For Everything There is a Season

"In order to write about life, first you must live it." ~ Ernest Hemingway

Page 26 of 44

What I Have Come To Understand




In the two and a half years I have been writing this blog, I don’t think I have ever written a post about a doctor’s appointment with my rheumatologist. The appointments tend to be pretty significant since the rheumatologist treats the Sjogren’s syndrome. I am sure that I have mentioned events that have happened at certain appointments, but I think that has been the extent of it. I think the reason for this is because I don’t think people will be interested or that the post may be boring. Today I realized that I may have made a mistake. Sharing information from these appointments with my rheumatologist not only may help someone else, but it also gives other people the opportunity to give me feedback about their experiences with different treatments, side effects, and complications from medications.

I have had more severe symptoms than usual lately with some new ones thrown in for fun. Therefore I have been seeing my rheumatologist, Dr. P, more often than usual. These appointments tend to be  stressful for me compared to those with other doctors. Sjogren’s syndrome, like many other autoimmune diseases, often presents with a myriad of symptoms and often it is like trying to fit together the pieces of a puzzle. Is this symptom autoimmune related? Is it a side effect from a medication? There is the unpredictability of not knowing what the next step may be in treating the illness. Then there is also the fact that Dr. P’s office is an hour away from home, she is usually running behind (I have attributed this to the fact that she does not rush through her visits), and sometimes there is lab work to be done after the visit. From the time I leave my home to the time I pull back in the driveway, I am looking at a five hour trip. Exhausting.

I have  been more frustrated than usual with her, myself, and the whole Sjogren’s situation in general. I had just recovered from the whole Guillain-Barre/blood clots in the lungs fiasco when I began to develop severe, debilitating migraines thought to possibly be autoimmune related. After struggling to find a medication at a dose I could tolerate to manage these migraines, some of my Sjogren’s symptoms decided to come out and play; most likely because I had weaned off my steroids. Severe fatigue and joint pain worse than I have had in at least a year were the highlights. In addition to that, I have been having some significant urinary issues that come and go and that has prompted some further testing; the cause thought to possibly be autoimmune or medication related.

What this has meant is that Dr. P and I have been continuously trying to figure out a course of treatment to manage my illness. A course of treatment for an illness that has no cure and really no acceptable or standard form of treatment. If you have diabetes, you change your lifestyle, check your blood sugars, and take insulin. The end result is that most of the time, your illness can be controlled. Not the case with Sjogren’s, or many other autoimmune illnesses for that matter.

And there are only so many medications to try. Appointment after appointment Dr. P and I discuss the options and what may come next in regards to medications. She keeps wanting to put me on or increase my dose of prednisone. This gets me pretty worked up to say the least. If you have spent any time reading my blog, you will understand how much I hate prednisone. Here’s the thing though: as Dr. P said today, I am between a rock and a hard place and it is a matter of choosing the lesser of all evils. I have already been on many of the other autoimmune medications such as methotrexate, Imuran, Cellcept, and Enbrel. Cellcept did help quite a bit but made me so sick that my previous doctor had no choice but to take me off of it. Enbrel helped a little but not enough to justify the chronic sinus infections it was causing me to have.

As we discussed today, there are some other options to consider such as the medications Arava and Rituximab. But they are not without their risks as well. It is hard to make decisions, I am sure for her as well as for me, about which risks to take. Do we consider Imuran again and take the risk of liver damage and other complications or continue trying the steroids at different doses and see what side effects I can live with and risk long term complications such as diabetes, cataracts, and stroke? As much as I hate the prednisone, there is no doubt, it works for most of my symptoms. The problem is that I need a lot of it and the more I take, the worse the side effects are and the higher the risk of severe long term complications.

So our plan for now is to double up my prednisone dose to 15 mg for a few days and then slowly wean it down to 10 mg rather than the 7.5 mg I am currently on. We did this about two weeks ago when the pain and swelling got bad enough to interfere with my daily functioning and it worked but once I got back to 7.5 mg for a few days, the symptoms started up again. So this time we will only wean down to 10 mg. We agreed that 10 mg is the maximum dose of prednisone that is comfortable for me long term. Well, for Dr. P anyways. 0 mg is the maximum dose I am comfortable with but the reality is that my options are getting fewer and fewer and I cannot risk further Sjogren’s complications or live in this state of health.

