Dear Medical Professionals

I want you to know your dedication, passion, and intelligence doesn’t go unnoticed. As a disabled young adult with complex conditions, I have had more interaction with you than my peers, my parents, and their parents. My life has been saved by you and your peers countless times and your knowledge, compassion, and care has given me the opportunity for a life outside of the hospital. For that and many other reasons I am grateful. In the many hours of I have spent interacting with all of you, I feel as though I get to know many of you well. From that, as well as my experience working in the medical field, I write to you this post in hopes that you hear me, the me that is uneffected by my social anxiety, acute medical condition, or time. I hope that some perspective is gained from this but at the very least I hope you read it and know that I am still here with the same appreciation for who you are and what you do.

I have several complex medical conditions, many which lack education and understanding within the medical community and some which are vague/hidden enough that by their clinical presentation could be any number of things. I have issues that present “atypically” “weird” or “just don’t fit” with the models you were trained on. It is very annoying by the way. I have been misdiagnosed, mistreated, and misinterpreted more times than I can count. (For a great article on that, read this!) I am thankful that over time, more knowledge and direction has come my way and we now have a decent understanding of what is “wrong” with me (though of course there are still plenty of mysteries). Due to my experiences, I struggle in how to approach new providers. Yes, I have anxiety but this is more than that. Ultimately, with each new interaction the thought that runs through my head, and many of my chronically ill friend’s heads, is how do I need to act/present things to be taken seriously but not be flagged as crazy, too knowledgable (yes, unfortunately thats a thing), or disrespectful of the professionals knowledge/training. Interacting with you comes in two forms for me, voluntary or involuntary (emergency situations) but both come automatically come with the same calculations.

How do I explain that my dystonia might not look like primary dystonia, because it’s not, but is caused by mast cell activation in the brain possibly tied with my connective tissue disorder also maybe my autonomic dysfunction and we can’t really test any of those to confirm them but this is not a new problem and from many months of trial and error we have found that treating it with xyz is most effective even though that contradicts the treatment for primary dystonia but yes, I know this its just not primary dystonia and I can’t prove it and I can’t show it to you but I have world renowned specialists helping me navigate this impossible situation and I don’t want it to seem like I am trying to undermine your knowledge and experience as a doctor but also know that it is likely your training and experience didn’t cover this because the human body is so complex and more and more diseases and processes are being discovered every day so how on earth could we train humans to know all that and be able to draw upon it at a moments notice in order to treat a patient quickly, safely and effectively?

In my mind, I try to judge who is open to the fact that they can be a great doctor and not know everything and that, in cases where people have weird, rare, or complex issues, your knowledge base might not cover what is needed to help that person and that is okay. I try and judge who might see my medical knowledge from starting nursing school, working in the medical field in many settings, managing my conditions, and just an interest as something negative or as a red flag for attention seeking, faking, or crazy. I try and judge if they might be able to see me beyond what I look like in that moment. I try and judge who might be having a bad day so that I can modulate myself as much as possible to make that day less bad. I try and judge who might get my sarcastic, dark sense of humor and who I need to be literal with. I try and judge how you will react when you get a test result back that is normal, even though things are clearly not normal. I try and judge who is reading this and thinking man, she is super anxious (yes, yes I am) or man, which doctor screwed her over that gave her this chip on her shoulder. It may suprise you that who I am today and how I approach this has been shaped by hundreds of experiences — good and bad — over more than 10 years of being sick.

I want you to know that I understand what its like to be in a stressful job where there are patterns to patient behavior. There are frequent flyers, red flags, abusers of the system. I can’t imagine how hard it would be to, especially in a setting like a emergency department, parse out who the abusers are and who aren’t. I know, especially if you’ve read this far, you care about your patients and do not want to do harm. I know the pressure to make the right decision is high and that is really hard. I hope that by sharing some of the things I got through, often before I even see you, it may help you understand patients like me.

