Yes, This Hurts!

Posted on by SingleRheum

Some of you will already know that I’m losing my motability car on the 23rd of April. I’m incredibly angry as this effectively leaves me housebound. So I’m having to spend money I can’t spare on buying an ‘old banger’ so I can get out.

So why is this happening?

  • Because this govt don’t want people on disability benefits
  • Because in conjunction with the MSM they have wrongly demonised disabled claimants as scroungers
  • Because they’ve moved the eligibility goalposts to make it even harder to evidence disability
  • Because their contracted “health assessors” (who aren’t experts in many conditions including mental health issues) are targeted on reducing benefit levels
  • Because their contracted assessors blatantly lie, misinterpret & make erroneous assumptions in their reports which are then treated as gospel over claimant evidence, scans, & consultant correspondence
  • Because they f*cking can & the MSM is complicit in covering up their lies

I know I’m not alone in this, I know other people who’ve been through this right to the appeal tribunal stage & won back their rightful benefits because at a tribunal you’re dealing with humans, not dwp targets. But I also know so many are just too ill, too tired, too anxious, too stressed, too alone, too defeated & too confused, and have given up without appealing even though they know they’d likely win. The fight is too hard & this govt are relying on that to cull numbers.

Almost a third of DLA to PIP claimants lose benefits, cutting their independence & their income. Disability charity Scope said these figures are “deeply concerning” and called for an “urgent overhaul” of the assessment process

“It’s deeply concerning that so many disabled people are facing a sudden drop in vital financial support,” said James Taylor from Scope.

“Life costs more if you are disabled. These extra costs haven’t disappeared just because there is a different assessment process.

“Without an urgent overhaul of the PIP assessment process, the system will continue to work against disabled people, instead of for them.”

I won’t go into my medical details here because much of it is very personal, but I cannot emphasise the following things enough;

The stress & anxiety have been absolutely horrendous. Imagine some unknown & unsympathetic stranger has complete control over your finances & your car, then imagine they won’t tell you for month after month what they’re doing next. I had my initial dwp letter in June last year. My assessment wasn’t until 1st December. I didn’t get a decision until February (and I had to chase them).

So I completed with Citizens Advice the initial Mandatory Appeal (which is known to be a pointless exercise but still took us two hours), unsurprisingly I’ve had a letter today denying the HR disability again & repeating what was said in the last letter almost verbatim. So next stage is to go to court for a legal Appeal Tribunal, which I understand from others can take up to a year.

My depression has absolutely been impacted by this process too, I’ve had more down days, the black dog nips a little closer when even thinking about not having reliable transport, & also of being accused of being a liar which is essentially what the dwp have done to me & thousands of other disabled people. I’ve been agitated & restless & I know exactly what the cause is.

My rage has settled down to a simmer now, but I was so bloody angry when I finally got my report copy. (Confession – I may have written certain rude words in pencil all over the margins). It’s outrageously poor.

Bear in mind here for a minute that in a previous life I ran huge contracts across the South West for (plot twist) the dwp, supporting the unemployed into work. The irony isn’t lost on me! But had any single member of staff in one of my centres turned in a report of this poor a calibre about a client some very serious conversations would have been had.

I’ve not picked it up for a few weeks because it’s still a bit raw, but off the top of of my head…. It’s a badly written cut & paste job, some of which obviously came from doing someone else’s assessment. It’s practically illiterate. The same phrases are repeated over & over like magic, as if when you say something stupid/untrue often enough it becomes reasonable or true. It contains as I said earlier outright lies, glaring inaccuracies and erroneous assumptions. There is no logic or consistency.

It took me a few days to work out that at least part of my anger was precisely because of the poor composition and lack of attention to the construct and meaning, as well as the errors. I know I’m a detail orientated person and these things matter to me, but surely in doing work that will actually impact people’s lives, wellbeing & financial circumstances everyone should pay attention to detail?

Almost a third of DLA to PIP claimants have lost benefits, cutting their independence & their income. Disability charity Scope said the figures are “deeply concerning” and called for an “urgent overhaul” of the assessment process.

“It’s deeply concerning that so many disabled people are facing a sudden drop in vital financial support,” said James Taylor from Scope.

“Life costs more if you are disabled. These extra costs haven’t disappeared just because there is a different assessment process.

“Without an urgent overhaul of the PIP assessment process, the system will continue to work against disabled people, instead of for them.”

