The Rejects: 6 Things People With Chronic Fatigue Syndrome Want You to Know (But Are Too Exhausted to Tell You).

At one time the UK parliament took a break from arguing about how we could slip discreetly from the EU like an introvert leaving a party at 9 pm, and instead argued about a disease called Chronic Fatigue Syndrome (CFS). This illness is also known as Myalgic Encephalomyelitis, a slightly more imaginative if unpronounceable name. This being the 21st century, where everyone’s opinion can be shouted in cap locks across the internet regardless of experience or expertise, social media was flooded with posts discussing the illness. Of course, not many people remembered to ask the sufferers of CFS, because that’s too obvious or mainstream or something.

At 14 years old a virus decided that my brain was the perfect vacation spot, and through a series of unfortunate events that even Lemony Snicket would have trouble imagining, I developed Chronic Fatigue Syndrome. It’s time for someone with experience to have their say, albeit with naps between each paragraph.

  1. CFS is Real.

I have lost count of the times I have faced accusations of faking my own illness to play truant from school or work, to gain access to prescription drugs, to get disability payments from the government, or simply for attention. I have also lost count of the number of times I have been told that the disease is fake, or purely imagined by all those said to have the disease, despite an ever-growing body of evidence suggesting otherwise. Why listen to scientists, though? It’s not like they’re experts or anything.

Social services even became involved when an anonymous accusation was alleged against my parents suggesting that they were making me use a wheelchair unnecessarily to obtain extra benefits. Fortunately, social services neither had the time nor the resources to look into such a petty and under-evidenced claim, but the experience was perturbing all-the-same. This had a large, soul-destroying impact on a teenager in the midst of puberty. My poor parents.

  1. It’s More Than Just Needing a Nap.

CFS, aside from being the most unimaginative name ever, does give the impression that sufferers of the condition get a bit tired and need to follow the sleeping schedule of a cat. Yes, I get really, really tired, really, really easily. As in, sat-up-and-opened-my-laptop easily. However, there is also the joint and muscle pain, headaches, dizziness, nausea, sickness, muscle weakness, cramps (holding a pen is a fun way to induce hellish cramps, which won’t have any effect on my writing career at all), irregular appetite, sleep disturbance (ironic), itchy skin and eyes, muscle tics, passing out, short term memory loss, and poor concentration to contend with. What was I saying?

To summarise, it is a debilitating condition forcing many sufferers like myself to use walking sticks and wheelchairs, and in some rare cases can even prove fatal.

So, to encompass the nature of CFS in a name, (and what, after all, is in a name), it would have to be called Chronic Fatigue, Pain, Dizziness, Nausea, No Sleep, Brain Fog Syndrome, which is a lot less catchy, and a lot more tiring to write.

  1. Yes, I Do Need Those Pills.

If you have managed to stomach any recent news reports, you might have encountered news of an “opioid epidemic” sweeping America. One of the main talking points is whether people with chronic pain such as fibromyalgia, arthritis, and CFS should have access to these drugs. While I personally have had very limited experience using opioids (but the few times I have, man I felt good), I have at least been able to access alternatives that might not be affordable were they not on the NHS. It should also be noted that some of prescriptions I use are to manage the side effects of other prescriptions, in what I like to call “pres-ception”. It once got so bad that the shelf in the medicine cabinet collapsed, I kid you not. One of my favourite jokes is to claim that I am a human maraca because of the number of pills I take on a daily basis. What that actually turned out to be was gall stones, but that’s another story for another day.

Here’s the thing; on occasion I am unable to take these medicines as most of them require ingesting with food to prevent stomach ulcers. If I can’t eat, or throw up everything I eat, I can’t get the medicines down me. When I haven’t been able to take my medication, I notice it pretty quickly. On these days sitting upright, even propped up by pillows, is exhausting. Even going to the bathroom is practically impossible, which has led to one or two awkward scenarios.

  1. No, I Don’t Just Need to Exercise More.

Here’s the thing; I was prescribed “exercise more but with medical jargon” by my physiotherapist. Being the naïve teenager I was, thinking that the medical professionals would know how to treat my illness, I followed her instructions to the letter. It worked so well that I went from being able to walk around outside with only the need to take occasional breaks, to having to use a wheelchair when I want to travel more than a few metres.

