoms and had already had many bad and, to be frank, abusive interactions with medical professionals, so I knew that seeking private treatment, and seeking it abroad, was the right decision for me.

I have been under the care of this clinic in Washington for about 18 months and boy, it has been a tough road. A couple of months after I started treatment with them, things got really, really bad. My physical symptoms were flaring left, right and centre; I was gaining new symptoms; and, worst of all, I became very severely depressed. I suffered with really bad insomnia and I spent most nights crying about how awful I felt, how much pain I was in, and how I couldn’t see a way out of it all. I felt like my brain and my body were on fire. Me and my boyfriend were recently reflecting on how things were for us at that time, and honestly, I don’t know how either of us coped. He had to deal with me crying, sometimes for hours at a time, knowing there was nothing he could do to make things better. That guy has the patience of a saint.

But 2018 has, on the whole, been a year of slow, steady recovery, which I attribute to several things.

In terms of my Lyme treatment, I have been treating with pulsed antibiotics for 18 months. That means I take several different antibiotics for a set period of time, followed by a period of not taking them. This approach is believed to “trick” the bacteria, which are very good at hiding from the immune system under conditions of threat, for example when antibiotics are present. The breaks in treatment cause the bacteria to come out of their hiding places, at which point we hit them again with more antibiotics. A pulsed approach is also aimed at improving the host’s (i.e. my) immune system in learning to deal with the infection by itself.

I do believe that antibiotics have a part to play in chronic infections and I am sure they are part of the reason why things are improving for me. But I am also increasingly of the belief that recovery from Lyme disease is about more than just kill, kill, kill.

The Gupta programme

In January 2018, I started a “brain retraining” programme called the Gupta programme, which is designed for Chronic Fatigue Syndrome, Fibromalgia, and other chronic health conditions. In the chronic illness community you’ll often hear people using the phrase “game changer” and for me, the Gupta programme was my game changer.

The overall aim of the programme is to reduce the ongoing fight or flight response that people with chronic illness tend to experience, in order to calm the system and thereby strengthen the immune system and allow the body to heal. It involves several different elements but the core approach is a) a series of techniques to break thoughts that are focused on illness and symptoms (“I’ll never get better”, “I feel so horrendous”, “I can’t cope with this” etc etc), and b) mindfulness and meditation.

This programme was a massive eye-opener for me. When I first started using the techniques, I noticed that I was having negative symptom- or illness-related thoughts ALL. THE. TIME. As in, hundreds of times a day. When I felt ill, the thoughts were about how awful I felt and how long this would last and what might I have done/not done to cause a symptom flare today. When I felt well, the thoughts were about how long it would last, how much I had to do before the next flare came around, and general worry about the illness. Although understandable, these kinds of thoughts serve no purpose other than to increase my stress and anxiety, stimulating the fight-or-flight response and making healing much more difficult.

Within a few weeks of using the programme these thoughts were cropping up much less often and I found that my mental health benefitted enormously, but I also had some huge gains in terms of my physical symptoms. I got a bit lazy with my use of the techniques over the summer but I have started using it in full-swing again, to great benefit. I really believe that this is the key to health and healing for me and that if I continue to use these techniques alongside the other things I am using to both kill the bacteria and support my body, that I will recover.

Meditation, mindfulness & pacing

I have meditated on and off for a long time, but the Gupta programme really helped to show me how important it is for those of us with poor health (and, to be honest, everyone with good health) to take the time to slooooooooow down. I now have a twice-daily meditation practice and whereas in the past meditation could sometimes feel like a chore, it is now something I look forward to each day. (If you are interested to know what meditations I use, I have details of the ones I have found helpful on my new “Resources” page – click here)

As well as sitting down and actively meditating, I am also learning to live more mindfully day-to-day. This is a part of the Gupta programme and this has quite honestly been life changing for me. I never even realised before that I spent every single second of my life rushing. I thought fast, I walked fast, I spoke fast. Cooking dinner – do it quickly. Reading a book – do it quickly. Having a shower – do it quickly. This, my friends, is stressful. It is stressful for the mind and it sure as hell is stressful for the body, especially a body that is trying to heal from years of chronic infection.

This is a part of the Gupta programme that I still struggle with. I have days where I manage to slow things down and other days where I don’t even realise until I get into bed that I’ve been rushing, mentally as well as physically, all day. I will get there, but this is a habit of a lifetime I am trying to change!

Fertility & hormone balance

Ok, this is a biggy and I suspect it will have its own blog post in the near future. For now, let me just say that my 15 years or so of infertility appear to be reversing. At age 27 I had oestrogen and progesterone levels of a post-menopausal woman. I haven’t ovulated once (as far as I know – but I’m pretty certain) since I came off the pill about 4 or 5 years ago. That is, until last month. I ovulated for the first time in ~15 years, just a few months after my 30th birthday. And, my hormone levels are now normal. This is absolutely HUGE and a sign to me that my body is healing, little by little.

Other symptoms that are changing

There are various symptoms that I am slowly losing and it’s nice to actually write this down because often we get so caught up in the symptoms we still have to work on, that we forget how far we have come. I am gradually gaining more energy. I still have crashes, mostly when I have done too much or allowed myself to get stressed. But on my “good” days I now have what I consider to be the energy levels of a normal person. Woohoo!

I sleep about 9 hours a night. This is more than I’d like but a healing body needs a lot of sleep, and I am letting myself sleep as much as I need, as often as I can. Still, 9 hours of solid sleep is so much better than the 1-2 hours I was getting last year.

I am not depressed. In fact, my mood is probably better than it’s ever been and I feel genuinely happy and contented with my life right now, even with the remaining symptoms that I have. There aren’t enough words to describe how amazing that is.

