Monday, February 27, 2012

Cautiously optimistic

Just over two weeks into the chiropractor treatment plan and I'm starting to feel some changes. I am hesitant, given my 7-year history of failed "solutions", to say that I am "getting better" but I would be amiss not to recognize some improvement.

First, I have started to experience some relief in my shoulders and neck. Given that they have basically been held together by piano wires since September of last year, this is a HUGE relief. I hadn't realized how much the tension prevented me from breathing. I notice myself wanting to take deeper breaths now. When the pain returns, which it still does, intermittently, I notice that I lock back up again and often catch myself "holding" my breath. Part of it is due to the fact that the part of my spine that is affected actually goes to the third rib, which makes it uncomfortable to take deep breaths sometimes. Being away from the computer for extended periods of time and being more generally active/mobile, helps tremendously too. I notice my shoulder and neck pain return after extended computer use, no matter how I sit. Being in one position for too long is just not for me. Otherwise, mostly I am just really sore from the constant adjustments and deep-tissue massage.

My knee pain has all-but gone again. Phew. I asked my chiro if he thought my knee issues were structural or if they were a result of tendons and muscles being tight. How he answered was that he thought my knee problems were "functional" not "structural" which, yes, means tendons and ligaments and muscles vs. skeleton. This makes sense because my knee pain comes and goes, which it would not do it was a structural issue. That's at least a relief because I was really starting to fret that I would need knee surgery in year from now.

S.I. joint pain is back, however. It's manageable and not surprising, given that this would be the first time anyone has really even attempted to shift my sacrum and pelvis. I was pretty much told to leave it alone because messing it was making it worse, so I did. Now we're doing the complete opposite of that - cracking it three times a week. Soreness is to be expected. Of course, it didn't help that I decided to get all ambitious and bike an 8 mile round trip from our house to Old Town Folsom on Sunday. I was proud I made it and that a sore S.I. was the extent of my issues. I guess keeping even the light workout I have managed to maintain, actually paid off.

Biking by the river. Awesome.

The next step in treatment is the first stage of my detox. I got an overview of the diet plan this evening. Here it is. Gulp. No coffee. No wine. This could get desperate.

The diet

Despite the limitations, I'm kind of looking forward to cleansing my system. This part of the detox is only 3 weeks (timed to end before my Disneyland vacation in April) and I think I can endure for that long. I'm certainly interested to see how it makes me feel, once I get over the shock of having to exist without caffeine and alcohol. (Hubby is already threatening to put a plane ticket on reserve.) After Disneyland, however, will be the liver detox, which I hear is a real bear. Not looking forward to that one little bit.

In other news, I deposited my, er, specimen in the plastic cup and it is currently in my freezer, awaiting me to find 30 minutes in my day to take it to the UPS store.

Wednesday, February 22, 2012

A brief update

For those of you who have been following along on my pain journey, I wanted to provide a brief update.

So far I've had 4 appointments with the new chiro. Each appointment consists of:
  1. 15 minutes doing mild exercise (arm bike) while inhaling 90% oxygen.
  2. A 10 minute deep tissue massage
  3. A chiropractic adjustment
There have also been some other experimental things, like a little electronic pulse that is applied to your ear, at common accupuncture points, to try and stimulate my brain. Through repeated brain stimulation tests, we've pretty much figured out that the right side of me is **cked - reflexes, response time and other things like my ability to touch two fingers together over my head. Things I can do (easily) with my left side just don't happen right now with my right (which is where all my injuries and the majority of my pain symptoms are), so we're trying to kick-start my brain again into firing on all cylinders.

The oxygen therapy or E.W.O.T. (Exercising with Oxygen Therapy) is interesting. I have an open mind about it and, while exercising, read this brief book about the theory behind it. However, I'm not sensing any changes from it, as yet. Initially I was a setting of "3" for 10 minutes (I can't remember off-hand what the number represents but I'll look it up) and today I moved up to a setting of "4" for 15 minutes. I admit to feeling a little more "awake" with the additional oxygen, kinda like when you suck a really strong mint and it floods your sinuses and air cavities with that cool sensation. But the feeling goes away as soon as the oxygen does.

The regular massage is FABULOUS and provides immediate, although transitory, relief in my upper back, neck and shoulders. Thirty minutes back in the "real world", however, and I feel my shoulders creep up and my pain begin to return. 

The adjustments are... mind-bending. For someone like me, who cracks and pops constantly without assistance, and where those cracks and pops represent injury, weakness, and often pain, it's hard to accept that rapid-fire popping in various parts of my body is positive, productive and healing. I have a very physical reaction to adjustments - I literally produce a full-body jolt right after them. Mainly it's been my spine that's been doing most of the cracking but also my neck, arms, and pelvis. So far, no major issues as a result, except of course for some soreness. 

Also, however, no major improvement. I have experienced periods of reduced pain in my upper back and my neck does feel slightly less stiff/stuck but mostly it's status quo. Since I've avoided massage or therapy on my S.I. for some time, after a previous P.T. told me it was "irritating" it, my S.I., sacrum, and lumbar areas are sore from the massage and adjustments but it's not anything I wouldn't expect. Mostly, I feel exhausted and a little loopy at the end of a session.

Unfortunately, as I said in my previous post, my right knee pain has come back with a vengeance - I'm talking can't walk up the stairs on it, can't stand up from a chair on both feet kind of pain. The good thing about the knee pain is that it's only present with certain activity, as opposed to the back and neck pain which is present all the time. The bad thing about the knee pain is that it is aggravated by and in some cases prevents me from doing the exercises that have proven effective in staving off back pain. 

I have no idea if the knee pain came on because of what we've been doing elsewhere in my body or if it's an unfortunate coincidence but I'm leaning toward it being a result of the other adjustments since I've come to believe just about everything is connected to everything else right now. The chiropractor seems non-committal either way, which makes sense because he's only just beginning to get to know me and my body. He has begun massaging the tendons of that knee, which are RIDICULOUSLY sore, tight and "tweaky". In fact he managed to find some pretty major "knots" that I just would not have thought possible to be hiding in an area that small.

For now I'm just trying to be patient and let things unfold while simultaneously icing my knee and heating my back.

And then there is this...


Yes, that is exactly what you think it is. I poop in it, seal it up, freeze it for at least 24 hours, and then send it by UPS to a lab for analysis. We'll be testing for lots of metabolic and auto-immune-type stuff that could be messing with my body (because, you know, what we've already diagnosed is not enough) one of which will be gluten sensitivity.

