Hero of the Month: Margie Smith, My Sister

The Edge of Seventeen

My sister truly is a white-winged dove, much like the one Stevie Nicks sings of in her song “Edge of Seventeen”.  And although her struggles began close to birth, seventeen is when things really went south.  It was also when she began to learn strength and resilience far beyond what I can imagine.

Today, there is a name for the anxiety disorder that has plagued “Magg”, as we call her,  since childhood: selective mutism. I had the same condition, but much milder.  I was able to at least put my hand up in class or ask for help.  My fear of having no friends was strong enough to drive me to talk to other kids, though I was still labeled “shy”.  I hated being called “shy” for as long as I remember.  In her relaxed, socially comfortable state—a state she was only ever in around me and our parents—Magg would confess to hating the “shy” label too.  Yet she couldn’t talk to aunts, uncles, cousins, or even our Nanny with the same gusto I could.  This created the illusion I was a show-off at times, even though I was merely being a typical little girl/teenager.

Magg is plagued with epilepsy too.  Many children with selective mutism have epilepsy or migraines, and many have psychiatric conditions like obsessive compulsive disorder.  My sister once knitted a scarf obsessively, to the point where it was taking up considerable space in the living room.  She had to watch the show “Emergency” each night, and no one could say they liked Roy without inciting Magg’s rage.  She always had to be Roy in our little “Emergency games”; others had to be John or Marco or Dixie or Chet.  It got to be very annoying.  She could somehow find the courage to defend her role as Roy among the neighborhood kids, something I never understood.  And in between Emergency games and fury at the others who wanted to play Roy, Sis would have seizures.

Her problems didn’t stop there.  A man targeted us once.  We had met him the previous weekend when he was looking to buy an old car that was parked in our yard.  No longer considering him a stranger because we’d met him before, we were happy to let him play with us when he showed up unexpectedly while we were playing in a nearby field.  He was very friendly at first.  Suddenly, he turned angry with me, calling me a loudmouth and an ugly child who no one wants to play with.  The man must have figured out these were my fears while he was assessing and grooming us.  I can see now it was his way of isolating my sister from me.  He told her she was cute and had better toys.  I ran home crying.

The man kidnapped Magg.  And although he brought her back (or she was found…I am not privy to the details even to this day), the psychological damage he did was devastating and permanent.  That night started a rift between my sister and I, where her life veered away from mine quite suddenly.  We were never allowed to talk about it.  All I knew was she was harmed, all she knew was I wasn’t (although it affected everyone in the family tremendously).  Children with selective mutism are at greater risk for abduction because they appear vulnerable to predators like this man.  My sister’s first real brush with death may very well have been this episode.

The epilepsy was a daily challenge through Magg’s tweens and early teens, the seizures being intense enough to warrant stays in the ICU on several occasions.  Status epilepticus, which is a life-threatening chain of seizures that do not stop long enough for a person to get oxygen, was the norm for my sister.  And in periods between grand mal seizures, she was plagued with petit-mal seizures.  While in college, I witnessed her having ten one day.

In the middle of all of this, our father died suddenly, leaving Mom to bear poverty and my sister’s illness on her own, without her best friend and supporter.  Our father was a hard working deaf man who was loving and funny and cared very deeply for my sister.  I have no idea how Mom fared as well as she did over the following years.  My sister cried so hard the day he died she was nearly writhing.  Aunts and uncles catered to her, handling her gingerly and with great love.

I wasn’t privy to the details of the night the man took Magg, nor was I privy to the severity of her epilepsy.  I am not sure if this was to protect me, her, or to keep me from being in the way.  What I was left with was a vague sense of “something serious” that left me cowering in fear, or underestimating the gravity of what was happening.  I was both sheltered and chastised when it came to  my sister’s problems.  I wanted to help, but wasn’t allowed access to her in the hospital and wasn’t given many updates.  Even after I graduated from nursing school and cared for several patients with epilepsy, I was left putting pieces of the puzzle together (and still wasn’t allowed to be with her during a seizure).