I am gaining weight. When I first started treatment last year I lost a lot of weight, and got down to 7st 10 (108lbs), which is the lightest I’ve been since I was a teenager. Over the last 6 months or so I have been gradually regaining weight and am now firmly within the “healthy” weight range for my height (though a few more pounds for some extra padding would suit me just fine!).

Most of my other symptoms (headaches, fevers, joint pain, muscle pain, swollen glands….) are still there, but are less frequent and/or less severe than they once were.

What does the future hold?

I will soon be going onto a maintenance protocol with my Lyme treatment, which involves lower doses of antibiotics, taken less often (i.e. the “off” periods of the antibiotic treatment get longer and the “on” periods get shorter). I am very much looking forward to this!

I have been doing some pretty extensive research recently into herbal treatments for Lyme disease, as I would like to support my healing longer-term with the use of herbs. I have been reading Stephen Buhner’s Lyme and co-infection books and I have learned so much, they really are fantastic books. I am developing my own herbal treatment protocol and plan to add this in, with the agreement of my Lyme specialist, when I move onto maintenance. The thing that I like most about Buhner’s approach is that it is less focused on killing the infection(s), and more on supporting the body (reducing inflammation and the cytokine cascade, strengthening the immune system, and repairing damage to organs and systems). Also, they’re from plants, which is awesome. I am attending a local “Make your own herbal medicine” course in a couple of weeks which I am VERY excited about.

There is no question in my mind that I will keep using the tools in the Gupta programme to support my continuing recovery, and I really can’t imagine a life without daily meditation and mindfulness.

As I move towards reduced doses of antibiotics, I plan to get my gut microbiome tested. There is a fantastic company that will test your microbiome via a sample (read: poo), to learn what species of bacteria/yeast are under- or over-populated in the gut. They then provide dietary recommendations to optimise your microbiome. Gut health has huge implications for chronic illness (good books on this – The Paleo Approach by Sarah Ballantyne; Gut by Giulia Enders) and I hope that this will help my journey to recovery.

Mostly, though, my future is about continuing to heal and recover by whatever means necessary. I always assumed that health meant being symptom free, and this was initially my goal for treatment. But now, as I am learning more about health and healing, I want to be so much more than symptom-free. I want to be truly healthy inside and out. I want to thrive. And I honestly believe in my heart that I will get to that place, when the time is right.

Thanks so much for reading my blog and listening to my story.

Katie x

When recovery is a spiritual journey

Up until a year or so ago, I would never have considered myself a spiritual person. In fact, if I’m honest, I probably looked down on people who were religious or spiritual. I was a woman of science, and I had no time for anything remotely woo-woo. Despite my love of yoga and my increasing interest in alternative approaches to health, any mention of chakras or energy fields or “connection to a higher power”, quite frankly, had me eye rolling.

But when you have been ill for so long and nothing has helped, you will pretty much try anything. And while I still have one foot in the door of modern medicine, I am realising that alternative and conventional approaches don’t need to be an either/or situation. They can be used side-by-side to serve different functions and ultimately, work together to achieve healing.

Healing.

Another word I would have turned my nose up only a year or two ago. What does healing even mean? Isn’t it just a non-descript word that charlatans use to trick people into giving them money? The old me would have thought so, but now I am beginning to understand. I can take all manner of medicine to kill the infections in my body, but even modern science accepts that infection is more than just a function of the bacteria or virus. Because two people can contract the same infection and react differently. There are so many factors that can influence the body’s response to infection. So maybe, just maybe, killing the infection is only part of the story. And for years I had been looking at nutrition and supplements and exercise and hormone balance, and all of those things that add complexity to the story of infection, but are still safely grounded in the world of science that I was so familiar with. And yet there was a gaping hole in the puzzle. The one thing that I had neglected to pay attention to, for all those years: myself. My personality, my habits, my beliefs. Me.

And so began my spiritual journey (sorry, the word “journey” still makes me cringe). I realised that I had spent my whole adult life stressed, wired, and anxious. I was such a perfectionist that any mistake, no matter how small, was an intolerable hit to my self-esteem. I had no self-love, no self-compassion, and I, like so many people, felt wholly inadequate most of the time. I felt judged by the world, and I judged the world right back. And that whole package of personality, all of those traits that I thought were the only way to live and if anything, were something to be proud of because they made me strong and successful, were in fact part of the reason I couldn’t get better.

And so began my quest to no longer seek all the answers from the external world – infection, diet, exercise, sleep – and instead, I turned my attention within. And with that came the most overwhelming sense of ownership and hope, because now I am no longer dependent on finding the answer out there in the big wide world, of needing to research and learn and obsess about what I might be missing. Instead, I can relax and let go and enjoy life, safe in the knowledge that the final pieces of the puzzle are already here. I just need to open my eyes.

And this realisation has changed my life so profoundly. I am no longer rushing every second of the day. I am no longer judging my self-worth by how hard I pushed today. I am learning to love myself for who I am, not for what I have achieved. I am learning to be a human being, not a human doing. I am learning that the world is ultimately a good, safe place and that everything will be just fine.

And while there have been, and continue to be, some very dark days along the way, I am so grateful for everything I have learned from poor health. I am happier and more fulfilled by life now than I ever have been, and I can’t help but wonder whether I would still be painfully judgemental and convinced of my inadequacy, were it not for those difficult experiences.

I have no doubt that I can and will get better, and that I can live the life I choose for myself. It may take some time, and that is just fine, because I believe that I will not completely recover until I have learned all the lessons that I was supposed to learn from this experience. But I am in no hurry, because I know that I am healing.

 

Afraid no more: A poem

I am a totally concrete, non-abstract, logical thinker. I have no imagination whatsoever. So it came as a big surprise this morning when I had a really strong visualisation of me no longer running from Lyme disease, but instead, confronting it, calmly and peacefully, right in the face. It happened while I was doing one of my favourite chronic-illness/pain meditations where you meditate on the symptoms, deliberately focusing on them without judgement, without labelling them as good or bad and allowing them to “be” rather than trying to push them away. I get so much benefit from it and have been using it a lot this week, which has been one of the worst weeks I’ve had for as long as I can remember.

