This site is dedicated to the ongoing journey of emotional and spiritual growth in the face of physical deterioration. Join Susan S. in her day-to-day battles where victories are celebrated and defeats are sorrowfully appreciated for their lessons.

Click here to read My Story Begins or Lots to Think About Now.
Showing posts with label Pain. Show all posts
Showing posts with label Pain. Show all posts

Saturday, July 4, 2009

When The Answer is Clear: Stage I

The quest for an accurate diagnosis when riddled with atypical symptoms is emotionally painful and can test the emotional fortitude of even the most devout optimist. So many of us with mysterious ailments have blogged about desperate needs for an ICD-9-CM code, and the validity that comes along with it. Instead of finding explanations for the symptoms that have destroyed our lives, we are dealt cards of shame by medical professionals who will not accept their own limitations.

Because some medical professionals are not able to tolerate 'unclosed cases', they circumvent their own, personal feelings of frustration back onto the patient. As I have read in many blogs, this repeated ridicule of arrogant medical professionals is frequently as paralyzing as the physically disabling symptoms themselves. It's easier to accept the failures of our bodies than it is to accept the fallacy that is fed to us: We are failures to the world. It took quite a bit of emotional energy to fight this message and I am grateful to have an ICD-9-CM code of 756.83 which validates me as a legitimate patient, making it easier to battle the periodic attacks by doubting professionals who seem to feel very comfortable making others feel uncomfortable. Yes, 756.83 has bought me some credibility, just as the many initials after my name, but I STILL guard against such attacks.

In my first blog of 2007, I described how a story profiled on the television series Mystery Diagnosis lead me to a team of doctors who first gifted me with 756.83. My first year of owning 756.83 was wonderful…not that any of my outrageous symptoms improved, but at least I had an understanding of what was happening to my body. This understanding seemed to take a lot of the fear away and I was able to focus on building a new life within the limitations of my disease.

As an optimist, I never focused on the degenerative issues associated with 756.83. Convinced that understanding was the key to overcoming fear, I continued my quest for explanations for new symptoms as they arose. My most recent symptoms include dramatically increased pain levels over the past year. I now have pain in areas that I never knew I had. Lying on a gurney in the ER with a Dilaudid IV only made the pain seem distant. It seems to come and go as it pleases and, despite my talent at tracking patterns, no one has been able to identify a definitive pattern to my most recent attacks of pain.

Once upon a time, before any of this stuff hit the fan, when I was a highly functioning professional, wife, and mother, I spent a year telling a therapist that I felt like something was very wrong with my body. Having a lot of faith in me, my therapist encouraged me to pursue medical attention. Appropriately, I did NOT follow-up on this for fear of being labeled a nut. Hmmmm. I wonder if I would have been labeled a nut if I went to the doctor and told her that I had a feeling that something was very wrong with my body? Anyway, when everything did hit the fan and we first discovered my elevated intracranial pressure…way before I received 756.83…I told my doctor about the feeling I had for the past year. Her response was that she wished I had come to her because usually when patients say they have such a feeling, there typically is something wrong. Frankly, I didn't believe her and still felt I made the right decision by not pursuing medical treatment based on , "a feeling." Personally, I don't see anything wrong with being a nut, so long as you don't cause anybody harm (including yourself). Unfortunately, however, most of the world confuses being a nut (something like 307.80) with being evil.

Jumping forward to this past year, despite the cushioning effects of 756.83, I once again experienced that familiar feeling of impending doom. I tried to write it off as anxiety from new symptoms and intractable pain, but my intellect would not allow me to ignore what was once before correct. I tried to imagine what it was that my body was telling me…the secrets behind the mysterious, new pain. My imagination became ugly as I saw my internal organs falling down inside of me. It felt like everything was falling and, for probably the first time during my illness, I was terrified. Not wanting to let my imagination get the better of me, I pushed those ugly thoughts out of my head and focused on getting to NY for a follow-up visit at TCI, with all of the appropriate imaging and functioning studies scheduled to my specifications.

The ease with which Dr. B. of TCI first bestowed 756.83 upon me in 2007 was almost comical. It took a few months before I sincerely recognized that one very large piece of my puzzle was in place. Despite this wonderful gift, my hypervigilance continued as I maintained my stance at following up on every illnesses I had until I could piece it all together and fix myself up. Reasonable, right? After all, I am a scientist…able to leap tall buildings without breaking a single test tube! I should be able to fix this enough to get back to work, where my colleagues are still patiently waiting for me to return, right?...NOT! Not only haven't I been able to fix myself, but things just keep getting worse and I haven't been able to get to the root of the problem which will halt all of this decomposition. I have lots of ICD-9-CM codes in addition to 756.83, but most of them seem to result from 756.83 and nobody in the world, anywhere, has any answers about how to fix that…except to fix things as they break.

So I went to NY in the spring of 2009 in the hopes of a potential diagnosis which, if I had it, would be easy to fix and bring me much relief. I suppose I should be relieved that I won't need surgery for this problem that I don't have, but I would have liked to have something reasonable to fix. I met with several doctors on that trip, and none treated me with the dreaded attitude of some professionals with one semester of psychiatry training. No one accused me of being psycho. There was one commonality between them, however, regardless of the facility they represented. They each avoided eye contact with me as they initially expressed condolences for my condition and stated that I was far too young to have to deal with all these medical issues. This time, the doctors were all sad, and they did not blame me for it. I am grateful for the lack of blame, but the sadness frightened me.