When she was seventeen, my sister had a massive brain surgery done in Montreal at either McGill University or the Montreal Neurological Institute and Hospital, right before her high school graduation.  She was gone for a month.  I dealt with my subconscious worry by throwing huge, impressive parties with hundreds of drunken guests from all over Sydney.  I was a heavy consumer of alcohol by that time and was still plagued with anxiety about not having friends.  I achieved my popularity goals during that stressful time.  Word on my sister’s condition was scanty and, looking back, I was in denial.

When Sis and Mom returned home, it was as if nothing happened in the house (thank God it didn’t burn down!!!) other than one cracked window from where a boy fell against it.  My sister was bald, with a scar on the side of her head.  I prayed she was cured of both her disease and her mutism.  It was so much for her to go through.

She wasn’t.  A few weeks later, while out for an evening drive, Mom and Sis drove near my sister’s high school.  Mom was completely unaware it would have been graduation night, and all of Sis’s classmates were lined up in caps and gowns preparing to enter the gym.  Magg freaked out. Mom immediately regretted going near the school.  Magg went to school with those people her entire life, yet because of the timing of the surgery in Montreal, and because of borderline grades all year, she was unable to graduate.  I was off at a party getting drunk when all this was happening, at what was an initially fun then catastrophic night from my perspective too.  I had caught the boy I was in love with messing with another girl, and a boy who had been stalking me began to bother me again—things I probably would not recall if it hadn’t been for what happened to my sister the following day.  I awakened, hung over, to hear the dreaded snoring breaths of status epilepticus.  My sister had become so upset over the graduation that she brought on a seizure.  I found out last year she might have had a stroke that day.

The scenario was repeated again after a John Denver concert.  It was one of the most inspiring concerts I’ve ever attended; to this day I rank it in my top three.  It drove me to pursue singing as a career.  I wanted to make my living the way Denver did.  I wanted to perform in that very spot someday, before all the people of my hometown.  It set my life on a trajectory with success as a performer as the goal.  My sister was very moved by the show too.  She was all smiles afterward.

Whether it was the lights or the overstimulation of the crowd, Sis once again landed in the ICU with status epilepticus.  It was so disappointing that her surgery hadn’t worked.

But graduation night was a turning point in my sister’s relationship with everyone.  She strongly resented Mom for not waiting until after school was over.  Her anger grew as the years passed, and she seems to have mentally become “stuck” at age seventeen.  It seems to have trumped every other terrible experience she endured: the abduction, the death of our father, the surgery itself.  Mom needed constant reassurance that she had made the right choice.  I was, as Magg often points out, the “well child” who “didn’t have to go through anything and got to graduate with her friends”.

Over the last few decades, my sister has managed to live through a few more status epilepticus episodes, the loss of our mother, and rheumatoid arthritis.  When I was diagnosed with my disease, Sis was concerned—I feel guilty for perhaps leaving her the “last one standing” while everyone else passes on—but immediately reverted to teenage mentality.

“Well it’s about time you caught SOMETHING!” she said.  I spent so much time bracing myself, felt so terrible breaking the news of my shortened life span…and she says THAT?!?

My sister was merely demonstrating her resilience.  I have to pat her on the back for it. Maybe she was the “well/strong child” all along and I have been the weakling.  She is still selectively mute, and she is bound up with rheumatoid arthritis.  As I type her story, it doesn’t even feel true, the kid’s been through so much.  But she has overcome all of it.  Margie Smith fights.  Now I have to figure out her secrets.

Jill and Jansie

My first night working in the ICU after nearly eleven years went well. I was very nervous going in, with the same feelings I have before going on stage or stepping onto the glass at the Sears Tower observation deck, the Chicago streets 100 floors below me.  As in those two situations, I boldly went ahead with my new job.  Stepping through the ICU doors was an act of gritty courage.

My preceptor and I were assigned to two women I’ll call Jill and Jansie (Jansie is the name I chose for my novel’s main character).  I will muddy some of the details for the sake of patient privacy.

Jill was a twentysomething woman who had taken an overdose and was on a ventilator.  She was found unconscious by her aunt.  They were supposed to go shopping together and Jill didn’t show up.  Jill’s boyfriend alerted the police in the meantime to go and check on Jill, based on a cryptic text she had sent him.  Jill had a history of addiction to various drugs.  Her suicide note stated “I’m tired of fighting”.  When I entered Jill’s room, I saw a tiny young woman whose size and pretty face belied the rumors of her violent nature.  She was adorned with tattoos of roses and butterflies and messages of encouragement.