So, yeah, there will be poop in my freezer this weekend.

Meanwhile, I am continuing to explore other ways to stay exercising and strong, while the therapy part unfolds - the last thing I need is to go backwards in what little strength and fitness I have been able to maintain through all of this. I'm setting up clinical/reformer Pilates training sessions with the lady at my local gym who is a pilates instructor as well as someone who works with physical therapists. She was in a car accident a decade or so ago and had some major spinal issues with resulting pain which sent her in a downward spiral and threatened to take over her life but, through Pilates, has been able to restore fitness, strength, flexibility, and reduce her pain. Clearly, I'd like to do the same and she seems uniquely-positioned to help.

Which leaves 5 days a week consumed with therapy at this point. While there are still other things that have been recommended that I could explore (Rolfing, Bowen Therapy, and Body Talk to name just a few) there are only so many hours in a day, days in a week, and dollars in my pay check. I'm going at this stuff with all I got right now, so let's hope I start to see some improvement soon.

In other news, work = stress. This is not helping. 

Friday, February 17, 2012

The (latest) diagnosis


It's always too early to quit. -Norman Vincent Peale


I know I have left you all itching for "answers" after my last two posts: Catharsis and The Toll

Ok, I'll admit, my first creative passion was/is writing so part of me did that on purpose. Yet, at the same time, I just couldn't launch into an explanation of my most recent diagnosis without starting from the beginning. To me, it would have been like having you begin reading the book 3/4 of the way through. But, now I've finally got all that stuff out of my system, it's time to share where I'm at in the here and now.

----

In my latest quest for "answers" I started researching Fibromyalgia. My uncle was getting tested for it (he also happens to share my birthday in some weird coincidence) and it seemed like the last frontier. As you'll recall, I've explored muscular, skeletal, hormonal and neurological and found no real answers for why my body seems to be continually failing me.

So, I went back to my doctor and told him that I thought it was time that we explored the possibility that something more fundamental was at the bottom of the things that have happened to me in the past seven or so years. 

No sooner had the words escaped my lips than he was pulling out a form and writing down requests for arthritis bloodwork. 

"I don't think it's arthritis," I said. (Which was me being polite because what I wanted to say was "If you think this is arthritis, you clearly have not been paying attention for the last 3 years I've been your patient!")  My husband has a form of rheumatoid arthritis, so I know what that pain manifests as, I've watched the progression, I hear his symptoms; they are NOTHING like mine. 

"Well, this is a fairly in-depth bloodwork I'm getting for you, let's see what it pulls up," he said. So I acquiesced, thinking that, at least, if I could rule out his initial hypothesis, I could get him to take the next step in really diagnosing me.

Haha. This is where I realize just what an overly optimistic person I really am.

The bloodwork came back as negative for arthritis. Thank God, yes, but at the same time unsurprising.

"So, what's the next step?" I asked, expecting him to suggest another litany of tests. Lord knows, he's never been reluctant to sign a test slip before that day.

"Well, all the markers show you do not have arthritis but there is one thing that came back positive, sort of in contradiction of all of that. I don't really know what it means but it could mean you have some kind of non-specific arthritis," he said. "That may explain the little pains you've been having here and there."

THE LITTLE PAINS I'VE BEEN HAVING "HERE AND THERE"!?????

Are your freaking kidding me!?  Have you not been listening to me for the past 3 years? Have you not personally written three physical therapy referrals slips for different issues, performed x-rays, and had me come in every 2 weeks for the majority of that time for Osteopathic Manipulation? Do you think I am bored and need something to occupy my time!?

Ok, that's what I WANTED to say. What I actually said was: "Well, they're not little pains and they've actually been affecting the quality of my life. In fact, I would like a referral to a therapist to help me deal with some of the issues that have come up for me as a result of my chronic pain."

What I would have hoped would have happened at this juncture, you know, if this was someone who really gave a flying **ck about his patients, would be that the doc would pull himself up short and say something like: "Really? I had no idea it has been this bad for you. If it really is this debilitating, perhaps we should consider looking at some other things."

However, what he actually said was: "If you look on the back of your insurance card, you'll see a 1-800 number you can call."

And with that, he discharged me with prescription NSAIDs, which I told him I did not want to take because I didn't see how they solved anything and because I did not want to live a life of pill-popping.

Yes, this was the moment I mentally "fired" my doctor. (In a weird twist of fate, I received a survey for him just yesterday. I had a lot of fun completing it online.)

Soo.... having given up on the conventional medical community, I set about more Googling. As I've said before, I am well aware that this is a dangerous path because you can pretty much convince yourself you have almost anything/everything if you spend enough time reading symptoms online. Yet, the reality is that the web is pretty much all I have left at this point.

In Googling fibromyalgia, I came across this site: http://rosevillefibromyalgia.com/  and thought, pretty much, what the hell. With nothing to lose but an hour of my time and $50, I decided to make an appointment.

During my initial visit, Dr. Putman did some brain-function tests, analyzed the bloodwork I got from my doc, and did a full spinal and neck x-ray (something which, it hadn't occurred to me until that moment, had never actually been done before.)

A week later, my husband and I were called in jointly for a follow-up appointment.

First, as I have always felt, there is something(s) "at the bottom"  (or more specifically at the top) of my pain. 

The most concerning are some issues with my neck. In looking at the x-ray it was pretty alarming and obviously amiss. He said it was the worst case of neck issues he has ever seen.

To try and shorten the explanation, I'm going to share this image I found online. These ARE NOT my xrays.



One side (to the right) shows a relatively healthy curvature of the neck (the blue line is ideal, the red lines represent "actual" for this patient.) The left, shows how that curve has originally been lost and had started to almost go in the other direction. 

Ok, so look again at that image on the left and keep going... in other words, completely REVERSE a "C" shape. That's me. Curved 140 degrees in the other/wrong direction.

It's so bad that the doc asked me if I had ever had head trauma in the past. Gulp. (If you read up online, this is actually something that is more commonly associated with whiplash.) He was surprised that I was not having chronic headaches too. (Finally, something I don't have. Yet.)

Outside of being dropped on my head (Mum!?), this is the kind of thing that develops over years. 5-10 years to be exact, which is about right along the lines of when I began first experiencing shoulder and back pain.