What I came to understand from my appointment today is that there are no easy answers. Not even easy answers, but any concrete answers.

There is no medication in this world right now that is going to fix me without making me sick in some other way. Maybe someday there will be. But not today.

I am also starting to understand that I don’t think my body is ever going to go back to the point it was at before December 2008, which is when Sjogren’s started to truly ravage my body.

This does not mean that I still cannot do what I am doing; exercising, eating healthier, reducing stress. I will keep trying to control my symptoms through diet and exercise. I will live a healthy lifestyle. I will meditate. I will work with my doctors and stick with my treatment plan. I will laugh and I will play. But I guess for now at least, I am not going to place any of my hopes on any one medication to be the answer for restoring my body to the state that it was once in. Rather, I will continue to work with the body that God has given me in this moment and in this day to live in the best possible way that I can.















































































Photo Courtesy of Google Images

Partners In A Healthy Lifestyle

The very first time I ever noticed my fiance, I was sitting in my usual pew at church. He was walking down the opposite aisle of the church to sit in his own pew by himself. He had a certain presence about him. Maybe it was his long trench coat that hung on his 6’2″ frame or his stylish cowboy hat. Maybe it was his unassuming presence or the gentle way he looked at people when they were talking to him.

The very first time I knew, although I was in denial about it for months, that I was very attracted to my fiance, he was kneeling by my side after church, offering to lend me some of his movie collection as I was trying to recuperate from a very difficult hospitalization. I subsequently fell in love with him for a million and one reasons. Attraction was a part of that love. I was attracted to him on an emotional, mental and of course, physical level. In my eyes, I never saw him physically as anything less than perfect.

So because of this, it came as a surprise to me when last year he mentioned to me that he had lost weight since we started dating in September 2010, that this weight loss was intentional, and that he wanted to lose more. He told me how much he weighed when we started dating and again, I was surprised. I had never thought of him as overweight and to me he had been perfect just as he was when we started dating. I guess that is what happens when the pheromones are in charge! I found him attractive on all levels and his weight was irrelevant to me.

Ignorantly thinking that men are not as concerned about self image as woman are, I didn’t think much of it and 2012 came upon us. I drastically changed my nutrition plan, eliminating gluten and dairy (to help control my autoimmune symptoms) from my diet which meant that at dinnertime, Chuck did too. After my Guillain-Barre fiasco in February, I got more serious about my health. I started exercising regularly and fine tuned my nutrition plan; eating healthier than I had in my entire life. Because Chuck and I are together most evenings and weekends, my healthier eating affected him as well. It was important to him that I be as healthy as possible and do whatever I needed to do to try and manage my autoimmune illness and although I offered, he never considered the possibility of making two separate meals when we ate together.

And as the months have gone by, I have noticed the changes that he has made one by one. Getting to the gym more often. Eating smaller portions at meals. It has been interesting to watch because he is not dieting, but rather just making lifestyle changes, one at a time. It has been great because to be honest, it has made my lifestyle changes a LOT easier when there are not always so many tempting foods in the house and when your partner doesn’t want to eat out all the time. That is not to say that we don’t treat ourselves or indulge from time to time but when we do, it is without reservation or guilt.

He has become my biggest fan and cheerleader in my quest to become healthier and lose weight. For the first time in my life, I have a partner that supports my mission. It is also the first time I have been in a relationship where I am losing weight rather than gaining weight. And he has never ever complained. Not once. He eats every single gluten-free, dairy-free, vegetarian, sugar-free, cardboard tasting recipe I have ever tried. Together we figure out which ones we both like more than others and then I experiment some more so we are eating food that we truly enjoy. When he cooks on the weekends, he cooks gluten and dairy-free. He makes sure the ingredients are measured so that I can then calculate the Weight Watchers points as I do the Weight Watchers program in addition to my gluten and dairy-free lifestyle.

I have come to realize that we have become quite a team. We each have our own strengths and weaknesses when it comes to nutrition and exercise. He is better at staying away from take out and fast food. I am better at making sure we have vegetables with our meals. He is better at the fitness aspect of things and has been good in helping me construct an exercise plan that is doable with my illness. I am better at meal planning and keeping the kitchen stocked.

