Out of Practice

When a Trusted Physician Closes the Door

For those with “invisible” illness, it’s difficult to find someone who believes you’re sick – not just depressed, not just anxious, not just tired – but sick.

These nonbelievers can be siblings, best friends, spouses, children, or acquaintances, but the ones who leave us most helpless are the doctors. Physicians who dismiss our illnesses make us vulnerable to exacerbation of symptoms and sometimes irreparable harm.

Maybe you know what I mean.

You were never sick; always strong, productive, hopeful.  Now here you sit in one more exam room. How many has it been? How many white-coats have pressed a stethoscope to your chest, shone a light into your ears, nodded and wrinkled a brow in response to your long, long list of complaints? How many times have you sensed an internal eye roll? How many times have you witnessed one?  

But then it happens. You find the doctor who really looks at you. Who nods, not merely to seem attentive, but to acknowledge that she gets it; understands what you’re saying; how you feel.

That happened for me nearly five years ago.

Lyme disease can take its time before finally making a stand. Mine was like that. Symptoms came and went for years. I didn’t have the experience of seeing a long line of physicians, but I should have. I was just too hard-headed to go. As a nurse, I worked with doctors and didn’t wish to be at their mercy any more than I already was. So, I dealt with it.

Okay, I ignored it. I did my level best, anyway. I ignored the joint pain, the panic attacks, the sleeplessness, the flu-like feeling. The soles of my feet were like raw ground meat, so I bought shoes with more cushion and sat down more often. My brain, eyes, and ears didn’t like light or noise, so I wore earplugs and stopped going to movies and malls. I ignored it all until I couldn’t. In my defense, it’s tough to ignore two weeks of vomiting, chills, fever, and diarrhea.

At the time, an intestinal parasite-harboring bagged lettuce was in the news. I told my doctor that was likely my problem. Accepting my diagnosis, he prescribed the antibiotic I requested and seemed happy to spend no more than five minutes with me, order a single lab test, assure me he was impressed I’d managed to stay slim, and remind me to get up-to-date on all my “woman stuff.” Which I did.

Following that intestinal inconvenience, I began to decline until pretending became too much. My mind was going. I couldn’t remember the way home from work, how to get there, or why I was even in my car. I started trying to open doors with my cell phone, turn my dryer on with the light switch. My ears were ringing, my head hurt, the right side of my face was sliding downward. My rib cage burned; my muscles twitched, ached, and jerked. I could barely walk. Everything either hurt, malfunctioned, or both.

But it may have been the fatigue that finally pushed me over the edge. Maybe it was the day I fell asleep in a patient’s home while interviewing her. Or, maybe it was the second time that happened. I’m stubborn and that’s not a symptom of my disease.  

Luckily for me, the iron pill prescribed for my nine-point-something hemoglobin made me sick. That tiny, forest-green tablet bullied me into action and through the right door.

My new doctor’s practice had a name – not just doctor so-and-so. I won’t give the name here. I’ll just call it True Health. It was in an old brick building, in a tiny town I’d been to, maybe once in my life, but I had a patient visit there, and afterward saw the sign. I thought it was a health food store and decided to look them up, hoping they’d have an iron supplement I could endure. Turns out they did – and a whole lot more.

I’d never heard of functional medicine. Entrenched in the industry we misguidedly call “healthcare,” “ill-care” was what I actually did for a living – managed peoples’ illnesses; tried with pills and pills to keep symptoms at bay. It’s all I knew. But since functioning had become a problem, I thought I’d give this new approach a try.

Seeing a functional medicine practitioner is something else. Before your first visit, you complete a two-hour questionnaire – much of it consisting of inquiries into your bowel habits. The idea that my first visit was to last an hour and a half was jaw-dropping, but it was the first fifteen minutes that left me stunned. Turned out he was an expert in the disease, I didn’t know I had. When he said, “I think you have Lyme disease.” All I could do was repeat, “Lyme disease?”

Then he handed me another questionnaire – this one, Lyme-specific.

I passed with a very high score. Like most healthcare providers, I knew nothing of Lyme. I’d hobbled across the street and into his office that day, burdened by thoughts of Lupus, Multiple Sclerosis, Alzheimer’s – these were among the possible diagnosis I expected to hear. When I didn’t, I thought I’d gotten off easy. But, as I said, I didn’t know anything about Lyme.  

