Pink Puffer

I spent Thursday night in the hospital.

I was having a hard time breathing since Monday. I ignored it, because I didn’t have time to be sick. So it lingered and lingered.Then it got worse. But I still ignored it. I don’t have time to be sick. I have to go to program. I have to work. I have chapters to read, papers to write, articles to publish, people to help. I am not sick.

By Wednesday, it became an effort just to take each breath. I went to program despite my exhaustion, but I couldn’t hide my cough. I started running to the bathroom so no one would see me struggling to breathe.

I heard the nurse calling me on my way back. She seemed concerned. She said she didn’t even need to listen to my lungs to know that something was wrong; she could hear me breathing feet away. I told her I was fine. I’m not contagious, it’s probably just a mild pneumonia. I talked about it like it was a cold. Nothing major. I promised the nurse I would try to make it to the doctor, even though I didn’t really want to.

I wasn’t planning to end up in the hospital, but after three nebulizer treatments with no improvement, I knew I wasn’t going to make it through the next day. They started breathing treatments as soon as I got to the ER. No change. I ended up on a magnesium drip with IV fluids and Solu-Medrol. Blood tests, nasal swabs, and x-rays all came back clean. It wasn’t an infection. It wasn’t pneumonia. It was COPD.

I spent most of the night crying, eventually falling asleep only to wake up and cry again. I managed to get myself together enough to make it to PHP Friday morning. I made it through most of morning session just fine. Then I took a conscious breath and it all went to shit.

I don’t know if I can quite describe what it feels like. You take in a breath okay, but then it can’t get out. You feel like you’re drowning, but not in water, in air. I hurried out of the room to run to the bathroom again. I saw the nurse out of the corner of my eye, but I was coughing and wheezing so bad I couldn’t talk.

I spent several minutes in the bathroom trying to get back to normal. Shallow breaths. Just take shallow breaths and you’ll be fine. I went back to my group. A few minutes later, my therapist came to the door and pulled me out of group. Great. What did I do now? She took me to the nurse’s office and closed the door.

I sat there, surrounded, trying not to panic. The nurse sat across from me; my therapist sat on the floor. Oh, we’re all sitting. This can’t be good. Someone asked what was going on, if I had gone to the doctor. I told them I went to the hospital; that counts as the doctor. I tried to make it seem not-so-serious. They asked if it was pneumonia.

Before I could answer, I broke down crying. All the emotions came back to me again. The anger. The sadness. The hopelessness. I would have rather had pneumonia.

I didn’t want to cry. My tears did not feel justified. My pain wasn’t valid.

This diagnosis, it’s nothing new to me. I’ve known about the COPD for a while now. So why does it hurt every time I hear a doctor say it? Why am I still grieving? I should be over it by now.

It’s not fair. I went through hell. I got out. This was supposed to be my better life, my life without hurt.

Instead I ended up with this. I didn’t get a break. I got a punishment.

I could sense the concern in the room. I pushed aside my anger and stopped crying. They told me there were options. The nurse handed me a paper with quit assistance programs. My therapist said we could work out a plan. It doesn’t always have to be this way. It doesn’t always have to be a struggle to breathe. You are strong and resilient, she said.

I’m tired of being strong and resilient. It was the truth. What’s the point? Look where strength and resilience has gotten me. Look what I’ve become. A mess.

You need to take time for yourself. What’s that? I go to PHP from 8 to 3:30 every weekday. Then I go straight to work at 4. By the time I get home for the night, I have just enough time to put together a cohesive assignment for grad school. Weekends are full of more work, school work, articles, and errands. I don’t have time for myself.

I just want it to all go away. I want an easy life, even if it’s just for a little while. I don’t want to have to go to a program every day. I don’t want it to hurt when I breathe. I don’t want to be so tired all the time. I don’t want to struggle.

I want to pretend that I am healthy. I want to pretend this diagnosis doesn’t exist. I can breathe. This is normal. There’s nothing wrong with me. This has all been a mistake.

I managed to push it all away for a while. I can smoke a cigarette, nothing is wrong with me. My lungs are fine. My denial was fully engaged, and no one was around to tell me otherwise.

