Rituxan round 3 round up

The other week I had round three, marking the six month infusion of Rituxan. Walking into the Infusion Center I was already in bad shape: I’d been up most of the night before with my #peeingproblem and was still dealing with the peeing episodes as I entered the building. Not to mention, I had a headache. It was probably teetering at an eight out of ten at that point. Before the IV was inserted in my arm, I peed three times. I was freaking out and swore that I would not pee again once I was hooked up – I was determined to not go again!

I was also silently hoping that the nurse would not blow a vein. My veins had taken a literal beating in the month of July and my arm was still sensitive. Lo and behold, I was spared and the nurse got the IV in on the first attempt (as it should be, might I add!). Also, the infusion pretty much started on time (again, as it should; it was great not to have to wait an hour plus).

I pre-medicated at home with two Ibuprofen (instead of Tylenol), one Zyrtec, and one Klonopin. (Please consult with your doctor; this pre-medication combination was not done on a whim. It is a protocol that my specialist and I have found to replace any IV meds since those always made me feel worse. We finally have a combination that works pretty effectively for my body.) My vitals prior to the start were fine and I was not running a fever, which I was excited about since I have been more often than not of late been running a low grade fever.

My vitals stayed consistent during the four hour infusion. The infusion overall was uneventful thankfully. The only issue is that my head kept getting worse and was at explosion point – it was beyond a twenty on a scale of one to ten when I left. I wanted to rip my head off. I did not sleep at all through the infusion. I didn’t have any itchy reaction or any other crazy reactions during the infusion. (I didn’t’ even have to deal with my #peeingproblem – the three times before was the end THANK GOD!)

So again this infusion was different to the first two. Besides my head (and inbound #peeingproblem), it may have been the easiest. However, I was severely comatose most of the following day. Now I’m back to the waiting game, repeat in six months and continue to hope for improvement in the interim.  Unfortunately, I haven’t noticed any improvement in the past six months, so time will tell if the next six months will be the up I’ve been hoping for.

getting hearty with a Holter

Many of my postural orthostatic tachycardia syndrome (POTS) friends have serious heart issues and have cardiologists on their medical teams (even though POTS is not a heart condition). My medical journey to date hasn’t included heart drama minus my heart racing. My heart racing hasn’t been consistent or alarming enough for me to warrant a trip to the ER or seek a cardiologist’s opinion. That is, until recently when my heart started to concern me but not in a “tachy” sense.

The cliché of when it rains it pours seems to be all too apropos of late. Amidst my headache drama I was noticing that my heart had dropped to low 40s at night. The previous low I’d noticed was 48 – maybe a 46. So 44 seemed low. A night of 42 seemed particularly strange after being pumped with a caffeine IV, so I thought it was worth mentioning to my primary care physician (PCP).

My PCP suggested that I do a 48 hour Holter monitor test prior to him referring me to a cardiologist. (For details on the Holter monitor, you can check out: http://www.heart.org/HEARTORG/Conditions/HeartAttack/DiagnosingaHeartAttack/Holter-Monitor_UCM_446437_Article.jsp#.WXJnDjFK3IU.) Of course I asked him, “Well what if it doesn’t capture the drop…can we repeat it?” He replied with, “Let’s see what it does capture and go from there.” Fair enough. A few days later, I went to get outfitted. I decided to not Google what it would entail and just showed up with a list of questions. The only instruction I had when I made the appointment was that I could not shower for 48 hours. That would be no problem in my world! I was more concerned about if my body would find this too uncomfortable, or if I would sweat it off, or if my heart would not drop, or one million other things – I have lots of practice not showering for 48 hour long periods.

I showed up and the nurse asked a few a questions. I smartly had taken a Zyrtec and Zantac before arriving. The nurse would put five sticky nodes on my body – three on my chest and two on my sides. She would also put tape over all of them due to my self-shared sweating issue. These nodes would have cords attached to a small monitor that I chose to pocket instead of place around my neck. Leaving my neck out of it, would be one less potential way to irritate my body. I was also concerned that in my sleep that I would roll on the monitor – she warned me of that. Evidently, I was very subconsciously aware because every time I awoke on a different side I had flipped the monitor to the appropriate other side!   And thankfully I did not sweat off the nodes or have a serious allergic reaction to the tape or the sticky pads.

