But it got me wondering, for those living with a chronic illness (not necessarily terminal), how do you deal with the stress of it?
Since you cannot cure that illness, I recommend fixing everything in your life that you have control on and that might help you feel better.
Sleep well, eat a good diet, skip fast-food and alcohol when possible, etc. This won't cure it (don't listen to people that say it will) but it will make your overall life better. This will make it so that when the chronic illness hits you, you're at a more stable place.
Most of all, remember that it's not your fault if you fall down after doing your best. You have something that is external to your control and it's bound to win fights at time. Take the time to get better then stand up again. One day at a time.
If it is safe for you to do so, talk about it with your HR or your manager. They should understand that sometimes, you will be focused on that illness instead of workplace productivity. That's okay, that's how it should be. Trying to win both at the same time is how you burn yourself up.
There will be some unconscious bias against you, you'll need to play your cards well. Some people will try to support you yet come hard at you when you drop the ball. Remind them that you are doing your best and that the cause is out of your control, but don't waste your time trying to argue your way into changing their opinion of you. Some people will have empathy, others won't no matter what. Surround yourself with allies and built a support network. You may even meet other people that have chronic illnesses, and they will understand you the best.
I find that it's better to say as little as possible, you have the right to privacy after all. Your coworkers don't have to know the details of your life.
It's a marathon, really.
For me, it's all about reducing expectations and accepting more disappointments. Not as many doors will be open to me. I tend to think less about what I can do and more about what I will be able to maintain later on as my situation deteriorates. Just as as most adolescents accept that they won't be astronauts or Presidents, I have had to accept that far more mundane things will simply be out of reach.
As a life, it is smaller than most, not quite as brightly colored as that of a you who would have been healthy.
I try to be prepared to do things when I have that energy available to me, but I make sure that those things are important, because I cannot fritter away the few times I am capable.
You also have to develop some patience: patience with explaining things to strangers who may or may not be well-meaning with their questions, patience with friends who do not "get" that you won't be able to make it that night, and finally patience with yourself for not meeting your own expectations.
This all sounds very Zen when I put it that way but I am keeping much of the sadness and bitterness out of my description.
-Massive insomnia. I try to meditate, read tech news and listen to Javascript lectures. I can't reliably schedule meetings in the morning due to sometimes not falling asleep until 6-7am. Hack your environment to remove blue light.
-Pain. Basically, my only available option is narcotics, which I refuse to take for obvious reasons. Meditation, acupuncture helps.
The stress comes from how others react to me. They don't see the behind the scenes, so I'm just some young, rather unprofessional-looking guy, making halfway attempts. I chose to ignore that completely, because at the end of the day, none of these people are helping the situation in any way.
It surely helps to have a never-ending will to go forward, on step at a time.
One piece of advice I would give is to focus on positive stuff. It's all too often very easy to find the negatives. Don't take the easy route.
1) Learn to advocate for yourself. One wise doctor told us "we're all just guessing". I don't know exactly what you are dealing with, but do your own research and seek out health practitioners that are on the leading edge of that community. 2) Learn your "dose". Every body is unique and has its own limits. There is no "normal" with chronic illness 3) Trust your gut. Remember that the struggle is real. There are a lot of doubters, questioners, and "helpful" people. You know what is best for your body. 4) Seek out a community of faith/meditation/prayer/therapy/etc. Dealing with Chronic illness is often more mental than physical.
I spent a lot of time obsessing over it and the rest of my life was suffering as a result (it really exacerbated my trouble sleeping into a serious problem). In order to combat this I mostly tried to spend my time either being productive or doing whatever recreational activities my condition would allow.
Over time, as I started to eliminate worries (diagnosis, medication, learning what would cause flair-ups and just generally coming to a better understanding of it), it's become more or less routine/normal. Can't say the same will apply to other people, but that's how it has played out for me so far.
Best of luck and apologies that I can't give a more helpful answer.
I think about my disease every. single. day. I worry about my kids, and my wife. I don't want to be a burden to them, and I don't want my kids to have this horrible disease passed to them (there's a genetic factor). I worry about my future. When the pain is bad I have a hard time working (typing, using the mouse, sitting etc.) which has me thinking about what happens when I can't work at all.
I could write a novel, but I just wanted to say that in a nutshell ... life goes on. I now have a greater sense of empathy for others dealing with pain, and also realize that even your loved ones can't fully understand your pain - it's yours, and yours alone to bear.
One of the biggest things that I notice shift as I grow older is that I no longer package my illness and my life separately. I think there's a tendency to treat chronic illnesses as acute and only focus on them when severe symptoms arise. As others have mentioned, that almost always leads to burnout. I regularly packaged my illness when I was in undergrad (worked full-time, went to school full-time, and then spent the remaining hours either sleeping or on dialysis); do not do this.
I don't think you can really completely remove the stress but eventually it stops becoming the highlight. It's almost like tinnitus, it's there all the time but there are large swathes of times when you successfully ignore it.
Your world gets a bit smaller. You just don't have the mental energy/ability to engage the same number of people/events. My social life definitely shrunk when I was on dialysis. It opened a bit more once I got a transplant, but not terribly. You still have a lot of concerns because after transplant, you're immunocompromised for the life of the kidney. Going to events becomes very stressful because of the risk to your health (Covid is a nightmare).
At the end of the day, you have to REALLY pick what you do with your time. It's like you're a cellphone with a broken battery that only charges up to 30%; you can still do all the things you used to, you just run out of juice a lot quicker.