-Your chronically ill patient

Home Accessibility: Wheelchair User/ Physical Disability

Hands down the WORST thing about being a wheelchair user is inaccessibility. Not only is it a struggle to navigate public places but also my home. I currently live with my wonderful mother in a two story standalone home with a sunken room leading to an attached garage on top of a rather steep hill. None of the entry doors to my home had level access, although when we brought the house and renovated, we did widen some doorways incase I needed to use my wheelchair- good thinking eh? When I was discharged from the hospital in November there were 0 modifications. We had to put a hospital bed in our living room as I was not able to get up and down the steps and we put tension rods and curtains across the doorways as they had no doors. But all we had on the first floor was a powder room bathroom which was too small for my wheelchair. Additionally, to get out of the house I would have to roll to the den, which is sunken, transfer to the floor and bump my wheelchair down then crawl to the garge door, bump my chair down another three steps then scoot down those and into my chair.

Goal One: A Ramp

Ramp with wooden extension to lower grade ft. my awesome koala PJS

We started by trying to solve the ingress/egress issue by building a ramp. We had a few options but ultimately decided to put it in the garage because it 1) had the least number of steps 2) had the lowest rise and 3) was weather protected. I am blessed to have some handy people in my family but if you don’t, there is often a charitable organization in the area that builds them using volunteers. I would recommend calling a building supply store near you and ask if they know of anyone if online searches are not fruitful. What we ended up doing was building a 4 ft x 4 ft platform at the interior door level, then buying a pre-fab 10 ft metal ramp with grab rails on craigslist. To decrease the slope some more, we also built a small extra wedge to extend the ramp another 2 ft. My father also got stair stringers and built stairs off the other side of the platform for the bipedal members of my family. The metal ramp has worked great, it is easy to clean and durable and the handles allow me to pull myself up smoothly since it is steeper than ADA and I have a manual wheelchair. The one downside is it is rather noisy but that seems inevitable. We also added some industrial carpet squares to the platform and the wooden wedge to help dry my wheels, protect the wood, look snazzy and make it quieter.

Goal Two: Upstairs!

My Everest. For several weeks, anytime I needed to bathe, I would have to bum shuffle my way up the stairs, scoot my way into my moms bathroom, get all nice and clean then bum shuffle in my fresh new clothes back down the hallway and downstairs. As a night showerer, this was often the straw that broke my back energy and frustration wise. Between that and getting sick of my frivingroom status, we started looking at options to get me upstairs. Being a rock climber and maker I was thinking I could rig up this ridiculous system but sadly there were some design flaws. But seriously, there was really only two options: elevator or stair lift. Elevators are EXTRAORDINARILY expensive and especially since we weren’t planning on me living here til the end of time, a stair lift was really the only feasible option. Luckily, we have an amazing company locally that does everything from adapted cars to stairlifts to ramps so we were able to go try one out in their showroom. I channeled my best Carl Fredrickson.

We found out that stairlifts are typically $3-5,000 and are NOT covered by insurance. Boo. Thankfully I am privileged enough to be able to make it happen and so we got the stairlift installed the next week. We already had extra wide stairs which was beneficial for those pesky bipedal inhabitants so that wasn’t an issue for us. The track sits on top of the stairs (drilled in) and the chair runs up and down it and is controlled by either a remote or a little switch on the armrest. The chair also swivels when at the top and bottom to allow for easier transfers. Additionally, it folds up flatter so it doesn’t get in the way when not in use. It has a seatbelt that I totally use every time cause safety first? The model I have also has these bumpers on the footplate and the base that will stop the chair if it makes contact (ie toy left on the stairs in the way etc). It isn’t super fast (52 seconds to go 14 steps) but it’s fairly quiet and reliable. It plugs into the wall but has a battery that can make (at least) 2 trips if the power goes out. It may also be theorhetically of course very nice for carying up laundry or suitcases, I wouldn’t know anything about that though. This little bugger allows me to sleep in my bed, bathe myself, access my stuff, and navigate my entire house independently. It ain’t pretty but its absolutely worth it!

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Goal Three: Ditch the Hospital Bed

Adjustable bed frame with remote

Due to the nature of my disabilities and the limitations of my house at the time of my discharge, we had to rent a hospital bed for a couple months so I had a safe place to sleep while we made adaptations. While that did its job, I missed my bed and my door and all my decorations but even with the stairlift, my old bed wouldn’t be safe for me. I needed to be able to adjust my bed and feet to various positions at various times and I needed to make sure I didn’t fall out of bed. One of my wonderful friends suggested getting an adjustable bed frame which meant I could keep the mattress I already had (many mattresses are compatible with adjustable beds but not all- check before you buy!). So I got to researching and found that most queen size adjustable frames range from $200-$2000. After weighing my options and reading reviews, I decided on a frame by Blissful Nights as it was on sale and met my requirements. I could not be more pleased! This bed has changed my life!

