My POTS Story

An alternative title for this post could be "How a Parking Lot and Some Goats Led Me to a POTS Diagnosis."

For over a year-and-a-half, I had been dealing with a variety of vague and sometimes debilitating symptoms that I wrote off as fatigue, side effects from medications, or incorrect dosing of my thyroid medication.  During June and July of this year, I underwent a variety of tests that led to a definitive diagnosis of POTS: Postural Orthostatic Tachycardia Syndrome.  My symptoms seemed to have awakened one day and progressively gotten worse with time.  When I reflect back on this year and last, I can recall particular days where my illness was becoming more and more evident.  I am thankful that a diagnosis came quickly.  And I am thankful for my parking lot at work and some goats at a local barn for leading me in the direction of a fairly fast diagnosis.

My first memories of POTS symptoms started early last year.  In 2016, I had decided to begin taking antidepressants for episodic hormone-related depression.  I tried a handful of medications at the end of that year, and finally began the medication I am currently taking at the beginning of 2017.  With that new medication came some nausea and appetite loss.  Some mornings I would feel sick to my stomach like I was going to vomit, and there were days I actually did vomit.  Around this same time, I noticed that I was experiencing increasing pain in my hands and wrists, particularly with gripping or over-use.  I found that if I minimized time on my iPhone, it seemed to reduce the pain.

Moving towards March, I began to experience debilitating fatigue.  I have to get iron infusions periodically because I am chronically anemic and my body doesn't absorb oral iron.  I thought that perhaps my iron levels were running low again.  What I came to find out is that my body had decided to suddenly stop processing my thyroid medication--which is extremely rare and had only ever happened in one other of my endocrinologist's patients.  For a person without a thyroid, hormone replacement medication is necessary in order to live.  My blood labs reflected a total lack of thyroid functioning in my body, which explained the debilitating fatigue.  Around this same time, my morning vomiting became worse, to the point that I was in my doctor's office one morning for an appointment and they had to give me a B6 injection because I couldn't stop throwing up.

Looking back, I think that March of 2017 is probably when my autonomic nervous system broke--the beginning of my POTS.  As the year went on, I continued to face nausea and vomiting, as well as the migraines that had become the norm over the past year or so.  I only needed to use five sick days during 2017, but I did need to go to work late or leave early at times due to my symptoms.  Towards the end of the year around November, I found that it had become increasingly difficult for me to wake up in the morning.  By that time, my iron and thyroid levels were in appropriate ranges, but I found that I would be running late to work every day.  Because I already started work later that the majority of campus staff, I had to park in a lot that was about a half-mile from my department.  In the morning, I would rush to my building and arrive to my office out of breath, sweating profusely, dizzy, nauseous, and feeling like I was going to cry.  I also began to notice how difficult it was for me to walk up the stairs in the building to my office, as I experienced heavy legs and a racing heart.  I blamed anxiety and depression.

Because of my challenges arriving to work on time and needing to park so far away from my department, I decided to pursue disability-related accommodations through our HR department.  I was approved for an even later start time so that I could walk to my building without having to rush, and also an extended lunch break so that I would have enough time to walk to my car, go home for lunch, return to campus after lunch, and walk back to my building.  The walking felt extremely challenging to me, but I didn't entirely know why.  I was a mostly healthy 31-year-old woman that should be able to walk the equivalent of two laps around a track, but why did walking make me feel so ill?

The accommodations coordinator with HR encouraged me to explore a disability parking placard with a physician.  I contacted my endocrinologist and was told that they have an office policy against approving disability placards.  I avoided talking about my need with my psychiatrist because I was having a hard time finding a reason why I needed assistance with walking.  My pain and exhaustion and weakness felt so real, yet there wasn't a clear explanation for my symptoms.  They seemed to be getting worse.  In fact, I remember being on the verge of tears on Christmas morning in 2017 while my family was opening presents because I felt so unwell.

Early in 2018 marks another moment in time that I can now look back on and recognize the increasing severity of my condition.  In early January, I felt like I had come down with the flu.  I felt more run-down than I ever have in my life, and that is a significant statement for someone with multiple chronic conditions that cause debilitating fatigue.  My glands felt swollen, I felt weak, my body hurt, my cognition suffered, I struggled to participate in work meetings.  The thing was, I was still able to go to work and appear fully functional, but internally I felt like I was slowly dying.  My endocrinologist suggested I might have the flu without a fever.

My symptoms started to resolve a bit the following month, and I discovered that I had been getting cross-contaminated with gluten and possibly dairy from a local pizza place.  I assumed that the symptoms I experienced for all of January were the result of my autoimmune response to gluten and dairy, and I thought that avoiding eating out would help my symptoms to resolve.  From March through April, I used three sick days at work, but in May is when my body finally said, "Enough."

I was at work on a Wednesday, three days before my birthday, and beginning to feel like I had during January.  I felt dizzy, feverish, sore, and unable to concentrate at work.  I called my fiancé in tears because I wasn't sure I was going to be able to drive myself home.  I stayed on the phone with him until I did get home, and he rushed over to pick me up to take me to urgent care.  The doctor I met with at urgent care tested me for strep and mono, but both came back negative.  She told me that I likely had some kind of virus and that I should stay home from work until Monday.  I e-mailed my supervisor and explained that I would need to take some time off, and that I wanted to discuss modifying my student caseload because I thought work-related stress might be negatively affecting my health.

I slept for the better part of the next two days, and on Saturday, my birthday, my fiancé and I went to a local farm so that I could feed goats.  I still felt fatigued, but improving, and knew I could handle a brief excursion.  However, what I didn't anticipate was that I wouldn't be able to move my dominant wrist by the end of the afternoon.  We had gotten groceries the previous day from Costco, so I thought perhaps I had injured myself while lifting something.  However, in the days that followed my pain continued to get worse rather than better.  I began to experience numbness and tingling from my hands up to my shoulders, and there were days at work that I couldn't do anything with my hands during my last two hours in the office because I was in excruciating pain.

At this point, I had continued to put off pursuing a disability parking placard because I couldn't mentally justify my need for it, even though walking some distances had become a challenge.  I also noticed increasing pain in my legs in the evenings after a walking-heavy day.  It felt like my ankles, knees, and quads were on fire.  I would cry after work when I got home because the pain was so unbearable.  So, between my leg pain and hand pain, I finally sought to find a primary care doctor in town.  At my first appointment with the new doctor, I broke down into tears describing to her how much pain I was in from walking and how ill I felt when I arrived to my office after the half-mile trek.  Without my asking, she immediately said she would approve me for a disability parking permit.

In the following weeks, I was given an ultrasound of the veins in my legs and arms and referrals to an orthopedic surgeon and a neurologist.  The orthopedic surgeon ordered an x-ray of my hands, which showed no osteoarthritis or evidence of anything abnormal.  The neurologist performed a nerve conduction test to check for carpal tunnel, but my nerves were functioning normally.  I described my symptoms to the neurologist's physician's assistant, and when she and I and the neurologist were meeting to discuss a course of action, the physician's assistant asked me to stand up and then attached the blood pressure cuff to my arm.  She shot the doctor a knowing look and then said to me, "You have POTS."  Apparently, when I had first come into their office, my blood pressure and heart rate were in perfectly normal ranges.  As soon as I stood up, my blood pressure remained about the same but my heart rate shot up 37 beats per minute.  The neurologist said they would continue with standard POTS testing just to be certain, but that it meant at some point my autonomic nervous system broke and that there would not be a way to fix it.  He also said he suspected fibromyalgia and chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), but that further testing would be needed.  I was referred to a cardiologist and pulmonologist and ordered a variety of blood labs and an MRI of my cervical spine.

Testing with the cardiologist included an EKG, echocardiogram (heart ultrasound), Holter monitor, and tilt table.  The testing led to a definitive diagnosis of POTS.  The pulmonologist will be performing a sleep study, and he will be exploring sleep apnea, periodic limb movement disorder (PLMD), and chronic fatigue.  The MRI revealed a herniated disc in my cervical spine at the C5/C6 vertebrae, which has likely been the cause of at least some of my upper-body pain.  As for the POTS, that at least in part explains the pain in my lower extremities.  Essentially, my body has challenges with gravity, and so when I move into a sitting or standing position, blood pools in my legs and doesn't reach my brain quickly enough.  In response, my heart rate elevates significantly in order to get the blood moving as quickly as a possible.  When I am doing normal, non-strenuous activities, my heart rate might be the same as it would be for an adult of my same body composition doing vigorous aerobic exercise.  Essentially, my body is in an all-day workout.  At the end of the day, I find that my lower limbs tend to be uncomfortably hot and swollen.