Call me naive, but I guess I expected better from a government employed organisation when producing an official report on someone’s mental & physical health & ability. So yes, on top of everything else I was actually incredibly disappointed.

In my previous life with a fully functioning brain I would have torn this report to shreds in a couple of hours, referring to the DWP’s own guidance point by point to emphasise each and every error. Unfortunately with frequent brain fog, cognitive difficulties & fatigue unpicking this to refute it for a tribunal will take me weeks. But if needs be I will do so, with the support of friends, and the fabulous Citizens Advice, because even feeling as ill as I do daily I’m too bloody angry & stubborn to let this go.

I hope the above has made sense, I’ve probably rambled but this is the first time I’ve felt calm enough to write this out without ranting &/or swearing (a lot)!

Thanks to everyone who’s supported me, especially the lovely Essia who attended with me in December to literally & metaphorically hold my hand.

Quotes pictured above are from the incredibly useful Disabity Rights website which can be found here if you’re looking for further information

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Defined by?

Posted on by SingleRheum

A recent thread by @HannahPearl_1 on twitter questioned the suggestion from someone that “it’s important not to be defined by” our illness. Hannah went on to say she understood what the person meant but didn’t feel able to agree.

This got me thinking. ‘Defined by” is a term that crops up a lot in #ChronicLife circles & forums online. People tend to be either against it as somehow limiting, or in favour of it because our illness affects every aspect of our lives.

But what does ‘defined by’ actually mean? I’ve had a trawl through Merriam Webster online looking at meanings & synonyms to try & pin down a definition, and it’s a little slippery. But I love language so let’s give this a go!

Defined has a number of uses which vary the meaning:

  • to draw or make apparent the outline of
  • to mark the limits of
  • to point out the chief quality or qualities of an individual or group

It’s the second & third definitions I’m interested in here, because I think this may be where the divergent opinions around the phrase derive from. Let’s have a look at both…

To mark the limits of

If one applies this to living with a chronic condition I would take ‘defined by’ to mean that we acknowledge our illness affects us in ways that inhibit the way we live our lives. For me this meaning absolutely applies to my life. Inspiration porn often tells us nonsense like “the only disability is a bad attitude”, and this simply isn’t true.

Current popular ideology leans towards telling everyone they can be anything, do anything and there are no limits, which is a lovely sentiment in fairy tales but totally untrue in real life. We all operate within limits, whether they’re the law of gravity or simple genetics – someone like me with red hair, pale skin & freckles is never going to achieve a suntan!

That doesn’t mean giving up on ambition & dreams, or never setting goals, of course not. We all need things to strive for, to challenge ourselves, to work towards. What it does mean is that we can live our best lives by focusing on the possible, the achievable, and taking steps at our own pace to get there.

To point out the chief quality or qualities of an individual or group

Applying this to living with a chronic illness implies that we are characterised by our condition, that it becomes an intrinsic part of our being. Again, this undoubtedly applies to my life. I am no longer able to separate out my illness & disability from who I essentially am, and I don’t see that as a bad thing.

This doesn’t mean it is all that I am or can be, just that #chroniclife is entwined with my sense of self, my lifestyle & my place in the world and I’m very ok with that. I think this is completely natural human behaviour – if I flip back in time to when I was working my whole identity was entwined with my career in the training sector, which is why it was initially so very hard to accept having to effectively retire. I wasn’t sure who I was without being defined by what I did.

It doesn’t help that as a society we value people by what they do, not who they are, and we love putting people in boxes & applying labels. Would I let anyone else characterise me or define my limits? Not a chance. But as a chronically ill person with disabilities I’ve definitely earned the right to set my own.

And I choose to identify with my illness, my disability, and do so proudly. It’s taken me a lot of work & some fab therapy to get to this point in my life, and I’m happy to own it.

But you know what? If you don’t feel this way that’s fine too, surely one of the most important things we do is choose how to define ourselves 💙

Whispering Darkness…

Posted on by SingleRheum

Some of you will be aware I write when I need to process. Never more necessary than this week.

I’m struggling right now, both physically & mentally. This is totally down to our disastrous current government. I make no apologies for being political when those very politics are affecting my physical & mental health.

I received notification in June/July this year that even though I had been previously awarded lifetime DLA (Disability Living Allowance) for my chronic & progressive conditions, due to govt changes to the benefit system – namely the introduction of the new PIP (Personal Independence Payment) benefit – I had to reapply. Yes, reapply.

