anxiety

Hail

I self-soothed myself through the hailstorm last night, which, given my heightened nighttime anxiety and PTSD, I consider a notable win. I woke suddenly as it pelleted on the roof and ricocheted off the air conditioner jutting out from the window. The pinging and clanging was jarring and so unfamiliar that I was unable to categorize the noise as a weather-related anomaly, let alone specifically identify it as hail. I tucked into a ball, hugging my knees to my chest and listened. My frantic mind feared combat, an attack from an enemy, some sort of dangerous monstrosity. My muscles tightened and the inside of my closed eyelids flashed a fury of alarming reds and oranges as if staring into the rotating siren light of an emergency response vehicle. I fought the panic by trying to conjure up peaceful images and relax my muscles with each successive exhalation, employing progressive muscle relaxation techniques I’ve been practicing every morning. The sounds only got more disruptive and bewildering and although I was able to harness my worries and prevent continued escalation, I remained engrossed in concern, perched on the precipitous of sympathetic fight-or-flight.

One issue with auditory processing attributable to SPD is a pervasive difficulty in locating the origin of a sound. I can hear everything just fine; in fact, I have an extremely keen sense of hearing, but I often am unable to identify what the noise is or even what direction it’s coming from. This greatly complicates my ability identify and classify the sound, which heightens my anxiety because it’s not clearly evident if it’s innocuous or dangerous. (When in doubt, my brain errs on the side of caution and assumes danger.)

Last night, as the erratic banging continued, I pulled out my phone to try and put on a calming video for more engaging distraction. I noticed the alert on my weather app and quickly discovered that we were amid a hailstorm. Crisis averted.

I am much too light of a sleeper to sink back into sleep while the racket continued, so I relaxed and watched my show until the torrent was over and the more gentle rain lulled me back to sleep. A year ago, this type of unprecedented and unusual calamity would have sent me into an inconsolable tailspin. Even if I had rationally deduced the cause of the noise was innocuous as hail, it would have been nearly impossible to quell the initial panic and calm myself back to sleep. The hopes for additional rest would have been abandoned with the first weakening pitter-patter. The remaining hours of night would have been spent remembering the jarring noise, the resultant uneasiness, and the range of possible (and impossible) dangerous sources that could have generated such terror.

But not last night! Last night was evidence of my improved self-control, command over my previously-unbridled anxiety, and coping tools to manage startling situations.

Update on the Foot Saga

There are conflicting opinions about my foot. The doctor I’ve been seeing since February about it thinks it has not healed at all. Last Monday, in what can only be described as a bizarre and upsetting appointment, he told my husband and me that there is no evidence of healing and that surgery now is no longer an option. It was as if he was completely reneging on his prior assertions that surgery would be the only way to get it to heal, now he was saying because there was no healing, he was not going to do surgery. This paradox and contradiction completely confused both of us. Ben took the mature higher road and tried to ask very basic clarifying questions to ensure we understood his flip-flopped opinion. I sat there melting down with tears and sobs fretting that “I’ll be in a boot until I’m 40!” The surgeon completely ignored me and only shrugged at my husband’s questions. Ben, seeing that I was unraveling, said, “yeah so I mean if it doesn’t heal in another year or two you still wouldn’t do surgery to fix it?” He stopped shrugging, paused, then said, “maybe after another year.” Then he said he’d see us in another eight weeks and walked out.

Like a barnacle on a sea rock, I clung to Ben and wailed about my frustrations and that the doctor didn’t want to help me. Although my response was emotionally over-dramatic, the stress of the appointment, diabolical nature of the doctor, and his unwillingness to answer our straightforward questions met at an overwhelming head. Even calm, cool, and virtually unperturbable Ben said, “this guy isn’t our doctor. He wouldn’t even explain anything.” Then like a mother duckling, he led me out of the office, trailing behind in residual sniffles and tears.

I spent the rest of that afternoon trying again to find other viable specialist in the area. I made a couple of appointments and tried to table my anxiety and frustration for the rest of the day. Not easy. As usual, I could barely sleep.