It came as an even bigger surprise when, after my meditation, I had an urge to write a poem. I haven’t written a poem since school so I really have no idea where it came from but since I’ve been in bed all week, it’s not like I had anything else to do!

So here it is: my first grown-up poem!

Afraid no more

You open your mouth, wide as a cavern
And with all your might, you let out a roar
My soul fills with dread, my heart full of fear
For you, my stalker, my power-hungry tease
You lurk in the shadows while you let me prevail
Waiting to pounce, control forever yours.
Now you roar, you roar, you roar with such fury
Two choices I face, do I cower or run?

My heart starts to race, my fingertips tremble,
So desperate to be free from your embrace.
I turn and I bolt, praying I can outrun you
But as always you are stronger, right at my heels
I am so afraid, but I hopelessly run
And I hear you laugh at my feeble endeavour
My legs are tired and I start to slow
Walking, feet dragging, exhausted and weak.

I come to a stop and I close my eyes
Inhaling deep, my inner-strength reignites
I turn around and look straight at you
A flicker of hesitation as you question my will
My mind is calm and I trust my decision
I walk towards you as my heart starts to settle
Face-to-face now, your breath strokes my skin
No longer afraid, I feel your presence
I exist within you, and you within me,
In every cell, every vein, every breath that I take.

The faster I run, the harder you chase
So what do you do now that we are face-to-face?
I invite you in, and you relinquish your power
Know this, old friend: your days here are numbered
I am no longer the frightened girl that you crave
I am looking within, where answers reside.
The once crashing waves lap gently at the shore
I am no longer running, for I am afraid no more.

 

 

 

 

Detaching from the identity of chronic illness

Sometimes, when times are really bad, it is hard to know where the illness stops and where you begin.

I attended a yoga workshop today, where the underlying theme was opening the heart and letting go of that which no longer serves you. It ticked all the right boxes of where I am in my life at the moment, and I left feeling lighter, calmer and at peace with the world. In case you didn’t know: I love yoga.

As I was lying there in meditation, we were invited to let go of the things in our life that we no longer need to hold on to, and I realised that for me, that thing is illness. For those of you reading this post who also experience chronic illness, I suspect this will make a lot of sense, but for those of you who are generally fit and healthy, it may sound pretty bizarre. But chronic illness is so much more than just being chronically ill.  When you experience the same pattern of symptoms repeatedly over many months, years, or even decades, those symptoms become the very essence of your existence. Long-term illness creeps its way into every single aspect of your life: work, home, relationships, hobbies, diet, bedtime routine, the list goes on and on. Every decision you make, and I mean every decision, has chronic illness behind it. It’s like a constant parrot on your shoulder that you can never get rid of. Chronic illness becomes a part of your identity. Sometimes, when times are really bad, it is hard to know where the illness stops and where you begin. And not only that, but all of the thoughts, beliefs and emotions that come along with those symptoms, become part of your identity too.

Up until very recently, these were some of the thoughts I experienced on an almost daily basis:

  • Oh no, these symptoms again, I can’t cope with this
  • How much longer is this going to go on for?
  • Will I ever get better?
  • I’m going to have to cancel my plans again, what if “insert friend’s name here” gets pissed off?
  • YAY, I feel good today. Oh wait, how long is it going to last?
  • Maybe if I just meditated more/took this supplement/lived off of ice cubes, I might get better

Etc, etc, etc.

In addition to my US treatment for Lyme disease, I recently added a “brain retraining” programme for CFS/ME into my recovery. Sounds a bit nuts, and I don’t want to go into details of this just yet, as it’s early days and I’m still working out what I think about it all. But without question, it is helping. The focus of this programme is to calm the nervous system, in two main ways: 1) directly through meditation, deep breathing and stress management, and 2) by reducing attention (read: obsession) on symptoms, illness, and all the kinds of thoughts listed above. Amongst other things, it involves redirecting focus away from negative thoughts, beliefs and images, to more positive, empowering ones.

For the first couple of weeks, it was hard-going. The negative thoughts were pretty much constant. Any time I stood up, sat down, got in the car, noticed a symptom, noticed a lack of symptom…basically any time I so much as took a breath, a thought or image related to chronic illness would crop up. It was really quite eye-opening to start paying attention to these thoughts, not running from them or trying to push them away, but just noticing they were there, accepting their presence, and then calmly redirecting my attention. It made me realise just how much illness has become ingrained in my entire existence; my self-identity. And the trouble with this, is that it is a self-perpetuating cycle. How can you get better when you are constantly telling yourself, without even realising, that you and this illness are one?

But after those difficult first couple of weeks, changes started to happen. The thoughts were cropping up a little less, and my brain was automatically picking the positive images over the negative ones. Don’t get me wrong, the thoughts are still there. They’ve been there for about ten years so I guess they’re not going to go away overnight. But when I wake up in the morning, my first thought is no longer “am I feeling sick today?”. When I make plans for next week, I’m no longer assuming that there’s a good chance I won’t be well enough. Of course, I know that realistically, there is still a good chance I won’t be well enough, but I am no longer stressing, obsessing and expecting the worst. I imagine health. I picture energy. I believe, deep down in my soul, that I am on the road to recovery. And that may happen next month, it may happen in a year – it doesn’t really matter. I am no longer attached to a timeline, a “deadline” of how much longer I can cope with this for.

For the first time in my entire life I have stopped the frantic search for an answer from the outside world, and instead, I am looking within. And slowly, but surely, I am detaching from my identity as a sick person.

