Stress and Chronic Illness

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Stress is a powerful energy that can help and harm us. Stress can serve to motivate us to take action and complete tasks but it also can place great pressure on our mind and body with negative consequences. Stress affects every part of our body and often triggers or exacerbates symptoms and diseases. Find a full description of the effects of stress on the body here.

With small amounts of stress, I notice the inconvenient, annoying symptoms of muscle tension, irritability, anxiety, and difficulty sleeping. However, when I have intense stress the symptoms worsen and in addition I experience increased degenerative joint pain, sadness, often have crying spells, and my SBS symptoms worsen. The combination of inadequate sleep and stress sends my SBS symptoms into hyper drive. I'm unable to tolerate foods, even liquids, and any movement becomes unbearable. Ingestion increases the amount of waste produced to be expelled at a rapid rate and movement further increases the frequency of those restroom trips. The ongoing barrage of this cycle results in pain and soreness that spreads to my entire body. Sitting and lying down are even difficult as my body struggles to slow down the SBS.
From the onset of this cycle, I know my stress is out of control and I'm walking a thin line; I need to check my stress immediately.

We all experience and manage stress differently. I'm very Type A Personality, I'm a planner and a problem solver. For me, I have to tackle the problem and find a resolution. However, once I've hit the boiling point the first thing I must do is cease ingestion and find time and space away from everything - work and activity - so that I may allow my body to begin to relax. Once I secure this, I can begin resolving the source of stress. Identifying and establishing a game plan is a must for me followed by expressing my feelings through verbal or written word and utilizing a sounding board.

There are many options available though to help manage day-to-day and chronic stress to protect our bodies and prevent reaching the boiling point. Consider the following in your own regiment for stress management:

• Stress Management Diet - food plays a vital role in our health and eating foods rich in vitamins and minerals that promote healthy brain chemicals can help lower stress hormones. Participating in cooking classes can provide an additional benefit for learning new ways to create healthy and tasty meals incorporating such ingredients. Cooking classes may even double as a stress relieving activity. Communities often have various cooking classes available, such as the one offered by Chef Alex Friedman Master Class.
• Meditations - the different types of meditations are endless. Yoga, Tai Chi, Pilates, and Qigong are great individual or group exercises that include meditation. Guided meditations are also incredibly useful and can be learned to be used on your own in any situation.
• Breathing - although breathing is used in meditation, there are different exercises for focused breathing that are very helpful.
• Sleep Well - getting adequate and restful sleep is a key factor to protecting one's physical and mental health. This can be quite challenging when we are feeling stressed or anxious.
• Activity - engaging in activities of enjoyment, socialization, relaxation, distraction, and exercise all serve to reduce anxiety and stress. Get back to a hobby or try a new one out, spend time with a loved one, pamper yourself with a massage, hot bath, skin detox, watching a sunset, music or books, and get some physical activity. 
• Support - we can't go about life on our own. We all need someone to lean on for support. Utilize that person(s), that's what friends and family are for - to help one another. Reach out and find more individuals to add to your support system.
• Take Time For You - everyone needs downtime to relax. Sometimes it's hard to make time for this, but it is important. This time allows for decompression and recharging - both needed for tackling the next task you have.

The Touch of Cancer

Colon Cancer Awareness Month always leads me to reflecting upon my own family's experiences with colon cancer. I've mentioned before that FAP has ran in my family for many generations and we have had countless numbers of members die from colon cancer. Although my father's family doesn't have FAP, my paternal grandmother died of colon cancer and a very beloved paternal aunt of mine also unexpectedly developed and survived colon cancer.

Growing up with both my grandfather and mother living with FAP allowed me to gain a lot of firsthand knowledge and understanding of ostomies, FAP symptoms, and eventually cancer. I realized that the majority of people weren't experiencing what my family was and yet it was all completely normal to me. With each generation of FAP in my family, the more we've gained in information and understanding.