I received a phone call from one of the offices I had contacted by Tuesday afternoon. She had a cancellation on Friday in Connecticut, a distance I felt reluctant (but able) to drive. Friday, I drove myself down and met with the new doctor. He had a vastly different opinion and equally different mannerisms. He took the time to explain things to me, actually evaluated my foot with clinical tests instead of solely relating on imaging reports, and a contrary treatment plan. “It’s basically healed,” he asserted. “There’s still some residual swelling in and around the bone but it’s essentially undetectable.” He encouraged me to start weaning out of the boot and resuming low level activities. He even said he thinks I could be back to running within a month, quite a contrast to the other surgeon’s prognosis which was, I wouldn’t be running again for a year or so, if at all. After all, he didn’t think running was a healthy activity for anyone. Armed with a more optimistic prognosis, I headed home in much better spirits.

Unfortunately, that night while lying in bed, my foot had a more pronounced ache than normal. I had not even removed the boot for walking yet and it already seemed worse. As anxiety consumed my thoughts, we called the answering service (something I never do). To my pleasant surprise, the operator connected us with the doctor right away who assured me this is somewhat normal because he “really firmly manipulated it to assess the function and clinical symptoms.” He recommended icing it, taking anti-inflammatories, and keeping it in the boot the next three days and then resuming his purported plan. This made sense to me since we did do aggressive assessments after the conservative evaluation revealed nothing painful or abnormal. With the connective tissue disorder I have, it’s also normal to have tendon and ligament dysfunction coupled with extremely tight muscles, so he hypothesized that some of the calf raises and foot mobility against resistance had merely aggravated my muscles and tendons in the area.

I am optimistic about the treatment, care, and plan and delivered by the new doctor, but at the same time, my hesitation to remove the boat and start walking is rational. Not only has it taken so long to get to this precarious point of potentially healing, but the blatantly contradictory advice begs the question as to who is right and whom to trust. The answer lies within me. It is my responsibility and within my control to carry out whatever I deem best. It’s my foot and I’m the one who is experiencing the injury. More so than ever, I must listen to my body and pay close attention to my symptoms and needs. I plan to try carefully weaning out of the boot as instructed all while directly focused attention toward the area to monitor the physical response. I must strike an informed balance between heeding caution and restraining my anxiety so it doesn’t pollute my assessment. I pray that it has healed and can handle incrementally more sneaker time, but I am mentally prepared to dial it back if need be. This entire injury has been one of the most trying exercises of patience, maintaining faith and hope, and discipline. There have been more than many moments where I was ceded that I’d never walk again, let alone run. The future is still enshrouded in mystery, but the ominous gray cloud that used to conceal the bleak outlook portended, now looks lighter and brighter. My fears and worries are not gone, but they are better balanced by optimistic hopes for restored function, painless miles, and endless smiles.

Am I Safe? Are You Harmless?

Yesterday, at urgent care, I had my first trauma-related mini panic attack in a long time. It used to be a disturbingly frequent problem but with therapy, time, and courage, I’ve started regaining trust in men. I’m now able to make a critical distinction: not all men are likely perpetrators of rape or attack. Most men, like most women, are good people trying their best to lead honorable and meaningful lives (or at least not criminal ones). My attacker was the exception to the rule, not the rule itself. After the attack, I feared every man, even ones I knew (except a handful of close friends or relatives). As such, any time I was in close proximity to a man, especially in secluded or isolated environments, I’d panic. My brain would flood with worries: would he touch me, hurt me, have a knife or weapon on his person, hate me for some unknown reason or have some other motive? Was he getting too close to my body? Was there an exit close by? Physical symptoms would mount just as rapidly in tandem with my spiraling thoughts, racing heart, dizziness, a feeling of facial flushing then rapid draining of color, whispers of nausea building to overwhelming sickness. Worse, as if erasing the months passed since the trauma, I’d feel physical reminders of the wounds I had suffered, as if still etched in gaping scabs and swollen bruises on my skin. Even when I’d have flashbacks while doing everyday activities like driving, sitting in class, or grocery shopping, I’d re-feel pain from the injuries I suffered during the attack sort of like when you see a graphic scene in a movie or real life when someone incurs a serious injury and for a fleeting second, you grab that same body part on your own body as if recoiling in reactive pain and verifying your body is fine.