Bed rail

This bed had lots of extra features I don’t use but the ability to adjust the head and feet so easily and whenever I needed it has really been a game changer. Gone are the days of 56 pillows being shoved in different orders and pillow wedges that are never comfortable! If I have to spend the day in bed, I can sit up and be support and change angles every few hours to shake things up. I have finally found a way to sleep inclined without messing up my hips and spine! As for the not falling out of bed deal, I solved this with a 3 part solution. 1) I keep my bed against the wall so that eliminated a whole side I don’t have to worry about. 2) I have this wonderful creation called a Yogibo Caterpillar Roll which is like a long beanbag snake thing/pregnancy pillow that can be used as support, a snuggle buddy, or in my case to keep me from punching the wall or rolling on the bed — bonus it is super cute! 3) I have a small rail/organizer that helps me transfer, prevents me from rolling off the bed and stores all my stuff.

Goal Four: Upstairs Mobility

Wheelchair I use upstairs

Now that I have access to both floors and use them on the regular, a new problem came to — getting around upstairs when my wheelchair was downstairs. I had been scooting around for a while and while I am fairly mobile, I’m also fairly accident prone and was doing more damage to my legs than I thought. I don’t have a large house so there really wasn’t much ground to cover upstairs so we tried to find a cheep solution: office chair and a bunch of grab bars (vetoed), scooter like in kids gym class (vetoed), lawn chair with some wheels (vetoed), and second hand wheelchair (vetoed due to mast cells). What we finally ended up doing was getting a basic hospital type wheelchair that I only use upstairs until I get my next chair through insurance then my current chair will be my upstairs chair. I decided to go with this chair as it was light enough for me to push and I was able to strip off the footrests to decrease my turning radius. I also removed the armrests and part of the backrest. It is small enought to get me around and wasn’t too expensive. So far it has held up decently.

Everything Else

These are the major changes we have made to make this house accessible but are just a few of the many modifications and adaptations I use every day. Stay tuned for some of the hacks, devices and strategies I use to make my day easier!

It’s 2020 Y’all

Wow it has been a hot minute since I posted, writers block merged to flare which merged to a new job which merged into the worst flare yet which brings us to the land of rehab and falling through cracks because you’re diagnosed with weird illnesses. One of the things that can be extraordinarily tricky to navigate when you have rare/non big name disorders is the fact that you often don’t fall into a particular category, track, or program that will help you when you need it.

While some of my conditions have established organizations, few to none are large enough or have enough resources to help patients directly to navigate the system and you’re unlikely to be flagged by a hospital or government organization as qualifying for certain services/help. For example, many people who go from ambulatory to full time wheelchair user are those with spinal cord injuries. Starting a few days after your injury you are connected with case managers, support groups, rehab options, durable medical equipment suppliers, OTs, PTs, ATPs, organizations, and more. There are programs dedicated to these types of injuries which experienced professionals, community-based supports, and even charitable organizations (which is fantastic!). Similar types of “tracks” can be found for traumatic brain injuries, MS, ALS, cerebral palsy, strokes, memory loss, amputation, and more.

“I don’t always get sick but when I do, I get some shit no one has heard of”

But what if you are facing similar types of situations/symptoms as the aforementioned but because of a rare disease? Who is there to guide you through that? Will you qualify for the same type of rehabilitation, supports, and guidance? How can you make the transition from your previous life of being sick but mainly independent to needing help, rehab, equipment, home modifications, or vehicle modifications? Where can you find information, resources, and options?

While I have used a wheelchair in college and for long distances/flares previously, it has been nearly 3 years since I have needed it more than a day. Prior to November 2019 I was working, rock climbing, walking and fairly independent. I wasn’t without significant health challenges but was fairly well managed. I was admitted in the beginning of November following a dystonic storm that sent me to the ER. Due to a variety of factors, I continued to decline in the hospital. By the time I was discharged I was unable to exert myself physically without going into full body dystonia, could not walk or stand for long unassisted, and took a major hit in the categories of coordination, balance, proprioception, and motor planning. Oh, and being in the hospital is just making it all worse so avoid that. Consensus was reached that I needed to be transferred to an inpatient physical rehabilitation program to retrain my body how to walk. Sounded like a good plan. Ha.