You’d have thought the sensible thing to do for people with lifetime disability awards would be a simple transfer, but no. Reapply as if you’re a completely new claimant. There was an option to allow them to access your previous assessment records for DLA to support your claim – “if they are still available”. Yes, it appears the DWP may have failed to actually keep records properly. Who’d have guessed.

I want to be clear here before moving onto the effect this process is having on me personally – the only reason the govt have rolled out PIP is to get disabled people off benefits. It’s that simple & that barbaric. A UN report in 2017 “accused the Tories of creating a ‘human catastrophe’ in the UK” which violates disabled people’s human rights, the text below is quoted from The Canary, the full article is available here

The UN are currently carrying out another investigation into UK poverty and the impact the current government has had on this, looking at key areas including these listed below – text again is from The Canary, full article is available here.

I kind of wanted to be clear on this – this is not me as a benefit claimant just being awkward or heaven forbid “ungrateful” – but a widely acknowledged truth. Disabled people are being disadvantaged by this government, the facts prove that. The United Nations knows it.

So, back to to this process. I had to call to apply after receiving the letter which was incredibly difficult for me – anything to do with benefit changes causes me severe anxiety – I was physically shaking when I rang, despite being prepared by Citizens Advice on what to expect so I had the information I needed right in front of me. It took a stomach churning twenty minutes. Just to ask for the form.

Once the form arrives in the post there is a four week deadline for completion. The earliest appointment Citizens Advice had was for almost six weeks away. So again I had to go through the ordeal of phoning, this time to request an extension which thankfully was granted.

I cannot begin to describe the vile process of completing that form, even with a trained & sympathetic advisor. I can’t write for any length of time myself because of the RA in my hands, so they had to complete the form for me. It’s invasive, incredibly personal & embarrassing. Answering questions on what medications you take, their side effects, how often you manage to wash yourself, use the toilet, leave the house, eat, get out of bed, the assistance you need but don’t get, and the intimate details of every symptom of your conditions & disability from bowel movements to insomnia, light sensitivity to Myoclonic Jerks.

The awful thing is on a daily basis you are mostly able to avoid thinking about the vastness & sheer weight of multiple conditions & symptoms alongside chronic unceasing pain, you simply deal hour by hour because that is manageable, mostly. This is like plunging into the abyss with your eyes taped wide open. It’s not an exaggeration to say it’s traumatic.

Every tiny personal detail of your life is discussed & transcribed, ready to be pored over by faceless strangers – without the requisite medical knowledge – but with the power to remove your income & your car & leave you destitute & housebound. Yes, it’s that f*cking huge.

So – my appointment with the lovely & very empathetic lady at Citizens Advice? Three hours. Three grueling & exhausting hours. And I wasn’t done yet.

It took me another two hours at home to go through, copy & annotate twenty-seven separate pieces of medical evidence going back about 18 months. Scan reports, surgical reports, consultants letters, radiography reports, it all went in there. This took me about three days.

So finally it all went into the post. I had a text on the the 8th August to say my form had been received.

I then heard nothing until Saturday 3rd November when a letter dropped through my door. Yes, just over twelve weeks, or 3 months. Every single day since August my anxiety has grown worse. My depression is also pressing at the edges of my consciousness, whispering of hardships & darkness. My GP is fully aware & we’re monitoring my mental health, the frustration is that we know the exact cause & have no power to remove it.

So the last couple of days I’ve basically gone turtle. I’ve retreated inside my shell, alternating between Netflix & reading depending on my ability to concentrate. The minute I stop either my thoughts are immediately back to this planned assessment. I feel dreadful as stress flares everything. Fortunately I have a wonderful friend who has agreed to be with me for the appointment which is incredibly helpful.

My next task which I couldn’t bring myself to do today is to call them & ask why they’ve not taken on board the request on the form from Citizens Advice & myself for a home visit, and see if its possible to change it. Honestly from what I’ve heard I’m not particularly hopeful.

Then I need to prepare, think of this as a job interview but twenty times worse. Its so easy with fatigue, anxiety & brain fog for me to use the wrong words, forget whole symptoms & conflate conditions. It’s basically a quiz about me where I can get the answers wrong much too easily. I’m terrified of this, and not without reason – so many horror stories of poor assessments are a matter of record.