I was also instructed to keep a log of my symptoms during the 48 hour period. For those of you who have done this before, not sure how you have tackled this but I struggled. The examples were not applicable – and quite humorous I thought: “vacuumed and dizzy” “ran and headache”. And in my case, I live with a headache 24/7. It would have been interesting to have been up for PT during this 48 hour period but alas I was not…perhaps if there is a next time!

So I ended up typing up what I will call my “addendum” in which I explained I have constant and varying symptoms. I could have written a book but I knew that it would need to be short and sweet.   I wrote two long paragraphs that started off with “I have constant symptoms, the intensity varies. I have had a constant headache now for a few months that gets worse upon standing…” I also included that “I noticed last week that my HR dropped to 42 during the night, which had never occurred before…”

When the 48 hours were over the monitor screen went blank. I knew then I could remove the nodes. That hurt and my skin was raw and sticky. I bravely decided I would use Goo Gone to remove the stickiness. I had images of it burning my skin and wreaking bodily havoc but thankfully it did not. I rushed to wash it off with water and soap. Thankfully no drama ensued with my body. This could have gone south in a big way – as could have the whole 48 hour period but it was relatively peaceful minus some itchiness and sensitiveness. (I love Goo Gone but I’d never used it on my body, again I’m very thankful this experiment didn’t go awry so I will tepidly endorse it as a quick means of removing sticky stuff from skin, but don’t forget to rinse straight away.)

Then I just had to patiently wait for a cardiologist to review the data and send the results to my PCP. I was told it would take 72 hours. I have no idea if the cardiologist who read my data thought I was nuts or what he thought of my “addendum”. But at this point in my medical journey, I have nothing to lose; I go for broke and put it all out there. I want the best for myself – and if the cardiologist can’t see just how seriously I am taking this then I don’t want him near me, even indirectly reading my monitor data.   (I have no idea if anyone read my “addendum” or what they thought of it as it would never be referred to in the report.)

Of course it took longer than 72 hours to get the results. I was fairly certain that my results would be normal as I didn’t think my heart had dropped to the 40s. Being attached to any medical device is stressful for me, even this benign Holter monitor. And so not to my surprise, the findings were indeed pretty normal and not in the low 40s. #hearton So for now, my PCP has attributed the drop to the low 40s to my autonomic dysfunction (my POTS) and no need for a cardiologist at this time. There is always mixed relief when I get back normal results; yay for normal but frustration for no true explanation but it always seems to go back to the POTS. So that about sums up my experience “getting hearty with the Holter” (cue the song Gettin’ Jiggy Wit It). I now have more appreciation for STOP…get it, POTS spelled backwards? #sickbutsillsassy

viral invasion

Did you know that chicken pox is in the herpes family?  That mono, aka the kissing disease, is also in the herpes family?   I read about these facts last year when I learned that I had elevated levels of IgM of HSV-1, which is in the herpes family.  The herpes simplex virus is categorized into 2 types: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). It is estimated that about 60-80% of the population have HSV-1.  So readers, most of you naturally have it and may not even realize it since most oral herpes infections are asymptomatic.

As I shared last year, I supposedly had an HSV-1 infection; my blood work showed a very elevated level of IgM, but a negative IgG and a negative PCR and no outward cold sores.  Yet, a neuro-virologist decided to treat mine as an active infection given that I had a compromised immune system.  She first put me on an oral antiviral, Valtrex, at an extremely high dose – as if I had an acute, active infection.  As my IgM levels continued to rise, she would then decide to put me on an IV dose of another antiviral, Acyclovir.  I would be in a death like state for the two weeks I was on the IV.  I refused to go to the ER during this period.  The doctor never checked on me once.  When I told her it almost killed me, she didn’t follow up.  I have never seen her again.  Needless to say I fired her from my medical team.  My specialist briefly had me go back on the oral antiviral when she realized that my IgM level didn’t go back down to the normal range after the IV.  It was then that we realized my body never liked the oral antiviral either, although it hadn’t put me in a death like state like the IV one.  This saga ended in May 2016 when I decided I was done taking antivirals since they were making me physically worse (not to mention I was emotionally traumatized too after almost dying from the IV antiviral).