Immediately we were hit with barriers- many inpatient rehab centers require at least 3 hours of daily therapies, something my fragile little ecosystem definitely couldn’t handle. Additionally, it seemed uncertain whether the centers would be able to manage full blown dystonic storms or if they would send me right back to the hospital. Lastly, there was the issue of their ability to manage my medications, allergies, and reactions. So we tabled that thought and started trying to get me home with home health, PT, OT, and Speech. Sounded like a solid plan. Clearly we did not yet have 2020 vision. Ha.Ha.

So we spent a month or so getting creative at home with home PT. But we had to work with what we had, and all we really had was a gait belt and some therabands. We made calls looking for a day rehab programs that I would qualify for based on word of mouth suggestions, internet searches and home care recommendations. We essentially found nothing. And this was not because there was a lack of programs, but each program had an if and or but attached to it. So we pivoted yet again towards finding an outpatient PT center that would handle me. My previous PT is amazing but they were not a rehab center and lacked the equipment and staffing needed. Finally we stumbled upon a place that would see me, deal with complex patients and had some experience in the rehab world. The major downfall being that we would be constrained to the typical PT schedule: 1-3 times a week and 30-60 minute time periods but we are making it work. Thank god for the internet.

PT: check.
Now all that’s left is: figure out what is wrong with me, fix wheelchair, make 2 story house wheelchair accessible, stay out of the hospital, completely reorganize room, figure out transportation, schedule follow ups, find specialists, research, relearn how to walk, keep all my other conditions in check to avoid hospitals, try not to get the flu from these germballs walking around (PSA get your flu shot) and figure out what to do with my life now.

I would say in the past couple months I have interacted with over 50 medical professions, therapists, and service providers just to take care of the immediate needs. Doctors, NPs, pharmacists, nurses, PTs, OTs, ATPs, stairlift specialists, electricians, mobility specialists, DMEs, insurance, ramp builders, hospital bed suppliers, adapted driving/vehicle specialists, and more! It is complicated and exhausting and I consider myself to be a professional patient!

I can’t help but think about the barriers I faced and wonder how anyone manages to deal with all this. I have several benefits: good insurance, full command of the English language, a good medical knowledge, connections in the medical and rehab communities, internet access, communication skills, time management skills, organizational skills, financial assets, and many more attributes that have made this process easier for me that so many do not have. I have managed to fumble my way through the system and achieve a relatively decent outcome. Rare disease diagnosis should not translate to lack of support and options. These cracks in the system should not be so wide and so deep that the minute you step outside a few pre-drawn paths, you shit outta luck.

We need more advocates. We need broader reaching support for patients with complex and high need patients. We shouldn’t have to find all our own solutions, treatment options, and services. We need more help.

That’s all for now, hopefully I will come up with some post ideas and be posting more frequently. Feel free to comment or let me know if you have any ideas, I will be doing a post about accessible vehicles in the next couple weeks but after that I got nothing.

My Truths: Yammerings of a newly 24 year old

Disclaimer: This is not a J.K. Rowling post. I have no idea how it ends writing it now. It may make no sense ¯\_(ツ)_/¯. This is basically just a list of some random thoughts.

I believe you can accept and love yourself and still want to change parts of yourself.
I believe the ability to adapt is crucial to finding happiness.
I believe that differences are necessary for society.
I believe that artists and musicians do more for the greater mental health of our stress ball of a society than we give them credit and resources to do.
I believe we can all benefit from giving more people the benefit of doubt.
I believe that vulnerability is critical to human connection.
I believe that there are times to push and times to rest in life and that finding the perfect balance may be impossible but we shouldn’t stop trying.
I believe that sickness can be a big, important part of your life and still not define you.

k thanks i’m here all week

Feeding Tube Awareness

February 4-8th was Feeding Tube Awareness Week. This post will be mostly about types of feeding tubes and feeding as well as some possible reasons why someone might use a feeding tube as I have found few people actually know much about tubes. Ideally, I will also be creating posts about tips and tricks for living with a feeding tube and my experience as a young adult who uses a feeding tube. *lol I tried to get it done on the actual week*

Types of Feeding Tubes

Nasal Tubes

The two main types of nasal (up the nose) tubes are nasogastric (NG) and nasojejunal (NJ) tubes. These are thin, flexible tubes that are inserted through the nose. Both tubes are primarily for temporary and trial use and can often look similar from the outside. The main difference between these two tubes is where they go inside the body. These tubes can be left for 2-6 weeks per tube.