Later on that day, I sat across from my psychiatrist as he waited on hold to try to change my prescription at the pharmacy. I felt the tightness in my chest again. I took a breath and started drowning. I leaned forward and tried to get the air out as best I could.

As I sat back in the chair and tried to compose myself, I heard the psychiatrist say so, you’re a pink puffer. I looked at him, a bit confused. I never in my life heard of a pink puffer before. I asked for clarification. Your breathing, he said. That’s a classic forced expiratory wheeze of emphysema. I don’t even need a stethoscope, I can hear it from here.  Doctors would call you a pink puffer.

I don’t know how much longer I can deny the truth.

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Shame sickness

I have been sick the last few days. Constant nausea. Throwing up. Pain in the pit of my stomach.

But it’s not the flu. It’s not a stomach virus. It’s fucking shame.

I knew it was coming. This wasn’t the first time this has happened, and I’m sure it won’t be the last.

I had to make an appointment with a gynecologist earlier this week. I was actually supposed to make an appointment months ago. I had an issue back in July in which I was bleeding for longer than normal, and became so weak that I struggled just to hold my head up at times. I had to promise my therapist that I would make an appointment in the next couple months, but I (knowingly) kept putting it off. That is, until my therapist brought it up again. Then I had no choice.

There is a fear in going. I have never been to that kind of doctor before. I have never had anyone check that part of my body before. The thought  is terrifying in many ways.

But even more pronounced is the shame I feel in going. There is so much shit tied up in that part of my body, that I don’t even know where to begin to work through it all. I don’t even know how. I don’t even know if it’s possible.

I grew up believing that I was sick. That’s what she told me, that I was sick down there and that’s why she had to do what she did. And I believed her. Because I didn’t know any other way.

And as I grew older, that belief that I was sick only grew stronger. I was the only one of my peers who hadn’t started menstruating. I didn’t understand. I thought something was wrong with me. Years went by and I still wasn’t normal. The only way I could explain it was that my mother was right — I was sick down there. It was the only thing that made sense.

Any time I needed a physical, I would panic whenever the doctor wanted to check my private area. My mother, who was always in the room, would tell the doctor I was shy, and the doctor would leave me alone. But I wasn’t shy. I just didn’t want them to see the sickness I was hiding there.

When I was a teenager, I had to go to the hospital because I couldn’t breathe. I remember the nurse asking me when my last period was, and I hesitated. My mother was standing right there. I didn’t want her to know I was still sick. I didn’t want her to have to help me anymore. But before I could make up something, the nurse sensed my hesitation and assumed I was hiding something. I couldn’t tell them that I was just sick down there. Mommy says I’m just sick. I swallowed my shame, just as I had done so many times before.

Doctors wouldn’t understand. So I just learned to lie better. Any time a doctor or nurse would ask about my period, I’d tell them I started the week before. No further explanation needed. They didn’t have to see my sickness. They didn’t have to sense my shame. But I sensed it. Every time I had to lie, I remembered why I was lying in the first place: I am sick there. My mother was right.

In my 20s, I experienced random bleeding, but nothing that lasted more than a day — and never regular. I would have spotting one day and never again for another 6 months, sometimes even a year or two in between. Other women would talk about the pain and frustration with that time of the month, and I could never relate. When I told the women close to me my experience (or lack thereof), they acted as if I were lucky in some way. They were envious. But I was disgusted with myself. Don’t they see? The reason I am not like them is because I am sick. If I wasn’t sick, if I didn’t do bad things, if I wasn’t evil, I would be just like them, too. I wasn’t lucky at all. I was sick.

I’m not even sure I could adequately explain how I felt during all those years, never experiencing what society told me I needed to experience in order to be a woman. I had already felt inadequate. That only made it worse. I felt alone. I felt less than. Too old to be a girl, not enough to be a real woman. Who was I then? Not a child. Barely a human. Just a sick bundle of flesh, bones, and fat, held together by viscous shame.

Things have changed, but I still struggle with those thoughts. I know I’m not sick anymore. I got my first real period in August 2015, one month after I ran away. And I’ve been normal ever since. I know there could be reasons that have nothing to do with me being sick: malnourishment, eating disorder, stress (physical, emotional, and environmental). I know all of these things can and do affect your reproductive health. I know the sickness may very well have not been in me, but in my environment.