I live with it by trying to do as many healthy habits as I can and reducing stress as much as possible. Healthy diet, good sleep, meditation (<- massively helpful to me), physical therapy (the gentlest exercises I can do without causing pain to any of my joints). I also just try to be a bit kinder to myself. When I was younger and unaffected, I was certainly more arrogant about life and pushed myself to the limit in a variety of facets and took it hard when I didn't achieve something. Now, I try to live the healthiest and happiest life possible and not get angry at myself when I cannot focus or am tired.
I live with pain in my joints everyday, but I still consider my condition mild compared to many who have autoimmune arthritis.
I just try to live the healthiest life I can and remain hopeful for a better treatment in the future. It's being working well so far :)
I have CFS. Two people close to me have MS, and another has pretty severe UC and related autoimmune disorders.
Everyone on my list seems to be bearing up pretty well, knock wood. All of us have been managing these conditions for upwards of fifteen or twenty years now. Each of us had to get used to the idea that our lives would be different from what we imagined. But each of us is still living, and still doing things that seem worthwhile to us.
For all of us it seems like the hardest part was the months right after diagnosis, while we were grieving the life we thought we were going to have and getting used to the one we were apparently going to have instead.
But the adjustment can be made. Some of us, at least, have made it.
It helps to have friends and family that understand.
I can no longer do karate, my main hobby for over a decade and in which I have a second degree black belt. This is among my greatest regrets as I partially picked it because I thought I'd be able to do it until I was in my 70s. No such luck, alas, life is unpredictable.
I can no longer always work a full day, so I started a consulting company to be able to work at home on a schedule that aligns with my health rather than a clock.
I can no longer play the piano, give massages, do origami, or use a mouse comfortably. The primary emotion at losing these things is often grief. Acknowledge that and be okay with being sad about it but get therapy if you need someone to talk to.
There's no shame in it and it took me easily two years to learn to forgive myself for turning down invitations from friends to do things.
Three things that I do to deal with this:
- ignore: most of the time it's not top of mind; I can feel it always but don't think about it always.
- keep up some hope: every few years, I go through the usual rounds with my GP and other specialists to see if there's anything new that can be tried to mitigate it. This is something of a double-edged sword though, as it is eventually paired with another crushing disappointment.
- remember there is a natural end to this: one day I'll be dead and it won't matter any more, it's temporary in the same way that everything is temporary. And if I get fed up with it all and want to leave early, it's doable as a last resort. A literal last resort, really.
I've also developed chronic lower back pain and tinnitus in the past 5 years and deal with those in the same way.
I'll share a bit of advice she got from the groups she reads online: "Prioritize your well-being over explaining yourself to people who don't care about your well-being." It's understandable that not everyone has heard of or knows the details of some of these rare conditions. It's crazy how some people (even close friends) will react when you explain the reality of your situation to them. Don't put up with it. Just move on.
I blog and I run a bunch of Reddits in part to try to spread the word about how to do this well and in part in hopes of developing an adequate income for myself. I have about six years of college. I can write. I know a bunch of useful stuff. But I can't work a "regular" job and punch a clock and yadda.
I learned a lot about how the so-called "immune system" works and I take a diet- and lifestyle-based approach to dealing my condition as a superior approach to a primarily drugs- and surgeries-based approach.
I'm not anti-drug. I'm pro-health.
People routinely think that my focus on doing what is more effective means I'm some high-handed, judgy anti-drug person in the extreme and this is absolutely not true. It is the opposite of true.
I was thrilled to pieces to finally get good drugs when I finally got a proper diagnosis after a lifetime of being dismissed as some kind of hypochondriac. But eating right for my condition and living "defensively" to protect my health made drugs less and less necessary and my quality of life is just better this way than it was when I was on scads of drugs.
This seems selfless but it quite shrewd really, most people actively enjoy helping somebody occasionally but loathe becoming an actual martyr for somebody. When you're vulnerable you can't really let your health depend on somebodies honor and grace under pressure.
The help you receive is a limited resource. If you piss people off or stress them out until they're sick themselves you're gonna be vulnerable when that tank is on empty. You can't evaluate if it's worth to take a day off sick or ask for help without considering the impact it will likely have on others. You have to ration and time things correctly using stoicism. It may seem a bit lonely and fake but it's what's best for everybody.
In my case, it was stress related. I quit my job, took another job that paid more but with less stress. And everything disappeared over the course of two weeks.
I realize this doesnt work for every disease, but some are stress related.
Meditating on the essential impermanence of this body has helped to a degree. But it takes some highly exalted states to separate self from the suffering part of the body and I just don't have a lot of time nowadays to get up to those.
we mammals are good at ignoring things, too. Ignore the things you can't do, enjoy the things you can all the more. Ignore the things you can't prevent and ignore the regrets of the things you couldn't do.
No one cares about your health more than you. You must be your own advocate in how to maintain baseline health.
Also, you’ve got to reserve holiday / pto / downtime for when issues pop up. Life doesn’t go to 100% like it did before these issues.
I would not wish the pain and suffering of my daily life on anyone. Even those who are truly evil.
As for dealing with it, meditation, medication, and moderation. Also having family and friends who are supportive of you is helpful as well. I am no longer afraid of taking days off to relax and hopefully feel better the next day.
I have gotten some relief. Initially, could not walk for few weeks due to severe pain. Remote work helps. However, as long as I keep consistent eating schedule, low sugar diet, and eat clean I can my symptoms pretty mild and can do enough to feel "normal". Sometimes I do get hit with nasty tendon flair up and need to brace it. Brain fog is gone and neurological symptoms have improved.
