EDS Rehab

Some of you might know that I’ve just started a three week pain management programme to try and help me manage my Ehlers Danlos Syndrome.  Well, we had a rocky start and a few issues with the hotel but today is day three and things seem to be going a bit more smoothly.  The rest of the group are lovely and friendly which I think will really make a difference, particularly as the weeks go on.

Whilst I’m not going to be sharing everything we’ve been doing, there are a few things that I think other people with chronic pain might find helpful and some other info that you might want to know if you’re considering coming.

Hotel

First of all, there are two versions – one run in a hospital and the other in a hotel, mine is the hotel version so I can have care with me.  This meant that I was assigned an accessible twin room.  Thankfully I am able to walk a little way otherwise I think I’d have had to go home again…  The room is tiny, the twin beds are essentially one big bed and I can’t get my manual or electric chair to the bed.  There certainly isn’t space for transferring.  Ditto for the toilet and the shower is so tiny that anyone much bigger than me would struggle.  It does have a shower seat but when it’s down there’s no space for your legs…  It’s certainly been an intimate experience when my carer has showered me…

The rooms that the hospital use all seem to be on the lower floor and there is a wheelchair platform lift as opposed to a regular lift.  We used this once when we arrived and I think we broke it. No one asked how heavy my electric chair was and it was only when I was going up it in my manual yesterday that I noticed we were probably 100kg over the maximum weight…  This means that if I want to go to reception or the restaurant we have to go to the far end of the building and then out the fire exit, through the car park and back into reception.  This isn’t great but thankfully isn’t raining… Although the fire door gets locked from the inside at night so we have to arrange for someone to meet us there and let us in.  Last night we also discovered that a door between the main corridors and rooms and the fire exit gets locked at a certain time so we couldn’t get in that way… This poses questions about how I get out in a fire as it’s the only ramped fire escape… Questions that so far the hotel have been unable to answer…

Pain

Up to now we’ve done some one to one work with a physio, an OT and a psychologist and had some talks about what pain is, the psychological element of pain and such things. In one of these sessions, we were shown a really interesting Ted Talk which shows the role of the brain in interpreting pain:

This is not to say that the pain is “all in your head”, you are not making the pain up but your brain has an important role in pain.  As Moseley explains, your nerves send signals to your spinal cord which passes them onto the brain for interpretation.  It is here that our bodies decide whether something is a threat or not.

In people with chronic pain, the messenger system which conveys sensations to brain can become over sensitive and sends more messages to the brain about stimuli and sensations.  The spinal cord also becomes really good at hearing these messages so it picks up on quieter messages and hears them more loudly.

We’ve also been looking at how prior experiences, beliefs, culture and relationships affect how we feel pain and how we think about it.

One of the really interesting points was that when you are experiencing a pain flare up, your body reacts in a very similar way to how it would if you were being chased by a lion – flight or fight mode.  This explains why your temperature changes, why your heart races, why you can struggle to breathe etc when pain is high.

I’ve also been given a few different physio exercises to try and strengthen my weak muscles and stretch out the tighter ones which we’ve been practising in my room.  Of course this all means increased pain right now and fatigue but it’s different pain to my normal pain so I’m taking that as a good thing!  And I get to do hydro which is very exciting!

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Things which make my day easier

Someone recently found my blog by looking for “ehlers danlos can’t open jars” and I hope they found some help (try dycem jar and bottle openers).  I wrote a post in 2014 (2014, can you believe it?!) with some tips for stuff which really helps me. Anyway, a lot has changed since then so I wanted to write an updated version.

Collection of drinking vessels
a collection of my cups, a cup cover and one of my hot drink straws

If you find this helpful, do check out the 2014 post as it all still holds up.