But on an emotional level, I still carry the shame as if I were still sick. Like I am somehow still less than a woman. Like they can still see the sickness somewhere in me. It’s why I struggle so much with going to this doctor. I’m scared she will see all of my sickness, all of my badness, all of the disgusting things I’ve done, still lingering there, inside my vagina.

But maybe the sickness was never inside me at all. Maybe my mother was wrong. Maybe she was the sick one. Not me.

The only sickness I have is shame, and I don’t want to suffer with it anymore.

Lose enough

My doctor looks at me with concern. She asks how much weight I’ve lost since my last visit. I answer. She says, “I don’t want you to starve yourself.” I tell her I’m okay. I tell her I’ve got it under control. But only half of half of that is true. I’m not okay. And when I say I’ve got it under control, I mean I’ve got my weight under my control: my obsessive, unhealthy control.

A few hours later, I go and see my cardiologist. He says to me, “You need to lose weight.” Before I could finish telling him I had already lost 185 pounds, he tells me “you need to lose more.”

All he sees is the fat. He doesn’t see anything else. He doesn’t know that my protein is low, that I’m undernourished and anemic. He doesn’t know that I struggle just to make 500 calories a day sometimes. He doesn’t know how many times I’ve fainted because I didn’t eat for days. He doesn’t know how I spent time in the hospital having every bit of food I ate (and didn’t eat) monitored because my eating disorder had left me severely ill. He doesn’t know I am at my lowest weight in two decades.

He just sees the fat, and the need to lose it. He sees that I am not good enough. I tried to tell him the good thing I did, and it was just ignored. Because it wasn’t enough. I wasn’t enough.

I knew in that moment, that doctor had just opened a door for me. He gave me a warped, valid excuse to limit my eating.

And it worked. I found myself saying “I can’t eat that. My doctor said I have to lose weight.”

I focused on what he said  and ran with it. I wasn’t lying. He did say it. But I didn’t want to acknowledge what my other doctor had told me. I didn’t want to acknowledge that this doctor knew nothing of my history. That wouldn’t help my cause. I believed what he said because it was a belief I had already.

And after my lapses in judgment when I ended up eating, I heard that doctor’s words bouncing around in my head, along with the words of my mother. I felt so sick, but it wasn’t from the food. It was from the guilt and the shame I felt for eating. I tell myself that this is why I shouldn’t eat. Those sick feelings are signs that I was doing something wrong.

It’s a vicious cycle. It’s a constant battle that never has a winner.

I don’t know why I even bother trying. No matter how much weight I lose, it will never be enough. I will never be enough. Just like my mother said. No one will ever love you looking like that. You’re gross. I tried and I tried, but I never lost enough weight for her to love me. But I will still keep trying. I will keep losing until I won’t be gross anymore. I will keep losing until somebody can love me.

Fat on the outside; starving on the inside.

Fine on the outside; dying on the inside.

There’s no need for any doctors

I’ve been dealing with a significant medical issue for the last ten days.

And when I say dealing with, I mean actively avoiding, pretending it’s not happening, and keeping my mouth shut about it, hoping it will resolve on its own. Because you know, that’s how I handle most things in my life. That’s how I was taught to handle most things in my life.

Medical avoidance is my norm. That is one thing I have carried on from my mother. She only took us to the doctor when it was required (because of school forms) or when I was near death. And even then, I was made to feel like it was some kind of burden on her for me to be sick.

Well before I was diagnosed with asthma at age 14, I kept telling my parents that something was wrong. I had to struggle to catch my breath. I felt like I was suffocating.

“It’s just allergies.”

Except it wasn’t just allergies. I suffered for a long time until my lungs filled up with so much fluid that I could no longer breathe. It wasn’t until then that my mother finally took me to the doctor. I probably would have died if she had waited any longer.

By then, the damage was already done. I spent the next 14 years in and out of hospitals, battling pneumonia and lung infections, living off of oral steroids and liquid Albuterol just to stay alive (and for those that may not know, oral steroids are simultaneously the best and the worst drugs ever).

I always waited until the very last minute to seek medical treatment. Concerned friends would tell me I was turning blue. “I’m alright, just cold,”I’d tell them. Then within the week, I’d be in the ER on oxygen. I wasn’t cold, I knew what was coming. I just was taught to think that I didn’t need medical care. I grew up believing that I didn’t deserve medical care.