I recall bits and pieces of that day, but his words, as he left the examination room, imprinted on my mind. I have held on to them for all these years, through unspeakably difficult days. His hand on the knob, he turned back and said, “You know, a lot of people want to make you feel crazy for what you’re going through, but we don’t want that for you. We just want you to get better.”

That hope, expressed by someone who had the ability to help me realize it, pulled me out from under the fear. Until that day, I hadn’t told anyone how I was feeling head-to-toe. I’d tossed out phrases like,

“I’m so tired,” or, “I feel achy,” always shaking my head, baffled by my body’s failings. But how could I begin to list the thousand and one complaints in casual conversation? Even I thought I was losing it. Even I wondered if I just wanted attention or to get out of work. Maybe I didn’t want to hear the assurances that these things happened to women of a certain age or to women because they are, well, women.

There were many reasons I kept it to myself, but when he said that, I felt something break open; sorrow and relief rushed in together. I found confusion and clarity, peace and uncertainty. I was a jumble of emotions, but it was the comfort and compassion, the understanding and assurance – all the things a sick person needs, things I hadn’t yet admitted to needing – I found those things in abundance at that place, enough to deal with what lie ahead.

That place will soon be gone. My doctor’s practice closes the end of the year.

“My doctor was a safety net. I had settled in and expected to stay until I was well.”

The word I’ve heard most from his other patients has been “devastating,” I concur. It is a blow, a punch in the gut. The day I found out, I sensed a snap, the cord from life raft to ship had been cut. Adrift, unsure, alone, we all panicked; found ourselves floating in a fog with multiple, but untested, paths on all sides.  

What’s the big deal? Find another doctor people said; recommendations filled my message boxes and social media feeds. But those of us with Lyme know some things most don’t. Someone with an accepted, well-researched condition might think finding a great doctor isn’t too complicated, but Lyme is, in a way, illegal. Our doctors are few and far between because the risk of giving us as many antibiotics as someone with — say acne — is high. Lyme doctors can be shut down by a complaint from an insurance company or the health department for “over-treating.” They have lost their licenses because of us.  

So, we all scrambled. We googled; talked back and forth. “Have you heard of so-and-so in such-and-such town? His he any good? Does she take insurance? Does he treat with antibiotics, herbals, or both? How much is the first visit? My friend saw that doctor. He was horrible – she almost died! Ugh, that’s three hours from me. Bleh, that’s a six-hour drive. First visit is how much?! Yikes!” On and on it went, all of us forced to begin again or give up.

My doctor was a safety net. I had settled in and expected to stay until I was well. When his doors close, I must start over. He won’t be the only one out of practice. It’s been a long time since I’ve had to tell this tale from the beginning; since I’ve had to complete a new patient form or use my GPS to find my healthcare provider.  

It’s been four and a half years since I’ve had to feel nervous; uncertain about whether the person sitting across from me had my best in mind. I don’t want to wring my hands and avoid eye contact while I call out my myriad of physical aches and pains, my neurological disturbances. I dread sitting alone in a foreign and sterile room, unable to concentrate on the book in my lap, instead staring at soap dispensers, tissue boxes, sinks, and paper-covered exam tables — anything to look casual and relaxed, to not be caught wide-eyeing the door when my new practitioner walks in. Like a weathered sea captain taking sailing lessons or Jack Niklaus signing up for golf camp at the local YMCA, I don’t want to be a new patient because I am an old, experienced one.

New patient visits cost a lot of money. You have to pay the hefty first-visit price, adopted now, by most Lyme-literate MD’s. Some of them, at rates between five hundred to a thousand dollars, or more. Since there is no established treatment protocol for Lyme, your new doctor will try things — supplements, herbals, compounded capsules, untested intravenous therapies. All of these things will be costly, none will be covered; your doctor will not accept insurance. You’ll pray no one else in your family needs medical care.

 A new physician will, and should, run tests. Such a multitude of complaints warrants a broad array of diagnostic procedures. If your previous results are not recent, or this doctor prefers a different lab or method, you’ll be subjected to many needle sticks and scans of things. You may be referred to specialists until every week of every month you are committed to a doctor’s appointment. You’ll find ways to make it bearable – treat yourself — a grown-up version of the proverbial post-doctor lollipop. When I see my primary care, I’ll swing by a favorite upscale thrift store; when I see my neurologist, I’ll get a smoothie, my thyroid doctor, a gluten-free, grain-free, sugar-free, dairy-free lunch that I’ll eat beside a nearby lake.

