FAQs

Wednesday, August 15, 2007

Thoughts on Writing: Poet Kevin Young


Finding a middle ground: Writing is a necessity, you know. It's not just fun, though it can be fun, and it's not just torture, though it can be torture, too. I think the point is really to find that middle ground between pleasure and necessity, and for me that's what a poem is. --Kevin Young--

As I am sure you have all noticed I have been very 'blogger happy' lately. I find that I want to write and write and write. This is both a good and a bad thing, as I think Kevin Young stated so clearly.

I write even when I really 'should' be resting or trying to get to bed earlier than 3 am. I write when I feel really sick, but keep writing anyways. I write in bed sitting at my computer and certainly aggravating my neck pain more (Stupid, stupid, stupid!). I write when I 'should' be making telephone calls to doctor's offices, or emailing a friend, or calling a friend, or tackling the ever growing piles of papers around the house.

But somehow I cannot stop.

I did not anticipate when I recommitted to blogging that I would want to write so much. I didn't anticipate my subscribers would be in for so much reading!
REMEMBER: Read only the posts that interest you!

I have now added this new section, in addition to Weekend Lyrics, as a way to reflect on the process of writing. Today it is Kevin Young's thoughts.

As I enter this new journey of finding and using my voice again, I struggle to find the balance of which Kevin Young speaks. I write rather than email or call a friend. I am still learning. Please bear with me! At the end of a long day of making calls to doctor's offices or other 'business' calls, I find there is very little of 'me' left to give to others. I end up wanting to be alone with my writing, yet hoping that my writing will keep me connected to those I love.

At this point, writing and blogging is nourishing me spiritually, emotionally, creatively and intellectually in a way that I have not felt nourished in a very, very long time. And as my friends Carrie and Ariella have noted, it is a major sign of improvement that I am even able to write again. For so long I was too sick to even do the littlest amount of writing. I used to journal almost every day starting way back in high school.

When I lost the ability to write, journal, and send oodles of snail mail letters, I lost a part of me. I am finding 'me' again. I am finding my voice again. It brings me so much joy. I feel that I have been holding in these words for so long and they are finally able to spill out of me. It feels so good to write what is on my mind, rather than have the words spinning around in my head keeping me awake at night. It helps me purge the emotions I am dealing with. Now, I just need a few more hours in the day to write so that I won't have emails I need to write spinning around in my head. I literally write email responses and blog posts in my head when I am too sick to type! (The Gmail folks are pure genius--do you think they could come up with a system that reads what my brain wants to say and transcribes it for me? And then mails it to the person?)

I've lost so much of 'me' to this illness that being able to write again feels like finding 'me' again, finding a part of me that is not just illness. It is also an outlet that gives me a tangible finished product--unlike the ambiguous and intangible journey on which illness and relationships take us.

Thank you for reading, for cheering me on, and for encouraging me to find my voice again. I especially thank my mom, who quietly knew that I needed to begin writing again, but waited until my slow deliberate self said to her 'I think I need to write'. She breathed a sigh of relief and said, 'Yes.'

The bottom line is that ultimately I write for me: with the hope that my writing will impact others, move others, and connect me to others. But it's hard to strike the balance, especially with my limited energy, between writing or emailing a friend. Right now, my energy dictates that I must choose one or the other. Choosing writing feels selfish, especially after I've spent the whole day seemingly taking care of me--by making health calls and doctors calls, or just using my energy to get dressed, eat and take a bath. None of these 'selfish' things nourish me though. Writing does. So, somehow taking care of me in this new way for the first time in a long time feels really good. I'm trying to find the balance between feeling guilty (Oh, that Jewish guilt gets me every time!), taking care of others and taking care of me.

This is my new journey...

If you've figured out the balance between taking care of yourself and taking care of others and feeling guilt-free about it...PLEASE fill me in on the magic formula!


Kevin Young was interviewed on PBS during the News Hour with Jim Lehrer. I have included more of the text of the interview (a couple of his poems). One is on grief--which is so fitting for so many people I know. The other is on music and how he uses poetry as music. It reminds me of how important music is to me and so many others.

Enjoy!



This is "Redemption Song," a poem about personal grief but also about the transformative power of beauty and the healing power of time.


