Counselling & Other Things

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I finally got a call today from Mental Health Services and the Digby Hospital today. It seems that there is a free wellness clinic on Thursdays at the hospital from 9 – 3. She said all I have to do is show up and register at the registration desk and then I can see a counselor who will do an intake and determine where to go from there. I am unsure how it works but I am glad that at least there is somewhere to start. She said they can determine if some counselling sessions are needed and how often or if I need to be referred to someone else from there. It’s a bit of a relief. I was getting really frustrated and upset about it and feeling like I really needed to talk to someone.

With that and going to physiotherapy tomorrow to be assessed and get some help for the pain that is still there after the accident at least I am now starting to feel like I am getting somewhere. I was told by her today that to see a psychiatrist through mental health is a 3-5 month or longer wait. I go back to work after Christmas and still have not driven at all. I don’t even miss it. Usually, after a day or two of not driving, I am itching to get behind the wheel and go somewhere. At this point, I wouldn’t even get in a car if I didn’t have to and if I even think about driving I start to shake.

I made a bit of a mistake earlier though, my Libre sensor finished yesterday while Eddie was at work and he brought me home two sensors and I should have put one on last night but I didn’t feel like it. This morning I wanted to get a shower and had to wait a bit to ensure my skin was not wet before putting it on or it will just start peeling off. He had left for work already and before leaving we were talking a bit about everything and I still had not got the call I just mentioned yet from mental health and after he left I started feeling shaky and felt like a panic attack was coming on. By this time it was about 3 PM and I had not eaten since breakfast but I failed to notice that at first.

I tried to calm myself down and was talking to him on messenger and told him what was going on (he was on the bus to work) and he tried to calm me down but I just kept feeling shaky and then weak. Thankfully at some point, it occurred to me that maybe this one time it was not a panic attack and was maybe low sugar. I looked for my glucose monitor, test strips and lancet and could not find the case with them in it so I said the hell with it and went and got some glucose tabs and took them then made myself an English muffin.

After about 10 -15 minutes I started feeling less shaky. I put on a new sensor and activated it and waited the hour and sure enough, I was 5.7 which in the grand scheme of things is not low, in fact, it’s perfect but knowing that for the last month and a half (even before the accident) I have been in the teens and ’20s for the most part and after testing it a few times and seeing it curve upwards I know it was likely much lower then that about an hour and twenty or thirty minutes before. Which would have been before I ate and before I had taken anything to try and bring my sugar up.

I honestly don’t know how low I went but it must have been pretty low for me to get shaky because I don’t always get shaky sometimes I don’t know until I pass out. I am damn lucky I figured it out. I still feel pretty weak and now I have a headache on top of it. So, now I have the added anxiety of not being able to tell a panic attack from low blood sugar. Which terrifies the absolute hell out of me. I have to be more careful and I have to ensure I am checking and double-checking (with test strips) my blood sugar right now.

One other thing that’s been bothering me is wondering if some of the pain and fatigue I am feeling after the car accident is maybe because it has triggered a flare with my Fibromyalgia. I have probably mentioned that before and I know I have thought about that since the accident, especially this last week. Even earlier though this morning right after getting a shower I put my pajama’s on like yesterday to dry my hair with the intention of getting changed after and instead I dried my hair and then I fell asleep for an hour on the couch after sleeping about 10 hours the night before. I am so tired. No matter how much sleep I get I just don’t feel rested and each day seems to be adding to the previous day. Each day I am feeling more and more tired and weaker.

I am hoping maybe the physiotherapist might have some ideas or maybe one I tell them everything they might be able to shed some light on it. I feel like if I go back to my family doctor now he is just going to blame it on the accident or the fibromyalgia and not really do anything about it. If there even is anything that can be done. I just hope physio tomorrow does not make me feel worse and not better. I am not sure I can handle feeling much worse then I do now and I feel like one thing is feeding off another.