As has been the case for the entirety of 2018, my symptoms seem to be progressively getting worse.  I have had three instances of near-fainting, one of which included a visit to the emergency room for IV fluids.  My body is happiest when it is laying down.  It struggles the most when I am standing for too long, walking for too long, in heat, walking upstairs, rushing, dehydrated, on an empty stomach, or not laying down periodically.  My doctor has asked me to increase my electrolyte and water consumption and wear compression garments.  I will be starting POTS medications in a few weeks.

I wanted to capture the challenges of the past year-and-a-half so I don't forget what my lowest POTS moments have felt like.  I am hopeful that with treatment there are better days to come.  But I also want this to serve as a reminder that it can be dangerous to write off symptoms.  I didn't realize what I was doing to my body until I was given a label.  Blood deprivation of the brain is serious.  I am so grateful that the physician's assistant had the wherewithal to check my standing heart rate.  My constellation of symptoms seems unrelated and random; they could have easily been the result of my pre-existing conditions and side effects from medications.  I feel validated.  My body is sick.  There are treatment options.  There is hope for the future.

My primary care doctor suspects that I may have an underlying connective tissue disorder, so more testing is on the horizon.  We also both suspect I may have mast cell activation disorder (MCAD), which would explain my frequent hives, copious food sensitivities, and general system-wide sensitivity to every environment, which has been getting progressively worse.  There are treatment options to help regulate my autoimmune disease, manage my migraines, and promote hormone balance.  I am moving towards healing.  But, that doesn't diminish the fact that these past many months have been hard and exhausting and at times I didn't think I could push forward.  I know many people wait years for accurate diagnoses.  I know I should count myself lucky to have doctors who believe me and are doing everything they can to help me.  It has taken a certain level of bravery to entrust myself to this process, and there are moments that I wish I could trade in my body for a different one.

But, the reality is that I struggle daily with chronic illness and that makes me who I am.  I do the work that I do with my students because of who I am.  Other people might be diagnosed with these illnesses and then not choose to do this work.  For me, I willingly accept these diagnoses because with them I choose to do the work that I do.  And it makes it okay to face these challenges because they are what allow me to help my students best.  And so I say to all of this, yes.  Yes.  It's okay.  This is okay.  I'm okay.  I'm okay because I can help others because of this.  I'm okay because I can better understand others because of this.  I want to help and understand.  I want to affect positive change for people.  And if that means being on the front lines of the chronic illness battle, I give my yes.  Yes, yes, yes.  I take this cup.  This is not easy, but I will let it be my truth and path and purpose.

Bypassing the Process

As a goal-oriented, closure-seeking INFJ, the growth process can be challenging.  I want to have arrived now.  To know the lesson now.  To be aware of the ending now.  Submitting to a process is often a struggle for me.  I want to rush through all the steps to achieve a final product.  I forget that a solid building requires a sturdy foundation, solid wood, accurately-placed nails, and a host of projects that necessitate keen attention to detail.  You wouldn't want to buy a house that was built in a day (unless, perhaps, it was a tiny house).

I like when my life feels settled.  Loose ends make me anxious.  Ambiguity causes minor panic.  When circumstances are out of my control, I can get a little crazy--overanalyzing, ruminating, contemplating, plotting.  My mind goes into overdrive as I consider all the various ways a scenario could turn out.  And by worrying, somehow I think that I am taking control of the situation.  Too bad my worrying seems to muddle a situation more than remedy it.

I see a flaw in myself, one that alarms me and embarrasses me.  I care more about the end result than I do the steps taken to get there.  While I am a fan of self-discovery and the process of getting to know oneself, everything that happens outside of my own consciousness feels scary and uncertain, and that is when I stop being interested in processes.  I would rather immediately know outcomes than gradually progress through stages that I cannot control.

I know that not all growth can come from within.  We go through periods of growth as a result of circumstances, people, the environment, etc.  We are not immune to the effects and influence of the external world.  But so often I wish I could manage and dictate those effects and that influence.  I suppose what I'm really saying is that I'm afraid, and that I'd rather shield myself and avoid dangers than face a life of vulnerability.

Today, my friend told me that it seems as though I purposefully place myself in situations where I am shielded from the get-go, so that there is never the risk or option of being vulnerable.  I avoid opportunities to drop my shield, and instead cling to two types of existence: the internal world of my own consciousness, and the part of the external world where it would be unsafe for me to let my guard down.  I altogether avoid a third type of existence: the external world where it is safe for me to venture unguarded.  I'm not even sure I know how to be in the external world without a shield.

Admitting my reluctance to be vulnerable makes me feel vulnerable.  Or, perhaps I feel vulnerable admitting to the external world that I live a shielded life.  I say I want to change, but do I?  Dropping the shield means being exposed, and that is the thing I am most terrified of.  But what about being exposed is so terrifying?  The potential to be hurt, rejected, or abandoned?  Do I cling to familiar complacency because I'd rather know no change than risk being wounded?  Am I not harming myself anyway by avoiding growth?

And that is what it all comes down to--if I avoid the process, I avoid change.  I either want to see immediate results that demand no pathway of vulnerability, or I want to maintain the status quo.  Despite the fact that I claim I want my life to change, in reality I live in a way that reflects a desire to keep everything the same.  Don't rock the boat.  Don't stir the waters.  Just leave everything be.  Don't seek change--you'll just be wounded.  Stay in your comfortable little shell forever.

They say that with great risk comes great reward.  I am trying to think back on the greatest risks I've taken.  Has great reward followed?  Often, pain has followed.  And maybe that is why I am now scared to risk, because historically my risks have not always turned out as hoped.  But would I not take the risks if given second chances?  I think that I would, because despite the pain that has often followed each risk, growth has followed too.  And without those risks I would not be who I am today, and I am quite proud of where I've come from and who I've become.

I also must acknowledge that there will be times I take risks and embrace vulnerability, and it won't be pain that follows, but joy.  So while I certainly avoid getting hurt by shielding myself from risk, I also avoid potentially the deepest joy I could ever know.  And I am tired of living my life on the sidelines, longing for the kind of existence that embraces risk and all the joys and sorrows that come with it.  I want to dive into the process, and leave the safety of this shell I have so carefully constructed for myself.  I want change.

Isaiah 55:22 (NIV)

You will go out in joy and be led forth in peace; the mountains and hills will burst into song before you, and all the trees of the field will clap their hands.

Change That Harms and Change That Helps

My emotions and thoughts are like race car tracks right now.  My INFJ dominant introverted intuition is in high gear; I'm ruminating about future possibilities.

I was recently contacted by my alma mater regarding a position that I had applied to weeks ago.  I never expected to be invited to do a phone interview.  I never expected them to actually like me during the phone interview and then invite me to an in-person interview.  I never expected to be contemplating moving away from my family right now, taking Tobin away from the only home he's known, and adding some unwanted chaos to a graduate student's already hectic life.

I've been thinking about fear, and how fear can sometimes keep us from doing what's best for us.  Fear can cause us to self-sabotage; it can make us doubt ourselves.  We second-guess our decisions.  We come up with mental justifications for why not upsetting the status quo is better for us--why change is overrated and unnecessary.

I am not fond of change.  In my life, change has always brought on an immense amount of stress, and has propelled me into some of my darkest days and worst autoimmune flare-ups.  Moving always makes me feel like I'm having a breakdown--mostly because I'm away from my family, my support system.  New jobs can provoke a lot of anxiety.  Navigating life with a full-time job, full-time graduate program, and full-time fur-child is something I'm terrified to do, terrified to even imagine.

Is fear ever healthy?  I think that sometimes our gut-level feelings can direct us quite appropriately.  Fear keeps us from danger and makes us think more carefully about decisions.  But fear can also be crippling, because we can imagine so many dangerous scenarios that they prevent us from acting indefinitely--from ever making any movement with our lives.