And I’m still practicing that belief. I went to the doctor back in March, with my therapist, after her consistent prodding and encouragement. It was at that appointment that I was diagnosed with COPD. I haven’t been back to the doctor since. My prescription ran out, and I’ve been living unmedicated for months now.

I think I’m doing just fine, considering. My therapist is not as inclined to think so. We were discussing the impending hospitalization, and her reasons for wanting me to go. She mentioned me not receiving medical care.

“I don’t need medical care, I’m fine.”

“You have COPD, and you’re not getting treatment for that.”

“Yea but I don’t need it, I’ve been okay.”

“For now. But that’s not just something that can be put to the side.”

On a deeper level, I still feel undeserving of care. That ties into my even deeper belief that I am undeserving of love, and undeserving of life. Maybe I have COPD because I am undeserving of oxygen. Who knows.

I wasn’t even going to tell my therapist about my current issue. I had already endured enough of her semi-lecturing this session. But I found myself immensely tired during session. My therapist assumed it was related to not wanting to talk about the difficult stuff (which I admit, in the past, it has been). I kept telling her this was different, and she asked how I knew it was.

I finally told her what’s been going on. I knew it was just going to further prove her point about me needing to go to the doctor. Luckily for me, I squeezed in my admission right at the end of session, so I didn’t have to talk about it all that much. I’m sure I will hear about it on Thursday. Hopefully by then, the issue will be resolved and I can just say “see, I told you I was going to be fine.”

Or, it won’t. Either way, I’ll sit there and say everything is okay. I could be bleeding to death, and I’ll still tell you I’m okay.

That’s what I did in childhood. That’s what I do today.

Spurs, spurs, everywhere

I went to the podiatrist today.

It’s very hard for me to actively seek medical care. I think there are a lot of factors involved in that. I don’t have normal pain experiences. There are times when I am able to block out the pain completely, which does no good because the damage is still being done regardless of whether or not I can feel it. When I do feel pain, I have trouble admitting it. Pain usually leads to more pain.

My mother was never big on doctors, and I think some of her attitudes have carried on in me. There is also an underlying connection between doctors and the abuse my mother inflicted on me. She would use doctors and my illnesses as a cover for abusing me. Because of that, I did (and sometimes still do) associate doctors directly with the abuse. It’s a hard connection to deconstruct, but we’ve been working on it for a while now.

Regardless, I made the appointment and went.

The appointment wasn’t without problems. When I got there, I learned that my PCP never sent the referral. I called three times last week. I called Tuesday and left a message on the referral line. I checked with the podiatrist on Wednesday and they hadn’t received anything, so I called my PCP again and left another message. Still nothing. I called Friday and waited to speak to an actual person. I told them that I already called twice and they hadn’t done anything. The office person took all of the information again and insisted that she was sending it right out.

It turns out she didn’t send anything out. It was ten or so minutes before my appointment, I had taken two buses just to get there, and now I didn’t know if I would even be able to be seen. I had to sit there and seethe a little. The podiatrist’s office was able to get through to my PCP and was told they would fax over the referral right away. Like I haven’t heard that before.

The fax came through as I was being prepped to be seen, thankfully. I was still a little angry but I was able to keep myself calm. The doctor seemed really nice, and I felt comfortable right away. He asked about my pain concerns, and about my previous surgery. I had also noted on my forms about my foot fracture last summer, and he asked about that. He asked how I managed to fracture my cuneiform, as it’s a rare bone to break. Story of my life. Rare, weird shit always happens to me.

The range of motion in my left foot is considerably minimized. It is extremely painful for me to pull my foot forward towards my leg, enough so that I can’t even put my foot in a normal regular 90 degree angle position. The doctor pressed on some different areas of my foot; most were okay except for the spot on the bottom of my heel.

He didn’t want to address my right foot just yet. He acknowledged the visible growth on the top of my foot, but said a lot of the pain I am experiencing in that foot may be because I am compensating for the debilitating pain in my left foot. So we are going to focus treating the left and see if there is any improvement in the right.

