I have a hospital appointment coming up. It’s for a painless, straightforward heart scan (Echocardiogram) as a follow-up to my recent heart problems. Now this would be a simple activity for a healthy, able-bodied person but for someone with a disabling chronic illness like ME/CFS it becomes a huge undertaking. Added to the physical stress involved with such a task, is the mental strain placed on my body from the amount of planning and problem solving I have to do, and the anxiety this causes.
Routine is vital for someone who suffers from cognitive problems caused by ME/CFS and also for people who suffer from anxiety. Healthy individuals cannot comprehend the stress and exhaustion triggered by attempting new activities outside our normal routine. When I leave the protective cocoon of my bedroom I enter a world which is out of my control. My room has been adapted around my illness and the limitations placed on me. But when I leave this safe environment I encounter so many obstacles and scenarios which can damage my health.
When you suffer from a serious chronic physical illness, new situations bring with them a lot of obstacles. Change, however small, can trigger a worsening of our symptoms like pain and fatigue. Basic tasks are exhausting for someone with ME/CFS so the added physical activity of travelling to hospital and having a heart scan, is like a healthy person running a marathon. One of the main symptoms of ME/CFS, called post exertional malaise (PEM), means that even once I return to my well-adapted environment I suffer the consequences of this new activity, often for days or weeks. And the fear of not knowing how severe the crash will be or how long it will last, adds to my apprehension.
Not only is the outside world out of my control, it also harms me. The world is a busy, smelly, noisy place. When I venture outside I am met with an onslaught on my senses – a sensory overload. It feels like a million people are shouting at me from all directions. It’s not just painful and exhausting – it’s terrifying.
Added to this, I have my anxiety to contend with. When you suffer from anxiety, routine is your friend. Even the notion of change can trigger a panic attack. When faced with a new situation my mind races out of control trying to find solutions to every possible problem and outcome that may occur due to the change. When you have a chronic illness the amount of possible problems multiples, therefore anxiety levels also multiply.
I have to plan every little detail. I have to think about every possible scenario and “what-if” to try to minimise the damage caused to my health. It’s inevitable that attending this hospital appointment will cause increased pain and fatigue, so it’s not just my anxiety at play here. There is a real danger that this simple activity will trigger a crash that could possibly last for days or weeks. But, if I’m honest, my anxiety also plays a big part the deterioration of my health with situations like this. This mental stress is just as exhausting as physical activity
So, I spend the days and weeks running up to hospital appointments planning every little detail. I ring the department I’m visiting and explain my situation. I have to arrange hospital transport because I cannot sit up in a car. I pack my hospital bag including sunglasses, ear defenders and medication. I have to plan for my return and rearrange my bedroom accordingly. I have to plan for the inevitable crash that will follow and the limitations this will place on me on the days following the appointment. I have to try my best to rest on the run-up to the appointment in an attempt to conserve some energy.
And then there’s the seemingly endless amounts of “what-ifs” I feel the need to plan for. What if hospital transport doesn’t turn up? What if they can’t find my key safe to let themselves in? What if my health is so bad I’m unable to communicate properly? What if there are complications and I need to stay? What if they decide to run more tests? What if I get so dizzy I pass out? What if my appointment is late and hospital transport decide not to wait? What if my scan is cancelled? What if I need the bathroom but I’m too weak to stand? What if I have a panic attack and there’s no one around to help calm me? What if I’ve forgotten something really important?
Other people’s lack of understanding about ME/CFS, and this includes medical professionals, also add to my stress levels. I have to use my limited energy repeatedly explaining why I need to lay down, why I’m wearing sunglasses, why I can’t tolerate noise etc. It’s frustrating because people don’t understand the damage their actions can cause, and quite how traumatic it can be.
I will be travelling to this appointment on my own, without the support of my husband or a family member. I will be at the mercy of strangers – hospital transport staff, nurses and doctors; people that don’t know me or the often crippling symptoms my ill-health causes, and the limitations this places on my ability to function. I don’t look sick – I look like a “normal” healthy individual. Will the strangers who I am entrusting with my care understand the seriousness of my condition? How will I cope without the back up of my loved ones and the safety net they provide. If I’m honest, this is probably the scariest part of the whole scenario for me.
Feeling apprehensive about change or a new situation is completely natural and we all feel it to some degree. We are generally creatures of habit and change brings an element of the unknown. But for someone with a severely limiting condition like ME/CFS this fear is multiplied tenfold.
I cope with this fear and anxiety by planning every little detail, but I also have to accept there are some things (a lot of things in fact) that are out of my control and no amount of planning will help. Would my time be better spent resting and letting other people take control? Maybe, but my anxiety would not allow me to do this, and the stakes are too high for me to leave this in the hands of strangers who do not understand my condition. In the end, I have to remind myself; I have been in a similar situation many times before and I’ve survive every single occasion, I will survive this too.
Do you suffer from these fears? Does leaving your familiar protective environment damage your health and fill you with dread? How do you cope with change and new situations?
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