Armory

Amore, amour, amoire, armoire, armory,
My mind mistakes nothing.
Spelling is your weapon, 
But today it is merely my trail.
My mind and heart reside inside me.
I plead they do not abandon me in action,
And in careful disregard I bluff.
For I find myself donning armor this morning.

My head has been,
Will be, invaded.
No helmet is required.
I am letting in the armies to pillage,
To take what knowledge they will. 
The pounding has already begun. 

Rituals of battle preparation,
Mindful and deliberate,
I’m not armoring myself from physical invasion. 
Clothing confidence layers,
Even when the brain can’t find words and exhaustion is an invisible cloak.
Armor from judgement, 
Maybe my own.
To me, words worn are a hero’s talisman,
Lightening moods or strengthening purpose.

But in the act of peeling on compression,
I ready for a day’s battle.
My own body’s dysfunction salted,
Regulated.
Relentlessly tracked.
Choosing my armor and mask,
I ready for the unknown,
Plan for pain,
And no win answers wounding.

Inevitable exhaustion of a battle fought in my brain, veins, nerves, lungs and heart, 
Fails to undermine fatigue’s foothold. 
Pending relapse reduces my tactics to mud,
Until rest and time return, 
My will to fight through fever and pain,
Again. 

Long Hauler Fall

We expect to fall sick sometimes over a season, or a year. During the years we are raising children, our expectations become certain. Multiple colds, a stomach bug or three, an unknown rash, or a flu, even, are all expected territory. You…and your children…get sick, you suffer, you may even go to the hospital, but you. get. better.

Few of us, in first world countries, envisioned coming down with a virus that we could survive at home with fluids and over the counter medications, but that then could, and would, wreck the absolutely insane havoc Covid-19 has inside the bodies of Covid Long Haulers regardless. Or that it would continue for so long with so many syndromes and symptom sets staying with us, cycling, and relapsing.

Long Haul Covid is a journey I have embarked on unwittingly and without my family’s permission. Amy Watson, one of my principle support group’s leaders, was inspired when she named us Long Haul Covid Fighters and coined the term “Long Hauler.” So much road already traveled and, throughout those months, the unrelenting symptoms of fatigue, malaise, sore throat, and conjunctivitis just persist with many rising and falling waves, like the storming beaches of a small island, barely taking turns: nerve pain, fever & elevated temperature, body aches/chills, inflammation, histamine intolerance, orthostatic intolerance, brain fog, vasodilation/constriction dysfunction causing discomfort and noticeable changes to my hands & feet, high blood pressure, swelling, low blood pressure, fainting. Dozens more. Secondary infections, strange vitamin deficiencies, fungal overgrowths, and allergic reactions to things you never knew people could be allergic. If that is not enough, Long Haulers have to beware of the “relapse.” Even though I have not had one “well” day in seven months, if my dysautonomia triggers are aggravated, I could, and frequently do land myself in a full or partial relapse which means almost all my symptoms get worse and in full relapse I am as good as bedridden for days or weeks. Partial is not as bad and does not last as long, but it happens much easier and all the time for stupid things. Getting a chill in the mid-70’s evening because I have no normal ability to feel temperature. Sitting on the floor to sort papers a little too long. Sitting at the dining room table after my body gave the warning dizziness. Ovulating.

There have been so many points when the length of time endured and the returning, overwhelming illness both seemed unbearable. 3 weeks, 5 weeks, 9 weeks, 100 days, 4 months, 6 months, 200 days…so I know that now, at 7 months after my start of symptoms, an eternity, might seem like the 3 weeks mark when I look back at it from a year or 18 months. In the spring I kept saying, “Two more weeks…two more weeks and I’ll feel better.” I do not remember when I gave that up and looked ahead to the summer. “The end of the summer is a long way away, I should feel better by then…” Sometime in the summer I knew I was indeed going to make it to chronic, over 6 months, and my expectations would need to be adjusted to something more on the year timeline.