I had a few x-rays taken of my left foot, each taken in a different position. I waited as the doctor pulled the images up on the screen. I noticed something off right away. I had so many x-rays and MRIs done on my feet in prior years that I knew what to look for. As clear as day was a large bone spur, resembling a claw, growing out from the back of my lower ankle. As he scrolled further down, there was another spur, growing out from the bottom of the heel of my foot. It’s not nearly as large as the one on my ankle, but the location of it makes it all the more painful. There is also regrowth on the top of my foot, where two of the spurs were removed just over two years ago.

If you’re taking count, that’s four spurs. On one foot. I’m sort of thankful the doctor didn’t really look at my right foot. I don’t know if I could have handled knowing anything more.

The first goal of treatment is pain relief. The doctor gave me a shot of cortisone into my heel. He also wrote me a prescription for an anti-inflammatory and pain reliever. I go back in two weeks for another injection. There is not much the doctor can do right now in terms of physical therapy and other treatments until he can determine how bad it is. Right now, the pain and inflammation is too great for me to even move my foot properly. Once some of that is relieved, I will have to do some physical therapy, stretching, etc. and wear a boot (for those that missed out on the early posts of my blog, I hate boots. I ended up taking my knee-level boot off one day out of frustration and throwing it in a dumpster, just one month after I had fractured my foot). So yea, I’m not thrilled about that at all. At least I have two weeks before I have to deal with that shit. Oh, and the doctor is also going to set me up with orthotics. Yay.

I made it through the entire appointment. I’m not sure that it was all me, but I’ll explain that later in another post. For now, I’m just exhausted and need to sleep. Hopefully the cortisone will kick in soon and I can walk on my feel again.

Doctor’s Appointment

I had my doctor’s appointment on Monday.

It was full of a lot of disappointment.

I am proud of myself for sticking through it and not backing out, despite terrible anxiety.

I sat in the waiting room filling out endless paperwork. I’m pretty sure my legs were shaking the entire time. I considered walking out twice, but I couldn’t.

I finally got in the room and the doctor came in. She seemed a nice. A little upbeat. I’m weary of upbeat people. Perhaps she drank too much coffee. She looked over my paperwork, then focused on my lengthy list of hospitalizations. Panic attacks, psychiatric, psychiatric, malnutrition, psychiatric, psychiatric, and then at least six hospitalizations for pneumonia that I could remember in the last decade. Then she noticed the name of the hospital and asked me where it was.

“Oh, I delivered babies at that hospital. I used to live there!”

My heart sank a little. Of the hundreds of cities and towns in this state, this doctor happened to live in my hometown, just a few minutes away from where I used to live. It’s not even a major city, which makes it even more weird. A part of me instantly put a guard up. Anyone from back home is a possible threat in my mind, even though the actual likelihood that they are is slim to none. Tell my brain that.

She did a mental health/depression screening. I failed. I should have known better. Because then, of course, she wanted to put me on psych meds. No thanks. She named several antidepressants that her patients had shown success on. That’s great. Except a) I don’t have clinical depression and b) I can’t take anti-depressants. I am part of the small percentage of people who have reverse reactions to SSRIs and SNRIs and end up more depressed and suicidal. There are no medications for DID. I didn’t come here for psych meds. I started to get frustrated and lost hope in the rest of the appointment.

Then she suggested a medication for my migraines, and said it would also help me stop smoking. I recognized the name as a medication I had taken before and had to stop taking because I couldn’t handle the nausea and complete loss of appetite. But she was a little insistent, even after I subtly mentioned a few times that eating enough is already a problem for me. But I’m fat, so most doctors don’t see past that and assume I could benefit from a loss in appetite. They don’t realize that, just two years ago, I weighed 160 pounds more than I do now. I just gave in and let her write the prescription, telling myself I could decide later on if I wanted to take it. Then I realized that her dosage is 4X the dose I was taking when I stopped taking it some time ago. So I’m certain taking this medication will not go over well.

She was especially concerned with my respiratory problems. I have a history of asthma, chronic pneumonia, and respiratory failure. I smoke. I have a family history of heart disease. She wanted an EKG, but by the end of the appointment I just couldn’t do it. She listened to my lungs. I hate taking deep breaths, because I can hear and feel the air struggling to get out of my lungs when I exhale. It is not a good sound. It is not a good feeling. This was no different.