Lyme disease, mental health & insomnia

Sleep is like health. You don’t realise what a luxury it is until you don’t have it.

The last couple of weeks I have, completely out of the blue, started struggling with insomnia. This is a common problem for people with Lyme disease and yet, somehow, I have always managed to escape it.

Well, not always. When I very first got sick as a teenager, one of my most prominent symptoms was severe depression. I now know this is very common in Lyme disease, but at the time my family and I had no idea why I was suddenly so mentally unwell. Seemingly out of nowhere I went from a happy, healthy child to a very distressed and mentally ill adolescent. Sleep problems are one of the 9 symptoms of depression as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) and can present as either a) insomnia or b) hypersomnia (i.e. sleeping too much). For those few years when I was very unwell, I experienced terrible insomnia. I remember being prescribed sleeping pills when I was about 14 years old, and getting high the first time I took them.

The first few years of my illness were dominated by mental health symptoms. I had physical symptoms too, but the mental health problems were severe and impairing on a daily basis. I had a myriad of treatments, from antidepressants to family therapy to counselling. Nothing made any difference whatsoever. Presumably, because none of it was really getting to the crux of the issue (the Lyme disease), although I guess I will never know for sure that the depression I experienced was 100% down to Lyme, and it would be naive of me to say otherwise.

Anyway, fast forward a few years, and as my physical health gradually worsened, my mental health actually improved. I won’t say that I was completely mentally healthy all the time. Firstly, because I really don’t believe anyone is mentally healthy all the time. Secondly, because there were lots of challenges associated with being ill. Dealing with feeling like crap so much of the time, managing a job and relationships, not knowing why I was ill, feeling dismissed and misunderstood by doctors, to name but a few. So yes, I had mental ups and downs and some days were a real struggle. But I didn’t feel depressed. Not in that pit-of-the-stomach, deep within your soul, “I am miserable” way. And so with that, the insomnia lifted.

Over the last 5 or 6 years, while my mental health has remained steady but my physical health has declined, my sleep has been good. I may have experienced the odd sleepless night if there was something particular on my mind, but on the whole, if anything, I slept too much. As is common in people with chronic fatigue and various other chronic illnesses, most nights I felt like I could sleep for 10 hours if I allowed myself, and no matter how much I slept, I woke up feeling exhausted, unrefreshed and a little hungover. I can’t say that’s been fun, but jeesh, it’s better than tossing and turning for hours on end.

The last few weeks, my mood has taken a bit of a dip. I don’t know why, but I know that I am not alone. Just as depression is common in people with Lyme disease, it is especially common while people are being treated for Lyme disease. Neuroinflammation, reduced neurotransmitter production, the stress of going through treatment…there are many hypothesised reasons why this might be. Along with the dip in mood, insomnia has reared its ugly head. And the trouble with insomnia, is that it’s a slippery slope. What starts off as one night of an unexplained inability to drift off, soon becomes worry about having “another night like that” as you become increasingly fixated on the clock and worrying about how many hours you’ll be behind if you fall asleep right this second.

And for those of us with chronic illness, there is an added pressure. We are repeatedly reminded of the importance of getting plenty of sleep to allow the body to rest and recover. My doctor lists sleep as one of the crucial “foundations” that need to be in good order before trying to tackle Lyme disease. If sleep is poor, the body cannot effectively heal, he argues. Makes sense to me, but I’m not sure that having your mind scream “YOU NEED TO BE ASLEEP RIGHT NOW OR YOU’LL NEVER GET BETTER!!” is especially conducive to drifting off into a peaceful sleep.

I had a few nights of taking some over-the-counter sleep meds, but they add an extra nice punch to the usual Lyme disease hangover I wake up with each morning, and I’ve yet to decide which is worse: staying awake all night, or spending an entire day feeling drowsy, irritable and like I had 10 cocktails last night (without the fun of having 10 cocktails). So for tonight, I have accepted my fate of not sleeping and am embracing the opportunity for late-night PhD reading (surprisingly productive), selling some shit on ebay (I have a surprising amount of shit), and of course, writing on my blog (unsurprisingly therapeutic).

Lessons I’ve learned from chronic illness

I have been thinking for a while now about how long it’s been since I last blogged, and how I really should make the time to write something. So I log on to my blog and it tells me it’s been two months since I last posted. Streuth! This blogging business is high maintenance I tell you.

As way of a brief update: I went to Washington DC in May and am currently 6 weeks into treatment. It’s been a bumpy road so far, but I’ve been warned that this is a long treatment plan and to expect a marathon rather than a sprint (hurray, because I had so much fun that time I ran a half-marathon…). My physical health has been very variable, but I must confess that my mental health has been consistently struggling. There you go. I’ve broken the British we-don’t-talk-about-how-we-feel tradition and am laying my cards on the table. Although to be fair, I work in mental health research so if us folk can’t be honest about mental health, we’re all doomed.

I’m not sure why my mental health has taken a turn, but I’m trying not to fixate on it too much. Embracing my inner buddhist, I am reminding myself that a) life involves suffering, and b) our expectations, desires and aversions create a second layer of suffering over and above the initial suffering. In other words, shit happens. But, we add a heap-pile of shit on top of the initial little turd by the way we relate to, and think about, the turd. Sorry for the shit analogy, I didn’t mean for that to happen. The Buddha expresses it much more eloquently:

“When an untaught wordling is touched by a painful (bodily) feeling, he worries and grieves, he laments, beats his breast, weeps and is distraught. He thus experiences two kinds of feelings, a bodily and a mental feeling. It is as if a man were pierced by an arrow and, following the first piercing, he is hit by a second arrow. So that person will experience feelings caused by two arrows.”