I have blogged about and been very open about my health and weight loss journey but here’s the thing. It is not my journey. It is OUR journey.

That man that I was so attracted to two years ago? I realized when I looked at him about two weeks ago that he is NOT the same man. Not physically. I was so wrapped up in my own journey that although I knew he was losing weight and I could wrap my arms around him a lot easier, I was not fully aware of his amazing transformation.

I saw him getting dressed that morning and just exclaimed “Oh my God!”

I exclaimed a lot of other things but well, this is a public blog so we will leave it at that.

He had muscle definition in his abdomen, legs, and arms that I had never seen before. The result of exercising five days a week. The result of eating healthier. The result of losing thirty pounds in the two years we have been together.

I have to admit, it gives me a twinge of guilt now and then when I look at him. I am not any more attracted to him than I was before he lost weight but I cannot lie. He looks great. I fully appreciate the changes in his body and I have to wonder if on some level that makes me a bit shallow.

But then I stop and think about how concerned I was about his elevated blood pressure at his doctor visit last year before he lost weight.

I stop and think about how maybe this weight loss might prolong his life and therefore our time together.

I stop and think about how happy he is with himself and how proud I am of his accomplishment.

And I realize that those are the things I am really appreciating.



August 2012
 

Why I am Staying Gluten and Dairy-Free

Best french fries in the world!! Gluten-free!

Over the past month, possibly even longer, I have been thinking a lot about whether this whole gluten and dairy-free eating plan I have been doing is worth it. Although it has gotten much easier, once I started doing Weight Watchers in addition to it, it made things a bit more complicated and challenging. However on two separate occasions, I intentionally ate a food item with gluten and/or dairy in it and noticed that I had some joint pain afterwards. Coincidence? Maybe. However at the time, it wasn’t worth the drama of investigating the issue any further.

That was, until I was off prednisone for over a month and my old enemy, joint pain, came back into my life on a regular basis. Despite a regular exercise regime and eating healthy, the joint pain and stiffness associated with arthritis began to worsen as well as the autoimmune related migraines, fatigue, and worsening of dryness symptoms. Is it possible that if I was eating gluten and dairy that the symptoms would have been much worse? Maybe. Like everything related to my illness, nothing is ever certain. Everything about it remains elusive to me.

So I go back on a low dose of prednisone which I remain on as I write this, which has given me some relief while my doctor is working on contacting my previous rheumatologist to investigate what previous treatments have been tried, why they were stopped, what worked and didn’t work, and try to decide if some of the medications I am taking now are making me worse rather than better. There is the possibility of adding another, possibly toxic, medication. The saga never ends.

During all of this, my fiance and I leave for a four day weekend trip to Old Orchard Beach in Maine. A place not exactly known for its gluten and dairy-free lifestyle. Junk food everywhere you turn and you can smell it within like a mile of even approaching the pier and downtown area by the beach. I had a plan though. I packed a bag of gluten and dairy-free snacks for the three hour drive up and back so I wouldn’t have to worry about eating on the road. I did a Google search on restaurants in Old Orchard Beach (OOB) to see what my options were.

I had made a conscious decision that while I was not going to let myself eat out of control, I was not going to be strict about counting points for Weight Watchers while I was away and give myself a break in regards to being so strict about my Weight Watchers plan. I know my leader would probably frown on this but it felt like it was the right thing for me to do. The gluten and dairy issue was going to be difficult enough. I felt confident that once I was back home, I would get right back on track with Weight Watchers, which I have.

My plan at OOB was to allow myself one dairy item which was a soft serve vanilla cone that I have been wanting all summer; and I mean ALL summer. I have been going to ice cream places with friends and their children all summer and getting sorbet with this plan in mind. My intent was for everything else at OOB to be gluten and dairy-free.

So this is what really happened. Out of the four days we were there, I was completely gluten and dairy-free for two of them. I was already having quite a bit of joint pain and fatigue when we got to the beach and pretty much was having a “what the hell is the difference now?” attitude about the whole gluten and dairy issue. I don’t think my eating was out of control in terms of amount but the type of food I ate made me feel so lousy that my body felt like I ate 10x more than I actually did. When I sit and think about the gluten and dairy items I actually DID eat in those two days, it came down to: that small soft serve ice cream cone, one regular beer, a buffalo chicken quesadilla (didn’t finish it), and a large slice of pizza. Everything else I ate the whole trip was gluten and dairy-free as far as I know. But I think the gluten and dairy was such a shock to my system that it felt that I ate so much more than that. It’s called bloat.

