My grab and go anxiety management tools

Disabling- Enabling- Communicating - this month's word prompts. 

Disabling-Anxiety

A bit of stress occasionally might not need too much thought to live with. But what if the stress bursts in suddenly and looks like it won’t leave anytime soon?  How can you keep getting through each day when every day is overwhelming?

Recently we entered a time that seems like it will be one of prolonged stress. 

Cue anxiety. It is hard to focus and breathe. 

It's pretty intense and looks like it might go on for a while. It's been 2 months already. What tools do I have that I can just grab straight away and start using? What has been helping?

Enabling- On Anxiety Management

Exercise

In normal times I wait until I have a good amount of time to go for a bike ride. I need half an hour or more to make it worth it, enough time to ride to the other side of the park.

But with anxiety threatening to overwhelm I've been taking any bits of time I can. Even if it means only 5km, and even if it’s in a hot part of the day. Even a little bit of movement makes a difference.

On intense days it means I can feel it right away. On not-so-intense days I know it’s still important. If I’m exercising regularly anxiety spikes are less fierce.

And I'm riding through trees and past lakes/moats of water so the scenery is beautiful which helps too.

Breathing

What if you could calm your nervous system for free, (almost) anytime and anywhere?

At first, breathing exercises made me dizzy, but now that I know how to do them, it feels like a superpower.

Deep breathing exercises centre your nervous system. In counselling, I learnt triangle breathing and another similar one. Box breathing is another well-known method.

I felt how much I had come to rely on breathing when I found myself in the hospital earlier this year.

After rushing our child to the hospital I started to feel anxiety building up in my body. Time to breathe! But, it didn’t work with a mask on and it wasn't an option to take it off. (It was the pandemic, and we were in the ICU of a children’s hospital in Cambodia. There were at least 10 very sick, very small children in the room.)

In that situation, all I could do was notice how I felt and deal with it later.

However, in our current season, I'm able to use breathing exercises to manage anxiety. 

Other tools that have been helping include:

Sleep, nutrition, guided imagery, and books.

More on how books have helped:

Reading Narnia out loud has given me a chance to focus on a magical fictional world. While reading I’m holding the physical book in my hands and having to articulate each word. My children and I really enjoyed it. We read all 7 Narnia books over the last few months. Coincidently we just started before this anxiety began. I wrote more about our experience in these 2 posts:
We are deep in Narnia
From the Dawn of Time until the Last Battle.

I was a bit sceptical when I heard about a Christian book on anxiety, was it going to quote "Do not be anxious" at me?

I was proved wrong when I heard the author interviewed on The Pastor's Heart. In fact, the blurb did quote Philippines 4 but in a way that attracted rather than repelled me.

‘Do not be anxious about anything' says the Apostle Paul. But Paul Grimmond says saying that to an anxious person is a bit like telling an ice-cream not to melt in summer.

NB- I haven't actually read this book yet, hoping to one day. It's helping me just by its very existence.  

When the Noise won't stop

A Christian guide to dealing with anxiety 

by Paul Grimmond

Communicating

There is so much hype around the issue that is triggering my anxiety. I don't want to expose myself to unnecessary triggering. I’ve been trying to take in all the relevant information and bypass the rest. Not possible to do it perfectly but a balance to strive for.

I also have to be careful about the time of day I take in information. I know it will stress me out more if it’s later in the day. If there is some big news I need to hear, my husband knows to share it with me at lunchtime rather than in the evening.

 

Thanks for reading. What's on your grab-and-go list? 

Head over here to read what other chronic illness bloggers wrote for these prompts: A Chronic Voice October Linkup

Photo by Jason Leung on Unsplash

When getting sick feels like you’ve landed in a foreign culture (1 of 2)

How I Make Sense of Chronic Dizziness

Part 1- How it started

 “Sorry I can’t come, my husband is dizzy.”

It sounds ridiculous.

Why would I need to cancel something because my husband is a bit dizzy?

And people’s natural responses sounded ridiculous to me.

