Thursday, May 14, 2015

When They Grow Old...


As many of you know, I have this amazing dog named Molly. She is a 13 year old (14 in two months!) basset hound/black lab mix who I adopted from a local shelter with my ex-husband back in 2003. She and I have been through it all together: serious illness, a divorce, a job loss, loss of another pet for me and serious illness, severe separation anxiety, a divorce, and the loss of a dog brother for her. Through it all, we have been constant companions.


Molly is different now than she used to be and the change happened sometime around the time I got divorced and moved into my own place with her. She used to be the hyper one, not especially affectionate, and always wanted her own way. She still wanting her own way, but the move changed her. At first, it was for the worse. The separation anxiety she experienced was bad enough that she almost hurt/killed herself trying to go through a window when she was home alone, I was renting at the time and my landlords were not appreciate of her constant howling and barking every single time I left the house. It was a hard time for me as well, because I was disabled and even getting to doctor's appointments was a struggle, because I didn't know what I would come home to.


It took a long time, but we worked it out. A year of behavior modification and psychiatric medications, as well as visits to a dog shrink at Tufts University, got us through the bad parts. Not to mention several kind and compassionate friends and family who would watch her for me during the rockiest of times.


I will be honest. I almost gave up on her during this period of time. My own physical needs were so extensive at the time that I didn't know how I was going to mange the severe separation anxiety because I obviously had to leave the house. I remember one afternoon, I came home to find her panting and in so much distress. The apartment was torn apart. I sat on the floor with her and cried. Then I google searched basset hound rescues and found the one I was going to call.


I never made the call.


And from that point on, that is when the change happened. She was completely and utterly devoted to me. It's almost like she knew...


A year later, Molly, who was about 8 years old, started to have multiple medical problems. The vet bills mounted up and the care she needed increased. The most notable incident was the day I came home from a friend's funeral to find that she couldn't get up and down the stairs and cried every time she tried to move. I still vividly remember the pain in my heart upon hearing her cry like that. It sounded like she was being tortured and I had never seen her react to pain at all, never mind as if someone was beating her.


Several days of hell ensued. Multiple vet/E.R. appointments got us nowhere. Then the day after Christmas, I realized she was almost completely paralyzed. I was able to get a hold of a supervisor in the E.R.who said she read what happened when Molly was brought in and I was to put her in a car immediately and rush her to the MSPCA Angell  Boston Animal Hospital, two hours away. Because of my own limitations at the time, I had to call a friend to get her in my car for me. We drove to Boston, during a major winter storm. I honestly thought we might not make it there in one piece. I also knew that I had to try and get her there.


She received the best possible medical care there. After a lot of tests, I was told that she had a ruptured lumbar disk in her back and that was why she was paralyzed and couldn't go to the bathroom correctly. I was told that a $5000 surgery was needed and it was thought that the surgery would help her walk again and get rid of her pain, but there were no guarantees. Even if the surgery accomplished all this, she would most likely be incontinent of urine and stool the rest of her life. I could do the surgery, or have her put to sleep. The decision was mine.


I don't know if words can adequately express the agony in making that decision. The only financial resources I had at the time was some money from the sale of my house during my first marriage. But, I was also on disability and that was the only money I had in the world to fall back on. Taking $5000 out of it could have serious consequences for me in the future. I also wanted to do what was best for Molly. I didn't want to prolong her life if it meant a life of  pain and suffering. Would I even be able to care for her long-term? The aftercare from the surgery alone would be incredibly difficult.


I remember my boyfriend at the time (my now husband) just holding me and letting me cry. I prayed a lot. I decided to go ahead with the surgery.


Molly came home several days later. She was never incontinent after the surgery and made a full recovery. The doctors were astounded. I know we were lucky. We trudged through the following few weeks of her recovery together.


The years since that day I made that difficult decision have been a blessing. I got married. Molly took really well to my new husband and once we moved into his home, she rarely ever had separation anxiety issues. She remained my constant companion. She continued to be by my side during several medical crises. She kept me company during those long days and weeks when I couldn't get out of bed and my husband was at work all day. She was my emotional healer.


It has been an interesting experience watching her age, and a precious one at that. I've never been responsible for a senior dog before and I will say, I treat it as a privilege. I watch her get grayer with each passing week. I see how drastically she has slowed down in the past year or two. No more one hour walks romping through the park. No more play dates at the dog park because it is just too much for her. We have to be vigilant about keeping on top of her pain medications and some other health issues, especially as the arthritis continues to progress from her back surgery all those years ago. I have made a commitment to her that when she is ready to go, I will not prolong her life.


