Endurance

An essay in five parts, originally written for a CWRT700 portfolio at AUT in 2019.

MORPHINE AND KETAMINE

Morphine is used for the relief of moderate to severe pain such as after an injury, or operation or pain caused by a terminal illness such as cancer.” (Health Navigator NZ, n.d.)

Continue reading Endurance

curled-up flesh

Pain. Drowning  crinkle-cut curled-up flesh in whitest milk. Obligation lifts the cup, pours it in. No foil-wrapped magic tricks want to have anything to do with it; the capsule sinks below the surface before it can ignite. Flickers as a match might, but with the untiring power of the glowing ember.

No end in sight. The worst days were better, because hope was still cradled that the broken parts could be cut away and mended, dead branches and grafts. But the poison is in the tree and eventually there will be nothing left but dried parts broken on the forest floor.

All the words that a dragged-down mind can label itself with, be labelled with. Anxious. Depressed. Pathetic. Lonely, lonely, so lonely. When I stood alone in drifts of snow in another place, at least mind and body were whole, or still clinging together in the hopes of human unity. The future was allowed to be clouded.

Now I must clutch myself, squeeze my own arm, dig nails into my palms. The crescent shapes do not leave scars, not yet. Record videos intended for a public audience, a forum of confession and reality. Then delete them, because tears are not becoming, not in real life and not in a little box on your screen that you can escape from when you feel uncomfortable.

No one to do the holding, the whispering. Nobody to tell me that I’m being crazy, that I’m more than a foolhardy experiment gone wrong, that my best days aren’t necessarily in my past, that it’s okay, it’s all okay. That I can be loved again, that I’m not ruined by or defined by my body, by my awful, uncooperative, sliced and reconfigured body. Nobody. No one to rely on, to call in an hour of need, no family to go and hide with when it’s too hard to be alone.

Silent nights in a house of extremes – the joyful noise of the happiness of others, going on all around, or the silence that hangs more and more, as the nights close in and nobody else is home. A kitchen untouched – what kind of energy do you think I have? Expend what precious little there is on cooking, when I’ll either be in tears from the blandness, or in tears from the pain?

The pain, the body of pain. The mind draped in it.

 

world IBD day

It is May 19th – at least in New Zealand, it is.

On this day, the following things have happened throughout history

Anne Boleyn was beheaded (1536)
Nellie Melba, the soprano and namesake of a delicious dessert, was born (1861)
Oscar Wilde was released from prison (1897)
Pol Pot, leader of the Khmer Rouge and totalitarian dictator of Cambodia, was born (1925)
André René Roussimoff, AKA André the Giant, was born (1946)
Marilyn Monroe sang ‘Happy Birthday’ to JFK (1962)
Tu’i Malila , the world’s oldest known tortoise died at 188 years old (1965)
Jodi Picoult, Queen of Depressive Chick Lit, was born (1966)

Nowadays, it is apparently Malcolm X Day in the US, St Calocerus Day in the Eastern Orthodox Church, and Greek Genocide Remembrance Day.

So a lot goes on on this day. But there’s another importance to this particular date that is of significance to me, and to many other people, even if they don’t necessarily talk about it as loudly as I do.

It’s World IBD Day, one particular day given to talking about Inflammatory Bowel Disease. Some of you will have read my pieces on IBD in the past, some of you may not have. So we’ll go with a basic level of explanation.

The first thing to remember is that IBD is completely separate from IBS. IBS, or irritable bowel syndrome, is fairly common, and whilst unpleasant, it is rarely a serious disease. Don’t get me wrong, I wouldn’t wish uncooperative insides on anyone, but the reality is, it pales in comparison to IBD, so it seems reasonable that many of us with IBD get a little frustrated when people confuse the two. IBD is, by most accounts, autoimmune, putting it in the same family as lupus and rheumatoid arthritis. We just happen to have immune systems that really, really hate our guts (ha!).

It is understandable that some people are quiet about their Crohn’s, or their ulcerative colitis (the two major forms of IBD). We have been conditioned to not talk about things to do with digestion – tell us about your migraine, sure, or your asthma, but we don’t want to hear about the fact that you have spent your day doubled over in the bathroom. So people keep silent. They avoid bringing up the subject of their pain and suffering, even with their doctors. I am one such culprit. I started presenting symptoms about a year and a half before they got to the point that I knew I really couldn’t go on with the way it was. I was a twenty year old girl, I wasn’t prepared to talk about ‘gross’ things with anyone. If I had spoken up sooner, it’s possible that things could have gotten under control more thoroughly, without having to go down the rocky path that I ended up having to take – that I am still very much on.

Here is a sample idea of what twenty-four hours in the life of a really bloody stubborn gal with majorly flaring IBD is like. I’ll start from going to bed, because that’s probably the best way to illustrate it.