Two to three paychecks away from being homeless

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This is something that has been on my mind for a while now and something I just feel like writing about. Almost half of Canadians are only two to three missed paychecks away from being homeless. I am sure this is true for many other countries as well. Something I have experienced myself is wondering where the next rent is going to come from or not getting groceries because you need to put gas in the car to get to work. It’s something that has been on my mind a lot lately because we have been struggling with money a lot.

Today, my mom told me about a story in the Chronicle Herald (Halifax) which really hit home for both of us. A 63-year-old woman, a woman my own parent’s age, suffering from diabetes living in her car in a Walmart Parking lot in Dartmouth Crossing after losing her job and then her apartment due to what she called “three bad blows”. Blows that could happen to anyone, anywhere, at any time. Blows that do happen to anyone, anywhere, at any time but that if you do not have a nest egg of savings to get you through can render you homeless.

The first of which was her mother getting sick and having to move home to Nova Scotia and to Halifax to take care of her. She also ended up taking care of a special needs niece and her brother who needed palliative care while dying from cancer. Having to put her life, her job and everything on hold to take care of loved ones selflessly asking for nothing in return. She found a job at a call center, again something that hits home for me as I have been working in call center’s for most of my life and only recently left to work in a branch of a bank. She worked there for 8 years when her luck ran out.

The second blow came when she had to have three toes removed from complications of diabetes. It does not say what type of diabetes she has and honestly, it does not matter. As Leah writes about in her blog the.insulin.type all types of diabetes matter and all have the potential to cause horrific complications if not controlled, and getting and maintaining control is a constant struggle which even a little cold or infection can have a huge effect on. Anyway, this is what happened to this woman. She ended up having to have three toes removed. After coming back to work from a leave of absence, most likely too soon, but when you need money you need money, she was only able to get part-time as her hours were cut back.

Of course, her bills started piling up and she was falling behind on her rent and she was eventually kicked out. Family helped her as much as they could at their own expense, a brother-in-law allowed her to stay in a house he was selling before the new owner took occupancy but then she was forced to move again. All of this took a toll on her job as she kept having to miss work to move and she was eventually fired. She doesn’t blame the call center at all, as she says in the article she knew the rules and she didn’t comply with them, really through no fault of her own though.

Without a job and without a roof over her head she has resorted to living in her car in front of her brother-in-law’s place at first moving around every few days, after a while, she found out that Walmart allows RVs and campers to park in their parking lot and that is where she currently is. A friend took her in during Hurricane Dorian and her brother-in-law maxed out his own credit card putting her up in hotels every few nights so she could have a good sleep and a bath. An MLA also reached out to the Department of Community Services and they provided her a few days of accommodation in a motel. She is 2 years too early for Old Age Security and only has a small Canada Pension Plan (CPP) amount of $277 a month that she is getting and due to having no permanent address she does not qualify for further assistance from the Department of Community Services.

A GoFundMe campaign was started for her by a friend and co-worker but honestly, unfortunately, it takes time for funds to be raised through GoFundMe, and then once the goal is met and the money is requested it takes time for the funds to reach her. She doesn’t have time, however, as another blow has come, living in her car and not taking her shoes and socks off often, she failed to notice a blister forming on her heal that had gotten infected. Anyone who knows anything about diabetes knows how serious that can be, especially after already having three toes removed on the same foot. She is supposed to wear a special boot while healing but due to circumstances can’t because she would not be able to drive or get around as she is living in her car.

She is falling through the cracks, the weather here right now is getting cold, very cold. It is currently -3°C in Dartmouth and it feels like -8°C and it is just going to get colder. She is in an impossible situation and she is just one of many people and children in the same or similar situations in this country. It’s a big issue and is only going to get bigger. My husband and I are fortunate at the moment that we have family that has stepped in and helped us but sometimes that help can only go so far and even being in a bad position ourselves this haunts me to the core, her story and the stories of people like her.