  • Tablet and tablet stand – these were included in my last post and I still love my tablet and use it so so often throughout the day.  It’s my contact to the world.  It’s my books and my storytellers.  It’s my calendar.  It’s my notebook.  It’s my teacher.  It’s my alarm clock.  It’s my tv.
  • Pillows – find pillows that work for you.  I have two standard bed pillows and a, rather pricey but worth it, U shaped pillow.  It’s filled with beans so it squishes and my shoulders have dislocated a lot less since I got it as they are now supported at night.
  • Mattress raiser – I got mine through the local council.  Basically it goes under your mattress and allows you to raise the head end of the bed like a profiling bed would using a remote.  This makes it so much easier for me to get in and out of bed, more comfortable when I’m in bed but wanting to sit up and it’s easier for my carers to get me out.  The combination of this plus my mattress topper means that I have king size sheets for my double bed.  Much easier for my carers to get on and less likely to twang off in the night!
  • Bed wedges – there are lots of different options, I have one which supports my knees and ankles
  • Duvet raiser thingy which keeps the duvet off my feet (the weight of my not very heavy duvet is enough to hurt my ankles and dislocate my toes).  I have my thingy attached to my bed using a strap which goes round the mattress and I have a blanket pegged over the top, round the sides and the end of the bed so my toesies don’t get chilly!
  • Overbed table – I got mine for a bargain price of £3 at my local second hand furniture place.  It gives me a place to put things like meds, my tablet etc so that they’re essentially in my bed but not going to fall prey to my tossing and turning.  I have a tray on top of mine which has the advantage of making it look less clinical whilst the edges stop things falling off.
  • Key safe – this means that my friends and carers can let themselves into my flat if they know the code to the key safe.  In my old flat I kept my spare keys in a combination lock locked shed.  It means I don’t have to get out of bed to let my carers in and it’s there in an emergency so other people can get into my flat.
  • Cutlery – I can now only use my bent spoon to eat, anything else causes too much pain or is impossible.  You may find spoons easier than using a knife and fork or maybe just need a thicker handle.
  • Plastic crockery – this is lighter and obviously less breakable.  I have some nice bits from Cath Kidston, paperchase and I got some in the BHS closing down sale.
  • Cups and drinking accessories (what you don’t accessorise your drinking? how last season are you…?!)
  • Trolley – this lets me move a lot of stuff from room to room at once, reducing the need for multiple trips as well as reducing risks of dropping things and lessening the pain in my hands
  • Plug pulls – a little bit of plastic which attaches to your plugs to make them easier to pull out, genius!
  • My pouch – I love my pouch.  It holds my tablet, my money, my keys etc.  And because it isn’t an actual bag, it squishes down beside me in the wheelchair so I can get to the important stuff.
  • Hairbands – especially wide fabric ones and headscarves are perfect for bad hair days, weeks when you’ve not managed to wash it etc.  And dry shampoo is also helpful here!

I’ve included links to help illustrate what I mean.  I don’t get any money from the companies and obviously you should shop around and find what works for you.  You may also be able to get some of these things through your local community equpiment service (in the UK at least).

 

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When sex hurts: Sex and chronic pain

The post is looking at when sex exacerbates existing non sex related pain rather than pain caused purely by sex.  Although not discussed here, changes to appearance, self esteem etc will all impact on your psychological wellbeing which can then impact on your sex life.

Chronic pain can be distracting, it hurts obviously and it can impact heavily on your life. Including your sex life…  Being in pain all the time does not make you (or at least me) feel sexy.

I wanted to do a post specifically about pain because I think the impact pain has on sex can be different to other disabilities. My first point would be to talk to your doctors… However,  I know that that isn’t always all that helpful… indeed, the NHS seems a bit lacking for in depth support…  (but yay, they have something, I guess)

I don’t have a magic wand to make sex with chronic pain easier but having sex can help with the pain so it’s worth a try, right?!  Orgasms cause endorphins to flood your body which helps with pain relief.