The effects of this are both obvious and not-so obvious. First, the front part of my body is taking the weight of my head, which it is not designed to do (and we all know I have a big head.) Secondly, I am developing some unnaturally large spaces between my disks. The front part of my spine is compressed or pinched, as it is being curved in the wrong direction, while the back part is showing splaying of the vertebrae.  Third, it's pulling my thoracic spine (and of course everything else) out of alignment. Fourth, I am developing some mild degeneration (arthritis) in the joints. 

It's not completely correctible... it's too far changed for that. I will probably never get back to a natural curve in my neck but our goal is to get it back to, at least, straight. If I don't, by the time I'm in my 50s and 60s, I will likely have problems walking, maintaining balance, and have numbness and pain down my arms. Remember, your neck is the nexus for all those nerve endings that come up from different parts of your body, to your brain. So pretty much anything that affects your neck has the ability, over time, to affect pretty much everything and anything.

Next, I have a rotated pelvis. We kind of already knew this. Old news. Which came first? Who knows? Who cares at this point?

Next, I have a slight "s-curve" to my spine. It's also known as scoliosis but mine is not so bad as to be clinically diagnosed as such. But essentially, this is what scoliosis looks like:


Pretty, right?

Next, I have incredibly low oxygen profusion. What this means is that I have good oxygenation in my red blood cells but the oxygen is not being passed through the walls of my blood vessels to oxygenate my organs and soft tissue. The "normal" range for this measurment is 2.5 - 4.9. I am measuring... wait for it... 0.4. Again, gulp. I think we all realize your body needs oxygen to function. Mine is not getting it.  My brain and my body is basically being starved of the oxygen it needs to function properly - knock-on impacts to my overall system and to my energy levels. Apparently this is very common for someone who has been experiencing chronic pain for some time. Think about, when you're in pain or under stress, how you tend to want to hold your breath. Now think about subconsciously doing that almost every day for years at a time. (If you would like to learn more about the connection between oxygen and pain you can click here.)

All of these things, along with dealing with chronic and increasing pain for 5 years, are affecting my brain. The ongoing stimulous of "pain" is now expected and required by it. In other words, my brain wakes up every morning and searches for pain signals. How this shows up in my life is that, for instance, a hard workout that the average person would wake up and feel sore from the next day, makes me feel like I was just run over by a semi. (Nodding head.) More commonly, these are known as fibromyalgia symptoms. In addition, since my brain is overpowered by pain signals, and is starved of oxygen, it's affecting my memory (which has become increasingly and noticeably worse in the last 3-5 years) and my concentration - my brain tires more quickly/easily.

Still with me? I know, it's a lot to take in.

There could be more. He conceded that I have a chronic inflammatory problem running throughout my body that may or may not be related to all of this stuff but could also be caused and/or exacerbated by metabolic issues - in other words, food allergies, thyroid or something of the like. That is testing we'll have to do later.

Of course, the biggest question I had to ask was: What would the regular medical community do if they saw this x-ray? Would they recommend surgery? Physical therapy? I mean, how have successive doctors, physical therapists, and osteopaths who have physically touched and analyzed my spine, missed that my neck is curved in completely the wrong direction??

The answer is that the medical community does not have a way to deal with this until it starts to cause some of those more severe symptoms I mentioned earlier - loss of balance, function, and/or acute pain. Nice. I have to be all-but an invalid to get help. Not going to work for me.

Which leads me back to my path forward.

I am looking at, at least, 6 months of treatment to begin to try and address these issues. 3 days a week, an hour each of those days. A combination of chiropractic care, massage therapy, physical therapy, oxygen therapy, brain-based therapy, supplements, and some detox. So, with travel, 6 hours out of my work week, somehow. Oh, and let's not forget the thousands of dollars out-of-pocket. All of this is just a start. It may take a year or more to see real progress in my x-rays.

But how do you not do it? How do you ignore a degenerative change in the structure of your body? I think it's been clear to me, and most of you too, that I cannot continue to go on living with the pain I have been experiencing much longer without everything else in my life falling apart. 

By the time of writing this post, I have already had two treatments. 

The first one was pretty intense, with lots of DEEP massage and some alarming adjustments. It seemed to clear up neck and shoulder pain, at least in the short term, right away. However, the day after my first treatment, I tried to stand up from a stool in my kitchen and my right knee gave out a shot of pain that I haven't felt since I initially injured it back in September of last year. Now, unfortunately, I am back to not being able to walk up the stairs or stand up from a chair while bearing any weight on that foot.  (If you want the back story on the knee issue, check out this post here.) After 5 months of following my P.T. to a "t" and getting to a place where my knee almost never bothered me anymore, it's pretty disconcerting to feel I am back to square one here.

I told the chiropractor about the relapse today at my appointment and he said that I might expect to see some other issues periodically dissipate, flare or rise up as they begin to realign my body. Which makes sense but doesn't take away the despondency associated with going backwards in something that you've worked hard to make progress in., especially when that one area prevents you from performing other exercises that help other areas of your body! 

As with almost all my symptoms, it's not like I did anything strenuous to cause the issue to resurge. If I had, at least I could concede that I shouldn't do "that" for a while. But I'm pretty sure that there's no way to avoid sitting down and standing up.

Now you're brought up-to-date. That's the latest diagnosis. I don't want to say it's "the" diagnosis because I have made that mistake about ten times in as many years.

I'll update you as my treatment progresses. 

Wednesday, February 15, 2012

The toll

A mind that it anxious about future events is miserable - Seneca




At the end of my last post I asked the question: "If you had come to truly believe that you would not be physically competent to do all the things that you're currently planning for your later years, your retirement, what would change for you, right now?"

This question hits at the heart of what chronic pain does to you: it takes away hope. It makes your future uncertain, worrying even.  But this doesn't even begin to address the different ways that 7 years of chronic pain have impacted my life.

First, there are the practical things. 

For more than two years, I have been unable to sleep under the covers in our bed. I have to sleep on top of the covers with a loose, warm blanket over me. Why? Well because the pressure/restriction of a sheet and duvet on me make it hard for me to turn over or shift positions in the night. With my pelvic instability problems, I have to move a specific way in bed: every part of my body has to move along the same plane, at the same time. I can't twist or push off with one foot or things crack and pop or sometimes even seem to "dislodge". Laying under a blanket that moves with me makes things better. I've also taken to placing a pillow under my knees, to keep my pelvis slighting tilted and to relax my knees. And no, this is not sexy nor the ideal situation for your husband to reach across the bed to request an impromptu night of intimacy. You know, should either of us have the energy for such things at thee end of the day.