It all came to an emotional head for me when, while meeting with one of the doctors, I assertively zeroed in on the source of my debilitating, abdominal pain…the pain that at times would not go away with Dilaudid IVs, the pain that has kept me from my beloved recumbent tricycling, the pain that is new, and scary, and unknown. Backed into a corner, the doctor seemed to throw up his arms and exclaim that with 756.83…Ehlers-Danlos Syndrome…everything falls down and causes all kinds of pain. I was told clearly that it hurts in my feet because of the falling of my spine and the abdominal pain could be from a dislocated coccyx, bad hip from years of repeated subluxations, neuropathic pain from pressure on spinal nerve roots, or falling organs.

It was the last one that hit me: the falling organs. This was my fear. This was what I felt in my heart had been happening to my body. This is what had been scaring me for so long now. I was facing my fear right in the face of what we tend to pray for: a doctor who takes our symptoms seriously. I got what I prayed for. I got my answers. But I didn't like my answers. The office had to work around me the rest of the afternoon because I was so hysterical that I could not be moved from that examination room for some time.

So what do we do when we finally satisfy all the questions but we don't like the answers? I don't know the entire path yet, but I know that the first thing you do is cry. Then you borrow your mother's credit card while in New York and go shopping…it's kind of like binge eating. Then you go right back to crying.

And then you isolate so your crying isn't disrupted, because it stinks to have to keep up a cheery face when you really need to be crying. You dye your hair bright red as a way to scream out something to the world, but who knows what it is you're screaming out with bright red hair. Then you sniffle. Then your hair fades to pink. Then you chuckle at your hair and put on long earrings and hang out at Starbucks…and you blog.

To be continued as I migrate into Stage II...

Tuesday, May 5, 2009

Celebrate the Day


I recently attended a local, outdoor event which included terrific community performers. The day was beautiful and the mercury peaked at about 90 degrees. My body's inflammation level was low, so I was able to cycle from my home to the event and enjoy the performers in the comfort of my recumbent trike's seat. Ahhhhhh. Lazy in the sun!

Despite the heat, there was a gentle breeze which flowed through everything from trees to people. The breeze gently nudged the flowering trees that spring had recently awoken, and it moved through the crowds of people who were gathered at the base of a stage, and traveled upward to cool the performers. Just as the breeze moved the trees, the music seemed to move the people in a common wave. No one was untouched by the feel of the music, but some were capable of feeling it more than others.

The audience was made up of families and unattached adults of varying races and ages up to 80ish years old. The kids danced freely with little inhibition while the young adults moved with precision and sex appeal. One participant caught my attention as I was able to identify her as a chronic pain sufferer by her appearance. She clearly had orthopedic complications, including a scoliosis. Despite her apparent disability and advanced years, she was the most celebratory dressed person there and danced like she had once been a professional. Her professionalism was as nostalgic as the 60's style music coming from the stage, although it looked like she might have been able to contribute some nostalgia even in the 1960's! At one point, she executed a dance maneuver while close to me and I observed her shoulder subluxate. Without missing a beat, she reset her shoulder back into normal position and continued on with her enjoyable performance. I understood the kind of discomfort that accompanies that type of orthopedic hypermobility and I knew then that her overall body pain must be quite severe. Yet, despite the crippling pain, she left her walker on the sidelines and danced in celebration of the day.

Since I always keep a camera on my trike, I captured some of Carolyn's spring day celebration, and then had the honor of speaking with her. Anyway, without further ado, he-e-e-e-e-e-re's Carolyn!


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...and here's an auditory treat for your day from Monty Python!


Wednesday, April 1, 2009

How I Cope When All Is Bleak

I don't always have the perfect attitude, but I try to keep in mind that things tend to get better when everything is really bad. Statisticians refer to this as the floor effect. This video shows what I look and sound like now that everything seems really lousy. Please ignore the fact that I'm overdue for a haircut.


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Susan S.

Wednesday, January 30, 2008

Lots to Think About Now

It's been a long road so far, but alas it appears that there might be a resort full of lively activities just over the horizon, waiting for me to check in. Unfortunately, the road between here and there is partially 'unpaved', but with the support of my family, we'll make sure our wheels are ready to roll before we continue on from here.
It appears that the shunt which was implanted in my brain two years ago to relieve increased intracranial pressure has NOT failed and is functioning properly. Thank you Codman, Inc.! Despite this, however, my intracranial pressure appears to be rising, giving me many annoying symptoms such as poor vision , tinnitus, head & facial pain, silly walking, and seizures. Although the shunt's setting somehow got changed to a non-optimal level, it is not anticipated that reprogramming it with a big, electronic magnet in New York last week will have much of an impact on my intracranial pressure. The consensus is that my intracranial pressure is rising because my overall condition is deteriorating…but do not fret!...all is not lost!!!
The past few months have been exhausting with multiple trips to see Dr. Chainsaw while being in less than travel worthy condition. Last week, interspersed with visits to Chainsaw, I went for a second consultation at The Chiari Institute (TCI) in Great Neck, NY, followed by a consult with a leading expert in Ehlers-Danlos Syndrome (EDS) in Baltimore, MD: Dr. Clair Francomano. While I hesitate in naming doctors and institutes until all the cards are in, diagnostically these people have been incredible and unbelievably keen. These are not 'highlighter' doctors who run their highlighter pens across a lab sheet…these people think!