Her story really hits home for me. Partly because she is a diabetic, partly because she is the same age as my parents which kills me the most and partly because her story shows the human side of it.  It shows me that it can happen to anyone, anytime, living anywhere and that there are people even worse off than her, here in Canada and really all over the world. My mom and I have both been really affected by reading her story and have been racking our brains all afternoon on how we can help, how we can make a difference, to the point my mom said she wished she could drive up to Dartmouth and bring her home to stay for the winter to get her off the streets and give her a chance.

While that is probably not possible or feasible, there must be something we can do. Money is tight for both my parents and us, but we just feel like there has to be something we can do. We just have no idea what. She is two and a half hours away. Maybe even just getting her story out there might help. I have no idea. All I know is it is really bugging me.

 

How fibromyalgia affects other illnesses and injuries

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Fibromyalgia & Oseoarthritis

One thing I have noticed over the years since being diagnosed in my early 20’s with fibromyalgia is that it tends to intensify everything else that is going on. Whether it is a psych issue such as anxiety or depression, a physical issue such as osteoarthritis or a disease such as type 2 diabetes, fibromyalgia seems to make dealing with them so much harder. I have learned a lot over the years about my chronic illnesses but there are times when they still take me by surprise and times when I wish things could go back to the days before any of this started affecting me. If there ever really was such days. Honestly, I can’t really remember a time that I didn’t get sick easily or injured easily. Even as a child I had strep throat and ear infections constantly. I caught everything going around from rubella as a baby to chickenpox to scarlet fever mumps, measles, and hand, foot, and mouth among others. I’m surprised I didn’t have the plague to be absolutely honest.

I am very prone to injury. I am not sure if this is just because I am clumsy or if it is more related to the fact that people with fibromyalgia seem to be more prone to falls. One study mentioned on WebMD suggests that this is because people with fibromyalgia tend to have balance issues. We apparently score worse on balance tests than people who don’t have fibromyalgia. It also mentions that the number of medications had no relationship with the scores but as we take more medications typically it can’t be ruled out. Not sure how they came up with that one…

In the early years of my diagnosis, my balance seemed to be pretty good. I really didn’t have many issues. Over the years, however, my balance has really declined. I started suffering about 10 years ago with severe bouts of vertigo that would render me immobile. This seems to come and go. Remittent and recurring it seems.

When I am injured either due to a fall or impact or something else I tend to heal a lot slower them most healthy people. Even long before the type 2 diabetes diagnosis, this has been something I have noticed a lot I seem to take two to three times as long as most people I know who are relatively healthy. Sometimes I even start to get better and then easily re-injure myself or if it’s an illness then I seem to get better only to then start getting worse, sometimes even worse than the first time.

Image Credit: Kirsten Corbett

This was the case with my leg the summer before last. One fall caused me to injure my knee and ankle and it took forever to heal. When I was finally starting to feel better I fell again and the second time through the fall was less of an impact (falling in the tub vs a fall downstairs) I was hurt even worse. Then the time I spent on crutches causes a shoulder and wrist injury that took forever to heal and I ended up having to forgo the crutches for a rented wheelchair for over a month. I’m actually still not fully healed. I still have tons of pain from all the injuries almost a year and a half ago. I was diagnosed with Osteoarthritis in my left hip and knee during all this and was sent to a specialist.

It would take both my fingers and toes to count the number of sprains, strains, pulls, tears and even breaks I have had over the years. Even when I was a child actually. They put it down to be being clumsy but honestly looking back I really wasn’t. I have always been careful and paid attention and gone slow. I was never one to rush anything just ask my husband and parents

 

Dermatographia & Rosacea

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I also have two skin conditions known as dermatographia and rosacea. Both are quite common in people with fibromyalgia, comorbid conditions (oddly enough they are not listed in that list) that are often present in people with fibromyalgia. Rosacea primarily affects the face but can affect your chest and neck as well. It causes inflammation and swelling on the cheeks, nose, and forehead. The skin typically looks red and inflamed. Facial flushing is common with rosacea as well as a bumpy look. One of the main causes for me is stress or just being overtired or sick. Any sort of stress causes a flare. With rosacea itself, I do not experience and pain or itchiness typically.

