I celebrated my birthday last week. My 31st.

In many ways, it was nice for me.

My friend at work brought in an ice cream cake for me the day before my birthday, and we all ate ice cream at 10 o’clock in the morning (because the morning is our afternoon). It really brightened my day, even though it was such a short amount of time, it meant a lot to be around people I care for, and that care for me.

When I went to my PHP program on Monday, one of the women gave me a bag of fancy dark chocolate caramels. Most of the people in program know me for two things: my love of dinosaur chicken nuggets and my affinity for chocolate. Since I stopped smoking a few weeks ago, I replaced my cigarettes with Hershey’s chocolates, willingly provided by the director of the program. It was so nice (and a little embarrassing) to be recognized for my chocolate addiction, and I was so surprised that someone would think to do that for me. My face must have lit up, because people commented that they had never seen me that happy before.

It’s the small things that really get me. It’s weird, because in some ways, I don’t want to be recognized, acknowledged, or even noticed on my birthday. But in other ways, I just wish I could enjoy a day that so many other people get to enjoy. I realize a lot of my issues are tied up in trauma. There’s also the fact that my friend died on my birthday 11 years ago, and it feels wrong to celebrate anything happy on the anniversary of his death.

But I made it through. I took it all in. I didn’t break down. I kept myself busy between program and work, and that was probably for the better. Silence and being unoccupied are usually what lead me down the black hole.

Then life happened. The birthday fun was over and I found myself sitting in the ER two days later in excruciating pain. My knee gave out and I fell. Hard. I just wanted to make sure nothing was broken, as I am the girl who broke her foot walking across the street. I thought I was making a wise decision going to the hospital that night. The doctor came to see me, asked me about my history, and sent me for x-rays. Nothing unexpected.

And then the doctor came in with an odd look on her face. I couldn’t tell if she was perplexed or concerned (or maybe both). She asked if I was sure I hadn’t been in pain before this. I told her no, but that answer wasn’t exactly the truth. How can I explain that I learned to block out pain? How can I explain that I learned to deal with pain in order to survive? How can I explain that I learned to believe that pain was my normal? I couldn’t. So I told her no, because the truth seemed too impossible to explain.

I’ve never seen this degree of damage in someone your age. You have severe arthritic damage to your knee. I’m referring you to a orthopedic specialist for more testing and treatment.

I…just went there because I fell. I didn’t break anything, so I guess that was good. It’s most likely a sprain, possibly a ligament issue, but the doctor wasn’t even concerned about that. She was concerned about the old damage. I’ve never seen this degree of damage in someone your age. Those words stuck with me, because they’re words I’ve heard before. I didn’t need to hear those words again. I didn’t want to hear those words ever again.

In all the ways I am trying to improve my mental health, my physical health is deteriorating. I was just starting to cope with the emphysema, another thing they don’t see “in someone your age.” It took an entire year to get to a point of really acknowledging it. I ended up in the hospital several times and it all became real. I was told in my last hospitalization that I had bronchiectasis (non-CF type), another form of COPD. As if emphysema wasn’t enough, they want to throw ANOTHER diagnosis at me. Blow after blow. 

I don’t want to go to any more doctors. I don’t want emphysema or bronchiectasis or a fucked up knee. I’ve had enough shit in my life already. It wasn’t supposed to turn out this way. I was supposed to get out and get better, not become free and lose my health. I can’t handle any more diagnoses, any more problems, any more hospitalizations.

I’m not really sure what state I’m in. It isn’t shock, because really these are things I should already know. Is it grief? I don’t think so. I’m not sure I have the right to grieve. These things are my fault. If I didn’t smoke, if I went to the doctor more, if I didn’t block out the pain, maybe I wouldn’t be 31 years old with problems I should be having when I’m 70.

How am I supposed to feel? What am I supposed to do?