Although the long-term effects of the EDS have had dramatic effects on my entire body, the most significant at this time is my brain. Because the EDS has affected the connective tissue around my craniocervical junction (where your skull meets your neck), my skull is kind of falling off and because of this my brain is slipping out. This is called Functional Cranial Settling and as it slips down, my neck bone presses up, into my brain. Ouch! That's why stuff happens like loss of speech, hearing, sight, temperature control, etc. Because the head appears to be connected to everything else (hmmmm), lots of secondary effects occur such as adrenal fatigue (I have that), flattened pituitary gland (I have that too), increased intracranial pressure (I guess I have that one too), etc, etc, etc. We absolutely know I have this, but it is still up for grabs whether or not I have something called Tethered Spinal Cord. This is also related to spinal problems from EDS where the bottom of the spinal cord is getting yanked improperly which can lead to similar symptoms. TCI has some incredibly educational videos on their web site: http://www.northshorelij.com/body.cfm?ID=6407 .
Now we're talking surgery. It's scary, but exciting at the same time. I think we're at least a year away from the surgery because of all the preparation, both physical and financial. I saw films of what they do and it scared the hell out of me. I'm incredibly tough when it comes to this sort of stuff, but I got scared when I saw this. I think that's why they showed it to me because they don't want any woosy-ass patients. Oy. Guess I gotta' get a grip!
Surgery #1: Craniocervical Fusion…oy vey. The idea is if they stabilize my head and neck, then my brain should float back to where it should be and my symptoms should improve dramatically. Hopefully, my intracranial pressure will even come down. Within three months before the fusion surgery, TCI implements a procedure they developed called invasive cervical traction. It is used first to confirm the diagnosis of functional cranial settling, and then to pinpoint the exact measurements to be used in the actual fusion surgery. This process goes on for a couple of days and a patient named Kriss posted pictures of herself during this procedure: http://www.killerbanshee.com/family/medical/headtongs.html . First they put bolts into the sides of the skull (under anesthesia) and they attach the bolts to a traction device which allows them to manipulate the position of the head and neck while taking both radiographic measurements and assessing my symptoms while awake. It's like trying on a dress before you buy it! From what I understand, nobody else in the world is using this procedure and it has been suggested that I take advantage of this wonderful technology they have developed. After all the measurements are together, I'm ready for surgery (?) where they fuse the bones together as prescribed by the invasive cervical traction procedure. Kriss has been very kind in posting pictures of her post surgical x-rays (http://www.killerbanshee.com/family/medical/cervicalxrays.html) and incision (http://www.killerbanshee.com/family/medical/surgery-Pages/Image9.html) although my pictures won't look exactly the same! The big debate is if they will be able to stop at C5 or if they will have to go down to C6. It is anticipated that I will lose about 40% mobility in all directions, but I consider that to be minor compared to what I have to gain.
Surgery #2: Tethered Cord (huh?). I don't know much about this procedure because I don't know if I even have it, but there's many signs that I do. From what I understand, it involves releasing the base of the spinal cord from an abnormal restriction. The results of this procedure appear to be just as miraculous as Surgery #1, but substantially less invasive. This is not an option, however, instead of Surgery #1. It is simply being discussed at this time as an additional diagnosis and I do not know how it is recommended to handle both conditions.
So what about right now? I'm going to be in more restrictive orthoses between now and then to accommodate my deterioration and to try a mimic the effects of the surgery to ensure that this is what I want to do. I'm even getting orthotic devices for my poor little EDS stricken fingers! I've also got better supervision for physical therapy, although I need to find a therapist in my area who can work with an EDS citizen. The neurosurgeon and Chainsaw have to battle it out to determine when it would be safe to go, although Chainsaw feels that the problems with my maxillary and mandibular bones will not spread beyond. TCI and Dr. Francomano need to agree on the diagnoses and course of treatment. There are several financial battles including negotiations with TCI, the insurance company, rehabilitation centers and lodgings for family members, some way to pay for stuff like our laundry services as I can no longer have my head lower than my chest. I'm getting close to the point where I need help dressing myself and expect this to happen before we get to surgery time.
Aside from all this focus on getting myself better, I'm also focusing on keeping some normalcy in our lives. This is the only way to approximate sanity! Believe it or not, what I've wanted to do for the longest time is go to weekly Weight Watchers meetings. Yes, I'm concerned about my weight and my internist and I agree that this is a safe program for me, but I really just want to feel like I'm doing something normal on a weekly basis (besides flying to New York for the day for a little crunch and grind). I know I can do the same thing with physical therapy, but Weight Watchers sounds like so much more fun…especially when I go to Ben & Jerry's afterwards!
Love to all…
Susan S

