Thursday, May 18, 2017

Trauma and the brain...

I tried to use the broiler on my new stove—the stove I've already had to repair once—and it wouldn't shut off.  So, I have another warranty repair appointment for Monday.  SIGH.

I had a therapy appointment today.  Afterward, since I was out, I fetched milk and a pump sprayer for the Neem oil extract concentrate I got for the carpenter ant nest in my evergreen tree and to put on my cucumber plants since last year they ended up getting the powdery mildew.  On the way home, I treated myself to fries and a frosty (which also means a junior bacon cheeseburger).

However, when I started to eat the french fries—a food that gets quite mushy when you chew it so it should have been no problem—I had the worst swallowing episode to date.  I was terrified.

The key to dealing with food stuck in your esophagus is to remain calm, but that is really, really, really difficult.  It is easier to fall into a panic because your body feels like you are choking, even though you are not.  The gastroenterologist told me that I needed to remain calm and talk myself throw the episode as I continue to try and swallow the food.  Eventually, she said, my attempts at swallowing will trigger the process lower down where the food has been stopped.

It is incredibly painful.  I am not sure why.  Perhaps the muscles are spasming or something.  Today, it was the most painful it has ever been.  And that scared me.

The episode was also longer than it has ever been. I tried and tried and tried to swallow, but nothing was happening.  I ended up walking around in a panic, flailing my arms about and shifting my torso in all sorts of positions to try and get the food moving again.  I longed to throw up, but, frankly, my years as an anorexic has ruined that ability (forcing yourself to vomit) for me, even though they are three decades in the past.

I ended up bent over the sink, frustrated because I could not swallow and because the tears I would have been weeping are not in my eyes due to the blasted Sjogren's.  I had my arms across the sink and my head in between and below them.  In that position, something shifted, just enough for me to stop thinking I should call 911 (there's nothing for anyone to do).  It was then that I was able to gird my loins, pull myself up by my bootstraps, and take a few calming breaths.  I tried to think of a calming thought, a calming Bible verse, but none came to mind.  However, I did redouble my efforts to swallow then and the food finally began to move the tiniest bit.

It was another ten minutes or so before my esophagus was clear.  The whole episode was over an hour.  My fries and burger were cold.  But, then again, I had no interest in food.  I was spent, and I was utterly overwhelmed by what had just happened.

It occurred to me in that moment that living with Chronic Illness means living with chronic trauma.  With autoimmune disease, your body is literally attacking itself.  With dysautonomia, the malfunctioning autonomic processes often feel as if your body is attacking itself.  Between both conditions, life can be rather rough.

That thought was a bit of a foreshadowing, for later in the evening I had the worst blood sugar attack I've had to date.  Once I finally realized what was happening, my blood sugar was only 36.

I was feeling so very ill, but not the way I usually feel when my blood sugar is low.  Then I started battling pre-syncope in a rather visceral way.  Usually, when it is bad, I will stop fighting the faint and just let go.  But something about how I felt made me afraid to do so.  I kept struggling to remain conscious.

Then, my heart started racing and pounding.  I checked my rate (136), but my blood pressure cup was upstairs and I did not feel well enough to fetch it.  I wondered if this was all BP related, but things just didn't fit.  I was anxious.  Then, when I started sweating, I realized it must be my blood sugar.  When the number popped up so very, very low, I shoved five glucose tablets in my mouth and began to chew as fast as possible.  I downed a small glass of milk and some cheese to get that balancing protein in and then gobbled up a granola bar in under a minute.

It is such a primal time for me, an almost feral desire to eat washes over me and I find myself standing (or sitting) before the refrigerator grabbing food right and left.  I will often eat more than I need because it takes a while for my blood sugar to rise.  Once I finished eating, I slid to the floor and lay down, waiting for my body to respond.

I posted on Facebook what was happening because I felt so very alone and so very scared.  I hoped someone would pray.  Once my hands were shaking a bit less, I posted an update and then curled my body around Amos.  Eventually, I fell asleep.  I was so very exhausted from the crash.