“Ok, make sure he drinks enough water.”

Photo by Francesco Ungaro from Pexels

When we arrived in Australia we expected reentry/culture shock. We knew we were going to be in a different world and that that would mean stress and disorientation.

It’s an inherent part of your life when you’re an Aussie married to a Cambodian. I’d read books and blogs, talked to people, made my own lists of my own experiences so far. I was expecting the first few months back in Australia to be extra hard.

Being uprooted from the familiar and landing in a new place is exhausting. It helped that we expected it and we could understand where the stress was coming from.

Even though we anticipated this, it was still stressful and painful. Some things might not have been obvious at the time. But later we could look back on it and notice the role culture shock played.

So we entered a new country, Australia. At the same time we also entered the world of undiagnosed debilitating sickness.

We didn’t know we were going into it, and so there was no preparation or expectation of what it would be like. I don’t think I even knew such a world existed.

Unlike culture shock, we had no way to prepare and often no way to even know where the stress was coming from.

Why is a world of undiagnosed debilitating sickness stressful?

Stress #1

Seeing my spouse in pain was bad enough. But not knowing what it was, not having a name for it, not being able to do anything about it — made it worse. There were a few times of acute pain when I actually thought Soeun was going to die. And many months of feeling like he had disappeared under a heavy pile of symptoms. It was hard to imagine that he would come back, as despite all the things we tried he was not improving.

I could see how The Dizzy Monster had transformed him. Since it began its attack the 24/7 fight with it exhausted him. But doctors could only see negative test results, and to others, he looked normal. On one hand, it was a relief when we got the brain CT scan results back and it was all clear. But also frustrating as it meant the enemy was still invisible.

Stress #2

Unsolicited medical advice is a normal part of life for a chronically ill person. The internet is full of articles on how to handle it, and mocking memes. When I learnt this 4 years after the fact it was a big relief!

It’s usually with good intentions. Your friend (or a random guy on the street) tells you that his neighbour tried cutting a certain thing out of his diet. It worked for them so you should try it too and you’ll be better in no time.

When advice is coming at you from many people, and you’ve already tried lots of things it is a source of stress. But because you can see the giver is trying to help you feel you should be polite and say thank you.

Stress #3

Social isolation is another part of chronic illness life. Before entering dizzy world receiving a dinner invitation would have been fun. But it became frustrating and disappointing. We would say “yes” to an invitation but on the day Soeun would be sick so I would end up going by myself, or not going at all.

As a few one-offs, that’s kind of ok. But when it becomes a general pattern it makes life hard. Not being able to keep commitments. Not being able to show people they are important to us by spending time with them. So it’s easier not to make plans, then we don’t have the disappointment of breaking them.

We had a community of people around us who were trying to care for us. We found that even when friends asked how they could help we didn’t know how to reply. The double whamming of entering the two new worlds at once was overwhelming.

Fast forward to now

Almost a decade, two kids, and many house moves later, we are still struggling to live with The Dizzy Monster. But here in Cambodia Soeun’s symptoms aren’t debilitating. Sadly our old normal is gone but the real Soeun is back and we have a new normal.

The stresses didn’t go away when a doctor described his symptoms as Vestibular Migraine. It’s a little-known, little-understood condition so in some ways receiving a diagnosis didn’t make it easier.

Telling people he has Vestibular Migraines seems to make them think he has a headache or a sore ear. These commonplace illnesses don’t describe our experience at all. A huge transformation took place when The Dizzy Monster joined the family.

I could never have guessed what a big impact this would have on us. I thought it was like any other stress we’d had before, that the memory would fade with time. But all these years later making sure he drank enough water feels like putting a band-aid on an amputated leg.

Is it a holiday? Is it a conference? No, it's a...

It’s not like any other travel I’d organised before. 

It’s not a mission trip to a host country. 

It’s not a visit to a passport country. 

It’s not a holiday. 

It’s not a conference. 

It’s not going away for study.

It's a tailor-made international health trip.