My grandpa survived colon cancer and appeared to lead a healthy, stable life. He developed colon cancer in the late 1950s and had his colon removed and a reconnection. I have vague flashes of visiting him in the hospital in 1994 when he developed rectal cancer and underwent another surgery for ileostomy and radiation. I never saw him struggle with his health after that until the last year of his life. He didn't let his ileostomy stop him from what he enjoyed. We went on several fishing trips, hiking through the woods, canoeing and camping trips every year. My grandpa was one of the most cherished individuals in my life. He taught me indescribable amounts of knowledge, skills, and values; we spent countless days and sleepovers together. There was no one like my grandpa and in my eyes, he could do no wrong. He was a strong, independent man with a great love for the land and his country; he fought in World War II and was awarded a Purple Heart. He saw and experienced unimaginable horrors that he kept locked away, rarely to be spoken of again. He was a no non-sense man and yet he could laugh and play in the most fun loving ways with his grandchildren.


Me and My Grandpa

Then one day, the health of this robust man began to decline. It started with reflux after eating at times, this reflux continued to worsen and he began vomiting small amounts and then large amounts after ingestion. He was rapidly losing weight. He sought medical care at our local VA and was prescribed anti-reflux medication and was advised that his esophagus was narrowing causing the reflux and vomiting. He underwent procedures to place stent like devices at the opening of his stomach and within his esophagus to reduce the vomiting and reflux. This reduced the symptoms temporarily but never provided the necessary relief. His weight continued to decrease, his body was wasting away already. Unfortunately, thorough testing wasn't performed from the onset of his symptoms but instead 4 months later when he was admitted to the VA hospital. After he had his ileostomy, he was never told he should have routine endoscopies and therefore never had any performed again until this admission. Once he finally underwent an endoscopy, the true culprit of his symptoms was discovered - FAP had caused stomach and esophageal cancer. This discovery came too late, cancer treatment wasn't a viable option and hospice was elected. Over the course of the next 3 months, my parents and I visited him routinely to help provide care and spend as much time as we could with him. Towards the end of his life, his mental capacity was altered and he was succumbing to the vast effects of cancer. I watched him mistake tv remote controls for the telephone as he tried to answer the ringing he heard. The bedroom I grew up in taking naps and watching wrestling with my grandpa was now his deathbed. He was no longer speaking and rarely conveyed any acknowledgement of his loved ones around him. I held his hand and told him how much I loved and cherished him and although deeply saddened, it was time that he left this earth. He squeezed my hand and I knew my grandpa was still there trapped within that cancer ridden body. I knew he heard me and he gave me the greatest gift he could - a hand squeeze. He died the next day.

My mom was the only child of my grandpa's to inherit FAP and expected her experience to be much like his had been the majority of his life. My mom's journey was fairly calm until she unexpectedly received a diagnosis of colorectal cancer shortly after giving birth to me. My grandpa's health wouldn't change for the worse until 14 years later so everything up to this point was considered normal in our family. My mom expected to have the same surgery as my grandpa's first surgery, large bowel removal and reconnection. My parents were surprised with different news - a permanent ileostomy and very little information. Soon after my birth, my mom had her surgery and experienced a multitude of complications and nearly lost her life. Unlike my grandpa, whose struggles I rarely witnessed until the last year of his life, I witnessed my mom's struggles daily with her energy, ostomy, and frequent intestinal blockages. I've been fortunate to never have issue with food causing intestinal blockages. Yet my mom experiences intestinal blockages nearly monthly in spite of her best preventative efforts and would often require hospitalizations from the blockages. Fortunately, her number of hospitalizations have significantly reduced over the years. In 1998, she underwent the Whipple Procedure due to a precancerous FAP polyp in her duodenum. The surgery was successful but she had a difficult recovery with extreme pain and stomach issues that seriously impacted her ability to eat for an extended period of time.