It is now 12:54.  I awoke a little while ago, feeling ever so much better.  I have something heating in the oven, because I want to eat again before I sleep for the night ... I want to get some more protein on board.  Then, I will walk around a bit since I am eating so last.  I thought I would catch up here, though I plan to back date the entry to 11:59, as I always do when I want to capture a day and it is past midnight.

The time with my therapist was interesting.  Mostly, it was more of a here's-all-the-stuff-in-my-head dump rather than what I would think of as a therapy session.  I came wanting to focus on two things:

1) I wanted to read her this passage from the shame research book by Dr. Brené Brown, I Thought It Was Just Me [But It Isn't].  The passage is from the chapter on the role of empathy in shame resilience.  In it, she has several segments of folk talking about shame, scenarios so to speak.  Then she identify the emotions in them.  Then she has a "Dig Deep" bit where she asks questions or poses moments that have similar emotions so that even if you are not familiar with the scenario, you can still identify with the person and share empathy.

Experience:  When I think about shame I think of being sexually abused when I was growing up.  I think about that what that's done to my life and how it's changed everything.  It's not just the abuse itself.  It's everything you have to deal with the rest of your life.  It's like you feel different from anyone else; nothing is every normal for you.  Everything is about that.  [even medical care for physical things]  I'm not allowed to just have a regular life.  That is the thing that made me who aI am and so everything is stained by that.  That's what shame is for me.

Emotions:  Feeling labeled, dismiss, misunderstood and reduced.  Emotions might include grief, loss, frustration and anger.

Dig Deep:  Have you ever been defined by an experience?  Found yourself unable to get out from under a reputation or "an incident"?  Have you ever been unfairly labeled?  Have you ever had people attribute your behaviors to an identity you don't deserve?  Have you ever fought to overcome something, only to find others less willing to move past it? (p.60) [my experience added above]

When I went to read it to her, I found myself choked up.  Once again, I was oddly frustrated because I could feel my body ready to weep, but there were no tears in my eye ... just a little bit extra moisture for my now perennially desert orbs.

I was thinking about this on the drive over to Mendard's because I got caught in a storm and then behind a train.  I was talking to my dear friend Mary and was trying to work up to asking her about it, about my thoughts, about having that as my identity, but I was chicken to voice the words and she had to go before I got them out.

This might sound strange, but I think I would like to try reading it again and talk with the therapist about why I got so choked up.  After all, I couldn't even identify what I was feeling when I read it.

The therapist took down the name of the book and said she would order it so we could use it as a tool since it was so important to me.  I still think The Courage to Heal is the BEST book ever for sexual abuse, but it lacks anything substantive on shame.  And shame fills my being.

2)  I have been really, really working on my relationship with my sister, talking with her about things I normally keep silent and trying to be more vulnerable with her.  I have also redoubled my efforts to be her cheerleader.  Well, in one of our talks just a bit ago, my sister said she remembered my father getting my uncle out of our bed.

In that moment, I was stunned.  I didn't know what to say and so I said nothing.  But I wanted to shout to the doubters:  SEE, I AM NOT MAKING THIS UP!  And I wanted to know if she remembered more.  I mean, was she sleeping the sleep of a child, dead to the world around her?  Did she see what he did to me?  Did he do it to her?  But it wasn't time for those questions.

When I relayed what had happened, the therapist said:  you had validation.  I don't think I thought of it in those terms, but I could say that there was a similar feeling within as when I learned I needed a pacemaker.  SEE, I AM NOT MAKING THIS UP!