Nor am I alone in this, as multiple studies have found that these exercise programmes tend to make things worse, not better.

  1. It Varies From Person to Person.

CFS would be a lot easier to study and treat if it didn’t vary like the British summertime climate. Some people just need to take breaks or naps every so often, and some people can’t sit upright unsupported. I’m somewhere in the middle, using a powered wheelchair but able to work, and I can hobble around the flat leaning on walls, furniture, and my husband.

I am often compared to others who have had CFS, and people will even try to shame me by saying that “X” was far more active than me when they had CFS, or that “Z” had it far worse and I don’t know how lucky I am. The reality of the matter is that the wide variability of the disease means that knowing one person with the illness does not give you enough experience to make judgement calls on others.

  1. We Hate the Fakers as Much as You Do.

The debate as to the existence of CFS can be largely attributed to the fact that, as yet, there is no medical test available that can distinguish who has and hasn’t got the illness. There are no biomarkers that can provide distinct answers. This means that people are able to fake it, knowing full well that their lie can’t be undermined by pesky scientists. It raises questions as to how to tell the fakers and real patients apart.

The fakers (I like to replace the A with UC) give the rest of us a bad reputation, and have made the lives of those of us suffering from the condition significantly harder than they already are. So, if you think the fakers piss you off, imagine being in our shoes (or wheels).

A Legitimate TED-Talk.

Disclaimer: I wrote this a couple of months ago before I had even been offered the opportunity to deliver a TEDx talk, & it was scheduled for release at the time of writing. Therefore the timing of the post is purely coincidental!

Anyone under the age of 35 has probably been lectured about how technology is sucking out our souls through our eye sockets and we’re only one grammatical error away from Skynet doing its thing. Some of us will even have received the lecture via social media, the irony of the matter being lost entirely on the person posting their expressive art about technology’s role in the destruction of humanity online. Technology gives us cancer, and big corporations use it to brainwash us into buying their products, and we’re losing the ability to socialise properly, and it’s making us paranoid etc.

Technology is not all bad. How many lives have been saved because instead of having to find the nearest phone box, someone could call an ambulance at the scene? How much more data can scientific studies collect and analyse for even better results? How many people have received earlier diagnoses of progressive diseases that would have just killed them before? How much progress would have been made in the fight against ableism if disabled people didn’t have technology to help them voice their concerns?

Chances are that even the most disabled among us can still use technology. New apps and programs become available all the time that read out loud to the visually impaired, or translate between English and sign language for the deaf, or give someone who is unable to speak a voice. Social media has allowed people with the same disabilities from across the globe to connect to each other, so even the most isolated patients can find others like them and support each other.

Cameras are very useful for providing physical evidence of discrimination such as blocked access routes, and also the abuse we can receive when asking people not to block access. Once posted online the rest of the world can finally see for themselves the difficulties disabled people face in their day-to-day lives. Sometimes it can even result in legal action.

Perhaps most significantly of all it can be extremely difficult to organise a demonstration against ableism due to poor access to transport, and the fact that all of the affordable hotels in the area will only have one accessible room apiece, which will be quickly booked up. Technology has instead allowed us to break the taboo around disability and discuss it properly, highlighting and resolving issues, and raising awareness of the fact that we are also humans.

Nor can disabled people easily sue for discrimination due to the difficulties in finding employment due to access and transport issues, and also because many courts lack wheelchair access, even going so far as a have steps up to the witness box. Technology has allowed us to shame ableist actions to the point where public outcry has forced government leaders to tackle the issue.

Technology does have its drawbacks, but the truth of the matter is that technology has helped to improve more lives than it’s ruined. There was a point in history when reading and writing was considered unnecessary technology, but now those abilities are almost sacred to us. How much of technophobia is actually due to a genuine fear of technology, and how much of it is simply a fear of change?

 

Braveheart on Wheels.

There are lots of assumptions made about disabled people. It’s assumed that we are stupid, have no desire for independence, are lazy, ungrateful, uncooperative, and only our mothers could ever love us due to our needs. It’s assumed we’re not educated, employed, or even able to break the law (disclaimer: I am not a criminal, I’m making a point, please don’t call the FBI). There is, however, one assumption that to me seems the most problematic, and is responsible for a lot of the disagreements between able-bodied and disabled people: our mobility aids are seen as a prison.