Anyway, for the first year after the attack, any encounter with an unfamiliar man catapulted me into panic or flashbacks. The reaction was so automatic and so dramatic that I found it very limiting. I never wanted to find myself in a situation where I’d be one-in-one with a man or the only woman in a group. So, I stayed home. I avoided asking my male professors in my graduate program any questions during their office hours or while my peers were filing out of class, even if I was clueless about assignments or concepts. Email was my only vehicle of communication. I couldn’t risk it. (Surprisingly, a number of my professors turned out to be instrumental in helping me defeat this crippling anxiety by, of course, being so friendly and harmless.)

Eventually, I got over it by slowly loosening my grasp and gradually letting the fear slip away, by taking small, manageable steps at first, restoring some confidence, amassing successfully safe interactions, and continually trying to expand the “risks” I took to conquer more and more normal situations.

Yesterday, my encounter with the x-ray tech caused all the anxious feelings to flood back in and swell to a critical mass in my brain. With the door shut behind me, I felt mildly nervous, but with all my injuries in the past couple of years, it was certainly not my first time post-attack in a closed room with a male technician; I can think of at least five this year already! Perhaps it was slightly more anxiety-provoking because I had on a gown with no pants or underwear. I don’t know if this is inappropriate to admit or helpful to those with SPD but I can’t wear underwear. I’ve tried every kind imaginable and nothing is comfortable. Like socks, something seamless may first seem tolerable, but then suddenly, it becomes a screaming impossibility to handle. I’ve been known to stop dead in my tracks while out and about and frantically rip my shoes off to peel away my socks when the sensory threshold is surpassed. I rarely see it coming, but even in January, among the icy sidewalks carved into knee-high banks of snow, I’d plop right down and remove my boots to free my feet from a sock: trudging back home with cold, wet feet was still preferable to suffering the offending sock. I imagine this same solution for uncomfortable underwear is beyond socially acceptability, so it’s better to start with nothing! Luckily, the types of pants and shorts I wear and of comfortable fabrics and loosely-fitting designs (though they leave much to be desired in terms of fashion!).

All this is to say that I ended up on the x-ray table with no pants or underwear. A thin, gauzy white gown was my only shield. I lay there, staring up into the machine’s camera arm, my own arms folded over my chest as instructed waiting. Tim, the technician, tinkered on the computer to enter my demographics. With the light out, my heartbeat starting accelerating; first, it was hardly noticeable, but with my hands over my chest, I quickly realized that it was not only beating quickly, it was also pounding, visually displacing my hands up and down with each beat. Relax, I told myself. When Tim emerged from the small closet containing his desk and computer, my ears started ringing and I became dizzy. “Are you OK?” He asked. I nodded yes, unable to speak, but my spooked eyes were a tell that I was lying. “You are very crooked on the table,” he commented. “Can you straighten yourself out?” As I have terrible kinesthetic awareness and body position sense, I am never surprised to hear this and have received similar instructions almost every time I’m at an appointment. I tried my best to align my body on the table. He started gently pushing my shoulders and straightening my neck and then my feet to position me appropriately for the picture. Like a reflex or the pop of a Jack-in-the-box, my limbs recoiled into a tight tuck position over my trunk to avoid his touch. “You’re fine! I’m just getting your spine lined up here. Don’t worry I’ve done this for years!”