I find it hard to sit at a computer and work for more than a few minutes at a time without experiencing acute shoulder and neck pain. Unfortunately, my job often requires that I do exactly that - for sometimes hours of focus at a time. I have tried multiple positions and ergonomic solutions (including eliminating my office altogether and working from my bed) but with limited success. Trying to sit in an "ergonomically correct" way just tired my muscles in just a minute or two - they're just not ready to be in that position and they don't want to be "convinced". What relieves my shoulders irritates my lumbar spine. 

Walking and performing every day movements requires thought and constant awareness. I almost am never stationary or moving without constantly being aware of my posture and positioning.Folks have tried to tell me that I focus on it too much, that I've created a situation of hyper-awareness, which may be true. But my reality is that to "ignore" these things usually results in injury or at least hours or days of pain.  Just walking up stairs requires bracing my pelvic floor muscles and watching that my knees stay in alignment. With all the physical therapists I have seen over the years and the multiple diagnoses, it's like a have constant, running commentary in my brain. I'll give you a literal example of something that happens almost every day:

I'm standing at the cook top making dinner. I suddenly feel a "twinge" down my leg. Immediately I check in with myself. I realize I have transferred all my weight to one leg (a no-no) so I switch to both feet. Then I realize that my back is too arched, so I correct by tucking in my pelvis. Then I realize that this adjustment has resulted in increased shoulder pain so I lift my chest and pull my shoulders back. Which calls attention to the positioning of my head, so I try to tuck my chin in a little but not too much. All of this happens in a matter of seconds in my brain and body but this mental dialogue between brain and body is almost constant in my day. And then a moment or two later, after my mind has wandered, I realize all those adjustments have come undone and I go back through it all again. Just standing still is tiring both mentally and physically. I feel like I am constantly trying to fight what my body "naturally" wants to do.
Even clothing can be an issue. The latest craze for skinny jeans have left me writhing in agony, trying to get inside them - pushing and pulling with my pelvis is an issue. I can't wear high heels anymore and racer-back sports bras put too much pressure on my lower neck to tolerate.

My ability to do housework has incrementally diminished. Vacuuming is a killer for my pelvis, laundry kills my neck and shoulder and knees, making the bed yanks my back around in every way possible. Forget about trying to get on hands-and-knees to clean the shower so I've learned to live with gross shower mold. All of this is if I can find the energy to tackle any of it. I'm a zombie by 8pm, when my daughter goes to sleep. I usually try to tackle chores on Saturdays, which gives me Sunday to recover from whatever damage I did. My house is a disaster area. While I have never been a perfect housekeeper, I have also never been this slack either. Just looking around me most days only adds to my stress and disappointment. I don't enjoy living in a dirty, untidy house; disorder seriously messes with my mojo.

I have had to give up many activities I love: swimming, hiking, skiing and yoga being the main ones. Physical activity has always been my stress buster, my personal therapy and yoga was the ultimate form of that. I also enjoy the challenge of new things, especially when they take me to new places. I have skydived, parasailed, horse-back galloped, skiied and zip-lined around the world, climbed thousands of steps on historical monuments, hiked through rainforests, swam in beautiful oceans, and whooped with joy on some of the world's scariest roller coasters. Now I just don't know if I could put my body through that without damage. Some things (like skiing) I know I just could not do right now and have come to accept that I may never do again. Other things I'm just afraid to do in case I hurt something "for good" this time. I live in constant fear that I'll put myself in a wheelchair with some kind of mundane activity, let alone something physically taxing. Bottom line: I've lost confidence and trust in my own body to support me.

Yet, at the same time, I am unable to stay at home and just "relax", something which drives my husband crazy. Part of it is that I work from home and have cabin fever in my personal time but a lot of it is that, unless I stay busy both mentally and physically, all I can think about and feel is the pain. I need constant distraction to take my mind off of whatever hurts in any particular day. 

Financially I estimate that I have invested around $10,000 over the years in treatments and diagnoses: doctor co-pays 2-3 times a month, physical therapy co-pays (some of which were out of network and required full payment) sometimes 2-3 times a week, and frequent massages, to name just a few of the out of pocket expenses. 

The attitudes of other people don't always help either. On more than one occasion by more than one person, it has been suggested to me that:
  1. I am suffering from hypochondria
  2. I have a low pain tolerance
  3. I need to just "accept" my situation and the acceptance will allow me to "let go" of the pain
  4. I need to have a more positive attitude
  5. I need to stop talking about it because words make my world and, of course, nobody wants to be around a negative whiner. There are people out there with much worse physical ailments that me.
  6. I need to just "meditate" and take time for myself; I am too stressed out and this is causing the pain
I admit that, at some points during this journey I have indeed wondered if I really was oversensitive to pain and should just chalk all this up to getting older. You know, suck it up and all that. But what I realize now, 7 years in, is that is just bullshit. I don't just have one issue, I have multiple issues. I don't just have pain I have pain that has changed the way I live. And so let me address each of these points one-by-one. 

Allow me to vent here, k?
  1. Hypochondria does not cause pelvises to rotate, ribs to dislodge, labrums to tear, and knees to run "off track".
  2. This may be true but what's the point here? The level of pain I feel is the level of pain I feel. It's not "relative".
  3. Hahahahahahahaha. **ck off. I will NEVER accept that pain is inevitable.
  4. ARE. YOU. KIDDING. ME!? If I did not already have a positive attitude, do you think I would have been able to spend the last 7 years chasing down specialist after specialist, potential treatment after potential treatment? No, I would have crawled into a corner, downed some Vicodin and cried about how horrid my lot was in life. Anyone who tells me that 7 years of never giving up on my body is not a positive response to my situation is an idiot.
  5. Fair enough. Maybe you're tired of hearing about my aches and pains. Maybe you need to be around people whose lives are all rainbows and roses all the time. Good luck with that. You always find out who your real friends are in these situations. I'm ok with that. And yes, there are people with terminal illnesses and chronic pain issues that are absolutely debilitating. All I have to say to those folks is: I am so, so, so sorry for you. Any measure of positivity and hope that you manage to retain makes you a superhero in my book. But here's the thing: their pain, no matter how bad, does not stop me feeling mine. See #2.
  6. Which came first? The chicken or the egg? Am I in pain because I'm stressed or stressed because I'm in pain? Certainly I am in more pain during the week when I am at work, which could be a combo of time at the computer and the stresses of my job. But the reality is I don't have much latitude to change the stress level in my life in that department. What I do know is I WILL feel less stressed if I'm not worrying about my body falling apart all the time. Maybe my life will not be stress free but pain is my #1 cause of stress right now, so I'm starting there.
Despite my answer to #4, the last 7 years have worn me down and it has got harder and harder to hold out hope that I can affect my situation. I defy anyone to spend that amount of time dealing with undiagnosed chronic pain, to go through the emotional roller coaster of successive, incorrect diagnoses, and not come out the other side feeling doubtful that help will ever really arrive. 