If you choose a doctor not trained in Lyme disease, you’ll save cash but have a lot of explaining to do. As you relay your symptoms, your new doctor may become alarmed. He may wonder why you haven’t already been to a rheumatologist, neurologist, endocrinologist, allergist, sleep specialist, physical therapist, and on and on. She may be puzzled by your cavalier demeanor, the way you shrug when describing the sudden numbness to the right side of your body, or your occasional loss of vision in one eye. He may attribute your neck stiffness to poor sleep posture instead of a coinfection like Babesia or Bartonella. Same for your night sweats, those will be, most likely, if you’re a woman, due to womanhood. She will not have been taught to consider infectious disease as the root cause. You may have to bring documentation – peer reviewed studies that demonstrate the true nature of Lyme, that explain it as a collection of infections, not just one; the way it persists in the body, an ongoing, active contagion lying in wait. You’d better bring this paper work wrapped in humility and pray he is willing to learn from you.

This process, being sick, has worn away some of my stubbornness. I am giving in, making a list of those after-doctor treats. I know I was spoiled to have stumbled upon the right doctor that day; to have had one provider who understood he couldn’t send me to specialists who didn’t believe in the thing that was making me sick. I was blessed, on my second attempt, to find the help and wisdom I needed to get better. I know that what’s ahead for me is what many with my condition have tolerated their whole lives, and so, I find myself again, breaking open on the inside; once more a jumble of feelings. Hope will show up, but right now grief wins the day. I am succumbing to a path in life I did not and would not have chosen.

We all know the comfort of familiarity, of coming home after a hard day’s work, a funeral, a long trip. We see our favorite chair, our pillow; tune in to the sounds – the ones we don’t always notice because they’re always there, a refrigerator’s hum, a clock’s tick, a dog’s soft snores. A doctor’s office can be a place like that when you’re sick for a long time. After a hard month of pain, memory loss, shortness of breath, exhaustion, a familiar caregiver can be a welcome sight, can release a contented sigh borne of trust. It can be a place where you anticipate, with relief, the opening of an exam room door; where you know you’ll leave encouraged.

Once you know a doctor is listening; that he hears you and cares, you let yourself believe he wants what you want, to see you walking tall and strong, hiking the old trails, pumping the pedals of your bike. And so, you tell him your story. You start at the beginning and each visit you speak to him the middle, all that’s happening in your right-now. You’ve no doubt he will be with you at the end, bringing this affliction to a resolution of wellness.

But his role has ended. He has stepped out of your story, and you’ve no choice but to bring in a replacement; to put on the brakes, slip into reverse, and start over.

We’ve all heard people say it, that they put their lives in the hands of a doctor. I did. Not consciously, but in that room for the first time, I lay down the weight of all I used to be and now was not, could not; all I wished to be and do again. And he had willingly picked it up; lifted my burden. In that place, I had a safe room where someone wanted me to tell what hurt; where I would be validated, find healing — a place I could express my fear that I would forever be unable.

As his practice ends, mine starts over. I’m not sure if this will be the commencement of a whole new marathon, or just a long, steep incline in the middle of the same endless route. But I’m breaking out my equipment: My long list of medications and symptoms, treatments that worked and the ones that failed. I don’t feel ready, but I’ll narrate, once more, the longest story of my life and hope that my new doctor will really, truly just want me to get better.

Lyme feels like this.

(This article was first published here: https://theunchargeables.com/when-a-trusted-physician-closes-the-door/)

Try And Try And Try Again – – Or Not

Gardens in early spring are broken, dry, and brown, but if you look underneath the leaf litter and last year’s mulch, you’ll find green.

It’s the same every year. I snap off the old dead stems and seed heads and toss them into the compost where they rot themselves into nourishment for the new florae. I try to clear the way and clean the slate. I add new plants, divide the ones too big for their own good, and remove those taken by the cold.

Every year, I start over.

But front to back, and side to side, my plot is filled with stubborn invaders.

Gooseneck loosestrife is lovely, but I didn’t research it, just stuck it in the ground delighted by its drooping cluster of dainty, white blooms. I soon learned it’s not meant for containment but needs its own space and will choke the life out of everything else to get it. An apt name, it is on the loose and causing me immense strife.   