I pleaded with my mind to relax. I didn’t want to feel afraid of him, and logically, I knew that he was totally harmless. In fact, I felt guilty even having unintentional anxieties about the situation. We tried again to situate my body as well as possible and then he swung the overhead camera into its designated location. He reached over me to palpate my iliac crests in tandem to verify proper positioning and a level pelvis. This is it, I thought. I squeezed my eyes as if to will myself out of the situation and transport myself to safety. But, I was safe. Just as he should be and just as he should have clearly seemed, Tim was a harmless healthcare worker trying to do his job in providing necessary medical images for my care. He retreated to his computer command station, told me to hold my breath and not move, and snapped an image. As he repositioned me for the next series, I was visibly more relaxed, and a wave of relief came over me, not just because nothing had happened and I knew that I was safe, but because ultimately, I knew the whole time that I was in good hands but my anxious reaction seemed entirely out of my control. I was embarrassed by it the moment it began stewing, and struck by how unfamiliar the reaction had become to me—a testament to the vast improvements I’ve made over the past two years. What was once as natural and automatic as turning my head when someone says my name has gradually become a faint memory, an abandoned instinct like a long-forgotten nickname whose familiarity only resurfaces years later when you hear it again.

It’s easy to feel displeased with my behavior/reaction during the imaging because it feels like I must’ve taken steps back. I’m hoping it makes sense to simply blame it on the stress and frequency of my recent medical appointments. I also choose, in this situation, to recognize the progress I have made. The encounter served as a helpful reminder of how far I’ve come, how unfamiliar and removed I felt from those once-pervasive worries, and how naturally and normally I now face everyday situations without the looming fears of getting victimized by every passing man.

Mental Health Awareness Month

April was Autism Awareness Month and May, among other things, is Celiac Disease and Mental Health Awareness Month: two other causes near and dear to my heart. There’s been a boom of awareness around celiac disease, though partly convoluted by the gluten-free fad, yet I don’t feel I need to devote much attention to it at this point.

Mental health awareness, on the other hand, is more important to discuss, primarily because mental illness still seems to carry a stigma that it’s a weakness and should be hidden, something disgraceful that should be covered up—a coveted secret not to be confessed. Even when I was in graduate school last year, I remember telling a classmate that I wanted to adjust the arranged meeting time for a group project because of therapy and he replied, “oh, what injury do you have?” assuming that it was physical therapy to address a running injury (an innocent, and reasonable mistake). I said, “no, psychological talk therapy for depression and anxiety.” “Uh woah, yikes, weird. Uh yeah, let’s just pretend it’s physical therapy.” He, by no means, said this with any ill-intent; on the contrary, he was trying to protect my ego and present the “safer” or more respectable alternative to the group to spare me the assumed embarrassment.

I’m so accustomed to mental health treatment and therapy at this point that I’m not afraid to admit that I need it, use it, and find it helpful. Of course, I prefer not to broadcast it and it certainly would never have a place on a brag reel, but mental health services are simply another legitimate, and necessary facet of healthcare. Like physical illness, which can range from acute viruses or injuries to chronic illnesses like multiple sclerosis, and range in severity from mild infections requiring a short course of antibiotics to intensive or emergency care situations or terminal cancers, mental health illnesses run the gamut. Some conditions are acute and short-lived, while others are chronic; some are more of a mild nuisance while some are debilitating. Even depression can be experienced in an acute bout in response to a difficult situation and some anxieties or phobias only crop up when encountering a specific stimulus. Other people, myself included, have chronic depression and generalized anxiety (and PTSD) that are regularly present. Beyond anxiety and depression, there are probably hundreds of other recognized psychological conditions with just as many varied presentations as people afflicted with them. Also like some physical illnesses, a variety of mental health conditions go undetected or untreated. This can happen in cases where the umbrella of symptoms is hard to identify or they exist at a low enough level or persist for so long they become the individual’s “normal,” or because of lack of awareness that there is help, or one’s pride or lack of insurance/resources preventing one to seek help.