Apparently, there have been cases of individuals recovering after 10+ years. There was a doctor who did a lot of work with people affected by FQs but he unfortunately passed away. Thankfully, surgeons and other doctors are now coming forward discussing the issues and trying to figure out how the damage can be reversed.
I think with any chronic illness diet plays a big part as when your system is down the food we eat doesn't get processed as well as we like. That is, if you eat junk/processed foods your body can't deal with the 'artificial' components as well as it can real food (no or little human interference). The side effects of poor food choices for me are lethargy and 'brain fog' along with exacerbating my body pain levels. On these days I no longer fight it and just rest. I recover much better/quicker this way rather than trying to fight through it.
Your illness can consume you at times and this can be quite depressing. Learning and practicing some type of mindful meditation can bring you back to some kind of normal, even just 10 minutes a day can make a big difference and I do notice this if I skip a day or two!
Stay well.
But it does cause me problems. What has helped me a lot is working from home. I have been doing that mainly for like ten years or more. Not having to deal with the stress of commuting and possibly getting that much more sleep and having 1 or 2 hours of extra time, is a huge deal for me. Because the biggest symptoms with my health are fatigue and needing to go to the bathroom a lot from the IBS.
But you did use the word stress. I think that is the biggest adjustment I have made compared to most people. I have deliberately reduced a lot of the causes of stress that people normally have in life. I have a greatly reduced social life. Don't own a car. I actually moved to Mexico so that I would be able to easily save money.
But the weird thing is because I have always had asthma and acid reflux (which in my adult life has really been a significant breathing issue especially at night etc.), I suspect that most people often think I am just lazy or something. Especially since those are common problems and lots of times I can operate just fine for hours. I just usually look tired and sometimes need breaks to crash out for a couple of hours. But people don't see how tired I am because I don't go out much or go on video.
I was actually hesitating to say that I have those issues. Because a lot of times they end up being fairly minor for other people with good treatment. For me, in my adult life the acid reflux has been a big deal for breathing and waking up tired and my first surgery attempt so far was not successful.
But people generally don't cut me any slack for it. And with a flexible work-from-home schedule, I don't need to ask for slack.
After a couple of months of living with diabetes I created a simple app to enter the numbers, glucose level and insulin units, involved in managing diabetes. Among other things the app showed percentage scores of how much the glucose measurements were on target. That little bit of gamification was exactly right for me. Nowadays it's more like autopilot though.
Still it feels a bit awkward when I'm out having dinner with people that don't know I have this. In the first year or so after the diagnosis I would go to the bathroom to take the glucose measurement and insulin shot. Nowadays I explain the situation and take my shot sitting at the table. So far people have been cool about it.
If yesterday you were able to wipe your own ass, but today you can't; That's what it means today. Don't dwell on the past, remind yourself of what you still can do today.
Be gentle with yourself.
I guarantee that you are beating yourself up worse then other people are.
Also, this is when your domestic support network matter the most. You are at your most vulnerable.
And one more thing, Chronic Illnesses bring all their friends. If you have one now, you will have more later. Especially if it's an auto-immune disease.
Do you own research, and be informed when you goto the doctor.
Re-evaluate your expectations as often as you need to. Remind yourself, you are not alone. Find solace with others that share your similar conditions. Be kind to yourself. Be gentle with yourself.
A good healthcare team really helps, but it's pretty rare to find in America, and even harder to keep hold on when insurers change and coverage is all over the map. Therapy helps some - I don't get much benefit from the group stuff, but one-on-ones, knowing someone actually understands and believes you is a huge boon.
I personally find no reason to not share my experience and I'm honest when I'm having a bad pain day and someone asks me how I'm doing - there's a reality that pain colors moods and decisions, so it's worth others knowing. If you can't trust your coworkers or employer not to discriminate against you for that, then you're probably working in the wrong place.
But, one day at a time is the only way you really can take it.
I have come in and out of remission over the years. Unfortunately, my case has been quite difficult to keep in remission, so I live with left-side chest pain most days. There are a wide variety of other exciting symptoms.
Before I got sick, I was a healthy person. I worked out five days a week. I traveled internationally. I ate widely. These have all become much, much harder.
So what I would say to people who are not chronically ill: it can happen to anyone. It can happen any time. All that stuff you think happens to other people, it can happen to you. I literally woke up one day in pain, and that was it. That was the end of the good part of my life. One day I was fine, the next day I was permanently not fine. I was 27. I worked very hard through my 20s thinking I had time to enjoy life. Don't put off living. This can happen to you.
On the whole, as others have said: one day at a time. You just keep going. You will not believe how much suffering you will be able to put up with and keep going. On bad days, I tell myself that I can still go for a walk. I can still watch a sunset. I can still pet a dog. Get a therapist. Talk to the therapist.
Other things that have helped me: extremely careful dietary control. Reminding myself of the hundreds of extremely more horrible diseases I don't have. A care team of doctors who I trust, having replaced the doctors I didn't trust (for instance, the first doctor I saw, who told me it was all in my head).
Chronic illness is a very hard experience. I do not recommend it.
1. Try to learn what the world knows. I've read 2 books and close to 100 scientific papers ranging from 1980 up to 2020 about the condition. This helps placing the incident as a point along the timeline. You will see how people in the past coped with it, what are the most promising treatments today, and what is coming up around the corner. Also a lot of insights into what might have caused it and what changes can be made to slow it down. Also you will most likely see that the future is bright. The medicine is full of hot upcoming things. Training t-cells to fight cancer, selectively suppressing certain pathways to turn-off auto-immune responses, healing gut bacteria to get rid of sub-clinical infections, etc.