Now I cannot say that any of my autoimmune symptoms got worse because I already had joint pain and if anything, that got better. Not from eating gluten and dairy, but probably from being back on pain medication and decreasing my stress levels by being at the beach. But those food items did wreak havoc on my stomach. Now you have to keep in mind what I ate. That was some seriously greasy (and yes tasty) food. I cannot say if it was the gluten and dairy that caused the stomach issues or the type of food that did it. I can say that before vacation, I was eating much healthier. But, I was also eating, on occasion, similar foods such as pizza and buffalo chicken. I was just eating gluten and dairy-free homemade versions that were much healthier as well.

Here is what I do know. Without a doubt, I am very glad that I took my two day hiatus from my gluten-free, dairy-free lifestyle. While it does not answer the question of whether or not gluten and dairy directly the severity of my Sjogren’s syndrome, it is very clear to me that is directly affects my overall health. It does this by making me stop and think about what I put in my mouth. I make healthier food choices. I eat more whole foods rather than processed foods which is much better for people with inflammatory disorders like mine. Gluten and yes, even dairy (no matter what the media tells you), have no nutritional value and therefore are not a necessity for my body. I cook more than I eat out. I have seen improvement in other areas of my health not related to my Sjogren’s including my weight (because I am making better choices), my skin, hair, and nails, my gastrointestional system, and my menstrual cycle.

I am not saying that a gluten-free, dairy-free lifestyle is for everyone but for me, for now, it is worth the effort. My health is worth the effort. My life is worth the effort.

Photo Courtesy of Google Images

“What Do You Do All Day?”

“Disability is a matter of perception. If you can do just one thing well, you’re needed by someone.”  ~Martina Navratilova

What do you do all day? A question that I have been asked many times by a variety of people. For those of you who don’t know me, the question gets asked because I have not worked at a job for approximately three and a half years now due to a medical disability. I am forty-one years old. I have no children. In a society where most citizens work, stay home and raise children, do both, or are retired, I am an anomaly. And yes, I am very well aware of this fact.

I will be honest here. Up until recently, anytime this question was asked of me, I would get angry and defensive. The question gave me the impression that if I was not working a job outside of the home or raising kids in the home, what else was there to do in life? It made me feel that because I could not do either of these things due to circumstances way beyond my control, I was no longer useful. And that is why I would become defensive. Because for a while after I became disabled, I did feel useless. But that was MY issue, not the other person’s issue. I was in my late thirties when I became disabled and I felt like my life was over.

But my life was far from over. I started over and built a different type of life for myself and made my days productive and fulfilling in ways I never thought possible before I got sick. I don’t know what my future holds medically and maybe the routine of my days will change again someday. Although I am very realistic about the nature of my illness, I also hang on to the hope that maybe there is a chance that as insidiously as my work life was taken away from me, maybe someday it will eventually be returned to me.

Very recently, someone whom I respect and care about very much asked me “what do you do all day?” I had not been asked the question in quite a while and something in me clicked. Because it came from a person who I knew genuinely cared about me, I knew the question was just one of curiosity. It was at this point that I realized that maybe people just did not understand that there can be more to life than going to work every day or raising children. That someone like me can go through their days without being bored. Or even go through their days feeling fulfilled and with purpose. Maybe people just don’t understand how much is involved on a day to day basis in managing a chronic illness.

And because of those thoughts, here we are. Instead of getting defensive when the question was presented to me again, it made me think of how I do spend my time and I would like to share that. Not because I feel like I need to justify how I spend my days or my life but because I hope that this blog entry may help bring awareness and understanding to those people who may be curious what it is like to be in my situation. And trust me, I am not alone in my situation.