I don't know if I'll be offered the job at my former university.  But I do know that for the longest time I said that my dream job would be to work in this department at my alma mater.  And it seems as though this dream may come true much earlier than I anticipated.  But then I begin to wonder, is it really my dream?  Does my INFJ idealism build up these imagined scenarios to be better than they would actually be in real life?  Can my autoimmune-diseased body realistically handle this dream I've conjured up for myself?

I keep asking that God would only have them offer me the job if it's His will that I accept the offer.  But then I am reminded that God often doesn't work that way, and He may leave deciding up to me without giving me a clear sense of His will.  Perhaps either decision would be His will.  This is one time when I would need to make a decision that I can't simply back out of--I would be committing to a move and an apartment and a career and a new life.  And I worry that I'm not ready yet.

I keep repeating the lyrics of "He Leadeth Me" in my head.  It reminds me that God's hand is upon me and guides me.  I want to make a decision that's best for me and best for Tobin.  I don't want to do anything that will exacerbate my illnesses or make Tobin depressed or that I'll regret a few days or weeks in.  Change is scary.  I pray for myself the serenity prayer, that I would accept the things that cannot be changed, that I would have the courage to change in the ways God wants me to, and that I would know the difference between change that will harm me and change that will help me.

He leadeth me, O blessed thought!

O words with heav’nly comfort fraught!

Whate’er I do, where’er I be

Still ’tis God’s hand that leadeth me.

On the Brink of 30 (Sort Of)

I should be reading or watching online lectures for my classes.  Since I was instead binge-watching "Law and Order: SVU," writing a post seemed like a productive alternative.

I've had many thoughts swirling around my mind for the past few days.  It's funny how living on the brink of 30 makes you start to feel like there's an invisible, symbolic clock ticking over your head--reminding you that each year passes a little faster than the last, and that a decade isn't so much time after all.  Because I'm 29, I still feel safe and like my circumstances are socially-appropriate and like I'm being a typical 20-something.  Already, the mere thought of me being in my 30s makes me start to feel restless and vulnerable.  Perhaps I'm not so safe after all.

Sometimes it worries me that I've never had a serious romantic relationship as an adult that has lasted for more than a few months.  If you divide my age by two, that indicates about how old I was at the time of my longest relationship.  And that relationship was interesting in its own ways; I was very hot and cold with my emotions, and sometimes I would completely ignore my boyfriend.

As an adult, knowing that I am an INFJ certainly explains my relational history.  And also terrifies me, because I realize my own insecurities, expectations, and romantic inactivity are reflections of my personality type.  I recently discovered an article on Thought Catalog that explains what kind of romantic partner each Myers-Briggs type goes after.  As for my type:

"Who you usually go for: No one, because everyone is going to hurt you. Even the ones you’re only mildly attached to, especially the ones you really really like. Once in a blue moon, you’ll meet someone who seems to have the potential to never screw you over. And you’ll put them on a pedestal until, eventually, they’ll let you down too."

Truer words have never been written.  I can feel deep romantic attachments, and yet I am an expert at making sure those feelings are never revealed.  I am excellent at creating imaginary scenarios and idealized realities in my mind, and that's where I retain all of the emotional energy I should be expending in the real world.  Part of the reason I spend all of that time in my mind is because my primary MBTI mode is introverted intuition, so I sincerely derive pleasure from daydreaming.  But part of me is terrified of getting hurt, because of past disappointments and pains inflicted by loves ones, and also because I know the depth of care I have for those I hold closest to me.  And loving someone that much who is not related to me by blood (I know my family loves me unconditionally) is the most vulnerable thing I could ever do.  In the beginning, it was even hard for me to open my heart to Tobin because I know the potential gravity of my attachments.

With loving a person comes being let down by that person.  And as a values-driven, perfectionistic INFJ, it's easier to not love anyone than to welcome that inevitable disappointment.  Cue the author's words above.  I don't want to be elderly and alone.  I don't want to be a crazy schnauzer lady.  I make jokes about that possibility, claiming I'm a has-been who will be surrounded in my advanced years by my flock of schnauzers.  But it's just a defense mechanism--a means of hiding how much I really do want to get married and my insecurities over the fact that I'm almost never in relationships.

Recently, a group of my friends told me I need to put myself out there by getting involved in new activities and being present at more locations where I have the potential to meet a romantic partner.  The introvert in me shudders and laughs at the idea of trying to be more "out there."  But the turning-30 part of me wonders if that's what I have to do if I have even the slightest hope of getting married.  It would be so much easier if my life turned out the way I narrated in my sixth-grade autobiography, and I meet my future husband when we reach for the same bag of dog food at the grocery store.  Too bad I buy Tobin's food on Amazon.

Accepting Your Whole-Self

I found myself coming home in a bad mood for most of the week.  My supervisor tells me it's due to some unusual planetary alignment that's going on right now.  I blame my ongoing self-esteem issues.  And perhaps the fact that my job keeps me so distracted and so busy and from living out my innate MBTI preferences that I come home from work feeling like I've been living as a false self.  I have also been thinking more and more about relationships lately, and the fact that I would really like to get married--or at least have a romantic partner to share my heart and life with.

Getting older sometimes feels uncomfortable and sad and unsatisfying.  So many of my friends are starting families, advanced on their career paths, making their marks on the world.  Social media can be so dangerous because I find myself stalking contacts near and far, comparing my circumstances to theirs.  It's easy for me to momentarily forget my chronic illnesses and struggles and cancer in those few seconds of comparison that lead to a snowballing of self-doubt and self-deprecation.  I read somewhere this week that we should get off of social media because it's unfair for us to compare our own behind-the-scenes to a highlight reel of the people around us.

I've been feeling better the past few months.  Meaning, I've been taking better care of myself.  Meaning, I've had more energy to do my hair and make an effort with my outfits.  I've been trying to treat myself with much grace, not pushing myself too hard or expecting too much of myself.  I am just grateful to be alive and cancer-free and feeling mostly happy, and I don't want to upset what has become a semblance of balance.

At the same time, I realize that the person I present to the world is the person I present to the world.  Not a deep statement, I know, but what I mean is that people don't know about my inward struggles at first meeting.  All they see is my shell, a shell that often reflects the half-person that I often feel that I am.  A half-person because of fatigue, exhaustion, pain, depression, and insecurity.  A half-person because my energy is expended trying to support myself financially while dealing with constant emotional upheavals and health issues.  A half-person because I often have to put hopes and dreams on hold as I attempt to make it in there here-and-now.  A half-person because I spend the workweek functioning out of my inferior MBTI function.

As I often do, last night I turned to Google for advice.  It's become a sort of Magic 8 Ball for me as I navigate a life of ill-health.  When I did a search for "come home feeling bad about myself," the first search result was for an article from Tiny Buddha called "5 Tips to Stop Making Comparisons and Feeling Bad About Yourself."  Sara Davies' 5 tips are:

1. Appreciate what you do have.
2. It's not a fair game.
3. Things aren't always what they seem.
4. If you must compare, compare to you.
5. Accept what you can't change and change what you can't accept.

The third hit from my Google search was for an article on Psychology Today entitled "Social Media Makes Me Feel Bad About Myself."  I do largely blame social networking for providing the ability to compare and assess ourselves in a matter of only a few seconds.  If we slowed down to thoughtfully consider our self-talk in those few seconds, I think we would be both ashamed and surprised.  I'm guessing that for most of us, the self-talk involves a lot of negativity, either because we envy the people around us, or because we make ourselves feel better at what others lack or where others are at in life.

Aside from social networking, I also find that having young co-workers has unearthed some personal feelings of self-doubt and comparison.  Mostly because being around them immediately propels me back a decade, to a time before diagnoses and cancer and living a strict life.  I am reminded of the freedom I had back then, the sense of choice and opportunity.  It really felt like the world was my oyster, and I looked forward to travel and relationships and adventures.  I was naturally self-confident, and I enjoyed being involved in social groups, discovering new cultures around the world, and meeting potential romantic partners.

As I've gotten older, my social groups have mostly disappeared, I haven't been able to travel, and romance has not been a top priority.  Now that I'm finally feeling interested in having a boyfriend and possibly getting married at some point, I realize that I feel as though I lost an entire decade.  Illness was my boyfriend.  Medical treatments were my adventures.  So, not only do my young co-workers remind me of what felt like a simpler time, but they also provide me with the opportunity to live the years that I feel like I lost.  And, of course this is somewhat problematic, because I really can never get those years back.  And based on brain development and life experience, I am further along than them in almost every way.  But it seems as though my circumstances are more akin to theirs than to the circumstances of people my own age.  I am mentally and emotionally more developed, yet the external reality of my life is almost exactly the same as theirs.

