Categories
Osteoporosis

8 Mistakes People With Osteoporosis Make

What to Do—and Not Do—If You Have Low Bone Density

Osteoporosis is a chronic, common condition causing bones to weaken and become fragile. If you have this condition or are at risk for it, there are things you can do to help preserve the bone you have—and even add new bone. But there also are mistakes you can make that can slow this progress, often based on misconceptions or misunderstandings. By avoiding these common missteps, you can reduce your risk and keep your bones at their best.

 
Man golfing

1. They think it can’t happen to them.

While most people with osteoporosis are post-menopausal women, it can affect both men and women at any age. All kinds of factors can cause osteoporosis: medications you take (corticosteroids, for example); other medical conditions you may have, such as cancer, irritable bowel syndrome, anorexia or rheumatoid arthritis; being sedentary; smoking; drinking excessively; and many more. Talk to your doctor to see if you are at risk.

 
Doctor examining patient's leg

2. They don’t take fractures seriously.

About 80% of older Americans who get low-impact fractures (such as a fall from a standing position) don’t get follow-up scans to check their level of bone density. Yet fractures are often the first sign of osteoporosis, and also can have a severe impact on your life (especially hip fractures, which can result in life-long disability, loss of independence and even death). About half of osteoporosis-related repeat fractures are preventable—if you get proper treatment.

 
Female doctor talking to female patient

3. They let alarming headlines scare them off medication.

Certain kinds of drugs called biphosphonates, such as Boniva or Fosamax, have been in the news for possibly causing jaw cancer or femur fractures. But your risk for fracture is almost always much higher than your risk of encountering any of these rare side effects. Medications can cut your fracture risk in half. Before quitting your medication, talk to your doctor about your risks and any alternative treatments, such as other types of drugs.

Medication for strong bones

4. They shy away from calcium or supplements for fear of side effects.

Recent studies have raised concern that excess calcium or calcium supplements can lead to heart problems. However, the National Osteoporosis Foundation says its experts and those from the American Society for Preventive Cardiology have reviewed the research and believe calcium (including supplements) is safe at recommended levels. The foundation recommends people get 1,000 to 1,200 milligrams of calcium daily (depending on age and gender) from food sources if possible and supplements if needed, but not to exceed 2,500 milligrams daily.

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Ankylosing Spondylitis

10 Common Symptoms of Ankylosing Spondylitis

Ankylosing spondylitis is a protracted inflammatory condition that can affect various joints, as well as the eyes and intestines. Most frequently, however, the disease targets the spine. Doctors classify ankylosing spondylitis as a form of spinal arthritis to clearly distinguish it from common back injuries. The condition can be more harmful than common back problems because it may eventually impede mobility and damage eyesight. Ankylosing spondylitis usually develops between the ages of 17 and 45, although children can get it too. It’s more common in men, although some experts believe this is due to under-diagnosis in women.

1. First Noticed After a Muscle Strain

Ankylosing spondylitis and regular back injuries may start in the same way. The patient tells the doctor that they strained a muscle, and shortly afterward, the back pain begins. However, the pain associated with ankylosing spondylitis comes from inflammation around the spine rather than trauma and therefore requires different treatment.

2. Pain Develops Over Time and Varies

Pain from ankylosing spondylitis may occur in any part of the body where tendons or ligaments connect to a bone, often developing slowly over the years, although it can flare up suddenly. The symptoms may lessen or worsen as time passes. Sometimes, pain builds after a period of rest, though it may also wake an individual during the night. In the mildest cases, it is barely noticeable, but severe ankylosing spondylitis can make it extremely painful to bend, turn around, or perform other movements usually carried out unconsciously. Teenagers do not normally experience pain in their lower back, so this symptom indicates the need for immediate medical attention.

3. Exercise May Help

Exercise generally aggravates back pain while rest eases it, but in the case of ankylosing spondylitis, the opposite holds true. This is one reason why the pain is frequently worse in the morning. Because exercise brings relief, people with the condition are often encouraged to lead active lifestyles.

4. Pain that Spreads Around the Body

Even though the symptoms of ankylosing spondylitis generally first develop where the spine joins the pelvis, this arthritis-like inflammation may spread to joints in the shoulder, elbow, ankle, knee, heel, and other areas. Swelling may accompany pain and stiffness, as may a sensation of warmness. The exact course the disease takes, and its severity, differs greatly from person to person, so it is difficult to predict.