NG tubes are tubes that are inserted through the nose, go down your throat, and end in your stomach. These tubes are common inpatient and outpatient for acute needs or for temporary trialing of tube feeds, however, some patients chose to use NG tubes long term as (with training) they can be inserted and removed at home and therefore can only be on their face while feeding (usually at night in those cases)

NJ tubes are tubes that are inserted through the nose, go down your throat, through your stomach and the first part of your small intestine and into your jejunum. These tubes are less common and need to be inserted by a doctor with imaging to guide the tube into the right place. Many patients have NJ tubes if they have significant vomiting, have an improperly functioning stomach, or cannot tolerate feeding into their stomachs.

Surgical Tubes

There are three main types of surgically (or endoscopically) placed feeding tubes: gastrostomy (G tube), jejunostomy (J/ “straight J” tube), and a gastrojejunostomy (GJ tube). While these are considered more permanent tubes, they can be removed if the tube is no longer needed. These tubes are placed by creating a stoma, or opening that allows the tube to connect to the stomach or intestine, essentially it is an extreme body piercing.

Low profile G tube on left, traditional g tube on right

Within these options there are also some differentiations based on the type of tubing and the securement device. Options vary from traditional tube (aka danglers) to low-profile tubes that sit more flush with the skin. Tubes can also vary in how they are held in place on the inside: balloon (filled with water), a hard bumper, or a capsule shaped bumper. Most tubes need to be changed out every couple of months but some can be changed out at home by the user!

That girl has a feeding tube but just ate some cookies! They must not need the tube!

There are many different reasons why someone may need a feeding tube. Some people are able to eat and drink and still needing a feeding tube. This can happen either because they have a very restricted or unreliable diet/food tolerance or because they cannot eat or drink enough to sustain themselves purely on oral intake. Some people can eat, but it makes them very sick and so they only eat on special occasions, however there are plenty of people with feeding tubes who cannot eat or drink at all (NPO). Whether someone can or can’t eat orally does not correlate to how much they need a feeding tube or how sick they are!

What are some reasons someone needs a feeding tube?

There are countless diagnoses that may require a feeding tube such as dysphagia, cancer, gastroparesis, mast cell disorder, IBD, spinal cord injury, muscular dystrophy, ALS, MS, and many many more! Generally, people who need feeding tubes either: have difficulty swallowing, difficulty digesting/absorbing their food, have risk for aspiration (breathing food into lungs), cannot chew, have multiple food allergies, or have a gastrointestinal disorder that impairs their digestive tract.

#rarediseaseday

Wednesay is Rare Disease Day 2018! This is a day dedicated to people who live with rare diseases, awareness of rare diseases, fundraising for research, treatments and cures, and a day for those of us with rare diseases to share our stories.

Living with a rare disease can be incredibly isolating and at times, frustrating, scary and  challenging. You get used to knowing more (or anything) about your disease even when talking to medical professionals. You get anxious trying new things or going new places in case something happens and the medical staff don’t know your condition. Every year during rare disease day I strive to spread awareness not only for rare diseases (most of which have no cure), but also for orphan drugs and the researchers and companies supplying them. Orphan drugs are drugs that are designed for a problem or disease that is rare. They often struggle to find funding and complete clinical trials and most do not get through the trial phase. Additionally, if these medications or therapies do make it past clinical trials, they are often ridiculously expensive (think >$10,000).