She tried to explain, using her hands, what was happening to my lungs. She mentioned COPD – and this wasn’t the first time I had heard that. My long history of respiratory problems and consistent pattern of breathing difficulties had been pushing me towards a COPD diagnosis, but no doctors had ever made it official and never made it a priority. She prescribed me a few different inhalers, which she said would treat both asthma and COPD. And in my mind, it hadn’t yet clicked that she was insinuating that I had COPD. I thought she was just saying it was a risk to try to get me to stop smoking.

But then, the next day, I checked my medical record online to make sure all of my information went through, and right there, towards the top of my chart, was chronic obstructive pulmonary disease, unspecified – Active – Diagnosis Date 03212016. For some reason, in that moment, it hit me. This diagnosis was on my medical record. What the fuck.

I was angry. I was enraged. Not at myself. But AT THE DOCTOR. How could she do this to me? I am 30 years old. COPD is for old people. I am not old. I do not have COPD. And being the irrational person that I am sometimes, I responded by going to the store and buying MORE cigarettes – because in my mind, if I already have the diagnosis, why the fuck should I care now? It’s just been a whirlwind of emotions about this that I still haven’t processed yet.

Going back to the appointment, she took a lot of blood. Probably more than I’ve ever had taken before. She is testing my vitamin levels, thyroid, blood titers, all the usual shit and then some. And that was it. There was so much focus on my mental health and my breathing, issues that I thought I had under control, and nothing about my constant pain. I was disappointed. I have to go back and see her next month, but I just don’t know if it’s worth the travel to get there. It did not go as we (me and my therapist) had hoped. I will talk to my therapist more about it in our session tomorrow, but I just don’t know. I need to take some time and think it over. As I smoke more cigarettes. With my new inhalers.

I’m sad that so many doctors don’t consider the past, only the present. Of course I have trouble sleeping and hate life sometimes. If you knew what I experienced the last 30 years, my present makes sense. Yes, I’m overweight now. But I lost a tremendous amount of weight in a relatively short amount of time and got sick from it. So while yes, I need to lose weight, I don’t need to promote my eating disorder to do so.

I know that some of my health issues are my own fault. Smoking does not help my cause. But I also had severe respiratory problems well before I started smoking. I started because at that point, I didn’t care. Part of me still doesn’t. But still. I’m only fucking 30. Where the fuck did I go wrong in life?

Meanwhile, the shittiest fucking people alive are still living. My mother will probably outlive me. My father has had several heart attacks, a stroke, and congestive heart failure for years and he is STILL hanging on. What the fuck.

Life is a cruel joke sometimes.

Doctors

I haven’t been to the doctor at all since I’ve moved here.

I’ve been avoiding doctors like the plague. I was always like that, though. I never really liked doctors. I felt like I needed to protect myself from them, and my way of protecting myself was to avoid them any way that I could.

It probably wouldn’t be that bad if I was a person in generally good health. But I’m not. I have asthma, arthritis, anemia, and malnutrition – all conditions that should be monitored regularly by a doctor. I know I need to see a doctor. I made a few half-hearted attempts to find one nearby, but the places I called were not accepting new patients, so I quickly gave up the search.

Then I received a notice from my college that my account was blocked due to missing health records. I’m not sure if I had mentioned it before, but I have no medical records, no immunization records, nothing. My mother switched doctors so much that my medical records were never complete, and I eventually lost track of them altogether. The only required vaccination to get into graduate school was the MMR, so I found a Walgreens clinic last month and paid for the vaccine with my credit card.

I didn’t realize, however, that a second MMR vaccine was required. I got so frustrated and angry because I know I had to have had these vaccinations as an infant, but because of my mother’s foolery, it is impossible for me to prove it. I looked into paying for a titer test, which would cover all vaccinations, but that cost way more than getting a second vaccine would. If I would just find a doctor, this would all be no problem. I have insurance that covers everything. But doctors. No doctors, please.

Perhaps it was because doctors and medical issues had been on my mind more than usual, I don’t know…but last week, I had a memory that eventually put things into perspective for me.

I was very sick. I had been sick for awhile, but my mother didn’t like doctors very much so I only went when required. By the time I got in to see the doctor, I was sick enough that he wanted me to be hospitalized. My mother talked with the doctor, right outside the exam room, insisting that she could take care of me at home. After enough back and forth, my mother somehow convinced the doctor to not hospitalize me. I was stabilized with breathing treatments and sent home with a bunch of supplies and medications.