Me and My Mom

My mom is my true inspiration and my hero. We experience the common mother-daughter relationship issues but I couldn't ask for a better mother. She has always been there for me, so very understanding and supportive. Because of her FAP experiences, she's able to fully relate to my health challenges. That's an incredible and rare gift a mother can give her child, especially when it comes to a rare disease. My mom let me know I wasn't alone in this journey when I didn't know anyone else outside of the family with FAP. Even in her own health challenges, I'm one of her first thoughts. When we were both simultaneously hospitalized, she chose the adult hospital connected to the children's hospital so that we could visit. As an adult, I've had the honor of returning some of the care she so quickly and willingly provides me. FAP has placed very difficult choices and tasks upon my mom regarding herself, her father, and her child and yet she faces each obstacle with an intense resiliency and quiet strength. I would never wish any health issues upon my mom but I can't help feeling grateful that if both of us were going to have health issues anyway, I'm glad we share them. By sharing this disease, she was able to teach me about the disease, ostomies, and the values I would need to develop the skills necessary to live with this disease. I would be lost without her. 

Like most families affected by FAP, colon cancer is sadly part of our family. I think of the numerous ancestors my family has lost to colon cancer and how it has touched each of my family members. The rarity of FAP, a colon cancer causing disease, is evident in each of our stories. We all experienced doctors who were unfamiliar with FAP and thought cancer stopped with the colon with FAP. Medical care and informed medical decisions were not properly provided to all of us. This lack of information and proper medical care significantly impacted us and our outcomes could have been drastically altered with the proper information and treatments. My grandfather and mother could have been diagnosed significantly sooner, received treatments at the early stages of cancer and not have experienced such risks to their lives and ultimately death for my grandfather.

This is yet another reason why research and awareness is essential for the treatment, cure, and survival of  individuals with rare diseases and cancers. The FAP Research Fundraiser was a huge success and we raised $640 to start a FAP Research Fund with the National Organization for Rare Disorders. You can now find all kinds of products with various designs with profits donated to NORD FAP Research Fund at Life's a Polyp Shop. I hope you'll join our efforts.

Bye Bye Baby

The finality of spoken words are the hardest to push past our lips, to break our silence. Once spoken, the glass is shattered leaving us only with the reality that we are now forced to accept. In our silence we may delay the inevitable until our psyche is more prepared.
In Alone Together and Supportive Lengths, I spoke about a heart wrenching struggle that I've been slowly processing and gradually accepting.

I finally have reached a level of acceptance to allow myself to publicly disclose that my husband and I have come to the decision not to attempt to have any children.

This has been an excruciating and devastating decision for me. Through this process I learned that the best choice is not always the choice you want. Those close to me know that I've dreamt about Ending the Family Cycle through IVF with a surrogate and planned for this for over 15 years. I never believed anything different would happen. I maintained an unrealistic optimistic hope and pure belief that I would have a child in this manner and it would happen. There were no ifs, ands, or buts about it...it was happening. I planned out every detail I possibly could throughout the years. I planned names, nursery themes, educational opportunities, birthday themes, godparents and legal guardians if needed, parenting styles, etc. I've had my heart set on a baby and the joys and struggles of raising a child. And now, I must say goodbye to my baby. My baby, whom I will never get to see on an ultrasound screen, hear a heartbeat, feel kicking my surrogate, or hold in my arms because this baby will never have existed within the womb or in the world. I must say goodbye to it all, to my dreams, my hopes, my plans. The baby items I've slowly collected and saved for the big day when I would welcome home my own baby, I must pass these items on to a living baby, not a dream world baby. I know all the reasons to have a child and the joys that come with a child. I absolutely cherish the times with the children in my life and the memories of children I taught and cared for throughout my educational career.

 We must let go of the life we have planned, so as to accept the one that is waiting for us. - Joseph Campbell

In spite of all the reasons to attempt to have a child, there are a lot of reasons not to as well. After extensive contemplation and discussion, I find the reasons not to outweighing the reasons to in our situation.