For a list of known rare diseases click here

 

Resources for Ehlers-Danlos Syndrome

***At the suggestion of a friend I will keep two running posts to be updated randomly, this one, for educational resources, studies, etc and another of fellow bloggers and vloggers with EDS. Please let me know if any links are broken/nonfunctional!***

General Information:

• The Ehlers-Danlos Society is a great resource for information, guides, and awareness. They also have information to help with diagnostics, emergency information, and education for medical professional.
• NIH on EDS
• National Organization for Rare Disorders on EDS
• Ehlers- Danlos Syndrome C.A.R.E.S. Network
• RareConnect Forum for EDS
• Medscape Info with genetic and pathophysiologic information
• Compiled resources from OHTWIST Blog

Research:

• EDS Society Current Research
• Clinical Trials
• Vascular EDS Research partnered with C.A.R.E.S

Books for EDS and related conditions”

• Joint Hypermobilty Handbook by Brad Tinkle. He also wrote another book but it is very hard to get your hands on but can be found here. This is a very useful handbook covering common issues of EDS by body system. Great to share with healthcare providers or to just understand your body more.
• A Guide to Living with Ehlers-Danlos Syndrome (Hypermobility Type) by Isobel Knight
• Living Life to the Fullest with Ehlers Danlos Syndrome by Kevin Muldowney PT. This book describes a physical therapy protocol by a well respected physical therapist.
• Special Like Me… Ehlers Danlos Syndrome by Janelle Shannon LCSW is a children’s book about a boy with EDS to help children with EDS cope. If you have Amazon, there is a free e-book avaliable.
• Never Bet Against Occam: Mast Cell Activation Disease and the Modern Epidemics of Chronic Illness and Medical Complexity by Lawrence Afrin M.D. I HIGHLY recommend this book to anyone diagnosed with a mast cell disorder, especially since it is a rather new condition and there is limited information out there. Afrin is one of the leading researchers/providers studying and treating mast cell disorders and his writing is thorough and easy to understand language (verified by people who aren’t me for those of you that snickered).
• POTS- Together We Stand: Riding the Waves of Dysautonomia by Jodi Epstein Rhum. I haven’t personally read this one but its on my list per recommendation by a friend.

 

Majoring in Chronic Illness Management with a Minor in Applied Nursing

Seriously guys. Every time I hear those commercials for continuing education that say things like, “get credit for military experience!” or “use job skills to get an accelerated degree!” I think… man… if only they gave out degrees keeping yourself alive with chronic illnesses. I have a lot of spoonie friends and every single one of them should get to add C.P.P. (certified professional patient) to the end of their title in addition to an honorary nursing degree for many of them. For those of you who don’t get a peak into this aspect of my life, here are some of the behind the scenes tasks needed to function.

Medication Management

This takes up SO. MUCH. FREAKIN. TIME. You have to make sure all your meds are cleared with all your specialists because they don’t chat, you have to make sure no new meds will kill you (allergies, interactions, effect on other conditions), you have to get the script, send it to the pharmacy (assuming they have it), pick it up or set up shipment, keep track of refills, separately order all your OTC meds and supplements, sort out medication or check if medication is presorted correctly, make sure any ED staff, EMS, or doctor can access what prescriptions you are on at any point in time, fight insurance, pay bills, likely deal with 2-3 pharmacies, infusion companies, specialty pharmacies, mail order pharmacies, and actually remember to take them and have rescue meds with you at all times. But yeah… just that. Add secretary and applied pharmacist to your CV.

Appointment Scheduling, Cancellations, and Heckling

This one might be my LEAST favorite. Doctors and other medical professionals have a HUGE range in availability, responsiveness, attitudes towards collaboration and remote patient contact. I hate talking on the phone. I hate talking to people I don’t know in general. People find it hard to understand me and I have a hard time understanding them. It isn’t a great combo. But I do it because I have to. Generally, my team falls into two categories: can see you within the week or can see you in the next 3-9 months. While I totally get the deal with both types, it can be more than frustrating for something to come up in between your 3-9 month follow ups. I am currently playing phone tag and portal spamming with my GI teams because things need getting done but have been less than successful.

As mycharliequinn so aptly explains going to the doctor as a spoonie: “going to the doctor when you’re chronically ill is weird. It’s like imagine everything in your house is on fire, and you’re standing there and the fire department come[s] in like, describe the fire to me and maybe we can find out what caused it and put it out. And you can’t just say everything so you’re like… well the fire in the curtain is the biggest but the fire in the photo albums might be doing the most damage also the fire in the couch is really inconvenient. Occasionally the fire guy is like, well your tv is on fire so it might be electronic- fireitus but that would cause other things like fire in the DVD player. And you’re like, oh yes. That’s been on fire for years. I forgot to mention it because it’s always been a relatively small fire. It’s right next to the bookshelf which has much more fire. And then the fire guy is like, oh. I wouldn’t worry about that, book shelf fire just happens sometimes.”