There’s also common speedwell – – not native to North America, it’s certainly made itself at home.  Every spring, I think I’ll just give in and call it my ground cover. But, every spring, I tug and tug and tug it out, knowing my efforts are futile. It’s long runners will produce new shoots faster than I can say, “shoot.” I apply mulch like a pillow to a face and hope against hope it won’t resurface.

So, my gardening season begins in a sort of panic. Pre-Lyme, I was a butterfly – – fluttering from task to task; soaking it all up, productive and happy. But, I’ve become a caterpillar. I inch along, stay low to the ground, always seated. I pull the garden cart – – two steps then rest, two steps, then rest.

I am defeated before I start. It’s a simple fact.

I know gardens are never finished, even for the healthy. That used to make me happy, but now I’m more acutely aware that my growing season is limited and feel pressure to get it done; make it perfect. I want to make the most of what I have, but spring and summer outpace me. I can’t keep up anymore.

Gardens are places of constant change and perpetuation. They’re filled with decay, death, and disease, but they heal, even resurrect.  A garden can be suffocated by alien life; its residents killed by ignorant gardeners who don’t bother to learn what their plants need.

But, they endure. They not only withstand fire and freezing but rise new and vibrant from the ash and snow.

Gardens keep trying.

I am also in a perpetual state of succumbing to disease and decay, then standing again in healing and new growth; succumbing, healing – – always starting over. There are days, when dry, brown, and brittle are all I know and days of flourishing, of feeling bright, full of color and hope.

But, this year’s different. After four years of treatment, and at the risk of being overrun, I decided to stop. I told my doctor I was taking some time off, that I didn’t want to spend the warm days as a patient, keeping appointments, and swallowing pills, or worse, those brown, acrimonious tinctures so popular among Lyme-killers. I have had the same symptoms for a long time, without change, so I need to think.

Can I live with some dry twigs? Develop a rapport with these invaders? Can we function as one?

Do I have to keep snapping off the brittle remains of my old self, making room for new shoots only to find them dead again? Must I continue plucking and pulling at invisible bacteria, viruses, parasites only to find them alive because their roots are many and strong? No amount of pruning or pesticide has destroyed my vermin. Can I just call them my cover? Pretend they belong?

Is it possible to simply look away?

I mean, they aren’t unobtrusive.

The fatigue crushes. Pushing a spade into the earth is not always possible.  Somedays, I’m too weak and  worn-out.

I bend to plant, then raise up gasping for air, heart pounding, hand to chest wondering if it’s a heart attack or just a Lyme-fake. Can I ignore this?

The depression is dark, an immovable mass; the anxiety like pieces of paper in a blender, swirling, coming close, but never hitting the blades. Some days in the garden, I spend in numb defeat, ruled by blight, sitting in slumped surrender. Other days, I cry, knowing it’s too much, and like me, will never be what it was. How do I keep planting hope when I’m buried? How do I take root and find peace, when I’m scattered?

The roaming, restless pain can’t find a place to land. It rears its head without warning, subsides without a hint. It aches, stabs, stings, burns, spasms, pounds, pierces, throbs. Sometimes, my insides are a bug zapper, overrun by bugs, constantly sending useless zings through my neurons; firing without apparent purpose and with miserable aim.

My brain is another world, where the barometric pressure is prone to dramatic shifts. It swells with damp clouds; blooms with a disorienting mist that steals words, thoughts, the ability to spell, converse, or feel things. Can I be fruitful in a stupor?

As I yank speedwell, and ponder what to do, a tiny green butterfly stops for a sip from one of the relentless weeds. I smile. My nemesis, is this little pollinator’s vast spread of sugary nectar. I’ve heard it before and have said it myself – – weeds have purpose. Struggle and suffering feed our character, nourish our souls, and point us to God. I could end this post on this inspirational note; could list the benefits of trials and the hidden blessings of chronic disease. In my writer’s brain, the butterfly is metaphor for mind and heart; for the way they discover sweetness in weeds. 

But, that rosy conclusion wouldn’t be an honest picture of how I feel, not right now. From my little stool, in my big garden, in front of me, I see a small circle, cleared of weeds, filled with multi-hued snapdragons. But if I look left, right, in front of, or behind those flowers, I see speedwell. I see gooseneck loosestrife. I see my perennials looking for air, for light, and finding little of either. I see small gain and huge loss. Clearing this circle was costly and painful, and it won’t last. The dragon slayers are waiting to move in.