I found myself mid-journey in early autumn in the middle of a world grieving. My world is a daily memorial to those who did not survive Covid-19. I grieve, I pray, I contemplate the lives lost and the lives left. I see a need and I’m the one virtually standing there with ears and a heart. I listen and I help if there is anything my words or listening ears or even actions can do. Long Haulers grieve with each other and struggle to find our way through the morass that is our pain and fatigue filled daily lives and the outside world that hurts our hearts because we all tried to protect family, friends, and community members from the torture we have endured only to see much of the world dismiss our very experience and walk into super-spreader events with sneers and hubris. Our families want to participate in normal get-togethers too, backyard barbecues, beach parties, lunch dates, and not to mention in person school, but we are still so sick from March. I have a true respect for this demon virus and no desire to risk my life again, this time intentionally, and also I’m too sick still to participate in much. If I think about whether I am up to eating dinner at the dinner table each night, on the good days, and often do not follow my self-care instincts, but my mom instincts instead, then going to an event of any kind is not even a possibility.

Long Haulers and Covid survivors with damage or lingering symptoms have the same lives as everyone else and yet we seem to live those lives in a completely different world. This year we faced the same events while in pain and fevered, while our children tell us how their heads or internal organs or chests HURT. With those eyes. Worse than those eyes are the weeks when some of us tried to protect our children and spouses. Weeks we could hear pain, grief, worry, or breakdown, but could not go to our babies.

My kids and I had to resort to Zoom hugs and communication by technical means only, for weeks, while I fought Covid. They will take any sort of hugs they can get, virtual, air, or the never letting go, velcro sort with tears.

Too sick in bed, too contagious. I used to pride myself in my power of delegation. Well. There is not much I have left to delegate now. I HATED needing to delegate my comfort and hugs last spring. I am glad to have this ability back, but it was a low point when my 12 year old daughter was giving my 11 year old son as much comfort as she could, and I could not, after the death of his pet, and so much normalcy too.

In March, when the reality of the pandemic hit hope, just in the figurative sense, we even thought we might get a nasty virus. Worse case, we knew we could die from it. Nothing…prepared us, me, for what actually happened. The acute virus was both much, much worse and, also, only the beginning of the nightmarish, multifaceted illness in the same league as scary viruses and illnesses from our history. Again and again the symptoms long haulers commonly suffer are normal for a similar list of systemic disorders including leukemia, diabetes, organ damage, rheumatoid arthritis, lupus, Lyme disease, dysautonomia, multiple sclerosis…and serious viruses like HIV and STDs. Sometimes they list will say “infection” or “viruses” as a possible cause, but often only specific viruses are listed. If researchers pay attention, and do the research necessary, these lists should one day also include Covid-19. That’s where Covid Long Haulers have found ourselves these last 7 months, fighting dozens of symptoms on par with HIV and cancer. All while the world seems to explode like a ripped beanbag chair outside our snow globes.

Nothing was expected back in March, if you recall. We canceled the after-school activities we lead or participated in before we strictly had to. fortuitously, a couple days before my youngest came home from school with unrecognizable Covid symptoms on the last day of school and 9 days before I came down with Covid symptoms. We had multiple events, activities, meetings, and practices planned for the first week that California started to shut down, equating to time NOT spent with around 100 families. In person school shut down rather quickly.

We try to teach our kids a team mentality and to face life changes with flexibility. When life turns upside down, you have to work together as a family, do what needs to be done and change with it. We were trying to be flexible and go with the flow of the events.

What we did not expect, at all, was that our youngest child would actually come into lock-down sick with Covid. We did not know about any community spread in our small town, although now I know there was plenty in neighboring towns where everyone we know does most of their shopping. We still do not know the extent of the Covid spread because lock-down DID happen. It was very fortunate that we shut down as many activities as we did. My son, 8 years old at the time, did come home sick, though, we just had no idea it was Covid. His strange and noticeable symptoms did not start until Monday, March 16th, but on Friday, March 13th he came home merely a little under the weather. I did the mom thing of times past and pushed him into going to one tennis practice and my kids’ one last sleepover. He had no symptoms besides acting tired and not his normal healthy self. I knew as a mom he was not well, but obviously did not guess Covid. Yes, I cringe at the very thought, though when I figured out he had Covid weeks later and checked, everyone seemed to be healthy. I did not even guess it the whole next week when he was sick on a mattress in my room and not when I got sick at the end of the week starting with fatigue, chills, body aches, and extreme shortness of breath, a few days after an bout of diarrhea.

When my son got very sick with what we thought was an allergic reaction because there was no information yet about Covid rashes and he has bad allergies that cause him to vomit. He had a chickenpox-like rash all over his torso and one on his arm, except it was not chicken pox because it did not itch or scab. It did hurt. Vomiting started several days after the rash and lasted two days and lethargy and nausea started. Two plus months of severe headaches and nausea followed that up with a bit of a break and then a return and increase in symptoms for the 6th and 7th months. None of that I could have guessed though from that first week, though it was bad enough. I did not even associate my illness with my son’s for several weeks, not until after dermatology information came out describing his exact Covid rash.