Emails flying between 3 countries. Collecting the correct documents for medical matters and crossing international borders. Trying to write a budget with 3 or 4 different currencies. Scheduling doctor's appointments not knowing how long it would take to get there from my accommodation, or how I would do that with no local language or knowledge or sense of direction. Trying to choose the cheaper flights that also matched up with when counsellors and guesthouse beds would be available...   

It felt like such a hassle to have to organise it, and it was annoying that we would all need to put our lives on hold for the duration. Going away cost so much money and I needed many people’s help to make it happen. If only I didn’t live somewhere without these services, there would be no need for a trip like this. I could just slot it into our normal everyday activities.

These were my thoughts as I prepared to have our babies overseas, and more recently as I got ready for two weeks of counselling and medical appointments in a country we have no connections to.  I resented having to travel for fairly run-of-the-mill health events. 

So what was this trip like?

It was a little like a holiday, in that I was in a relaxing environment away from normal life. 

And a little like a conference in that I learnt a lot of exciting things that I’m eager to take back to my real life. 

I was in a country that was neither my passport country nor host country. Daily activities included catching taxis from my accommodation to meetings. They weren’t big group meeting though, rather individual counselling sessions or doctor’s appointments. It was great to finally be able to investigate the mental and physical health issues I had been trying to work on over the last six months.

And the accommodation wasn’t just a place to sleep. It’s a little like a guesthouse, but specifically for cross-cultural workers. People often stay and rest when they visit the town for a holiday, health care, between conferences and while in transition between countries. 

This means I was instantly part of a community of others who have similar (but very different) life experiences and who are also there for counselling, or having babies and a variety of other reasons. Joining feels so easy and enjoyable; it makes the whole experience of a health trip even more valuable. I don’t know how to describe just how amazing it is to be briefly immersed in relationships that start and end quickly but with a connection that feels so unique and deep.

And it means it felt slightly reminiscent of living on Bible college campus, each family or individual has their own place to sleep but we all eat together. Perfect balance of personal space and community life. The big difference being that instead of classes to attend there is a pool, gardens and playgrounds. Other differences are that people often arrive and depart via the international airport, and stays are usually measured in weeks rather than years. 

It also means that I could really focus on my health as food and laundry is all taken care of onsite. Counselling and getting blood tests results back is exhausting, so I didn’t have energy for much else.  The only “housework” I needed to do while there was collect drinking water from the dining room, and drop my clothes off at the laundry.

Being away from both my passport and host country meant that I was free from any distractions and obligations. I could use all my brain space and energy on the specific things I needed help with.  Instead of resenting that I had to travel for health care, I’m actually really glad now. It worked really well. I feel like it was more helpful doing it like this than doing things from home, slotted in around normal life.

I remember the same feeling when we were away to have our first baby. It had been so hard to get there, and I was annoyed I couldn’t just do things from home like pregnant friends in my passport country. But when we were there, it felt so beneficial to have that family time away while going through such a big transition.

Yes, it was expensive, time consuming, and I needed a lot of help to make it happen; especially from my poor husband who basically had to put things on hold for a couple of weeks. But it turned out to be really effective in the ways we were hoping, as well as enjoyable. In fact so enjoyable I almost didn't want to come home!  It's a strange thing to have such meaningful memories in a country we aren't connected to in any other way. 

My clean laundry waiting for me! Boring photo but exciting moment.

I was excited to see Velvet Ashes this week is all about TRAVEL. I wanted some way to remember this whole experience of a two week counselling intensive while staying in a missionary retreat, so this blog post is what I came up with. 

I enjoyed being driven around by drivers who know where to go, on smooth roads, in closed vehicles with suspension. 

Photo by Owen Beard on Unsplash

4 surprises in June

"Give him 4.5ml once a day."

I couldn't understand what the nurse was telling me, although I knew I should be able to, and I knew it was important. My son had a scary looking infection, with a weird red line growing out of it. Why couldn't I understand the instructions? And what would happen to my son if he didn't take the antibiotics correctly? What if his blood got infected?