Mental health awareness, or increasing the frequency with which these conditions are discussed is therefore important for two key reasons: to increase the general public’s understanding of symptoms and available resources (to aid diagnosis and treatment so that individuals don’t suffer in silence or from an uniformed place) and to show the variety of shades and types of psychological illnesses and their common prevalence (to help reduce the stigma of it being “weird” or “shameful”). Anyone can experience mental health problems, although some people are more susceptible to certain illness than other people. Receiving a diagnosis and participating in treatment is a critical step in managing or mitigating symptoms and reducing risks associated with symptoms or behaviors of such diseases. I can speak to the fact that left unaddressed and unchecked, mental health problems can escalate to severe issues or dire situations. Like physical problems, the earlier a mental illness is addressed, the better. It would be dangerous to allow bacterial pneumonia to fester for weeks, lest it turn into a more critical condition; it is equally risky to sit with depression for weeks on end, allowing it to spiral into a more critical condition. Then, instead of responding with more conservative treatment or improving more quickly, it can stick around longer and necessitate more comprehensive measures, not to mention the unnecessary suffering.

I hope that people will continue to speak up about their battles with mental illnesses. Discussions and admissions are some of the best ways to increase awareness, educate others, reduce the stigma, and potentially help or save someone else’s life. I vow to do my part and try my best to be brave, honest, and open and engage in conversations, even if personal or uncomfortable. I’d rather be slightly embarrassed (though my whole point is that I shouldn’t be, it’s natural to be in our society’s current attitude towards such issues) and divulge certain parts of my life that are nowhere near pretty or perfect, and potentially help someone else who is suffering alone, confused or worried, or too shy to take the next step.

Here is a resource that may be helpful

http://www.mentalhealthamerica.net/may

Blood Work

I can’t stand getting my blood drawn. This phobia does not extend to needles in general, as I don’t mind shots, but getting a lab slip for blood work is a doomsday sentence for me. This is more unfortunate for my circumstances than for the average person, because my health conditions necessitate frequent routine draws. I’ve trained myself out of my fear of flying, fear of men post-attack, and other phobias over my life, but this one seems impossible to conquer.

This fear confuses me. I’ve tried to analyze it, somewhat unsuccessfully, because there are still gaps in my understanding. For example, I’m not directly afraid of anything specific about the process of blood work. In contrast, when I was afraid of flying, I was terrified that the plane would blow up in a fury of flames at take off as it built up speed. I could also explicitly point to anxiety that turbulence was “abnormal” and the plane was going to lose its lift and plummet. I reasoned my way out if these through research, which was one step that helped me conquer the gripping phobia I had. I can’t identify a cognitive (even if flawed) reason for my blood draw issue. I’m not afraid of anything bad happening: I don’t think I’ll bleed out, I don’t think the phlebotomist will damage my body in some way. Sure, it hurts, but I’ve faced many significantly more painful situations, so I don’t think it’s that. I have had several bad experiences (passing out and hitting my head because they sent me on my way too quickly, waking up another time after fainting and not understanding where I was and then panicking, and incompetent nurses or techs that had to stick me several times when they themselves panicked due to an issue with the stick, but again, nothing Earth-shattering compared to other actual traumas I’ve faced. I think part of my anxiety is that I do feel sick and lightheaded with bloodwork, but I think some of that is physiological (as I’m chronically anemic and hypotensive so I do get weakened), but it’s undoubtedly also the anxiety feeding into the physiological anxiety reaction in a chicken-and-egg self-fulfilling prophecy. The more worked up I get, the worse I start to feel, and that in turn, makes me feel more uneasy and panicked. Ever since my attack, the number-one trigger that sends me into a PTSD bout is not feeling well or, more precisely, experiencing unaccustomed or unwarranted feelings in my body. I haven’t really divulged the details of my attack here yet because it hasn’t seemed necessary and it’s quite upsetting and emotionally shaking for me to actually think about it in a detailed way. Instead, when I say “my attack,” it couches the severity of the trauma into an emotionally safer package for me. One that has become such a habitual term that I can sort of displace myself or disengage from the feelings around that day. Just saying “attack”, doesn’t fully conjure up the utterly devastating and heinous acts I survived. I’ve recently been starting targeted trauma therapy though and my therapist thinks I would benefit from talking more explicitly about what happened, as a way to get some of terrifying memories that monopolize my brain. I do occasionally talk about it in detail with my mom or Ben, but even with them, it’s generally just mentioned in passing using the globalized “attack” terminology. Anyway, I’m leading myself quite a distance from my intended topic, and thus is more of a post for another day because I’d like to continue to evaluate my lab work phobia, but the point of my digression was to confess that my physical feelings of “unwellness” fuel my PTSD because I was so severely injured during the attack that I was genuinely worried I was going to die. Unfortunately (for once), this wasn’t even all inflated by my anxiety. Anyway, I think consequently, as I kind of was operating in survival mode for the first few days afterward, stunned pretty much into silence, not working or really doing anything, I just had me and my body and it didn’t feel right and I felt unsure if I was actually going to still make it through. Even though the acuteness of the trauma was over, I felt broken in so many ways and there was no clear path, however distant, to my guaranteed recovery. Over the first few days, I started healing physically but deteriorating emotionally. I’d check my own pulse periodically to see if my heart was still beating. While thankfully I’ve never come even within earshot of that sort of physical and mental trauma since, it takes a much smaller stimulus now to shove me back into that am-I-really-going-to-be-ok? place. Although I’m countless levels tougher than I ever was before, I’m a baby when it comes to triggering feelings.

