Tag Archives: illness

Spoonie for Life

The Spoon Theory was written by Christine Miserandino, while explaining to a not-chronically ill friend how her chronic illness, lupus, effected every part of her life.

It goes like this: Christine picked some spoons off a table and told her friend that everything she does—from getting out of bed, to shaving your legs, to preparing a meal, to making a phone call—costs a spoon. When she is out of spoons, she cannot do anything else. The spoon theory exists to point out the limits the chronically ill face, limits that not-sick people might not think of on a daily basis. Those are the basics—but I really, really recommend reading the whole, original article.

I don’t remember when I first read the spoon theory—I don’t remember it being a part of a whole website-network-forum like it is now, nor do I recall being able to buy mounted posters with its details. I just remember how it began to be passed around in a whisper, devoured by others like Christine and myself, to people who had no way to conceptualize the reality of our lives. I don’t remember when I began to call myself a “spoonie,” only that it sure sounds nicer than “chronically/invisibly ill.” And now spoons are kind of our thing. (I’m dying for this pendant in particular.) From the spoon theory sprung many social groups, an aesthetic to rally around, and (I believe) helped mobilize us sickies—along with social media—to create networks through which we can support and care for one another.

When I first read about the spoon theory, I had been diagnosed with rheumatoid arthritis and fibromyalgia for a couple of years. I’d endured strange looks when taking the elevator from the first to second floors, supposedly light-hearted teasing from friends, and of course, the inevitable cajoling and pleading: “Just one drink!” “Stay out with us until 10!” “It’s not that far of a walk, right?” Even after talking to friends, loved ones, and professors, over and over, I still found my illnesses—this new way I had to live my life—so hard to explain.

There’s the fact that I am alright one day and barely able to get out of bed the next—some days you have a lot of spoons and some you don’t. I took on successive, strange diets to try to curb my body’s inflammation. If I didn’t get ten hours of sleep, I felt like death; the same went for getting out of bed before 9 am, when my arthritis is the worst (damn you, 8:30 am college algebra!). I had been sick for four years before getting a diagnosis, but it took another four to find a “medical cocktail”—less fun than it sounds!—that my body responded to without unbearable side effects. Even now, I struggle with managing my illnesses, symptoms, lifestyle, pain levels, and medication/therapy schedule in order to maintain what looks like a normal life.

But thankfully, I have the spoon theory. A very dear friend, who’s known me from my first days of college as a perpetually-grumpy-and-pained frosh, recently told me that reading the spoon theory really helped her understand what I was going through. My boyfriend understands when I groggily wake up in the morning and groan “not enough spooooons.” They help represent the reality of my life, where I only have limited, constantly changing amounts of physical, and thus emotional, energy. That sometimes putting on make-up gives me an extra emotional boost, or that I can walk through a grocery store but need a wheelchair at Disneyland. I’m thankful for the idea of spoons—that they represent concepts so intangible, like chronic fatigue, pain, discomfort, and the fatigue that comes from being in pain all the time, in a way that I myself can easily communicate to others.

Like Christine says in the article, no matter how much someone watches you from the outside, it’s really hard to conceptualize what their life might be like. We live in an ableist society that subtly insists that our value as people and the amount of things we can do are intrinsically tied—and that getting out of bed, going to work, and seeing friends is simply a matter of willpower. In this way, I’ve also found a lot of strength and hope in identifying as disabled, because a) I am, b) I have a community with a history of anti-ableist activism, and c) people sometimes believe you if you say you have a disability! If someone can’t understand the basis of the spoon theory, that my energy is limited, and that it’s a thing they should respect—my objections to being called an “old lady” or being told to go out dancing when I physically can’t—then I probably can’t be friends with them. Realizing this saved me a lot of heartache. Spoonies ourselves are an exercise in cognitive dissonance—we may not look sick, but that sure as hell doesn’t mean we’re healthy.