'Redemption Song'

Grief might be easy
if there wasn't still
such beauty--would be far
simpler if the silver
maple didn't thrust
its leaves into flame,
trusting that spring
will find it again.
All this might be easier if
there wasn't a song
still lifting us above it,
if wind didn't trouble
my mind like water.
I half expect to see you
fill the autumn air
like breath--
At night I sleep
on clenched fists.
Days I'm like the child
who on the playground
falls, crying
not so much from pain
as surprise.


I can't play any music, so I'm sure that's why I write about music, because I think it's a beautiful solace-producing thing. I think poetry, though, approaches music, and for me, the best poetry has its music in it. It's not behind it like a song where the lyrics are up front and the band is behind, but it's all mixed together.


'April in Paris'



This is taken from "April in Paris" a poem about seeing the jazz musician Lionel Hampton a few months before he died.


Playing the subtleties
of silence, Hampton traces,
like a government agency,
the vibes--quietly--
his wands a magic,
a makeshift. Arthritic solos
hover like a bee
above the flower, finding
the sweet center.
Two days before Easter, Monsieur
Hampton plays the changes,
offering up
songs read off
a napkin bruised with lyrics:
What did I do
to be so black and blue?
his voice wobbles
along the highway
called history,
flying home.
The sax player stops
between tunes to dab
a handkerchief at the drool
gathering his chin.
Such
care. The mind's blind
alleys we wander down.
This is enough, just--
This is Paris--




ALL text and quotes taken from the following link:

http://www.pbs.org/newshour/bb/entertainment/jan-june07/young_03-01.html

To listen to the interview with Kevin Young or to hear him read his poems (or to read the complete interview) please visit the website listed above.

Blessings,

Emily

Photo: Yes, another picture of a gladiola!

Monday, August 13, 2007

Making Patients Wait...

I have continued to have back and forth conversations with Dr. Pain's office, but today's conversation with a nurse reminded me of something that happens all too often in health care.

First here is a brief synopsis of the past week:

Last Wednesday (after my Saturday night page to Dr. Pain): I called the pain clinic to speak with a nurse. I received voicemail and did not get a call back.

Thursday: Received a call back from one of the nurses in the office (the only nice person in the office I fear!). I described my 'failed trial' of Neurontin, told her about the other medications my ANS specialist had recommended, asked if Dr. Pain would please contact my ANS specialist directly to discuss my case. She said he would be more than willing to do so. I gave her the phone number AND email address of my specialist (who, I am now getting tired of writing out ANS specialist, so I will call him Dr. ANS). I clearly stated that I knew Dr. Pain was leaving town on Monday (today) and needed to contact Dr. ANS by end of day Friday. I also clearly noted that Dr. ANS would be out of town the two weeks following Dr. Pain's vacation. Of course, Dr. Pain was not in the office on Thursday.

Friday: Received another call from Dr. Pain's office asking me to call. Also received an email from Dr. ANS stating that he was looking forward to speaking with Dr. Pain. Called Dr. Pain's office and was told he had prescribed Lyrica. I said, "Okay, good. Does that mean that he spoke with my specialist?" Nurse Pain (who is super rude--when I went in for my first appointment I politely asked how long the wait might be and she curtly replied: "It will be a while". I gently said, "What is a while? And she said, "It will be a while." Note: Patients have the right to ask how long a wait will be and to be seen in a timely manner (these 'rules' are even posted at my PCP's office!))

Back on track here: The nurse replied in response, "Was he supposed to contact your specialist?" I said, "Yes." She said, "Well it is not here." I tried to ask how he made the decision about the medication, dosing, etc. I explained that I was very frustrated that Dr. Pain had not contacted Dr. ANS. She said, "Well, I get frustrated too." Grrrrrr....I asked if there was a number that Dr. ANS could please call Dr. Pain at before day's end. She said, "Oh, no he's gone for the day." Remember: Dr. Pain is leaving for vacation Monday and did not call Dr. ANS! I ask also if we will be able to get this medication approved by MA and she grumps that she doesn't know and we won't know if we don't try will we? Because Dr. Pain uses this medication often (Lyrica is the new 'hot' pain med) and deals with MA frequently, I figured she should have an answer to this question.


Please note that most medical mistakes in this country are due to a break down in communication
. Dr. Pain made his own decision without calling Dr. ANS and Dr. Pain's nurses were not 'in the loop' as to what had transpired. When I emailed Dr. ANS about the Lyrica, he said that would be okay to try, but he did not agree with Dr. Pain's dosing choice. Of course I trust Dr. ANS and will follow his dosing schedule--but it gets a bit tricky trying to walk the tightrope between the two doctors, especially Dr. Pain who wants things his way!