And this is what frightens me about the possibility of ever meeting a partner.  How will he perceive me when he meets me?  Will he judge me as the half-self I present to the world?  How will he know what I've been through and why I am the way I am?  Will he understand my circumstances?  Am I in a place to meet someone?  Can I be emotionally available to someone?  Do I need to lose weight to meet someone?  Do I need to be financially self-sufficient to be with someone?  Am I pretty?  Am I thin?

I know that I have a lot to offer someone on emotional and intellectual levels, but I fear that my circumstances and present-day realities will prevent me from finding love.  But, is that a legitimate concern or just my own insecurity?  I realize that opportunities to meet people my age in this area are few, but even if I did go somewhere else, how and where would I meet someone?  The older I get, the less and less likely it seems that those questions can be answered.  I know that God can work beyond my comprehension or planning, but I also realize the danger of expecting Him to do work while I choose not to be proactive.

I think for me the biggest hurdle is my own self-esteem battle, and for that I know I probably need to return to counseling.  Chronic illness seems to infiltrate every component of life, and perhaps most strongly affects a person's self-perception.  It's hard not to see myself as damaged goods or high maintenance or too much for someone to want to deal with.  I keep thinking, "I'll wait until I'm thinner.  I'll wait until my cute clothes fit.  I'll wait until my upset stomach issues are resolved.  I'll wait until I'm on my own.  I'll wait until I have a real job.  I'll wait until..."

But if I keep waiting, I fear I'll look back on most of my life as years lost.  I don't want to perpetually feel ostracized from my own age group.  I don't want to have to revert back to a time of lesser maturity in order to feel comfortable with my own life.  I want to learn to move forward in my life at my age in a way that accepts my experiences and circumstances.  I want to have confidence in what I have to offer the world and a potential partner.  I don't want to feel like I have to fix myself, but I want to learn to accept myself as I am in the here-and-now.  I want to extend grace and love to myself always.  I want to trust God, and also see myself as He sees me.  I don't want to look at my life as a mistake or disappointment, but I want to dwell on the ways in which my struggles have shaped the person I am.  I want to be un-apologetically me.  And I don't want to rate myself according to the Joneses.

I'm going to try to be more conscious of my self-talk.  I'm going to try to stay away from social media stalking.  I'm going to try to focus on a more meaningful relationship with God.  I'm going to try to live as a whole-self, the self that He created me to be.  May He give me self-compassion in the process.

Self-Acceptance and Authentic Relational Connection

I have low self-esteem.  I feel both burdened and annoyed by this.  And, somehow, acknowledging that I don't feel very good about myself actually makes me feel worse about myself.  I peruse Google for tips on how to create healthy self-esteem, and for information on the emotional causes of self-sabotage.  I know there's no quick-fix when it comes to loving yourself; it's a slow and steady process that comes with time, healing, and probably help.  Sometimes I wonder how much of our sense of self-worth is affected by our language; because I have diseases, do I then see myself as inherently diseased?  I understand the disease label as an indicator of functioning that differs from "normal," but what is normal anyway?  And if the word disease didn't hold so many connotations of abnormality and brokenness, would the various days of my diagnoses have brought such sadness and disappointment?

Last night, I found an article that discusses our use of addictive behaviors to deal with loneliness and low self-esteem.  The author focuses in particular on eating, but the ideas extend to any practices that distract us from our own emotional turmoil, namely loneliness.

When you’re chronically lonely, just being around other people doesn’t fix it.  You can be married and lonely; you can be lonely in a crowd.  If you’re chronically lonely, what you lack is authentic connections with other human beings, and generally that’s because you block these connections by not sharing your authentic self.  Why?

People who are chronically lonely almost always have as a core problem that they don’t like themselves very much. The give-away is that they generally find it almost unbearable to be alone--especially at night when the distractions of the day are over and it’s quiet.  They may even dread turning off the light to go to sleep at night, and procrastinate on that.

Chronically lonely people often have an almost phobic reaction to being by themselves.  It feels like falling down a black hole--an awful "dust in the wind" feeling of utter emptiness and alienation from everything and everyone, as though you’re the only person on the planet.  If you live alone, you probably avoid going home at night because you can’t bear to be home alone with that feeling.  You call it loneliness, but it’s really something else.  It’s the horrors; it’s existential alienation.  The Big Empty.

Quiet evenings alone are often when emotional eaters binge, perhaps numbing out in front of the TV.  They may stay awake until so late that they practically drop from exhaustion, or they may use alcohol to go to sleep so they don’t have to experience their own thoughts lying in bed in the dark.

What is this about?  If you can’t bear to be by yourself, it essentially means you can’t bear yourself--you can’t bear your own company, you can’t bear the experience of being "you".  That is a huge problem, and it’s also a big block to developing healthy relationships.  That’s why it goes along with loneliness and people call it loneliness, but it’s not exactly the same as loneliness.

You can’t stand your own company without distractions because you don’t like yourself.  And because you don’t like yourself, you assume no one else will like you either, causing you to shun social contact, making you lonely.

Sheryl Canter argues that the only solution to chronic loneliness is authentic human connection, or finding people who accept and love you in your entirety--which I don't think can be done until we accept and love ourselves and truly believe we deserve acceptance and love.

The only thing that cures loneliness is authentic human connection.  That means allowing another to see you for who you really are and experiencing their acceptance, and seeing another for who they really are and accepting them.

If you don’t like yourself much, it can be scary to let others see the real you.  Your impulse will be to hide your real thoughts and feelings under the mistaken notion that the real you is unacceptable and will be rejected.  But you’ve got to get past this and take the risk because if you never let anyone see you, you will stay lonely.

My lack of self-love is not a new realization, and I have discussed it openly in the past.  However, this week was the first time that I allowed my low self-esteem to affect my relationships with other people--and drawing people into my inner-turmoil is not something I want or hope to do.  Primarily, I don't want to hurt the people I care about.  And, equally important, I don't want my sense of self-worth to hinge on a relationship with anyone, because: 1.) humans are imperfect, and eventually I will be disappointed; 2.) that is an unfair amount of pressure and an unrealistic expectation to place on an individual.

Several years ago, I had a vision of myself carrying around my heart in my hand, trying to pass it along to anyone who would take it.  In many ways, I think I still do that, desperately seeking a person who will see me holistically and love every part of me.  I know that approval, affirmation, and acceptance need to come from my relationship with God first and foremost.  Sometimes I am so overwhelmed by my own neediness and sense of waywardness.  He promises to draw near to me as I attempt to draw near Him, and that truth is my only comfort.

Psalm 139: 1-5, 16 (CEB)
"Lord, you have examined me.

You know me.

You know when I sit down and when I stand up.

Even from far away, you comprehend my plans.
You study my traveling and resting.
You are thoroughly familiar with all my ways.
There isn’t a word on my tongue, Lord,
that you don’t already know completely.
You surround me--front and back.
You put your hand on me.
Your eyes saw my embryo,

and on your scroll every day was written that was being formed for me,

before any one of them had yet happened."

The Imagined Life vs. Real Life

I've struggled to live in the present for probably half my life.  Sometime during high school, as childhood came to an end and I propelled towards adulthood, all that demanded my attention seemed to exist in the future: test scores, grades, college applications, a bachelor's degree, a first job.  We were trained to do everything for the sake of what would eventually come, and so I think in some ways we were conditioned not to live in the moment, but instead to always be moving forward and looking to the next thing, the bigger thing, the better thing.

This week I've experienced a tumult of emotions, which I blame in large part on a mix-up at my local pharmacy.  I was unknowingly given the wrong thyroid medication last Monday, and for most of the week I experienced severe mood swings; they caused such a marked change in my disposition that I eventually had the intuitive sense to check the imprint on my hormone tablets, and thus uncovered the error.  It was emotionally exhausting, to say the least, but in combination with beginning to read Steven Pressfield's The War of Art last weekend, I've had some time to thoughtfully consider where I am in life and the direction in which I am and/or hope to be moving.