Just before lock-down, my husband and I were worried and careful because I have bad allergies that can give me breathing issues. We were worried I would catch Covid-19 and possibly die if I had compounded breathing problems. The “Coronavirus” was THE unknown. We did not know what to expect. So we did everything to prepare to avoid catching Covid and to prepare in case we got sick. We are a family that combines the forces of multiple forms of scouting, a PhD scientist/engineer dad, and a mom who grew up doing anthropology fieldwork with two linguistic anthropologist parents for entire summers. We prepared…all except for hoarding and toilet paper was the one thing that was totally unavailable before lock-down, so that was one thing we had less of in the house than usual. We did fortify though, we had cold medicine, our regular medicine, and disinfectant. We had soup, electrolytes, flour, yeast, and sugar (we are a baking family). I went to Costco and we prepared to plant a victory garden.

We survived Covid, it felt frighteningly close though, and we survived not going to get supplies in person for seven months, so far. Nothing we did then could have prepared us for the overwhelming nature of Post Viral Covid.

My job has been full. Even the part managing my health, my healthcare, and work…work on getting better. I have other smaller responsibilities, but this has been my focus since I got sick. Only I had no idea it would be like THIS. In some ways I have made progress in others I have failed. I mean, I’m not better, I’m worse and none of my doctors have answers. I am managing some symptoms, though, and not every infection, rash, or symptom is still plaguing me. I’m not at the end of my medical scavenger hunt, but…I AM NOT AT THE END OF MY MEDICAL…investigation! I had to regain confidence and use my will to navigate the Post Covid game of Medical Group Chutes and Ladders. My doctors are all compassionate now and want me to get to a specialist who can help. I feel like I earned my spot now and I will have to earn any further advancement. I am proud of myself because it is not easy to meet a new doctor while sick with no proof besides a paper trail and your own convincing, but sometimes missing words. With my honest plea for help I bring facts, my facts, Long Hauler facts, and Post Covid Dysautonomia facts and the authority I borrow from the awesome doctors at Mount Sinai Post Covid Care. I give doctors what they need to not dismiss me, including a confident if weary presentation. I hold them by the hand until they know who I am and what I need from them on the surface and inside as well.

We are still fighting, inside and out, visibly symptomatic and not. I fought for every minute of medical care, for every hour of halfway normal activities with my family. This fall I miss the traditional activities too. It’s plain bitter to miss back to actual school, trick-or-treating, the pumpkin patch, Thanksgiving, and our every year service projects we are missing this year for the first time in 8 or 10 years. Overlaid all of that for Long Haulers, and their families to a degree, is constant or frequent illness. We are fatigued and even more, we are tired of the forever returning relapses shutting us down and making us start over. We are tired of new, fightening symptoms always starting. Most of all, we are bone weary of the outside world’s frightening aptitude for jumping back into danger like we have not tried to shout a warning with our hoarse voices and the frequent disparagement we get for trying.

I acknowledge the season and my own desires and regrets, and yet I can only keep surviving. Sometimes that is curling up under the blankets unable to read, write, or even think fluid thoughts and sometimes that means putting on jeans, mascara, boots, internal armor, and external confidence, while getting a presentation ready like I am presenting at a specialized conference session for one medical specialist with far more education than I have, but not the information or personal experience.

It is autumn, but know that during your fall we fall. We fall and we’ll fall again and again before winter. We pull ourselves back up out of full relapse every time to advocate for ourselves, for our families, for other Long Haulers, and for you too.

Familiar Fall

Rising rhythms raising rates,
Heating higher heights unhealthy,
Wake up worse,
What was sore is more,
What was noticeable is noticed.
Did gravity triple?
Your limbs grow roots?
Short breaths resurrect fears not forgotten.
Crawling through your bones, and up your spine,
The ill feels like Covid climbed out of hiding.

You've fallen, Friend

What you did, you didn't know, 
Lived a little,
Or stood too long.
You may have had a month, or an hour, of something better.
A walk, a week's work, a paycheck,
A "good day."
Bones without the ache of fever,
or the full body distracting torment of chill.

Fall like an autumn leaf.
You know what's coming, 
You've been here before, Long Hauler.
Don't be discouraged;
You know what's coming, 
But each time you know more,
And start over.
Breathe, rest, gather, be calm.