Jansie was in the adjacent room. She was middle-aged and had suffered complications following an orthopedic procedure.  The root of Jansie’s problem turned out to be pulmonary hypertension and mild congestive heart failure.  This was all new to Jansie, who was crying while trying to watch the Olympics to distract herself when I entered her room.  Jansie’s first words to me were an apology for crying and an expression of great fear and frustration.  Her entire life had turned upside down in the past month, and she was fearful of both death and burdening her wife.  Her feelings were amplified by new, chronic pain from a neck injury.  Several times throughout the night, I found Jansie sobbing.  She expressed fear that she will never be the same and asked why this was happening to her.

i felt a bond with both women, especially with Jansie.  I remember the flood of terror that bowled me over when I was first diagnosed with PH.  My own chronic pain from nerve compression and arthritis in my neck struck in 2015 and stayed with me, adding an even darker shade to life.  It peeled my fingers from the edge of the cliff PH had thrown me over, and I went into emotional freefall.  I shared my experience with Jansie, with the hope she’ll see I’m able to live a fairly normal life five years into my diagnosis.  I caught a fleeting look of reassurance on her face, and she stopped crying.  I even got a few laughs out of her with my crazy antics (“You can be G.I. Jansie in the war with your fear of PH.  You can even shave your head like Demi Moore if you want!”). Then the next wave of shooting pain would hit and take her down again.

Jill reminded me of myself, as I was three weeks ago.  The police came to do a wellness check on me.  My bank notified them I felt like harming myself over my financial situation.  I was in a dire panic that night, beating myself up for what I’d done, angry as to why I have compulsive and addictive tendencies, afraid of what I’d gotten into.  I felt hopeless and saw no way out.  Jill also reminded me of two young women–one of them a teenager–in my recovery group.  Those ladies are struggling with drug addiction, and as time passes, two kind but hurting souls have emerged from under their anger.  My addiction is overspending, but I do it for many of the same reasons: to deal with “something missing” and to make reality disappear for a while.  Without it, my anger and panic flare.  I suspect there is a wounded girl under Jill’s violent facade, and I know how “wounded” feels.  Mental illness and addiction are two highly stigmatized problems, and intense shame goes with them.  I could feel much of Jill’s emotional pain.

Perhaps my problems can offer rays of hope for the people I will take care of in the ICU.  Maybe they’ll see I am the type of person who doesn’t stop, and it’s possible to push forward with life despite an incurable condition, pain, and living without my “substance”. Maybe they will look at me and see someone making the best of things, putting one foot in front of the other, one day at a time, and see that I embody possibility. I am “tired of fighting” most days too, but I have learned to keep moving and working and learning from my experiences.  I hope my patients will see that.

Stuck In A Moment

My goal for this blog/website is to help people live their best lives in the face of chronic or incurable conditions.  To improve my skills, I chose to enroll in a life coaching course. The course I chose is “Life Coach Certification (Beginner to Advanced)” by Kain Ramsey.  The session I’m currently working on involves a story about a man going about his business then suddenly falls into a deep hole.  He fights to get out of the hole at first, but gets weary from his efforts.  Depression, doubt, hopelessness kick in.  He is too proud at first to call for help.  Then a therapist happens to walk by, then a doctor.  I imagine the former offered a form of cognitive behavioral therapy (CBT), and the latter some antidepressants or anxiolytics.

The third person to come by is a friend or classmate who jumps in the hole with him…but reveals how to get out because that person has been there and can relate.  Such is the essence of life coaching.

I’ve mentioned a thousand times I am a big (but recent) fan of the Goo Goo Dolls.  I am also a huge fan of U2, and for over half of my life.  U2 has a song called “Stuck In A Moment”.  Bono wrote it about Michael Hutchence of INXS, a good friend who profoundly affected Bono’s life.  Hutchence was in the type of hole Ramsey describes.  Only he didn’t make it out.