1. The primary reason I sought sterilization was to be able to prevent passing FAP on to my child. I survived unimaginable experiences during my childhood and I can't bear the thought of my child going through the same experiences. To have a child is a personal decision and I hold no judgments over anyone's decisions regarding their family planning. This was my family planning decision. I didn't want to attempt having a child unless I could prevent my child from inheriting FAP. As I recently discovered as well is even with the genetic counseling and IVF, there remains a minimal chance that FAP could be inherited. Any chance is too large of a chance for me.
2. Another reason I sought sterilization is that I personally am appalled and terrified by pregnancy and childbirth. I don't know how I came to have this view, but both honestly repulse me. I find pregnancy and childbirth unnatural and a twisted joke from the universe. Cabbage patch kids type development makes much more sense to me. I know this is a very strange view for most people to understand and I don't expect anyone to agree with me. It's just my personal view and this view works fine for me as I am also medically terrified of pregnancy and childbirth. Due to my abdominal surgeries, previous twisted intestine around organs complications, low pain tolerance, and short bowel syndrome I truly believe, without a doubt, that if I were to become pregnant I would actually die or I would be in so much pain and misery that I would wish I would die. I don't want to risk my intestine twisting around organs again or if I required a C-section and risking my intestine to be cut or nicked. I have no intention of endangering myself and risking failure of my straight pull thru.
3. My current health, although stable, still provides for plenty of sick days where I don't feel able to move. How am I to take care of a baby when I have no energy, am running to the restroom constantly, experiencing high pain, or am unable to move very much? It isn't fair to my husband to expect him to take on the majority of caregiving for our child. I know he would but my child would deserve both parents to be involved. And with my health, I never know when the stability will end and my health will decline or when I'll die. I don't want to leave my husband to be a single parent with a young child.
4. My husband now has his own health issues as well with diabetes. Although diabetes is a very manageable disease and we are taking every effort to manage it properly, I still worry about his future health. He is also 10 years old than me. I don't find it fair to my child to have two chronically ill parents and I don't want either one of us to become a single parent with a young child.
5. Financially we have two options at this time. We can either use our finances to attempt to have a child; an attempt that may not work and still result in the loss of our finances. Or we can use our finances to start our life goals. We want to move to our land, build a small farm and small business. We can advance and complete these life goals at a much faster rate without first spending our finances on the attempt to have a child. With my husband being 10 years older than me, we are both ready to advance our life goals.

I began this disclosure a few months ago and since then, my husband was unexpectedly hospitalized with diabetes and my energy has been focused on his health and navigating through the terrain of diabetes, settling hospital expenses, and arranging care. I'm not sure if I've come to a full acceptance yet or I've been too consumed with other crises. A flooding of peace washed over me after a dream I had about having a baby. I dreamt I had one more attempt to try the process for a baby, a last ditch effort my psyche gave me. But even within the dream, reality seeped through and the plan failed. We couldn't accomplish both goals of a baby and our future life goals. I awoke in the morning feeling defeated with the finality of the situation. With all options exhausted, my mind was able to begin to rest and accept that we had made the correct decision for us. I am more at peace now than I was when I first started this post. I haven't been breaking into tears at the mere mention of childlessness or fertility issues. I still feel saddened when I prolong my thoughts about our decision but ultimately I am at peace and no longer debating the issue.

To help me obtain a sense of closure and to welcome in positivity for our future, my husband and I partook in a smudging ceremony. Traditionally, my Cherokee ancestors went to water for cleansing. However, we didn't have access to water and decided to participate in a smudging in order to regain balance and harmony within my spirit. I invited the talented and heart touching K. Talley Photography to help us capture this moment in our lives so that I may have mementos.

 

We began by lighting a fire and giving our thoughts to the universe. I lit cedar and sage and let the flame quell itself leaving only billows of smoke. With this I cleansed myself with the smoke before proceeding to cleanse my husband. I repeated this with a mixture of sage and sweet grass. The scent of the plants filled the air and swirled about before quickly being swept away by the wind. Once cleansed, we laid the smudging sticks within the fire pit to mingle with the smoke from the previously lit fire. We meditated on our loss and what the future held for just the two of us together. I was overwhelmed with a sense of relief and loss leaving me in a melancholy state.