In no particular order, here’s some things to consider:

  • Communication – talk to your partner, its ok to be worried about the impact of sex on your pain, particularly if you’ve been avoiding it. Talk about where the pain is worse right now, should your partner avoid touching parts of you today etc
  • A lot of conditions fluctuate, make sure your partner understands this; being able to do something one day doesn’t mean you can do it the next.
  • Plan ahead. Unlike the movies, sex doesn’t always have to be spontaneous.  There are so many reasons why that doesn’t work such as children, working unusual hours, carers etc.  And if it helps, you can try and schedule in some rest time before hand and recovery time afterwards.
  • Find out what the best time of day is for you in terms of low pain, higher energy levels and higher libido
  • If being touched is painful (or even if it isn’t!), use none contact ways to arouse each other eg sexting, phone sex, talking flirty or dirty, mutual masturbation, pornography, erotic literature or try light touch such as feathers and silk
  • Massage is another way of being intimate, just be careful with painful joints, muscles etc
  • If your hands are in pain, try using your tongue
  • Warming the bed beforehand eg with an electric blanket may ease some of your pain
  • Sex toys might be easier for you and your partner
  • Cushions – well placed cushions can be invaluable! Think propping up hips etc
  • Where are you having sex? Would your wheelchair or riser recliner chair or electronic bed be more comfortable or in the water?
  • There’s also the impact of pain meds, they can decrease your libido, and you need to make sure you are on the right meds for you at the right dosage. If your pain isn’t controlled at all then of course sex will be harder
  • If your partner is your carer and you need help getting changed or into position, maybe you could ask someone else to get you ready or make the care into the foreplay.
  • Go long and slow or short and sweet, whatever works better for you
  • Have a think about what positions are best depending on where your pain is etc
  • Try not to stay in the same position for a long time if this causes you pain
  • Depending on where things are in your sex life, go back to basics with date nights, flirting, kisses, holding hands, cuddles…
  • Muscle relaxants, a warm bath, massage, a glass of wine might all aid things by relaxing you and your muscles
  • If something doesn’t feel good, say something.  Don’t assume your groans are conveying the right message! Maybe even have a safe word or be clear that stop means stop right away.
  • Use Google, look up good sex positions for ehlers danlos or whatever you have
  • edited to add, lube, lube is good

None of this is going to be a quick and easy solution unfortunately…

I’d really like to hear from you if you’ve got any more tips.

I’d also suggest popping over to The Hippy Geek who has joined two beds together so she can have an adjustable bed and still share a bed with her husband which I think is awesome*!

*be in no doubt here, as awesome as the idea is, if you ever end up in a relationship with me, you’ll be in the spare room! I love my double bed and all it’s very specifically arranged accessories and I’m not giving up my middle of the night internet for anyone!

Disability and sexuality, part 1

I was on a train about a year ago, the first time I’d been on a train in my wheelchair. I was sat in the wheelchair section along with some guys off to a football match. It was ten in the morning and they’d been drinking. And were talkative. I ended up left alone (as far as I was aware – it turned out there was a women round the corner listening to this who only spoke up once they’d got off the train…) with them for the 22 minutes between York and Leeds. And they were awful. They completely invaded my space, leaning on my chair and many other things which I’m not going to go through. But then, basically out of nowhere, one of them asked if I could have sex what with being in that thing, insert wild gesturing towards my chair. What the f***?

I’d “known” them about ten minutes and now they wanted diagrams about my sex life. And felt it was completely fine to ask for them. Not ok. Way way way not ok. But I was alone with them and had no idea how far they were travelling and I couldn’t move to another part of the train.

So I handled it in the only way I felt safe, with humour and changing the subject. Inside I was fuming and wanted to have it out with them about how inappropriate it was but I felt too vulnerable. If they’d turned nasty, I’d have been stuck. Indeed, when they left one of them hugged me and the other full on kissed my lips. Again, not ok.

But… and I am in no way excusing their behaviour, society paints people as asexual so when they were faced with a young woman in a chair I suspect they genuinely couldn’t put two and two together. I suspect they’d have hit on anyone who was female and near them on the train but it just so happened that it was me and my disability. And I think it threw them through a loop.

Which is why we need to talk about disability and sexuality.

So, can disabled people have sex?

Yes.

Wait, you want more than a one word answer? I think you’re probably wanting to ask how disabled people have sex then. And the answer is long. Probably infinite. Because, like with abled bodied people, everyone likes different things and is capable of different things. Indeed the sex that a disabled person has will probably vary depending on the partner, like with abled bodied sex…

But isn’t it a bit rubbish?