One last note – DWP or whomever, if you’re reading this and thinking even for one second “well if she can write a blog that makes sense she can work” you are stunningly misinformed about what being chronically ill & disabled looks like.

This, as with many of my posts takes hours – but never all at once. Initial thoughts, a few notes, finding links, remembering what the hell I was talking about when I lose thread mid sentence, stopping for sleep or rest, editing, rechecking, a final read through to make sure I haven’t made a compete idiot of myself. It all takes precious time and energy spread out over days, to do something that when I was well I could have rattled off in ten minutes.

This is my reality, please simply believe me.

PS – for anyone who has bought into MSM (Main Stream Media)’s outright fairy tales about benefit fraud & demonisation of claimants – here’s the real deal from the government’s own data. A tiny 1.2% of benefit claims are fraudulent.

“Like HMRC, the DWP also estimates fraud and error for its benefit payments. Its most recent estimate shows that overpayments to claimants in 2017/18 were £3.8bn, or 2.1% of its total bill. Of this, 1.2% (£2.1bn) of its £177.5bn budget was claimant fraud. Full article here.

Butler Wanted…

Posted on by SingleRheum

Wouldn’t this just be fabulous? Simply the fetching & carrying would be a total blessing! I’ve gone with

  • Coffee because, well, coffee
  • Great food because my appetite is horrendous & cooking takes too many spoons (pun intended 😊)
  • Secretarial skills – oh to just dictate blog ideas at random hours, this would be a real treat, I might even get that novel done!
  • Who doesn’t want a psychic provider of heating pads & ice packs?!
  • Massage because, well, massage
  • Invisibility, on demand obviously, so I keep my sense of space

So what do you think I’ve missed? I’m sure there is loads more a spoonie butler could do, let me know what your top skills in a butler would be?

Namaste 🙏💙

The Gift of Being Present

Posted on by SingleRheum

There’s a campaign which raises awareness for ME (Myalgic Encephalomyelitis) called #millionsmissing. There will be events around the country next week on May 12th, with many sending in shoes which are laid out in public areas to represent those who are unable to attend. Others will post online, anything we can to raise the public (and sadly medical) awareness of just how devasting ME is. Details can be found at:

http://millionsmissing.meaction.net/

In essence there are millions of us across the world who feel we are missing from our lives. Many are bed bound, some for years. I often thank the stars my ME isn’t quite that severe, although there are many days I’m unable to walk around or get dressed, let alone leave the house. I’ve made a pact with myself that I will try to see other humans twice a week, even if just for coffee and a short natter, because I spend so many hours at home, alone.

I’m a natural introvert who has always enjoyed my own company, even as a child, so thankfully I don’t often feel the loneliness of many. But it is incredibly hard to maintain friendships when even a phone conversation can be exhausting, and sometimes the thought of replying to a message feels about as doable as climbing mountains. So I keep my pact with myself as best as I can, and will do for as long as I can, we all need human contact and shared laughter is a beautiful medicine of it’s own.

Over the past few years I’ve missed weddings, birthdays, lunches, and have completely lost my once active social life in the evenings. It’s difficult sometimes when you know your social group is all together having fun and you are yet again laying down quietly to conserve the precious little energy you have.

But…!! Today I wasn’t missing. Today I made it to a friends annual wedding anniversary barbecue (first time in three years I’ve been able to go) and it was so, so lovely. The sun was even out which is miraculous for a British May Bank Holiday! I managed to find myself a seat in a corner in the shade, I treated myself to a rare alcoholic drink and enjoyed a heavenly Mojito, surrounded by friends, dancing children, chatter and laughter.

I left when things were still in full swing but that’s okay, I know even on better days not to push too much and it was starting to get a little louder which I struggle with (background noise can be draining).

So I’m home now, windows open, sun shining, listening to the birds tweeting on a quiet Sunday evening. And I’m incredibly grateful for today, for these few hours of sunshine and laughter with people I love.

As always, Namaste 🙏💙

Why I Don’t Do ‘Stuff’….

Posted on by SingleRheum

This may sound a little odd but I often forget the reason my pain levels stay manageable is because I’m very careful with what I do & don’t do. Today was one of of those rare days when my mind was awake, I had some energy and was in the mood to tackle a couple of little jobs at home.