Wednesday, October 17, 2007

Autumn's Chainsaw

I'm not sure who painted this mornings picture, but who ever did it, she is a very gifted artist!. It appears that autumn is finally here as the strong light of the early morning sun pointed all attention to emerging colors of orange and red amongst the rolling hills of green trees. This is the sight that this morning's artist treated me to as I rode to the airport, on my way once again for a day in New York for a little crunch and grind with Dr. Chainsaw. The bone infection has been debilitating since I got back from my last treatment two weeks ago. I won't go into details, but its really gross! In the meantime, my body's overall inflammation level has skyrocketed. At the risk of sounding like a kvetch, the first wakeful sensation of yesterday was pain in my fingers, accompanied by stiffness. Neuropathic type of pain plagued me throughout the day with hits along my arms and legs, as well atomic strikes on my hands and feet. By nightfall, I was back to the feeling of battery acid pouring down my arms, similar to what I felt a year ago before I received some relief through nerve blocking procedures. I'm sure anxiety over the possibility that the nerve blocks wore off didn't help. Nerve blocking is not usually a permanent solution to inflammatory problems of spinal nerve roots such as mine. Oy. I'm back on some serious non-steroidal anti-inflammatories which I have permission to use for a maximum of three days, after which I will start to increase my risk of stroking dramatically. Jeeze. Give me a break already! In the past, when the bone infection has become very active, it sometimes triggers my body into an inflammatory state. I'm hoping that this is the situation and today's crunch and grind will help to wash away the 'battery acid'. Otherwise, I have to go on the hunt for a doctor to perform new nerve blocks. While I'm very happy to have moved to this new state and have access to a wonderful new pool of medical professionals, not to mention a whole bunch of nice people, its difficult to be in critical need of a skilled doctor and not have one already in place, not to mention not having the slightest idea of where to begin to search! In light of the fact that it's hard to start all over with new doctors when you're sick and in pain, I'm going to root for the bone infection's driving the body's inflammation hypothesis and settle for fixing this problem when I get off this plane in half an hour. Regardless of today's crunch and grind outcome, I will be relying on just enough local anesthetic to allow me enough sanity to direct the driver to my favorite bakery (that's why I don't like to do this on Mondays, this bakery is owned and run by an Italian family and is traditionally closed on Mondays) to pick up a dozen of the world's finest prune hamentashen before catching my flight back home. With God's help, I'll be back on my bike within a few days! Thanks for keeping up with me and for all the e-mails and, well, not so many lately, guestbook messages! Later!

Monday, September 17, 2007

Stepfather Part I

I know that the term "stepfather" has a negative connotation to it and we're supposed to use better sounding words such as "bonus father", but my mother's husband has truly stepped in as my father. I have no problem referring to him as my stepfather because that is exactly who he is to me. I thank God that I have him and, right now, I feel as if I am the luckiest person in the world. I know that I'm super sick and suffering and miserable and everything, but at least I have a wonderful stepfather to help me through it! Earlier this month, my husband and daughter and I picked up our lives and moved to a new state for: 1) better career opportunities for my husband, 2) better educational opportunities for my daughter, and 3) better medical opportunities for me. Part of that move left us in closer proximity to NY, with even the possibility of getting there by car. In the middle of all this craziness with settling in a new world, the osteomyelites kicked in big time. I have had pain running down the entire side of my body and my vision has deteriorated horribly. I have needed to get to NY for medical attention from my oral surgeon there but had a very difficult time getting anyone to help me, as it seemed all family members (not that there are many to begin with) were overrun with responsibilities and responsible medical aids were not available due to ridiculous reasons such as hurricanes. I hate not being able bodied enough to travel independently! Upon overhearing my desperation, my stepfather got in his car and drove half a day to my home and then spent another day driving me to New York. At this moment, I am safely tucked away in the hotel that my mother had arranged for us and I know I'm going to be o.k. throughout the procedures this week because my stepfather is here with me. While I wish I was independent enough to face this week on my own, I'm glad to have my stepfather here with me. He can't possibly make the pain go away, but he sure does make me feel like smiling!

Wednesday, August 8, 2007

Moving with Vitamin D

I'm exhausted! I would say our house is about 78.6% packed up in preparation for our move to Raleigh. I have to go to NY in a couple days for some 'maintenance' work on my facial bones, and then its back home just in time for the drive to our new home. Oy. Scared and excited at the same time. The genius neurologist came up with some interesting ideas about the role of vitamin D in my bone healing process. He has some interesting theories about low levels of vitamin D and headache prone people (his area of expertise) which seems to be supported by literature from other disciplines. I had, at the same time, independently been wondering about the role of vitamin D with my problems in that I've noticed whenever I spend time in the sun, I have substantially reduced inflammation and pain. Because of this, I had already begun D supplementation, but apparently not anywhere near the levels necessary to have an impact on my body. The doc wants me to have my blood levels checked before starting with large vitamin D supplementation (by the way, it's not really a vitamin). I'll keep you posted. Later!