First off, none of my days or weeks are typical. Sjogren’s syndrome is a very unpredictable and sometimes progressive autoimmune illness. I can have a week or even a few months without any major issues and then suddenly be unable to function for days, weeks, or months. This is the part that keeps me out of work because you cannot hold down a job when you could be out sick several days a week or even several months at a time; not to mention that you actually have to work several hours at a time, in a row! Even when I am not having a major issue that requires immediate intervention or concern, I have daily issues that need to be dealt with that have become an accepted part of my life. An example of this is the dryness issue. Not necessarily something that would keep me from working a job but it is something that requires regular medical follow up care and daily attention.

OK, so what do I do all day? It greatly varies depending on how I feel. One of the biggest considerations is that I cannot do a full day of activity for several consecutive days due to pain and fatigue so I have to plan accordingly. Due to physical issues and limitations on some days, many activities can take me a lot longer to do, such as housekeeping. Before I got sick, I could have cleaned my current home top to bottom in about three hours, scrubbing floors and all. Now it can take me several days because I have to break the work up into sections. Keeping up the house, shopping, and cooking is my responsibility for the most part. I have made it my responsibility. I have a fiance (Chuck) who works about 55 hours a week and I do not. Although I do have a disability income, I feel that this is my way to contribute more to our household. Now of course this all goes out the window when my symptoms flare up but I do the best I can.

I sit out on an open field on a sunny day and watch my dog run free with elation. I have never had as much appreciation for the good moments in my day as I do now.

When I am physically able to, I get myself involved with worthy causes and other people. I volunteer with my church. I volunteer for whatever comes my way when I am able so that I can make a difference in this world, even if I am not getting paid for it. Sometimes I cannot do something like this for six months at a time and sometimes I can do something helpful several times in one week. I make it a point to never commit to anything on a scheduled ongoing basis because I have done that in the past and it just does not work out due to the unpredictability of my illness. I help out my friends with their children when needed. I also help out friends who are also facing their own health struggles.

Unless something very catastrophic is going on with my body, I try to get to the gym five to six days a week, even if it is just to go and float on a noodle in the pool or swim a few laps. Exercise has been a salvation for me. My hope is that as I take better care of my body, it will become stronger and this will help my illness.

I am constantly doing something to sustain and nurture my personal relationships. Because I have had to slow down, I have the distinct advantage of being able to give my relationships the time and attention that they deserve.

I have been blessed with several passions that I pursue during the week when many other people are at work and they are activities that are especially helpful when I am confined to the house or laid up in bed. Learning to cook and experiment with different recipes has been wonderful; especially since starting a gluten and dairy-free diet seven months ago. And I have also pursued my passion for writing. I truly believe that during the past several years writing has been my other salvation. I can easily spend several hours at a time writing for either my blog, a book I am working on, or for a variety of places that I send submissions to. It is through my writing that I have been able to connect with the world and help people in a way that I can no longer do as a nurse.

I spend time in a library or online learning something new.

Last, but of course not least, I have made a part-time job out of being a patient. This is by far my least favorite thing to do but quite necessary. As I was driving to Hartford last Thursday for an appointment, I did some rough calculations in my head. In the past seven days leading up to the appointment I was driving to, I had spent approximately seventeen hours in the previous week managing my illness. I know there have been weeks where maybe this was a bit less, although not by much and I know there have been weeks where this amount has been MUCH greater. This includes: driving to appointments, hanging out in waiting rooms, the actual appointments, blood work, phone calls to doctors, getting lab results, a support group, picking up prescriptions, calling in refills, calling insurance and disability companies, dealing with social security, taking medication, managing my dry eyes/mouth, saline rinses, setting up/cleaning humidifier, and preparing medications and such for travel.

Seventeen hours.
Like I said, never bored.

I truly hope that this essay has shown that it is possible to have a life outside of a 9-5 job or raising a family. There is more than one way to define yourself as a person. I used to think that if I wasn’t a nurse or if that I wasn’t anyone’s wife or mother, that I could not be of value to this world. Although there are great values to being all of those things, there is also great value in being many other things as well.

A friend.
A mentor.
A daughter.
A dog mommy.
A godmother.
A writer.
A human being.

As people with disabilities, we may not always be able to get out into the world every day to define ourselves. We have physical, mental, and emotional limitations that we need to work around on a daily basis. Most of our days may just be spent trying to meet our physical needs. But I also think that it is important that we allow ourselves, as much as possible, the opportunity to spend some of that time doing something in our day that allows us to define ourselves.