While it was appropriate to “treat” the HSV-1 “infection” – let me be clear, it was NOT an active infection, nor was it an acute infection.  In hind sight, it could or should have been treated with a low dose in an attempt to SUPPRESS the infection.  A high IgM alone does not signify anything, particularly in my case since it is well documented that I have trouble switching classes of antibodies.  To further muddy the waters, an infectious disease doctor recently explained to me that blood work for patients with autoimmune diseases should always be reviewed skeptically; antibodies can “cross react” and therefore not always be accurate.

In November 2016, my specialist ran my blood for HSV-1 IgM and IgG again.  This time it was back to normal.  What was weird, she also ran it for VZV and suddenly, I had a high level of IgM for VZV, which had previously always been normal.  So my specialist even called and emailed the neuro-virologist who I refused to see again to ask her what was going on – well, she didn’t even have the courtesy to respond to my specialist. My blood work was run again in July 2017 and again HSV-1 IgM is normal but not the VZV IgM.

This all leads me to say, I recently added a new doctor to my medical team.  If you hadn’t guessed it, she is an infectious disease doctor.  She ran PCRs of the entire Herpes family.  All are still negative.  And she explained that we are going to try to suppress my high IgM for VZV (and by the way, VZV stands for shingles) with an oral antiviral, this time I’m trying out oral Acyclovir at a low dose along with an antibiotic, Doxycycline.  So no, I am not covered in a painful shingles rash, thankfully. And we’ll see how this medicine experiment goes (so far, not so good); I may just have to give up on the oral antivirals and try the antibiotic solo.  Suppressing this latest “viral infection” may help calm my body down but we are not certain. We are hoping, however, that by trying to suppress it with low dose meds it will prevent it from becoming an active infection in my compromised state—that is why I am willing to attempt giving these meds and this new doctor a chance.

My body may just be taking me through the nine viruses within the Herpes family… be it actively or inactively.  I’ve had mono, medically known as the Epstein–Barr virus (EBV), not once but twice and chicken pox. Then my blood work showed elevated IgM levels of HSV-1 last year and now VZV this year.  Not sure what viral invasion is next…any wagers?  I know I’ll be OK with any as long as they never become active or I don’t land another doctor who thinks just a high IgM equates to an active infection. #sickbutstillsassy

Post script note: Some doctors will argue that blood work is enough to determine an active infection.  Without clinical evidence I am not inclined to ascribe to that line of thinking, particularly when in my case the antiviral treatment did not lower my IgM blood levels and the dose almost killed me. Keep in mind, this is a blog of my experience; it does not serve as medical advice, as I am not an MD, just a master of diseases by experience not official training. 

autoaylie’s first excursion to the ER

I recently had my first trip to the emergency room (ER) as a chronically ill patient living in an autoimmune world. It was a Monday. I knew which ER I was going to. I was on a mission to get a caffeine IV per my primary care physician (PCP) in the hopes to stop the hellish cycle of headaches I’d been having. My sister was in town and drove me. I hadn’t showered in a couple of days and my left arm looked already beat up courtesy of two nurses the week before from the infusion center who blew multiple veins trying to get an IV started for my take three of a one liter of saline infusion.

I did not opt for a trip to the ER lightly. In fact, I took the entire weekend to fret about it. And hoped that the steroids my PCP had prescribed me would end the cycle of my hellish headaches. I never thought I’d say that headaches could be worse than migraines. But my migraines now have a contender: postural headaches. Every time I stand, my head rages. The worst part is that I find no relief laying back down. I used to. Somehow between October and now, these postural headache attacks have become more frequent and more disabling than ever. (I will blog about these postural – or orthostatic – headaches in a future post so stay tuned; there has been a lot of recent research and talk in the postural orthostatic tachycardia syndrome (POTS) and Ehlers-Danlos syndromes (EDS) communities about low cerebrospinal fluid (CSF) pressure leaks and headaches. Currently, I have not been diagnosed with a CSF leak.)

So that is how I landed in the ER. There was no wait upon my arrival. But the initial no wait would be made up for because everything after would be a wait. The whole experience overall wasn’t too traumatic except: 1) initially after I was admitted and hooked up, they told me they had no caffeine IV. So I said, “Well then I’m leaving.” Luckily, turns out they did. And I didn’t have to leave. 2) The nurse blew another vein. This one would be the worst of them all. It would later look like a golf ball was coming out of my arm and it hurt like hell. I could barely move my arm. The first 48 hours were obscene and that is putting it lightly. More than a week later, it still hurts and the rainbow bruising is magnificent. 3) The caffeine IV didn’t exactly solve my head pain. It maybe took the extreme edge off, but the next day would be even worse.