I’m not sure if Christine had anything to do with online support groups now available for young adults with chronic illnesses, but it least allowed me to have that keyword so I could look for “spoonies” on every social media site ever created. After meeting offline maybe three other young adults in my whole life who are also chronically ill, joining a group with twenty to three hundred members made my eyes do the heart thing as I sighed in relief at not being alone. These support groups have done just as much for me as any doctor or medication—the unwavering support and love of people I’ve never met, who nonetheless, get it in a way non-sickies can’t is abso-fucking-lutely mind-blowing. I’ve met thoughtful, struggling, lovely people and finally have been able to think Yes, this is me! Me too! And, just as importantly, I am able to give that love and support that I wish I had received early on, and that all people should receive from every person they encounter.

Photo by Gali Levi-McClure

Photo by Gali Levi-McClure

Concerning Cats

The most important thing to learn from my experience will be the first and the last thing I say in it: if your pet has a sudden change in behavior, get help immediately. Don’t walk—run to the nearest vet and figure out what’s going on.

It all started in March. For the two years that I had been living with my fiancée and her adorable, feisty furball India, I was greeted at the bed by a head-butt and a purr every evening when I got home from work. Head-butts and purrs usually lead to a happy kitty having attention lavished upon her. So when I came into the room for a week straight without being greeted, I was worried. What was even more concerning was the fact that she was sleeping alone under the desk, rather than nestled between our legs like usual. Well, everyone has an off-week, right? Besides, it was a particularly warm week; I figured that India just didn’t want to heat herself up any more than absolutely necessary. But when I got the chance to break out the laser pointer, then the catnip mouse, and then a long colorful shoelace with no response, some small voice of panic inside of me welled up and shouted that something was wrong.

A quick Google search told us that severe lethargy in cats can be capital-B Bad. Or it could mean nothing. But when it comes to the lives of pets (a.k.a., family), always err on the side of caution.

It was already after-hours at the vet when we were incited to action on Friday night, and our normal vet was out of the office for the next week on vacation. So, we found the next closest vet with the next closest appointment—I worked from home Monday so that I could bring India in as soon as the clinic was open. (My boss and coworkers were extremely understanding throughout this process, allowing me to work remotely. In any case, it wouldn’t have stopped me from getting India the attention she needed.) Into the carrier and off to the vet we went!

When your cat is healthy, you don’t necessarily pay attention to things like their urination or defecation. This is especially the case if you have a closed litter box and clean it on a regular schedule instead of checking daily. But these are things that the vet wanted to know, and they were answers that I couldn’t readily produce. As an indoor cat, we thought that the vectors through which India could be hurt were minimal. They told me to keep an eye on her and bring her into our normal vet as soon as possible since blood tests and x-rays showed no problems.

Rallied by the “all clear” that I received from the first vet, we thought that maybe India was just feeling a bit older and didn’t feel like moving around as much in the heat. Regardless, we got an appointment with our vet and brought her in together. Once again, blood tests and urine tests were performed, and everything came out as “normal.” Our vet asked us about a few common household chemicals and whether or not India had been around them. Of course, she hadn’t. The vet thought that maybe she had gotten into something and just needed her system flushed, so we left her at the clinic overnight to get some extra observation and IV fluids, and were hoping to pick her up the next day.

After observing her overnight, the vet decided that they wanted to keep her an additional night. On the phone, the vet asked us once again if there was anything that she could have gotten into. “We don’t even have human food where she can get to it. The only things that she can easily get to are her food and water. She gets a catnip toy when supervised, and we give her flea medicine to her every month…” The vet took some notes and said that she would get back to us the next day. We picked her up two days after dropping her off, and the vet gave us the likely culprit: her flea medicine.

Our vet had gone through the flea medicine’s ingredient list and had done research on each item. The “organic” and “green” flea medicine that we were using (stocked at a small child’s eye-level at Safeway and Petco) contained an ingredient that was so toxic that humans were required to wear skin- and eye-protection when handling it. This wasn’t the typical “IRRITANT” label that anyone who has used sunscreen is used to. As for the products claims of being “green,” our vet helpfully pointed out that arsenic and cyanide are “natural and organic” as well. If the medicine’s ingredients can cause such severe harm in humans, how much worse is that damage for a being that’s a tenth of our size? Quite a lot worse, as it turns out.