One of the hardest parts of this to deal with is the grief: grief of the things I begin to realize I may never do like teach my daughter to ice-skate or ski, climb Machu Pichu, or even just have the simple joy of getting through a really hard workout. Coupled with that is the anger: why have all these doctors and physical therapists failed me? Why have I spent thousands of dollars on health care only to never have found someone who truly listens and wants to find out what's wrong with me? 

Then there is the fear. And this is how I started out this post. Fear of putting a foot wrong and hurting something else all the time. Fear that whatever is wrong with me is only getting worse and, at 37, this doesn't bode well for retirement. 

Here I am working my patootie off in a stressful job that is not stimulating to me (and which probably increases my pain), to continually increase my income and hopefully build a nest egg that will enable me to retire and do all the things I neither have time nor $$ for right now... but what if, by the time I've reached this nebulous financial goal, I'm physically incapable of living out any of those dreams? What was it all for? What was the point?

Chronic, increasing pain, has made me start to re-evaluate my life choices at the most fundamental level.

At some point it leaves you wondering if you shouldn't just throw the towel in and, instead of killing yourself working for tomorrow, take a step back to try and enjoy what you have today. I continually, mentally war with myself on this subject. To give up everything I have worked so hard for now - my house, my career and income (and everything that allows me to do, not least of which is spend $10k trying to fix myself) - seems almost unfathomable, heartbreaking even. Without money I cannot travel the world and just the thought of having that dream yanked away from me makes me want to hyperventilate. I LIVE for the prospect of my next trip, my next adventure, for seeing the world, experiencing new cultures, for the moment of stepping off a plane in a foreign land and soaking up the new smells and sounds. (The only other thing that makes me feel this way is photography. Thank God I have that at least.)

Yet, at the same time, what if I never get to the end of the rainbow? How much will the "prospect" of all those things matter 10, 20 years from now if I don't have the ability to enjoy them anyway? 

Then, as I mentioned in my previous post, there is the memory loss and the lack of bandwidth to be "there" for my husband, my daughter, and my parents. They get the worst of me all the time because they get what's left at the end of the day, the end of the week. These days that's not a lot. I know they love me, understand, and forgive me for it for the most part but I would like to enjoy my time with my family, not just "get through it" in the hours before I can go to bed and finally exhale.  

For the first time in my life, I find myself seeking the ear of a good therapist. I have almost never been as uncertain about the direction of my life as I am right now. It's an unusual and uncomfortable place for me, not being able to sort through, and make sense of, my various thoughts and feelings. I have always felt sure of myself, hopeful, and empowered. Even that has changed for me. I feel a little lost in life right now and perhaps some of this is being "30-something', certainly pain is not the only thing contributing to my unease, but it is most definitely the most defining element of my life right now - like it or not (I'm leaning toward NOT.) 

Maybe all of this sounds a little dramatic to you.  If I was an outsider looking in, I might agree. But it is what it is. Clearly, I'm not all that happy with the status quo either. I never imagined this "place" for myself. I don't want to be here. I'm trying not to be.

And to be clear, if you didn't read my last/first post on this issue, I'd like to reiterate after all of this, that I am NOT seeking sympathy here. I appreciate the support of friends but don't need a shoulder to cry on. I am looking for answers, not condolences.

Which leads me to my next post. My latest diagnosis. 

Stay tuned...

The first step toward success is taken when you refuse to be a captive of the environment in which you first find yourself - Mark Caine



Monday, February 13, 2012

Catharsis

Before I begin, let me start with a brief apology to those of you have read this blog for a while or who stay in touch with me on Facebook: yes, I'm sorry, this blog post (and some subsequent ones) is going to be about my pain. If you're pretty sure that you don't want to hear me talk/whine/complain or however you want to characterize it anymore, now's your cue to navigate away because this is the last time I will apologize for it. I'm not Tony Robbins and this is not "The Secret". If you're looking for flowers and rainbows and positive affirmations, you may need to look elsewhere.

Ok, you still there? Hey, thanks.

So, we've established that I'm going to talk about my pain. I want to be clear, though, why I have decided to start writing about it again because, truth be told, with the exception of my previous declaration of war and some thinly-veiled references on Facebook, I have actually not written, at length, about what is going on with my body for some time.

This post will start from the beginning of my issues. For those of you that know me well and for some time, this will be repetition. For those of you who are fairly new to my life, this may be enlightening. Many of you think I have a "bad back", which is not entirely untrue but is certainly not the whole story. Either way, the point of the "rewind" is not to generate an outpouring of sympathy for poor ole me (which is entirely unneeded) but rather for three main reasons, some of which will become clearer in successive posts:

  1. For me personally. Writing is catharsis, like a cleansing ritual. I want to write all I have been through down, one last time, to get it out of my head and into words and then let it go. I don't just want to, I need to. Think of it like therapy. I am also hoping that I am coming to the end of the mystery of my issues (more in an upcoming post) and so I'm looking at this post like a clean break.
  2. For anyone else who suffers with unexplained, chronic pain. While I realize the dangers of what I call "Googlenosis" I am forever thankful for the power of the internet in helping me piece-together the issues my body has faced when my doctors and therapists have failed to. I wish I could reach through the computer screen to thank every person who posted their "out of the norm" experiences on a blog or in a forum so others could learn. So, if there is anybody else out there who suffers from chronic pain, I hope that, by sharing my experience they will find this blog and not feel so alone in their search for answers. I hope my story will encourage them to never give up trying to find help and to never accept what the medical community tells them when every other fiber of their being tells them that it is wrong.
  3. To highlight the inadequacy of the medical community and systems in diagnosing chronic issues. We are brought up to think that, with some high profile exceptions, modern medicine has pretty much seen it all, done it all, understands it all, and has a solution for it all. Even that which we know it does not cure we are at least confident can be diagnosed. Yet my experience has been that doctors and therapists are, in general, woefully inadequate in diagnosing multi-facted and deep-rooted chronic problems. The entire system is built around acute needs. Even the famed "Dr. House" only steps in to solve the puzzle once you're at death's door. Personally, I'd rather figure stuff out before then.
In many places these posts may sound negative and hopeless and in some places defiant and hopeful. I set out to make them, as a whole, neither. What I will be, and always am, is real. Bring to it what you will. At the end of it all, I hope to end on a positive note, a positive outcome, as you follow my journey through therapy for what is now, I hope, a diagnosed set of issues. But that ending has not been written yet. 