So with that in mind, I’ve upped my meditation practice and am focusing simply on trying not to exacerbate the suffering. Along this theme, I’ve found myself thinking a lot lately about all the things I have learned from chronic illness. So here are just a few…

1. Cherish the small things

When life is going well, I feel like we get a bit greedy. We take health, happiness, love etc, for granted. When it’s gone, your baseline level of expectation changes. And so, for example, when you’ve spent the last week in bed, stepping out of the front door and feeling a gentle breeze against your skin, makes you feel so alive. But isn’t it kind of sad that we don’t notice those things until we’re in a bad place? Over the last couple of years I’ve really started paying more attention to the little pleasures, and somehow even the darkest of days can feel a little brighter when you notice the sun shining or the sounds of birds or the kind person who held the door open for you. Cherish the small things, because when the big things aren’t going very well, they can be a surprising source of joy.

2. Keep hold of your real friends and let go of the rest

That old cliché is true, you really do find out who your real friends are in times of adversity. I have to admit that over the years, I have often been surprised by the level of support offered by people I would consider more acquaintances than friends, and the lack of support sometimes offered by those I thought were close friends. Of course, everyone has their own stuff going on and it’s unreasonable to expect any friend to be there for you 24/7, and I also recognise that being chronically ill can tip the balance of friendship somewhat. I, for example, cannot reliably offer any of my friends regular catch-ups over tea, because my ability to meet and do friend stuff relies on it being at least a sort-of-alright health day, and that is difficult to predict from one day to the next. But, my good friends, although I’m sure inconvenienced and perhaps a bit miffed that I can’t always be there, never make me feel guilty for that. They understand, they accept, and they are kind. My university friends, despite only managing to see them once or twice a year, will often send me a “how are you?” text or offer me a real listening ear on the rare occasions we get to meet up. Chronic illness is truly lonely and isolating at times, but having even a small handful of good friends makes everything feel a little less miserable.

3. You are the expert of you

I’m sure there are many medical professionals that would cringe reading this, but frankly I don’t care because it is one of the biggest lessons I have learned in my years of ill health. I don’t care what anyone says, you know when something is really not right in your body. Maybe it doesn’t make sense, maybe medicine has no explanation for it, maybe when you say it out loud you sound totally off your trolley. I don’t care, if it’s happening in your body then only you know what it feels like. There have been so many times over the years when I have tried to explain to a doctor a set of symptoms, or a feeling, or a pattern, and I have been told that what I’m describing is simply not possible, only to later discover through my own reading of the (scientific) literature, that it is, in fact, entirely possible. Doctors don’t know everything. Science doesn’t know everything. That’s what makes science so exciting, there are new things to learn all the time! I was told for years that it was impossible to have severe flu symptoms with every menstrual cycle. For about two years I had the exact same symptoms, at the exact same time, every single month. I knew, 100% without any question whatsoever, that this was linked to my periods one way or another. And the same GP told me month after month, “it is not possible”. Many years later I saw a gynaecologist who agreed it’s unusual but acknowledged, nonetheless, that there was no doubt it was happening. And I now know that menstrual flares are reported anecdotally by thousands of women with Lyme disease. Maybe you haven’t been to medical school, but you have lived with your body every day since you were born, and you know what is normal for you.

4. Be your own advocate

Related to number 3. This has been a hard lesson for me and one I am still working on, because being assertive does not come easily to me. I don’t want confrontation, I don’t want to have to argue my case, I just want to sit quietly in the corner and mind my own business. Working in academia has helped me massively with this, because you always have to justify yourself in science, and sadly, no-one will do the speaking for you. Only you can say what you need. If you’re not getting what you need, there’s no point sitting around being polite about it. The onus is on you, and only you, to create change.

5. Life isn’t a race

When I was younger I used to put so much pressure on myself to achieve, achieve, achieve. I, like many young people I’m sure, was convinced I’d be married with kids and a successful career by the time I was 30. Well I can tell you, 30 is creeping around the corner and I’m not married, am currently unable to have children and am going to be a full-time student until 2019. And I’m chronically ill; the limitations of which I could never have imagined as a child. But I am an infinitely better person now than I was then. I am more patient, more chilled out, more confident, more thankful, less pessimistic, less judgemental. I still have a way to go on all those things and more but that’s exactly the point – life is a journey, not a race to the end. There is no deadline for growth, for change, for learning. You haven’t suddenly made it the day you get married or have a kid or get a promotion or own a house. As soon as you reach one goal you will be thinking about the next in the hope that it will suddenly make things better; make you better. So what’s the point of racing so fast to the next goal that you don’t even stop to enjoy the scenery? Of all the things I have been forced to take note of in recent years, the thing that has changed me the most is simply learning to take it down a notch. As much as it pains me to admit it, I know that when I push too hard, my health suffers. That might be doing too much exercise, not getting enough sleep, having an argument, over-working, or just letting myself get stressed by day-to-day life. Chronic illness has forced me to pay more attention to the warning signs my body provides, and although the limitations of that can be very frustrating, it is also a relief to feel like I have permission not to constantly worry about expectations and achievements.

There are many more things that I have learned from chronic illness. Perhaps I will write a part 2 to this post at some point. When everything feels a bit overwhelming, it can be really helpful to take a step back and look at the bigger picture. For anyone looking in from the outside, my life is far more flawed now than it was 10 years ago, but yet, on the inside, it is so much more fulfilling.

Chronic Illness & Fear of Judgement

I’ve always been a socially anxious person. At the root of social anxiety is a fear of being humiliated, scrutinised or judged. When I was younger, I think I was quite a judgemental person. I was quick to criticise and see the worst in people; other people, as well as myself. As I’m getting older, I am learning how unacceptable and unnecessary it is to judge anybody for anything. We are all just trying to do our best on our individual journeys. Yoga has helped me immensely with this. It teaches me and reminds me, every day, to accept where I am in my own journey, both on and off my yoga mat. And I think that by learning not to judge yourself, you inevitably learn not to judge anyone else.