The other real thing that arose was how I do not remember things, even as an adult, not even the good things.  My therapist said that she's been doing some clinical readings on memory for another client and learned that when your brain is in that fight, flight, or freeze mode, its priorities shift and it is not dialed into the moment for memory making, but rather shifted most of its resources away from the prefrontal cortex to the amygdala because of fear, so what gets encoded for memory is different from the normal process of remembering an experience.  Fear also changes how the hippocampus works, which is responsible for short-term memories and those converted to long-term.  There is a Time Magazine article I found talking a bit about it.  I forgot to ask her if she would provide me some of the clinical articles, because I very much would like to read more about how trauma affects memory.

You see, one of the things the integrative medication specialist has taught me is that the reason my cortisol levels are so very high is that my brain has become de-conditioned to trauma.  It reacts (or you could say overreacts) to experiences as if they were trauma so easily because I lived in a trauma-triggered state so long as a child.  My body did not have time to calm down, especially because I had no help doing so.  And with each stressful experience, my brain dumped cortisol, norepinephrine, and adrenaline more and more easily/quickly.  So, now, the slightest startling, the slightest moment of fear, and I feel that fiery rush of adrenaline throughout my body.

Hearing her talk about trauma and memory making makes me wonder if the reason I do not have even good memories is because of the near constant state of physical stress in which I live.  I mean, heck, Becky and I had a most lovely time in Italy.  I cannot understand why I cannot remember our trip.  Or when my friend Mary has visited.  She says that I made her chicken enchiladas and she loved them.  Surely I should remember that.  Or my visit with my friend Celia.  Or Amos.  Why can I not remember my beloved Fluffernutter as a puppy.

I depend a lot on photos, though I had given away and/or discarded most of mine.  Staring at things and people I cannot remember is despairing.  I stare at the representative ones I have kept and spend hours trying to walk myself back through that moment.  Nothing.

I collect stories about myself like they are priceless treasures.  I rehearse the things I have been told over and over and over again.  I want to hold onto at least what I know, even if it is not what I can remember.  What I do remember, for the most part, I would give anything to forget.  Especially the physical memories.  SIGH.

The most interesting part of my appointment today was that my therapist said that I could bring Amos.  Hmmmmmmmmm....

I do find it sort of ironic that I had two rather traumatic experiences tonight, by physical failings of my body.  I am not implying in any way that seeing the therapist today were their cause.  I mean, the swallowing thing happens every day to some extent or another.  Today ... early evening ... it was just the worst episode thus far.  And it is a precursor to the time when I very likely will not be able to swallow, given the progression of this problem over the past year.  The blood sugar?  Well, that is the most random, frustrating symptom  have.  Frustrating in its randomness.

I find it ironic because here I was thinking how the engrained trauma response has affected my brain and my life and BOOM!  More trauma.  Life with chronic illness is hard.  In many ways, its a crap life.

But I found a therapist who is willing to help me at a reduced rate.  I cannot go as often as I would like (to move things along), but I have someone who understands both the sexual abuse and the burden of chronic illness.  When I read that part above about never getting to be normal, she filled in the word "normal" because she knew what was coming.

When we talked about normal, I mentioned the baby in the bottle.  And she understood what I was saying.  I am not normal.  I do not understand basic things about life and about family.  That colors and informs my life.  And defines me in a way.  I crave normal.  It's why I desperately long for someone to go out for a meal with me ... to do a normal thing ... even if it is with someone who is not kind to me.  SIGH.

A dear Facebook friend sent me two blank journals and two notepads at Christmas.  I am thinking about using one of the journals to write down the thoughts that bother me or the things that I wonder about me and then take the journal to my appointments.  That way, the therapist could skim them and pick something to talk about.  I'd like my appointments to be half about the past and half about the present, if possible.  I need help with both.

Well, it's an hour later now.  I stopped to eat.  Now I need to try and spend some time on my feet.  Maybe I'll dance about the living room with Amos for a bit.  Lying down to sleep causes quite a few problems with me, especially as my heart rate slows and my blood pressure drops.  And my innards find life without the help of gravity rather hard.  So, when eating late for blood sugar crashes, I like to help my innards out as much as possible before becoming supine.

What a day.
Interesting that ... trauma and the brain.

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