 We’re not talking plastering walls and laying brickwork here – but what in my old life would have been maybe an hour or two’s pottering after work! I painted my bathroom windowsill, put a couple of new screws in to fix and touched up the paint on my hall radiator cover, and painted a piece of wall approximately 7ft x 6ft using a step stool.
This wasn’t all at once, I know energy wise I have to be very careful because of the ME. I was sitting down for doing at least half of this, and I took long coffee breaks in between each task. This really wasn’t hard work – or at least it didn’t used to be.

However…

I’m now hurting everywhere. Fibro & RA are both flaring. My feet feel like they’ve been beaten with a hammer, both hips are shouting, my back, shoulders, elbow and neck are all complaining loudly and my hands are throbbing. Plus of course I’m now exhausted.

The really silly thing is I genuinely forget sometimes there’s a damn good reason I’ve slowed down – I have to, because if I don’t, ouch. I really must remember to actually tell my rheumy about this at our next meeting!

These days most of the time I get friends round or pay someone to do this stuff for me, which is obviously the sensible option as it keeps my pain down and protects my joints. But when it’s “just” little odd jobs (that in a previous life you’d have tackled on a Sunday morning in no time) not being able to to do them is really frustrating. Being able to rely on others is wonderful, but having to rely on others is not so great and you do worry goodwill will eventually run out! And of course paying professionals to do work for you is yet another part of the expense that is living with disability.

It always costs one way or another.

 Despite all this… I’m feeling a rare sense of achievement! Three things that have been bugging me for months are finally off my to-do list forever. Will I do it again? You betchya – probably in around three months when I’ve forgotten again 😊

The Mercurial Whirlwind..

Posted on by SingleRheum

*Content warning – suicide

On Monday 19th February it was eleven years since my Dad phoned me early one evening to tell me that my younger sister Mary had died. She was 35.

You hear people say things like “I knew it was bad news when the phone rang” but I genuinely went cold on the first ring – I’ve no idea how to explain it, but I swear I somehow knew it was really bad news about Mel.
Unfortunately she had ended her own life. I could speculate for hours (and did initially) on exactly why, but it serves no purpose. The simple truth is that at that moment in time she needed to stop. Undiagnosed depression certainly impacted her actions.
But that was how she ended, it wasn’t who she was. I’m not sure I have the words to capture the mercurial whirlwind that was my little sister. No one else has ever made me laugh (or cry) so hard. She was beautiful, funny, kind, generous, quixotic. She was also stubborn, defensive, argumentative and had a flash temper that raged white hot then just as quickly was gone.

She’d unexpectedly turn that megawatt smile on you and you had no choice but to grin back.

As kids we fought so much, but had each others back, always. I have loads of fabulous memories, good and bad, and that’s how it should be, saintly she wasn’t!

I remember at the time she died being unexpectedly angry with her, simply because we were supposed to grow old together. Losing her was hard, but it was almost as tough dealing with the loss of both past and future memories.

There is no-one else who remembers how to play “mummies, daddies & little darlings”, who knows how you had to step over the second floorboard from the bathroom door because it creaked so loudly, who swears she saw a ghost in our kitchen, who could play connect four for hours, who can remind me how I taught her all the basic swear words after she begged me to! Who was my partner in crime on teenage hair and makeup, and my best friend even when we ‘hated’ each other.

It’s like I lost some of the vibrancy from my past memories when she died, they’re still there, but without her to help me take them out and polish them or argue over them they’ve faded.

Of course we should also already have another eleven years of adult sisterhood to mull over. But she’ll never make a new memory in this life, as much as I carry her with me always.

There’s simply a Mel shaped hole missing from the second half of my life.

So I want to use this post to let anyone who is feeling like they want to stop know they are not alone. You are worthwhile, you are seen, you are loved. This really will pass, so please reach out for support in whatever form feels comfortable. I promise help is out there.

UK & ROI Samaritans – 116 123

USA – Lifeline Chat – 1-800-273-8255.