That said, I am definitely not perfect in this regard and I still sometimes catch myself making an unfair judgement about another person or, more often, about myself. I also still have an incredible fear of being judged by others, and this creeps into almost every element of living a life with chronic illness.

As an example, I have quite a serious phobia of doctors. This stems, I know, from countless appointments with GPs where I have not been treated with the respect or dignity that all patients deserve. Like the time I was told that there was “no way” I could be experiencing the symptoms I described because they were “medically impossible”. The time I was told that I couldn’t be that ill, because I had a boyfriend (apparently really sick people can’t meet members of the opposite sex). Or the time, and this is no word of a lie, I was told to “go to Africa and see starving children if you really want to know what sick is”. These comments are rude, insensitive, unkind and extremely damaging. They are judgemental. Anyone who knows me will know that, like many people with chronic illness, I really don’t exaggerate my symptoms. In fact, I am so afraid of people thinking that I am exaggerating my symptoms, that I massively under-report them. So when I go to the doctor to discuss my illness, I am not being a hypochondriac or a drama queen, I am simply seeking help for symptoms that are having a significant impact on my quality of life.

Despite this, I have been made to feel so stupid, over-the-top and unworthy of a doctor’s time, that I have a serious and significant fear of going to the doctor. As someone with chronic illness, this is a problem. It means that I am not properly monitored. It means that there is no one person who oversees my medical care or knows what treatment I’m having. It means I avoid telling my doctor how I’m really doing. It means that, 8 months after being diagnosed with Lyme disease, and 4 months into treatment, I still haven’t had a single conversation with my GP about it. If something serious happened to me, my medical notes are so out of date that no-one would know how best to treat me. My Lyme disease specialist requires me to have regular blood tests throughout treatment to monitor my liver & kidneys, and I am so afraid of speaking to my GP about it that the thought of even making the appointment is keeping me up at night.

The fear of judgement doesn’t stop at the doctor’s office. I am very private about my health issues and there are very few people who know a lot about it. I am trying to get better at this, because keeping it a secret is very isolating and makes me feel lonely and disconnected a lot of the time. I think it is essential for humans to have connection. Even as a socially anxious person, it is important to have meaningful relationships and to not feel like you have to hide what your life is like. But yet, the thought of sharing the details of my illness and treatment with other people fills me with fear because I have no idea what people will think or say. Sometimes I get snippets of opinions or advice that give a little hint that someone is making a judgement. The sad thing is that I know these people most likely have no intention of judging me and probably don’t even realise they are doing it. They are good people; people I like and respect, but still, the subtle signs of judgement are there.

Like, for example, the person who tells me that they think people with chronic illness should learn to live with their symptoms and not let the search for a diagnosis take over their lives. Or the person who told me how they had learned to live with their own condition (a condition very different, by its nature, to mine), and that I should do the same. Or the person who told me they thought the treatment I was having was very risky and that I should find a different doctor. These may all be valid arguments, and they may be well-meaning. But they have one thing in common: they all contain a “should”.

The word “should” suggests that you are making a judgement. It suggests that you think the person at the receiving end of the “should” needs to be doing things differently, or making different choices. That, if you were in their shoes, you would be doing a better job. I frequently catch myself using the word “should” in my head, and I like to challenge it because it typically means I am judging myself (you should be better than this, you should have done xyz by now, you shouldn’t be getting so upset…). Not only is judging someone unneccessary and potentially harmful, but it is also unfair. How can we possibly say what someone else should or shouldn’t be doing, when we have not lived a single second in their shoes? How can we decide what choices someone should or shouldn’t be making, when we have no idea what life is really like for them, or the struggles they experience each day?

I know that my fear of judgement is something I still need to work on. I know that it stems from social anxiety and a few bad experiences, and I know that there is value in learning how to let go of what other people think. But I also think that we all have a responsibility to catch ourselves when we are being judgemental. To question whether we are really in a position to make that judgement, and to consider what it might be like to walk in someone else’s shoes.

The paradox of being a brain-fogged academic

In the world of academia, I feel like a cognitive tortoise, surrounded by elegant hares.

One of the symptoms I find increasingly challenging to manage, is brain fog. Fellow Lyme disease patients will know exactly what I’m talking about. For those who aren’t so familiar, brain fog feels a little like an alien has invaded your head.

Cognitive processes like thinking and remembering come so naturally to us when our brains are working as they should, that we take it completely for granted. Even I am guilty of this on my good health days. From having complex thought-provoking conversations, to making a shopping list or recalling a story from the day before; when it is easy, it is so easy. Our amazing brains work at incredible speed to help us think, recall, imagine and decide continuously throughout the day without us even noticing. How incredible is that?

And yet, the speed and ease of a well-oiled brain makes it blindingly obvious and excruciatingly painful when the same very brain, the next day or even the next hour, suddenly turns into a pile of mush.

I remember the first time I read about brain fog. I was reading this paper about the prevalence of long-term symptoms in patients previously diagnosed with Lyme disease, so-called ‘Post-Lyme Borreliosis Syndrome’, which I think equates to the term ‘chronic Lyme disease’ often used by patients, the existence of which is painfully denied by many doctors (a complex, confusing and distressing debate that I will save for another day).

I came across this research paper with Forest plots showing the prevalence of persisting symptoms post-Lyme infection. For those who aren’t familiar with Forest plots, they are graphs that show the combined results of multiple studies that all addressed the same question, giving you one overall result from all the previous studies combined. They really are beautiful things. So I was reading this paper, scrolling through the Forest plots of all the different symptoms that had been reported in patients post-Lyme disease. Fatigue was first, no surprises there. Followed by musculoskeletal symptoms like joint pain and muscle aches, again, no real surprises.