Today: I call Dr. Pain's office and leave a message for the nurse. I cancel my appointment for next week (since I will not have started the new medication) and ask how long after I start the medication I should wait to schedule an appointment with Dr. Pain. I again repeat that he needs to call Dr. ANS before I come in for another visit (I really hope this will prevent some of his hostility!)

Nurse Pain tells me that she has called my MA Nurse Case Manager (Toni) and will fax her the dictation as soon as she has it available. I ask when that might be (because it should have been done when he prescribed this drug!). She says it will be at least a few days. I tried to pin her down and see if basically it would not be done until AFTER Dr. Pain returns from his trip. This means at least one week until he does the dictation, a couple of days for the transcription, time for Toni to type up a request for the MA Medical Director, and then however many days it will take to get an approval or denial (If denied...well, we don't even want to go there. Please pray on this one!). She curtly says maybe Dr. Pain dictated before he left for his trip but she just hasn't received the transcription yet. But, she did not know.

The point of this story (yes, there really is one) is that patients spend so much time waiting.

What I felt at the end of the day was deflated and frustrated because I felt that MY pain didn't matter. That waiting a few more weeks for a medication doesn't really matter. That my life and quality of life aren't that important.

So many times we, as patients, hear: "Come back in six months and we'll see if you're any better. Then, maybe we'll do some testing." or "Try this and come back in three months." There is no sense of urgency. No sense that the passing of time and the waiting make the patient feel that their pain, their suffering matter. This is literally how I spent the first 6 years of my illness until I met Dr. ANS.

I really feel that Dr. Pain should have taken care of the dictation BEFORE he left for his trip. He should have called Dr. ANS. I realize he is busy, but I don't believe you go on vacation and leave a patient hanging. He prescribed the drug, but I can't GET the drug because he didn't do his job.

I am in the midst of watching (in small parts) a series that was on PBS last fall called Remaking American Medicine. It is FANTASTIC. First, it sheds light on what is so very wrong with our health care system, yet it gives us hope that we can change it. I do believe that we have the best doctors in the world and the best tools in the world in America. But we do not have access to them. And doctors and patients are in crisis. I fear the system will fail us completely before it changes for the better. The episode on Johns Hopkins is especially moving--and I may have just found my new passion in health care!

In the current episode I am watching called 'Do No Harm' one of the interviewees comments that there is no other place or situation in life in which we lose as much control or authority of our own lives as we do when we step into a doctor's office or a hospital. Right on!

Tonight I'm having a great deal of pain. We had the blessing of company for dinner (a neighbor whom I adore) for the first time in ages and pain 'got me' by the end. And I just keep thinking, how am I going to make it to NY in September without a medication? I also keep feeling like why doesn't my pain matter? Why isn't it worth treating NOW rather than in a few weeks or whenever he gets around to it? If Dr. ANS was able to do it (but he can't because of MA rules) the prescription would have been called in immediately and the dictation done. He would have called MA himself.

Making patients wait...

It makes us feel devalued and as if the fact that we are sick doesn't matter.

Please note that my PCP, Dr. ANS. and Lyme Doctor (Dr. Lyme--how's that?) NEVER devalue me. They never take away my power. They trust me. They consult me. Dr. ANS says I wait out medications too long rather than letting him know. Why do I do this? Because before him, no one ever cared. We would call and they would say, "Keep waiting it out" or we would get NO call back. I am so blessed by these doctors. I do not want to say that ALL doctors are like Dr. Pain, but unfortunately, in my experience MOST are.

It's hard not to wonder where I might be now health-wise had I found Dr. ANS years earlier. Maybe we would have discovered the Lyme long before I got so sick and before it caused so much neurological damage. I don't ask a lot of 'what ifs' and most days I don't ask 'what if'--this is the path that I have been given and I am grateful that I have Dr. ANS now.


Most, if not all, of my friends from DINET are not as fortunate as I am when it comes to medical care. I'm one of the lucky ones. It is so disheartening to know that I have something that they can't get and don't have. Complaining about Dr. Pain seems like making a mountain out of a molehill compared to what I've been through in the past and compared to what my friends go through. Still, I think it is so important use what is happening with Dr. Pain as a microcosm of what is happening on a much, much larger scale day in and day out to patients.


I want my life, my pain, my well-being to matter. I hope more doctors learn to 'get it right' like my PCP, Dr. ANS and Dr. Lyme soon.

