Brooke hosts this very new blog, intimately sharing her experience as a person with myalgic encephalomyelitis (M.E.) who is currently in hospice care, or, more bluntly put, expected to die from the disease within six months.* That is her current situation, but she is also a person who loves dogs, languages, poetry, nature, and music. Regarding those interests, I feel like I just wrote an explanation about myself! I’ve enjoyed her few new posts ranging from recaps of who she is and has been, facts about the disease, and how hospice care can be of real benefit. I feel she has a valuable perspective and I expect however many entries to follow will continue to be enlightening and authentic. I also admire her idea to start something new when some might raise the idea of it being “too late”–her choice to express herself is testament that we are always, always evolving. In the entry I’ve chosen to reblog here, she explains the huge detriment of calling Myalgic Encephalomyelitis “Chronic Fatigue Syndrome,” the harm it has caused patients, and how that ever came to happen.
♥arainbow at night
“ME is not CFS. By CFS, I am of course referring to the diagnosis Chronic Fatigue Syndrome. Everywhere you go, you see the two names combined. Many patients themselves abbreviate their illness as ‘MECFS,’ ‘CFS/ME,’ etc. This is incorrect. Doing so hurts literally hundreds of thousands of people around the world. Let me explain.
“Myalgic Encephalomyelitis got its name long ago based on what experts saw in patients with the disorder, as well as the autopsy results of many of these patients. What the autopsies showed was inflammation of the brain and spinal cord, deterioration of the dorsal root ganglia, and more. The name Myalgic Encephalomyelitis means ‘muscle pain and inflammation of the brain and spinal cord.’ It’s a perfect fit. In 1969, the World Health Organization (WHO) recognized this fact and officially classified Myalgic Encephalomyelitis as a neurological disease.
Then the US got involved. In the 1980s, there was a breakout of ME in the Lake Tahoe area. The US sent a couple people to investigate. These individuals refused to meet with any patients, look at blood samples, or do anything productive. … There was not one single experienced ME expert on this panel. Rather than call the illness by the name already recognized by the WHO, the US came up with the name Chronic Fatigue Syndrome. This is where the two names became linked. “Read more
* ETA, Feb 2016: This didn’t happen and Brooke is still with us–not necessarily “fortunately,” if you know what an excruciating disease this is–because the final stages of M.E. do take years, which both her and her doctor were aware of at the time. However, she at least was able to enjoy six months of supremely attentive hospice care, which is more than 99% of people with M.E. ever receive, even though countless need it. Her doctor remains an integral part of her care to this day, including home visits, as she obviously cannot as much as leave her bed, much less her house, to go see one.
What made me even more motivated to do all of this is a situation I’m in with my pain management doctor. Words can’t express how thankful I am for his help, but the office is crowded, and sometimes they are more interested in swiftness than quality time. You’d think adequate communication was fairly important when discussing things such as burning away your nerves as a type of “treatment”?
The conversation has always been, We’ll try to numb the nerve, then if it works, we’ll burn it.Never once was I asked how I’d feel about this, or if I wanted to do it. So much so, that I nearly forgot to contemplate it, myself!
Because of the side effects I got just from the “trial” shot, doing something semi-permanent like radiofrequency ablation–or radio frequency nerve lesioning as it’s also called–would probably result in the same bizarre side effects, only forever: Never being able to recognize myself in the mirror, and never being able to keep my balance even with my eyes OPEN.
Does that sound AT ALL how I want to spend what could be my last stretch of life able to truly function? NO. I still don’t know why those odd side-effects accompanied my injection, but that’s what happened.
They were very willing to work with me when I discussed how I absolutely cannot have the steroids that usually accompany the nerve block/make it last longer, but I’ve still had a lot of anxiety about discussing how I don’t want to obliterate one of my nerves in an attempt at “relief.” That’s the exact opposite of what I view as self-care and treating my body kindly. But I don’t want to seem like I’m not wanting to help myself, something everyone with chronic illness has been accused of at least once but more likely a dozen times.
I also don’t want to come across as just wanting pills and nothing else, and get some unwanted reputation as a pill-seeker. As much as pain management advocacy groups make it sound like everyone has the right to pain control, I’m sorry, but being mislabeled still happens. A lot. Part of the reason it took me so long to seek pain management in the first place is because in the past I was always denied at the ER: They didn’t believe me and unjustly assumed I was only there for drugs because my conditions (Fibromyalgia, at the time) were so poorly understood. I know my anxiety has stemmed from all this, because what if my current doctors also don’t understand? But I’m at the point now where I’m too frustrated with the fact that my opinion over what I want to do with my body was never even requested, so they will either understand, or I’ll have to find a new clinic. We have to talk about how I do not want to do that to my body.