I will not let her suffer.


Mother's Day passed by recently and I was so appreciate of the dog mom friends I have on Facebook who were so happy to claim themselves as dog moms with all the different memes. I never had children of my own and Molly has helped fill the maternal need that I have. I have taken some crap about that and heard all the jokes, but really, it is serious business. She instinctively knows when I am suffering, either physically or emotionally. She acts in ways that make my husband and I laugh so hard, we can make a whole evening of it. She gives and gives and gives to us every day, expecting nothing in return. Sometimes society, and the people in it, judge how we love. They say there is no love like the love between a mother and a child. Or you have not truly loved unconditionally unless you have a partner or a spouse,


No, love is love. We each get to define it for what it is and for how we feel it.


I had an opportunity this week to talk to someone about Molly. A person who doesn't know her. I explained to her that it is a love like I have never known. It's not better or worse than the love I have for my husband or say, my parents, but it is very different. It is the fierce, protective love that is demonstrated by putting her needs before my own and trust me, it has happened many times. It is a quiet, unconditional love that has no rules; no boundaries, no expectations.


It is a love of true acceptance.


Up until recently, I was sometimes afraid to love Molly over the past two years. I knew she was getting towards the end of her days and I thought the pain of the loss would be more than I could bear. A few things happened to change that. I started leaving situations out of my control in God's hands. I realized that I could make more out of the time we do have left. I would also see profiles on dog rescue sites of elderly dogs abandoned by their owners, because they could no longer care for them. Dogs who have multiple health issues. Elderly dogs who get treated in many ways similar to elderly people in this country-like they are disposable.


I made the very difficult decision this week to have Molly put under anesthesia to get her teeth cleaned. It was a difficult decision because of her age, a heart murmur and a new found problem with one of her liver tests.There was some concern though that two of her teeth were very bad and maybe causing her pain, Some of those in my life disagreed with my decision, but I was OK with that. I made my decision based on my promise to her: that I would not let her suffer, no matter what. If it was God's will to take her during the procedure, then she would go peacefully, with no more pain.


The procedure ended up being twice as long and twice as difficult as anticipated. Seven teeth had to be extracted, as well as some root work that included a bone graft. A biopsy also needed to be performed. She is now recovering well and while I am grateful, I am not really surprised. She's a fighter that one. And now, she will live whatever time she has left without pain.


And we will love her just as much as ever.

Friday, May 1, 2015

Divorcing Sjögren's


I cannot believe I didn't blog the entire month of April. I knew it had been a while, but I didn't think it had been that long. I sat down this morning to do some writing and look over the blog design, as well as my Thoughts and Ramblings Facebook page, and I realized how much I have missed writing. I also realized that last month was the FIVE year anniversary of this blog!


Lots of stuff has been going on. For the past couple of months I have been working vigorously on a few things to help improve my quality of life, physically, mentally, and spiritually. I will be honest, it has been super tough. It usually is when you take an honest look at who you are, where you came from, and where you want to be headed. It has meant being rigorously honest with myself and well, let's face it, that can really suck sometimes. However, I am now seeing the benefits of all that hard work and I am excited about the future.


It can also be tough heading into uncharted territory in regards to my health. I have had some neuropathy issues going on as well as some possible autonomic neuropathy issues. I am currently on an aggressive alternative medicine course to try and manage those symptoms and if that doesn't work, I already have a very precise and well thought out traditional medicine plan worked out with my rheumatologist in terms of testing and figuring this all out. My guess is, it will be a combination of both alternative and traditional medicine that will help me deal with this new part of my Sjögren's journey.


The good news is that I realized yesterday that for the first time since the autoimmune journey began around 2007/2008, this is the most confident I have ever felt with every single one of my medical providers. I have had some great doctors in the past, but at this point I feel like I am being completely heard and I am an active partner with every one of my medical providers. I have ten providers (both alternative and traditional) that I am actively seeing now and I don't experience the anxiety I used to have. As I have talked about before, I made some difficult decisions last year about switching some of my providers in order to obtain better care and it's nice to see that those decisions worked out for the best.