They wanted to do tests like a CT scan. They wanted to do other IV cocktails after the caffeine IV. But I said no thank you to it all. First off, I want my head specialist who I see at the end of the month to weigh in on the testing. Secondly, we all know my body is super sensitive so I can’t imagine adding another cocktail to the mix. And sadly thirdly, I am already dreading the cost of this ER excursion. Not to mention, I wanted to get out of there as fast as possible and I just had one order from my PCP (though since he no longer has hospital privileges he couldn’t call ahead, which was disappointing and could have made for a particularly awful experience). Thankfully, they listened and I got released without a fuss. If I have another ER experience, I hope I have staff like them who listen and take me and my diagnoses at face value. They didn’t question me once, they didn’t look at me like I was crazy or on drugs, and they released me. I couldn’t have asked for a better experience. Well, actually I could have…no blown vein would have been fabulous but I don’t want to ask for too much now, do I? #sickbutstillsassy

simple saline | take three

Well I attempted a take three. This time, however, there was a big change to address my body’s abnormal reaction: we only infused ONE liter of saline, not two. Like in take two, 1) the saline was warmed up to about body temperature (instead of the usual room temperature or cooler) and 2) it would be a long infusion period, this time over three hours, yes for just one liter (instead of the typical one hour infusion period per bag). So here’s the skinny on my third saline experience from the beginning of July:

It started off on a bad note with not one but two nurses blowing my veins multiple times before successfully getting the IV started in my arm. (A few days later it would turn out that I would end up in the ER…thankfully the ER nurse had a sense of humor when I joked that it looked like I had track marks and that I hoped he wouldn’t blow any veins; alas he would too, this time severely imperiling my arm but more on that in a future post.) I had walked in that morning already with a relatively “mild” headache (and a low grade fever) but by the end of the infusion my headache had escalated (and the following days were worse keeping me more horizontal than vertical). During the actual infusion, I gratefully had no crazy incidents like I had during my initial take one (but I did not feel the vertical sturdiness that I felt after the initial infusion of take one – still don’t know if the rate or the amount of the saline of initial infusion provided that vertical stability but regardless that initial craziness did not allow me to enjoy that vertical stability so it’s a moot point for my body).

It is clear that pre-medicating (with Zyrtec, Zantac, and Klonopin), the warming of the saline to body temperature, and the slow infusion rate definitely helped acclimate my body. BUT again it failed to address the issue of my head. Pursuit of this treatment at this juncture does not make sense. So my specialist agrees with my migraine specialist after all: my body/head can’t tolerate saline infusions. For now, saline trials are bagged. #punintended (and inspired by my specialist!) #sickbutstillsassy‎

happy birthday to me!

autoaylie turns three today, happy birthday to me! Crazy I know. I don’t know what’s more hard to believe: that I still have topics to write about, that my body continues to spiral out of control, or that the number of my readers continues to grow.

I am not happy that my symptoms are still not under control, but I am beyond thankful that I still have an amazing support group of family and friends! If it weren’t for my dysfunctional body, I guess I wouldn’t have a blog, so maybe I am a tiny bit thankful for the continued source of topics. On that note, thank you readers for continuing to read. It’s not always easy I know, I do my best to sass it up because laughter is the best medicine after all.

I don’t have grand plans for the upcoming year, but I do hope that I continue to be a source of information and/or inspiration to others (whether you are a fellow patient, family member, caregiver, friend, or even a stranger) on a [awful or awesome or insert whatever word you choose] medical journey. I still haven’t found my new normal yet but years into this journey I imagine my “new normal” will always be evolving.

Feel free to share my blog, continue to ask questions, provide comments, email me, and/or follow me on Twitter! #sickbutstillsassy

do NOT order me around

Note: The following occurred back in early June, which now seems like a life time ago to me and I no longer feel as traumatized. But I still feel inclined to share the story…fellow patients can relate, caregivers will shake their heads, others will get a flavor of the craziness of what us patients endure, and for any readers within the medical community hopefully you can now better appreciate more what it means to be a patient, be more empathetic to our journey, and not assume we’re all alike or somehow don’t deserve “better” customer service or to be heard.