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Categories
COPD

10 Treatments for COPD

COPD stands for chronic obstructive pulmonary disease, but it is actually not one disease at all. A person suffering from COPD may have any one of the following: chronic bronchitis, emphysema, non-reversible refractory asthma and some types of bronchiectasis. Most people are diagnosed with COPD after they notice that they are extremely short of breath, and this isn’t necessarily dependent upon physical activity or a present illness. This is why so many older people go undiagnosed for so long because they see the “breathiness” as just a part of growing older. However, once a person is diagnosed, there are many treatments available to add to the quality of life.

1. Bromelain Supplements

Bromelain is a supplement that is mostly made from pineapple, especially the juice and the stems of the fruit. It seems to help patients who are suffering from COPD because it can naturally help with the reduction of inflammation, which may help the lungs work a little bit easier when trying to take a breath. Bromelain can be taken in doses that may range from 80 mg to 500 mg per day. It is not recommended for individuals to take Bromelain if they are on blood thinners, antibiotics or are allergic to pineapple.

bromine COPD

2. Taking Antioxidant Vitamins

Antioxidant Vitamins can be known to assist patients with COPD, including vitamins A, C and E. These vitamins may be good supplements to assist with COPD, because typically people who are suffering from its symptoms may have low levels of these particular vitamins, which can result in bad pulmonary functions. When people eat more fruits and vegetables, some research has even shown that it helps with certain types of lung functions, as well, and fruits and vegetables are packed with vitamins A, C and E. Also take note that patients who are still smoking require even more of these essential vitamins than those who do not smoke.

vitamins COPD

3. Getting More Vitamin D

Vitamin D deficiencies seem to occur frequently with patients who are suffering from COPD, and a lack of Vitamin D can also trigger osteoporosis. Osteoporosis can be especially dangerous for someone who has COPD, because as the spine begins to curve, it will make it even more difficult to breathe. Supplements are available, but if you pad your diet with healthy foods that include a lot of Vitamin D, such as tuna, salmon, orange juice, soy milk, cheese and its products, beef liver and egg yolks, a supplement might not be necessary, unless your body requires the additional Vitamin D.

vitamin d sources COPD

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Categories
Tinnitus

The Brain: “Ringing in the Ears” Actually Goes Much Deeper Than That

In some of the world’s oldest medical texts­­—papyrus scrolls from ancient Egypt, clay tablets from Assyria—people complain about noise in their ears. Some of them call it a buzzing. Others describe it as whispering or even singing. Today we call such conditions tinnitus. In the distant past, doctors offered all sorts of strange cures for it. The Assyrians poured rose extract into the ear through a bronze tube. The Roman writer Pliny the Elder suggested that earthworms boiled in goose grease be put in the ear. Medieval Welsh physicians in the town of Myddfai recommended that their patients take a freshly baked loaf of bread out of the oven, cut it in two, “and apply to both ears as hot as can be borne, bind and thus produce perspiration, and by the help of god you will be cured.”

Early physicians based these prescriptions on what they believed tinnitus to be. Some were convinced it was caused by wind that got trapped inside the ear and swirled around endlessly, so they tried to liberate the wind by drilling a hole into the bones around the ear or using a silver tube to suck air out of the ear canal. The treatments didn’t work, but they did have an internal logic.

Today tinnitus continues to resist medicine’s best efforts, despite being one of the more common medical disorders. Surveys show that between 5 and 15 percent of people say they have heard some kind of phantom noise for six months or more; some 1 to 3 percent say tinnitus lowers their quality of life. Tinnitus can force people to withdraw from their social life, make them depressed, and give them insomnia.

Some modern doctors prescribe drugs like lidocaine. Others offer patients cognitive therapy. Some have people listen to certain sounds, others apply magnetic pulses to the brain and even implant electrodes in the brain stem. Although many treatments have shown some promise, none is consistently effective. Recent research suggests why: Tinnitus is a lot more complicated than just a ringing in the ears. It is more like a ringing across the brain.

Normally, we hear sounds only when they make our eardrums vibrate. The vibrations cause nerve hairs in the inner ear to shiver, and that triggers electric signals that travel along the auditory nerve into the brain. One of their first stops is a patch of gray matter called the auditory cortex. Each nerve hair is tuned to a particular frequency of sound and excites only certain neurons in the auditory cortex. As a result, the neurons in the auditory cortex form what is known as a tone map. The neurons at one end of the auditory cortex are tuned to low frequencies; the farther you go toward the other end, the higher the tuning of the neurons.