Besides the neuropathy pain and dryness issues, I am actually holding my own. My joint pain and fatigue have improved dramatically. I am certain that  the improvement in the fatigue is related to someone FINALLY listening to me and following through about my thyroid and making some medication adjustments, as well as a change in my nutrition. The thyroid is not perfectly regulated, but it is much improved. Everybody kept blaming the fatigue solely on the Sjögren's when I have also had this longstanding thyroid issue since I had radiation to my neck a million years ago.


Besides working at my nursing job more recently, one of the other reasons I have been off the blog grid is that I have been working hard at changing the way I deal with Sjögren's and my health. That has been a gradual process for a few years, but I have been looking at it much differently lately. I think I have blogged before that I see a therapist who has experience in dealing with chronic illnesses and we have definitely made progress.


However, things kind of got to the point a few months ago where I was just sick and tired of talking about this illness all the time. I wrote a book about it, I talk about it at appointments all the time, and I was blogging about it a lot. Thoughts and Ramblings, and its associated Facebook page, is not all about Sjögren's or even autoimmune disease, but that's the direction it happens to take because so many of my readers have autoimmune illnesses and it is a place to share and exchange good information about the illnesses and their treatments.


And that's not going to change; but I was at a point where I needed a divorce from Sjögren's for a while. We all know that it's more like a separation rather than a divorce, and even the separation can only be partial because this illness invades every aspect of our lives. But I was able to find some separation. I stopped complaining about all my symptoms either on social media or to my family/friends. I stopped doing follow-up appointments with doctors just for the sake of having a follow-up appointment when things had been stable in that particular area. I stopped researching stuff online and lessened my visit frequency to the online Sjögren's groups. I still took my medications and attended necessary appointments. I was still spending about two hours a day dealing with the illness and its symptoms. But two hours a day was better than four!


I decided that for now, I am not writing another Sjögren's book.


I felt guilty at first because I know this blog, the Facebook page, and me as an individual have a lot to offer to those suffering from autoimmune illnesses. And, they (and I) will still be here. But my brain cannot be Sjögren's focused all the time for the rest of my life. I found that when I did do this separation, it was a very good thing. I pushed myself harder, especially at work and other projects, and I found that I can be of use to this world in other ways. I also found that my anxiety lessened significantly, I wasn't as fearful, and I could cope better with the physical challenges that did come my way.


I have been criticized in the past (even by a person with Sjögren's), and somewhat recently, for some of the things I say and especially write, in regards to keeping a positive outlook when dealing with a chronic illness. The feedback mentioned that I may not always be realistic in how miserable this illness can be and that not every autoimmune story has a happy ending or a positive lesson to teach. Or I'm told I must have a mild case of Sjögren's because I am upbeat. I tell them to go read my blog for the past five years and read about my journey. My attitude and disposition is inversely proportional to my physical experiences. I have a positive attitude most days, not because I don't suffer or struggle, but because I actually get to be alive.


And loved.
And I get to love back.


I know many people may not want to hear this, but I think many times, myself included, we get ourselves so wrapped up in our illness that we don't see any other possibilities except to be miserable or be a victim. And you know what? I get to do that sometimes. I get to be upset. But the problem is we take on our illness as our identity instead of it letting it be a part of who we are just like being a nurse or a writer is part of who I am. Rather than living my life as a victim, I want to live it as just me. Chris.Those of us with Sjögren's do not corner the market on pain and suffering. Those of us with autoimmune diseases do not have exclusive rights to the pain and suffering in the world. We all have something, whether it is physical, emotional, or spiritual pain. It has been that realization that has enabled me to recently step out of Sjögren's and step into helping someone else. It has enabled me to step out of Sjögren's and step more into the world.


So what can you step into today?





Wednesday, March 11, 2015

Loving Someone With A Chronic Illness


This post is being prompted by an incident that occurred last night. One that unfortunately, happens more often than I would like. And much more often than my husband would like. As I have talked about previously on this blog and on its Facebook page, I have been struggling with some issues regarding my feet. The issues started last July and after seeing a doctor, I was diagnosed with plantar fasciitis and tarsal tunnel syndrome in both feet.


The short version of the story is that I have been through months of physical therapy, countless doctor's appointments, night splints, trigger point therapy, orthotics in my shoes, the list goes on and on. It is likely that Sjögren's is a contributing factor and possibly the cause of this. Starting in December, I decided, after much consideration, to consent to cortisone injections in both feet. I had one in each foot with some relief, but the relief was only temporary. I then had a second injection in my right foot two weeks ago today and after a few days of some relief, things went from bad to worse, and pretty quickly I might add.