And then I scrolled down to this: memory problems, poor concentration, difficulties in formulating ideas, and difficulties in word finding. I nearly jumped out my chair. These were exactly the kinds of problems I had noticed in myself, but I had never really talked to anyone about. Cognitive symptoms, much like fatigue, are so internal and subjective, that it’s hard enough convincing yourself it’s not just all in your head, let alone trying to convince Joe Bloggs or, God forbid, your doctor. So I never spoke about these symptoms because, I’m ashamed to admit, I was afraid of what people would think. Was I really having memory problems, or was I just being a bit forgetful like everyone else? Were those difficulties finding the right words or thinking outside the box really a chronic illness symptom, or was I just having a bit of a dumb day?

When you have unexplained, undiagnosed illness, it really does mess with your head. I have hidden many symptoms purely through fear of not wanting to look like a hypochondriac. If you are trying to convince your doctor that you really do feel terrible and your illness isn’t all in your head, then conversations like “sometimes I can’t think properly” aren’t exactly the best way to go.

So, for years I pushed these cognitive symptoms to one side and convinced myself that they were nothing unusual. And yet this paper showed that all of these symptoms: memory problems, poor concentration, difficulties in formulating ideas, and difficulties in word finding, were reported significantly more frequently in patients who had previously been treated for a Lyme infection, compared to controls with no history of Lyme disease. For the first time I felt like it was ok to admit these were things I struggled with, because the science said I wasn’t alone.

Brain fog is horribly distressing. I will often find myself mid-conversation, in full-flow of a sentence, to suddenly find that I have absolutely no idea what the word is that I want to say next. I know what I want to say. I can picture it in my mind. I am thinking it in my head. But the word is gone. It is as though, suddenly and without warning, my brain has been emptied of all the knowledge I had 30 seconds before. It is unbearably frustrating. Similarly, I often find it impossible to think outside the box, to come up with new ideas, to learn. My brain loses the ability to analyse, to think, to be remotely creative.

These symptoms, on the surface, might sound mildly irritating. But the truth is, they are huge. In the world of academia, I feel like a cognitive tortoise, surrounded by elegant hares. I am constantly doubting myself. Feeling inadequate. Anxious that I might make a fool out of myself at any given moment. And not only that, but it is exhausting. The energy and effort it can take to perform a task that, on a good day, would be completely effortless, means there is little energy left for anything else.

I always try to end my blog posts on a positive note. Like a lesson learned, or a silver-lining to take away. But the truth is, I don’t know how else to end this post other than by saying: brain fog sucks.

 

 

The balancing act of good days & bad days

The last few months have been a strange time for me. After a relatively good January, February-March was one of the longest bad spells I have had for a while. The bad days far outnumbered the ‘good’ days. My health always goes in waves; bad patch, good patch, bad patch, good patch. But the length and severity of the bad patches, and the length and ‘goodness’ of the good patches, varies massively. I guess this means I have good and bad patches of good and bad patches?! That’s a head-scratcher.

A longer-term good patch might be 2-3 fairly bad days, followed by 4-5 pretty good days, then back to a few bad days, etc etc. February/March was a longer-term bad patch. This means several weeks at a time of bad days, followed by perhaps 1 or 2 days of feeling a little better, of hoping that the bad patch was over and I was on my way to a better place, only to be met by another few weeks of bad days. It is at these times that my mental health suffers most and I find it hard to cope. Having several weeks of bad days with only the odd good day or two in between, makes it feel very relentless. Somehow, having at least a few good days in a row makes me feel like I’ve had a bit of a break from it all. I get to do some nice things, meet some friends, hopefully do some yoga and tidy up the house a bit; before it all comes crashing down again. But the trouble with the longer-term bad patches, is that the good days are so massively outweighed by the bad days, that there is nowhere near enough time to fit in all the things that I want or need to do; the chores, the responsibilities, the workload, the relationships, and, most importantly, the fun.

And the strange thing is that those one or two slightly better days in between, can actually be worse than no good days. When it’s bad day after bad day, I somehow come to accept that I feel shit, and that there’s not much I can do about it. I know that nothing much is going to get done and instead, each day just becomes a quest for survival; the aim is simply to make it to the end of the day, no greater expectations. But when I have a glimpse of a better day, it gives me hope. Maybe a better time is up ahead. Maybe this is IT; maybe I am actually recovering and from now on it will just get better and better and I will never be as sick again as I was yesterday. Maybe tomorrow I will be able to clean the house. Maybe tomorrow I will be able to go to yoga class. Maybe this weekend I will be able to catch up with some friends.

I have written before about how important hope is in chronic illness. How, when all hope for a better future is lost, chronic illness becomes unmanageable. And in the bigger picture, I still think this is true. But day-to-day, hope can also be crushing. Because when I wake up tomorrow and it is, in fact, not a better day, there is a sense of loss. Grief, even, for the good day I thought was mine for the taking. Disappointment that I won’t be able to fulfil my hopes of getting the housework done or having a productive day at work. Guilt that I will have to let my friends down, for the millionth time, because those plans I had scheduled on a good day, are no longer manageable when today is a bad day.

On the good days, my awareness is suddenly brought back to all the things I want and need to be doing. I feel like I have been left behind from my own life. Like I have to catch up on all the things I missed out on on the bad days. And I have to suddenly catch up on it all right this second, before the opportunity is taken away again.