This sound system comes with an elaborate feedback mechanism. Neurons do more than just relay signals forward into the brain. They also signal back down the line, reaching out to neighboring neurons tuned to nearby frequencies, exciting some and muzzling others. These feedback controls allow us to sift through incoming sounds for the most important information, so that we are not overwhelmed by meaningless noise. In young brains, the neurons and their feedback controls grow and link up to each other. Even in adulthood, experiencing new sounds can rewire the auditory cortex. If a rat is trained to recognize sounds at a particular frequency, the corresponding region of the tone map will get bigger.

Tinnitus arises when this flexibility goes bad. Things may start to go awry when toxic drugs, loud noises, or even whiplash cause damage to the nerve hairs in the ears. The injured nerve hairs can no longer send signals from the ear to the tone map. Bereft of incoming signals, the neurons undergo a peculiar transformation: They start to eavesdrop on their neighbors, firing in response to other frequencies. They even start to fire sometimes without any incoming signals. As the brain’s feedback controls get rewired, the neurons end up in a self-sustaining loop, producing a constant ringing. That is why tinnitus often doesn’t go away when people get their auditory nerve surgically cut.

It’s not just the auditory cortex that is affected when people get tinnitus. Neuroscientists, using increasingly sophisticated brain scans, are finding that changes ripple out across the entire brain. Winfried Schlee of the University of Konstanz in Germany and his colleagues have been making some of the most detailed studies of tinnitus ever, using a method called magnetoencephalography (MEG, for short). They take advantage of the fact that every time neurons send each other signals, their electric current creates a tiny magnetic field. MEG allows scientists to detect such changing patterns of activity in the brain 100 times per second.

Schlee and his colleagues find widespread differences in the brains of people with tinnitus and those without it. A network of regions in the brains of people with tinnitus tend to fire their neurons in sync. Schlee has determined that his tinnitus-stricken subjects have a more synchronized pattern of signals coming out of regions in the front and the back of the brain. (For brain anatomy junkies, they are the dorsolateral prefrontal cortex, orbitofrontal cortex, and anterior cingulate cortex in the front; in the back, they are the precuneus and posterior cingulate cortex.) Schlee and his colleagues also discovered a more strongly synchronized flow of signals coming into the temporal cortex—a region that includes the auditory cortex—in people with tinnitus.

When Schlee compared people who suffer a lot of distress from tinnitus with those who are not much bothered by it, he found that the more distress people felt, the stronger the flow of signals out of the front and back of the brain and into the temporal cortex. This pattern suggests that the network Schlee discovered is important for the full experience of tinnitus. Tinnitus, in other words, extends beyond the ear, beyond a hearing-specialized part of the brain, beyond even any single piece of neural real estate. It is a disease of networks that span the brain.

Such complexity may explain why so many different tinnitus treatments work, but only modestly: Each attacks just one part of the tinnitus network. Christo Pantev of the University of Münster in Germany and his colleagues, for example, have brought some relief to people with tinnitus by rewiring their tone map. To do so, they edited recordings of music, filtering out the frequencies of the ringing in the ears of their patients, who then listened to the filtered music an average of 12 hours per week. Pantev and his collaborators found that their patients’ tinnitus significantly eased. They also found that the neurons tuned to the tinnitus frequency in the auditory cortex became less active.

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Categories
Graves disease

5 Causes of Graves’ Disease and 5 Solutions for It

It is estimated that between 3 and 10 million people are diagnosed with hyperthyroidism or an overactive thyroid.1 The most common form of hyperthyroidism is the autoimmune condition known as Graves’ disease.

I was diagnosed with Graves’ during my second year of medical school, and in my book, The Autoimmune Solution, I share my personal experience with Graves’ disease and how conventional medicine failed me. I never want anyone to go through what I went through, so it is my mission to empower as many people as I can with the information they need to use a healthier and more natural way to recover from Graves’ and other forms of hyperthyroidism.

What is Graves’ Disease?

Your thyroid, the butterfly-shaped gland in the front of your neck, produces hormones to help regulate body temperature, heart rate, growth, energy production, and brain health. Hyperthyroidism occurs when the thyroid produces too much thyroid hormone. When thyroid hormones are too high, energy metabolism will speed up, causing the body to burn through nutrients too quickly. This can result in malnutrition and chronic illness. While I combatted Graves’ I ate everything in sight and went from a size 4 to a size 0 in a matter of months.