It felt like there wasn't much action in the logical part of my brain, the fear response was taking over. My brain was tricking me into reliving the emotion I had when my husband was sick. Even though it was more than seven years ago it felt like it just happening in the present. The counsellor had explained it to me almost 12 months before, and the book I happened to be reading in the waiting room explained it to me on the spot. ( A Sandwich of Sickness Stories) That's what can happen after a "big T trauma".

I memorised the instructions (still without understanding) and repeated them to Soeun when I got home, and he gave our son the medicine. Part of it was written down in Khmer language but not in full detail.   

Just popped out the front gate to take this while cooking dinner.

Surprise 1
Dealing with my health was more urgent than I had thought! The last few months I have just been dealt with my post trauma stuff mostly by avoiding triggers, like thinking about going to Australia. But right at the start of June both our kids needed medical attention and I realised I wasn't really well enough to take care of them. Seeing a family member in pain can also be a trigger. Now I get why they tell you to put on your own oxygen mask first, before helping others. 

Surprise 2
It was too hard to arrange things for me to get help- that was our position over the last few months. But in the first week of June it switched to- it would be too hard to keep going without getting help. 
The surprise was that when we actually started planning things fell into place. And it will give us a chance to deal with a couple of other things too.

Surprise 3
Back in January we finished up with our Khmer church. We decided for 6 months we would just go to House Church (English speaking). It was nice for me, but weird for Soeun. We didn't have a plan for when the period of time was over, but just at the right time a new church popped up in our commune. Soeun has already been visiting and now it seems like its going to work.

Surprise 4
On the last day of the month Soeun started getting messages from his neighbourhood football team. A farming accident was in progress and ended up being fatal. Such a shock.

So here we are at the start of July, with the mournful music and monk chanting sounds all across the neighbourhood  from around 5 or 6 am. And it seems like mostly our days are filled with errands and admin, which are mostly health related.  Tomorrow is the funeral of the boy who was killed. Also its  our daughters 5th and final post exposure needle from her dog bite last month.  It feels a bit like a full stop of all surprises. Not sure what the next bit will look like! 

I didn't really think through this blog post as much as usual, feels like there is a lot going on and wanted to record it as it happens. Hopefully it made sense!

A Sandwich of Sickness Stories

A Chronic Voice prompts for June 2019- Wondering, Repeating, Getting

Hot season is over and the rains are here.  They say it never rains but it pours, and we recently had a week that felt like everything thing happened.  Let’s call it our Sick Week.

In the beginning...

How does a biracial family access health care?  The lack of trustworthy medical care in Cambodia was terrifying when I first arrived back in 2006.  I was told there was one specific clinic I could go to if I got sick. Seeing a doctor cost about a month’s worth of rent. That was the information given to foreigners at the time. There was no way the average local could afford that. There were other clinics for them. 

If I was going to marry a Cambodian and look after our babies here, how was that going to work? And what of our extended family? Those were my thoughts about 13 years ago, and I had cause to reflect on them this month during our Sick Week.  

It felt ordinary like bread on the first and final days; while the central day was more intense, like meat seasoned for a sandwich filling.

Wondering why he was contradicting himself

First Day of Sick Week

“Your son has chicken pox, he will be contagious for 7 days.”

“So I should keep him home from play dates and parties?”

“No, no need.”

“But those spots are from chicken pox? Is he contagious?”

“Yes”

“So I might not take him to visit friends this afternoon.”

“No need to stay home.”

I was wondering why the doctor was contradicting himself, when he was usually so helpful.  

Four years of respect and trust for him was the only thing that prevented me from getting angry and leaving in frustration. We tried to communicate about this but I was just left wondering. 

It wasn’t until later I realised what was going on as I interacted with parents of various nationalities over the next few hours. I was equating “contagious” with “stay away from other kids”. I stayed home from school when I had chicken pox, because it was contagious.  But for Khmer parents, those two things don’t seem to go together. Of course their kids will get chicken pox at some stage, no need to stay away from sick people.