2. Find the best doctor who takes a personal interest in your case. You should be able to go to your doctor and discuss any new development, any changes you noticed, and get a reasonable advice back. The doctor will compare your case with other persons he/she is treating and will be able to give you a lot of advice, even some anecdotal wisdom.
3. In addition to your local doctor, try identifying the leading figures that are investigating the disease across the globe. They typically attend conferences which you can find online, or write blogs on some website, or other things like that. They will also respond to emails, especially after seeing that you did your homework and know about their work.
4. If the disease is manageable - do what you can to stay healthy. Eat healthier, sleep healthier, avoid stress and excess pollution. Most diseases have some individual-specific corners to them. In this case experiment until you find what works for you.
5. For personal peace of mind, think about the big picture. Do not compare yourself with others. Rather think about what you are able to achieve for this world compared with the case of not being born at all. You will find that it is substantially better, for the world and humanity, for you to be born with the condition, than to loose you. Concentrate on that and do your part, do what you want, do what you can.
In the end I think that onset of some illness might be a hidden blessing. Someone might be healthy all life, seek pleasures too much, and waste a lot of it on hedonism. A durable yet uncomfortable disease can provide direction and a boost in motivation. And if the disease can be managed by a healthy lifestyle, chances are, you will turn out to be healthier than the average person on the street.
* It avoids getting into a negative cycle. When I feel good, I read what I wrote when I wasn't and reflect. Next time I'm feeling not well, reading how I dealt with the situation in the past helps me from dwelling on negative thoughts.
* I make notes about effective actions that help me feel better (physically and mentally) so I can take action without thinking too much.
* I write about what I want to do do in the future when I am feeling better. This helps to keep me positive and also helps me make effective use of the good times.
For context, I have to deal with eczema that can get pretty bad at times.
Today is more manageable. I improved my sleep schedule, diet, alternatives exercises, sun exposure, etc. All these actions reduced my stress levels. The funny story was that all doctors were saying "your body is extremely stressed". I didn't felt any mental stress at all.
In my opinion daily stress is strongly related to how quickly and how strong the chronic illness develops. I know it sounds cliche, but optimize to a low-stress life.
What I learned at a high level? So it turns out that if they only people you talk to are doctors, then your options will be limited. Doctors don't have time to research everything and most of them are not scientists. There are also some cases where doctors may subconsciously ignore options that may conflict with their business model. In many cases doctors will only suggest what their industry knows they won't get sued for and what insurance companies won't fight them on. In my case, I was told I would be on BP meds forever and it would only get worse with time and I could expect to not last more than a few years. Well, that was a load of BS and that came from multiple doctors at multiple hospitals. It turns out, you can de-calcisfy and de-plaque arteries and reverse damage to them. It's actually not at all difficult. I have lowered by over BP 20 points and I am still making progress.
TL;DR Read up on your issues until you know more about it than the scientists that have researched it. Take the time to learn some biology and what aspects surrounding your condition that you can control. Your body is the most important thing you own.
The best advice I got was to treat it as if I were at war. Nothing else mattered until I won the war, because if I lost, nothing would be left.
This meant I had to find a way to reverse the progression of the illness, which meant an accurate diagnosis and a cure. To do this, I used my environmental engineering background, free access to research (thanks to open access and sci-hub), ability to communicate with others in my position (thanks to social media), and ability to communicate with some of the best biochemists and doctors in the world (thanks again social media).
It took about 4 years of 60+ hour weeks studying biochemistry and anatomy. Well over 10,000 hours. And this is a conservative estimate. My ability to focus on studying was uncanny. It was survival instinct, but instead of focusing on a predator I was focusing on knowledge. I could barely think about anything else even if I tried. Entertainment became boring to me. Relationships became meaningless. I had to find a cure. This was in addition to the previous 10 years of 5-20 hour weeks studying. Part of me knew by age 18 that it was not going to end well unless I figured out what was going on, so I was always learning about my symptoms.
After all that I came to an accurate diagnosis and cure. This was not a linear process. It happened in fits and starts and I went down tangents many times. These tangents all tied together in a unified understanding once I found the root cause.
I've been pursuing treatment for almost 3 years now. Progress has been slow, but nothing short of miraculous, and I expect to make a full recovery within the next 2-5 years.
For those curious, as I always get asked this question on HN, my diagnosis is chronic mercury toxicity, and a key part of the treatment is chelation therapy with emeramide. Emeramide is currently in phase II clinical trials and will probably be approved by the FDA within 5-10 years. The right nutritional supplements, taken in the right forms, and at the right time, is also key. That, unfortunately, gets very messy and controversial, and all the chronically ill people I know spend a tremendous amount of time trying to figure this part out.
Borrowing from Sun Tzu, "know your enemy, and yourself".
Borrowing from Norman Cousins, "laugh your way to wellness".
Add to that the power of positive thinking, and those ideas helped.
It's not enough to just accept a dx, especially a life threatening one ("you have 2 to 5 years to get rid of this"); rather, in my experience, it pays to take ownership of your visitation; know all you can learn about it, and about how you are dealing with it.
Find the loopholes in your approach, and find something you can believe in; that belief, IMHO, is a component of whatever secret sauce will get you through the visitation.
In one case mentioned below, someone discovered an environmental cause - a mold. In my case, there were many other factors with which to deal; only those associated with my own behaviors and lifestyle were in my control.