Still, I don’t know that any of that necessarily plays any more than a correlation role in my blood draw anxiety. I don’t think it’s a cause. The one piece that I do think must have some effect on the phobia is that after I lay on the floor post-attack, I was bleeding profusely and I was fighting to maintain consciousness while my body seemed to want to pass out. I was alone, except for my dog, and my phone had been ripped from my hand and thrown behind the couch, so I was pretty removed from life lines. I was too shaken to scream. I knew if I succumbed to the faint, I could potentially bleed out eventually and part of me, in that moment, was okay with that, as I saw no possible way I’d be able to pick myself up literally and figuratively after this and pull together some semblance of dignity and strength to move on. I actually credit my dog for convincing the piece of me that was willing to fight to prevail. She came slinking out of the corner where she had been hovering by the door around the turn in our hallway, out of sight. Slowly, I heard her nails ticking on the floor toward me. She was crouched and sling-backed and the hair on the back of her neck was raised. Even though he was gone and had slammed the door in front of her, she wore every color of fear. As she got within arm’s length of my body, she stopped and looked at me as if seeking approval to enter the invisible outline around me. I stared back at her, barely recognizing her for a minute. I remember thinking in my head, “wait, who’s that?” Unable to lift my heavy head yet, I simply tapped my own finger on the floor. She could read me. Come. She gingerly came forward and sniffed me. Then, in Gross Comet fashion, tried to start licking blood on the floor. That was the moment that finally I cried. It’s also the moment I decided I needed to find a way to get up, and while I’ll detail that struggle another day, I do think she played an instrumental role in me fighting my body’s protective urge to pass out and helped me save myself. Now, I think I’m particularly conditioned to fear even whispers of lightheadedness and fainting. I can’t stand that feeling. I want to be as far from it as possible because it immediately puts me back into that very worst of all my catalogued memories (and I have a very detailed and vast collection stuffed in my brain). It becomes so real; it’s as if I’m transported back to that wooden floor, plastered in terror, deciding what to do, realizing with each passing moment that I was one breath further from the person I had always been and one more into one that was frighteningly foreign: a life I didn’t know I could or wanted to bear.

I do genuinely want to rid myself of this fear. On Friday, I had to get blood work for my preoperative appointment to fix a bone in my foot. To try to quell the anxiety before it had time or momentum to build, I tried employing all sorts of relaxation and distraction techniques prior to arriving: mindfulness meditation, listening to music, deep breathing, talking on the phone, playing games, progressive muscle relaxation, even bribing myself with the promise of a reward on my Amazon wish list for getting through it. Nothing really worked. My heart was thumping and I was overheating just waiting to be called in. I tried talking to the old lady sitting next to me, something wildly outside of my comfort zone, but my brain just kept honing back in on blood work. When the nurse calmed me in, I gave a sheepish smile and tried to walk bravely over to the table. My eyelids filled will tears. They filled to their capacity before the volume exceeded the force from the surface tension holding them in. They rolled onto the paper pillow and spread like cracked eggs. She asked me my name and my voice cracked, the lump lodged in my throat hindering the ease of my most familiar word. I just swallowed. I couldn’t speak. She then looked up from her clipboard and noticed how I’d quickly melted into an emotional heap, entering the room as a young woman and now a small frightened child. She even commented I was smaller than but reminded her of her nine-year-old daughter.