This ring of frilly, radiant dragons represents a few good days and some small victories, but mostly, treating Lyme has been like pulling weeds with long, stubborn roots that worm through my body, finding and taking everything. Sometimes, it seems treatment only clears the way for a new batch as soon as the medicine stops.

A successful garden, free of weeds and pests, starts with healthy soil; invites good soldiers – – ladybugs, toads, spiders – – to stand at the ready and make quick work of those bugs that would do harm. It has just enough hours of sunlight to warm the ground without thieving all moisture. It catches the rain and draws it toward the roots; doesn’t hold it on the surface in pools and puddles that corrode.

My “soil,” my internal bed, isn’t healthy. I’ve been looking for green, digging in, doing the right things – – diet, exercise, sleep, meditation, prayer. Ideally, these actions should feed my defenders – – those good bacteria and antibodies. They should open a path for nutrients, supplements, and tinctures to reach the places where they can do their promised work.

But these things work until they don’t. Sometimes, they just don’t. And that’s the problem.

This disease keeps finding its springtime. It keeps starting over, forcing me to do the same. I just don’t know if I can keep it up, keep pulling internal weeds, when to the left and right and all around I see illness – – a snaking, complex, foreign system – – that has made itself at home and thrives at my expense.

This disease will never be finished. I know this, and I know that means my efforts to vanquish it will never be either. It’s one of the first things I learned about Lyme – – that remission and maintenance are the goals, not cure. But, I feel so weary thinking of a life spent clawing out small circles of open space, a life of choosing, over and over again, to try and get done what I cannot. That choice, repeated many times, is wearing me down.

Of course, I won’t give up my garden – – not yet. I’ll do the best I can and try to be content when my efforts to eliminate speedwell or all that strife fail. I’ll try not to look at them, but instead focus on the plants I choose – – the ones I’ll nurture. I’ll look at butterflies when they show up, if only for a moment.

But, my body . . . I don’t know. I am losing the drive to clear the way and clean the slate and am, perhaps, at a place of surrender to the reality of more weeds than snapdragons, more shade than sun, more gasping than breathing. I am understanding that I may have to dig a little deeper to find the green and that I may not be strong enough to do it.

Lyme Disease keeps trying.

 

Lyme feels like this.

 

Psalm 119:49-50 Remember your word to your servant, in which you have made me hope. This is my comfort in my affliction, that your promise gives me life.

 