Had we had any previous indications or reactions, we may have looked online and seen the hundreds of reviews of this particular product, many claiming that their pets were poisoned almost to the point of death (or were sadly killed) by this product. Since this happened as a result of the build-up of over a year’s worth of applications, we never suspected that something that hadn’t caused her any issues before was the culprit of her sudden health problems. How were we supposed to know that counterfeit and bogus flea medicines are some of the pet industry’s top money makers? The vet informed us—our mouths agape—that some popular flea medicine brands are counterfeited so convincingly that grocery suppliers often can’t even tell the difference, leading them to be stocked at your friendly neighborhood corner store.

For a week after we got her back, we had to give her daily subcutaneous fluids to help flush out as much of the poison as possible—this meant we had a giant bag of saline hanging from our ceiling fan, and every day started and ended with one of us holding her down while the other shoved a needle of cold fluid into her neck. We’re now almost three months after the fact, and India still hasn’t recovered. Because of her lethargic response to the poisoning, not moving around caused severe muscle atrophy in her hind legs and she now has a hard time getting around and doing normal kitty things—holding herself up in the litter box, jumping on anything, walking across the room. We have done everything we can to make sure that she’s comfortable and happy, including replacing her litter box with one that has a lower wall so that she can get into it easier and adding a set of kitty stairs to our room so that she can get off the bed easier. We’ve taken her to a feline physical therapist, and now have a set of rehabilitation exercises that we perform with her morning and night.

Even though we’re still working through the mechanics of this ending (and it isn’t exactly the happiest), we now have a story to share with all pet owners: only trust the flea medicine you get from your veterinarian, and if your pet has a sudden change in behavior, get help immediately.

Photo by Sara Slattery

Photo by Sara Slattery

The ER: It’s nothing like on TV

Just under 130 million people visit ERs every year, complaining about everything from earaches to broken bones to severe pain. I, myself, have visited the ER more times that I would like to admit, due to some chronic illnesses that love to become acute at the worst of times, combined with a tendency to twist joints in directions they are not meant to go.

Photo by Meaghan Morrison

Photo by Meaghan Morrison

If you’ve never been to the ER, it’s good to know what to expect in advance, because the stress of the situation can easily overwhelm you.

Bring your ID and insurance card: While paperwork is often the last thing you want to think about when dealing with a health crisis, it’s important that you have the necessary documents so that the hospital can easily get you into its system. Without them, it can be a nightmare in the following weeks to  play middle man between the hospital and your insurance company—trust me, I’ve been there. That’s why it’s one of the first things you’ll be asked for: while you’ll never be denied care, insurance or not, having all of your information up-front will save enormous headaches down the road. Usually, registration is quick, and in big emergencies where you can’t really chat with the hospital staff, they’ll get it from a family member or friend as soon as possible. I keep my ID and insurance card with me at all times in my wallet, and I make sure at least one other person can access it: in college, my roommate and I had copies  of everything organized and accessible—it saved the day at least once.

Know your medical history: The first thing you will do after registering in the ER is go through triage, whether you arrive by ambulance or walk through the front door. This is a short process in which a nurse or nurse practitioner will measure your vitals (blood pressure, pulse, oxygen levels, and temperature), find out what symptoms you are experiencing (always be as descriptive and honest as possible—unlike hospitals on TV, they aren’t likely to spend hours and thousands of dollars worth of tests figuring out what you are hiding: drugs, drinking, sex, all of it is important), ask for your pain levels (scale of 1-10), and get your medical history. This will include information like what medication you take, including any vitamins, your drug and alcohol use (again, be honest!), medical conditions, and any past surgeries. If you are female, you will also be asked if there is any chance you could be pregnant and when your last menstrual cycle was (it’s as awkward as it sounds at first, and often I forget—I hate this part). All of this information is key to helping with diagnosis, so it’s important to keep it handy. If you have a few things you need help remembering, keep a list on your phone or somewhere else handy so that the stress of being sick doesn’t cause you to forget the dose of your daily medication or the name of that surgery you had years ago.

The wait: ERs are notorious for their wait times. This is most common in big-city ERs where life-threatening traumas are more commonly experienced. I’ve experienced wait times as short as ten minutes and as long as five hours. It’s a toss-up as to when these times will be the worst, but I’ve found that nighttime is definitely the longest wait. There’s less staff on call, tests take longer, and there are more accidents coming in.. In the end, your wait depends not only on how many people are there but also how ill you are in relation to the other patients. If you are having a long wait and your symptoms change, make sure you let the triage nurse know immediately.