My right foot is now at the point where the tarsal nerve is so messed up and irritated, that a good part of my foot is numb. I am also getting little electric-like sensation from time to time and some pain. I am scheduled for an MRI at the end of this week and have been given strict orders from my doctor to stay off my feet as much as possible, with the exception of going to work. Luckily, I only work about two to three days a month for six and a half hours at a time. I was told absolutely no exercising or long distance driving, and I had to give up the one thing that always helps my stress and that is yoga.


So after working a regular shift at the school yesterday, I started with some pain around 5pm that by 8pm, had me reduced to tears. While I figured it was good that I could actually FEEL something in my foot, the pain became unbearable. Despite how much I go through with Sjögren's and pain, it is rare for me to end up in tears over it. The pain medicine I could take would likely keep me awake all night, but I decided to go ahead and take it, as well as some heavy duty sleep medication that I save for emergencies like this. Today I woke up rested, and with a numb foot again. But, crisis temporarily under control.


My husband was with me last evening and I have to say, he did a fantastic job of helping me through the evening. It is so hard for him, I know it is. We laid in bed together watching TV for several hours while I worked through this incident. Actually, WE worked through this incident together. However I know it is hard for him because we have talked about this issue enough for me to now understand how difficult it is for him to see me in pain or in a really bad way.


I didn't really know this or get it when we first got together...how much he struggles when things go bad with me. I didn't know because he is so stoic and calm. He always tries to cover his fears for my sake. But I know. Now I do anyways.


As we have grown together as a couple, our talks have helped him to understand my needs and what works for me. And the talks have also helped me to understand some of what he is going through when I am having a medical crisis of some sorts. And what works for us may not work for every person with a chronic illness or the person that is trying to care for them or help them.


Last night, like all the other times recently, he really got it right. Trial and error I suppose. And some really good communication on both our parts. For example, when I am in that much pain, I want to be held, but not too tight. Its hard for me to have the TV too loud or too much stimulation around me. I also need some type of physical distraction so what he does is he gently rubs my head, or massages my legs, or some other physical touch that helps my brain distract from the pain that I am experiencing. As long as it doesn't involve the part that is actually hurting.


Sometimes.


And other times, it does help to touch the part that is hurting, although with nerve pain like I had last night, that was not the case. So how does he know? He asks me. And I am direct in telling him. And it works. And it works when he gets out of bed for the third time to get me the Motrin I forgot to take when I was up the previous time. And it works when he distracts me with ridiculous jokes or stories.


He also listens intently to what I am saying about my pain experience, if I even want to talk about it which if I don't, we have quiet time. When I talk about it, and he listens, he helps me figure out what the best course of action to take. For example last night, I was trying to decide if I should go ahead and take the pain medication because if I did, I would also have to take something to help me sleep. Otherwise the lack of sleep would worsen the pain cycle. However my husband knows that I am very careful about taking possibly addictive substances like this too often. He helps me think it through out loud to determine if yes, this is necessary or no, I can wait it out and see what happens. Last night, it was necessary.


Its not easy loving someone with a chronic illness.It takes an incredible amount of love and dedication to live this lifestyle each and every day with someone. One thing that I know has helped my husband is that he attends SSF support groups with me. Not only does it give him an opportunity to hear what it is like for other people to live with my illness, but it gives him a chance to talk to other partners, spouses, and caregivers about their experiences. At the last support group meeting we went to, he mentioned to me, after talking with other spouses, that he didn't realize how many Sjögren's patients also have a difficult time going out in the evening because by 6pm or so, they are ready for bed. Going out in the evening is a very difficult thing for my husband and I because I am absolutely exhausted and ready for bed. It takes a lot of preparation and pre-planning on my part to get myself out of the house in the evening. And, a lot of rest beforehand. Because he is aware of that, he makes sure to consult with me about activities, especially ones that just involve the two of us. For example, we don't go to the 8pm showing of a movie. You will instead find us at the 1 or 2pm matinee, where by the way, we save a ton of money going to an earlier show!


I used to feel guilty about the effects my illness has on my husband. I think I even blogged about that very topic at one point. I no longer feel that way though. And the reason for that is simple:


I no longer let my illness define every aspect of my life.
At least most days.
And together, we have established and defined what our normal consists of.