The thyroid can become overactive for many reasons, yet it is commonly a result of the autoimmune condition Graves’ disease. Graves’ disease accounts for roughly 60-80% of all hyperthyroid cases.2 Normally, thyroid function is regulated by the pituitary gland, a tiny gland responsible for secreting TSH, which signals the thyroid to produce thyroid hormones T3 and T4. In Graves’ disease, an antibody known as thyrotropin receptor antibody (TRAb) can mimic pituitary hormones and completely override the system, inducing an overactive thyroid. You can also develop Thyroid Peroxidase (TPO) antibodies or Antithyroglobulin antibodies. I only had antibodies to TPO, which I frequently saw in my clinic as well.

Two other forms of hyperthyroidism which are not autoimmune conditions are known as toxic multinodular goiter and toxic adenoma. Toxic multinodular goiter involves the growth of independently functioning nodules on the thyroid gland itself. These nodules are able to stimulate the thyroid without the use of TSH, creating havoc in your thyroid hormone process, and provoking an overactive thyroid.

Toxic adenoma is a benign tumor consisting of thyroid follicular cells, which produce excessive amounts of T3 and/or T4. The excess thyroid hormones produced by toxic adenomas can suppress the function of remaining healthy thyroid tissue, leading to hyperthyroidism.

Graves’ Disease Symptoms

  • Hot flashes, sweating
  • Unintentional weight loss
  • Frequent stools, loose stool or diarrhea
  • Difficulty sleeping and insomnia
  • Anxiety, irritability, or constant fatigue
  • Elevated heart rate
  • Changes in menstrual cycles
  • Reduced libido
  • Bulging eyes
  • Thick red skin on shins or feet
  • Increased appetite
  • Osteoporosis
  • Hand tremors
  • Muscle weakness

How is Graves’ Disease Diagnosed?

1. Blood testing your thyroid hormone levels is the first step. In hyperthyroidism, the thyroid-stimulating hormone (TSH) will be very low and the Free T4 and Free T3 will be elevated. In autoimmune conditions, you will see elevated levels of antibodies as well.

2. Radioactive iodine uptake (RAIU) is the next step in diagnosing a thyroid imbalance. An RAIU using a small dose of I-131 will determine how much iodine the thyroid takes up. A high iodine uptake is indicative of Graves’ disease. This test can be helpful in ruling out other possible causes of an overactive thyroid.

3. Ultrasound (US) of the thyroid is a helpful step to look at nodules on the thyroid. Your doctor may request for you to have a fine needle biopsy to confirm that the nodules are not cancerous.

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Categories
Gastric Bypass

35+ Celebrities Who Had Weight Loss Surgery

America has an interesting fascination with celebrity. We build up certain people to be larger than life and then follow their every move and decision. The United States, as a country, also struggles with obesity and weight loss. Many celebrities also struggle with weight issues, and the famous people on this list have all undergone weight loss surgery to help start their weight loss journey.

From gastric bypass to the Lap-Band, many celebrities have had surgery to get started on a healthier lifestyle and achieve their weight loss goals. This list features famous celebrities who have had their stomachs stapled or have the Lap-Band.

Read through the list below to find out which famous people have had a weight loss procedure.

Sharon Osbourne

Sharon Osbourne is listed (or ranked) 1 on the list 35+ Celebrities Who Had Weight Loss Surgery
Photo: Metaweb/CC-BY

Sharon Osbourne underwent gastric bypass surgery in 1999.  In a recent interview, Osbourne explained that having the surgery made her feel like a cheat.  She had the band removed in 2006 and now maintains her weight with diet and exercise.

Age: 66

Birthplace: Brixton, London, United Kingdom

Randy Jackson

Randy Jackson is listed (or ranked) 2 on the list 35+ Celebrities Who Had Weight Loss Surgery
Photo: Metaweb/GNU Free Documentation License

“American Idol” judge Randy Jackson had gastric bypass surgery in 2003.  He dropped over 100 lbs after having the procedure.  In 2008, Jackson announced that he suffers from type 2 diabetes.

Age: 62

Birthplace: Baton Rouge, Louisiana

Brian Dennehy

Brian Dennehy is listed (or ranked) 3 on the list 35+ Celebrities Who Had Weight Loss Surgery
Photo: Wikimedia Commons/CC-BY

“Tommy Boy” actor Brian Dennehy reportedly had Lap-Band surgery in the early 2000s.