Fight what you can change,
Not falling leaves. 
This is not the season you wanted, 
not the pain, the loss, the fog, or the fight.
Fallen from our old lives,
We keep falling into Covid again and again.
One battle wasn't enough, maybe, 
But hundreds, mean you are a fighter.

Your unfamiliar autumn, to us, is full of falls we find too familiar.
Different degrees of collapse, but all decrying the crash.
Chills like an old nurse dropping you in bed, 
Pulling all the covers up while air conditioning roars.

Battle roll out of bed, 
Fevered, help kids afflicted, or
Go to work scrubbed in fog and faintness, 
Testing dizziness and brain function as a fiction. 
Patients, clients, children...do you perform?
Struggling, falling with your list of recognized disabilities, 
Comorbidities you never knew existed. 
You now advocate, fighter.
While your body is on fire.

A season will come, maybe spring,
When we'll forget our last fall into relapse.

We will never forget to notice...
                      ...feeling healthy.
                            -RJLETTS

Top Left: My warm down comforter. Top right: One of so many swollen eye photos. Left to right: My littlest one has 7 month symptoms, we were waiting in the parking lot for a doctor examination. Trying to open my eyes wide. My droopy eye just won’t. My condensed bed tray now that I’m not as needy as before…and this is my life. Bottom: I have sweet friends and family to brighten up my space with special deliveries!

PT Successes

I entered my 7th month of fighting Post Viral Covid this week.

-SEPTEMBER 24TH, 2020

I entered my 7th month of fighting Post Viral Covid this week. It has been a “good” week, so I thought I would share my progress. Any long hauler, or individual with a chronic illness, I gather, knows that “good” is so very relative. Unfortunately, it does not mean a substantial change in my baseline symptoms…and my neurological symptoms have been worse, but I have not had a relapse for 5 days so far. Long haulers identify the triggered worsening and reappearance of old Covid and Post Covid symptoms, from a long list of symptoms including fever, chills, and severe body aches. 5 days is a record for the last couple of months. In addition, my daily high temperature has lowered to the lower 99s. Much lower and I will not even consider it elevated anymore, but, this week, it is usually low enough not to bring body aches or cause me to feel feverish all day, which as you can imagine is an improvement. On the down side, my body seems to compensate with increased nerve, skin, and joint pain, but that is another story and I am usually more mobile with pain than fever anyway.

My average daily heart rate also lowered and is not tachycardic as often. This week was after a particularly bad four to five days last weekend for my POTS (Postural Orthostatic Tachycardia Syndrome) symptoms, including extreme lightheartedness, faintness, nausea, shakiness, etc., when not lying down and less extreme when resting horizontally. So I got this set of POTS symptoms to dissipate, to a noticeable degree, by this Monday (September 21st). I still have orthostatic intolerance and tachycardia when my dysautonomia is triggered, but it is a problem after standing or sitting for too long or getting warm, not incessantly.

The really exciting part is I seem to have MADE these improvements happen and I think I can keep using the same methods or use them again after I relapse. I might feel like I am starting all over, but really only am taking a step or two backward for the time it takes to suffer the relapse.

At the end of July, I began using the principles of graded exercise protocols, but modified to the equipment on hand (my body) and what my body preferred (gentle walks). Not a lot of the POTS patients, who the original protocols were made for, had as many additional syndromes and symptoms, or were as sick, as Post Covid fighters, so Mount Sinai Post Covid Care warned us the protocols might not be good places to start without modification.

The suggested first step was to be a breathing therapy program, but I got impatient waiting for this therapy that I did not yet even understand. I know I may need further supervision with more advanced physical therapy since it is such a balancing act. Post Covid fighters are always so close to overdoing physical or mental activity with post exertional malaise causing relapse. I liken the balancing act to walking on a tight rope woven of fatigue, pain, and dozens of debilitating and unknown symptoms. You have to try to walk across the rope, balancing, but if you are not careful, push yourself too hard, and fall off, you start over, losing weeks or months of progress while you start over at the beginning of the tightrope course. Even for those who think they got the hang of the rope, they can start thinking they can carry some of their old burdens and walk the tightrope…and that is when they fall off. The end, of course, is the end of the illness, but it is not in sight and you will not know it when you have found it. Either way the rope seems to stretch on indefinitely, when at the beginning we could always see the end just a little bit further. Another two weeks and the fever would be gone. Another two weeks and I would feel better. I may feel forever stuck in the middle with no visible end and little support beyond that of my family, conventional and Long Hauler, and the balance and skill I find within myself, but others are still crawling on the rope. Clinging. Hoping they will be able to stand and walk soon.