For the past several years, living an imagined life has been my default.  I think I've encountered so much pain during this second half of my life that I cope by dwelling in the land of imagination.  INFJs are naturally future-focused as it is, so I'm likely hard-wired to use daydreams as a sort of coping mechanism.  I've constructed fantasies about where I'll live, what I'll do, what I'll have, who I'll be with.  I've created imaginary depth in relationships with people I actually know, and dreamed of pretend scenarios that some part of me hoped would come true, if only to take me away from the life that I actually know.

Clearly, using imagination as a means of escape just signals a larger issue of not wanting to deal with my reality, the here-and-now.  Perhaps my imagination has bred a sort of hope that has made the pain of disease and illness bearable.  If that's the case, I can't be too hard on myself for finding a way of moving forward in what have been the most difficult years of my life.  At the same time, living so much in fantasy not only keeps us from progressing, but prevents us from appreciating the people and circumstances that exist in a given moment in time and space.  Incidentally, focusing on an imagined future has actually prevented me from advancing in life.  Now that I think about it, I suppose that I haven't wanted to move forward, as I'm sure that in many ways I maintain a fear about what is to come.  Will there be more pain?  Disappointment?  Suffering?  Disease?  Hopes squashed?  Imagining a future has given me a sense of control over the terrifying unknown.

What is to be done about chronic disappointment?  Normally I would say that a person has too many expectations.  I thought it was fair for a person to assume s/he would experience good health, true love, and vocational fulfillment, but now I realize that any expectation is already too many.  We can't know what life will bring us, what will be our assigned portion and cup.  I have handed my security over to dreams and fantasies, when I should have been entrusting my security to God.  Isn't it like us to trust our own imaginations over the sovereignty and loving-kindness of a divine and all-good Creator?  I find myself proving over and over that I lack trust and faith in God.  Fortunately, He continues to be good and loving and all-knowing whether or not I believe Him to be so.

I often say that I wish I trusted Him more.  And I do.  But more than that, I think I wish I knew Him more.  Because if I truly knew Him, I don't think I'd be afraid of Him.  Because I don't think I'm as afraid of entrusting my future to someone else as much as I am entrusting it to God.  Because when I entrust my future to God, it feels like I am inviting more pain and disappointment and suffering and disease and squashed hopes.  I know I'm partly jaded because of misfortune, but hasn't it been the very hand of God that has allowed my life to go on like this up until now?  And isn't it up to His sovereign hand what the outcome of my life will be in the future?  I wish I could say that I honestly believe that He uses all of our life experiences for our own benefit.  But it's difficult to truly trust that the enormity of my pain and disappointment has been a blessing rather than a curse.

It would be selfish and ungrateful for me to ignore the great amount of blessings in my life, from living in a beautiful location in a beautiful home, to having a loving and supportive family; from being the dog-mom to a most handsome miniature schnauzer, to having a secure job that I enjoy enough on most days to keep me going back; from having a master's-level education, to having access to healthy food and a healthy lifestyle.  When I consider the struggles of people around the world, mine seem so small.  But, my emotions are as they are, and because so much of my pain has been internal, sometimes the evidence of external blessings is clouded.

And I've arrived at this point in my writing without any conclusions.  Except that I know I want to be more present in my life, in the here-and-now.  And I do still have hopes for the future.  And if I am going to make an effort to stop living an imagined life, that means all I can do is entrust the outcome of my life to God.  And my one true future hope is this: that He will fulfill His promise to do more in my life than I am capable of hoping for or imagining.  My hope is to truly internalize, despite whatever circumstances I encounter, His divine goodness and love for me.

Upon further contemplation, I realize that my greatest gift as of late is vision for the future.  Not that God has imparted me with specifics on where or what or who, but I feel deeply drawn (perhaps called) in a direction.  And I don't think I would be moving in this direction had it not been for the very experiences I've endured.  I have always said that my one desire in life is to help people.  Now it is my desire to see my experiences, particularly the painful ones, act as the platform for my destiny and purpose.  If I am a lump of clay in the process of being made into some useful piece of pottery, then my trials are the tools that are shaping the form I am to become.  I believe that my pain is deeply tied to God's designation for my life, and so I can see now how my disappointments will actually lead me to be a truer, more authentic version of myself--the divinely-ordained version.  Ultimately, I cling to the belief that my pain will be the most profound source of my abiding joy.

Disheveled: Becoming “Post-Evangelical”

The main title for this post came to me as I sat in my bedroom in momentary silence, reflecting on the current state of my life. It was the one word that popped into my head as I stared at my messy closet and the shelved books I had just sorted through. My collection of books has always acted as a sort of barometer for where I’m at and what I’m interested in. In the past, the shelves were brimming with titles related to theology, Ethnic Studies, Christian romance, nutrition, classics. Over the years, I whittled down my number of books in hopes of abating a semi-addiction to buying reading material from Amazon. The books I knew I wouldn’t read, I parted with, and I refused to allow myself to purchase anything new until after the books on my shelves were read.

Since that first weeding through the books, my collection has seemed to shrink rather than grow. Or, perhaps the contents--the themes and topics--have merely changed so vastly that it seems shrunken, when in fact it’s not the number of books that’s been depleted but my sense of faith.

As I was examining the spines of books still in my possession, I came upon my university yearbook. The summer before I left for college, freshmen had the opportunity to send in copies of their senior photos along with a selection of two interests from a form that listed pre-determined activities and fields. I still remember when I received this notice and decided to participate. There was no option for Jesus or faith, and so I chose the write-in option at the bottom and inscribed “Christianity” on the blank line. At that time, it was very important to me that people knew what I was about. In my mind, knowing that I was a Christian was more important for people than knowing my name, or major, or how I spent my weekends (although, I could have come up with a way to link all of those things back to the fact that I’m a Christian). Even during my first phone call with the dorm roommate I was paired with, I openly talked about my faith and the depth of its importance to me.

Along with the yearbook, I found some old books on practical spirituality that I no longer want to keep. They seem to be the last bit of proof that I was once evangelical. Now, I make that claim with some hesitation, as I don’t know that I will ever be entirely “post-evangelical.” My upbringing in the church and experiences doing ministry around the world have created deep roots that I don’t know will ever really die off or be able to be pulled out. But I know that my faith is not the same as it once was; it seems to have become disheveled.

I was contemplating my feelings towards the church, and the only thoughts I can ever really come up with are that I have been deeply wounded. But as I sat and considered those words, it occurred to me that God and the church are not one in the same. God has not wounded me, but the church, and more specifically Christians in the church, have wounded me. And it’s not even necessarily specific people or churches or occurrences, but it is in large part the ideas and ideals I was imparted with so that I feel that I was in some ways recklessly (though the intention was not reckless) led to believe things that actually did more harm than good. Rachel Held Evans articulated my own sentiments beautifully:

“When you grow up believing that your religious worldview contains the key to absolute truth and provides an answer to every question, you never really get over the disappointment of learning that it doesn't...Like it or not, our religious traditions help forge our identities. The great challenge...is to hold every piece of my faith experience in love, even the broken bits, even the parts that still cut my hands and make them bleed. We are all post-something. We are all caught between who we once were and who we will be, the ghosts of past certainties gripping at our ankles. There’s no just getting over it. There’s no easy moving on.”

I haven’t regularly attended church in over two years, mostly because I don’t really know where I belong, but also because I needed space. My life was so hyper-focused for so many years on my participation in church and evangelical activities that I lost my sense of self. I would use the justification that we are to sacrifice ourselves for the cause of the cross and a crucified Savior. However, I think that my lifestyle was more representative of a codependent relationship and sense of fear than anything else. I was terrified of somehow losing my faith that my entire life became based on being engaged and a leader in as many Christian organizations and opportunities as I could possibly be involved with. In some ways, I admire that kind of dedication and commitment. At the same time, I had no idea who I was.

As my 20s quickly come to a close, I’ve been reflecting a lot lately on the amount of growth and change I’ve experienced during the past decade. I feel that every year since I first left for college has been one of pivotal self-discovery, particularly my year in China and those following. I can thank my time in college for providing me with the tools to think critically. It all started with ideas related to social justice. The frameworks for thinking that I learned in my Ethnic Studies classes began to shape how I viewed other fields, including Christianity. As justice for the oppressed grew in importance to me, I began to see my political ideals aligning with Liberalism. And because I had grown up believing that Christians were automatically Republicans, I had to begin to reconsider my faith and how I could possibly reconcile belief in Jesus and His message with Democratic ideologies.