My brain repeating that emotion from years ago

Central Day of Sick Week

                                                                                                                           

My fear response was taking over my logic.  I was at the medical clinic with my son and his scary looking infection.  Over 7 years ago I felt like my husband was moments from death and that feeling keeps getting replayed. When it is triggered by things such as seeing family members in pain it doesn’t matter that I know things are probably OK, my brain tricks me into re-living that old emotion.

Spookily (but in a comforting kind of way) I happened to be reading about trauma as I sat in the waiting room with my son. It was as if Someone was with me, explaining what was going on. A woman called Marsha has her brain scanned while she re-lives her trauma. The Body Keeps the Score (chapter 3) explains what happens in her brain. It was similar to what my counsellor had explained to me about my own brain only in more detail.

It wasn’t only my 8 year old emotion that was being repeated.

Last July I was at the medical clinic with my husband and his scary abdominal pain.  Over 6 years ago I felt like my husband was moments from death and that feeling keeps getting replayed. When it is triggered by things such as seeing family members in pain it doesn’t matter that I know things are probably OK, my brain tricks me into re-living that old emotion.

Spookily (but in a comforting kind of way) I happened to be reading about trauma as I sat in the waiting room with my husband. It was as if Someone was with me, explaining what was going on. A friend had just messaged me a link to this blog post about trauma. It was similar to what my counsellor had explained to me about my own brain only in more detail.

Getting the post exposure rabies shots

Final Day of our Sick Week

“Whaaa!”

Our daughter came in crying.  She was bleeding from a dog bite. I’d seen other expat friends rush to get the rabies post exposure shot so I knew that’s what we needed to do. Even though there was a really small chance she was infected, it was such a serious thing. I began urgently asking on Facebook which clinics in town had the vaccines in stock.

Soeun drove our daughter straight to a clinic and got her first of five shots done. Phew! I breathed a sigh of relief and so did the friends on Facebook.

In sharp contrast, a local woman in the waiting room told Soeun he was being ridiculous. He was advised by his fellow Khmer that washing the wound was all you need to do. The shots are just so the doctors can make money. I guess she hadn’t seen all my expat friends running to the doctor, but I’m sure she’s seen people getting bitten.

Conclusion

You can experience the exotic by eating in a Chinese restaurant or watching an Indian movie. Relying on doctors in Asia for my children’s health has given me another way to gain insight.

War is part of this country’s recent history so I’d read about post trauma issues before I came to Cambodia; but having a personal taste of it feels like the beginning of a different level of understanding.

Hopefully I’ve been able to share some of that insight and understanding with you here. Stories like the chicken pox and rabies shots are our usual way, using the Khmer doctors’ expertise but sometimes in a different way to their other patients. Whereas the central story of re-living emotions feel like the start of something new.

 Photo by Jonathan Pielmayer on Unsplash

5 ways living with undiagnosed illness in the family is stressful

I couldn’t have articulated it at the time, it was too overwhelming. 

But now all these years later, and with the help of A Chronic Voice‘s  Link up prompts I’m able to explain some of the things that made the initial years of Soeun’s sickness so hard. I also want to share this with the Velvet Ashes community while the theme is "marriage".

My husband was consumed by an incapacitating, invisible, incurable disease. I didn't have any of the physical symptoms but it had a huge impact on me. 

The stressors listed here are about what it was like before we had a diagnosis; he is still sick but now but we are not in crisis. We have a name and a way to manage it.  Although some stressors are still part of our life this list is mostly in past tense. 

I’m thankful for chronic illness websites and counselling that helped me identity these stressors , I hope this list can help you and your family too.

Prompts this month: Adjusting. Hoping. Surviving. Befriending. Awakening

 1. Adjusting to unexpected change

We didn’t know we were adjusting to a new normal. It only dawned on us years later. We weren’t given a warning or time to prepare. It took us by surprise. And even after the symptoms started we kept making plans, thinking that he would get better soon. It was always about waiting to see the next doctor to work out what was wrong and how to cure it.