And with the help of his love, I have come to understand that yes, life is more challenging for us than for many other couples, but despite that, I have just as much to offer a partner as anyone else. Throughout all this, all my husband asks from me, both on my good days and on my bad ones, is that I love him.


And I do.
Completely, and without reservation.


And that makes every single day worth fighting for.








Thursday, March 5, 2015

Sjögren's and Fatigue


A few days ago, I posted a status update on the Thoughts and Ramblings Facebook page asking those with Sjögren's/chronic illness if they could pick just one symptom to get rid of for the rest of their lives, what would it be. I knew what the answer would be for me, which was going to be the basis for this blog entry, but I wanted to see if others with Sjögren's felt the same way.


I was taken aback by how many responses I received with that poll and it was clear to me by the responses that fatigue was the clear winner; which is also the case for me. That relentless, brain-numbing fatigue that most people without a chronic illness typically cannot understand.


There was an article put out by the Sjögren's Syndrome Foundation last year that for the first time I have read, did an excellent job of describing the different types of fatigue encountered by those of us with Sjögren's syndrome. The title of the article was: 13 Types of Sjögren's Fatigue by Teri Rumpf, PhD. The article does and excellent job and you can read it by clicking on the article title link above.


For me, as for so many of us, the Sjögren's related fatigue that comes with this illness is often the most debilitating symptom we have to deal with, day after day, week after week. It affects every single aspect of our lives and even worse, fatigue is often misunderstood not only by the other people in our lives, but also by our medical providers. It is one of those invisible illness symptoms that is usually not outwardly obvious to other people. Or on the flip side of it, people think they do understand what the fatigue is like because they too have experienced "tiredness."


I'm here to tell you that illness related fatigue is nothing like being tired.
Nothing.


I remember the days, before I became ill, when I worked as a registered nurse on a busy pediatric nurse, often on my feet for most of my twelve (more like thirteen-fourteen) hour shift and then commuting an hour each way to work. I remember the years I worked the night shift and could barely remember my drives home because I was that tired. Exhausted is probably a better word.


But fatigue is different for me than tiredness or exhaustion.It is that feeling that I physically cannot take another step, even if my life depended on it. Sometimes it is predictable and sometimes it is not. An example of this is that if I work two consecutive days at my current job, it is pretty much guaranteed that sometime in the following forty-eight hours, the fatigue will consume me. That is predictable.


An unpredictable example is going out with friends on a weekend evening, which happened to me recently. I had made sure I got enough rest for twenty-four hours before we went out. I was in good shape for the first few hours, but halfway through a concert, at an intermission, the fatigue hit me like a freight train and I almost actually fell asleep during the intermission while sitting in my chair! I really thought I had my bases covered, but that night, the fatigue won.


And that's the problem, many times the fatigue does win. It very much affects my work life, what little I do have of one. It affects all my personal relationships and definitely my social life. And, it is frustrating as all hell. Because when you are fatigued, everything else is worse and I mean everything. It impacts my pain levels, my other physical symptoms, and definitely my ability to cope. It contributes to anxiety and depression and overall can cause a feeling of hopelessness.


I would say that fatigue is probably the issue I have had to work the hardest at and it has taken me the better part of the last seven years to do so. Working on it doesn't mean I can get rid of it, but it does mean that I am able to live better with it and improve the quality of my life. It means that even though I hate it with a passion, it does not always win. And the times it does, it does and I move on.


There are a few strategies that I have used to help me manage my fatigue more effectively. One of the most important is planning ahead of time and prioritizing. Planning meaning not just my activities, but my rest as well. That is hard for me because when I am feeling less fatigued, I want to get as much done as possible. However I have found that for me, the fatigue is cumulative and rest periods every day are critical in managing it.


Another important component to managing my fatigue is diet and exercise. I cannot emphasize this enough. And oftentimes, I need to emphasize this even with myself because it is an area that I can easily neglect. I have found a significant improvement in my fatigue levels when I exercise three to five times a week and cut out processed sugar, gluten, and processed foods. The exercise doesn't even have to be much, maybe a fifteen minute walk or a half hour of gentle stretching. I just have to move my body.


I also need to listen to the fatigue. When its here, its here. Yes, there are some things I have to push through, like finishing a shift at work. But otherwise, I listen to my body and give it the rest it is screaming for. I find that most times when I do this, I recover more quickly than if I did not listen to my body and kept barreling through my day.