I don’t consider myself to be a Democrat, but I merely point out this example to mark the first moment of the dishevelment of my faith. It was that one small reconsideration that has led me to become more critical in my thinking about Christianity, in relation to people groups, sexuality, church attendance, relationships, purpose, and beyond. I know that there are many circles and branches of Christianity throughout the world, but it’s difficult not to feel like you’re amidst a divorce from evangelicalism and looking to remarry a new Christianity. And perhaps that’s why I’ve taken a break from church for so long; I’ve been mourning the loss of a Christianity that was as formative as it was painful for me.

As I lay the on carpet in my bedroom and stared at my ceiling, all I could think about was the fact that God is with me and will continue to go with me--no matter the state of my heart or circumstances. And I know I will never fully understand Him in this life, and I know that I will often feel disappointed by the church and by Christians; but I also know that He is not done with me yet. He has appointed me my portion and my cup, and as much as I’ve faced disappointments and trials and pain, I truly believe that I am part of a much larger purpose and story. I just hope that those disappointments and those trials and that pain shape me to be more compassionate and Christ-like in my life. And even when I don’t know what label to use when it comes to talking about my faith, I pray my eyes will ever be fixed on Jesus and all that He was and all that He stands for and spoke about. God is bigger than our interpretations and ideas and labels and debates and churches.

Life is Passing Me By

I woke up last night to a vomiting dog, and then found myself unable to fall back asleep.  I was awake in the first hours of the day, Googling things like "life is passing me by."  I almost laughed aloud when the first hit that popped up said, "When you're unhappy, you tend to be thinking a lot about life. When your job sucks, you're not engaged. You're listless and googling sh*t, and in general not enjoying what's going on."  Nailed it.

After reading some articles on Milk the Pigeon, I tossed around my bed in the dark, attempting to sleep, but distracted by the realization of how scared I am.  I am scared by how uninterested I am in my own life.  Aside from loving my dog, I am not doing anything I enjoy or am excited about or that gives me a sense of purpose.  I'm unfulfilled by my job, but I need it to pay the bills.  It consumes most of my time, and I have nothing to show for it.  I have no time to devote to creativity or outside interests because I am so exhausted on my days off that I end up sleeping through them.

It's terrifying to realize that you really, truly hate everything about your life, and that you feel powerless to change anything.  I feel limited by my own health problems and medical conditions, and so I don't allow myself to dream too big because I don't know how far I can realistically go.  I do job searches, but they generally feel futile or meaningless; I am picking a job to have a job, and none of them get me excited or arouse my interests or passions.  I would love to work for myself (maybe; I say this, but I'm not sure how I would feel if I was actually doing it), but I don't know where or how to start.  I need money for my monthly expenses--dog, supplements, visits to doctors, insurance, student loans, food, car, prescriptions, life--and it seems impossible to be able to start anything entrepreneurial before stopping my current job.

But, even more scary than realizing how uninterested I am in my life is realizing how long it's been since I've been excited about anything.  I really think the last time I felt content in my circumstances was about six years ago, when I was still in college.  I would literally have moments when I thought to myself how perfect my life was at the time.  I was studying a field I was in love with, which fed into my Clifton strength of intellection.  I was working for my department which gave me a sense of deeper involvement in our progressive major and closeness to my professors.  I was exercising daily and eating well, and I was keeping off the weight that I had lost a few years before then.  I was discipling a younger student through weekly Bible studies and mentoring.  I was working on an oral history project with the local historical society.  My life was full, but everything I was doing felt meaningful and I had a lot of freedom and time to myself.  I was so happy with my life back then that it drove me to apply to Ph.D. programs, just so I could maintain that same life forever.  But, when the reality hit that I would be moving cross-country to immerse myself in academia, my heart seemed to shrink and I didn't want that life.  I basically never wanted to leave the life I was living at my university, and I eventually realized that getting a doctorate at an East Coast school would not simply be a continuation of my college experience.  It wasn't so much the academia I was interested in as it was the academic lifestyle.

I wasn't terribly unhappy during the few years following graduation.  I worked in a gluten-free market, where I got to talk to people about healthy eating and organize things all day.  I experienced a lot of autonomy and time to contemplate, and so I was content.  I continued to maintain an active lifestyle and was involved in a local church.  I even had a few friends that were still in town and who I saw with regularity.  However, life began to shift in 2011.  It started with debilitating joint pain that sent me to physical therapy.  A rheumatologist couldn't figure it out.  Physical therapists couldn't figure it out.  My endocrinologist eventually figured out that it was a sensitivity to almonds, which I ate constantly throughout the day in every form you can imagine.  I was taking two art classes at the local community college, but outside of that I was mostly watching a lot of T.V.  I did start interning that summer as a photojournalist for three local papers, but at the end of summer I broke my leg, and so once again my life became all about physical therapy.

In January of the following year, I began working for the local school district and awaited grad school acceptances.  Once I decided to pursue a master's in Women's Studies, I immediately began to have misgivings about the program and whether I really wanted to study that field.  I knew I wouldn't be able to recreate college, and I think that's what I was after.  Additionally, I didn't feel like I fit in with the program or its students, and so I began to move in the direction of special education.  I wasn't necessarily something I felt passionate about, but it gave me a sense of purpose.

I numbly floated through my interdisciplinary graduate program, eventually realizing that I didn't really want to teach special ed.  I began to pursue school counseling, until I realized that I didn't want to do that either.  I desperately grasped for a sense of purpose, having somewhere lost my sense of passion or even any sense of what my passions might be.  I finished graduate school, and was essentially forced into the only job that wanted me, and shortly after that into the only other job that wanted me.  And then I eventually found myself in survival mode, no longer even thinking about purpose or passion or my idyllic time in college.  I had to turn off any sense of wants or dreams so that I could cope with the reality and limitations of illness, and get through the day-to-day grind of a meaningless job without becoming suicidal.

I try to get through five days of work so I can get to my two days of sleep.  I think more about paying my bills than finding purpose.  I think about my limitations more than I do my potential.  I don't really know what I want anymore, except I know I don't want this.  And the things I know that I do want--a cottage by the sea and a vegetable garden and a flock of schnauzers--are unrealistic without a job to finance them.  And so I dream of this vague life I want, but don't know how to get there.  And even though I feel stuck, I am terrified of getting unstuck because I don't want to get sick.  And illness seems to follow me wherever I go.

It seems silly for a person to feel trapped in his or her own life.  We think, "Go do something about it!"  But the logistics of actually doing something about it are profoundly more complex, generally because they involve money.  Do people with a lot of money ever feel stuck?  Maybe on an emotional level, but at least they have the means to physically remove themselves from lives they hate.  Or, perhaps I'm wrong.  I know money doesn't solve problems, but sometimes I think it might in some small way solve some of mine.

The article I read last night told me that I should stop thinking so much and just start doing things.  Anything.  Create things.  Learn things.  Keep myself busy.  And I think back to my time in college and how busy I was, and perhaps the key to my happiness was that I had so much going on and I was contributing to the world in a way that lined up with my values.  And perhaps the longer I've been out of college and the more sick I've become, the less I've been able to do.  And as I did less, I began to think more.  Exercise and church and seeing other people were no longer important factors in my life.  I blame my lack of involvement in anything on fatigue.  But is it that?  I don't even know anymore.

It seems there are many things I no longer know.  I have accepted this as my reality, but I don't want to settle for this.  This can't be it.  I won't let this be it.

"For most of us, we hit that 'stuck/fu**ed' spot right when we get the first secure job. It pays us good enough so that we don’t worry, we get a good enough apartment, then a good enough spouse, then a good enough marriage. And then life is 'Eh, good enough' for the rest of our lives. F**k good enough."

-Alexander Heyne

I know that my circumstances need to change.  I just need to figure out what I can realistically do to change them.  Please help me, God.

What My Schnauzer Really Means To Me

My friends and loved ones all know how important my dog is to me.  They will tease me about potential online dating profiles I could create, which would bear headers like "Must Love Schnauzers."  Recently, two of my co-workers and I got into a discussion about relationships, more specifically about my love life, and I tried to explain to them the importance of my dog in finding a life partner.  I told them, "I'm not really picking a husband for myself as much as I am a daddy for Tobin."  My co-workers laughed, one of them suggesting that I was crazy (which she declared in only partial seriousness--I hope).