Wednesday, August 1, 2007

My Story Begins

I always loved my work and took equal pride at my more traditional accomplishments at home, but I was never as comfortable with myself as I was during my mid-forties. I had arrived into adulthood and lived every moment to the fullest in the ways that I enjoyed the most.Throughout 2004, I could be seen picking out vegetables at the gourmet market on Wednesday afternoon with a Dictaphone in one hand and a cell phone head set attached to my head. On Thursday evening I would be cooking up a storm with my laptop computer in the kitchen running statistical programs and setting the table for Friday night. When we would get home from synagogue on Friday evening, soup would be simmering at the right temperature on the stove and the rest of the meal would be in foil packs in the oven at a low temperature. The table would reflect light from Grandma’s polished silver.
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Although I had been a research psychologist since the early 1980’s, most of my work has been in the area of physiology with an emphasis on statistical methodology. My publications primarily focused on physiological responses to different types of stress, but my dream was to research the specific effects of trauma on mental and physical health. During the later years of my career, my dream was coming true when I was invited to join a team of scientists looking at war stress. The resulting data from this exciting study were becoming available for analysis and write-up at the time that illness entered my life. I was in the process of writing up my dream paper when I was stricken down.
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As frequently happens when working in a research environment at a major University, several grant renewals came due at once. So, I had to put my dream paper down for a few months to work along with my colleagues to take care of grant business. It was during this time that I began to have female medical problems. They were unusual, painful, progressive, and unexplainable. I would frequently have to take Percocet while at work, so I arranged for a graduate student to watch over my shoulder and make sure I didn’t make any mistakes, which I of course did. This was my first feeling of defeat because I never used to make mistakes at work. The only medical explanation that was offered by my gynecologist (whom I adore) was, “You’re a freak.” In November of 2004 I had a uterine ablation and in January of 2005 I had a hysterectomy.
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While recovering from the hysterectomy at home about a week later, I was ambulanced to the hospital with partial complex seizures. I had never experienced this before. I also had the most horrible headache of my life, although I had been having terrible headaches for about a year or two. That day I received my first orphan disease diagnosis: Idiopathic Intracranial Hypertension (also known as Pseudotumor Cerebri or Benign Intracranial Hypertension), which is basically too much cerebral spinal fluid pressure on the brain for unknown reason. I was given medication which gave me some pain relief and partially retarded the blinding process from pressure on my optic nerves. Despite the horrendous medication side effects, I continued to work and returned to the front line outfitted with magnifying glasses to join my frantic colleagues in our desperate attempt at meeting all deadlines.
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Once all the grant deadlines were met, I was finally able to take out my beloved trauma paper to work on again. Apparently, however, completing this manuscript was not in the current plan for me. Whatever was affecting my ability to work, pressure on my brain, seizures, medications, whatever, I could not understand my own work that I had done a few months earlier. As a matter of fact, I was not able to read any material in paragraph form. I tried so hard to read what I had done and tried to understand what I had written and understand the diagrams I had designed, but I could not. I was devastated. I had to put the trauma paper away again, with the hope that that part of my brain would come back someday.
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So I went back to the simple, mundane statistical tasks that I seemed to still be able to do. Within a few weeks, however, those abilities were gone too. I’ll never forget how it felt to call my best friend, colleague, and boss to tell her that I couldn’t do it anymore and I had to resign my position. We had been having babies and working side by side since 1985. That was hard. It was hard to clean out my office and see my work in garbage bags lined up along the wall. The only work I saved was my beloved trauma manuscript in the hopes of regaining enough cognitive functioning to complete it in the future.
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I’ve worked since I was 19 years old and never imagined life without a job. Not only did I always have a job, but almost all of my identity was synonymous with my work. Giving up my career was the hardest thing I ever had to do in my life. This marked the beginning of my battle with finding a new identity. Jeeeze. How many times do we have to go through adolescence before we graduate?
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The summer of 2005 brought more physical deterioration, but spiritually I fought back with a vengeance. I hadn’t a clue as to who I was anymore, but I was driven to survive for the sake of instinct, love, and a past history of surviving the impossible. My abilities to walk and think were deteriorating dramatically and no one was able to offer any medical explanation. Not being able to comprehend the medical literature anymore, I began to rely on internet message boards not only for emotional support but also for my medical guidance. Most of the time it was hard for me to understand the words posted on the message boards, not that they were complicated, but that my mind was mush. But by monitoring these message boards, I was able to put together that the acne ointment I was using on my face was responsible for vitamin A toxicity in patients like me and once I stopped using it, I was able to walk by myself as well as read some of the medical literature on the topic within three days. Eventually I conversed with a scientist out of state who documented a case like mine (yes, it is published in a legitimate medical journal) and believes that most people who develop vitamin A toxicity through transdermal acne treatment wind up with psychiatric instead of neurological treatment.
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I rapidly learned to not be such a snob when it comes to medical information. By being taken down another notch in intellectual functioning through the vitamin A toxicity, I had to learn to get my medical information in other ways because the medical literature was out of my grasp. I’m not saying that message boards can replace medical journals, but I am saying that people who suffer from the same illness have the potential to help each other immensely. It was the message boards and not the medical literature that got me out of my wheelchair that summer.In November 2005 I had brain surgery. A ventricular shunt was implanted to take some of the pressure off of my brain. Within two weeks, I got myself a recumbent tricycle and finally found something to replace my work. A few months later, I was riding up to eight or nine hours a day and although I was getting very strong, the pain in my face was getting worse. The only thing that came close to alleviating this pain was my husband’s comments of: “If you think your face is hurting you, it’s killing me!”