The reason I am writing about this dark subject is because a week and a half ago, I nearly got stuck in a rough moment–forever.  Not only do I have pulmonary hypertension and fibromuscular dysplasia; I also have severe depression, anxiety, and addictive/compulsive behavior.  The latter got me into very serious trouble.  My issues with depression and compulsive shopping preceded any other problem by decades.

I binged on spending between September and the first week in January, sometimes several days in a row, and over $200 each time.  I knew I was headed for trouble, yet I felt some force was driving me to shop, to fill the holes in my life with “things”, to enter stores and not fight this force, even though I felt like a failure.

On January 12, I started working with a debt management company and their initial payment was $700.  That amount was taken out on Jan 15, along with my $412 retirement loan repayment.  I anticipated these.  What I didn’t realize was I’d scheduled many credit card payments and car payment all for that date.  The debt management rep warned me to cancel these, but I forgot (thank you, gabapentin, for messing with my brain).  I also made arrangements with the bank so I have limited access to cash, and no more debit card.  It’s a steep learning curve with no overdraft protection anymore.  When all was said and done, I was $1190 overdrawn, and there was nothing I could do about it.  The bank threatened to shut down all my accounts permanently and turn me over to collections.

I was very upset talking with the bank reps, trying to explain my mistakes and eventually telling them I am in a recovery program with people recovering from drugs and alcohol, to learn the tools they are taught and get help.  I spoke of the hopelessness of my problem; how “this keeps happening no matter what I do”.  Next thing you know, the police were at my door for a wellness check.  The bank rep put another rep on the phone during our conversation…while she went to call  911.  I was going to kill myself.

The following day, I confided in a few close coworkers, who then got concerned and went to management.  Management went to Human Resources, and now I have to jump through hoops to keep my job.  I must go to mandatory counceling, with a counselor who is “in the system” and chosen for me.  Meanwhile, I set up an arrangement with the group of counselors my psychiatrist recommended, so I am seeing TWO separate therapists in response to this emergency.  I am only allowed three “free” visits with the one arranged by my employer.  Then I’ll have a $90 copay, regardless of who I pick.  And when cash is already an issue…

Anyway, I believe in honesty and transparency, so I chose to share this with you, my appreciated readers.  This issue is proving to be MUCH harder than dealing with the PH and FM.  I might have even forgotten about them as all the mayhem was happening.  Sometimes emotional turmoil is worse than physical illness or pain.

For now, my plan is to a) not spend at all for the month of February, except for cat food/care, groceries, gas, and utilities, b) return to SMART Recovery meetings, church, and social outings with Meetup groups and c) practice mindfulness each day.  We’ll see if I can stay off the ledge.  I am never really that far from it, even on good days.

Flowers and Orbs

I don’t care what people say, home décor can affect your mental and physical health.

Last spring, I got a tattoo on my left inner forearm stating “Find the Beauty”.  I placed it there to remind me there is beauty in every situation and it’s my job to find it.  Not merely search for it.

I’ve told the story many times, ad nauseum for a few people, but the song “So Alive” by the Goo Goo Dolls cut through my very thick, dark wall of fear and anger in late 2016.  I went to my first Goo show in Hershey that fall, and by the end of the night I was a die hard fan.  Just like that.  It was an amazing experience.  The other fans are beautiful people. John Rzeznik is one of the most beautiful men I have ever seen.  Robby Takac is always pleasant, and his pictures on Twitter and Instagram show how fun-loving he is, even off the stage.  He seems really interested in everything and engaged with life.

I chose to disengage with life in 2015, when the high and distraction of finishing the New York City Marathon despite my lung condition wore off.  I was hit with severe pain in the left upper back, down the arm, and left chest area.  I’d had weakness in my left arm on and off for a few years, which I now realize was related to the vertebrae in my neck.  I was demonstrating proper burpee technique to a coworker on Christmas night.  Two days later, I was plagued with the most incredible pain I have ever felt.  By New Years Eve, I had been awake three days straight and my heart rate was in the 130s at rest, all due to the pain.  Each day I was at the emergency room or the chiropractor; nothing helped.  Finally, on January 5th I had an MRI.  It showed moderate to severe arthritis with bone spurs impinging on all the nerves to my left arm.  Nothing they can do about it either.