You Look Great

I look great. That’s what you’re telling me anyway. Oh, I know you don’t mean Beyonce-great. You just mean I don’t look sick. Great. I shrug. “I feel pretty good,” I reply. But, you don’t see the uncivil war inside; can’t know that I am wishing with all my might, to crawl out of my skin and get as far away from my body – – my battlefield – – as possible. Good riddance army of malicious bacteria. Stop assailing my tissues and ruling my life. I can’t strip you of power and end your reign so I settle for dreams of exile.
You are sitting with me in this park, but cannot detect the presence of my enemies, these invisible bacterium invading my realm. I’m not expecting you to. Most blood tests can’t find them. They are masters of the clandestine, concealing themselves from my immune system, antibiotics, laboratories, doctors, researchers; leaving no visual trace when you look at me.
I know their names; Borrelia burgdoferi, Bartonella, Babesia among others – – partners in Lyme. I feel their effects. Right or wrong, they are the most real thing in my world, and even though I cannot see them, they are looming larger than anything else. They are enclosed by my flesh, living and working inside my body – – a whole society of overtakers. Come closer and you might run into them. You might notice some things are off – – these puffy dark pouches beneath my eyes, this slight veer to one side when I walk, this limp, my aimless sort of antihistamine-like stupor. But no . . . you are too far away on the outside.
You’re noticing that I seem tired and acknowledge you’ve heard Lyme disease makes people very fatigued. My hopes rise a bit as I affirm that it does. But then you bring up the weather. You suggest it might be this weather we’re having. After all, this weather makes you feel tired. So, I don’t bother with detail; don’t tell you that all I know of ‘tired’ is what I remember, how much I liked ‘tired’, how good it felt when it followed a long hike or a productive day in my garden. ‘Tired’ meant I had done something. I don’t tell you how it is getting harder to remember myself before this disease. Instead of trying to explain, I nod agreement and blink a lot, trying to stay awake, but I am fading; feeling this sludge of exhaustion coat my limbs, painting me with a weariness heavy enough to keep me still no matter how badly I wish or need to move, stealing first my ability for motion, then my desire.
I am wondering if this weather makes you feel like you are trying to hold up a car with the back of your head. Does it encase your arms and legs in the same iron sleeves I wear? Does it make chopping a vegetable akin to climbing a salmon ladder? I often turn to the Psalms for comfort and find the singer speaking of God as the lifter of his head. I know literally what this means. If God didn’t hold my head up some days, it would just stay plastered against the bed or the back of a chair. And some days He doesn’t.
You are suggesting we walk a bit. Do you see me cringe? It’s there, right under my smile . I am aware I can’t sit forever but really don’t want to bear my weight. One of these bacteria must have thousands of tiny fists whose only job is to pound the soles of my feet day and night. It hasn’t let up in almost a year. I am gritting my teeth as I stand. You are chatting, but I am distracted,. I can’t help it – – thinking about how hamburger might feel if it had feelings – – would it feel like my feet? Maybe the tenderness, but then there’s the burning, buzzing, stinging, tingling. I doubt hamburger would feel that way. A fleeting thought of lying down, of relief, and then I remember my heels can’t touch the mattress; my toes can’t bear the weight of the bed covers.
What did you just say? I was thinking maybe I should stop being stubborn and just get a cane, or a wheelchair and missed your last comment. You are laughing, so I laugh too, but have no idea why. (I can’t imagine I really need to go that far – – a wheelchair? Wasn’t I hiking up and down ravines a few months ago? How could I possibly need to be wheeled on a paved, flat trail or through the grocery store?)
Oh, you were saying something about how you heard Lyme causes arthritis. I think, ah, you believe in my pain. Then you ask if my knees hurt and I say, “Oh . . . yes!”
“Well, honey, at our age what do you expect? It’s time for our joints to hurt.” I know you are only trying to reassure me, letting me know my pain is normal – – for my age.
I feel a strange need to defend myself but fold up inside instead of pointing out that my knees didn’t hurt until I got sick, that turning forty-eight doesn’t mean every joint in my body should suddenly feel full of knives and needles, that my skin should hurt, my muscles should burn and ache, or that lightening bolts of pain should strike in my legs, arms, ribs, ears – – wherever they please. It shouldn’t mean the weight of a book on my lap is more pain than I can bear. A closed-mouth smile is all I muster.
We stop walking to stand and talk. Do you see me favoring one foot, then the other, until I finally point out I need to sit? Your side of the conversation never misses a beat, but I’m not hearing much as I am so focused on the bench ahead. Like a marathon runner at mile 26, that 0.2 feels like the longest day of my life only I skipped the 26 – – all I have to do is this 0.2. I am gripping the arm of the bench, knowing my pain shows on my face, in my movements, but you’re showing me your new shoes. “They’re cute,” I say, recalling all the shoes in my closet, unworn for the last year – – dress shoes, boots, tennis shoes, running shoes, all of them like wearing a bed of nails or pounding hammers.
What did you just say? I’m ashamed to ask, ashamed I missed it – – again. I listen, but lose track, certain I am a couple of sentences behind by now. Don’t take it personally – – I am trying, really. And will try until I am exhausted, until panic sets in because the word I need to retrieve from storage is taking too long to locate. I fear I may pick the wrong one, or maybe I already did, because you’re looking at me funny. Words, thoughts, ideas, whether yours or mine, do not flow and connect the way they used to. They are stuck behind a bacterial barricade, piling up into an unmanageable aggregation. Sometimes I get up and wander around, not knowing why, and then I think maybe I’m looking for all the words I’ve lost. I see and hear you but from a rudely awakened state, as if someone dropped and shattered a plate next to my ear while I was in the deepest part of a dream sleep leaving me in a groggy limbo.