So let us start at the beginning...

----

Before the fall of 2005 I was a fairly fit and healthy 20/30-something girl. I got up at 4:30 in the morning almost every day to go to the gym where I would work-out HARD, lift weights, and pound the cardio machines. Once upon a time in my 20s I did a stint as a personal trainer and so I knew what I was doing. I was in great shape. I did yoga, weights, swimming, hiked, and skied. My thighs were notorious with my friends for their power and muscles, folks would always comment on them. I was strong and happy - for me these two are closely connected. Working out was also my therapy, my stress-buster. I was one of the few people who actually liked going to the gym.

Then, in the middle of a stressful period at my job at the time, I began to have muscle spasms in my neck and upper back. Like everyone, I put these things down to too much time at the computer, bad posture, and the stress of my life. I would often say, in excuse "I carry my stress in my neck and shoulders." I took a couple of ibuprofen and soldiered on. That was until it got so bad that I couldn't sleep at night without a heating pad and a ton of medication. So I went to my doctor at the time and he sent me to physical therapy.

After 6 weeks of physical therapy, my pain was all-but gone. Hallelujah! I was discharged with a series of exercises and a deep sigh of relief.

The day after I was discharged I woke up and went to the gym as usual. I got on the eliptical trainer to warm up and practically leapt off in pain. My right hip seemed to be "stuck" or "locked" and every time I tried to push down on it in that plane of motion, it was incredibly painful. I found I could not lunge or squat, although I seemed to be able to walk fine, and my hip suddenly began to pop or crack for the very first time in my life. I literally sounded like popcorn as I moved. (Little did I know back then!)

Back to the doctor. Back to physical therapy.

Again, physical therapy seemed to help out quite a bit. Went through the motions, left with some stretches. But something lingered that I couldn't get past. The popping/snapping never really went away and I was left with a feeling of tightness in my hip/groin. Trying to move my right leg toward the center line of my body was uncomfortable and, in my cases, painful. I left it for a while and then went back to my doctor. 

At the tender age of 30, I was told that my symptoms were the result of getting older. After picking my jaw up off the floor, I left for one of those prerequisite 6-8 week periods that all doctors seem to think will "cure" everything. You know "give it 6-8 weeks and see how it feels then."  Nothing changed and so I went back to the doctor and insisted that he refer me out to someone else. Reluctantly he did and I got an x-ray and an appointment with an orthopedist.

The x-ray showed what looked like a very small tear in the labrum of my hip socket. I was sent for an MRI of the area to confirm, which it did, and referred to an orthopedic surgeon who, of course, recommended surgery to remove the torn soft tissue, which was impinging on my hip socket. I had just got engaged and was planning a wedding, so the last thing I wanted to deal with was a surgery, so I decided to put it off until after the wedding, continuing with my physical therapy exercises to see if I could address the pain that way.

Unfortunately, the issues remained and so I went back to the doctor. By this time I had changed medical groups and so I had a different doctor. Which meant another set of x-rays and a different orthopedic surgeon. This time he diagnosed me with not only a labral tear but an acetabular impingement, which changed very little except for the scope of the surgery.

In March of 2008, I had surgery to repair my labral tear and to "debride" my right femur, which is a fancy way of saying that the docs went in there with some medical sandpaper and re-smoothed the top of my leg to fit better into my hip socket. I recovered quickly and was walking in record time. Unfortunately, I was left with more issues than I started with. 

The physical therapy my insurance covered focused on getting me back to walking without a limp but that was about it. If I had any desire to get back to the kind of shape I was in before the surgery (and I had still managed to stay fairly fit despite some limitations) I had to pay for a private P.T. Which I did because I still had the popping/clicking, continued to experience pain and discomfort in the same plane of motion but now worse, and, in addition, had a very tight and very painful I.T. band as a result of the traction they placed my hip in during the surgery.

By August of 2008 I was doing a little better but still was not as good as I had been pre-surgery. Unfortunately, just about that time I got pregnant. 

I say unfortunately but truly it was a blessing. I was one of the lucky women who got knocked up on the second try. The "unfortunately" came from the fact that I had expected to spend many months trying to conceive, as it had my mother before me. So just 5 months after my hip surgery, I was about to put my body through one of the most taxing physical experiences of its life. In hindsight, not the best timing.

Despite the usual morning sickness in trimester one, I had a fantastic 6 months of pregnancy. Sure, I did not like being pregnant one little bit but from the perspective of health, I was picture perfect. I remained active, working out, and my hip seemed to have stopped hurting.

Then, in January of 2009, at 7 months pregnant, I slipped during a mild, pre-natal yoga routine at home, felt a sharp pain and "crack" in my pelvis and hit the floor. Fortunately, I did not land on my stomach but I could barely walk. Lifting my feet off the floor made me wince in pain and sitting down for longer than a few minutes at a time left me almost unable to get up. As I came to find out, I had separated my pubic bone, something actually not uncommon in pregnancy and known as S.P.D. I was told this would go away fairly quickly after I gave birth.

Unfortunately, it did not. In fact, when I tried to so much as walk around the block after my daughter was born, I was faced with pain that shot around my body in sharp stabs. Up my back, down my legs, into my feet, around my lower back. Trying to do something as simple as turn around or lift my daughter would result in me putting my back out to the extent that I would have to lie in bed with a heating pad and heavy painkillers for a few days at a time. I tried repeatedly to return to the gym but, each time, seemed to hurt some other area of my back. 

Back to the doctor. She recommended Osteopathic Manipulation, sort of a combination of chiropracty and massage therapy. The Osteopath diagnosed me with Pelvic Instability, a rotated pelvis, and pelvic girdle pain. She identified that my ribs would repeatedly pop in and out and would, on a weekly basis, "fix" them, as well as doing some manipulation to try and encourage my pelvis to rotate back. She also did massage therapy on my pelvic girdle muscles, which is as intimate and invasive as it sounds.

After about 3 months of this, I was doing better and discharged. Yay! We're now in late 2009.