Is this too much to ask?

Blessings,

Emily

Saturday, August 11, 2007

Weekend Lyrics: Rain

Rain
by Patty Griffin



It's hard to listen to a hard, hard heart


Beating close to mine


Pounding up against the stone and steel


Walls that I won't climb


Sometimes a hurt is so deep, deep, deep


You think that you're gonna drown


Sometimes all you can do is weep, weep, weep


With all this rain falling down


Strange how hard it rains now


Rows and rows of big dark clouds


But I'm holding on underneath this shroud


Rain



It's hard to know when to give up the fight


The things you wanted that will never be right


It's never rained like it had tonight before


I don't want to beg you baby


For something maybe you could never give


I'm not looking for the rest of your life


I just want another chance to live



Strange how hard it rains now. . .





Why I chose these Lyrics: Sarah and Bob first introduced me to this song by Patty Griffin on a mix CD they made for me. The CD came during a time of great emotional, spiritual and physical struggle. Sarah and Bob went through all of their CDs to choose songs they thought I might like, and Bob topped off the mix CD with a gorgeous label and case decorated in butterflies. I have played 'Sarah and Bob's Butterfly Mix' over and over again--but this song and this artist quickly became my absolute favorite. In those days when tears flowed, I would play this song over and over and over again. I continuously find comfort in Patty's music.



I chose this song before I knew this was going to be a 'rainy' week--emotionally, physically, and literally! We finally got some much needed rain in the form of fabulous thunderstorms. When I picked it I also did not think about the coincidence that Friday was Sarah's birthday and she and Bob were ultimately responsible for introducing me to this artist. Nor did I realize how exhausted I would be at the end of the week from fighting the medical system. Still, even though it's not nearly as 'rainy' as it has been before, I wanted to use this song as my introduction to this artist that I love so much. I didn't know, in life, how hard it was going to rain for me or for my parents or for my friends (Jeannine and Melissa this one's for you girls!) I'm not naive, and I never EVER thought life is easy for ANYONE. Still, I didn't know the dark times to come or how deeply such lyrics would speak to me in those times.



I now own three Patty Griffin CDs and am, of course, convinced that I need all the rest of her CDs! I chose 'Rain' because it was the first song I ever heard by her, because it has the power to speak my sadness in difficult times, and because ultimately, 'Rain' is the song that made me fall in love with Patty Griffin.



Patty's voice is: Raw. Rich. Robust. Real. Powerful. She harnesses her powerful voice to create gorgeous melancholy, mellow and fluid melodies that flow from her mouth. The clarity and fluidity of her voice stand on their own; she needs no 'loud background' noise to cover-up for a voice that might be lacking in some aspect. It is Patty's voice that I love so much. And, on a rainy day her melancholy lyrics comfort the soul. A friend challenged her to write a 'happy' song on her latest CD but even her other lyrics, while speaking of pain and heartache, manage to remind me that we do and can endure.



We may feel that it has never rained this hard before--and Patty gives us permission to weep, but she also reminds us that we will hold on underneath this shroud.



Blessings,



Emily


Photos: My beloved gladiolas! They've been sparse this year, so I think next year it is time for new bulbs! I have a special affinity for this patch of gladiolas in our yard because for a time, I was able (with LOTS of help from my mom) to manage a small flower patch. Gladiolas were the first flowers I planted, and I absolutely fell in love with them. They remind me that maybe someday again I will be able to plant a little flower patch. And, of course, they are PINK!

Wednesday, August 08, 2007

Part II: Crash, Boom, Boom!


"Wow Em! You look green!"

--Jeannine, my best friend since 7Th grade, remarking on how I looked last Thursday when I was 'crashing'--


"Well, I've seen you pale recently, but it's been a long time since I saw you looking a different COLOR!"

--Jeannine, commenting Wednesday evening on how I looked last week--



Well, for some reason Feedburner has been a bit tempermental. The post I most wanted to go out recently letting folks know I was down for the count, did not got out to subscribers. Sooo, you'll have to go to my blog itself to read Part I of Crash, Boom, Boom!


Warning: Part II of Crash, Boom, Boom! which follows is definitely a rant. I'm frustrated, tired, worn down and just plain grumpy. However, the post is worth a read if you want to know the answers to such burning questions as: What does my neck pain feel like? Why is being chronically ill a full-time job? Why do we need a serious makeover of our health care system? And, a question I cannot answer, why are some doctors so hateful? (This is NOT a new question for me--I'm not sure why it even surprises me anymore when I am treated so miserably).