Australia – Lifeline – 13-11-14

Canada – The Canada Suicide Prevention Service – 1-833-456-4566

Behind The Illness is Me…

Posted on by SingleRheum

Thanks to Emma, who is part of my twitter tribe and a fellow person with ME for tagging me in #behindtheillness – it’s a lovely reminder that all of us living #chroniclife are also very human! You can find her great blog at NotJustTired

So you can find below some interesting & totally not useful facts about me 😊

Four places I’ve lived:

1. Stroud, Gloucestershire (my actual & spiritual home).

2. Eastbourne, West Sussex

3. Clifford’s Mesne, Gloucestershire
4. Constantine Bay, Cornwall

Four places I’ve worked:

1. The Swan Inn – chef & barmaid extroidinnaire!
2. Stroud College – Lecturer in Floristry
3. JHP Training – teaching then management across the South West
4. Athena, Bournemouth – book retailer

Four favourite hobbies:

1. Reading
2. Knitting (very much a learner)
3. Writing – my blog, poetry & occasionally stories
4. Meditation

Four things I like to watch:

1. Criminal Minds

2. Game of Thrones
3. The Walking Dead
4. Movies, especially good thrillers

Four things I like to read:

1. Fantasy – swords & sorcery – Feist, Eddings, Hobbe, Douglass
2. Spiritual – Thich Naht Hanh, Ruby Wax, Russell Brand, John Kabat-Zinn
3. Thrillers – Koontz especially
4. Poetry – most recent discovery is the C14th Persian poet Hafiz – sheer beauty through words

Four places I have been:

1. Guardalavaca, Cuba
2. Marrakesh, Morocco
3. Vienna, Austria
4. Ghent, Belgium

Four things I love to eat:

1. Chocolate
2. Steak & roasted vegetables
3. Indian food
4. Lamb Tagine

Four favourite things to drink:

1. Coffee especially cappuccino!
2. Green Tea
3. Havana Club aged rum (very occasional treat)
4. Mango & Passionfruit Juice with soda and ice

Four places I want to visit:

1. Budapest
2. Iraq, Iran & Syria (ancient Persia, pictured below)
3. St Petersburg
4. Canadian Rockies

Four bloggers I’d like to tag:

1. The very lovely Wren at RheumablogWren
2. The wonderful disability advocate Shona at ShonaLouise
3. The fabulous & focused Sally at SallyJustME
4. The boldy tweeting and often amusing Elise at TheFragileBones

There are lots of other bloggers I’d love to tag, I’m just hoping I’m not duplicating the tag with my choices!

I initially thought this would be a quick five minutes, then started thinking, reminiscing….. It’s been good fun.

Namaste 💙

Please watch #Unrest

Posted on by SingleRheum

Some of you may know I have Myalgic Encephalomyelitis, or ME/CFS. Many of you will have no idea of what that actually means beyond “being tired” which is so far from the truth. For too long the medical profession & the media have treated ME/CFS as a joke, a mental illness, or fakery. It is none of the above, and the mindset is insulting to every single one of us.

It affects waking & sleeping. It affects cognitive thinking and speech, memory, writing and listening. It causes seizures and myoclonic jerks. Clumsiness. Bowel problems. Joint pain. Muscle pain. Exercise intolerance and PEM (Post Exertional Malaise) which can last for weeks or months. Flu like symptoms. It affects every minute of waking life every single day.

In the face of ignorance and incompetence from those with whom she sought help, Jen did what many of us do. She went online and found a tribe. Somewhere where we are heard, seen and understood. Where we are validated.

She then went much further, eventually creating and filming Unrest. This is her story, but it’s also our story. Thankfully I’ve never been as severe as Jen, I pray I never am.

But I have periods of days when I am invisible, when no-one sees me. I don’t get dressed or leave the house. When I wake from an 18 hour sleep then have a three hour nap. When holding a conversation is impossible. When simply sitting up is just too hard, let alone leaving the bed or sofa. I am too often one of the #millionsmissing

Please watch #Unrest – it’s now on Netflix. The link to the trailer is below. Yes it’s hard viewing. But it will open your eyes to the reality of the lives of millions with ME.

PEM – or Bed Now Please

Posted on by SingleRheum

Having just started to come out of a bad incidence of PEM I realised it’s something I’ve not specifically posted about. Yet it’s been a huge part of my life for over three years. So I’m going to try to explain in personal terms just how incredibly debilitating it is. A little background is probably necessary.

According to the NIH* “Post-Exertional Malaise (PEM) is a cardinal symptom of the illnesses referred to as Myalgic Encephalomyelitis (ME), Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS), and chronic fatigue syndrome (CFS).”

A cardinal symptom is one that must be experienced by the patient to confirm diagnosis of the condition, in this case ME. Although my official diagnosis of ME wasn’t confirmed until about eighteen months ago, my GP and I are both in agreement that this has been ongoing for me since the time of my original RA diagnosis.