10pm – Last minute bathroom visit before bed. Worst of the day is hopefully over, some pain, probably still some blood, maybe twenty minutes spent dealing with it. Take evening medications (4x Asacol, 1x prednisone, 1.5x azathioprine, 2x paracetamol because the doctors haven’t prescribed you anything stronger yet, 1x citalopram because the prednisone has caused fully fledged depression to finally take hold). Go to bed.
11pm – Still can’t get to sleep, too wracked with pain, clutching stomach, possibly sobbing quietly into pillow.
2:30am – Woken up by insides. Pain. Go to bathroom. Pain. Back to bed.
5am – Woken up by insides. Pain. Go to bathroom. Pain. Back to bed.
6:25am – Woken up before alarm by insides. Go to bathroom. Start getting ready for the day – this involves making sure that an ’emergency’ kit of sorts is in the bag.
6:55am – Second ‘official’ bathroom visit of the morning.
7:10am – Leave house, get to the porch before doubling back to go to the bathroom again. Keep in mind that on all of these bathroom instances, there is pain, and blood of varying amounts.

Does that give you an idea of how things are? I can’t go into the intricacies of the whole day, really – but I would always have at least one possible stop off on the way to work, I would always allow a lot of extra time to get there, just in case I had a really bad attack. I would generally go to the bathroom two to three times an hour in the first half of the day, lessening as the day went along. That was the reality.

And it’s the reality for a lot of other people too. We all have different precise symptoms, but pain is universal.

I was only diagnosed at the end of 2010, but even though it’s only been three and half years, I still couldn’t possibly tell you how many times I’ve had needles put in me. I’d hazard a guess at fifty blood tests, maybe fifteen IVs (and that’s not including all the times that I’ve been stuck more than once because my veins are so worn out). I have had IV infusions that almost much amount to chemotherapy (hardcore drugs given intravenously), I’ve been on drug trials (multiple injections in my stomach, every week, about seven vials of blood taken every week), I’ve been on steroids, I’ve been on the sort of drugs they give to organ transplant patients.

As canny readers will realise, none of this has properly worked. I had fifteen centimetres of my colon taken out last year (I have the laparoscopic scars to prove it – I’ll show you if you ask – my belly button looked super brutal for the first few weeks after the op). I have an ostomy, for now (cf. my happy clappy articles for various publications on the topic). These meds and surgery probably saved my life. People can – and do – die from complications of IBD. The internet IBD community has recently been mourning the death of twenty year old Alexandria Davidson, a Crohn’s advocate who spent the last months of her life in hospice care. I had only vaguely heard of her and her organisation before I heard about her passing, but it still upset me. IBD is not something to be trifled with – and to suggest that it’s a stomach ache that’ll go away if we eat raw vegan/paleo/gluten-free/insert fad here is deeply insulting both to those of us suffering from it, but also to those who have died as a consequence, and to their families.

I am still not well. I take painkillers most days, I take anti-nausea meds more often than I’d like. I get joint pain – my knees are below par, and sometimes my elbows,  fingers, and toes play up too. Now that I’m ‘healthier’ than I was, I would like to be able to get more active, but instead my body seems to be letting me down when I push myself. I still get intestinal pain – and after my specialists agreed, post-surgery, that it was most likely Crohn’s, not ulcerative colitis as previously though, I am living in constant fear of inflammation and pain spreading to other parts of my gastric tract, instead of limited themselves to my large intestine like well behaved UC symptoms should. I am going to need to have at least one more operation at some point in the future – and even that is scary. You never know exactly what will happen, what will have been done when you eventually wake up. You have to deal with a whole new kind of pain during recovery.

There is a lot to handle. Especially when you’re in a new city, still waiting to be seen by their gastroenterology unit, when you don’t have people around who understand what you’ve been through, when you no longer have someone to sit with you when you choke down colonoscopy prep, to rub your back when you’re in bed crying from the pain.

So, today, spare a thought for me, for your cousin who has Crohn’s, for your coworker who has taken time of for mysterious stomach pains. Think about the reality of what we live with, a life of pokes, prods and pain, a life of boxes of medical supplies at your door just to be able to function in society. It’s a mixed feeling when you get excited about the arrival of a new style of bag. If nothing else, just remember – it’s a hell of a lot more than a tummy ache.