Unfortunately, as seemed to be the pattern, I decided to try and start back on an exercise routine and, every time I did, all but my pubic-bone pain returned.  I had the shooting-stabbing pains coupled now with a burning in my sacrum and just general feeling of displacement in my pelvic area in general. Just so much as a foot out of place as I exited my car would result in days of pain and discomfort. My daughter was trying to walk and I would often find myself crying in frustration alongside her as she all-but begged me to bend over to hold her hands and helped her but I could not. Getting her in and out of the car was awkward and painful and I routinely crossed my fingers that I wouldn't make a wrong move and wind up back in bed again. I remember many summer days watching my husband and daughter in the back yard while I sat on my zero-gravity chair with an ice-pack on my sacrum, downing NSAIDS. I just couldn't imagine what I would do when she became even more active. I was heartbroken to be sitting on the sidelines and the pain seemed to be getting worse.

I changed Primary Care Physicians to get out of my restrictive network and decided to get a second opinion. Again, another referral to another physical therapist. This one was, again, outside of my network, but I was assured by my new doc that she was "the best", so I paid out of pocket. There was no amount of money too much to get rid of the pain.

This P.T. diagnosed me with S.I. Joint Dysfunction. Basically my pelvis was hyper-mobile and unstable, causing everything to be out-of-whack. This was pissing off my nerves, not only in that area but now in a spreading pattern, which was the shooting pains in seemingly unrelated places I was feeling. I was told there was really no fix and that I would forever have to modify my movements and behavior to accommodate. No skiing for me, for sure and I had to give up yoga, something which I had come to love.

Again, more new exercises (all of which I did, routinely, every time at every stage in this process, I might add. I never phoned them in) and more ice and more massage. This time, there was limited impact. I felt I had more understanding but no results. In fact, if anything, the experience with this P.T. had caused me to feel more despondent about my physical outlook. Part of me refused to accept or believe that, at 35, this was the best I would now ever be. 

We're now in late 2010 and I was beginning to get desperate. My daughter was going to turn 2, I couldn't return to exercise, couldn't lose the baby weight, and couldn't really enjoy my time with her. Everything with an infant requires lifting and sitting on the floor, both of which caused me significant pain and discomfort. I was getting despondent, grouchy, tired, and a little depressed.

During this whole time (from pre-surgery and until today), I had been seeing a massage therapist who managed to help me address some of my symptoms through her mix of massage techniques. She recommended that I try accupuncture with the lady in the same office suite as her. Despite having a fear of needles that is almost unrivaled (I faint when having my blood taken unless lying down) I decided to give it a go. I had 24 needles inserted into my back and lay there for 90 minutes while they vibrated. When I got up I found I could not focus my eyes for almost 24 hours. Needless to say (or should I say needlelesss to say) I never went back. It's a testament to my level of desperation that I even tried it.

Next up in the list of tried-and-failed treatments was seeing a specialist in The Alexander Technique. I had felt for some time that I was finding it increasingly more difficult to find "center" with my body. I knew my posture was getting worse but I couldn't figure out how to fix it. Everything I tried - from ergonomics to biofeedback - didn't seem to work and a friend who had similar hip issues had tried, and found useful, this technique. Although this was a helpful process in making me more aware of my body and it's movements, it did not relieve my pain. At $80 a session and a 30 minute, one-way drive during business hours, it was emptying my wallet and cutting into my workday so I called it quits after 5 or 6 sessions.

And then I saw a news segment on a physical therapist who trained athletes and specialized in getting them back into shape after injury. I convinced him to treat me for a reduced cash fee and it was the best thing I ever did because, for almost a year after I started seeing him, I had virtually no pain and felt the best I had felt in years. Unlike every other physical therapist, he worked on getting me back to peak performance, creating a grueling regimen of exercises that had me lunging and squatting (two things I thought I should never be able to do again) and jumping and leaping. I was absolutely overjoyed. I actually started plotting when I would take my daughter skiing and ice skating for the first time. 

Then, in summer of 2011, my shoulder and neck pain resurged with a vengeance. I did all the P.T. exercises I remembered from years past and managed to mitigate the pain. However, right after I did that, I stood up from my spot on a Tahoe beach and felt my left side spasm. Back to nursing back pain again.

Not long after that episode, I started to feel pain in my right knee when doing the plyometric exercises that I had been doing for the past year or so. I rested up for a while, thinking it was an overuse injury or strain but the pain got worse until, finally, I could not walk up stairs to my bedroom without using all fours.  Since many of my P.T. exercises of my back involved my knees, I had to stop doing those too, resulting a resurgence of my S.I. and pelvic pain.

You guessed it... back to the doctor.

An x-ray of my knee revealed nothing amiss.

Guess what? 

You're right... back to physical therapy. 

Physical therapists gave me a non-specific diagnosis of a knee that basically keeps "running off the tracks" causing degeneration and pain. But don't worry, it could be mitigated with... more exercises.Although, of course, the pain would never go away entirely.

By this point, I had about 2 hours worth of physical therapy exercises that I should be doing in any one given day. Forget a "workout" I was on "full time" physical therapy.

Let's pause here for a second because, before you ask, I should share that I did, throughout these interactions with doctors and therapists, try to give them the history of all my issues in an attempt to inquire if something more fundamental was going on with my body that was causing me to repeatedly injur myself. However, nobody listened or was interested. Each successive person wanted to hear about only the acute issue at hand. I was repeatedly cut off mid-sentence, ignored, or told my information was irrelevant when I tried to bring up what seemed to be, to them, unrrelated issues. The closest I had got to any kind of explanation of my multi-faceted pain symptoms was the one from the two therapists ago that said I had inflamed, "pissed off" nerves. However, that did not explain how I was experiencing successive structural issues in different parts of my body.

The knee physical therapists' exercises helped/help with my knee pain meaning I can now at least climb stairs but the pain is not all gone. I'm left with lingering pain and instability in my right knee that pops up inconsistently and constantly leaves me with concern that one wrong move will result in me needing knee surgery. Oh, and I now have snapping in my left knee when I walk up stairs. I'm not even going to bother mentioning that to a doc.