I got coffee with my best friend yesterday (I seriously struck gold in the friends department; I don't maintain a large inner circle, but the people dearest to me are the best people I could possibly hope for), and I recounted to her my experience at work.  We then sat together and discussed what Tobin has gone through with me.  Tobin entered my life in July of 2010, only five months after I had been diagnosed with Hashimoto's.  At that time, I had only been to one doctor for my condition (the naturopath who discovered I had the disease), and I had absolutely no idea what having an autoimmune disorder meant or how it would impact my life.  Tobin and I moved to North Carolina when I started graduate school in August, but after only a few weeks I had to drop out because my health was collapsing quickly and I felt like I was having an emotional and physical breakdown.  The following month, I was diagnosed with PCOS.

For the bulk of 2011, I couldn't work because I was in such immense physical pain and so extremely exhausted.  I went to physical therapy multiple times a week, in search of help with severe knee and hip aches that left me barely able to walk (which my current doctor was eventually able to determine to be the result of an almond allergy).  I was attending two art classes at the local community college, but couldn't muster up enough energy to do anything more than that.  At the end of summer, I broke my knee while running with Tobin on the morning of a day I was supposed to go to Disneyland.  I was out of commission for months, and was only able to start part-time work the following January.  During all this time, my hormones were riding a treacherous roller coaster; I felt irritable and anxious, and didn't menstruate at all.  I would go through stretches when I felt angry at everyone, only because of the imbalance that was making me feel angry--something outside of my control.

I started a master's program in the fall of 2012, and Tobin and I moved to San Diego after much waffling about whether I wanted to do the program and/or move out of my family's house.  I started school with much ambivalence, and in the first week of classes I switched my entire degree program.  I only lasted in San Diego for a little over a semester.  My period had returned the month school began, and had been coming consistently every month after that (mind you, this was after nearly three years of not getting it at all).  However, with it came even more extreme mood swings and hormonal issues.  I became increasingly depressed, to the point that there were some nights I felt nearly suicidal.  I would call my mom or sister in tears, feeling like I had no power over my own life.

My landlords were gracious and kind enough to release me from my lease early, in March of 2013.  Tobin and I moved back in with my family, which alleviated much of the stress of living alone with Tobin while managing school and chronic illnesses.  I had to commute over an hour both ways several times a week, but the stress of commuting was a welcome alternative to the emotional upheaval I had experienced while living on my own.  I was able to work with the local school district that summer, and finished my master's that fall.  I began working full-time in January of 2014, but had to leave my job after only a little over two months.  While in tears on the way to work, I would call my mom and tell her I felt like I was dying.  Little did I know that only a few months later, I would be diagnosed with thyroid cancer.  My body knew what was happening.  I quit my job and found work closer to home, and without the emotional stress of working with children with the most exceptional of needs.

All that is to say, Tobin has been with me through it all.  My Hashimoto's diagnosis in 2010 was the smallest of moments amidst the ensuing four years.  There were many days when I probably wouldn't have gotten out of bed, but because of Tobin, I got up, I fed him, I cared for him, and I didn't give it a second thought.  It was my duty to make sure he was okay, and I was able to take the focus off of myself and my disease and my suffering and invest my attention into something apart from me.  Meanwhile, he was totally oblivious to much of my suffering (at least as far as I can tell), and was the happy-go-lucky, energetic, loving, playful dog that he is, regardless of my mood or behavior.  That is exactly what I needed: consistency.

In many ways, Tobin became a sort of anchor to me as I drifted to and fro in the tides of sickness and wellness.  Whether I was rejoicing or suffering, he was the same every day, and his needs were the same every day.  He was the one joy I had in the midst of much joylessness.  And, even though my friends and family knew about my (mis)adventures around the country and state, Tobin was the only one who was physically with me through all the changes and struggles.  He was the one with me as I drove cross-country.  As I flew back home from North Carolina.  The moment I broke my leg.  The nights I called home crying because I was tired of being alive.  He was always there.

And so, for me to tell people that I want a daddy for Tobin isn't meant to be a joke.  It may sound funny to people when I say it, but only because they don't understand the gravity behind those words.  It's the easiest way for me to say that Tobin, in some senses, represents all of my illness and struggles for the past five years.  He represents the anchor that kept me grounded as my little boat attempted to drift out to sea.  To understand what Tobin is to me is actually to understand and validate my experiences and hardships from the past few years.  It is to accept me in my entirety, and to know the depth of what I've gone through and the ways in which my trials have shaped who I am and where I've been and who I'll become and where I'm going.  For me, Tobin is not just a dog, but he is God's greatest blessing and gift to me.  A sort of embodiment of God's love: consistent, constant, present, unwavering.

Tobin \t(o)-bin\ - Hebrew origin; a variant of Tobias (Hebrew); means "God is good."

My sweet dog lives up to his namesake; he is the embodiment of God's goodness in my life.

My Future: A Poem

I want to live in a small cottage by the sea

And have a flock of schnauzers

And drink tea

And write

And have a vegetable garden

A Smart Car

And a big desk overlooking the water

And an art studio

A husband who will with me: go to Starbucks and play board games,

peruse local antique markets,

read on the front porch

I Am Valuable, My Life is Worth Living

I don't love myself.

It's a realization I've made during the past weeks, or perhaps months or even years.  I don't love myself or find value in myself, and so I haven't been taking care of myself.

I'm not usually the biggest fan of Joyce Meyer, but over the weekend I came upon some words she wrote that spoke to my soul.  We can't love ourselves until we are healed emotionally, and we can't heal emotionally until we accept God's profound and unconditional love.

The depression demon usually visits me a handful of times throughout the month, generally in relation to a combination between where I am in my hormonal cycle and how I've been eating.  Tonight I was trying on some outfits, and all I could think about is how fat I am.  I looked in the mirror at how big (objectively speaking) I've gotten in so many places, and it made me feel totally unattractive and undesirable.  Coupled with those feelings is my already low self-esteem resulting from knowledge of my diseases, and the belief that I'm abnormal and tainted and not someone who anyone would want to marry; I cry in desperation, feeling like an alien creature stuck in a life she doesn't want, but incapable of having anything more or different.

In reality, I'm only 20 pounds heavier than my "normal," a result of hormone imbalances, cancer, and a puttered-out thyroid.  However, I think much of my self-worth hinged on my thinness, and now that it's gone (objectively speaking), I don't feel good about myself.  Before that, I found value in academic performance and achievement.  Before that, the perceived strength and quality of my faith in God.  I'm not in school and I've moved away from my legalistic Christianity and into something that feels less certain and secure (the loss of legalism is a good thing, the loss of security is not such a good thing).  Without my previous appearance, or academic accolades, or the recognition of a mature faith journey, I no longer have anywhere to find value.  Except the value that God has inherently created me with.

So much of my life has been about performing and doing and achieving that I missed out on many years of just be-ing.  When I was a missionary in China, for the first time in my life I was surrounded by a team of people who spent time doing things they enjoyed, simply for pleasure.  That concept was so foreign to me.  I didn't even know what I really liked doing.  I remember starting to spend afternoons outside with my camera, and then I bought some paint supplies at a bookstore and painted some pictures for the first time ever, just because I could.  I bought fiction books.  I downloaded music and learned about different singers and bands.  I began to exercise and cook healthy foods.  I became less focused on the appearance of my life to other people, and made choices that brought joy to my heart.

I'm not sure what's happened in the past four years, except I think that somehow with my medical diagnoses I began to give up on my life a little bit.  I remember when I was first told I had Hashimoto's Thyroiditis and probably PCOS, my immediate thought was, "Well, I guess I'm not getting married."  Somehow a disease made me abnormal, and that abnormality made me unlovable, and to be unlovable meant I had no value.  I think that I've been caught in the web of this pattern of thinking since that day in the beginning of 2010.  I am abnormal, so I have no value.

It's difficult to come to terms with the physical ailments you've been born with--to know that God created you with these proverbial thorns in your flesh.  I know that we all have our weaknesses and idiosyncrasies and problems, but somehow because I now see that I am not and can never be perfect, I have lost all sense of self-worth.  Perfectionism is such a painful and exhausting addiction.

