How, exactly?

I have well-documented anxiety, and have recently begun discussing it with a therapist again. Why, you ask, wouldn’t I be in a constant state of therapy if I know I have anxiety? Because I very much dislike crying. I get an awful headache after I cry, and it’s obviously embarrassing and exhausting, but I also don’t feel that I can be clear when I’m sobbing. It’s the worst, and I don’t want to make a weekly appointment to do something that is the worst. You fight the oncoming tears and try to choose words that won’t make you cry extra, and those words might not be the most accurate depiction of your feelings, but you just don’t want to blow your nose in front of a stranger again so you say whatever you can manage.

Nevertheless, I cry in front of a stranger semi-regularly now. Somethings for seemingly no reason at all. Therapy just makes me cry, even if the topic is a happy one. One day a week I am dangerously dehydrated.

In what will come as a surprise to zero humans who have met me, my anxiety stems from my illness. For people whose anxiety is worse during certain activities like flying on airplanes or public speaking, they presumably have a break from doing those things. You are not constantly speaking to a crowd or in the air. For a person with a chronic illness, it’s all the time until death do us part. And, because sometimes I am instantly knocked down without warning, the times of relative good health are not much relief because who knows what could happen tomorrow, or even an hour from now.

True, sometimes there is a slow spiral down and though I feel surprised to end up in the hospital, when I look back I see it was a long time coming. Other times, I’m feeling amazing, and then BOOM something I eat gets caught in the quagmire that is my gut and I am in excruciating pain and my entire life halts. It’s a bit like skiing on a clear day and slamming into an invisible tree.

My anxiety is not always specifically about my health, though I have plenty of that to go around. Maybe I have cancer. IBD raises your risk of cancer. Maybe I have a different kind of cancer. The medicine I take can also cause cancer. Maybe I’ll get COVID-19 and die because of my weakened immune system. The medicine is lowering my defenses on purpose so my immune system stops trying to murder my digestive tract. Day to day, though, my anxiety is about logistics.

I cannot turn off the logistics. Everything brings up logistical challenges. I can’t even fantasize in my wildest imagination without logistical anxiety. I could be watching a cooking show where Ina Garten is making a dish with $300 worth of lobster in it, and my brain does not say you live in a landlocked desert with limited access to fresh seafood and cannot afford $300 worth of lobster, it says if you ate those walnuts you would get an obstruction and die if you didn’t get to the hospital fast enough. I don’t even like walnuts! The show will cut to a commercial of people hiking a volcano in Hawaii and instead of just imagining myself on a tropical getaway, my brains says you can’t go hiking. There are no bathrooms and if your protein bar got caught in your small intestine you couldn’t get to a hospital because the hospital helicopter couldn’t pick you up on a volcano. All extremely reasonable and normal things to think while watching three minutes of television.

Day to day challenges wear me out, especially lately. The amount of thought that goes into school pickup and drop-off makes me want to curl into a ball and cover my head. But these fears are not unfounded. After I had my second child I had a massive flare. I was nursing and he didn’t take a bottle, so I wanted him to be in the hospital with me. That isn’t allowed, because if I had to have emergency surgery or something, who would take care of the baby? My aunt stayed in the hospital with us and helped me care for myself and my baby because I was bested by logistics.

My most recent emergency room party occurred after my third baby. I ate something that got caught, was in blinding pain and throwing up. I kept her near me so I could see her while I threw up everything in my stomach, and once I was just in pain and only throwing up every thirty minutes or so, I drove us both to the ER. I saw a doctor and explained (while holding a barf bag) that I might have an obstruction and I needed to know if it was partial or complete. He said okay, but your baby can’t come with you for the CT scan. Obviously I didn’t want to expose my child to radiation, but I couldn’t be in two places at once, so someone from the OB floor came down to stay with my baby while I was wheeled into the scanner. It was awful to leave her with a stranger, but I didn’t know what else to do.

The obstruction was partial, but the doctor wanted to keep me over night and stick a tube down my throat (or was it up my nose?) and into my stomach to suck out anything that might be putting pressure on the blockage. Even if you don’t eat or drink, your body produces fluid that heads down your tubes and continues to make you miserable if you’ve got a blockage. He said most people found the procedure very uncomfortable, and he looked at my baby. Ah. I couldn’t do the procedure and be a parent, and I was nursing another baby that didn’t take bottles. I couldn’t even take the Vicodin I was offered for the pain as it would pass through my body into my milk. And so, I declined to stay overnight and took my baby home. I knew I wouldn’t die because it wasn’t a complete blockage and I just had to get through the pain until the clog cleared up and then stay on a liquid diet until I felt somewhat normal again.

Those were logistical nightmares. And having spent time in hospitals unexpectedly, I now shower and shave my legs if I suspect there is something trying to get caught in my gut because if you’re going to be in pain and miserable you don’t want to also have prickly legs and dirty hair. Lesson learned. Now, I find that I focus on logistics in casual conversation to the point where I don’t understand jokes. Someone told a funny story where the ending was something like, “and then my car was full of mold!” and all I could think was how did you fix your car? which was maybe deep down how will you get to the hospital in an emergency if your car is full of mold?

You might think that a focus on logistics would make me an ideal travel partner. You would be incorrect. I flew with my kids to Florida and had practiced for a few days ahead of time to see what I could safely eat without incident and the answer was nothing so I ate nothing until we arrived at my parents’ house. I had a change of clothes for myself and for the kids. I had emergency pain pills in my bag in case I somehow got an obstruction from the big plate of nothing I ate for breakfast and also lunch. But I forgot my driver’s license and had to have my very patient husband drive back to our house and retrieve my passport and come all the way back to the airport to hand it off.

This is maybe why I’m so terrible with the normal things people focus on like directions and parking and travel documents and gate numbers. There is just no room left in this jumbled brain for anything else. I am calculating where the nearest bathrooms are and how long it will take me to get there. I’m wondering if there is a medical professional on my flight in case something happens and they need to make that announcement like in the movies — is there a doctor on this plane?? I’m holding my breath because someone I can’t see in another row is coughing and I don’t know what a COVID-19 cough sounds like.

This brain is full. No room in the inn. Someone else take over the dinner menus and travel plans because I’m overbooked.