We DID since then figure out the cause of my 'crash'. Turns out it was the Neurontin--the medication I was trying for neuropathic pain. Since stopping the medication we are now certain is was making me worse. Oddly, my pain is better off of the medication than it was on it! I'm still feeling pretty miserable, but I'm not nearly as sick as I was and I was able to visit with my Uncle on Monday and Tuesday--just in much more limited time slots than I would have liked.


What makes it so hard to discern what is causing what with me is that I have basically the same reaction to everything. If I do not tolerate a medication or treatment, I have the same constellation of symptoms--basically an ANS storm and a lot of looking green! So, it really doesn't matter WHAT the side effects are supposed to be for the 'normal' population, I will most likely react with and ANS system going nuts, as I did this time around. It's also hard because we never quite know when the medication will build up in my system enough to create a reaction--this time it was about three weeks, which makes sense for a drug like Neurontin, which takes about a month to know whether it is working or not.


I give my mom all the credit this time for her 'mother's intuition' in solving the puzzle. By Friday of last week I was so sick and pale (your choice of color--gray according to my mom, green according to Jeannine), that it seemed unlikely it was the antibiotics, as I had not increased my dosage.


I put in a last minute email to my ANS specialist hoping to catch him Friday evening before he left the office (he often emails around 6:30), but quickly got an out-of-office reply. Just my luck!


I opted, on Friday night, not to take the Neurontin.


I was up all night until 5 am, feeling agitated, anxious, jittery and could not sleep. It was as if I was having some sort of withdrawal symptoms. I knew to wean off of this medication to avoid a risk of seizures, but I was taking the lowest dose possible. So weaning, in effect, meant going to a dosing schedule of every other day for a few days.


I was so relieved on Saturday afternoon when I woke up and logged on to my computer only to hear the familiar Gmail 'beep' signifying a new email from none other than my wonderful ANS doctor. He happened to be back from his trip and on email--thanks be to God.


He said based on my response to the Neurontin I should definitely stop it, and could most likely stop it abruptly with no problems.


I emailed him back, hoping he might be on email later that day to tell him what had happened to me off of the drug (a call into the pharmacist suggested that my symptoms were possibly withdrawal so I needed guidance on whether or not to take the medication every other day instead of stopping abruptly). I also left him a voicemail, hoping he would call. I DID NOT want to have to page him, as he was NOT the prescribing doctor for this medication.


As Saturday progressed we felt more and more uncertain as to whether or not I should take the Neurontin or not. I was super sick on the medication and very sick going off of it. What was the best strategy? Stop it and get it over with? Or take another dose every other day and keep some in my system? I leaned towards just getting it out of my system, but dreaded another night like the previous one.


I did not hear back from my specialist, and at Mom's suggestion paged the local pain clinic and doctor who had prescribed the drug.


The following enraging discussion ensued:


Doctor: "Yes?"


Me: A quick description of the reaction to the medication, the suggestion of my specialist to stop it, and my question regarding what to do about stopping the medication considering the withdrawal effects.


Doctor: (YELLING) "If you want to talk to me about Neurontin, do not call me on a Saturday evening. If you want to talk to me about Neurontin, call my office on Monday. Do not call me on a Saturday evening."


Me: "But, I need to get off of this medication because it is making me sick, but I am having withdrawal effects."


Doctor: "How much Neurontin you taking?" (He is not American, speaks broken English and is often very difficult to understand).


Me: 100 mg


Doctor: (YELLING) "That is not possible. Absolutely not possible to have withdrawal at that low of a dose. Absolutely zero percent chance of that happening. Not possible."


Me: "Then what should I do about dosing?"


Doctor: "Do you still have Neurontin left?"


Me: "Yes"


Doctor: "Well, then keep taking it."


Me: "But I need to stop it. It's making me sick. I need to know how to stop it and go off of it."


Doctor: "Just stop it then. OKAY??"


Me: (having given up at this point) "Okay."


Doctor: "Okay then."


Me: "I did not call to get yelled at." (I said this very calmly!)


Doctor: "Have a good evening."


Total phone time: 2 minutes


Did he ever think that I wouldn't call on a Saturday evening unless I felt absolutely desperate? Did he ever think that HE prescribed this medication so it is HIS job to help me if I am reacting to it? How was I supposed to have a good evening when I felt so sick? And, when did it become okay to yell at patients? Did he remember that HE chose to be a doctor in a town where he would be on call? He could have stayed in Texas in a big hospital where he wouldn't have had to take as many weekend calls.