So, what exactly is it? And how does it differ from the fatigue experienced by patients with RA or other autoimmune conditions?

The NIH* states that “Unlike generalized fatigue, PEM is much more profound and reduces daily functioning. This symptom is characterized by a delay in the recovery of muscle strength after exertion, so it can cause patients to be bedridden for multiple consecutive days.”

And this is exactly what I’ve just been through. More recent studies into PEM recognise that the earlier criteria of ‘exercise’ was misleading and led to confusion amongst patients affecting diagnosis, ‘exertion’ is now used to provide a clearer picture, and it’s recognised that this can be mental or physical exertion, and that the physical exertion has a much lower baseline than in the standard population, as patients with ME are rarely able to exercise.

So we know PEM is profound and reduces daily functioning. But what does that look like? And how does it feel in real patient terms?

The NIH* describes it as “a worsening of ME/CFS, ME and CFS symptoms including fatigue, headaches, muscle aches, cognitive deficits, insomnia, and swollen lymph nodes. It can occur after even the simplest everyday tasks, such as walking, showering, or having a conversation.”

Seriously? Showering? Having a conversation? Actually yes, and in my experience having conversations, chatting, talking, call it what you will is incredibly draining. That doesn’t mean it can’t be enjoyed, but it does mean I’ll often pay for it later.

I’ll try and describe as clearly as I can how I was affected this weekend. I came home Sunday evening from visiting my Dad, which involves more driving than I would usually do. I want to make it clear here that I’m not blaming you Dad!! ❤️ Going to Waitrose or even popping out for lunch can have exactly the same effect. That’s the point. It doesn’t take much. And it doesn’t have to be physical. Dealing with simple paperwork for a short time can do the same thing.

So, Sunday afternoon. The first sign for me is usually yawning. Before I had ME I never thought of yawning as being a physical thing, but this can drop me to my knees. It’s like my whole body yawns with me. A couple of friends in my regular social circle will spot this a mile off now, and they’ll simply say ‘time to go home’. Apparently I suddenly look exhausted. Always attractive!

I’d say that on average within twenty minutes of this yawning starting I’ll be asleep, there is no choice, no putting it off. It’s like my whole body is simply shutting down. My head stops thinking, my muscles go heavy, and I can barely walk.

I lay down on the sofa at about six pm on Sunday, and only came to properly at about 6am this morning. So that’s 36 hours of basically being unconscious. I know I woke twice when my alarms went off to take my meds, and I know there was a third alarm I ignored so I missed a dose. I know I briefly came to and made a coffee at about 7pm on Monday, and it took everything I had to get into the kitchen and back. The rest is a blur of weird dreams involving a pub fire, going swimming in Italy and a trip to a theatre. Strange but true.

So that’s 36 hours lost so far. When I woke at 6am this morning I knew the worst had passed, the almost coma like feeling had gone, and my mind is awake to some small extent. Enough to slowly write this at least. But I have zero energy, and little concentration. From experience it will take another 24 hours at least before I’m able to actually get up and shower. I won’t be able to read or follow a TV plot properly, and I will probably sleep a lot today, though hopefully more refreshing sleep, not the passed out exhausted-ness of the past two days. Although it’s not an experience I’ve had I imagine I probably feel about the same as a marathon runner the day after, when everything hurts and you can barely move!

This is not a rare occurrence, it happens about once a week. I can lose from one to three days. I do pace my activities quite carefully, plan down days around days I have to be up and out, whether for medical appointments or social. I live alone so I try to get out three times a week for a couple of hours each time, usually a couple of coffees or soft drinks with friends. It’s incredibly easy to become isolated with chronic illness and it’s so very important we don’t.

So today will be a ‘sofa day’, as it happens it’s very rainy and dark outside so a perfect day for a couple of daft movies and snoozing. Then, fingers metaphorically crossed, I’ll feel human again tomorrow 😊

Footnote – it’s curious but common in #chroniclife to feel the need to validate ones symptoms and experiences, especially with something like ME which is incredibly still dismissed by some doctors. In this instance I’m actually glad I was wearing my sleep tracker, which has recorded 23 hours of sleep for yesterday. Proof!

*I have referred to and quoted from the American NIH or National Institute of Health because I find their website carries clear and up to to date articles. The full text that I’ve quoted from can be found here.