So I’m back to discuss (simple) saline infusions, which I didn’t think I would be until my head was under control. It’s not (and the past few weeks have been particularly ugly for my head) but here I am nonetheless. My specialist has decided I should try an infusion of only one liter (instead of the usual two) of saline over a three hour period (instead of a normal one hour period) and again heated to my body temperature. She thought I could get it at home instead of at the infusion center and put through an order as such. A couple days later, I received a call from the lady who coordinates the orders.

The conversation sent me into hysterics, which is why I find myself writing about the traumatic conversation and sharing it with y’all. I would think that anyone who works in a medical office would have better customer service skills and be more sensitive to patient needs than the average person behind a desk in general. I don’t know if this lady was having a bad day, thought she was the doctor for the day, or is this bossy every day. Regardless, no patient should endure such a conversation so for any medical staff reading this post, please know and understand that your interactions with patients can end up being very traumatic.

Here’s a recap of the conversation – almost verbatim – and names (other than my own) have been changed for obvious reasons.

X: I’m calling to tell you that you can’t have the hydration infusion at home. (She goes on about it being too costly to do at home…so it must be done at the infusion center.)

Me: OK no problem. (Note: the conversation should have stopped here! I was disappointed the infusion couldn’t take place at home but understand her explanation and said fine let’s schedule at the infusion center I’ll just have to figure out rides. But the she instead proceeded to talk…)

X: You’re going to need a peripherally inserted central catheter (PICC) or a port.

Me: No I won’t.

X: Yes you do.

Me: No I don’t.

X: You do.

Me: No.

X: You’ll be getting infused multiple times per week if not daily.

Me: What?!

(Note: this went on multiple times. So imagine a repeat of stanzas…)

X: Yes Dr. F puts in orders for her patients for as up to as much as daily.

Me: No. There’s no order for it. What?! I would rather die. You do not understand. I can’t even touch a pole. Someone has to escort me to a bathroom even. The machine has to be covered with a blanket. Ask P (the lady who covers the infusion center). I’ve also had a PICC before for two weeks. I couldn’t look at my arm for two weeks, my mom even had to fly out. I am not getting either. I am NOT. You are not hearing me. We do not even know if one liter will work. I have a fear of all things medical. I can’t even look when I get a simple blood draw. If I see anything, I will pass out.

X: You will need one or the other. Dr. F prescribes orders for…

Me (in tears now)‎: Noooooo. If it even works, then it will not be as frequent. Maybe every other week or once a month. Or even just by occasion so I am more functional then. I am not getting either. Even the words send me into a tizzy. I don’t understand why we are even having this conversation. It is not relevant.

X: But you can’t be infused without one of them.

Me (still in tears): Then I won’t get infused. I’d rather be dead than have either in me again. You are not listening. Again I may not even tolerate one liter so this is not relevant.

X: Yes you will.

Me (absolutely hysterical): No. This conversation is over. We will see how one liter goes and I will talk to Dr. F. This is not a conversation I am having with you as there is not even orders for either.

X: OK. I’ll have P call to schedule you at the infusion center.

As I have stated in several different posts now, I have a fear of ALL things medical (no exaggeration). I’ve been that way since I was a kid. Now with chronic conditions, it’s awful and it’s not easy being a patient. ‎I know it’s terrible that I literally said I’d rather be dead as I know other patients with ports or PICCs (and how I wish I could be more like them, I love you my warrior friends!), but it is how I feel. It’s a quality of life I could not handle; it’s a personal decision and not an easy one to make. Having had a PICC for two weeks last year I could never do it again. As much as I hope that saline will give me my life back there is no possible way I could live with a device in me. It’s not a decision that I’ve come to lightly but nothing can change my mind and it was so insensitive of this random lady who has NEVER spoken to me, who is NOT an MD, who has NO orders for a PICC or port, to be having this sort of conversation with me.