2. Hoping in vain for health

I was always eager to see what was around the next corner. What would the next doctor say? What would the next test results reveal?  Always hoping there will be answers or something new to try.  It was horrible seeing Soeun in pain for so long, I kept hoping it would end. Surely he will be healthy in a few weeks’ time? The frustration of watching him in pain and not knowing why motivated me to keep waiting to see that next doctor, or try that lifestyle change.

 3. Surviving without him

“When will my husband get better?” morphed into “Will he ever get better?” and we just had to live day by day.

A heavy pile of symptoms had swallowed him up. It was hard to imagine him ever coming back to life. Physically present, with all normal test results, looking healthy- but it felt like he was absent. I missed the person he was before he got sick.

Without Soeun daily stressors were harder to cope with; I was used to talking to him about everything. Happy experiences also became hard to deal with as I had been used to sharing everything with him. I discovered it was hard to enjoy anything if Soeun couldn’t enjoy it too. I didn’t know how to function without him, or even how to articulate that’s what was happening. And it felt selfish to focus on my own pain when I wasn’t even the sick one.

Living with uncertainty. Not knowing why he had gone, or having medical acknowledgement that something was wrong, not having a treatment plan, not knowing if he would come back to life or if he would be like this forever? Or would he actually die? Just surviving.

4.  Befriending and social isolation

We had just moved to a new community when the symptoms hit.  People started befriending us...well trying to anyway. When we were invited to events it became to frustrating and disappointing. We would say “yes” to an invitation but on the day Soeun would be sick so I would end up going by myself, or not going at all.

As a few one-offs that’s kind of OK, not so OK when it becomes the norm. I hated not being able to keep commitments, not being able to show people they are important to us by spending time with them.

It became easier not to make plans, and then we didn’t have the disappointment of breaking them.  So I came to dread invitations, but also dreaded that people would give up inviting us.  

The Chronic Traveller has a more poetic way to describe this- The Well of Despair.

5. Awakening and unsolicited medical advice.

I didn’t have a way to describe this at the time; it was a nameless struggle. When we shared our medical issues with people they tried to help- so why did that make me want to scream? I should be grateful for help.

It wasn’t until years later I came across websites such as The Mighty, Fruitful Today and My Migraine Brain and found others had the same struggle. The awakening was such a relief and I allowed myself to feel the bitterness that had confused me at the time. I was able to move on from delayed bitterness when I read words from a Christian teenager:

"I have to choose to respond graciously and not be bitter towards people for misunderstanding what I’m going through. They have never been chronically ill so they can’t possibly know how hard it is. Jesus has demonstrated so much grace toward me and He is teaching me to reflect Him in my relationships."

Ally, on Fruitful Today

This issue was described in a positive way recently by Erica on A Chronic Voice 7 ways to be a better friend to the chronically ill:

"2. Listen Without Trying to Provide a Solution

Sometimes I’m just frustrated and complaining. I’m not looking for you to fix the problem – I just want someone to listen. I’ve more than likely tried or heard the suggestions or advice you have to offer. Listen with an open mind and really hear what I have to say."

********

Its seems partners of the invisibly ill are likely to either end up with their own health problems too, or the relationships breaks down. I don't have any stats on that, just from the situations I've seen. When your partner keeps saying they are sick but the doctors say they are fine it looks like they are lazy and unwilling to pull their weight;  leaving may feel like the only option for some if this goes on over time.  I refer to Soeun's sickness as '"our sickness" which sometimes ends up being confusing, but its a mindset I find helpful.

Its only in recent years I've had counselors who listened first and found out the actual issue. My pain was seen, they used words like grief and trauma. At the time, all those years ago I didn't know how to explain it, and the only help I received didn't seem to have any positive impact. 

If its a choice between divorce and PTSD, I'm happy to take the trauma. But hopefully there is something in between. If you know someone in this situation it might help them to find ways to work out what is happening for them emotionally.  In last month's linkup I wrote about this under Allowing Emotion and posted some grief resources which might be helpful.

 Photo by Tony Rojas on Unsplash