Then there is the second condition dermatographia aka skin writing. This comes and goes for me as well in flares and is usually worse when sick, overtired or stressed. This one causes me a lot of annoyance. My skin is always itchy and dry no matter how much I moisturize it or what moisturizer I use. Most moisturizers actually aggravate it. Anything with feverfew is a no go for me. Typically suggested for rosacea it just makes me miserable. I found this out with Aveeno Ultra Calming lotion. It made my skin crawl for days after using just a little. I was tested for an allergy to it and I do not have one. My dermatologist at the time thought it might be from the dermatographia but was not really sure.

I can skin write. Sometimes very plainly and easily but I don’t because it really makes my symptoms worse and makes me miserable so anytime anyone who finds out I have it asks I refuse to show them typically. It just makes me so uncomfortable and itchy. My diagnosis with it was a weird one: about 3 years ago Eddie and I were trying to get pregnant and as part of the blood work etc, I was diagnosed officially (finally) with type 2 diabetes. During this time they decided it would be best for me to start on insulin right away.

I was put on the fast-acting insulin Humalog. I had a 15-minute appointment with a nurse who showed me how to inject the insulin in my stomach and was provided with a Novopen 3, a box of BD ultrafine pen needles and a script for Humalog and one for test strips. This was my pre-Freestyle Libre days. I was also given a 15 minute consultation with a nutritionist who said I should avoid eating sugar and sugary foods and eat some vegetables (no shit sherlock) and proceeded to provide me with a couple of recipies by email with turned out to be smoothies with a ton of sugar and some sort of protein pancake recipe which my best friend (who is a nutritionist) said was full of carbs and not so good for me.

Once home I started injecting myself at the next meal. Very little info was given on how to bolus for carbs etc. It was just “make your meals each a set number of carbs and use this much insulin at each meal” kind thing. I struggled with it. After about a week I noticed big welts each time I injected. I thought I was doing something wrong. Called them up went back was told I was likely not sticking the needle in far enough (I was, it was a 4mm needle and it was flush with my skin) and told to go to a 5mm needle. So I bought a new box. This did not help.

After injecting my skin around it would become really itchy, inflamed and welted. My dad injects insulin and said this should not be happening. Ocassionally yes if I actually did not get it in all the way and the insulin was too close to the surface but not each and every time. He watched me inject, gave me pointers and still it persisted.

They switched me about 4 times to different types of fast-acting insulin but it still happened. It sometimes would stick around long enough that the next time I would still have an old one. I took pictures and posted them on a facebook group for diabetics and was told no, this should not happen. So off to an allergist I went. She did allergy testing and said I was not allergic to insulin. Instead, she diagnosed me with dermatographia. I could always skin write but had no idea it was a “condition” or not normal.

Type 2 Diabetes & Neuropathy

Image Credit: Kirsten Corbett

As mentioned above I was diagnosed in 2016 with type 2 diabetes and later with associated neuropathy in my hands and feet. Obviously this is a totally unrelated disease but sometimes the two seem to feed off each other for me. Especially the neuropathy. Fibromyalgia seems to make it so much harder to bear at times as I am so sensitive to pain, especially nerve-related pain.

Diabetes itself is not really made worse by fibromyalgia. Fibromyalgia in itself will not cause or make my sugars any higher. That’s mostly diet, lack of exercise and the fact that my body either does not produce enough insulin or can not use the insulin it does produce effectively. One really has nothing to do with the other.

My body must have had issues now for a while though utilizing or producing insulin though because I have been diagnosed with diabetic neuropathy rather early in my diabetes diagnosis. It was only about 8 months before my diagnosis that my doctor suggesting I might be pre-diabetic.

Diabetic neuropathy is caused by high blood sugar injuring your nerves. It can cause a burning sensation (pain) and numbness (tingling) in your hands, legs, and feet. It can cause issues with your digestive tract and urinary tract and issues with your blood vessels and heart.