I am back to dealing with a different chronic condition, using the same mindset, and recent data suggests I am on the right path. Thinking about writing a medium piece about these ideas.
For me, it's mostly diet. No alcohol, no/low dietary fats while trying to make sure I get enough B12, iron and protein as I'm anemic and my diet mostly rules out red meats now. And for pain, some codeine (or when things were/are worse, Dilaudid) or acetaminophen or ibuprofen. That's about it.
My focus is on what I have and what I want to do from here out. The initial circumstances nearly killed me, and that kind of thing is, cliche as it may be, but nevertheless, enough to alter one's perspective.
In short, mine's a case of dietary efforts to prevent an organ from failing and pain management. So I do that and get on with it, no more spinning the wheels. I feel good when I'm moving forward with something else.
Some of my thoughts have already been shared by others, but I try not to push myself as much as I used to do. I still try to do things I enjoyed before such as light exercise, taking long walks, and hanging out with friends (carefully, obviously, because of COVID). I might not go for a long bike ride, it doesn't mean I can't stay active without stressing my body beyond what would cause symptoms to flare.
The more I can keep my mind of symptoms by working, spending time with family and friends, and moving around, the less depressed I am.
I also try to educate myself on my condition/symptoms. I try not to diagnose myself or come to solid conclusions. However, I feel like having a greater knowledge of anatomy and physiology with regard to my situation aids in asking appropriate questions to my physicians and understanding their feedback.
Just get through one day at a time like someone else said. And look forward to the sweet sweet embrace of death. At least that is what my wife says.
I had terrible issues with acne on my back and shoulders. They were terrible, painful, constantly being inflamed, bleeding all around. I couldn't imagine wearing a white shirt, going to the beach, pool, scars showing with short slieved shirts. People actually asked me what's wrong with me, some thinking I was self injuring myself with cigarettea. Doctors described it as one of the worst cases they seen, recommended all sorts of medicine (some doing more damage than good). Spent a fortune treating them and years.
At one point I embraced them. It's me, I stopped being caring. And they went... Psychotherapy probably helped, although I went because of completely different reasons.
I wouldn't write this, but replace acne with ulcerative coalitis, and you have my good friend's story...
I've learned to cope with it in hundreds of ways, just like people cope with their career in hundreds of ways, or their kids, or their marriage. It's a central faucet of my life. It's destructive as hell to shove it aside and try to "forget about" all the small, daily issues.
So I've learned to co-exist with it by doing the following:
--Like another poster mentioned, pay attention to the little things. Sleep, exercise, diet, stress levels. Treat your body like a spoiled little princess, and it'll be less likely to throw a fit.
--Stay away from online "support groups" for chronic illness. 99% of them are toxic as hell, especially the "spoonie" community. Instead, seek out people who have chronic illness and are living the sort of life you want. Develop individual friendships with them, and learn from them.
--Educate the people around you. The stigma of chronic illness is generally less than the stigma of "that person who you can sometimes depend on, but then randomly blows deadlines, and appears to be hungover all the time."
If you're in a safe environment, talk to your boss. Talk to your coworkers. Tell them what's up, don't leave them guessing, because they're not going to guess something you like.
If you're not in a safe environment, GTFO as soon as possible, salary be damned.
--Educate yourself as well. Not knowing is the most stressful thing, and you can mitigate a lot of that stress by developing more knowledge of your disease. Try to avoid anecdotal evidence (random forum posts, ect), and stick to respected journals and textbooks.
--Advocate for yourself. I was misdiagnosed six times before they finally figured out my issue. If I hadn't demanded further testing, I would most likely be dead at the moment. (This is another area where educating yourself really pays off.)
--Choose a supportive partner. If they treat you like a hypochondriac, or aren't sympathetic to your issues, then get out.
(On a similar note, don't believe anyone who says chronic illness kills any hope of relationships. I have a fantastic partner, and have many chronically ill friends who do as well.)
--Keep a detailed diary of your symptoms and your daily activities, even when you're feeling good. This will help you figure out what helps, what doesn't, and what your tolerance levels are for activities, exercise, medications, ect.
--Stay on top of medical developments related to your disease, and reach out to any trials that may benefit you.
I could add a hundred other things to this list, but I think those are the important ones.
So yeah. Keep fighting the good fight. Again, and again, and again, and again.
(Edit: Took out some identifying info.)
In the process of switching medications every six months for four years now, with everything working well then fading (the body can work around immuno-modifiers... grr), and my wife's determination to get me to Find A Solution... I've learned to accept that I may never have 100% relief.
Having most of my mobility and only some small bone growths at this point is my current normal, and I understand that I can't control whether it stays at this level or progresses.
(Using the word 'progresses' instead of more negative variants actually helps my frame of mind as well.)
Life is just adjusting to what is and what might be and being grateful for now.
I had surgery and I am basically living a normal life, I didn't have symptoms until I was about 25 years old. The thing is it made me lactose intolerant and very sensitive against sleep deprivation.
What basically happens is stomach pains from time to time and that I need to visit the bathroom quite often, sometimes in a big hurry.
I'm living basically as before, eating too much lactose still and getting too little sleep. I am starting to get better on it though.
Get enough sleep is a big point in general I believe if you want to your body to be healthy. Also eat healthy and move a lot. I have a standing desk and tries to stand most of the day. It helps a lot.
Because I know when the bad days come (sometimes more often than good), I'm going to have to take a break and sometimes see my productivity plummet to nothing.