Not just our sick selves.
But as our true authentic selves.

Photo Courtesy of Chuck Myers http://myerscreativephotography.zenfolio.com/

Diet and Exercise Update

“Take care of your body with steadfast fidelity. The soul must see through these eyes alone, and if they are dim, the whole world is clouded.” ~ Johann Wolfgang von Goethe

I realized this week that it has been six months since I made the drastic change to eliminate all gluten and dairy from my diet. Wow, six months! I think that is the longest I have ever stuck with a change in my eating habits. I can honestly now say that it is much easier than it was when I started back in January.

People ask me from time to time if I think that eliminating gluten and dairy from my diet has helped my autoimmune symptoms. It has not eliminated the symptoms but at this point, I feel that it has helped. On a few occasions I have intentionally eaten something with gluten or dairy in it and I have noticed a change for the worse either in my level of joint pain and/or in my asthma symptoms. In addition to that, I never have any gastrointestinal issues at all anymore and my menstrual cycle is much more tolerable.

I have become frustrated with this eating plan at times, most notably when I came off of my last round of steroids and my joint pain immediately came back. I sat and wondered why the heck I was making my life more challenging by eliminating gluten and dairy when I was still having joint pain. The point that I was missing at the time though was that the joint pain was not as severe.

One of the biggest advantages that I have found with living a gluten and dairy-free lifestyle is the changes it has forced me to make in my eating habits. Changes that have positively affected my health, weight, and overall well being. For example, I have to plan out and think about what I am going to eat. Gone are the days of impulsively shoving something in my mouth because I am either hungry or because I crave a particular food. The options available to me at fast food joints and restaurants are much fewer and therefore I am spending much more time at home cooking meals from scratch which means healthier meals.

Many people say that eating gluten or dairy-free, as well as organic, is much more expensive but I would have to disagree. Yes, my food bill is more each week but it does not compare to the amount of money I save by not swinging by Subway several times a week or eating dinner out more than once every other week. I have also found that unless it is a homemade food, gluten-free products such as bread, muffins, etc. tend to be much more unhealthy and filled with more preservatives than non-gluten products. This has resulted in eating these items once in a great while and instead I choose whole foods such as fruits, vegetables, lean meats, nuts, and whole grains.

The second big change I made in my diet was making the decision to start the Weight Watchers program. This has literally been a godsend for me. I have found the program to be much more “whole foods” friendly than it used to be and I enjoy the fact that in addition to going to weekly meetings, I can also use their online program which enables me to work the program from my laptop or cell phone. I have found a meeting I really enjoy on Tuesday afternoons. Adding a Weight Watchers program to my gluten and dairy-free lifestyle has been a challenge but well worth it. Since my birthday, which was May 3rd, I have lost eighteen pounds. If you add that to the weight I have gradually lost over the past three years, my body is now fifty-five pounds lighter. Oh yeah.

I continue to go to the gym anywhere from four to six days a week. Exercising has become a more difficult task since coming off prednisone and sometimes I just want to say “the hell with it” and quit. But I don’t. I am committed to changing my life and I cannot let joint pain, fatigue, and migraines get in the way of that. I have however changed some of my routine around and have cut back on the length of time I am exercising until I can get my symptoms more under control. I have started taking Pilates classes which was a big step for me and I am in love with it. Right now my exercise regime consists of Pilates, water aerobics, lap swimming, the cross trainer, and rowing. My goal is to be able to increase the time of my workouts and try some other different classes once my joint pain has improved.

I love to exercise. Shocking but true. For most of my life it has been a chore and something I dreaded doing; when I did do it. It is different now though. It is a necessity for me mentally as well as physically. I have worked hard to find activities that are not only safe for my joints but also fun. Despite the physical challenges that I still have, every week I find that my body is getting stronger. Every time I swim a lap in the pool of sit on the mat in a Pilates class, I feel like I have more control over the body that I have spent so much time cursing.

My hope is that as I continue to lose weight and build a stronger body that more of my autoimmune symptoms will lessen or even disappear. If not, I figure the worst that can happen is that my new lifestyle will help prevent future issues such as heart disease, diabetes, and cancer. Not to mention how much better I will feel about myself.

Works for me.

Photo Courtesy of Google Images

« Older posts Newer posts »