No. Again, everyone enjoys different things and are able to do different things.

I think it’s important to remember that we have mental disabilities, sensory disabilities and physical disabilities and obviously they will all have a different impact on sex. Often the difficulties people have in understanding how disabled people have sex is with regards to physical disabilities. Issues around learning disabilities tend to focus more on before sex, in particular around things like consent. And people seem to on the whole forget about mental illness when talking about how disabled people have sex… FYI, depression, anxiety and other mental illnesses can impact on your sex life. Perhaps that’s a different blog post.

Go on then, how do you do it?

Firstly, what do you mean by sex? So many people are referring to penis in vagina penetration when they talk about sex. Which is so uncreative… I can’t have penetrative sex as I’ve discussed here previously but I still enjoy lots of other things. You just need to explore more, see what works for you and your partners. Kiss, cuddle, use sex toys, make use of the bed raiser, have strategically placed cushions…

And communicate. The odd grunt and groan here and there probably isn’t going to cut it – can you tell the difference between the “keep going that’s amazing you’re rocking my world” groan and the “shit, my hip just dislocated but I don’t want to say something and ruin the mood” groan? Make it sexy, make it dirty, make it intimate.

You might need to talk beforehand about some things – where are you in pain, where should I avoid touching you, what happens if…, is the bed or the floor or the bath best for you, how does your disability affect you when it comes to sex…

There might need to be another person involved for example to help you get undressed or to get you onto the bed etc.

And if things go off course, humour is helpful. Except if you’ve just accidentally knee-ed your male partner… Turns out that’s not so funny… Oops!

But other than that, it can be a lot like “normal” sex.

Sexuality and disability has information about sex with partners and masturbation including ideas for particular conditions etc. And talk to your professionals.  Some of them will be squeemish and not answer your questions or try and deter you from having sex but that’s their issue not yours.  Keep trying until you get the info you want.  Sexuality is part of who you are and a healthy sex life can be great for your overall wellbeing.  Plus, orgasms are apparently great for pain relief.

Have fun and stay safe!

Personal strategies for living a good life

One of the last sections of my Future Learn course is around personal strategies for living a good life with an impairment.

“Because disability studies collects a huge range of impairments, each of which are experienced differently in everyday life and have different impairment effects, there is no end to the personal strategies people with impairments use to support a good life.”

That being said, it does suggest some examples; community, the spoon theory as a means of helping people understand and mindfulness.

I started to respond with my own personal strategies but ran out of space so I thought I’d carry on over here and invite your ideas and strategies as well.

Community

Online community is a huge way I cope with things. I blog and use twitter to “meet” other people with my condition which helps me feel understood as well as having people to offer helpful tips such as what bottle opener works best. These friends also understand the impact of society and it can be so helpful to know you aren’t alone in dealing with things such as access issues or abuse. Indeed, it helps me to realise that I am not the problem, if it’s happening to other people then it’s not about me personally. I could rationally reach that conclusion but the individualistic nature of western society can really make things feel personal.

Pacing

Pacing is one of my really important strategies. If you have chronic pain or fatigue, do look it up. It’s the idea of doing something for slightly less time then breaking then going back to it rather than doing a lot of something all at once and then paying for it.

Humour

Humour is essential. Admittedly, my humour tends to be dry, sarcastic and biting but there you go.  The first day I had care we got into a bit of a mess getting changed. It, like a lot of my life, is undignified and humour can make it easier to cope. It can still get me down of course, it just means I’m not always down about it.

Without a degree of humour, it’s hard to let someone else wash you intimately.  It can become tense and awkward if you let it.

Action for change

This is something mentioned by one of my fellow students.  Instead of coming up with personal strategies to navigate a world which isn’t designed for us, we should challenge that society.  And I think this is really important and there are lots of ways of doing it, from raising awareness by sharing your experiences to hanging off a bridge in your wheelchair.

A moan

It’s not a very fashionable thing but having a bit of a moan from time to time can help.  Don’t get stuck there but getting frustrations off your chest can be cathartic.  And can help with awareness raising!