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Throughout our laughter, I also started developing numerous new neurological problems stemming from pain to impairments of my vision, speech, and gait. There seemed to be very little if any explanation for my symptoms, except of course for the frequent suggestions of histrionic tendencies (that means I was looking for emotional attention). I think that histrionic tendencies as a diagnosis has its place in medicine where it serves as an explanation for not-yet-diagnosed disorders just as frequently and inappropriately as when drivers only come to a rolling stop at a stop sign. Jeeze, I wouldn’t have to put up with any of this abuse if I would just keep my mouth shut and tolerate my pain in silence. It felt like I was repeatedly being punished for speaking of my pain.
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Spinal taps to determine the level of my intracranial pressure at times did not make sense and were inconsistent with other clinical observations. Medical explanations ranged from honestly shrugged shoulders to cowardly accusations of Munchausen's (I was doing something intentional to make myself sick for attention). When it was pointed out that it was impossible for someone to do something to increase their intracranial pressure that much, the response was that I was so intelligent that I could figure out a way. Although I appreciated the compliments about my intellect and creativity, I felt as if I was a criminal and my crimes included: (1) speaking of my pain and (2) being smart.
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It was during this period that my personal war shifted from battles with illness to battles with arrogant medical professionals and, very frequently, their equally arrogant clerical staff. I learned from a very wise person that even though everyone may stop believing in me, all will be lost if I stop believing in myself. No one in our local medical community had any idea what was happening to my body and since it couldn’t be seen on an MRI, I was usually dismissed as some type of annoyance left to deteriorate both emotionally and physically. It was my husband and minor daughter who carried the entire burden during this time and to them I am eternally grateful. Without them, I would have stopped believing in myself. Oy, I hate to think of the issues my poor daughter is going to have to work out for herself over all of this! Well, at least she’ll have something to talk about with her therapist, right?
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And so, I learned to scrape myself up from the ground and to keep walking forward, despite the degradation offered to me by others. It helped when I figured out that when doctor’s are stumped, many of them become frightened and cope with it through anger as an attempt to gain control over the situation. Unfortunately, their anger usually hits the weakest person available: the patient. You should see it when the doctors disagree with one another. Man, the sh-t really hits the fan! Instead of being angry with each other, it all feels like it’s falling on you as the patient! I learned to stand clear of the doctors’ frustrations by recognizing their human limitations, giving them their space to work in the way that they each need to work based on their own personality, and walking out of the offices of the one’s who are inappropriately hostile. Don’t let my brave words fool you, I still go home crying every time there is an uncomfortable encounter with a physician or any of their staff.
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Shortly after my brain surgery and during the turbulent times of 2006, I became disgusted with doctors who would look at a lab report and run their highlighter pens across the rows of values that fell in the ‘out of range’ column. I consider that to be clerical work and not part of the practice of medicine. I searched endlessly for doctors who were willing to think outside of the box. I am one of the fortunate few who have family financial support to be able to pay out of network fees which brought me into a very small world of doctors who are willing and able to spend time thinking about my situation. I found a neurologist has one of the most brilliant minds I have ever had the pleasure to know. There is no question in my mind or the minds of my family that I would not be alive today without his quick, creative, and courageous thinking.
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As for my supposed history of Munchausen's, my new neurologist said at an early meeting that he felt that this might be a possible explanation, but if I was willing to pay him, he was willing to treat me, although he did not think it was possible for me to have manipulated my intracranial pressure. I do not consider myself above mental illness and I told the good doctor that I didn’t care what he wanted to call my illness or how he wanted to treat it; I just wanted to feel better. I think part of having the courage to master life is to accept whatever is thrown our way, be it illness, arrogant doctors, or the prospect of our own sanity. Somewhere along the line I figured out that it wasn’t the accusation of a psychiatric problem that bothered me, but the withholding of medical evaluation and treatment that frightened me. So long as I received proper medical attention with the prospect of a future including quality of life, I didn’t care what field of medicine the diagnostic code fell under. My neurologist’s belief in me allowed him to bring my body from a dangerously inflamed, hypercoagualable state, to one where I was not as imminently threatened by clots, ‘…floating around in the blood vessels of my eyes.’ Oy.
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During the summer of 2006, I became so incapacitated that many times I had to rely on others to turn my head for me while I waited in bed. The pain was horrendous, like battery acid pouring down my body. It was suggested to me that this symptom might be from a condition involving my brain stem’s sending out of control pain signals. I was told that there was nothing that could be done about it and no medication would be able to relieve the pain. I was facing a fate worse than death. This is when I began my spirituality struggle. Oh no! Adolescence again?
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Throughout my entire life, I have always identified strongly with my Judaism. I was born a Jew, and I have chosen to live a Jewish life. I never, however, even for an instance, would suggest to anyone that the Jewish answer is the final answer for everyone. Judaism is my comfort zone and it is how I choose to live. When faced with the idea of my mortality, either through the direct effects of illness or from a decision to end my pain by my own hand, I hadn’t a clue about my thoughts on dying. The Judaism I practiced focused on living issues. I never really talked about dying with anyone. I knew all about comforting people who experienced loss, and I myself have been through the grieving process. I never, however, really explored my feelings on the afterlife. You can imagine how this latest diagnosis of inescapable and eternal pain thrust me into a search for spiritual meaning.
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I am grateful to the many Christian people who saw my physical and emotional struggles during this time, but it was the comfort of my Jewish community that I cried for at night. It is my hope that my people will also learn to embrace the quality of compassion and nurturance for the weak and sick. While my Jewish community is filled with many loving and compassionate people, it is unfortunate that we are failing each other in providing ourselves with comfortable mechanisms to deal with these types of situations. By accident, however, I met a woman on the internet who I refer to as my Internet Angel and her efforts, along with phone calls from a few people in my local community gave me a feeling of connection to my Judaism. The lack of responsiveness to my humble requests through the proper channels, however, was a painful pill for me to swallow and it rocked the very foundation of my faith.