Eventually, I was able to find my voice and string together enough coherent language to answer her questions and assure her I was fine, just scared of lab work. And so we began. I wish I could say it went well, but this blog is all about honesty and my reality, in all its highs and lows, mistakes and weaknesses. It did not go well and I was not the brave solider I fully intended to be. I’m unparalleled in my ability to imitate and emulate behaviors and personas in most cases (in fact, it’s one of my qualities that helps me camouflage amongst neurotypicals and evade diagnosis for so long), yet I was entirely unsuccessful in terms of willing myself to act unphased by the draw. I cried and cried. To my credit (if I can even say that in this case), they did have to get three nurses and try the stick three times because my veins kept rolling, but I still should have played a more stoic role. After the first puncture, the nurse panicked and called another over for an assist. The superior said, “oh, it rolled…no problem.”

They continued to try to rectify the draw and since I don’t look, I envisioned the worm-flipping feeling in my forearm to be part of the sample collection process. It was incredibly uncomfortable and interspersed with sharp transient flashes of pain. Then, it stopped. I felt the needle recede from my skin and the gauze applied with heavy pressure. “All done,” she said. “That was terrible,” I cried, but breathed a sigh of relief that it was behind me.

As I sat there trying to get ease my heart rate back down, I started thinking about some of my challenges and wondering if the sensory issues play a role in my body’s repulsion to the whole blood drawing experience. The textured astringent wipe that is intended to sterilize the skin creates a toe-curling offensive friction on my sensitive inner arm skin as it’s vigorously rubbed back and forth. The rubber band tourniquet similarly irritates my skin, and though I don’t necessarily have a low pain tolerance per se, it feels like I can discriminate each individual cell layer that the needle penetrates and a searingly hot wave floods my whole body even when my antecubital space is touched gently or lovingly. SPD can transpose even soft touches to razor-blade like stabs. Somewhere in my mental survey of sensory insults, I’m brought back into awareness of the pre-op room and the nurses. “Ok, let’s try this again,” she says. “WHAT?” I exclaimed, “you said we were done!” “Oh no, honey. I just meant we were done trying to fix it.” Cue the waterworks. I freaked out. Like a petulant child, I started sobbing. “You said we were finished!” Needless to say, it was two more sticks until we were done, but I survived. I’m not proud of my behavior; far from it, I was filled with shame. As I hobbled on my crutches to the car, I vowed to myself to further research how to overcome this phobia.

I have. Extensively. But nothing has really resonated with me. Even the act of writing this post has made the multifactorial nature of this phobia more apparent to me. I did notice that Autism Speaks (which has its own pros and cons) has a comprehensive downloadable toolkit for parents to exercise with their autistic child prior to bloodwork. Unfortunately, even though I can be quite child-like in many regards, this is definitely geared toward a significantly younger demographic and therefore not useful for me. (If you are reading this and are parent of a young child, you may find it to be a helpful resource.) Becoming aware of the toolkit and assessing the amount of effort that must have gone into it did encourage me to imagine that there may be truth to my sensory processing issues exacerbating the experience for me. I know that the site they always collect from has some of the thinnest and most sensitive skin on my whole body so the cleansing with the alcoholic prep pad alone sends my system into overdrive before we’ve even begun, but I’ve been surprised how many phlebotomists seem reluctant or unwilling to try another site. They are the experts, so I am sure there is a valid justification for this (though I don’t know what), but the least offensive procedure I had was at the Celiac Disease Research Center at Columbia Presbyterian and they didn’t even ask-they just used my hand. It was more seamless and less excruciatingly stressful for me, by far. Who knows. I’m not a very adamant self-advocate when it comes to medical appointments, so perhaps I am less assertive and demonstrative of my self-informed position to adequately request the procedure modifications that would be most helpful for me. I’m working on my medical-appointment imposed unintentional and involuntary selective mutism. Clearly, I’m also working on trying to understand remedy my various challenges, though it’s not a quick nor easy process. At least I have my enjoyment for research and analysis on my side and plenty of opportunities to practice. For the record, I was too disappointed in my “performance” at this last blood draw to warrant getting the foxtail I want on Amazon, so hopefully the longer that carrot dangles in front of me, the more I’ll want to deserve it. (At the same time, part of my ADHD seems to be incredibly focused but short-lived interest in any one thing, so I’m not confident that won’t need updating as well). With my surgery pushed a few weeks back, I can guarantee there will be several updates to that wish list, more reasons I’ve uncovered for my anxiety, and hopefully a bevy of additional resources or facts to pacify (or at least inform) my problem.

