Chapter 7

Chapter 7 - GI Symptoms and POTS

How did I not learn to listen to my body, such that I found myself crying in the dentist chair? How did I get to that point again? 

Around 2019, I started feeling really stressed out at work. Then the Spring of 2020 brought the Covid pandemic. The workload got much higher, and the emotions of everyone (from staff to pet owners, and their pets!) reached an all time high. My stomach was sick all the time. No longer was it just my usual lactose intolerance; I suddenly couldn’t tolerate fatty foods or celery or apples; or even garlic and onions – the ingredients of love in all of my cooking! 

I had gone on high doses of antacids for a possible stomach ulcer after experiencing nearly constant nausea. It was so bad one day that I felt nauseous simply by smelling a dog’s halitosis through my mask. Then I developed terrible bloating after each meal, along with the food sensitivities. I went to an allergy doc to test for food allergies, had an upper endoscopy with biopsy, and was placed on a strict food plan to identify my triggers. In the beginning, I could only eat 22 things–and several of them were seasonings! I felt like one of my patients on a prescription food trial.

I identified my food triggers and was able to slowly re-introduce them, right around the time I started at a new company. My stress was lower by then and my stomach was improving. By late 2021, my gastrointestinal tract was mostly back to normal and life was good.

Unfortunately, it was short lived. At the end of the year, I contracted a mild case of Covid, and within a week of recovering I developed symptoms consistent with post-viral POTS (postural orthostatic tachycardia syndrome). I spent the first half of 2022 in and out of POTS flares, feeling lightheaded and dizzy, nauseous, fatigued, and wrestling with brain fog. Some days I had to take a nap in my car during my lunch break, in order to have energy to see patients in the afternoon. In retrospect, I think the POTS flares lasted longer than they should have because I was starting to feel stress at work again, and my stress was delaying healing. (Darn it, the impact of never truly dealing with my burnout!) 

I love digging deep into a medical case and finding solutions. It’s very fulfilling to improve a pet and pet owner’s life that way. But I’d had my fair share of consecutive sad and difficult medical cases. Unable to make some of them well, I had a hard time not absorbing the pet owners’ emotions of grief or anger. After one especially sad euthanasia, I quietly asked the young owner’s mom if her daughter was going to be okay; I had seen old scars on her wrists from prior suicide attempts and feared for her safety. On the other extreme, I’d also seen a few cases of neglect that kept me up at night. So by early 2023, when my POTS symptoms had settled down and I had learned how to better manage flares, I should not have been surprised that something else was about to “break” in me. 

A series of challenging encounters with a particular pet owner may have been the tipping point. She had a serious, unmanaged mental illness that included paranoia. This prevented me from providing life saving care to her dog. She wouldn’t allow me to treat the dog, nor would she allow me to euthanize him to end his suffering. At one point I anonymously called in a welfare check to her home, to no avail. Ultimately, the dog suffered and died. A week later she finally agreed to bring in his decaying body for cremation.

It was reminiscent of a case five years earlier (2018), just hours before David had to help me walk into the ER. I’ve told you everything else about that day, but not the pet I saw immediately before my symptoms acutely worsened and I could barely walk. It was a very emotional appointment. The old dog was so painfully arthritic and sick that he had to be carried everywhere, and it was not curable. His eyes were sad, and it was heartbreaking. The wife, a quadriplegic in a wheelchair who could not walk herself, wanted to humanely euthanize the dog, to end his suffering. The husband refused. I think in the man’s mind he viewed euthanasia as giving up on his dog over a disability, and if he gave up on the dog, was he also giving up on his wife? That pitiful dog went home after the appointment to suffer more, and feeling helpless to save him from his pain, something in me broke.

It was also reminiscent of my freshman year of college (2003), that first warning sign of conversion disorder, when my friend had to help me walk back to my dorm. That first year of college, with all its apparent freedoms, isn’t always easy. I had been jogging for about a year, when, unrelated to any injury, my knee pain vaguely started. (I would find out later that I have knee hypermobility, but I still shouldn’t have hurt this badly.) Looking back, I think the pain was the dissonance of what I hoped and believed, versus reality. I subconsciously wanted freedom from my dad and stepmom, and I thought it was coming when my then boyfriend and I had briefly talked of marriage. When we split up, that dream was over. My ticket out of parental-control-land was voided. It would be another twelve years before I’d meet David; another three before I’d really come to terms with my family issues of control and manipulation. And another five years after that before I’d have my five minute cry session at the dentist office over a cracked tooth.

So here we are, now in 2023, with a cracked tooth (on top of a bad knee flare). Just another health issue…and an internal conflict I had ignored. As I reflect back on all the physical health challenges the last few years–the kidney issue of 2017, the migrating pains and neurologic symptoms of conversion disorder in 2018; the GI problems leading up to 2021, the POTS symptoms of 2022, the recent TMJ pain and cracked tooth, and the current knee flare…much of it was directly caused by or exacerbated by stress. Oh, the mind-body connection; conversion disorder in its various forms! 

So what have I learned along the way?

Your body has a lot to say about the state of your mental health. So listen! For me in 2023, I needed to transition to part time hours to finally address my burnout, and we were fortunately in a financial position for me to do so. 

The longer you experience trauma, the longer it will take to heal, to rewire the brain. 

It’s okay to call it trauma, even if you weren’t physically or sexually abused. Even if there were good aspects of that part of your life. Some experts loosely define trauma as anything that makes you feel unsafe.

…And life is not black and white, all-or-nothing. (I’m still working on that one!) One of the roadblocks to my healing was my refusal to call my experience trauma, because there are so many people who have experienced more serious life events than I have. I think of the men and women who have served their country and come back with post-traumatic stress disorder. My experiences weren’t that scary. Yet mine were cumulative, and have seriously affected me.

Conversion disorder, or its milder Mind-Body syndrome, takes many forms. I’ve also experienced flu-like symptoms that went away within hours without treatment, once I reflected and chose to set a necessary boundary or make a difficult choice I had been avoiding.

Sometimes I think I “should” be 100% healed or I “shouldn’t” be struggling with a pain flare. Beware of the “should”s and “shouldn’t”s you place on yourself!

It’s okay to ask for help. Yes, be wise with whom you share personal details, but vulnerability is part of opening yourself up for healing, love, and friendship. When David and I were first dating, he shared with me that during his time in the army he sought help for his anxiety. That conversation is part of what made me fall in love with him. Here was this intelligent, driven, resourceful, witty and handsome man, who had the courage not only to serve his country, but also to seek help for the impact that service had on his wellbeing. In turn, he has helped me over the years to do the same.

You are good enough. You are strong enough, as you are. You are not meant to live as a victim, or to live in anger and unforgiveness. Your mind and thoughts are powerful, and you can heal little by little. You will have good days and not so good days, but there is always hope.

I intend to spend the rest of my life figuring this out. I’m on a journey, and I won’t give up. 

God says we are more than conquerors (Romans 8:37). 

And finally, you need to find a way to make peace with your past. Along those lines, I’d like to share a journal entry from earlier this year, as I was wrestling through a difficult six months. Perhaps it sounds cheesy, but I titled the journal entry “Proclamation”, because I felt as if God had reached through the TV screen and used the movie script to speak straight to my heart.