Less than a year after contracting viral meningitis I was told by a physiotherapist, who at the time was advising my parents to buy me a wheelchair, not to become overly dependent on said wheelchair. It instilled within me a fear of my wheelchair and I used it as little as possible, unable to admit to myself when I really needed to rest. I almost seemed to be in denial that I was ill in the first place. That, among other factors such as being denied the right to drop some classes including gym and dance, and the very same physiotherapist pushing me through Graded Exercise Therapy far too quickly, led to the deterioration of my health. I spiralled out of control until I was begrudgingly using the wheelchair every time I left the house.

At this point I faced a difficult choice, neither of which could be defined as right or wrong. I could “give in” to my illness and embrace the use of a wheelchair, or I could shut myself indoors in the hope that I would get well again. Essentially I had to sacrifice either my health or my education. Spoiler alert: I let my health take the fall.

My wheelchair was never a prison. It enabled me to finish school, go to university, get a job I hated, get a job I loved, have a social life, and GET FRICKING MARRIED. I go shopping, I go for meals out, I go for drinks, I go to the cinema, and I’ve even been clubbing once or twice as a student (not really my scene). My wheelchair isn’t a prison, it’s my freedom (and now the title of this post makes sense).

I strongly believe that if more people understood this they would stop feeling sorry for me, and therefore they would be able to see that I’m a (relatively) normal person trying to do this “adulting” thing. The notion that “surrendering” to the use of a mobility aid is a bad thing is a terrible notion. Yes, being in a wheelchair has its flaws (see the entire rest of this blog for evidence), but I don’t for one second regret getting into the habit of using it simply because my quality of life has actually improved. I’m not confined to a wheelchair, I’m liberated by it.

It’s Not Easy Being Green.

There are countless political parties, pressure groups, and lobbyist groups in support of reducing fossil fuel consumption, non-recyclable waste, and any other practices that damage our planet. On the whole I am in support of these groups and think we should preserve resources for future generations wherever possible. However, there is one aspect of these groups which I find infuriating. It may not be intentional but disabled people are often victimised and penalised by these groups for needing extra resources.

Take the recent movement to ban the use of plastic straws. These straws were actually created to make it easier for people with various mobility issues to drink independently, and banning or placing a tax on them immediately leaves disabled people unable to drink in public. Most of the people lobbying for the ban simply hadn’t considered the existence of disability, but those who had thought of it waived it off as such a minor proportion of the population as to be negligible. It’s not like we need fluids to survive or anything, and we should all be locked up indoors anyway.

Once the fact that disability is a thing had been realised, some suggestions were put forward. Some suggested using paper straws as an alternative despite obvious flaws such as the inability to hold their structure in liquids, and also the lack of a bend near the top which is the element that enables disabled people to drink. Others suggested buying a pack from the supermarket, having failed to realise that finding them in a shop is difficult at the best of times, and that reduced purchases of straws would result in many shops choosing not to stock them. No one realised that those who didn’t need them could stop using them, leaving those who did to use them in cafes in peace, and altering the supply and demand so as to reduce the production of straws in the first place.

Similarly there has been a movement to ban the use of excess plastic when packaging foods, in particular highlighting the pre-peeled citrus fruits packaged in plastic. For most people this is ridiculously and needlessly wasteful, but what about those of us who have difficulty peeling these fruits? The idea of getting someone to peel the fruit for the disabled person was tossed around under the assumption that everyone with a disability has a carer there 24/7 to do their bidding, and also has no desire for independence. Again, simply not buying these products if they’re not needed would solve the problem.

Another contentious issue is recycling. The bin store in my building has a step in the door so either I have to walk, or it gets left until Jarred has the time to do it. We also cannot recycle glass, instead having to take the trip out to a recycling centre. I would be happy to do this despite the inconvenience, but of course the bins are completely inaccessible. I absolutely would recycle more but if I can’t access the facilities to do this, I have very little choice in the matter. When I admit that I don’t recycle every last piece of glass I expose myself to criticism and verbal abuse, and am told I’m just not trying hard enough. Once again disability is forgotten and neglected.