And just as my mother had often done, she saw opportunity in my illness. I was a perfect target now, sick enough that I could not fight back. She abused me. Under the guise of a concerned, caring mother, she took advantage of me. And she got away with it, because she continued to do it every time I was sick, throughout my adolescence and adulthood.

At first, I didn’t really think much of this memory. I didn’t think it had a purpose. But I thought about it for a couple of days, and then I realized something. In some twisted way, I associated doctors directly with the abuse my mother inflicted on me. Doctors were not there to care for my health; doctors helped my mother hurt me. As an adult, intellectually, I know that those doctors had no idea what my mother was doing. They didn’t help her perpetrate; she did that all on her own. And as I’ve mentioned before, my mother had the amazing ability to sway people on to her side. Those doctors didn’t know what hit them.

As a child, I wouldn’t have known any better. I didn’t know the extent of my mother’s powers over people at that time. I just knew that the doctor sent me home with my mother so she could hurt me. So I associated all doctors in the same way: as my mother’s helpers.

My feelings towards doctors became less muddled as I thought more about this. This whole time, I have been unconsciously blaming doctors for my mother’s abuse. I can’t do that now. My mother has no access to my doctors anymore. I can go to a doctor without fear that I will be hurt. This was a huge realization for me.

Acting on this new insight, I gathered some more phone numbers from my insurance website and made a few calls. I found a doctor who was accepting new patients, and scheduled an appointment for the end of the month.

I told my therapist in the beginning of our session Monday about the big news. My medical issues and my hesitance to go to the doctor have been an ongoing discussion over the last several weeks, and I had regularly shot down her subtle insistence that I see a doctor. She smiled as soon as I told her I finally made an appointment. I could see that she was genuinely happy for me taking this step. I gave her my usual weird look and told her that this wasn’t that serious.

I could tell that she was holding back excitement. “I really want to celebrate, but I don’t want you to be all uncomfortable and tell me I’m weird,” she said. I told her to just let it all out. So she did. She did some version of a sitting dance in her chair and threw her arms up in celebration. All I could do was laugh.

My therapist then asked what prompted the sudden change. So I told her about the memory, and my subsequent insight and connecting of the dots. She agreed that it made sense, and was not surprised at all that I would have formed that association in the first place.

We started talking about the possible complications of seeing a new doctor. She had e-mailed me a packet of information for trauma survivors on how to handle medical situations a few weeks earlier. During today’s session, my therapist asked if it would be better if I called the doctor ahead of time to explain my trauma history and some of the things I may need. I gave her a look, and she already knew my answer. Using the phone gives me horrible anxiety, and needing to engage in a regular conversation, especially about those topics, is still not doable for me.

Then my therapist suggested a second option. She offered to call the doctor for me, to vet her and her experience with trauma patients, and find out if the doctor would be a good fit for me. If she was, then my therapist would talk to her about some of my issues -my diagnoses (physical and psychological), my triggers, things I would not want to talk about, etc. I was all on board for this. My therapist and I came up with a list of what I wanted to be included in the discussion – she would not talk about anything that I didn’t want to be disclosed.

I agreed to have the PTSD diagnosis disclosed, but not the DID; I don’t feel like most medical doctors have enough of a grasp on DID to handle that information adequately. My therapist asked if I wanted her to address my issues with eating. Since I am overweight, doctors automatically assume I need to diet and associate all of my health issues with weight. The reality is that I have lost a significant amount of weight in the last two years and I struggle with an eating disorder that often causes me to not eat enough. I know that my eating habits will need to be addressed because I have chronic malnutrition, but it would be helpful if my doctor knew my specific issues ahead of time so she doesn’t end up triggering me into starvation.

We talked about what procedures I wouldn’t be comfortable with, and what the doctor could do in case I am triggered during the appointment. It was a lot to discuss, and I ended up getting a headache halfway through our session today just thinking about it. I still have a few weeks to prepare. My therapist is going to call the doctor in the next few days, and I guess we’ll go from there. Until then, I’ll just try to deal with my anxiety about it as best I can.