Prognosis

I’m crutching all around the hospital today. For some reason, they’ve designed it so that the orthopedist is in the basement in a small office that’s only reachable by snaking through several very long hallways. The radiology department—where he sends nearly every patient to get an X-ray after first seeing him—is upstairs at the opposite end of the building, in an entirely different wing, down another set of long, zig-zagging hallways. Thank goodness that I’ve been doing my strength training and have these triceps in gear!

After crutching for what feels like 30 minutes, I’m sitting back in his office waiting: waiting for him to come back in, waiting to hear why my foot is not getting better, waiting for an action plan. I start working myself up into an anxious state, flirting with a full-blown panic attack. I have my huge headphones on to drown out the rattling of the heating unit that seems to be situated in the wall behind his office rooms. I wear my noise-blocking headphones without exception when I go on most errands, unless I’m certain the place is very quiet or I’m accompanied by someone (in which case, it would be rude). I’ve also been wearing my winter beanie basically as part of my daily get-up since November (at least I have three!). It not only keeps me warm, but it tamps down my little flyaway curls that otherwise blow as I move—a guaranteed fast-track to throwing me into sensory overdrive.

The thick hat and the enormous headphones are quickly sending me into overheated territory. Thermoregulation and body temperature awareness are significant challenges for me with SPD. I seem to have to no idea if I’m trending towards becoming too hot or too cold until I’m beyond the point of easily reversing the situation and re-establishing comfort. This is one of those moments. It seems I am still dressing for January and it’s in the 60s outside. I begin to sweat. Anxiety is indubitably contributing to this heat flush, but my down coat isn’t helping. This doctor makes me nervous and so does this injury. I have a premonition it’s not going to be a favorable prognosis. My foot throbs as if to remind me, yes, I’m here and I really hurt. I don’t need the reminder but the throb won’t be silenced.

For some reason, once I’ve identified that I am, indeed, too hot, I do nothing to remedy it. I keep waiting.

I wish Ben was with me. He’s at work so I send him a text telling him I’m bored. I’m sure he knows to substitute in the word scared or lonely. I do multiplication problems in my head while I wait; over the years, I have found this to have a mild relaxant effect. 243×77

Finally, my doctor enters after reviewing my x-ray. Even though I struggle to interpret facial expressions appropriately, his is a clear tell.

It’s not good news.

I need surgery. He will insert an intermedullary screw, which is essentially a screw that gets drilled longitudinally into the metatarsal bone marrow. It will help my fracture heal.

The word surgery doesn’t jive well with runner or anxiety-riddled—both of which are equally understated adjectives to describe me.

So that’s where I am today: just wrapping my head around this next hurdle and working on convincing myself that I’ll be fine and this will ultimately be the best treatment. I will and it is.

I’m sure that I’ll have a lot of thinking and writing to help me digest this but I’m actually feeling like the depression might be lifting a little bit. Even though this is a scary proposition, it will ultimately help me heal. April 25^th sounds like a good day to have surgery anyway, right?