Chronic illness is the most enormous juggling act. I have the to-do list of a healthy person, with only a fraction of the days in which to complete it. The first good day after a bad spell brings so much pressure. What do I prioritise today? My instinct is to prioritise work. My PhD is important to me; it matters. And after several days or even weeks of feeling like I have only been touching the surface of what I want to be achieving, the sense of suddenly being able to work at full-pelt feels liberating. But then….what about the housework that needs doing? Those jobs that I simply have not been well enough to worry about, like scrubbing the shower or changing the bedsheets or emptying the bins. Wouldn’t it be great to get those jobs done so I don’t have to worry about them if tomorrow is another bad day? But then, what about yoga? Oh how nice it would be to roll out my mat and stretch my body and feel my breath and focus on how good I feel after being curled up on the sofa for so long. Or better yet, I could go to a yoga class and combine the joys of yoga with a change of scenery and some social contact. But, what about those friends I’ve been cancelling on recently? Wouldn’t it be great to give someone a call and catch up over a cup of tea? To be able to talk to someone about what a tough time it’s been recently and how grateful I am that today is a brighter day. To ask how they are and what has been happening for them. To chat, to laugh, to moan. To be a friend. And what about my relationship? Wouldn’t it be amazing to head out for dinner or go to the theatre or out for an evening walk? Wouldn’t it make me feel so happy, so alive, to be able to be a girlfriend and focus on his needs, on our needs?

How on earth does anyone make such choices? We all lead busy, stressful lives, and we all have to decide what we want to prioritise. But when the number of days available to you are cut so significantly, and when you have absolutely no idea when the next available day will be, how do you decide? And then there is the risk of trying to squeeze in too much; of tiring myself out and bringing myself crashing back down into another bad patch. Every tiny decision of how to spend my time feels like life or death because the consequences are enormous. There is a constant pressure to make the right choices. To not fuck it up, for myself or anyone else.

And yet, having to make these choices forces you to think about what is really important in life. I don’t want to live in a pigsty, but does housework really matter? When I’m on my deathbed will I look back and say “I wish I had changed the bedsheets more often”? My PhD is important to me and I want to do well, but as PhD students we are always taught to let go of perfection; to learn how to just be ‘good enough’. Perhaps I am lucky that chronic illness doesn’t even give me the option of perfection, that I have already had to learn how to be ok with being ‘just good enough’. So what really matters to me? Relationships. Nature. Yoga. Being present in the here and now. Making the most of all the things I am fortunate enough to have in my life because, as chronic illness has taught me, there is no guarantee that those things will still be here tomorrow.

Published on The Mighty

What chronic illness looks like behind closed doors

Many chronic illnesses are described as “invisible illnesses.” Depression, anxiety, chronic fatigue syndrome, Lyme disease, fibromyalgia, autoimmune disease… they all have one thing in common: most of their symptoms are invisible to outsiders.

Like many others with chronic illness, I have become very good at hiding how I really feel. Since I don’t generally walk around with a sign saying, “I have chronic illness,” my friends, family, colleagues and acquaintances (and that miserable lady in the post office who makes me want to cry on a bad day), would be forgiven for thinking I’m perfectly healthy.

Before I got sick, I think I’d have found this concept hard to understand. I’d have assumed that no one could possibly hide how they’re really feeling all the time, and that I’d notice if someone was really that ill. Now, of course, I know different.

When my sickness level is a nine or ten out of 10, I stay at home. I call in sick from work or work from home, I cancel my social plans, and I skip my yoga class. No one sees the really sick version of me. Well, no one except my parents and my boyfriend (lucky them).

When my sickness level is a seven or eight out of 10, I do minimal activities. I might head into the office for a few hours and leave at lunchtime. I might pop to the shop. But that’s about it. I’m likely to do these things with plenty of painkillers, and I’ll avoid speaking to anyone. If I seem quiet or grumpy or stressed, it’s probably just that I’m having a seven or eight kind of day, and I am just about able to make it to the office but I feel too sick for conversation.

When I’m at a five or six sickness level, I’ll do most of my usual activities. I’ll do a whole day at work, I’ll meet my friends for coffee if we’ve made prior arrangements. I do these things feeling very tired, and a little fluey, but it’s manageable and I’m normally able to hold a conversation and keep a smile on my face. Anything below a five on the sickness level is rare, but on the occasional level two/three/four days, I’ll be on top of the world! I’ll be the first one in the office and the last one to leave, I’ll be joking and laughing and making conversation. I’ll be at yoga and then I’ll meet a friend for dinner. I’ll be, for all intents and purposes, normal.

So if you see me and you think I look quite healthy, either it’s a particularly good day, or it is a moderately good day and I am just about holding it together. The true sick version of me rarely shows her face, and if I did, I really think my friends and colleagues would be horrified.

So what does chronic illness really look like? On those days when I wake up and can barely make it out of bed, or when I walk through the front door after a whole day spent in the office wondering how on earth I’m going to make it til 5 p.m… What does it look like, behind closed doors?

There are normally pyjamas, dressing gowns and blankets involved. I will often have my head in my mobile phone or on my laptop, researching this illness, trying to find the right balance of self-educating without causing panic and upset. There will be no makeup, no brushed hair, no nice clothes. There are lots of cups of tea. There may be a nice dinner if I feel able to make something, or if my boyfriend is around to cook, otherwise, there will be takeaway or leftovers or whatever scraps I can find in the fridge. There are few smiles, few jokes, few memories to be made. There are tears. Sometimes there are a couple of tears that can be wiped away and pushed to one side. Sometimes there are inconsolable sobs as the enormity of how terrible I feel and how tired I am of feeling terrible, comes to the forefront.

Behind closed doors, chronic illness is ugly. It is unwashed, undressed, it is grubby. It is lonely and isolating. It is both stressful and boring at the same time. Sometimes I feel like a fraud for writing about how hard chronic illness is, about how sick I feel, because I know that for anyone looking from the outside in, I look like a normal, happy, healthy young woman. Please know that I hide the truth. Please know that looks can be deceiving. Please know that behind closed doors, chronic illness really is an ugly old beast.

 

Originally published on The Mighty:

https://themighty.com/2017/03/what-living-invisible-illness-is-like-what-people-dont-know/