Use It And Lose It

Writing and editing this piece revealed to me some defensiveness. There is a strong impulse to tell – my body does this and this is why – and not show. I think I might know part of why. It’s what I felt I had to do, continually, when friends, medical staff, and authority figures repeatedly failed to mirror to me the experiences of my divergent body, to show me that they were real. Perhaps I appeal to an invisible authority in my writing to hand down some explanations, some realness that I was not afforded. The experience of worsening with exertion rather than improving was so primary to me that I assumed everyone knew what I was talking about. I question what is real even now.

Photo by Lukas from Pexels

One thing I wonder if healthy people experience is the sense that activity is actively weakening you rather than strengthening. I have felt before that exercise was eating my muscles or brain.

I started noticing this in maybe my sophomore year of high school. I described it as the “gunk” I would get in my legs after track practice that meant I wouldn’t recover properly from the workout. I knew instinctively that if I rested and avoided running on hills, I would run better than if I did the hard workouts. I remember the almost ill feeling that would come over my legs as I slogged through an interval training session, and the dismay when I would be slower and weaker the next time I ran. My freshest legs and best race times always came at the beginning of the season. “She can run one week, but can’t the next!” my coach once mused.

Why wasn’t I assigned an easier workout regimen? Looking back, this idea seems reasonable. Yet I hazard that it would have run very counter to the culture of competitive running. The standard mantra of athletics (perhaps of society as well) seems to be “no pain no gain”; you push through pain to ultimately achieve resiliency and benefit. You certainly don’t ask for a special exception to be made when everyone else at your level is working so hard. My struggles were easy to typecast as, at best, part and parcel of the painful sport of running – or, at worst, a weakness of character.

When my coaches doubted the urgency of my body’s cries for relief and kept pushing me to do more, I began to question it too. I remember that during my more disastrous workouts, I would write parts of a poem in my head called “The Cross Country Coach’s Lament,” from the perspective of an anguished coach chiding an obstinate runner. “The time that on the clock does read / it matters not to me” is the line I remember the best. “You’ve surest longing in your eyes / yet run so _____ly.” (The adjective never got filled in to my satisfaction.)

However, when the stakes became higher than running a good race, I was forced to contend more seriously with this problem. At the onset of my severe illness, I became so intolerant to exertion that the effort of standing to watch part of my teammates’ race could mean I missed school for the entire next day. I was sleeping up to fourteen hours a day and was scared to shower, feeling that I would pass out. For someone who used to be able run a mile in under six minutes, this was a big shock. I had been diagnosed with celiac disease and inflammatory bowel disease (IBD), but the people I met in online support groups with these conditions didn’t share my “exertion intolerance” problem. Again I found myself the freak, but now I was even a freak among freaks.

The fatigue improved dramatically with biologic treatment for the IBD, but when I tried to gradually return to running the following summer, something seemed off. A leisurely 2- or 3-mile jog at 12-minute-per-mile pace would spike my heart rate to 180. I would finish with a lightheaded, beat-up feeling, and not experience my previous “runner’s high.” I had built up to this level of activity at what was, to me – a former varsity athlete – a painfully slow pace, having started with just walking one time around the block per day and increasing to two blocks when that got too easy. Why wasn’t I feeling stronger? Was this out of proportion to the deconditioning (medical-speak for loss of fitness after long periods of bedrest) that I experienced when I was very ill?

Life with chronic illness flies in the face of what we are told about our own resiliency. I do believe it’s important to try new things fearlessly as often as possible, but to also trust my body and know that it often worries due to very real past upsets. The various ways I’ve learned to protect my body – certain postures, avoidance of certain situations like standing in line, minimal hair and makeup products, saving mental energy by being a bit “rude” – are all very easily stereotyped negatively unless viewed with an open mind.

Something To Hold Onto

I guess I want to tell you it’s getting better in some way. Maybe there are more superficial ways that will become more manifest in time. The physical therapist who had a plausible explanation for why I have failed over a year of pelvic floor physical therapy and thinks she can help. The fleeting, sputtering moment of clarity where I told my parents that I was relying on the executive functions of a mentally and physically ill 24-year-old with long-standing ADD tendencies to manage the care of a complex patient – the aforementioned 24-year-old – and we regrouped and got some help with care coordination. The unknowable time at which the anhedonia lessened and I could truly enjoy a few things again, for who knows how much more time. The support of parents who allow me to breathe a bit and stop being a full-time advocate who cannot advocate.

But I feel I do myself and others a disservice by romanticizing. For months I’ve been wandering a weird mix of trauma, hypersensitivity, depression, aggression, and brain fog, such that I often cannot even remember enough to describe how my day went but know in some vague sense that it was bad. I weather weird assumptions about my quality of life based on physical symptoms or labels, wanting to scream that I would cut off all my limbs if it meant I get my brain back. I have learned what it means to spend hours of a morning wracking ones brain for how to do a morning routine, then 10 minutes of that morning trying to attend to a 101-level lecture online, then the rest starting to go to the gym but being so agitated I have to get out. I have learned that maybe it’s ok that this is the first time I’ve felt able – as in, focus-wise, genuinely capable – to write a blog post since the last one. I have learned that even the fogginess isn’t so bad when your mind and body remember how to be calm. It seems not so long ago that mine truly did.

I have wielded diagnoses as a Something To Hold Onto, validation from a mystical board. Of course I don’t feel well, I inform you. I have celiac disease, Crohn’s disease, postural orthostatic tachycardia syndrome, lichen sclerosus, secondary adrenal insufficiency, and mast cell activation disorder. All of these are real; laboratory tested. Yet it’s an armor against how none of this explains what is going on; why I sometimes find even good and pleasurable thoughts torturous, like fingers raking into lava veins of nerves; why I feel worse and worse mentally despite no major demands on me, some improvements in physical conditions, and few other life stressors; why I scream threats at loved ones and then minutes later am relaxed and joking; why I haven’t truly slept through the night since December; why even gentle medications or supplements often lead to agitation and dysphoria. I haven’t had a single break from reality through all of this, always excruciating awareness that I sometimes wish I had some escape from. I don’t want to see myself behaving as I do. I don’t want to see others wanting to reach out and to not have the heart to tell them that lately, company often makes things substantially, critically worse. Harder. On. Me. Not. On. Your. Ego. Insistence on what I know I need, attunement to a soma trying perversely to protect me, becomes paramount.

I both hope I remember and forget this time at some point. At times I’ve looked back at my early days of illness through Facebook memories and feel generally what I should; compassion for the person involved but great relief and wonder that I am not her anymore. How odd that now I would gladly trade my current situation for hers.