I clung to the scent of the cedar, sage, and sweet grass for the remainder of the day. With each breath, I felt wrapped in a blanket of comfort from the scents. We treated ourselves to dinner and spent a quiet evening together as my mind reeled around the events of the day. It was coming to a close. I was filled with a hushed anxiety, it will soon be all over and my mind will rest in the finality. This is my last step, to disclose. To shed the façade of maintaining the intent for a child. To bear witness to my soul and our future.

To view the full gallery please visit K Talley Photography

Staying Healthy

For those of us with chronic illness, our immunity is already suppressed and the risk of our health status changing due to viruses or a flare up upsetting our body's delicate balance is a threat not to be ignored. It's a constant struggle to maintain proper electrolytes even without the presence of an additional illness. The consequences of an upset balance can easily land us in the hospital. It seems like even the symptoms of a non-severe virus, such as a cold, are multiplied for the immune suppressed.

Over the course of the last couple months with my husband's health changes I've noticed my stress levels peaking and the wear of it upon my body. Although the stress of his health crises have quietened, my stress has changed focus from him to work and my dwindling energy has become more apparent. Although I am sleeping soundly, I'm discovering I'm not obtaining the amount of restful sleep I truly need in order to function properly. Most nights I awaken early in the morning and am unable to resume sleep for 2-3 hours. And even on nights without any insomnia I continue to struggle with my energy the following day. My days are long and difficult, leaving me mentally and physically exhausted and my only salvation is the weekends when I can sleep in late. The perplexing issue is my lab values have maintained their usual levels - remain anemic but not any lower than usual and my B12 is above average. My only conclusion is stress is robbing me of truly restful sleep.

I've worried about my health deteriorating due to the combination of a lower immunity, high stress, and sleep deprivation. This is definitely not something I can afford, particularly at this time. My doctor, advocating for me as always, immediately suggests I reduce my work hours and offers to help me do so medically. My fear is that full time employment will no longer be an option if I can't find a way to maintain my health. I nearly required hospitalization after my first attempt at full time employment several years ago due to the effects of stress upon my body. I've survived full time employment since that time and I want to maintain that ability.

We can help to reduce our risk by controlling our stress and boosting our immunity. And the Immunity-Boosting Guide by the lifestyle blog Fix.com couldn't have appeared at a more opportune time. I had been placed on a special diet and supplements to cater to my electrolyte imbalance during the rough years of my health. At the time I tracked the essential vitamins and minerals in particular foods so that I could incorporate them into my diet regularly. Since that time I've forgotten that wealth of information and the Immunity-Boosting Guide sums up a lot of this information and tips in one infographic to help reduce illness risk while naturally boosting our immunity through food and behavior.
Granted, anyone with a bowel disorder and who has gone through abdominal surgeries needs to be mindful of foods that may risk an intestinal blockage or excessive diarrhea. Review the UOAA Diet and Nutrition Guide for further information.
I hope you'll find both sets of information helpful for your arsenal in maintaining health and reducing further health complications.

What FAP Means to Me

We are all faced with at least one event, one experience that shapes us, changes us, and forever transforms us. It etches out a path, trailed with the obstacles and joys that may stem from our transformative experience. We're drawn to this path like a moth to a candle, we may fly elsewhere but we are always drawn back.

Familial Adenomatous Polyposis is that transformative moment that lasts a lifetime for me. For someone unfamiliar with FAP, it's hard to grasp the full meaning of what FAP is and how it changes a person. FAP is more than a mere chronic illness, it is more than a lifetime of coping and managing a disease. Every aspect of one's life is touched along with the potential for generational changes. In the midst of the horror that is FAP, inspiration and goodness is able to sprout. These buds provide deep wells of strength, compelling us to forge on, lighting our path.