But then I think about how much God has created me to be able to offer to the world.  My emotional and spiritual and physical struggles are but fodder for the possibility of ministering to others--of feeding God's sheep.  My suffering makes me more real and authentic and genuine (I hope), so that I can be a source of comfort and respite and truth to the people around me.  And He has given me gifts, as a human be-ing, that are unique only to me.  And not only gifts, but a calling to which no other person has been called.

I think about so many people He has placed in my life, people who love and value and appreciate me for who I am and nothing I've done.  People who have loved me through the ups and downs of my autoimmune disease, the good days when I've been kind and grateful and warm, and the bad days when I've been depressed and cranky and cold.  People who have loved me through my cancer, showering on me their support by way of an outpouring of financials gifts and notes of encouragement.  People who have continued to seek out relationships with me, even when that seeking out is very much one-sided.  All of that love and support and seeking speaks volumes about the love of God, and if the people in my life have valued me in this way, how much more does my Abba Father lavish His value and love and pride on this little creature He has created--me?

Earlier this year, I began to see a counselor to help me with PTSD from a near-fatal car accident I was in two years ago.  During our first session, she gave me a list of positive self-affirmations and negative self-talk.  We discussed some of the phrases from the list that I want to come to believe to be true.  I no longer see the counselor, but I have since begun writing these positive phrases in my journal.  I think there is a lot of power in claiming these affirmations in my own writing in my own personal journal.  I also began to rewrite some of the affirmations as truths about God (i.e., God is in control; God can be trusted).

I haven't been very consistent about going to the gym since my cancer surgery, but tonight, amidst a mini emotional meltdown, I knew I just needed to get out of the house and focus my mind on something other than my own unhappiness.  As my endorphins kicked in and I actually began to feel the cloud of depression lifting, I began to say to myself, over and over:

My life is worth living.

And then I added to that:

I am valuable.

And so I pumped those elliptical pedals and chanted to myself, "I am valuable.  My life is worth living.  I am valuable.  My life is worth living."

I have begun to make a list of things I want to commit to doing every day and/or every week in order to nourish my body and soul.  If I feel trapped in my life and want things to go differently, I am the one that needs to take steps to change what is changeable.  I am going to start taking care of myself because I am valuable, and my life is worth living.

He made me valuable.  He gave me a life worth living.

God, grant me the serenity to accept the things I cannot change,

The courage to change the things I can,

And the wisdom to know the difference.

Entrusting My Care to His Hands

No one tells you that when you're diagnosed with cancer, so much of the emotional turmoil and overwhelming nature of the situation won't have to do with the diagnosis at all, but with all the planning involved in having cancer.

My brother commented that it seems unfair for people with cancer to have to plan and pay when they didn't choose illness and all of its life interruptions.

There's the taking time off of work.  Getting shifts covered by co-workers.  Making calls to your insurance company (I thought I hated them before--true medical crisis takes hatred to a whole new level).  Coordinating finances with medical providers.  Tracking down a clear retainer to use in lieu of your nose ring so the piercing doesn't close while in surgery (wait, that one's just me?).

I stare at my computer, switching back and forth between my online banking homepage and my insurance company's summary of benefits.  I try to figure out how this is all going to work.  Why doesn't anyone tell you how expensive and annoying cancer will be?  It's so distracting that you forget why you're making the calls and perusing the websites and adjusting work schedules in the first place.

I contacted my boss earlier to let her know that I will be having surgery on Monday, and that I will need to take next week off if it's not a problem.  Her response made me cry, because it reminded me that this is about my cancer.  She told me she's proud of me and that I'm going to kick this thing's butt.

I was thinking about my sweet Tobin, and how much money I've spent on him over the years without ever batting an eye.  When it comes to caring for him, money is never a question or issue.  I'll do whatever it takes.  And then I realized that I need to extend that same grace towards myself.  I am worth excellent treatment by a skilled physician.  I am worth the cost.  Why do I place his needs so high, while so easily discounting my own?  Why do I apologetically ask my manger for time off to treat my cancer?

Reaching out to people for financial assistance has been hard and good.  Hard, because I feel guilty asking people to help me fight cancer.  Good, because it forces me to not fight cancer alone, which I would be prone to do.  I would isolate myself and place the burden on my own shoulders and not want to inconvenience anyone.

But I realize that instead of being inconvenienced, people experience great joy in providing support.  When it comes to those we love, we think about doing the best for them no matter the cost.  I think sometimes I approach God in that same way, feeling like I am an inconvenience and burden or not believing in the gravity of His love for me.  Having Tobin has allowed me to see that my love for him is not only mirrored by God's love for me, but that God's love is so exponentially beyond the love I'm capable of giving anyone or anything that it's truly beyond my comprehension.  And He is the one in whom my well-being and care is entrusted.

I was told to not let red tape or insurance hoops stand in the way of the best care.  I'm terrified to have my surgery done on Monday, not because they're cutting me open, but because of the bills I know will be arriving in the mail in a few weeks.  But, I'm entrusting myself to the hands of the Greatest Physician and Provider, and trusting that He knows and sees my needs and already has a plan.

Jesus, calm my nerves.

Cancer's Lessons on Love

I think for many of us, the word cancer conjures up images of hairless scalps and hospital rooms and colored ribbons and walks for cures.  We think of kids with leukemia and women with breast cancer and smokers with lung cancer.  In terms of media and popular representations of cancer, there is a group of people that seem to totally be skipped over--those from 15 to 39.  Until I was diagnosed, I didn't realize that as a 28-year-old, I thought of cancer as some far-off thing that might happen to me much later in life.  I think I somehow subconsciously thought that if cancer didn't affect me as a child, I would be safe from it until I was elderly, or at least more advanced in age.

Even though I've only known about my cancer for three days, my perspectives regarding and perceptions of the C-word are changing.  I'm learning that it's not all chemotherapy and hospital stays and planning for the end.

What I've discovered after three days of knowing about my cancer (and I write this to sound like a generalized experience, but know that it is actually specific only to me):

1. A diagnosis makes you an insomniac.  You find yourself up at 3AM trolling the Blue Shield and American Association of Endocrine Surgeon websites, trying to find a skilled doctor that is part of your insurance network.  Or, you start Googling the scientific words they used in your biopsy report to figure out what the hell they're actually saying about your cancer cells.
2. You will find yourself in the bathroom a lot.  It will feel like you're getting an ulcer.  Food won't agree with your stomach.  You'll wake up and run immediately to the restroom.  You'll realize that at a time when you should be taking the best care of yourself ever, you end up making poor food choices because the bad foods comfort even if you can't digest them.
3. You will become an experienced ugly-crier, complete with snot over-production, mascara-stained cheeks, and whaling sounds.  The hardest moments will be when you find yourself alone and in a quiet place.  Those are the moments when you don't feel like you have to hold it together or be strong for anyone, and all you'll be able to hear amidst the silence is your conscious reminding you, "I have cancer."

But, in all seriousness, I think the reality of my condition hit about 30 hours after I learned about my diagnosis.  I was driving home from work, and I just started crying uncontrollably.  All day I was assisting customers with their needs, focusing on solving problems and finding what they were looking for, while being totally distracted from my own woes.  But it's once I got in my car and didn't have to smile anymore or be helpful or take care and be supportive of anyone else that I felt the weight of the world on my shoulders.  It's hard to muster up strength to meet people's needs when really you just want to collapse for a while and let someone carry you.  In some ways, going to work has been beneficial because it does serve as a distraction, but I think it's going to take time for me to learn that it's okay to go home and be weak.  He is sufficient to be my strength once I'm not distracted, and He's given me my family to share in His duty of carrying me through this without my having to feel guilty.

And I think that's the hardest part.  Realizing that despite the fact that you're stronger than you ever realized, you're simultaneously weaker than you every dreamed possible.  I guess that's the beauty of His power being made perfect in weakness.  He provides you with strength and hope and courage and tenacity, while also bringing you to terms with your need to seek help and accept compassion and rely on others without being able to offer anything but gratitude in return.  You will likely see an outpouring of love, and all you can do is accept it and realize you deserve it because you're invaluable and that people don't expect you to feel indebted to them in any way.  I guess I'm discovering that cancer teaches you about love.