I am one of the first people to say that I have empathy for people on all sides of the health care world--the caregivers, the doctors, the patients, the nurses, etc. Doctors and nurses are overworked and overtired. They are stuck in horrible binds with the insurance companies. Being a patient is hard work too. But, there are lines. There are boundaries that should not be crossed. Yelling at a patient is one of those.


What happened, oh what happened, to the Hippocratic oath?


This call follows an absolutely horrible first visit with this pain specialist. However, I'm caught in a bind--he is the only pain specialist in town who works with neuropathic pain AND my ANS specialist cannot prescribe any medications that need pre-authorization from MA because I have not seen him in the past year. My ANS specialist knows my case inside and out, and in the end, he always seems to know what is best for me--but I'm stuck trying to see a doctor locally to go through the hoops of MA.


On Sunday, my ANS specialist emailed me regarding my phone call and email to him on Saturday. His email popped up just as I was on the computer, so I said, "I'm online, will write right back!" He wrote: "I'm surprised that you are reacting to such a small dose, but I guess I shouldn't be, as that has been a consistent pattern for you before. I would agree that these side effects sound like withdrawal symptoms." It made me laugh in a difficult time. Note: He said my symptoms certainly fit those of withdrawal. We then discussed the next possible options in drug treatment.


Somehow, I feel like he always picks up the slack. He's always the one who has to pick up the pieces that the other doctors don't want to deal with. He does it with such humility and grace (and humor), never seeming bothered. It's as if he's resigned to knowing that most doctors won't deal with difficult cases or cases that don't fit in their 'boxes'. I feel guilty, but I think somehow he has accepted that this is part of treating patients like me--the kind who NEVER have things 'go as expected'. He will now monitor whatever drug I am prescribed. This means, as he says, I may NOT start it until he is back from his summer vacation so that I am not stuck in a situation where I cannot be in contact with him! This is an ongoing joke between us--he will write, "I will be out of the office such and such dates so I do not want you starting any new medications while I am away."


For the past few weeks, I've been feeling like I'm drowning in this MA frustration. It's eating at me.


Today, I spent the entire day of my 'awake' time calling the pain clinic (no call returned), the pharmacist (angel pharmacist out of town), and my MA nurse case working trying to find the answer to what should be a simple question: Are Trileptal or Lyrica covered by MA? If so, what are the pre-authorization requirements? It was me who told the MA nurse that Lyrica is covered only if you 'fail' at Neurontin.


Why isn't this information readily available, especially to the nurses who work for MA?


So, I ended the day with no answers and more frustration. The Ambien ordeal is on hold for now because I must recuperate from this medication and find a new one to try before we travel to NY for my Lyme appointment in late September.



And if you're actually still reading this rant, I might as well finish my story, eh? The first visit with the pain doctor--a pain in the toosh!


At my first visit I spent 3 hours waiting to see him for 20 minutes. I spent quite a bit of time with a nurse and provided her with documentation of my underlying conditions and a bulleted list (as suggested by my ANS doctor) of how moving my neck creates pain and what symptoms follow (i.e. pounding heart, sweating, dizziness, etc.).


Usually, I go into appointments alone but since I had been waiting for hours, the nurse offered to bring my mom back to keep me company. I am glad that she was there to witness the appointment because sometimes I lose sight of how I was treated or take things too personally. Later, after I told my ANS specialist about the appointment he joked that it was just too bad I was so intimidating in person! Ha!


Immediately the doctor--whom I will call Dr. Pain--came into the room talking very loudly and saying (in reference to the information I had brought him on my underlying conditions), "I do not know anything about these illnesses. I do not know about Chronic Fatigue Syndrome or Orthostatic Intolerance. I can only treat your pain. Do you understand? I can't treat your other illnesses. I can only treat your pain. Do you understand?"


After he said this several times my mom, who NEVER asserts herself to a doctor said, "Yes, we do. We're intelligent. We understand." My jaw about hit the floor.


Dr. Pain says, "Okay good. Because people come in and expect us doctors to have the answers to everything."


Now it was my turn to assert myself. I said, "I don't expect you to have the answers to everything. I'm just asking you to treat my pain."


Dr. Pain: "Good."