Getting care: Once you are seen, don’t expect there to be a private room: it’s often simply a curtained-off area. This can be extremely awkward at times, because you can hear everything around you. Sometimes it’s difficult to overhear, especially if someone is very sick around you. Other times, you’ll hear the wackiest conversations: I once heard someone find out that they were pregnant with their mother there, and her reaction was hilarious. In the ER, people watching is one of the few forms of entertainment available.

A different nurse will probably take your vitals again, will likely take some blood, and will ask you many of the same questions you were asked in triage. They are required to do this: it’s annoying, especially when you’re stressed and worried, but it ensures that they are getting the right information. Depending on your symptoms and complaints, they may also put you on an IV immediately. An IV is a tube  inserted into a vein, most often in the arm where blood is taken, which facilitates getting fluid into your body (often saline) and medications for pain or nausea. It only takes a minute to insert and, though it’s super uncomfortable, it no longer hurts once it’s in.

After the nurse has seen you, a doctor will follow. Sometimes this wait can also be a bit lengthy, depending on how many people that doctor is covering. He will again ask you about your symptoms and conditions, and may have more extensive questions than you have experienced previously. Depending on your situation, he will then likely order medications or tests to figure out what is going on. Those tests can vary from blood work or urine analysis to an ultrasound, X-ray, or CT scan. Every trip of mine has varied because it really depends on what the issue is. The worst by far for me was when I was in a severe amount of abdominal pain. Seven hours later, I had gone through three rounds of blood work, an ultrasound, a CT scan, and an EKG. Other times, I simply had one test and was out within an hour or two. No matter what, they try to get these done as quickly as possible, but there can be a long wait even when you are in a room.

Leaving the ER: Once the doctor has the results, he or she will either order more tests or, if they’ve found a diagnosis, will get you the right medication or care. Remember that the ERs are for acute care (for sudden and often moderate to severe issues). I’ve always left the ER with a prescription for pain medication or other temporary treatment, with the direction to follow-up with my doctor as soon as possible. Usually, once the major issue is solved, my regular doctors are able to get a better idea of what is wrong and find a long-term solution so that I can avoid acute issues down the road.

If the condition is serious enough, it may warrant admittance to the hospital. I’ve been admitted three times in my life: once right after an emergency surgery, and twice when I spent six days in the hospital before solutions were found and solved by surgeries. Those were expensive, scary, and extreme cases, and I am definitely an exception to the rule: in reality, only about 13% of ER visits result in hospital admissions. Likely, admittance would occur for something like heart trouble, breathing issues that can’t be resolved, severe pain that can’t be managed, dangerous blood pressure, or serious infections. Hospital admissions are expensive and the beds are in high demand, so it requires sound medical necessity. However, if a doctor wants you to be admitted, know that it is in your best interest and they will aim to have you better as soon as possible. It’s always been worth it for me!

Otherwise, it’s back home you go! You will be discharged by your nurse, which, like everything else, can take anywhere from ten minutes to an hour, in my experience. Discharging includes home care instructions, information on your diagnosis, and any prescriptions you might need. Be sure to also request records of any tests you received, so that you can show them to your primary doctor and have them added to your medical file.

ERs are overwhelming places. Sometimes fear of them will keep people from going at all. However, if it could be a medical emergency, you need to make sure you get it checked. It’s never silly to go if you are unsure of a severe pain or of a mystery symptom that concerns you, especially if your doctor is unreachable. And if it’s a critical emergency, never hesitate to call 911 and get an ambulance, as it is always the safest and fastest way to get to the nearest hospital. I’ve arrived at the hospital by ambulance and by my own transportation: sometimes, it was out of my control entirely as I wasn’t the one calling the shots, but other times when I could make my own decisions, I never hesitated to go by ambulance if it was my best bet. Don’t be afraid to call one, despite the possible expense, because it can make all the difference in your situation—some counties even cover the cost of an ambulance for this very reason (mine does!).

Hopefully, you will never need this advice. But if one day you do, you now know how to be prepared and make it just a little bit easier.