I consider explaining that my white matter probably resembles swiss cheese, but I know you would assure me once more that it’s just menopause or old age, and joke about how you’re forgetful too. Something like, “Let me tell you, I have cognitive deficits, and I don’t even have Lyme disease. We’re just getting old.” You would think that was funny.
Does turning 48 mean forgetting how to get home from work? Or struggling to spell words you learned from Dick and Jane? Or recalling your address or phone number? When you reach your midlife, do you really think flipping the light switch will turn on the dryer, or pushing on the rearview mirror will turn off the car radio? Is it really so hard to discern left from right in your late forties?
I am hoping you don’t suggest following me home for a visit. We might not make it. I might not remember how to get there, or I may have to stop and ask you where we are and where we were going in the first place. As we discuss those things, I may see something and comment on it. You would wonder who is crazy, me or you? You may not see what I see, but don’t worry, it’s not you losing it. Sometimes I see things that aren’t really there. Is that normal for my age?
You are hugging me and I realize you must’ve said you were heading home. I’m hugging back and wishing I had been more attentive, more absorbed in your world, your thoughts, your jokes and stories. But your words and their meanings seem to float across a slow moving pool toward me and sink before I can catch them. I have to dive down and by the time I surface, so many more are coming my way. I’m afraid I grew weary today and let many of them drift past.
Waving, you pull away and I sit still in my car, in the quiet. My body hurts. Not a centimeter of my frame is pain-free. I dread turning the wheel, my upper arms ache as if I had ten tetanus shots in each one the day before. My fingers and wrists may snap it seems. My calves, shins, feet, ankles, hips, back, ribs, head, ears, shoulders – – all owned by pain. Which way is home? Right, no wait, that’s left, right is the other way. Isn’t it? I’m not sure, but head out anyway and things look sort of familiar so I keep going.
I am wondering if you think me a fraud; maybe an attention-seeker or hypochondriac. Who has this many symptoms? I must be crazy. You always try and tell me I am just like you – – that you forget things, your joints ache, you feel tired. But, you are going to work tomorrow. I cannot safely work as a nurse. I tried for awhile but procedures I’d done a thousand times were impossible for me to complete in the right order. I’m still not sure if I filled those last few pill boxes right. You mentioned what you were making for dinner tonight – – a new recipe. You will be able to follow a recipe today – – even after a walk in the park and a conversation. I tried to make an egg this morning – – prepared my skillet, cracked the egg, and opened it onto the stove top instead of into the pan. I watched it lying sunny-side up and battled to understand its cold, runny state. Something was wrong, but it was a good minute before I found the answer and formed a plan to clean up the mess.
I’m not like you, and for some reason I can’t quite understand, I really need you to know that – – to cut me some slack, to lower your expectations. Instead, I feel as if I lie in a coffin made of frosted glass. I keep trying to tell you that I am trapped, that I can’t move, that it hurts, that I am losing my way and my mind, but you can’t quite see me. I’m not clear to you. So you keep going, and I give up sometimes and lie still. I stop trying to communicate my suffering and wonder if maybe you’re glad I’m in here – – where you can’t really see or hear me. Maybe that’s why you keep trying to tell me I’m O.K. Are you trying to feel more comfortable with my decline? Maybe you are sad over my failing health, but don’t want to be, so you keep slinging a positive attitude my way – – but it’s just bouncing off this glass lid, not because I don’t want to feel positive, but because this lid is real.
Isolation is worse when other people are present. If I were trapped in this coffin and no one was around, I would not hope for an understanding, empathetic friend. But every time you walk by, I hope. I hope you will be sad with me when I’m sad. I hope you will encourage me, not by denying my illness, but by acknowledging it and knowing that I cannot walk far, or stay awake too long, or always understand your words. I hope you will be in this box with me as best you can so you will know this war is real, my enemy is strong, and that even though I win a battle now and then and have a good day, I have a long way to go before I win this war, and likely, I will never have a clear and final victory; there may be scars. I may have physical pain the rest of my life. My brain my never work as well as before. Even if I hike again, an overgrown path will likely always cause a cold sweat and rapid heart rate. The tiniest tick will swell in my imagination to a giant disease-ridden monster and the uninhibited joy of the trail will never be the same.
But the most prominent scar, I think, will be the knowledge that I came through a war – – that my whole life was changed, became a fight, that for years I lost much, and you will never know. For you it will be as if nothing happened. A majority of the medical profession, of which I have been a part for 30 years, will not believe me. I fear the isolation I felt in my illness will continue after I am well. I will have a membership in a secret club to which I will never really want to belong. Those unwelcome members – – Borrelia, Bartonella, and Babesia – – they’ll always be lurking in the dark corners, blowing poison smoke, never gone completely, always looking for opportunity to rise again. There will be others like me, my comrades in arms, who will know without words how I feel because they have felt it too – – they will be keeping their eyes on the enemy the rest of their lives, just like me. But not you. We are close; maybe friends, spouses, sisters; maybe you are my child, or parent, but you will never really know. I wish you could know for my sake and for others like me, but I hope, for yours you can remain a pacifist – safe from this chronic, destructive war.
Lyme feels like this.