Me: "But some doctors also think that they DO have all of the answers."


Dr. Pain: "Oh not me. I don't have a big ego. I was born with a small ego."


And he so clearly demonstrated this on Saturday evening when I paged him, didn't he?


During the appointment he did not let me get a word in edgewise, he did not let me explain my pain or look at my bulleted list. He did not examine me. At the end of the appointment he just said, okay, I'll give you Neurontin 100 mg a day and walked out.


I had NO idea why he picked Neurontin, why he labeled my pain as neuropathic, what side effects to expect, how long the drug would take to begin working, etc.


Luckily the following week I had an appointment with my PCP who then examined me and discussed my pain and how it might be neuropathic pain. For example, I have been having pain in my elbows when I bend them across my belly or chest to fall asleep, and then they go numb. Dr. Pain did not let me explain this symptom. My PCP, on the other hand, examined me for ulmer nerve problems, carpel tunnel, etc. and when I showed no signs of those, suspected the pain was originating in my neck. I also have a lot of pulling and throbbing sensations, rather than pain which I can describe as shooting or sharp or dull or achey.


The major issue is finding something to inhibit the ANS responses I have to moving or using my neck. For example, I cannot lie on my side and rest because there is so much 'pull' in my neck that my heart begins to pound, and the vicious cycle of pain and ANS symptoms takes off. Oh how I envy my friends--when I watch them curl up in bed and feel comfortable or when I watch someone type at a computer or watch TV without it causing a barrage of symptoms. And what would it feel like to sit down in a chair without a zillion pillows propping me up in a precise position that does not create too much 'pull' on my neck?? What would it feel like not to rely on ice packs and heat and Ben Gay in addition to my Lidocaine patches? I would very much like a super-sized lidocaine patch as they do work wonders, but just not even close to enough! I wonder, I hope, I dream that I will know what it feels like to be in less pain.


Blessings to you if you've made it through these mixed up ramblings. On my part, I'm promising to be less of a Miss Grumbolina next time I post!


Emily



Photo: I thought a picture of Kermit the Frog was fitting based on Jeannine's comment. Anyways, ever since my gallbladder surgery the term 'you look green' has come up a lot, especially before my gallbladder was removed and I really did look green. I became known as 'the green girl' on DINET and then later 'the girl formerly known as green'. Unfortunately, I still turn green sometimes!

Friday, August 03, 2007

Weekend Lyrics: Mi Shebeirach



Mi Shebeirach

Music by Debbie Friedman
Lyrics by Debbie Friedman and Droroah Setel


Mi She-bei-rach a-vo-tei-nu
M'kor ha-bra-cha l'i-mo-tei-nu,
May the source of strength
Who blessed the ones before us,
Help us find the courage
To make our lives a blessing,
And let us say, Amen.


Mi she-bei-rach i-mo-tei-nu
M'kor ha-bra-cha l'a-vo-tei-nu,
Bless those in need of healing
With r'fu-a sh'lei-ma,
The renewal of body,
The renewal of spirit,
And let us say, Amen.



Why I chose these Lyrics: Debbie Friedman's album, Renewal of Spirit, is dedicated completely to songs of healing. Debbie herself suffers from a debilitating mystery chronic illness, so her songs resonate from her own experience and her own heart and soul. Mi Shebeirach is perhaps her most famous or most commonly heard song, especially in reference to healing.


I actually chose this song before I knew I was 'crashing'--and it has, in fact, turned out to be a perfect choice given how I am feeling.


While I love this song, it is not my absolute favorite; it would be hard to choose a favorite though. Over time I am certain that I will share more of her lyrics with you because this particular album has been played over and over and over again, comforting me through some very difficult times.


I am always searching for Jewish music--which is certainly difficult to find! I particularly love Debbie's music for two reasons: 1. her lyrics speak to me profoundly, and 2. she sings in both Hebrew and English (While music sung exclusively in Hebrew is glorious and gorgeous to listen to, I do appreciate understanding what is being said! I do have a life goal of learning Hebrew, but I think that is a ways away!)


Particularly moving to me in this song is her reference to gaining strength and courage from our ancestors, her Biblical reference to "...and you shall be a blessing" from Genesis (she has another album titled You Shall Be a Blessing), and her blessing for all of those in need of healing. What an important reminder to give ourselves each day: To be a blessing.

Shalom,


Emily


Photos: Lillies in our yard. Photo of Debbie Friedman taken from http://www.debbiefriedman.com/.