She sent my heart rate to almost 200, I couldn’t stop crying for hours, and my eyes were still puffy the next day. I get I’m not a typical patient with such a fear of all things medical. She probably thought I was some crazy patient. Fine. But she was not professional either. She shouldn’t be ordering me around – again, she didn’t even have an order for a PICC or a port! I’d like to think staff in a medical office would be more sensitive. But I felt bullied. Traumatized even. Perhaps next time I will hang up rather than try to have a rational conversation. Clearly only my tears signaled that she needed to back up. But even then it still took a while for her to reach that realization – and even then she was not even apologetic. Not sure why she was so stuck on the PICC or port line but it was not an order I was going to take from her – or anybody for that matter. #sickbutstillsassy

rollercoaster (bed-bound) lows and (vertical) highs

Life is like a box of chocolates [cue the scene from Forrest Gump]…life is like a highway [cue the Rascal Flatts song]…lately life has got me thinking it’s a rollercoaster ride that I’m so over.  For those who know the former me, those words would be sacrilege, as I was the gal who LOVED me some rollercoasters (though I never did make it to Cedar Point – it was a bucket list item in my former world).

June marked the official two year mark of my postural orthostatic tachycardia syndrome (POTS) diagnosis. Despite this official diagnosis and having made life style changes, sadly I’m no closer to getting any form of stability or any semblance of my former self back. In fact, reflecting back on the past two years, I’ve progressively gotten worse.

This anniversary is not one I’m celebrating. ‎I’m instead reminded just how volatile the symptoms of POTS are. How quickly they come and go. How unpredictable they are. Just how “normal” I look despite how miserable I feel. Just how invisible the symptoms are despite them ravaging on me. How I can go from being bed-bound one minute to being vertical the next.   The dysfunction that this disease causes continues to blow my mind.

June also marks antiphospholipid syndrome (APS) awareness month here in the U.S.  Another disease that like POTS is under-recognized even within the medical community.  And again, one which wreaks havoc in my body.  I was first tested for APS in June 2015 and then my diagnosis was confirmed three months later when I still had antibodies in my blood, along with clinical symptoms.  It also blows my mind just how many doctors don’t understand this disease.

So back to my dysfunctional body, I jest that I’m on a symptom merry go round. But the other apropos analogy is a rollercoaster. ‎It’s a physical one. A mental one. An emotional one. With so many more lows than highs, and the lows always being lower than the highs. I used to love rollercoasters, but in my current condition, I couldn’t imagine getting on one even if I were paid (well maybe for a million bucks I’d consider it…let’s be real, it would help fund my medical bills since health insurance is getting more and more out of control).

So this form of rollercoaster is not fun like the real thing (well I guess for those who don’t like rollercoasters they wouldn’t be considered fun but hey it’s an option to not go on them). But the past few months when I’ve been vertical I’ve definitely been taking advantage of the highs because I never know how fleeting they may be or when I may have the next one. But I’m so ready to get off the rollercoaster ride – but sadly I don’t have a choice.  I know none of us get to sign up for what life hands us and it’s our attitudes (well our support networks too) that get us through the crap we’re dealt.   And I can scream and cry and complain too but that just won’t make any of this go away.

So yes, every day, every minute of my life is a rollercoaster. It is a daily struggle – invisible to you.  Filled with lows. Filled with highs. And just because I walked out my door doesn’t mean I feel great, it means I’m having a vertical day and that I am seizing the relative “high”! So while I am drawing attention to my wild rollercoaster ride, I don’t want your sympathy, instead just be aware of what us patients go through. I may look “healthy”, but I sure as heck don’t feel OK (and will never again but that doesn’t stop me from pretending to). And of course, I wouldn’t be me if I didn’t ask y’all to help me raise awareness for APS today. #GoBurgundy #sickbutstillsassy

I got dumped

I’ve gotten so use to “firing” doctors that I was recently blindsided when one of my favorite doctors on my medical team had a heart to heart with me… He informed me that he’s failed me, he’s got nothing left to try on me. He hasn’t fixed my skin issues (itchy episodes, hives, and acne), my scalp issues (bumps and peeling), my hair loss issue (but I’m lucky it doesn’t look like I’ve lost hair yet!), my tongue issues (sores, swelling, and pain), my feet (swelling, blisters, redness, sweating, burning, and pain) or hand (swelling, pain, redness and burning) issues. He’s just wasting my time at this point, he said. So there’s no point in continuing to see him regularly.

Of course if anything severe comes up, I’m to call the nurse line and his nurse will fit me in. He loves seeing me every two to three months but we’re just not getting anywhere. Everything we’ve tried has failed. He finally sees that my body doesn’t like drugs – even the topical kinds. He doesn’t want to aggravate my body by doing a biopsy of my tongue to (dis)prove oral lichen planus (OLP). So we’re at an impasse. I got dumped albeit very nicely. By a doctor who is old enough to be a grandfather and has seen a lot in his day. I’m not gonna lie, it took a lot to not break down in tears in his office, to not feel defeated, and especially to not feel like a lost cause.