held

i meant to find some comfort in the keyboard, finding myself awake later than i should
borderline hyperventilation, reliving moments best left to the past, ill-chosen reminders
for every word of reassurance, this too shall pass, you are so strong
once in a while the breakdown, the relinquishing of control to that baser part
known for its lingering, its fears, its dread – it descends and the wind outside will not dislodge it
the rise and fall, lost in the trough where bad dreams feed and breed
the but, the every but that comes to mind
so easily shot down, words are wind, since this is some strange fantasy after all
alms given in casual words
he told me i lacked empathy, smug and meditative
i told him empathy is why i’m still here

sometimes my illness makes me feel strong
sometimes i tell myself that it is what has led me to this place
that it is no bad thing to have your path drawn in strange ways
better sense tells me that it was not health that drove me this way
in goals and in dreams
but it is what i owe my unhappiness to
directly, indirectly, every day, looking at scars
a constant thrum of malcontent
no end in sight, just a lifetime of people telling me
how strong, how brave, how inspirational
and waiting for the next drug or op
i do not want sympathy
i just want to be better
i want to have energy so that i may be able to live
i want to not live in fear, or less of it at least
i want to not have to use this page
as a diary or a one-sided counsel
i just want to be better.

things that are scary…

…having a colorectal surgeon tell you she does actually wonder whether it could be Crohn’s, not ulcerative colitis, because of the area of involvement in the lower colon.

It’s more of a ‘we need to be sure before final surgical decisions are made’ type situation, because my case is evidently a bit peculiar. People heading in for colectomies don’t tend to be left-sided folks, like I am – so it’s unusual territory for the surgeon, apparently. The current plan is to take out most of the diseased section, rather than the whole-colon-except-a-rectal-stump as would be the usual course of action for a UC colectomy. Since for me, taking everything but the stump would mean taking a whole heap of currently healthy bowel, and leaving like a third or even half of the diseased bowel behind. Which just doesn’t make sense.

That could be happening as soon as September. Sometime in the next few weeks, I’m going to get and MRI so they can take a peek at my small intestine, get a bit of clarification on the UC/CD situation. It’ll be a blast trying to make that happen in parallel with one of the busiest times of the year at work, but we shall see.

That first surgery would involve about three days recovery at the hospital, and then about a month recovery at home before being in back-to-work mode, apparently. Which is in all likelihood an impossible amount of time to take off, especially given that it’s just the first of at least two, possibly more, surgeries. So I’m going to have a chat to the higher powers at work, and see what we’ll do. And in the meantime, do the necessary investigation into temporary sickness benefits and whatnot, so that I can, you know live.

Sometimes it does just feel like this whole thing is getting far too drawn out, like I’m going to end up spending half my twenties just trying to get stable or moderately healthy in order to go on with life. There are so many things that I should have achieved or done or seen by this stage, and there’s just been no way to make it happen. I’m 23. I’m sick. I’m looking at the prospect of having not one but two stomas over the course of my operations – one colostomy on my left side initially, and later down the line, an ileostomy on my right side, depending on what the consensus is after the first op. And who knows – if stuff goes wrong, either of those could wind up being permanent.

At 23.

That’s scary too.

an ode to blood and guts

and the blood
always blood
it comes
and it goes
but it’s always back

and the pain
how one deludes oneself
into rationalizing it
until it returns
and it twists between
organs
and connective tissue

and the prisons
of different sorts
small rooms
boxes, suffocating
and the mind
and the belly
and the fact
that you can’t
sever the connection

no epidural to be given
as in childbirth
no window of hours
or of days
before it will be gone
women will scoff
yet i would trade them
with absolutely certainty
i will take your pain
and the knowledge of
a squalling prize
the knowledge that
it will be done soon
i can say no such thing
while demons pluck
at my abdomen
eking out some kind of
hellish melody

where did normal go?

I’ve been meaning to do a video post, just for kicks, and because hey, why not bring some roguish Kiwi charm to the colitis and literature discussion table?

But that’s not tonight, because I’m suddenly feeling spectacularly sore, and am hour by hour convincing myself that I am getting more and more of a prednisone moon-face. So that’s a blast.

Related, kind of, here’s my current new-drug status…

– Week and a bit on prednisone.
– One and a half days since my first infliximab/Remicade infusion
– Week and a bit on my increased dose of Asacol (4 pills twice a day instead of 3)

 

And the ‘results’? Well, less blood and whatnot. Which is progress. Less frequency, kind of… but I’ve still been taking at least one tramadol most mornings, and just spent quite some time writhing and nearly crying in the bathroom and now am propped up in bed, having taken two tramadol capsules just to try to make the pain go away. I felt exhausted and icky all day yesterday after the infusion, to boot. Fun times.