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Eventually, over many tearful phone conversations with my grandmother, I emerged with my faith intact when it comes to God, but not when it comes to people. This battle yielded more emotional wounds than those left on me from the mysterious ailment that felt like battery acid. While feelings of bitterness and disappointment have left me somewhat hardened and somewhat sad, my spirit did not die.
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Nor did my body die! Through some really fancy techniques by an anesthesiologist, it was determined that the nerve roots along my neck were, for some reason, very inflamed and a bunch more medication and some nerve blocking procedures brought me back into the world of the living. No, I was not out of pain by a long shot. My face still hurt like hell and no one had any reasonable explanation for the inflammation. At least I was able to walk around and even ride my bike once in a while.
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And so, my spiritual pursuit continued in a healthier body and a bit more individualized than before my previous battle. The dilemma of my spiritual growth without a spiritual advisor was complicated by the fact that I could not read very well. I could read recipes and message boards, but that’s about it. I certainly was not capable of unlocking the secrets of the universe by decoding Talmudic pages. Hmmmm. There’s no question that this was a job for Rabbi Glixman (עליו השלום, 1928-2007), my beloved Rabbi of several years ago, but I was afraid of the emotional flood that was likely to overly irrigate my path. I knew he himself had been ill, and I felt his time was coming. Indeed, Rabbi Glixman passed away in the spring of 2007, taking with him a wealth of knowledge which I longed for. I mourn his loss today very much (http://www.rememberrabbiglixman.com/) and hold dear all that I remember of his teachings.
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So, how does a Jew build up her emotional and spiritual faith without the luxury of books or a teacher? I’ll tell you how: She tries different things until she figures out a way! I tried Jewish message boards but they did me little good because no one was posting. I subscribed to several electronic Jewish publications, but almost all were too complicated for me to understand. One finally took hold of my mind though. It’s called Daily Dose and is published by the Chabad organization. Every day, a short message appears in my electronic mailbox and I usually can understand it. Each is oftentimes encouraging and frequently stimulates my thoughts to a higher, spiritual level (sorry if I sound a bit like I’m from the 1970’s, but I am). I keep an electronic notebook of organized Daily Doses for review, in case of emergency.
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The remainder of 2006 was plagued by a myriad of bizarre medical difficulties such as inadequate adrenal functioning, overactive pancreatic functioning, and unusual presentations of inflammation. As my neurologist frequently experienced brilliant brain bombs resulting in creative medical breakthroughs for me, I found myself able to partake in life more and more. We knew that the tricks being played on my body were not necessarily getting at the root of the undiagnosed problem, but at least my painful symptoms were becoming more manageable. The most incredible breakthroughs generally involved basic gifts from God in highly condensed forms such as vitamin B-12, bio-identical progesterone, and fish oil. Sometimes a natural substance can destroy your body, like my toxic reaction to vitamin A in 2005 and once I went into respiratory arrest from vitamin K in 2002, and then others like the B-12 brought my c-reactive protein down from 8.9 to less than 1 and the fish oil brought my inflammation under control when the maximum amount of prescription NSAIDS could not. Together, my neurologist and I have learned medicines include those that are not being peddled around by the pharmaceutical companies.
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It was clear that I would have to be travel worthy in order to take advantage of more of our world’s experts in understanding this mysterious ailment that had disabled my body. It was clear that I would have to be travel worthy in order to take advantage of more of our world’s experts in understanding this mysterious ailment that had disabled my body. By the beginning of 2007, I was cleared for medical travel. My hypercoagualable state was under control and my shunt appeared to be functioning most of the time. Although the pain level was high most of the time, it was manageable. My first priority was to get to the finest neurological institute in the world where there were also physicians from other disciplines in hopes of gaining a multidisciplinary evaluation. Naturally, I chose the Mayo Clinic and after detailed letters from both my neurologists, they rejected my application because they said there was nothing they could do for me. Personally, I think they did not want to run the risk of having a ‘bad’ statistic show up on their reports. (Incidentally, they indicated they evaluations were department specific, suggesting that my dream of doctors from different disciplines sitting around the same table did not occur at this institution.)
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Setting my sights a bit more basic, the first stop on my travels was The Bronx, New York, NY, to visit my mother’s oral surgeon. For the last 17 years, my mother has been battling bone infection stemming from improperly healed wisdom tooth extractions when she was 16 years old. There is no explanation for her difficulty in healing from this osteomyelites. Since some of my symptoms were similar to hers, we had all been suspicious that this disease might be playing at least a partial role in my problems. Indeed, this was confirmed to be true and, like my mother, I now travel back and forth to New York to undergo the grueling process of locating and removing necrotic bone and then packing remaining tissues with antibiotics. The results of these procedures on me have been nothing short of miraculous. My neurologist describes me as being substantially more animated and energetic. Biological explanations for why my mother and I are both susceptible to this type of an illness are being pondered and actively addressed by both the oral surgeon and neurologist. Weather or not they come up with the definitive answer, at least there are two doctors who believe in me and are actively working on my case.
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Weather at home or traveling, I actively work on my emotional and spiritual state. Because I don’t read very well, I tend to watch more television than I used to. I pick my shows carefully and am sure to have fun. I watch Judge Judy a lot to laugh out my anger. I also like to watch a show called Mystery Diagnosis which is all about people dealing with strange illnesses. I find that this show encourages me to keep going and fight to find out what’s wrong with me and not just accept explanations from doctors that are unacceptable. Many episodes encouraged scraping myself up off the ground once again to use my brain in putting things together and figuring out which direction to go toward next.
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As I casually watched one episode of Mystery Diagnosis from my bed at home in the spring of 2007, I lay there dumb founded by the similarities emerging from the story I was viewing and the one I had been living for the past two year. I must have replayed that TiVo recording 10 times to make sure I got it all right. I got the names of her doctors and looked them up on the internet. Their institute’s web site offered all kinds of information. I ran it by my neurologist and he felt it was worth a shot. So, I sent my medical history up to The Chiari Institute in Great Neck, NY. I was NOT rejected as a patient, and received a two day diagnostic evaluation there during the summer of 2007.