I definitely had a meltdown when I got home. After all, I got dumped by a wonderful doctor. Who wouldn’t be heartbroken? So no I won’t be on a search to replace my former dermatologist. I know he’s there if I need him; after all, it was an amicable break up. I will likely still see him one to two times per year instead of more frequently but know it’s just maintenance and no longer a quest for answers. I have the basic diagnostic codes of chronic urticaria (unexplained – of course), geographic tongue (bloody painful), alopecia (a fancy word for hair loss), along with sweating and erythromelalgia (EM) (burning hands and feet). And no oral or topical drugs to help any of the above – only those that aggravated (or if I was lucky maintained the condition as status quo) the conditions after trial and error.

It’s been over a month since I’ve been dumped by this dermatologist, but it’s still a raw wound. They say time heals wounds, I’m hoping it will heal this one too. But in my world, it’s so hard to find doctors who listen, who persevere with you, who don’t rush appointments, and who are patient in answering your questions. He was a gem! So that’s why this one stings – and may for a while even though I know he’s willing to see me in an emergency. It’s just hard to digest that I’ve exhausted this doctor’s arsenal. But I guess that’s what happens with a body that is uncooperative with oral and topical drugs. So I don’t have a moral of the story other than to share being dumped is evidently inevitable and a part of the medical journey (just like in matters of the heart – so instead of boyfriends I have doctors dumping me) – but thankfully in this case, an amicable split. He was also a reminder that there are honest doctors out there too – although a rare find, they do exist (which then of course has me wishing there more like him and my dad – so on that note, a happy belated Father’s Day, dad! I don’t publicly acknowledge you enough on this journey, you may not play my nurse but sometimes you do say the appropriate things to keep me from ragging on all doctors). So here’s to healthy breakups! #sickbutstillsassy

my peeing problem

We all know that I tackle all subjects, even the difficult ones. This one is no exception. While admittedly I am a bit embarrassed or perhaps I’m feeling a bit more exposed than usual, I have decided to forge ahead with this topic regardless. Today’s topic is about my random episodes of frequent urination, formally known as polyuria in the medical world. Yep, brace yourself for yet another not so sexy topic.

For those female readers out there, you may be thinking urinary tract infections (UTIs). But nope, I don’t have UTIs. I don’t have pain while I pee. To be sure, I even had multiple urinalyses that have ruled out UTIs. Next for those of you with Sjogren’s, you may be thinking I have interstitial cystitis (IC). But nope, I don’t have IC either. Again, the pain element is missing. For those of you with POTS, you may be thinking ugh, I have these random peeing episodes too. Bingo, and there is no real name for it – I just call it my #peeingproblem; some say bladder spasms, while some say frequent urination, and others say lower urinary tract symptoms.

So yes, it’s a POTS thing. It comes and goes and is totally unpredictable. It used to come every few months and last about an hour, where I’d pee every five minutes. Then it became a monthly thing where I’d pee every five minutes and last for up to about four hours. Then suddenly in April it happened five times in one month. And I suddenly was questioning my POTS sanity – hello multiple urinalyses later and they’re all normal, whereby restoring my POTS sanity much to my relief and dismay. You see there isn’t much you can do about this POTS symptom; just pee it out.

All but two episodes have struck while I have been at home (mostly because I spend most of my time at home and likely since most of the episodes strike at night though lately they are striking in the afternoons now too). I don’t have a solution – except a recent one of testing a drug DDAVP (stay tuned as it may or may not work to help dry out my #peeingproblem when the attack begins). I am just trying to be grateful that there is no pain just some discomfort in my bladder that alerts me that I am about to go into one of these episodes. So when one strikes I just hope it’s when I’m not having a raging migraine or when I’m seriously vertically challenged because that’s when I usually end up spending half the night in the bathroom – because oh yeah the pattern of the episodes have expanded to eight hours and a combination of every five minutes to hourly. It’s only fitting the #peeingproblem be added to my POTS symptom list; at least it’s a cut and dry symptom (pun intended!) that’s not daily (and hopefully will never become daily) because it sure ain’t a sexy one. #sickbutstillsassy