My point in this two-part entry, is this:
You don’t have to do what’s “expected” of you, when it comes to your health. Whether that concerns end of life care, medical treatments, or prescription options: If you want them, and you think they’re worth the risk–and they all have risks–then try to get them. But don’t feel pressured to get them just because someone else thinks it’s right, because your doctor thinks it’s right, or because other people wish they could have it, if it’s not really what YOU want for YOUR body and YOUR life.
For a long time I even felt guilt over turning down my Lyme etc. treatment because there are people who want to get treatment, that can’t… But that doesn’t do anyone any good at all. It doesn’t make sense to kill myself with antibiotics just because someone else wishes they had any antibiotics at all.
And don’t forget to consider what it means for you in the long run. Many people want to stay around for as long as possible, no matter what the cost; for their children, spouse, best friend, others who need them, without stopping to think of how those emotionally-charged decisions are actually going to affect their life. It’s worth the extra thought.
Are they still getting “you” if your attempts to stay alive rob you of your body and mind? Is it in the best interest of your values and morals? And are your morals and values in your best interest?
At what point is prolonging your being alive with the aid of modern medicine only going to promote your suffering?
There’s every possibility that I could be involved in some unexpected incident–a car crash, ANOTHER tree trying to land on me for a THIRD time, an abrupt, rapidly-progressive infection that takes me out overnight–but those aren’t the most likely situations. The only thing that makes sense for someone in my situation is to plan for some type of gradual decline.
I’ve had a living will for years, but someone’s situation recently made me wonder if what I had written down was specific enough to fully protect me. Living wills only cover you if two or more physicians declare your case terminal. If you want someone to express your wishes in the event you cannot communicate for yourself but aren’t yet deemed terminal, you need to declare someone your medical power of attorney. Not your power of attourney, but your medical power of attourney.You can also include in writing what you want just like a living will, and that’s a very kind thing to do for your family so they can have physical proof of your wishes.
This is especially important to me right now because it hit me that doctors just aren’t used to dealing with cases like mine. I’ve seen that time and time again over the years. Most physicians I’ve seen can’t even understand how I dehydrate so quickly. Too many times, I’ve even been told my symptoms are “impossible,” yet here I am. That doesn’t give me much hope for other situations, so if I want the best help in the event I’m unable to speak for myself–a situation which can and does happen to people with both severe M.E. and Lyme disease–I have to include specific instructions and appoint a Medical Power of Attorney.
In my current condition, where even half a child’s dose of the most basic antibiotic causes me immense suffering, I need to check the “no antibiotics” box, in the event my doctor wanted to try them in some optimistic attempt to save my life. The hospital won’t understand the consequences of someone like me going through something like that, but I do. For instance, I recently had to take ONE olive leaf extract capsule to quell the a relapsing h. pylori flare up, and ever since, my head has felt like it’s going to implode, even more than usual. That’s not even a prescription antibiotic! These extreme inflammatory reactions–herxheimer reactions–actually hospitalized me for five days in 2011, and that’s when I was able to tolerate treatment!
And if I’m unable to communicate, at what point will I think it’s no longer worth it to continuously visit the emergency room for IV fluids? When things got bad in previous years, I was going every two months, via ambulance, because the dehydration was so sudden and so severe. Right now I’m okay with that assistance because I’m still functional and it helps me bounce back. But at what point would I have to say, “This is just too much, it’s only prolonging my suffering; no more fluids, just keep me comfortable“…?
What about breathing assistance? I like the nasal oxygen, but I’m against any ventilators or breathing machines.
And I know I don’t want to live off of a feeding tube, if I’m otherwise completely incapacitated. To me, that is when it’s time to let nature take its course. People with severe M.E. are faced with this particular decision often. Many concede to a feeding tube in hopes of getting better later, or because they’re still able to participate in life in some accommodated way which makes it worth it to them to stay around. But I wouldn’t see a point, if I had so much else going on. Plus you have to add my Lyme disease to this… I think I’ve been through enough.
The only reason myalgic encephalomyelitis doesn’t kill more than it already does is the availability of life support measures. Otherwise, there would be many more people–all or almost all from the 25% severely affected group–dying of wasting syndrome, dehydration, inadequate oxygenation of the major organs, and infection.