I've shared my struggles with FAP throughout this time; the new and old challenges, haunting memories, overwhelming fears. There's more though to the true depths of FAP, it's easy to overlook as it's overshadowed by the medical, the now that constantly berates us for our attention.

FAP is my disease, it is what makes me me. I own this disease, I know nothing different. I am the last known in my family to have inherited this disease. I come from a long line of FAPers and I'm not sure if any of the descendants of my great uncles and great aunts have FAP as the family has lost contact. As a child, the only individuals I knew with FAP, who were like me, were my grandfather and my mother.

FAP is my taker. I endured the constant barrage of death taking loved ones since I was an infant but I was to be surrounded by FAP as well. Not only was FAP within my genes but it was attacking my mother while I was developing within her womb. My life was to be intertwined with the mixture of death and FAP in a twisted poetic sense. Shortly after my birth, my mother discovered she had stage I colorectal cancer. At 3 months old, I nearly lost my mother to FAP and the cancer it brought. Real or not, I have always had the vision of myself as an infant sitting or lying atop my mother's stomach while visiting her in the hospital as she fought for her life. Years later FAP took my grandfather from me - he survived colon cancer but decades later developed stomach and esophageal cancer courtesy of FAP.
FAP doesn't end with the removal of the colon. The polyps often spread, we're at risk of associated cancers and other complications. There is no security with FAP. These complications limit my everyday life. Food and activities are my enemies, easily upsetting the delicate balance of my stomach and my body. Stress and lack of sleep aggravate my symptoms further creating obstacles. Everyday is a new day, a new race for the end of the day onto the next. No longer do I have easy choices, I am forced to make some of the most difficult decisions I have been faced with and as a result long time dreams have been stolen from my grasp. I can no longer think of the present only or what I want, I must take into consideration the greater good for the long term. Decisions I am still preparing to disclose that have ripped apart my heart.

Somehow, FAP has also become my giver. In the course of changing my life with ongoing medical issues, trials, and even near death, it sent me on a road that I'm not sure I would have traveled without the guidance of FAP. Amidst the landmines, FAP gave me a beaten path that led me to a beautiful oasis. I couldn't be more grateful for the treasures of my life. I have found blessings around every corner - through my parents, spouse, friends, school, and employment. FAP gave me a compassionate understanding, strong will, incredible sense of determination, and need for security. This combination has driven me throughout my life to conquer my goals. I have managed to achieve the goals I set forth and continue efforts to reach new goals. My doctor, parents, and I were uncertain of what my body would withstand. Without disability accommodations with my schools, I wouldn't have been able to complete high school or college as scheduled. My first attempt at full time employment was a failure; the stress crippled my body. I will never forget the lessons I learned and the skills I gained. With each trial, each failure, and each success I withdraw information about myself necessary for my survival so that I may try again and reach higher. FAP even shaped my career, steering me into the medical field with the intent of improving medical experiences for others. I am amazed by where I am in my life now. Although I would have easily made it here without FAP, the journey is that much more beautiful and triumphs that much sweeter because of the obstacles set forth by FAP.

In spite of my triumphs, FAP and fortune are not always so kind and can change directions without notice. We can't be safe guarded forever from the complications of FAP. Many are lost to the devastation of FAP and there will be many more. This is not an easy battle to win and we are at a disadvantage due to the rarity of FAP. Too many of us have doctors who are unfamiliar with FAP and attempt to lead us in the wrong directions in our care. I have fought to end FAP in my family. Now I would like to expand my fight and join the ranks of others battling to end FAP for future generations, prevent the development of colorectal and associated cancers and reduce or eliminate the other risks and complications for present FAPers.

It's these personal touches and steering by FAP in my life that led me to launch the FAP Research Fund Fundraiser. My hope is to launch this fundraiser regularly in partnership with National Organization for Rare Disorders. I have had the life long goal to change the course of FAP so that others close to me may not suffer as I have, I take this hope to the community now. As a community, we are stronger. As a community, our impact is greater. I ask you to join me so that we may fight along side one another against this disease.



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