I have both peripheral neuropathy and autonomic neuropathy. Peripheral neuropathy is what causes the burning sensations, numbness or tingling, loss of sensation, reduced ability to feel pain or temperature changes, muscle weakness, and sharp pains or cramps. loss of reflexes, balance and coordination, ulcers and other serious foot problems and infections. Mine is mild to moderate.

The autonomic nervous system is what controls your stomach and intestines, your heart, bladder, your sex organs, and your eyes. Autonomic neuropathy is when diabetes affects the nerves in these areas. The main symptom for me with this is a lack of awareness when my blood sugar goes low called hypoglycemia unawareness, something else I have been diagnosed with. For some reason, I find fibromyalgia really seems to play havoc with this. Instead of just not knowing when I am low I seem to get false symptoms, high symptoms when I am low and low when I am high, etc. I have no idea what the reasoning behind this is and I can find little to no information on it. However, when I am in a fibro flare this always seems to be much worse.

One of the things I am really looking forward to and really hoping my insurance will cover is the Freestyle Libre 2. Which has added Bluetooth and alarms that push to your phone or reader when you go below a certain blood sugar level. While not a full CGM like Dexcom because you still have to “scan” to get your actual glucose level it will at least alarm you when you are going low so that you can head off an extreme low. This will help with someone like me who doesn’t feel when they are going low or for peace of mind when your diabetic child is sleeping at night and goes low.

My insurance will not cover a Dexcom continuous glucose monitor unless you are type 1. Which I think is antiquated as for one, studies have shown there is actually 5 types of diabetes, something that is becoming widely more accepted.

This sums it up pretty well (source: LiveScience):

  • Cluster 1: Called “severe autoimmune diabetes,” this form is similar to type 1 diabetes. People in this cluster were relatively young when they were diagnosed, and they were not overweight. They had an immune system (autoimmune) disease that prevented them from producing inulin.
  • Cluster 2: Called “severe insulin-deficient diabetes,” this form was similar to cluster 1 — people were relatively young at diagnosis and were not overweight. They were also not producing much insulin. But, crucially, their immune system was not the cause of their disease. People in this cluster “looked for all the world like [they had] type 1” diabetes, but they didn’t have “autoantibodies” that indicate type 1, Wyne said. Researchers aren’t sure why this happens, but people in this group may have a deficiency in the cells that produce insulin.
  • Cluster 3: Called “severe insulin-resistant diabetes,” this form occurred in people who were overweight and had high insulin resistance, meaning their bodies were making insulin, but their cells were not responding to it.
  • Cluster 4: Called “mild obesity-related diabetes,” this form occurred in people who had a milder form of the disease, without as many metabolic problems as those in cluster 3, and they tended to be obese.
  • Cluster 5: Called “mild age-related diabetes,” this form was similar to cluster 4, but the people were older at their age of diagnosis. This was the most common form of diabetes, affecting about 40 percent of people in the study.

So I really hope that they will cover the Freestyle Libre 2 since they cover the original. If Health Canada ever approves it for sale in Canada. Anyway, end rant, so basically the neuropathies cause some major issues and combined with fibromyalgia as well it can be a bit of a nightmare. As with what I mentioned above about injuring my leg last year and then the whole thing with my Wisdom teeth and now what I have gone through the last month with a simple tooth extraction of a tooth with a failed root canal and infection, fibromyalgia can really exacerbate and make things that much worse.

Does it technically do this or does it just feel like it does? I really don’t know. All I know is tons of other people I have talked to with fibromyalgia agree that 1) they usually have multiple comorbid and not comorbid conditions along with it. It’s such a broad diagnosis anyways and 2) that they feel that it worsens their symptoms for other things such as depression and anxiety or other mental disorders as well as many other disorders, diseases, conditions, syndromes, etc.

If you made it to the end of this post I commend you and would offer you a lollipop but I don’t have any