Age: 80

Birthplace: Bridgeport, Connecticut

Roseanne Barr

Roseanne Barr is listed (or ranked) 4 on the list 35+ Celebrities Who Had Weight Loss Surgery
Photo: Metaweb/GNU Free Documentation License

Roseanne Barr had gastric bypass surgery in 1998. She has been public about her decision to go under the knife. She jokes, “I had my entire digestive system removed, so I should look thinner.”

Age: 66

Birthplace: Salt Lake City, Utah

John Popper

John Popper is listed (or ranked) 5 on the list 35+ Celebrities Who Had Weight Loss Surgery
Photo: flickr/CC0

After suffering a near-fatal heart attack in 1999, Blues Traveler musician John Popper underwent gastric bypass surgery.

Age: 51

Birthplace: Chardon, Ohio

Star Jones

Star Jones is listed (or ranked) 6 on the list 35+ Celebrities Who Had Weight Loss Surgery
Photo: Wikimedia Commons/CC-BY

Star Jones had gastric bypass surgery in 2003.  She did not admit to having the procedure until years later in an interview, at which point Jones had lost 160 pounds.

Age: 56

Birthplace: Badin, North Carolina

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Categories
Lyme disease

10 Facts You Should Know About Lyme Disease

  1. Lyme disease is caused by bacteria called Borrelia burgdorferi that is only transmitted to humans when they are bitten by an infected tick.

  2. To infect its host, a tick typically must be attached to the skin for at least 36 hours.

  3. Most cases of Lyme disease occur in late spring and early summer.

  4. The most common symptoms of Lyme disease include a red, circular “bulls-eye” rash often accompanied by muscle and joint aches. About 70 to 80 percent of people infected develop the rash, which shows up several days to weeks after the tick bite.

  5. Lyme disease is diagnosed by medical history, physical exam, and sometimes a blood test. It may take four to six weeks for the human immune system to make antibodies against Borrelia burgdorferi and therefore show up in a positive blood test. That is why patients with the Lyme rash usually have a negative blood test and diagnosis is based on the characteristic appearance of the rash. Patients with other clinical manifestations such as Lyme arthritis will usually have a blood test.  Anyone who has symptoms for longer than six weeks and who has never been treated with antibiotics is unlikely to have Lyme disease if the blood test is negative.

  6. Most cases of Lyme disease are successfully treated with a few weeks of antibiotics. Using antibiotics for a very long time (months or years) does not offer superior results and in fact can be dangerous, because it can cause potentially fatal complications.

  7. Tickborne diseases have been reported in all 48 contiguous states and Alaska, though the majority or focused in the Northeast and Midwest.

  8. Researchers didn’t identify the cause of Lyme disease and connect it with ticks until 1981. The bacterium that causes the disease is named in honor of Willy Burgdorfer, the scientist who made the connection.

  9. In 2016 there were over 58,000 cases of Lyme disease reported in the US. Cases of vector borne diseases from ticks and mosquitos have tripled since 2004.

  10. The best treatment for Lyme disease is prevention: Be cautious when walking in the woods, avoiding bushy and grassy areas. Wear long pants and long-sleeved shirts and wear insect repellent containing DEET on exposed skin. After walking in wooded areas, thoroughly check the skin for the poppy-seed sized ticks, paying particular attention to the scalp, armpits and groin. If you find a tick, carefully remove it with tweezers.


Categories
Celiac disease

20 Things You Might Not Know About Celiac Disease

  1. Celiac disease is a chronic autoimmune disease, which means that you cannot “grow out” of it.

  2. 1 in 100 people worldwide have celiac disease.

  3. Celiac disease affects an estimated three million Americans.

  4. 80% of Americans with celiac disease are not diagnosed and are needlessly suffering.

  5. People with a first degree relative with celiac disease have a 1 in 10 chance of developing celiac disease themselves.

  6. More children have celiac disease than Crohn’s, Ulcerative Colitis, and Cystic Fibrosis combined.

  7. Celiac disease can affect every organ in your body.

  8. Lifelong adherence to the gluten-free diet is the only treatment for celiac disease.

  9. Approximately 20% of people with celiac disease do not respond to the gluten-free diet.

  10. There is an average delay of 6-10 years for an accurate celiac disease diagnosis.

  11. Without a timely diagnosis, celiac disease can lead to intestinal cancers, type 1 diabetes, osteoporosis, thyroid disease, multiple sclerosis, anemia, infertility and miscarriage, epilepsy, and more.

  12. There are over 300 symptoms associated with celiac disease.

  13. Approximately 20% of people with celiac disease are asymptomatic, meaning they don’t experience any external symptoms at all. However, everyone with celiac disease is still at risk for long-term complications.