Lately, my fatigue has been more manageable for me and while I know that how I manage it is a crucial component, I have also been finding some relief lately since being on a steady dose of low-dose naltrexone (LDN) and increasing one of my thyroid medications. I always encourage people to talk to their doctors about checking their thyroid and also exploring any other possible causes of fatigue such as adrenal exhaustion, etc.


What techniques and management strategies have you used to help manage your illness related fatigue?




Sunday, March 1, 2015

Sjögren's and Interstitial Cystitis


Several years ago, in 2012, I began to have some issues that confused the heck out of me. I was having some urinary symptoms such as feeling like I had to go all the time, lower pelvic pain, and oftentimes feeling like I could not quite empty my bladder. These symptoms would wax and wane and were episodic in nature. I would go to the doctor and often, I would get treated for a urinary tract infection (UTI), even though my urine sample was always negative. However the symptoms I was experiencing seemed like they were classic UTI symptoms.


Around the time of my wedding in Spring 2013, the symptoms were acting up, but it was the months between my wedding and honeymoon that were the worse. The pain was relentless and had actually become crippling at times, I constantly felt like I had to urinate. During this time I saw a urologist in western Massachusetts. I had found some information in The Sjögren's Book by Daniel Wallace which pointed to the suspicion that my symptoms may be related to something called Interstitial Cystitis (IC). The doctor's appointment was a nightmare. He insisted that this was not the issue and furthermore, IC is not at all related to Sjögren's syndrome.


Well, things were getting worse by the week and I realized that I couldn't go back to that doctor and I needed help. I did my own research and ended up in the urology clinic at Lahey Clinic in Burlington, Massachusetts. These doctors were top notch in the urology world and by the end of the first visit, they told me I likely had IC. As an aside, I highly recommend Lahey Clinic and this was also a perfect example of how important it is to advocate for your own health care. They put me on a bladder medication and had me radically change my diet to avoid foods with high acid content, as that can make IC much worse. I got no relief from the medication and minimal relief from the diet.


One month before my honeymoon, they brought me to the operating room and did a procedure called a hydrodistention with cystoscopy. Typically, you can see an indication of IC during this procedure and although the doctor did not necessarily see what he was looking for in terms of diseased areas, they went ahead and did the hydrodistension part of the procedure to flush away any inflammatory cells that may be present.


I did unbelievably well with the procedure and my symptoms disappeared. Since that procedure in August 2013, I have had a few very minor pain flare-ups with my bladder, but I can always correlate it with an increase in acid in my diet. As soon as I fix that, I am good. I am firmly convinced that  the Lahey Clinic they did was what got me on the road to recovery and since then, I have tried to be very vocal about the possibility of having IC with Sjögren's so that more Sjögren's patients like me don't suffer more than they need to. Especially since that first urologist I saw was so uneducated and uninformed.


I was delighted to open up the February 2015 Moisture Seekers newsletter last week to see an article about Interstitial Cystitis. Because the article is so well done, I am going to reprint it below for your information:



Intersitial Cystitis (also known as IC) is a chronic bladder condition that usually consists of recurring pelvic pain, pressure, or discomfort in the bladder and pelvic region, urinary frequency (needing to go often) and urgency (a strong need to go). IC also can be referred to as painful bladder syndrome (PBS) and chronic pelvic pain (CPP). The exact cause is unknown, but researchers have identified different factors that may contribute to the development of the condition.


About 25% of IC pateints have a definite or probably diagnosis of Sjögren's and as many as 14% of Sjögren's patients are estimated to have IC.


Some things you can do to control your IC include:


1. Avoid or limit foods and beverages that may irritate the bladder, including coffee, tea, soda, alcohol, citrus juices, and cranberry juice. For some, spicy foods may be a problem as well as foods and beverages containing artificial sweeteners.

2. Apply heat or cold over the bladder or between the legs to alleviate some pain.

3. Modify or stop Kegal exercises which may make pelvic floor muscles even tighter.

4. Avoid tight clothing to prevent further irritatiion and restricted blood flow to the pelvic region.

5. Treat constipation.

6. Develop healthy sleep habits as sleep is crucial for pain control.

7. Adjust fluid intake. Increase or decrease depending on your situation.

8. Retrain your bladder by learning to urinate on a set schedule and not when your bladder tells you.

9. Find healthy ways to manage your stress since it may make IC symptoms worse.

10. Find, in advance, the locations of restrooms along your route when traveling.

11. Get active! The health of the bladder depends on good blood flow to the area and having flexible and strong muscles around your bladder and other pelvic organs to protect and support them.