And what about a DNR/Do Not Resuscitate? If/When my heart were to go into life-threatening arrhythmia, do I want them to try to “help” me? Right now, I say yes. But later on, I might want to sign forms telling emergency dispatchers to not electrocute me or break my rips trying to “revive” me.
There’s no way I can predict right now when I’ll decide enough is enough–these decisions can’t be made overnight–but I do know when I reach the point of not being able to communicate with my loved ones, that will probably be the breaking point.
I do not want to continue past the point that I cannot communicate, being kept alive only by machines and tubes, and I don’t think it’s even natural to want that, when the body is obviously trying to pass on in a way that would actually limit the suffering involved, if only we’d get out of its way.
We should all think about these things, whether severely ill or not, to help relieve the burden on our families when that time comes.
“The suggestion that modern western medicine can and has made life easier is countered with the fact that sometimes, it can prolong life too far, and then allows more suffering than was necessary. It is up to each person to decide what’s enough.” *
I did not arrive at my decision lightly. I experienced… Ah, I experienced a lot. The Caring Connections organization put together a great example list of the emotions involved in living with serious illness:
“Emotional changes that you may experience include:
Fear – about what will happen as your illness progresses, or about the future for your loved ones
Anger – about past treatment choices, about the change in diagnosis
Grief – about the losses that you have had and those to come
Anxiety – about making new decisions and facing new realities
Disbelief – about the changes that will be taking place
Relief – about ending difficult treatments and setting new goals for care”
“Myth: Accepting that this illness cannot be cured means that “nothing more can be done.” Truth: When the focus shifts from cure to care, a great deal can be done to relieve physical pain and emotional suffering, and to ensure a good quality of life. Remember: Have conversations with your loved ones about what you do and do not want. Designate a healthcare agent to speak for you in the event that you can no longer speak for yourself.”
I can talk about this more clearly and rationally now, after several weeks of living with my decision, but like I wrote earlier: It was anything but easy. (This entire post is quite embarrassing to write, actually.) I experienced extreme guilt for not wanting to get treatment.
Since I don’t believe in coincidence, it was difficult to figure out whether I’d learnt of the MTHFR gene mutation to get it treated so I could get back on Lyme treatment (but I thought of this more out of habit than any true desire or intuition), or to just be more aware of how I could help my body… I was living too much in the trying to find the Lesson and not enough in the living the Experience (which ultimately gives you the lesson). I heard something like that during Oprah’s Super Soul Sunday several weeks ago.
I knew I’d lose my mind if I tried to do “the Lyme fight” again.
I’m 99% sure I’d lose my mind if I fought my own body at all, at this point, to be honest.
So I didn’t know what I was “supposed” to do. I knew what I wanted, but I felt guilty for wanting it. Probably as a remnant from my more religious upbringing, I actually felt like God would be angry with me for my decision. I automatically felt like choosing to live without fighting disease, would be choosing to die, so how could The Universe possibly support me in that? I felt like I couldn’t trust myself anymore.
But that same day, the guest on Super Soul Sunday started talking about God’s Love, and it really brought me back to my core beliefs… The Universe bringing me back to Itself, surely.
It reminded me that I am not being judged. That God–whether a He, She, It, The Universe, whatever that Source may be–does NOT hold anger or negativity toward me for my decisions, that those feelings come from my interpretation and not reality. It reminded me that I could NEVER be a disappointment, and the most important of all: That there is nothing but Love and Acceptance for me; Love and Acceptance for What Is; Love and Acceptance for what I decide…
As a recovering codependent, I had to realize The God Force I believe in is not like so many humans I have known, who bestow their version of love based upon how much what I do agrees with their opinion.
Probably the craziest part of it, was that in my darkest, anxiety-ridden moment, I felt like if I made the “wrong” decision then all my suffering would be my fault and I would deserve to be punished and abandoned, for not being in alignment with “God’s will.”
I was so focused on What if I make the wrong decision? that I wasn’t able to stop panicking long enough to figure out from where my suffering was arising. And I was so absorbed in assuming my thoughts were a form of escapism–I must be running from my fear of going to a new doctor, I must be terrified of the new treatments not working, I must be running from the reality of another health problem…right?–that I completely neglected the idea that turned out to be the real problem:
I was actually running from the fear of not treating, and what would happen when I did that.
Treating felt too wrong to possibly be right. But choosing to forego it is something I’ve never done. I can see now, in hindsight, this discovery WAS the lesson in itself. It wasn’t a lesson in what to do. It was a lesson in how to Not do, something I’ve never known how to.. well, do.