Wednesday, July 23, 2008

Invisible Illness Part 2: What NOT To Say

A woman that I met through the Dysautonomia Information Network (dinet) has a great explanation of things that can be difficult for people with severe chronic illnesses to hear. I received this list from Melissa Mambort, aka Sunfish, who also has autonomic dysfunction (severe progressive autonomic neuropathy). She has a great website on which she shares many of her struggles and ideas at http://www.freewebs.com/sunfishoutofwater/adayinthelife.htm.

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A few things NOT to say/ask (pretty please?)

I realize that 99.9% of the time the things I'm going to list are NOT said with any malintent. People may simply be trying to make conversation in a difficult situation.

I am posting this to let people in to a bit of my world. To raise a bit of awareness and educate people about how certain things that may seem benign can actually sound on the receiving end.

Here goes:

1. "Are you feeling better?" When asked generally, this question is particularly tough for me. Because my reality is that I don't even know what it means to feel "better." If asked in the context of something specific, i.e. a recent hospital stay, a particularly bad day, a certain situation, etc. that's entirely different and fairly easily answered, but often it's asked in a general sense because people want to hear me say "yes." I would LOVE to say "yes" and have that be the truth. But that's not the truth and after years of decline and it's not likely to be anytime soon, if at all. If I were better I wouldn't have had to stop working, stop even part-time school, move in with my parents, etc. You get the idea. But trust me...if "better" enters into the picture, I will be shouting it from the rooftops.

2. "Stay positive/ hopeful, things will get better..." Most people who know me well tend to say I'm a pretty positive and hopeful person. I'm also stubborn & determined & have thrown in some denial over the years to keep going at times when my body has vehemently protested. I will never give up hope of improvement(s) - however small or large - whether via medical treatment or a miracle. I wholeheartedly believe that anything is possible. But my current reality is that there aren't any promising treatments on the horizon for my overall health. And to be truthful thinking on a daily basis that things will get better when it is very possible that they won't is more difficult than trying to move forward as best as possible within the actual limitations of my body.

3. "I know exactly how you feel (regarding fatigue, nausea, moving home, etc.)" Whether in the context of chronic illness or anything else this is dangerous territory. There are many realms wherein I would have no place saying this to another. And, however well intentioned, it's a hard thing to hear when one knows full well that it's not true. The few people who really can say this to me in my life because they have in fact been where I am in some way are precious, but the reality is - thankfully - that most people haven't been. Because being fatigued, even if from illness that is more short-term, isn't the same as being fatigued all the time. Having a stomach bug that limits food for a few days isn't the same as not being able to eat at all for months on end. And moving in with parents for various other reasons isn't the same as moving in because of not physically being able to live alone any longer. So while empathy can be a great thing, the good intention can end up hurting more than helping when the comparison isn't really comparable.

4. "It must be great to not have any schedule/ commitments" It IS great when normally one's schedule is packed and it's for a weekend or even a few weeks. But it is NOT great when it's because it is physically impossible to keep a schedule or honor commitments. I would love to be able to know that I can do anything at all in a given day much less schedule anything and feel confident that I would be able to be there.

5. "I wish I could sleep/ rest that much" Much along the same lines as the above sentiment, it's a situation of something being a choice or a luxury rather than it being a mandate. Excessive rest and/or sleep isn't enjoyable when the body refuses to do anything else.

6. "Are you glad to be home?"/ "It must be great to be back home" This issue is a double-edged sword. As I wrote a bit about in the update about the move (10/30/06), it's in truth very difficult. I am very thankful to have a place to come home to. It is a safer place to be in the midst of ever-evolving medical sagas. And since we've known the move had to happen it's good to have it behind us rather than looming ahead. But that doesn't make it great or something that I can get excited about. I'm almost 27 and had lived on my own for over nine years. I never could have imagined moving back in with my parents. Coming home to visit is one thing but moving in indefinitely because I physically can no longer live alone is entirely different and more than a little difficult.

7. "You don't look sick" To be honest I'm thrilled that I don't look as bad as I often feel. There are times when I don't look well at all but most of the time - if I'm sitting or lying down & you can't see my IV lines - I don't look sick. But hearing "you don't look sick" can feel like doubt or disbelief when the reality is that no matter how good I look, I am.