Support groups

This should probably be included with community but there’s something more specific about a group of people who are experiencing the same things as you.  With that shared knowledge, you can problem solve, you can suggest ideas which have helped you, you become more aware of shared issues and can come up with ways to address them.

Netflix days

Sometimes, we need a down day.  And if that’s watching netflix in bed, do it.  I remember a conversation with a friend who has mental health issues where she was describing how helpful it can be to give yourself a day to indulge in things.  So long as you have a day or time in mind to force yourself back out of it.  My fear of giving in and not getting out of bed has long been that I’d just never get out again.  So this ensures that won’t happen (sort of) whilst giving you the crash time you might need.

Acceptance

God, grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And wisdom to know the difference

– Reinhold Niebuhr

I’m not religious or in AA but the sentiment expressed in the serenity prayer is one that I think is important when it comes to coping with long term illness and disability.  There are lots of frustrating things I can’t change – I can’t make myself better for example – and getting stuck in a place where I’m angry about it isn’t helpful (there’s a grieving process around coming to terms with acquired disability which is fine, but it’s not a place that’s nice to get stuck in).  It’s taken a long time but I feel I’ve mostly accepted my illness and that’s so much better for my mental health and wellbeing.  And then there are things I can (attempt to) change such as my old workplace being inaccessible.  And this is a much healthier way to use my frustrations and anger.

Creativity

Whether it’s a page in my art journal or a bit of work on a canvas, creating things helps me in many ways.  It’s a distraction from my pain, it gives me a sense of achievement, it’s a way of expressing myself and probably helps in other ways that I’m not really aware of.

image

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What strategies do you have?

Carriage clocks* and more

Retiring at 29 wasn’t part of my life plan. Not that I really have a life plan. But, like most people, I assumed I would spend my adult life working and, given my pain and the ever increasing retirement age, I’d have to leave on ill health. But i was expecting that to be in my 50s or so.

DSCN1009 MO
not an accurate picture of my retirement…

But increased levels of pain and fatigue have sped things up. I’ve done all i can to keep working :

  • I’ve had numerous access to work assessments and been provided with lots of helpful equipment and taxis to and from work
  • I reduced my hours to four days a week
  • I tried working at home
  • I reduced my hours to three days a week
  • I looked at spreading my hours across the week, more days but less hours
  • I’ve carefully organised my leave to ensure I got regular time off
  • I tried to get the employer to understand how their partly inaccessible building made my day so much more difficult

But even then I still couldn’t make it through my three day working week. At the end of a day in work I would get in, collapse into a chair and struggle to give my carers coherent instructions. And I would spend all my none working days recovering from work. And there were parts of my job, such as phone calls to the public, that I wasn’t comfortable doing when I had taken increased pain relief. As well as the physical issues, the mental exhaustion and fog made it hard to think and assess situations as fast as I know I can.

So, in early February I put in my application for retirement and went off sick. It’s taken a lot longer than it should but I finally have a leaving date – 20th may.  I will also receive some pension as well, details not yet known, which will help me financially.

I have had numerous people tell me “Ooh, I couldn’t do that.. I’d get bored..” and have come up against medical people who have been less than supportive and haven’t even attempted to understand my circumstances.

An illustation: I saw a pain doctor for the first time a few months back, I normally deal with a lovely woman who is all about maximising quality of life.  This guy may have read my notes, but quite probably hadn’t.  He asked what medication I was on and I went through it and went on to explain that I was hoping to reduce some of the morphine because I was stopping work.  He said “from a pain management point of view we would not recommend this”.  I started to justify my decision but he didn’t want to know.  He kept repeating his statement, even when I started to cry.

This isn’t an easy decision.  It’s not something I’m taking lightly.  I haven’t done it on a whim.  I have tried all the options available to me and cannot find a workable solution.  And this is with the most supportive manager and team that you can imagine.  If I can’t do it with them, I can’t do it anywhere.