In August, I noticed improvements in my temperature and heart rate after a couple of weeks of short geriatric walks and occupied days full of frequent rests. Throughout those days, as soon as my body or mind gave me warning signals, I was careful to recognize the need to lie down. It took a couple of weeks with those short walks and those I had to undertake even when my body told me it needed to rest as long as I did not go into full relapse.

On my symptom spreadsheet for August (a subject for later discussion), the difference was not even that noticeable. It is more a matter of how long my temperature stayed low before peaking and a breaking of the daily pattern my dysfunctional temperature had followed stubbornly for five months. My temperature was in the low to mid-99’s for most of these specific days, only peaking to previous high numbers for short periods of the afternoon or evening instead of most of the afternoon and evening or daytime. This felt like an improvement compared to living most days with a temperature of mid to high 99s or 100s up to 100.9, especially for someone whose natural temperature is 2-3 degrees lower.

Long haulers with fevers and/or elevated temperatures for months are drained and depleted. We have all the body aches, feverishness, chills or sweats (depending on the person) to go with them. My autonomic nervous system is dysfunctional and has lost its ability to regulate temperature, among many other body system dysfunctions. So my temperature does not do what it is supposed to and my body does not react to temperature the way it is supposed to as well.

Unfortunately, it was that point in August, here in California, when the first triple digit heat wave happened, a thunderstorm, and fire season began in earnest. I had relapse after relapse since then with no way to break the cycles until last week because the air was too unhealthy and too hot to restart my walks for more than a day or two when I was not also on the worst days relapsing.

Last week, I was able to restart my walks and in less than a week my temperatures and average heart rate both lowered to their current relatively low numbers. I was careful not to trigger any Dysautonomia triggers and rest plenty. In addition, I incorporated breathing therapy, and my own brand of therapy, musical instrument study.

I did finally start the breathwork therapy that Dr. Putrino spoke about ages ago. Stasis Performance works with the Mount Sinai Post Covid Care patients for breathing therapy. I knew he said it was the first step for long haulers before graded exercise protocols, but I did not know it was specifically supposed to help regulate the autonomic nervous system in Long Haulers. So it was with surprise that I learned the point was not just to strengthen lungs after Covid, but to train the lungs to breathe a certain way that strengthens the parasympathetic autonomic nervous system which will in turn help balance and strengthen the more dysfunctional sympathetic nervous system. I do understand how this sounds, but the director of Mount Sinai Post Covid Care, Dr. Putrino, has been more knowledgeable about Post Viral Covid than any other doctor from any other institution and Mount Sinai’s theories have only become more applicable and accepted. I’ve come to trust Dr. Putrino’s theories in the generous spirit they were given.

Interestingly, when I do specific breathing cadences at night, from Stasis Performance, I keep activating full body nerve sensations. They are similar to the extremely uncomfortable, not exactly pain sensations I experienced when I had a home sleep evaluation and I had the device on my head attached with electrodes. It seemed to plug into my system of nerves and felt like my body was wired with tortuous electricity. It is worse than pain even if it is not exactly pain. I feel internal buzzing and vibration throughout my body that increases in intensity and turns into external tremors. That sensation is similar and and often coincides with peripheral neuropathy nerve pain, like burning skin and needle pricks and more, so I know it is my nerves. I am happy to know that the breathwork therapy is in fact affecting my autonomic nervous system, but it is unusual. I cannot actually stand the sensation so I actually have to get up move around and take what nerve pain medicine I have (CBD tincture) before I can continue. Then I fall right to sleep. If I try to hold out, the sensation will win. It can last for long periods in the night and used to delay sleep.

I have no idea if this is a thing, but I am calling it one. I started teaching my sons to play the recorder and penny whistle at the end of the summer. Well, it is a stressful year and the boys come and go while they get adjusted to an unusual school year and lingering post covid symptoms, but I continued to teach myself both instruments. Ever play an instrument with full body and hand tremors or when you are battling short term memory deficits? I think it is good for my brain, my manual dexterity, my lungs, and I am positive music is good for the soul, uplifting us and giving our wordless thoughts wings like a prayer.❤️

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Mixing the old and the new. Making new memories honors the old.