However, since late 2011, I have not been able to shake the pain and stiffness in my neck and shoulders.  My thoracic spine is often in a lot of pain, only momentarily relieved by being "popped" while I roll over a foam roller. The muscles around my neck, scapula, and thoracic spine feel sore to the touch, spasm, and constantly ache. The P.T. exercises I was given back in 2005 no longer work and the pain has been getting increasingly worse. Unlike the knee pain or the S.I. joint pain, these pains don't let up no matter what position I am in - sitting, standing, laying down. In fact, some days it's hard to get to sleep without a process of deep breathing and meditation. Driving was/is painful because of the static position. Working at a computer was/is painful. Sitting on the floor painful. Light exercise seems to make it better but that is a fine line too - try to step-up the routine in any way, shape or form, just makes things worse. Even rest doesn't really help. I wake up in the morning with pain and stiffness and I go to bed with pain and tightness. Shooting pains migrate throughout my body, down my back, my arms, my legs, into my feet on any given day and at any time, seemingly without cause, rhyme or reason. The other day, my heels began to hurt like crazy. Went away after a few days inexplicably.

600mg of ibuprofen at a time stopped impacting the pain at all some time ago so I basically stopped taking them altogether (not that I really took them except on really bad days.) Muscle relaxers take the edge off a little but turn me into a bit of a zombie for a few hours. Bottom line: I don't like taking pills because they don't "solve" anything and Lord knows what other issues they create.

Further, an overly-ambitious massage therapist I went to for a "fun" massage, managed to dislodge my pubic bone again in January, meaning I had to try to repeat some of the therapy I remembered back from 2009 to ease it back into place. Another thing I was forced to realize is always just one wrong move away from going "wrong" again.

As a last shot in the dark, I recently resorted to pulling my I.U.D. because I had found that some women online had been experiencing some undiagnosed shoulder and knee pain that was alleviated after theirs was removed. That was back in early December and, if anything, the pain has got worse not better since then.

We're pretty much up-to-date now... early 2012. Physically, I feel like my body is caving in on me. I feel like I can never get comfortable. Mentally, I am despondent and frustrated. Both emotionally and physically, I am tired, dead at the end of the day. I feel like I could sleep for 12 hours every night and still never feel rested. Unlike the days when I used to bound out of bed at 4:30am, I now find it hard to rise by 7am. I'm irritable, short-tempered, and unable to absorb the regular stresses of everyday life that used to just roll off my back. I've got very little left to give to the most important people in my life any more. I spend all day just trying to push the pain to the back of my mind just so I can work and then I fall apart in my personal time. My not-yet three-year old daughter is already so tuned-into Mummy's problems that she drags a pillow and a bean-bag to the area she wants to play with me in, before even asking me to hang out with her. She often asks me why I look so sad and then rubs my back and tells me "It's going to be ok, mumma," It sounds sweet to an outsider but to me it is the most heartbreaking thing in the world. I wanted to be a positive, strong role model for her, not a broken mother who sits on the sidelines throughout her life. This is not the legacy I wanted to create. It's far too early for her to be caring for me.

My memory seems to be impacted too. I forget things with a frequency that is alarming, causing my husband to ask me "who are you?" at one point in Kohls after I forgot, dropped, or left behind a succession of things.  People tell me things and I quickly forget them if I don't write them down, something which I almost never did before. I forgot my parents' anniversary last October for the first time in my life (something I am just owning up to now because I was too ashamed to admit it to them at the time - sorry Mum and Dad.) I double-schedule things on my calendar, forget appointments, and, in general, have become to feel like a basketcase.

I feel like the shadow of the person I was just five years ago. And while I have not lost any of the determination to keep fighting, I had lost most of the hope in actually being able to change my situation. Pain and limitation have begun to feel like the norm and all I can think is that I'm only 37 - this is the best it's ever going to be, it will only get worse from here as my body ages. I can't imagine being 60, the regular aches and pains of old age, coupled with my current pain and issues, which only seem to be getting worse. I have been increasingly worried that I have some kind of major, undiagnosed issue that is degenerating my body bit-by-bit and that, at some point, maybe 10 or 20 years from now, it will all come home to roost.

And this kind of worry impacts how you live your life, let me tell you. Not just in the here-and-now but also in your plans for the future. If you had come to truly believe that you would not be physically competent to do all the things that you're currently planning for your later years, your retirement, what would change for you, right now?

I will talk more about the impact to my life and psyche in the next post because, honestly, it's just as degenerating in it's own way as the pain and dysfunctions themselves.

Then, I promise, I'll move onto the diagnosis I recently received and the path forward.

Until next time....

Friday, February 03, 2012

Dear Body... this means WAR!

Dear Body,

So, here's the deal: I know you're feeling pretty cocky with yourself right now and you have every reason to.

For the last seven years, you've won battle after battle, getting more aggressive with every one, and, if I'm being honest, have sent me into retreat, inch by inch, day by day, failed-solution after failed-solution.

You've impacted my life, my personality, my relationships, my finances, my hopes, my dreams, and my desires. And while there have been days where I have hit my pillow at night and felt that I was finally reigning you in, the fact is that those have become fewer and further between as time has gone on. I'll admit, there are days, sometimes many at a time, when I can't see past the pain you throw at me and where it takes every last ounce of my inner strength not to give up entirely and let you have at it once and for all. All of which leaves very little of me left for the other important things in my life: my husband, my daughter, my parents, my friendships, my work, and those hopes and dreams I mentioned earlier.

Many days, I don't like who I've become. I stare at images of myself before you started your attack and can barely connect with the life that girl led. With each new tactic I try hope resurges but you always seem to manage to swipe back and, each time, make it a little harder for me to get up and try again. Someone once said something on Facebook like: "Pain doesn't change who you are." They're wrong. It changes everything, gradually and slowly, almost so that, if you didn't pay attention, you would barely notice until it was too late. Apparently, this just as literal and physical as psychological, as I found out today from someone who understands a bit more about your dirty tactics.

But here's the deal. I'm not giving up. I will NEVER EVER EVER give up.

I will not retreat into a pharmaceutically-induced haze to block out what you throw at me. I will not sit on a couch, afraid to move, afraid to follow my dreams, just to avoid your attacks. I want to feel every last little stab and ache and crack and pop because it reminds me to never quit.

There may not be a single diagnosis or a magic pill but I refuse to believe that there are no solutions. And I'm willing to do whatever it takes to find them. I will leave no stone unturned. I will never, ever accept that retreat - the life you seem to want for me - is inevitable, no matter what mumbo-jumbo-meditational bullshit people throw at me. I am not listening to them, period. Deep down I am a fighter and you have seriously underestimated me.

See, you and I got too much to do yet, too much living to fit into whatever time we have left and I'm sorry to tell you this, but you've got little choice but to come along for the ride.

If anyone needs to practice acceptance, it's you.

I WILL win the war.

Consider yourself warned.

ME.
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