I am also writing a book, collecting my sarcastic thoughts on my particular illness: https://leanpub.com/you-only-have-crohns-once — I find that one outlet I have is pretty heavy (but friendly) sarcasm, when I'm stuck in a hospital, doing testing, etc., and I like to write and share in hopes someone else can have a laugh at their own situation.
I remember to push myself on the bad days, it's too easy to avoid painful joint positions, which just makes things worse in the long run.
It's terrible to get flareups, but medication and pre-emptive tactics work. So I drank a lot of water, and just have to feel my body. Used to be my left toe at first, but then it started to spread.
You need to make headspace for 'self care' as a category of activity, one you not only give yourself permission to pursue, but expect of yourself. One of the best comparisons I've heard is the oxygen mask instructions on an airplane. It's foolish to help other people when you haven't helped yourself. You just end up killing yourself by prioritizing expectations of others over your own health. If you do it right, you can often accomplish both.
I'm quick to admit my limitations with people. I own the potential lifespan issues, and view my financial plans accordingly.
I've focused on freelance, for flexibility in doing treatments, etc. I have actually been at my current role for years, but that came out of a freelance project, and it's a small company where I have a great relationship with everyone, so I have as much freedom as I need. I wouldn't trade that for a hot startup or a FAANG job.
I hire people as necessary to help me do things around the house, etc.
I'm fairly upfront with how I'm feeling and what's going on. I even did a Zoom call with a client from my hospital bed one time.
It's hard. You have to go through pain, fear and disappointment but at the same time going through all that is a testament of your strength and gives you a unique perspective around life and experience in general.
That's on a more personal perspective based on how I managed to deal with the psychological effects of something similar. The current thread has some great advice on many other aspects of dealing with it.
I had a super rare form of gluten intolerance that caused problems all my life. Was only picked up in my 30ies. Made a difference like day and night. I wonder what I could have achieved if it had been picked up earlier.
As for living with the illness. You need to find a doctor that you can work with. There will be tough times and you need someone you can trust and reach 24/7 when things go south (which they do from time to time in my case). Also, without counselling I wouldn't be here today. Your career is impacted, your family life is impacted, your sex life is impacted. I needed someone to talk to and that someone had to be outside my social circle. I had 3 sessions per week for the first months, now I go once a week. It helps.
Also, people will get upset for different reasons. Your friends, family co-workers etc. Counselling helps, but most of the time it's still hard to tolerate and accept the pain and the anger. Most of the time I'm managing their expectations, not mine.
Some people mentioned good diet, sleep, no alcohol. This is the absolute baseline. If you have serious chronic disease, you cannot afford any of these luxuries. For every mistake you make, you and someone else will have to compensate. Discipline is key.
That being said, I still have a very fulfilling life. I go on vacations, see my friends (or rather most of the time they come over and visit), have some form of a career, have a loving partner and we're planning on having children. Life is good even if it's not like I imagined it 5 years ago.
kidding, of course one is finding the humor in things
reminds me of that guy who said that in life even if we're forced to deal with the cards we're dealt with, bluffing is and always an option
sympathy is the last thing i'd want from the people i care about, i'd rather give them a good time as long as i can since they can cry their asses all the way once i'm gone anyways
Given how tech-focused HN is, I'd reckon RSIs to be quite common.
Your response to chronic disease depends on your personality. Being stoic by nature, with strong background in sports I refused to accept I was disabled. I would not decline friends invites to play sports, even though I had to take a bunch of advil to last an hour of soccer. I wouldn't slow down on air travel, even though I spent half the flight in the bathroom where I could take a pose with less back pain. I had no empathy for myself and was refusing my condition. I regret that period and think it actually made me and my condition worse.
At about year 7, I started to accept my new, limited by back pain, self. I told my friends that I have the condition. It allowed me to vent periodically. Or make odd requests like asking to sit on side seat at a brunch table, so I can take frequent walks. I reorganized our house to be more forgiving for a back pain sufferer (basically moved everything I ever needed from the floor to waist level, so I didn't have to bend). Started taking days off work just to rest. Told my coworkers that I needed to adjust schedule because of the "back pain thing". I allowed myself to talk about it, vent about it and complain about I had a particularly bad day.
In the following years I was in more pain than before, but I actually felt better. I felt like I was accomplishing things I wanted and that my situation was just different, not hopeless. It no longer felt like I was disabled, but rather that I had a "thing". Everyone has their own: someone is taller, someone's brother beat them up, someone has a limp from a car accident, others grew up in poverty. It doesn't make them better or worse, it makes them who they are. My thing was that I had back pain. And it required me to make behavior changes to live a fulfilling life.
My advice is to evaluate your feelings to your condition and to yourself with the condition. Have you accepted it? Do you accept the new normal for yourself? Are your ok that some behaviors and experiences are out of reach? If the answer is "no" to any of these, finding peace with your new self should be the focus. It's not going to happen overnight, but it also won't happen without reminders and deliberate work.
When you have accepted the new normal, your happiness tank would start to refill with new experiences. The road ahead would not be easy by any means, but you would have the strength to walk it.
At 19, I was diagnosed with Barrett's Esophagus, which is when you've had heartburn so much that the lining of your esophagus starts to mutate as a protective measure and develops cells similar to the lining of your stomach. The cell mutations make you predisposed to developing esophageal cancer, so I have to get it biopsied every year or two to keep an eye on it. Rarely fatal, but also usually diagnosed after the age of 50, when there are other age-related issues that are more likely to get you first. And you basically have to take a super high dose of heartburn medication forever (which doesn't fix it, but prevents it from getting worse), which causes it's own issues.