What does it feel like to have normal insides, I wonder? I really don’t remember. A day has really not gone by in the past couple of years in which I have not either spent a period of time worried about whether I’ll suddenly have issues/where the nearest bathroom is at ALL times – or alternatively, felt two awful/anxious to even leave the house. So that’s fun. There’s a reason why I have meltdowns of a fairly impressive nature once every two or three weeks. Normalcy is gone. My normal is planning a route to work that takes me via several publicly accessible bathrooms first thing in the morning. My normal is constantly worrying that my colleagues could be saying things behind my back while I’m on my fifth bathroom trip of the morning. Looking at my arm and seeing a mottled bruise from an IV that looks like it should belong on the arm of a 80 year old, not a 22 year old. Avoiding going out. Crying in the bathroom. Being woken up by my angry colon at night, not being able to comfortably lie on my left side because too much pressure is put on the ulcerated area. Using up all my sick leave and a fair chunk of my holiday leave for colitis related absences. Not being able to plan trips/travel/anything because a) will I get there in one piece and b) even if I do, how am I going to hold up long term… because the treatment I’m on (that might not even work) is hardly likely to be covered by travel insurance, and each infusion costs more than I have saved right now.

I never wanted to be normal when I was younger. Non-conformist was a buzzword that I seriously subscribed to at fifteen. I’ve been alternative/off-beat/indie – I’m generally weird-ish and I love it – but for once in my life, why, why WHY can’t I just be normal, in this one way?

the party grinch

There are few things in my day to day life more terrifying than being in a situation where a bathroom may not be easily accessible. When a flatmate has a small party/large gathering without my knowledge, I go into hyper anxiety mode. I wait for no toilet. There are two in our house, however, one is an ensuite attached to said flatmate’s bedroom, upstairs and not really accessible for myself, not for the party going public. 

That being said, other people in my house, drinking, while I’m not around to make sure nothing goes wrong, is also moderately terrifying, because I’m convinced that they will destroy/steal/whatever my many books on the lounge shelves, my huge beautiful 21st birthday present atlas on the coffee table, or our flat ‘mascot’, Cornelius the T-Rex. And, of course, there’s no way that I’ll go mingle with these unknown creatures, partly because prior interactions with flatmates’ friends in this particular home of mine, have proven them to be any combination of yuppie/blokey/bitchy/commercial-lawyery/accountanty/take your pick of adjectives that don’t really meld well with my ‘I’m a book buyer with an English degree and goals of having several novels published one day would you like to see a picture of my pink hair or listen to my Dresden Dolls CDs?’ persona.

And the boyfriend is currently gaming with a friend, so all I can hear in our room, apart from the so-called sociable noises from the other room, is their talk of Saints Row, and the sound effects of the game. So concentration of the ‘lets do some writing!’ variety is somewhat shot for the night – save for the angsty blogging variety. So, my solution, after far too long spent playing Civilization V (the first game I’ve gotten into on a reasonable level since my Sims obsession of yesteryesteryear), is to internet, and contemplate continuing reading Specials by Scott Westerfield – the third book in the ‘Uglies’ series. The writing’s not amazing, and the protagonist’s a little… dull, at times, but the concepts are intriguing, and since a teen-oriented dystopia is on my to-do list, I have the perfect excuse. 

First, of couse, I’d better hit the painkillers. Especially as it sounds as though more party-goers have arrived…

things to do while stuck in the bathroom

Reading the backs of shampoo bottles can only get you so far when you’re on intimate terms with the bathroom. Here’s a handy list of ways to wile away the agonising hours (if you add up colitis bathroom time, it gets a little scary!) in the loo.

  • do your nails. Only applicable when you’re not in writhing pain.
  • put on moisturizer. Nothing like a bit of tearing up to help it soak in!
  • listen to music. Especially good if you’re worried about unseemly noises, just bring along a iPod dock and crank it. Although, let’s be honest, if you’re at the point where you’ve been diagnosed with an IBD, noises are probably the least of your concerns. But you can choose music to suit your pain/movement mood! O Fortuna is best reserved for special occasions.
  • wail in pain. Because sometimes it’s all you can really do.
  • sing. Not just for the shower anymore! Serenade your flatmates with your musical prowess!
  • cry.
  • read. A Kobo or Kindle is your best friend. Best thing is trashy teen novels that you secretly want to read, but don’t want the perceived shame of carrying around the book itself. Plus they are generally fairly straightforward when it comes to reading comprehension, so you’re unlikely to miss anything crucial is your eyes glaze over during particularly bad waves of pain.
  • internet. Whip out the old smartphone. Read up on the news, or check out a colitis/Crohn’s forum or support group. I’m a particular fan of IHaveUC.com and both the CrohnsDisease and IBD subreddits on everyone’s favourite Front Page of the Internet.
  • text people. I’m terrible at remembering to contact people, so the bathroom is sometimes my go-to for responsible daughter text messages to my mother.
  • ponder. Eg. when will the drugs work / should I just get surgery / should I just get surgery NOW by myself with a kitchen knife / was the cheesecake worth it
  • philosophise/theorise. If Archimedes could make scientific discoveries in the bath, why can’t you do it on the loo?
  • or just think about how delectable those painkillers are going to be when they start kicking in.