12. Quit smoking. Cigarettes may irritate the bladder and worsen the pelvic and bladder pain.

13. Take a trial and error approach to treatment as no one treatment works for everyone. A combination of treatments is often necessary to get your IC under control.

14. Track how your symptoms change with treatment and speak with your healthcare provider if you think a therapy is not working.


Visit the Interstitial Cystitis Association website at www.ichelp.org for the most up-to-date and accurate information about IC and to find knowledgeable healthcare providers.


******Reprinted from The Moisture Seekers, Volume 33, Issue 2, February 2015.*****

Tuesday, February 17, 2015

Read "On Being Naked" on The Manifest-Station


I have been a writing a lot lately and I thank the Lord for that. I was going through a difficult time with my writing, which started sometime before Tales From the Dry Side was published and lasted right up until about the end of 2014. Part of the reason was due to being so busy in early 2014 with the book and starting a new job back in the nursing field (yay!). I love and am absolutely proud of Tales From the Dry Side, but the marketing that goes into self-publishing a book successfully is astronomical.The other big reason for having a difficult time with my writing was that I was having a hard time connecting with myself and I just couldn't seem to get it together to make the sentences come as often as I would like.

Some of my blogging, maybe half of it, is writing designed to teach and inform, mostly about Sjögren's syndrome and autoimmune diseases in general. The rest of it takes the form of a personal essay. If I just wrote personal essays for the rest of my life, that would be fine with me. I may try my hand soon at fiction again; we will see. I may try and publish another book. The jury is still out on that one.


Lately, for reasons that have recently become clear to me, my writing has been more intense, more authentic, and not to sound like a jerk, but good. More like great. Great because I am more willing to share more of my personal experiences and feelings with my readers and at the end of the day, we are all human. We all want to connect and know that someone else feels how we do. Some of the writing never gets published or makes it to my blog; its just for me.


My girlfriend, Tina, is one of those people who connects well with others. I know that if I want to get together and have a chat with a gal pal and have a conversation with some real depth to it, she's one of my girls. A few months ago, Tina introduced me to a website called The Manifest-Station, founded by Jennifer Pastiloff. Jen is a writer, yoga instructor, and overall great human being. She leads sold out workshops all over the world which you can check out HERE if you'd like. Tina knows how much I am devoted to writing, yoga, and how sensitive a soul I am. The Manifest-Station is a website/blog where sensitive souls, and excellent writers (including Jennifer) share their personal experiences and more importantly, look for the beauty in every day life. Also known as Beauty Hunting.


Tina also called my attention to the fact that The Manifest-Station was accepting essay submissions. I was working on a piece that had to do with body image issues and I thought it would be a good fit for The Manifest-Station. I found out yesterday that the piece was accepted and it was published this morning.A huge thank you to Jennifer Pastiloff and her staff for loving this piece as much as I do. You can read it by clicking on this link:


On Being Naked


Sunday, February 15, 2015

Who Reads Thoughts and Ramblings?


I few days ago, I posted a status update on the Thoughts and Ramblings Facebook page (which you can find HERE) asking readers where they are from. On the Facebook page, approximately 5% of those who liked the page answered the question and that is where I got all the information about states in the U.S. where people are located.This is a huge issue I have with Facebook because for very small business pages like mine, my posts often do not show up in the newsfeed, so I know I am missing a ton of information on this poll. However, I also have some information on where people are from included in my statistics for this blog, countries only. I wanted to tally up some information on these statistics because I am curious and also to see how far this blog, and its information, is getting.


From the information, however limited it is, I did get, I was able to tally up the following information:


Thoughts and Ramblings followers are from at least thirty-one states in the United States of America and three provinces in Canada. In addition, besides the U.S.A. and Canada, there are readers from at least ten other countries including Ireland, England, Ukraine, Mexico, India, China, Germany, Taiwan, Italy, and Australia.


I think this is awesome! Thank you to all who responded to the poll on Facebook and to all of you who follow this blog, share it with others, and help raise awareness about many of the issues that I discuss here, especially autoimmune illness!