A few years after that, central sleep apnea[2]. Which is a neurological form of sleep apnea, where your brain just randomly decides to stop telling your body to breath. It's not due to physical obstructions like obstructive sleep apnea, so very little you can do to improve things.
Also in the interim, I was diagnosed with a urethral stricture[3]. Which is where scar tissue in your urethra cause a blockage and prevent you from being able to urinate. Scar tissue never really stops growing, so periodically I have to have a surgery to remove the scar tissue that's built up, wear a catheter for a few weeks for new scar tissue to grow, and then wait until it gets bad enough to necessitate another surgery.
All three of them are chronic, albeit not terminal. Although the first one makes you pre-disposed to esophageal cancer, which doesn't exactly have the best survival rate. Dwelling on any of it can be overwhelming, so eventually I just stopped doing that. It is what it is, all you can do is accept it and move on. From a practical standpoint, it just means:
- Substantial budgeting for healthcare. Although I can time it to an extent to optimize things, I'm looking at a minimum of $10-15k every three year cycle in recurring costs even while everything is relatively stable.
- All three of the above were discovered incidentally, rather than deliberately. Two of which happened to be followups to specialists after (unrelated) visits to the ER, and one due to a sleep study I did myself.
- I no longer trust PCPs, due to the above. I had voiced concerns/issues around symptoms for all of the above over many years, and my PCPs had never taken them seriously enough to truly look into the root causes of any of my concerns. I also have a form of eczema that presented atypically, which my PCP basically ignored for ~3 years before I insisted on seeing a dermatologist. Dermatologist couldn't actually tell what it was, but was wayyy more concerned when seeing it as it presented similarly to skin cancer. Turned out to not be, but took a biopsy to confirm. The fact that two different PCPs never felt the same level of concern was mildly irritating and frustrating after the fact. So I'm now far more likely to actively participate in my doctor visits, taking what they say under advisement but following up with my own research and being more insistent on diagnostic tests and referrals. I'm sure my doctors see me as a hypochondriac, but I'd rather have excessive diagnostics and potentially annoy my PCP rather than be surprised by another unlikely but easily tested for issue.
At the end of the day though, it is what it is and I can't do anything about it. And the only real way to manage the stress is to pragmatically accept that and not dwell any more than you have to on it. If anything progresses and gets worse I'll deal with that when it comes, and otherwise I'm not going to let the specter of those possibilities put a damper on things before that.
[1] https://www.mayoclinic.org/diseases-conditions/barretts-esop...
[2] https://www.mayoclinic.org/diseases-conditions/central-sleep...
[3] https://www.urologyhealth.org/urologic-conditions/urethral-s...
More advanced / things that might require help: blood work, therapy, medication.
Sleep: Many chronic conditions are exacerbated by lack of sleep. There's been a general push for better quality sleep lately, but I still feel like we're not placing enough importance on sleep. Without good sleep, your diet and exercise won't be anywhere near as effective. Some easy wins: blackout shades, white noise machine, avoid blue light in the evening, and find a consistent bed / wake time.
Diet: Your mental and physical well being is a rolling average of the things you eat. Cheat days are fine; cheat weeks are not. A lot of chronic conditions come from inflammation, which can largely be improved by eating smaller meals with more colors in them (for most people). We’re only just discovering how important a healthy microbiome is for both physical and mental health. Eat more things that have or had roots. Eat less red meat. Find a good probiotic. HYDRATE. Most people don’t drink nearly enough water—so many issues disappear when you get enough water. Easy wins: use spices, avoid fried food, consider intermittent fasting (good for inflammation) if your doctor is okay with it.
Exercise: I hardly do it for physical reasons (though they are very positive), but instead for chemical reasons. Exercise is very important for your brain, and to flush toxins. I play soccer and lift weights, but you might find something else that you enjoy. Getting your body moving can make a very big difference with chronic conditions. Get the lungs and blood pumping. Easy wins: go for a walk after eating, do 10 pushups + squats + situps after a Zoom call or when you finish a task.
Reflect: Whether you do a 5-minute journal, transcendental meditation, 'Getting Thing Done', or whatever system is popular today... give yourself time to zero out your “stress box” the same way people zero out their email inbox. I personally enjoy using an infrared sauna several times a week—30-45min of uninterrupted time to let my thoughts go. An adrenal system that is constantly bombarded by stress causes so many of the chronic diseases that people suffer from (such as my own thyroid). The more you learn to de-stress, the better you become at detecting when you feel mentally or physically stressed. It takes time. Easy wins: schedule time to unwind on a consistent basis, learn some simple breathing techniques (here is a good one: https://www.youtube.com/watch?v=6FyE3VOWJI0 ), find a ritual you enjoy.
Bloodwork, therapy, medication: it helps to have a few thorough blood panels done so you can get a good idea about where your body needs some assistance. Chronic illness doesn’t always manifest itself the same way in everyone. If you can afford it, find a doctor who charges per unit of time and not per visit; they will be better able to properly listen to your problems and work towards fixing the cause of the problem rather than just the symptoms. Just as a chronic illness doesn’t mean you’re broken, medication also won’t fix you. It takes time to figure things out and adjust your lifestyle.
Chronic illness can be very stressful, and sometimes people might tell you there’s nothing wrong with you even though you have the deep sensation that something is. Consider seeing a therapist. Doesn’t necessarily need to be for psychological reasons. I personally visit a physical therapist 2-3 times a month as a way to better understand how my body is feeling and where I can make improvements over time. Being receptive to help is a big first step for many people.