The other standard reaction is jealousy.  Which I find difficult because I don’t want to be doing this.  The rest of my life is stretched out in front of me with nothing in it.  Literally, I have no plans this year except hospital appointments and a trip to Oxford (this has a lot to do with the door and carer situation but the point is there).

I’ve not worked in three months and, even before that, I knew I needed to be careful because this was a risky time for my mental health. Again, things haven’t been helped by the door opener not being in place making me housebound and not getting all my care hours.

Up until a few months ago I had worked or been studying or both all my life.  I worked for my dad (a farmer) from an early age, basically when I could start being helpful; I started working Saturdays as soon as I could (16); I worked full time in the summer holidays when I was in sixth form and uni; I had one painful month job hunting when I left uni and then moved straight from job to job till now.  So not working is a HUGE change.

So… what next?

I am hoping to find a course to start in September on writing, craft, humanities…  I’ve got lots of interests so should be able to find something to go to for a couple of hours a week.  And hopefully I’ll meet other people who aren’t working the traditional 9-5 jobs.  Because almost everyone I know is, and that means I can’t see them during the week.  I’ve also looked at online courses through futurelearn and coursera.

I already know i need to do something creative most days and I’ve realised I need to do something intellectual on a regular basis so i came up with a list of things I need to keep doing on a daily-ish basis to help me cope with retirement:

  1. Something creative – art journalling, working on some of my creative projects or wanderlust activities, writing etc
  2. Something intellectual – a course, a non fiction book, a crossword
  3. Something outside – when the door is fixed of course…
  4. Something which helps me check in with myself – tarot, art journal, friday morning check ins (which I keep meaning to blog about)
  5. Something restful – because I am still ill and still need to look after myself and give myself enough down time

What I would really like is for people to suggest more ideas for these areas and tell me how you cope with being off work, whether its long term sickness, retirement or not having a job.


  • engraved carriage clocks, pocket watches etc seem popular retirement gifts – you’re no longer working, you’re probably in your last years, have a time keeping device to count them down…?  I do not want a clock or watch for my retirement!

Self care with EDS

It’s clearly that point in January when Christmas is barely a memory, new years resolutions have gone the way of the dodo and the forecasted -15 degrees is getting people down.  To combat this advice is flying all over the internet; I woke up to about 101 emails on the subject of self care.

Now, self care is something I’m still wrestling with.  I know it’s important, I know it’s helpful and I’m working on feeling that I’m worth it.

In amongst the emails, there were a couple which stood out for different reasons.  Blurt had sent an email which included a link to a long list of suggestions for self care and part of my struggle is knowing what works for me.  I know from a lot of attempts, that a bath is not self care for me.  Now I know these days I can’t actually get in the bath so it’s not an option but prior to that I had this vision of the perfect bath which would make me feel better.  Instead I would lay in the water getting cold and filling my head with nasty thoughts about my body.  Back then, this was the only thing I knew about self care so you can understand why I wasn’t into the idea.  I’m now a little wiser.  I know a bath will never fix me.  I also know that a bath isn’t the only option for self care.

And that’s why I like the list from Blurt but also Chronically Kate because I know that she knows that self care is harder when you are ill.  Yes, self care is hard when you’re struggling with depression, I know, but factor in epic pain and exhaustion and take away a load of self care options, and you’re in a different situation.

I can’t go for a walk in the fresh air, I can’t write frantically in a journal, I can’t hole myself up with a book and read and read and read, I can’t bake, I can’t go to the sea on a whim, I can’t do anything on a whim.  So what does that leave you with?

Well, one of the things that Kate advises is pausing and checking in with yourself.  I think for me this is becoming a big way to look after myself. It’s something that I’ve been working on with my psychologist. I imagine different people have different ways to do this but I needed some tools for it. So I have started to use tarot cards to check out what I’m thinking and feeling more clearly. I also have a couple of inner versions of me which, sort of like the idea of an inner child, and I check in with them as a way of checking in with myself.  It’s similar to voice dialogue but has been a very organic thing which has developed in my therapy sessions.

I’d be interested to hear how other people check in with themselves or what other people do for self care.