  14. Celiac disease can develop at any age after people start eating foods or medications that contain gluten.

  15. The later the age of celiac disease diagnosis, the greater the chance of developing another autoimmune disorder.

  16. There are two steps to being diagnosed with celiac disease: the blood test and the endoscopy.

  17. People with celiac disease have an increased incidence of microscopic colitis and inflammatory bowel disease (Crohn’s disease and ulcerative colitis).

  18. People with celiac disease may have lactose and/or fructose intolerance, both of which can be diagnosed by a hydrogen breadth test.

  19. People recently diagnosed with celiac disease are commonly deficient in fiber, iron, calcium, magnesium, zinc, folate, niacin, riboflavin, vitamin B12, and vitamin D.

  20. Any food product that is labeled “gluten-free” cannot contain more than 20 parts per million of gluten, which is the safe threshold of gluten consumption for people with celiac disease.

Categories
Lyme disease

10 Things To Know When Someone In Your Life Has Lyme Disease

Someone you know is sick with Lyme disease. It could be a friend, a family member, a significant other or just an acquaintance. Whoever it is, you have questions. Or maybe you don’t, but you want a better idea of what the heck is going on. This article will hopefully offer some explanation, and can probably be applied to a variety of chronic illnesses. I’m not a doctor (disclaimer!) but I have personal experience with many “invisible” illnesses and Lyme (unfortunately). I am the Commissioner and Secretary for the City of Danbury’s Commission for Persons with disAbilities, and I have been diagnosed with Lyme and Chronic Fatigue Syndrome. In addition, I am the Communications Coordinator for Lyme Connection.

Lyme Connection, a 501(c)(3) nonprofit organization (formerly Ridgefield Lyme Disease Task Force), works with the community about prevention and early diagnosis and support patients. The goal is to connect patients with compassionate care, helpful services and fellow patients. Lyme Connection’s mission is to make the community a healthier place by preventing tick-borne diseases and supporting patients and their families throughout their illness. Everyone needs encouragement and validation to make it through what is often a daunting challenge. Please read on for the 10 things to know when someone in your life has Lyme disease.

1. Lyme disease is an invisible illness. What does this mean? When someone with Lyme is feeling absolutely horrible they are likely looking no different on the outside than they do on one of their “really good days”. This disease usually does not present itself with obvious visible symptoms. Normally you will not see a Lyme patient with their legs wrapped up in casts or with huge bleeding gashes on their bodies. Our symptoms tend to be more internal. Things like extreme fatigue/weakness, joint and muscle pain, dizziness, nausea, anxiety and brain fog aren’t necessarily easily detected just by looking at a person. It can be hard to understand how a person can be feeling so horrible when they look “fine”. Often times, they even seem to be acting fine!

2. Lyme patients quickly become amazing actors. When you’re sick with a cold or a flu for a couple of days, maybe even a week, you likely spend that whole time in bed or on the couch, maybe complaining about how miserable you feel (definitely not venturing out in public and likely not even leaving your bedroom). You probably tell your friends and family you’ll see them when you’re feeling better and you feel too horrible for company right now. Simple tasks like food preparation and household chores are put on hold. Basically, life is put on hold. Which is acceptable when it only happens for a week at a time, probably once or twice a year. Everyone gets sick, it’s fine, it happens, it sucks, but life goes on. But, when you have a chronic illness, you often wake up everyday feeling like you have a horrible flu and the worst hangover of your life all rolled into one dreadfully uncomfortable package. As easy as it would be to stay in bed and not talk to anyone or do anything, you know these symptoms aren’t going to just disappear tomorrow or even next week. This means you try to push yourself as much as you can to do normal things. Some days you might not be able to push much more than making yourself dinner. Other days you might venture out to the store or to see a friend. Your friend might tell you how great you look. “You must be feeling better! You’re out and about!” You’re conversing and laughing and you look like you’re feeling fine! Unfortunately a lot of the time, it’s all an act.

When you’re chronically sick you learn pretty quickly that wallowing and complaining about symptoms and refusing company leads to a very lonely and isolated life. People quickly get tired of hearing you complain about how horrible you’re feeling, and you quickly get tired of being stuck in bed with no company. So when you can, you get up, you go out, and you put on a show. You smile and you laugh and you act like you aren’t feeling any pain or discomfort at all. It is difficult and heartbreaking to have to live your life “pretending”. It’s also extremely exhausting. And sometimes in the middle of this act symptoms get worse and you find it harder to appear normal.

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