ME is a fluctuating illness. Sufferers have good days and bad days, good hours and bad hours. For those a bit further up the functioning scale, the fluctuations are pretty easy to see. On a good day random ME person can go out and do stuff (how, what and for how long will depend on how their ME affects them, but I’m thinking out of the house). On a bad day that’s just not possible, and for anyone with moderate to severe ME a bad day can mean being unable to get out of bed.
I bounce around the bottom of the functioning scale (there’s actually several, all measuring slightly different things, but I’m at the bottom of all of them). To an observer, there’s not that much difference between a good day or a bad day. On a good day, I’m stuck in bed, incontinent, and reliant on 24 hour care. That’s still true when I have a bad day. To me though, there’s a massive difference, even if it’s only a percent or two on the actual scales.
On a good day I need the light reduced as I’m photosensitive. I can’t tolerate moderate to loud noises, and my body floods with adrenaline if the phone rings or the doorbell goes (even with all the doors shut). Sitting up will make me faint, and if I move too much my pain levels increase massively and my muscles become weaker. My muscles spasm, my limbs randomly jerk, and I’m experiencing too many other distressing symptoms to list. What I can do is speak, prop myself a bit up using the bed, manage my lamp to provide enough light to see by, my normal glasses while looking at my tablet (on minimum brightness) and the big one, go on my computer. This means I can communicate as easily as is possible for me, and I can talk to my daughter, Sammie.
Using my computer I manage our finances, do food shops, use Skype (to talk to Sammie), attempt to use Facebook to keep up with my friends and family, research whatever I need to research at the time, buy stuff, and play games to distract myself from how horrendous I’m feeling. I can’t manage it every good day (on other good days I’ll have a bed bath, change my pyjamas, and occasionally have visitors instead) but I really appreciate it when I can. It makes a massive difference to how I feel. On very good days (which are rare, maybe a couple of times a month if I’m lucky) I’ll be able to try watching a TV programme or a film, have lots of hugs (physical contact is painful) and do more work on trying to sit up without fainting. If transfers were possible (I need a hoist which I don’t have yet) good days would mean trying to get into my wheelchair, and very good days I could attempt to have a shower (using a tilt in space reclining shower chair, which has been approved but I don’t have yet, like the hoist).
Bad days are different. The computer is completely out. I need sunglasses to tolerate the lamp for pad changes and other personal care, and need it off otherwise (even with sunglasses on I can’t manage it for too long). My tablet becomes my lifeline to communicate, but I can only use it in short bursts then I have to rest. Thinking is extremely difficult and I can’t distract myself from the overwhelming pain I’m in. Communication becomes harder, as I can lose speech (or be too exhausted to speak – both happen), typing is very difficult, and my concentration and memory become very unreliable. All my symptoms become much worse, having basic care (such as pad changes) done is almost unbearable (and kept to an absolute minimum) and I often lose the ability to chew and swallowing is very difficult so I mostly live on milkshakes. I also experience random bouts of paralysis- sometimes just my arms or legs, but other times I’m unable to move any part of my body, which is terrifying no matter how many times I experience it. If I’m lucky it’ll only last a few minutes, but it has lasted days before.
I’m scared of bad days. I know some of the main triggers that are likely to cause them, and so I do my best to try and avoid them. It’s not always possible though and a lot of the time it’s out of my control. How well I am can change within hours or even minutes – sometimes getting better, but usually getting worse. Doing too much and being overwhelmed are pretty reliable causes of a bad day, yet I’m not always able to judge how much I’m able to do at any time without experiencing payback, and if the neighbours are fighting or a car alarm goes off I’m likely to have a period of relapse through no fault of my own (I can cope with relapse better if it’s because I’ve done something I wanted to do).
Due to how ill I am when I’m having a bad day, on good days I don’t feel like I’m that ill. I forget that most people with a severe disability or chronic illness are still able to manage more than I am, and see myself as more moderately ill than severe. If I hear that someone is so ill that they’re only able to get out of bed to go to the toilet, I think they’re more ill than I am, forgetting that I’m not even able to do that. One of Johan’s jobs is to remind me of what I am capable of, and also what I’m not (as if I try to do something I’m not able to do, I’m pretty much guaranteed to relapse). Since confusion and cognitive issues are part of my illness, I sometimes forget that I can’t walk, that I can’t sit up, and try to do so anyway (which never ends well). The cognitive problems can be some of the scariest, and unlike pain and nausea there’s no real treatment for them and unless you know me well it’s not always obvious how with it I actually am. At it’s worst I stop being able to understand language at all, which is scary when someone is talking to me and I have no idea what they’re saying.
It’s taken me a few weeks to write this blog post. I knowingly overdid it yesterday so am starting to pay for it now, but since it was talking to Sammie it was worth it. I’m hoping the payback won’t be too bad, and I’ll come out of it quickly. I’m grateful that even through the bad days I’m able to stay happy, and I have people who love me. Though it’s not always a good thing, I’m also grateful I’m able to forget how ill I am when I’m having a good day for me, as it makes life much more bearable. I’m hopeful that in time I’ll improve and what’s a good day now will be worse than my future bad days 🙂 I’m also very aware that there are people with ME for whom my bad days are their good days, and I really hope that they are able to get better.
Danni, thanks so much for taking the time and energy to write this post. I’m somewhere around the middle of the severe level and it’s hard sometimes for me to understand my own symptom fluctuations – and I agree so easy to forget just how sick you are on the good days. Reading the details of your good and bad days was very illuminating and I think helpful for anyone to understand very severe ME.
You accomplish so much and have a good balance of what you need to do and want to do. I hope I would do as well if I got sicker and seeing how well you manage makes that possibility a tiny bit less scary for me. I hope you recover from your payback soon and wish you many more good and even better days in the future. 🙂
-Jan