Finally comes the issue of transportation. I can’t ride a bike, obviously, so if something isn’t within the range of my wheelchair battery I rely on vehicles. The use of public transport is encouraged and, while buses are mostly manageable bar the odd rude customer or having to wait several buses for one where the wheelchair space is available, trains are virtually impossible to use. When disabled people choose to use taxis or their own vehicle, which is of course larger and heavier due to the need to carry equipment and thus spitting out more fumes, we are lambasted for being uneconomical. In one admittedly extreme scenario I have even been told I should be using a manual wheelchair instead of a powered one, and that my laziness was killing the planet. The idea that some disabled people might actually need a motor instead of being able to self-propel was preposterous to them.

The brutal truth of the matter is this; when disabled people are treated as equals with individual needs by the eco-friendly groups, we will be able to support their initiatives. Until then there isn’t a lot we can do apart from let these people know that being green simply isn’t that easy.

Take the Shot.

If there had been a vaccination for the strain of meningitis I contracted in 2011, chances are I would never have developed chronic fatigue syndrome. Luckily for you, I fell ill and then decided to whinge about it, calling it entertainment.

Vaccinations are a contentious topic in the court of public opinion all thanks to a scientist who wanted some extra pocket money. The scientific community are very familiar with publication bias; papers that show no correlation or have a null hypothesis are far less likely to be published. After all, medical journals are still a commercial enterprise and need to make money, and no one wants to buy a book where nothing happens. So the scientist forged some data to give the false conclusion that the MMR vaccine resulted in autism, and the world reacted with its usual level-headed reasoning abilities. Even if this were the case, measles, mumps, or rubella have deadly consequences, whereas autism is at least manageable with the right support despite its difficulty.

However, there is a debate surrounding vaccinations that is much closer to home for me, and that is the association between CFS and vaccinations. Vaccinations make people who already have CFS feel horrendous, which I can confirm from personal experience. I get a flu jab every year, and for the next 48 hours or so I will feel like Jupiter’s gravity is emanating from my chest and I also have an elephant sat on me. However, developing the actual flu would be significantly worse, leaving me incapacitated for several weeks at best, or at worst, dead. Therefore I consider the flu jab worth it.

The real question is whether CFS can be triggered following a vaccination. Having scoured the internet the vast majority of scientific evidence that I can access suggests that there is no correlation between the two, and given that CFS is often triggered by a severe viral infection, vaccinations may even offer some protection against CFS. However, there are also abundant case reports of people developing CFS out of the blue, and it has been noted that in these cases, a vaccination has usually been given a short time before.

Given that we know so little about CFS, it’s causes, and it’s biochemistry, there is no definitive way for researchers to establish a connection between vaccinations and CFS. For all we know there could be undiscovered associations with air pollution, food poisoning, or physical injuries. Vaccinations are constantly in the media and the forefront of our minds, making them the first conclusion that is all too easy to jump to. I remain extremely sceptical, however, as having studied the biochemistry of vaccinations as part of my degree, I simply cannot align inoculations and diseases like CFS.

It is also worth mentioning at this point that CFS, while a brutal disease that can even prove fatal, places far less immediate danger on the patient than meningitis, measles, mumps, rubella, poliomyelitis, and even influenza. Sometimes in life we have to balance the risks, and take the lesser of two evils. Take the shot.

What Came Before.

Given that the title of this blog is Diary of a Disabled Person you could be easily forgiven for thinking that discussing my life prior to disability is somewhat irrelevant. However having had many conversations with able-bodied people who accidentally discriminated against the disabled and pleaded ignorance, I have been able to reflect on my own actions before disability was a factor in my life.

The saying that “you never imagine that something like this could happen to you before it does happen” is clichéd, but it is also true. Before a virus decided my brain tissue looked like a tasty meal, disability was something other people had to deal with. Of course had you asked me, I would have thought myself to be highly inclusive and non-discriminatory, a result of my ignorance. I realise that in my time at school I have probably obstructed a corridor, left someone disabled to struggle with a door, and stepped across the front of a wheelchair without a second thought. I probably spoke to someone in a patronising tone or ignored them altogether in favour of speaking to whoever they were with. I certainly never stopped to consider that I could enter buildings that wheelchair users couldn’t, by virtue of the fact that I could climb up steps. Had I been old enough to drive chances are I would have parked over a lowered kerb. My parents brought me up not to misuse disabled facilities like toilets and changing rooms, but other than that, I probably caused many disabled people a headache or two.