I was started on Gabapentin, which gave me a lot of relief.  But the pain had sent me into a downward spiral.  Like water as it gets closer to the drain, I had begun a much faster descent into the despair brought on by my lung diagnosis two years earlier.  But I woke up at the concert and realized I hadn’t been expecting such a profound experience.  Therefore, there MUST be beauty everywhere.

In 2011, I met Bono.  It was serendipitous.  So few miracles had happened in my life, this one blew me out of the water.  Later, I realized miracles happen every day if I look for them.  Only I would forget to look.  And when diagnosed with my PH, I lost sight of them altogether.

The tattoo saying “Find the Beauty” will always be with me.  But now that my apartment is cleaned up, I have chosen to decorate it with some of the prettiest things I can find.  The nicest of my treasures have been the flowers and orbs I found.  I got the idea for orbs from my Christmas tree: some of the balls did not have a Christmas theme, and were labeled as “orbs” or “spheres” in the catalog.  I decided to leave the prettiest ones out, and I bought ornate bowls and baskets for them. They are placed in various parts of my apartment easily seen from wherever I sit or rest.

During my cleanup, I found several vases left over from flowers sent to me over the years.  I bought gorgeous artificial flowers and stones, and put them in the vases.

All of this makes a huge difference in how I feel when I am at home.  Finding beauty takes no effort behind my front door anymore, and I am more at ease.

Grateful

Long before I developed the chronic medical conditions I have now, I was consumed with other concerns. It doesn’t take a bad diagnosis to make you go into a tailspin.  Anything can take you by surprise and send you reeling in a new direction, one you hadn’t planned to take.  One that throws you for a loop.  A road you avoided, but are now forced to explore.  Examples include–but are not limited to–losing your job, filing bankruptcy, losing a loved one, economic downturns, betrayals, and natural disasters.

I honestly don’t know why I had depression and anxiety most of my life, and why it led me to do some of the things I did.  Addictive/compulsive behavior got me into a lot of trouble, starting at around age 17.  At first, I drank a lot.  But when the partying stopped, other addictive behaviors took over.  Like binge eating, compulsive shopping (to the point where I landed in bankruptcy court and faced the humiliation of repossession.  I lost friends, boyfriends, etc., to this behavior).  For many years, it was the primary issue I had to deal with.  Even today, I battle many temptations and compulsions.  Whatever restraint I had before my pulmonary hypertension diagnosis evaporated in the face of my eventual death.  I stopped caring.  Just like you can stop caring when faced with any crisis.  Only now I have to deal with the PH, the FMD, and the consequences of my indulgences.

So what can be done in this situation?  Medical bills on top of consumer debt on top of anxiety meds on top of overeating?  Seems impossible.

I can be grateful.

Forcing myself to appreciate my life, to stand back and look at how good I have it compared to some people, and even at the time I’ve been given beyond what I thought I would have, takes my mind off my negative thoughts.

It’s hard to be grateful in the midst of a crisis, when you are scared to death or feeling like you aren’t in control.  But it’s a choice.  Find something to appreciate.  It may take some effort, but you will.  If you have a dog, for example, pet him.  Look at his eyes.  Notice how he comes to you, how happy he is to see you no matter how dark you feel or nasty you have been.  He doesn’t care.  He loves you as you are.

Or consider the homeless people.  When I went to Boston to see the Goo Goo Dolls a few weeks ago, I came upon a woman in the train station who was curled up in the corner with a sign saying “My name is Amy”.  I didn’t read beyond that.  She was emaciated, maybe 18 years old, pale, and quiet.  She had marks on her face you sometimes see with methamphetamine use.   I said hello to her, mostly to help her feel acknowledged and visible.  She probably feels pointless, ashamed, and dirty.  Regardless of Amy’s reason to be in the train station begging, she is worse off than me.  I felt great compassion for her, drug addict or not.  Though I was still floating and happy after meeting John Rzeznik, Robby Takac, and Korel Tunador (and several others who work for the band, and members of the opening band as they passed the line), I stopped for a minute to consider Amy.

Of course, I can easily spot people in need and am much more open-minded after a good experience.  When down, I have learned over the years that acting like I care makes me care.  Acting grateful makes me grateful.  And that changes my entire outlook.  So each day, no matter how I feel, I choose gratefulness.