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When I explained to the neurosurgeon at The Chiari Institute that while riding in a car I frequently speak funny and sometimes lose the ability to speak, his response was matter of fact and even imitated what my words sound like when this happens. He said that this is what happens with all people who have what I have. The neurological and neurosurgical team there diagnosed me first with Ehlers-Danlos Syndrome, which is a disorder having to do with how the body uses collagen in building and maintaining connective tissue. Hmmmm. Another orphan disorder. Oy! They then pointed out that the many years of loosening connective tissue in my neck has left me where, literally, my head is not connected to my neck. Well, I must admit it was rather refreshing to hear my 'head is not connected' from a neurosurgeon as opposed to a series of doctors pretending to be perceptive psychiatrists!
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Precise imaging based on years of experience with patients who have experienced similar symptoms as mine yielded a primary map of my neurological problems which are partially based on my orthopedic instability. Jeeze. What was always considered to be impressive flexibility for a woman of my size was not necessarily the sign of a born ballet dancer but a symptom of a dangerous underlying genetic disorder. Amongst many painful results, my cranium was found to be settling down upon my neck, causing pressure on my brain, particularly when jostled around such as when riding in a car. Ouch!
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Well, as of the end of the summer of 2007, the following is a list of credentials that I carry with me as my current badge of accomplishments:
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Ehlers-Danlos Syndrome (Hypermobility type)
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Craniospinal Instability
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Functional Cranial Settling
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Flattened Pituitary Gland
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Cerebellar Atrophy
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Spinal Anomolies including:
Cervical Stenosis with decreased posterior flow at C4 to C6
Herniated Nucleus Pulposus from C4 to C6 and at L4-L5
Retroodontoid Pannus Conus at L1-L2
No lumbarized S1
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Idiopathic Intracranial Hypertension
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Chronic Migraine with Atypical Visual Aura and Cluster Features
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Atypical Facial Pain
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Fibromyalgia
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Complex Partial Seizures
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Possible Neurocardiogenic Syncope
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Restless Leg Syndrome
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Orthostatic Hypotension
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Osteomyelites (facial bones)
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Hashimoto’s Disease
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Hypoglycemia
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Adrenal Fatigue
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Dumping Syndrome (secondary to gastric bypass surgery and Ehlers-Danlos Syndrome)
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Hypercoagualable State associated with:
B-12 Deficiency
High CRPAnti-thrombin III Deficiency
High D-Dimer
Heterozygous for MTHFR A1298C
Heterozygous for Prothrombin 20210 single nucleotide polymorphisms
Family History of premature cardiovascular disease
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Latent Strabismus and Monocular Diploplia
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Temporomandibular Joint Syndrome
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Obesity
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Gastritis
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It appears that my personal diagnostic list is longer than my professional publication list. Oy vey! I suppose that should stimulate some type of emotional crisis, but I think I’m tapped out of emotional ups and downs. So, instead of another mid-life crisis, I reframed the whole thing. I looked backward and took out a copy of my abbreviated publication list, unfairly cut short by the items on my sick list. I grinned as I remembered how I struggled with my colleagues toward the final printing of each of those titles. In the same light, each of the labels I carry now has involved many horrendous struggles, both physical and emotional, tests of physical fortitude, love, perseverance, and even faith. The irony hit me that while the world certainly celebrates my publication list much more readily than my illness list, I had to struggle much more with my illness titles than with the titles on my curriculum vita. Although I certainly feel a great deal of pride from those publications, I feel proud for surviving the many types of battles involved in the war of my illness so far. I can only imagine the battles in store for me in the future. This is where the faith part comes in and that can certainly carry me when nothing else can.
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Have I won the war? Certainly not yet. But I have come out the winner in some very important battles. At least I have a diagnostic path to follow with the support of my family to scrape me up when I fall down. My plans include genetic testing to determine the precise form of Ehlers-Danlos Syndrome I have as some forms could affect organs such as my adrenal glands and uterus directly while the simplest form might have affected these organs indirectly through pressure on my brain. The groundwork is being laid for shunt revision surgery as I have been advised on alternative devices to control the pressure in my brain when my current shunt totally fails, as it apparently does at times. And once the bone infection is controlled, I will also be considering surgical interventions to stabilize the cervical area of my skeletal system to reduce some of my problems. This will all entail much creative work in that many systems are involved and none function independently.
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God’s closing my eyes to books for a time resulted in leading to a better understanding of my condition through the entertainment of television and words of non-professionals, as well as a few professionals. I have learned that you never know who or where an answer will appear so long as you keep your eyes and ears open. I will continue to listen to people from all walks of life and frankly, if what they say makes sense, I will incorporate it into my spiritual life. So long as God grants me adequate physical wellbeing, I will continue to pedal my recumbent tricycle waiting for answers to approach me through unsuspecting ways such as a peacock running across the road or from a stranger who I join for lunch. This is how I will continue to fight my war!
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Thank you for reading my story. I hope that you will follow my travels through my entries as my family and I begin our new lives in a new land and I continue to stumble through this ordeal.
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Susan S.
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