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The comments from Melissa's list that have been most difficult for me are #3, 4, and 5. I had a few people saying that it must be nice to have a “vacation” and sleep and rest. One said that now I could be a "Lady of Leisure". Another friend had someone say it must be nice to stay home and “eat bonbons all day”. Wow. Is it nice to be able to sleep when you have the flu? No. Is it nice to not be able to stand or walk or drive? NO. Is it nice to be forced to stay home when the only thing you want to do is work? NO. So of course it isn’t nice, it’s terrible. Thankfully, most people weren’t that insensitive and realized how difficult it must be to be that sick.

So, does this mean that we don’t ever want to talk about our illness or how we’re feeling? Not at all. It is a huge portion of our lives that cannot be ignored. It is fine to ask how we have been feeling or how our doctor’s appointments are going or what we’re up to during the day. In fact, we appreciate that. What we don’t like is people acting like if we have a day where we are not close to comatose then we are all better, or thinking that they understand how we feel. No one who hasn’t had their life completely taken away by illness can understand what we are going through. BUT, don’t be discouraged or scared about what you say every time you are near a sick person. If you truly care about and love that person, they will understand what you are trying to say. Just try to apply a version of the golden rule: If I were in that person’s shoes, what would I want to (or not to) hear?

7 comments:

Anonymous said...

After being diagnosed with Multiple Sclerosis 12 years ago I found it very difficult to tell people. However, after my husband and I had a month to try to cope with the news, I told my family and a few friends. Everyone was very concerned. However, someone asked me if I thought my children could get "it". At the time, my kids were 7 and 10. My facial expression must have been, "Oh my God, I never thought of that." Now I have to worry about their health as well as my own. I was devastated. That was probably the most disturbing question I have ever been asked. So don't ask if the children could get "it".

icesktr189 said...
This comment has been removed by the author.
icesktr189 said...

i can truely say i know exactly how you feel. i too have POTS and orthostatic hypotesion. I dont work or go to school and im not allowed to drive. The most frustrating thing with me is when im telling my mom how im not feeling well at all and she basically turns it into her ordeal by saying yeah i have low blood pressure too. im not looking for pity but gosh im tired of people telling me to have a positive outlook or to be stronger than it. my only answer is that if they could have it for just ONE day they would realize.

icesktr189 said...
This comment has been removed by the author.
icesktr189 said...

i can truely say i know exactly how you feel. i too have POTS and orthostatic hypotesion. I dont work or go to school and im not allowed to drive. The most frustrating thing with me is when im telling my mom how im not feeling well at all and she basically turns it into her ordeal by saying yeah i have low blood pressure too. im not looking for pity but gosh im tired of people telling me to have a positive outlook or to be stronger than it. my only answer is that if they could have it for just ONE day they would realize.

Lauren Butare-Smith, DVM said...

Thank you so much for your comment iceskr189. I know how hard it can be to have people not understand what you are going through. Since you have POTS, if you haven't already, make sure to join the forums on dinet.org and ndrf.com. It can be so helpful to talk to others dealing with the same kind of problems. Please feel free to send me a personal email as well if you want to talk (lmbutare@hotmail.com). If your Mom is having trouble understanding what you are going through, you may want to try showing her the posts to see if that helps her. I think a lot of people don't even realize how much little things can hurt. Thanks again for posting your comment and i hope we can get in touch.

Lauren

Michelle Roger said...

I feel it too. No POTS for me just severe dysautonomia for 3 yrs (I'm sure I'll get a label eventually at the moment my docs think I may be my own disease, woo hoo). People without chronic illness don't get it and often say offensive things without meaning it. "Stay positive" "Don't stress", "they'll find an answer don't give up". "but you look so good". I to am positive but I am also realistic and I know I am getting worse not better, that my doc's are at the end of their knowledge. I'm at a place where I can cope with that and although I still have to think about it because it's in my face I can also put it aside when I need to. I wish it was stress, I'd take a valium and the blood would instantly flow from my purple feet to my brain! I think many comments stem from their own stress and their inability to understand that our lifestyle changes are not a choice. Oh well what can you do. I now surround myself with people who understand, I paint, and blog for myself and 12 More Pages. You have to find a way to not let the comments get to you but it can be hard some days.

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Tubby
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