All of these little annoyances that now occur in my daily life I have probably put someone else through and while I hate to make excuses, I would say that most were a result of ignorance. No one in the family was disabled at the time, none of my friends were disabled, and I wasn’t disabled; I had no experience to learn from. This is why I try to have a little patience with others when they simply didn’t know or realise that what they were doing would cause me extra trouble, particularly if they are genuinely apologetic and help me resolve the issue when it is brought to their attention. I will
sometimes try to reassure them that I used to do similar things out of ignorance myself.

There are however, a group of “ignorant” people that I find difficult to deal with. There are those who take exception to me having a problem with blocked access routes, and neither apologise nor help me resolve the issue, often giving me a mouthful of abuse for daring to burst their precious little bubble in the process. Many car drivers will move forwards to clear a kerb drop only to roll back over it once I have passed, leaving it blocked for any other wheelchair users. Others tell me they’ll only be there a minute and to be patient, despite the fact that this attitude can make me late to wherever I am headed.
Then, there are the worst of them all; the people who park in disabled bays, and use their changing rooms and toilets who don’t need to, usually because they want to take their pram/trolley/shopping bags into a larger room with them, and not when all the other facilities were already in use. These people are invariably the rudest and most inconsiderate, and certainly cannot plead ignorance when there are signs everywhere highlighting that disabled people should have priority access to those facilities. I knew better than that as a child, and I know I would never have been that inconsiderate
as an able-bodied adult.
I believe genuine ignorance to be a forgivable reason for accidental ableism. However when people choose to carry on impeding the disabled by continuing to do things they know are ableist, neither apologising nor helping me to rectify the issue or simply disobeying the signs displayed clearly around the facility, I cannot accept ignorance as an excuse. It is these people who are truly ableist and shouldn’t get to hide behind half-hearted excuses to avoid responsibility.

Pain Pain, Go Away.

Unless you have been sleeping under a rock because house prices are soaring you will probably be aware of the recent opioid crisis in America where shocking statistics showed the true extent of opioid use in the USA, and the detrimental effect this was having on some people’s health. The backlash lead to doctors restricting patient’s access to opioids, particularly for long-term users. Almost immediately a huge debate sprung up between two communities; those who were concerned about the issues caused by long-term opioid use, and those with chronic pain who were now struggling to access painkillers, making day-to-day life significantly harder.

For pain relief I rely on medication traditionally prescribed as anti-depressants with two such tablets working together to boost the effects each other. On the worst days I have to rely on paracetamol and aspirin, despite aspirin aggravating the symptoms of my asthma, to control my pain levels. I was initially prescribed codeine for these occasions but as it transpires I am intolerant to codeine. This means that some days I just have to accept that the pain isn’t going to subside, which is a truly unpleasant realisation, but fortunately is not too regular an occurrence to cause me any great concern.

The one and only occasion on which I have used morphine, the mother of all opioids, was when I had a gall stone wedged in duct between the pancreas and small intestine blocking the passage so that no matter how hard my muscles contracted nothing was passing through. If this sounds like it might be painful I can assure you it was agony, especially having only had surgery the week before leaving the scar tissue fresh and tender, and it took a hefty dose of intravenous morphine to get the pain back under control. What I realised after taking the morphine was just how effective it was; my chronic pain which had been lurking in the background for several years was gone. Completely.

Suddenly I came to realise just how much of a relief it was for the pain to totally stop, even for a short time (everything they say about sudden realisations while high is true). Paracetamol might have dulled the incessant aching to a background inconvenience but the pain was still there. With the morphine, my head didn’t throb for the first time in years. My muscles weren’t permanently telling me they wanted to rest even as I was resting. It was quite the come-down.

If it is frustrating for me not to have access to the most effective painkillers for my condition out there, what it must be like for those who haven’t even got access to the less effective alternatives that I use is unthinkable. The chronic pain community are struggling to get access to any pain relief at all on a long-term basis, meaning they’re left to cope with horrendous conditions without any help. The side-effects and risks associated with long-term opioid use are well known and understood by the chronic pain community but given that they already have to live with chronic pain, the risk of side-effects in the future is worth it to be without pain now.

There are risks and America cannot continue on its current opioid usage and not expect to see the effects. However denying people the right to have a life worth living, a life not destroyed by debilitating pain, is equally horrific. Those with chronic pain are not asking for anything unreasonable; they are asking for life.