What I do:
1. Identify what triggers it.
Doctors don't know what to tell me apart from "take these pills / shots" as it is unique to every individual. However from trial and error I have found these key triggers: lack of sleep, lack of exercise, certain food choices, excessive alcohol, stress. Small slip ups on any off these are fine, but continual abuse over periods of days / weeks and it will flare up again. Nearly every flareup since I worked these things out can be traced back to a change in life patterns. Moving house, going on holidays, start of Covid (and closure of the gyms) etc. I've worked out the triggers and now I need to address them, which is easier said than done over a timespan of years.
Note for anyone who has a friend / family member with it: Initially, I tried everything under the sun with a possibility of working, and the only thing to fix things up were the drugs. Now I can manage drug free, but all those methods did sweet F-all until it was controlled with drugs (but every case is different). Send them a link to whatever method you want, and then never bring it up again. It shocked me how many people who thought they were doctors came out of the woodworks offering me crackpot theories and then were offended when either I didn't do it or it didn't work (oh you weren't strict enough, you didn't give it long enough). For everyone's sake, provide the information then shut up.
2. Address the triggers.
Food: Avoid overconsumption of dairy, wheat, sugar, alcohol (wine / beer are a lot worse than spirits, white spirits are the go to although I don't like them). A bit here and there is fine and in a normal week I'll have all of them, but it is when you are chaining days of them and they dominate your diet it becomes bad. Also avoid overeating in one sitting, as putting your stomach at max capacity seems to also be a trigger.
Sleep is obvious. Min of 8 hours, 8.5-9 daily is best
Exercise frequently, at least 3x a week. Cardio is ok, but it seems weight training helps the most. Of the list I feel this is the most infrequently mentioned by others, but has helped me a ton.
Stress: I deliberately took a job with a company that had a reputation of respecting work life balance. It is still a demanding environment, but you can choose how hard to push yourself. I try to keep to an 8 hour day but maximise how much I do in that time, and completely switch off after. I turned down a FAANG offer to work here, assuming I would be trading career / financial success for lower stress, but it has turned out better on all fronts (career, pay, stress) which was a nice bonus.
3. Plan ahead
Although I have it under control, I definitely feel like I have a lot less energy than my friends. I just feel my body using my energy reserves to constantly fight this thing and it is fatiguing, and is getting slightly worse every year. I don't want to be working when I'm 60, and have no idea if disaster will strike earlier.
Financially I'm focused on getting to a point where I can retire in around 10 years time, FIRE style. I love my work and plan to keep doing it whilst I still love it, but I need that backup plan covered. Previously I have had to take long periods off to rest up and heal, and during that time I did nothing remotely work related, didn't write a single line of code. I need to be prepared for that happening again.
Plan B is company stock options paying off which is looking more probably than not in ~4 years or so, and would make retirement more comfortable, but I'm not banking on a plan B.
4. Give up control
Control everything you can, and be indifferent to everything you can't. I wasted so much energy early on being angry about how things were, rather than using that energy to fix what I could. Easier said than done however.
5. (Bonus point) Get off the internet
Back when I was diagnosed I found various different groups online that I thought would be good to get some answers and see what other peoples experiences are like. Bad move. They are like news channels, reporting mainly the bad side of the experiences. Don't let your disease consume your life, let alone other people's experience of it.
That's all the advice I have. Bit late in the thread to be commenting, but hopefully a braindump will help someone.
For my SO, it's a day-to-day thing. Sometimes it goes down to minute-to-minute. But there is always another minute and another day with less pain. Keeping focused on the good days seems to help my SO.
Spirituality and religion have had mixed success. Spirituality has helped more than religion, so to speak. Organized religion may be good for some, but we have not had luck in finding a community that helps my SO. Church folks kinda get gossipy and start expecting things of my SO that my SO can't provide during painful times.
Love and support from friends and family have been essential to my SO. Limiting contact with family that is non-supportive has been good. Surprisingly, covid-time has been a boon on this front. Find people that actually support you and be quick to limit contact with unsupportive people.
Staying up to date on the latest medical new has been mixed. One can obsess over the newest studies. So we try to look into it about once avery 2-3 months for anything new.
Support groups have mostly been a wash. Online groups tend to be mostly people that are new to the disease. Over time they come to accept the diagnosis and the restrictions on life that come with the disease. But it can be tiring trying to help people still in denial. They also tended to become ... well ... suicide pacts, at least with my SO's disease. Keeping a good eye on your media consumption is essential.
Real Life support groups are hard to find as my SO's disease is pretty rare. We've gone to support groups for related diseases and those did help my SO. But as they were for a related disease and not my SO's, they were of limited utility outside of human connection.
Life expectations have been readjusted. It's not an easy process, and you need to give it the proper time to grieve. The grieving process takes as long as it takes, but you must take it. Finding new goals and dreams in your life is an important part of this. These goals must be meaningful and achievable to you for them to be effective. It's really hard to meet both criteria if you've not finished mourning your past conception of your life.
I'd be happy to answer any other questions as well. Good idea on reaching out and trying to get some help. I know that is a tough step to take. Your courage to do so is inspiring!
In general, my SO takes every day as it comes and we have to accept the realities of our lives as they are. It's not easy, but it's a lot easier with friends and family.
Switch to elimination diet to see if it changes anything (eg. Oxolate-free diets seem to help in quite a few illnesses)
This is advice for people that make it out of their critical treatment phase and now must manage the rest of their life with the aftermath.