 

Attending your “Weekly” Appointments

For me, I am currently on a “rather empty” schedule with weekly PT and Aqua PT sessions and biweekly infusions. Just getting those scheduled and being able to get to them and participate takes a lot of spoons and most of my schedule is based off these events.

Decide When to Brave Emergency Departments

Practically have an algorithm this one now but can be tricky, especially considering the “luck of the draw” on if your ED team has even heard of your conditions, actually pays attention to your chart, or can do anything to help. Chronic illnesses often leave you in this limbo where you’re not about to drop dead but not okay enough to stay home and NO WAY can get in to see your 3-9 month doc who manages that kind of stuff. It can be awkward for everyone.

Life Hacks: Spoonie College Edition

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      So I’m actually starting my 5th year of college going straight (fall, spring and summer except one summer). I have attended three different universities and started out only minimally effected by health problems (mostly GI, migraines) and wound up here, a professional patient needing complex care and supports. While each college had different systems, strengths and difficulties, I learned some valuable things about being successful in an environment that is largely unsuited for those with chronic illnesses. 

Here are some things I have learned along the way, in no particular order and not institution specific: 

1. 1. Disability services: The process towards getting accommodations is LONG, often repetitive, and stressful. Often, accommodations are generic,  inflexible, and “base packaged” (you probably will get about (max) half the things you need to keep up and be successful and the rest is up to you. Here are some tips to get the most out of the services offered there (and your time and energy):
      1. Start paperwork ASAP, pester those overworked doctors to get their part in before the semester starts as accommodations will never be retroactive. Also, make copies/ scans of every form or piece of documentation that leaves your hands. Things get lost all the time. 
      2. Know which battles to fight. Back to the max 50% of what you need thing, often times you will receive basic accommodation and get some pushback asking for more. Is that note taker necessary for you to succeed or can you work out a way to record lectures, ask a classmate to look at theirs, use assistive technology and save your fight for extended time on tests where you might fail without it.
      3. Send a personal note/make a personal introduction along with your formal accommodations sheet. In my experience, this has helped teachers relate to me, understand how my disabilities effect me and my learning/schooling, and also makes it seem a lot less like taking passes on things and more like “I expect this to happen, I don’t know when or where or how, but here’s a proactive heads up”. It isn’t necessary to name or intricately discuss your diagnoses to be effective.
      4. You’ll have to do a lot of accommodating for yourself/ working 1:1 with teachers. 
      5. In most universities, students with disabilities have priority class registration. SUPER HELPFUL!!!
   2. Housing: While living on campus may at first seem unappealing (again, varies in atmosphere by university), there can be a lot of benefits especially if you can’t drive. 
      1. They are required to have ADA accessible rooms. My room has widened doors, a lower peephole, lower closet bars, grab bars in the bathroom and shower, a fold down shower bench, and lowered light switches. 
      2. Accommodations for single rooms can be made for those with compromised immune systems, PCAs, MCAD, severe GI issues, and other medical reasons. 
      3. You can have a quiet place to rest in between classes, are close to dining (if you eat), and have access to evening events such as clubs, performances, and hanging out with friends without being too far from home or living in the Student Union Building. 
      4. DOWNSIDE #1: If you have problems that can be exacerbated by fire alarms… apparently no one knows how to cook MFing popcorn.
      5. DOWNSIDE #2: Germs spread fast and easy, may not be the safest place if you have a weak immune system without taking precautions.
   3. Class Schedule Advice

1. 1. 1. What you want isn’t always what is best. Sure, like nobody wants 9 AMs every day… or any day… but for me, the later in the day the more medication wears off, pain increases, spasticity increases, and overall deterioration occurs. Class is already hard enough to sit through, concentrate, learn and remember… don’t make it harder on yourself for a potential 2-3 more hours of sleep. Or flip all that if that’s how your body works.
      2. Register ASAP. Classes fill up, plans change.
      3. Schedule max number possible classes, attend all the first week and then drop as needed. That way you secure your seat, get to meet the professor, see the syllabus, see if there are major barriers in the class (i.e.  Service dog you’re allergic to in a small classroom)
   2. Medical care/ health safety