Thursday, August 02, 2007

Poem: Hope and Love



Hope and Love

by Jane Hirshfield
from the book "The Lives of the Heart"

All winter
the blue heron
slept among the horses.
I do not know
the custom of herons,
do not know
if solitary habit
is their way,
or if he listened for
some missing one--
not knowing even
that was what he did--
in the blowing
sounds of the dark.
I know that
hope is the hardest
love we carry
:
He slept
with with his long neck
folded, like a letter
put away
.


This is the poem in full that I spoke of in my earlier post. Thank you to Lauren on DINET for introducing this poem to me. I admit, I rarely 'get' poetry, but I do love this poem. And the image of the heron sleeping with his neck folded and put away reminds me a bit of my journey as a 'tortoise'--and how a tortoise pulls its neck into its shell to rest and hibernate

Photo: Mom just purchased this photo at a recent arts festival. It arrived in the mail yesterday and it is GORGEOUS. It's hard to do it justice on the blog! I also thought it fit well with this poem.


The Lone Sentinal: Lake Huron Shoreline, Tawas Point, Michigan
.

Following is the artist's description of the photo: After searching for a single symmetrical tree to photograph, I came upon this tree and an empty bench along the Lake Huron shoreline. It was such an inviting scene, I knew I had found what I had been looking for - or, so I thought. As I was facing east preparing to shoot, I noticed exceptional skies approaching from the west. The lighting and subsequent cloudscape transcended what I had envisioned; so, I waited there until a complete west-to-east shift in the horizon occurred. After several hours, the drama began to unfold and this image became the bonus that sometimes occurs when one is patient. --Howard J. Blichfeldt--

Blessings,

Emily




Crash, Boom, Boom!

"Hope is the hardest love we carry..."
--excerpted from a poem by Jane Hirshfield--
Okay, so I have 'officially' crashed. I guess I'm long overdue for a crash, but that never seems to make it easier.

I've been very blessed this summer with mild crashes in between 'windows' of feeling 'better' (better being relative). For the most part, the crashes have been predictable, following my antibiotic schedule or visitors.

With this crash, I'm not sure what has precipitated it. And sometimes there is very little purpose in asking "Why?" But, it's hard not to.

This time around I can't tell if it is 1. A typical herx from the antibiotics, 2. The new pain medication I started--Neurontin, 3. Just my body saying stop and rest after a very busy summer, or 4. A combination of one or more of the above!


I always know the crashes will come, but I never know when they will come, how fiercely they will come, or how long they will last. And somehow, they NEVER get easier. I haven't figured this out yet! I know they will come, I know they will pass, but I still get blindsided and emotionally overwhelmed every time.

So, I've done my fair share of whining, as usual. (Yes, I seem to be having a bit of a pity party for myself--not sure why! Time to alert Whine-1-1 (a term coined by a fellow DINET member))And I'll spend the time making myself as comfortable as possible (hard to do when I feel like I am going to pass out, my heart is pounding, I'm sweating up a storm, I have chest pain, every muscle in my body aches, etc. etc. and so on! And all I want to do is sleep, but my body doesn't want to!).

I'll cuddle with my Asher Dasher, my new teddy bear, Slumbers (from Miss Alexandra and family), listen to soothing music on my iPod, and maybe some of a fun children's book on tape.

I'm hoping this will pass in the next few days, as my uncle is coming for a visit on Monday and I am so excited to see him that I want to feel a bit perkier! I haven't seen him in five years. I always hope I'm getting the crash out of my system before company comes and then I will feel good when they are here. This has been working so far this summer! It reminds me of the 'bad dress rehearsal, good performance' phrase for some reason.

Thankfully, I do have my blog in place now to help especially during times when I can't be in touch.

I've got so many of you to catch up with on email...please remember that my lack of response is not because I don't care or because you are not in my thoughts. I hate so much that I can't write the emails I'm lying here writing to each of you in my head! Too bad my gmail can't just read my mind and type it out for me! Haha!

Aaaaaah, and I thought I was sorta kinda catching up on my to-do list and tackling, bit by bit, my inbox. Grrrrrrrr.............

So, until this crash is over I will:

Retreat.
Hibernate.
Rest.
Wait patiently.

Blessings,

Emily

Photo: Slumbers--my new teddy bear from Alexandra and family. His arrival seems to have been just in time!

Poem: Introduced to me by a fellow DINET member also suffering from chronic Lyme.