1. 1. If you live on campus, tape a folder somewhere visible (wall, by light, dresser) and write EMERGENCY INFO on it super big and put in your medical emergency info, copy of your license/state ID card, insurance card (if you have it), and your school ID/student ID #
   2. Start a file with on campus health. Even if they never care for you it is helpful for them to have your base information in case you need them in an urgent matter, have doctors far away, or just need something simple like a wound cleaned. Most student health offices will be able to do allergy shots, some will even help manage infusions. 
   3. Introduce yourself to the campus chief of police, especially if you have the potential for reoccurring EMS issues like seizures, anaphylaxis, diabetes etc. They are usually first on the scene and can inform EMS.
   4. Wear a medical ID bracelet. Bonus if it has a way to see all your info. See my post on my system here.
   5. If you have asthma, MCAD, or immune problems I highly suggest purchasing a high quality, relatively comfortable mask to wear outside around campus. I pass smokers, high perfumers, and other triggers CONSTANTLY on campus. I use these and love them (recommend the ones with 2 filters for comfort and breathability).
      
2. Miscellaneous 
   1. Join one club. Even if you only go twice a year, you may meet some people and you feel somewhat a part of things.
   2. If you live on campus, get to know some people on your floor. They may be good for procrastination buddies, errand helpers, cards against humanity mates, or near family friends. 
   3. Don’t bring everything you own to move-in. Stuff accumulates anyways and it is a pain.

Hope this helps. It can be overwhelming but it IS manageable with the right supports. 

 

 

 

It’s that time again! (EDS Awareness Month)

Hello lovelies, in case you didn’t know because you live under a rock and you like it down there, May is Ehlers-Danlos Syndromes (EDS) Awareness Month! Now you know. My hope is to make several (possibilities range from 1-30) posts about various aspects of how EDS effects my life and things that I experience that I might not always talk about or might not always be visible (whooooooo!). But since this is the first post I am going to do a brief re-overview of what EDS is (to see last year’s post for more detail click here). I am not going to touch much on the new classifications/criteria mostly because I don’t quite understand it myself (sorry guys). Links will be throughout for more enticing information!!

What is Ehlers-Danlos Syndromes?

       Ehlers-Danlos Syndromes (EDS) is a group of inherited connective tissue disorders that effect your body’s ability to produce strong collagen. Collagen is essentially the glue that holds your body together and is the most abundant protein in the body. With EDS, your collagen is weak or faulty. There are different types of collagen and each type forms certain types of tissue, bone, organ, muscle, and joint. The different types of EDS are due to mutations on different types of collagen (mostly joints vs mostly vasculature etc). That being said, if you have Vascular EDS you can still have hypermobility issues, it can get very complicated. EDS is a systemic disorder that is much more than just being bendy! Most types of EDS are rare, but hEDS/hypermobility EDS/type 3 is NOT rare and current estimates place its prevalence at around 1 in every 250. That being said, EDS is rarely diagnosed and rarely understood even in many medical circles. Every case of EDS is different, even when in families which can make it hard to diagnose. As my cardiologist says, “if you can’t connect the issues, think connective tissues”!

How is your life with EDS different than your “typical” peers?

        Probably the major ones would be coping with chronic severe pain, having less energy, and having the schedule of an 80 year old (hospital visits, PT, OT, medications galore, pharmacy trips, naps). When I try and explain it to others some go with the “remember that time you got a bad case of the stomach flu, how you felt? yeah it is like that but we spoonies don’t get better” but I don’t really like that. It does a pretty good job on the comprehension level but it further separates us and points out our differences rather than our similarities. I, too, procrastinate on my schoolwork with Netflix. I, too, laugh at memes. I, too, want to graduate from college and have a job. I am not saying we have to ignore our differences but it can be hard enough to fit in when many of your peer groups activities are out of reach for you (sometimes literally haha). I also don’t talk a lot about my pain with others because I don’t want pity. My illnesses are a part of me but they do not define me.

If they discovered a cure tomorrow would you take it?

      This one is hard to explain but probably not. EDS sucks but it is as much a part of me as having red hair is or speaking a bunch of languages. It has shaped me and my direction and made me tough as nails. That being said, if someone came to me with a viable pain medication we might have a different conversation.

I really do hope to post more later…stay tuned!