The Unbreakable Hope

Hermit Season

On February 18, 2021

A winter storm hit Texas last Thursday and it’s unlike anything I’ve ever seen. Temperatures have plummeted to historic lows, numbers of which are unheard of in my hot and humid neck of the woods. With over 4 million Texans suffering through power outages, my access to wifi and central heating feels like winning the lottery. I’m living every moment as if it’s my last with power and electricity because frankly, it very well could be.

I’ve spent the past three days huddled by electrical outlets while consuming alarming amounts of hot tea, mentally prepping for my next meal and its alternative, if need be. Classes are canceled, as is physical therapy, so I’ve been stuck at home like everyone else, racking my brain for ways to make the most out of this unexpected holiday.

There’s an odd feeling of familiarity within this situation, a sense that I’ve done this all before. And in a way, I have. Not with frosty terrain and winter weather warnings, but with an illness that made me housebound and a pandemic with lockdowns of its own. I’ve learned how to tolerate isolation, how to cope and even thrive within its catalog of restrictions, and at this point, I’ve become a seasoned hermit, a skill that’s boded me well this past year.

I find it almost amusing how POTS is no longer what’s keeping me inside these days. Now, it’s a historic snow storm, covid-19, and online classes that keep me locked up for days at a time. As I continue to recover and heal from chronic illness, there’s no “regular life” I can return to, no normalcy I can acclimate myself with or strive to finally attain. I know I said it’s “almost amusing,” but the longer I remain isolated, the words ‘frustrating’ and ‘lonely’ also come to mind.

Often, I joke that POTS prepared me for the pandemic, with all those days spent chained to the couch doubling as a weird bootcamp of sorts. I joke that I had a sixth month head-start on all my peers, building up the endurance required for a year of quarantine and isolation. And while it is true that POTS taught me how to be patient and nurture hope, covid-19 made my small world even smaller, and the limited contact I had with friends become even more scarce and constrained. These days, when I get cabin fever, it’s nearly unbearable; it’s as if I’ve been isolating in double time.

Picture of the snowfall from my walk yesterday, which was brisk in every way.

Spending most of my time at home, in a space that is comfortable and tailored for my body’s needs, it’s easy to find the outside world increasingly more overwhelming with its loud noises, busy freeways, bad drivers, and precariousness. At home, my meds and salty snacks are right where I left them, and anything I might possibly need is always within reach. I can pace myself easily, rest whenever needed, and I never have to worry about pushing my body beyond its limits. I feel safe at home, comfortable at home, and yet I can’t help but worry all this time in isolation is only prolonging and delaying my integration back into the “real world.”

I have to admit I’ve grown a little scared of the “real world.” When I developed POTS, I also developed an anxiety more acute than I’ve ever known. Once a daredevil child who flipped off diving boards without second thoughts, I’m now easily frazzled by things as simple as the local grocery store at peak hour. Small changes in my routine are enough to send me spinning, and while I used to consider myself a social butterfly, I now find myself sweating when I have to respond in the group chat. POTS has implanted a fear that runs deep within me, and now I can’t help but constantly anticipate the next flare or episode or trip to the emergency room. I can’t help but hate POTS for that, and all the other ways it’s altered me to my core.

I’m discovering recovery is as much of a mental endeavor as it is a physical one. It’s as if I’m having to rewire my brain, training it to trust my body and self again. Living with a nervous system that’s chronically hyperactive, I have to constantly coax myself out of “fight or flight” mode. Every day, I try to convince my body there’s no danger it needs to brace for.

As dispiriting as it can be to recover within isolation, it’s been a relief to watch the outside world slow down alongside me. Now, the world pulses in a rhythm much closer to my own, and it’s allowed me to take my time as I trudge through the gnarly work of healing. Now, I’m not the only one opting for another night in, becoming more and more socially awkward as the many days go by. Though I wouldn’t exactly call my situation “ideal,” I know it could be worse in an abundance of ways.

This time at home has allowed me to recuperate at my own speed, removing the temptation to “keep up” with everyone around me. It’s let me gradually ease myself back into a life that has deadlines and structure, while also giving me ample time to read and write–two things that sustain me. Because covid-19 has forced most universities to shift online, I’ve even returned to school as a full-time student, which happened sooner than I expected. As tired as I am of isolation, it’s provided me with a unique opportunity to focus on my recovery.

I know, eventually, there will be an end to all of this hermitting. The snow will melt, the pandemic will subside, and classes will be held in person again. I’d like to think there will be a day where I’ll forget how it felt to be this isolated. But until then, I’ll continue to make the most of all this time alone. (Which right now, if I’m honest, means watching Ted Lasso every night.)

May the power, WiFi, and central heating be with you,

Alli

Champion Park

By howellsalli

On January 16, 2021

In Uncategorized

Last week, I had an annual check up with my internist. She reviewed my yearly blood work before conducting a brief physical, doing what primary care physicians typically do during regular, scheduled check-ups. In retrospect, there was nothing to be nervous about, as the appointment was just for checking in, nothing new. But three hours beforehand, I felt that familiar fear creep out of hiding, the one that’s painfully festered throughout these past two years.

I seem to remember almost enjoying going to the doctor’s as a child. With their impressive supply of stickers, it was kind of hard not to. But I think it was because there was some element of it all that always felt like a field trip of sorts. I was never a regular there, at least not yet; I was simply a visitor who showed up once, maybe twice a year, mostly to confirm that I was still completely healthy.

In those days, there was no ailment I brought in that the doctor couldn’t quickly fix or understand. My pediatrician was for strep throat and flu shots, and I hadn’t yet traveled into the realm of Western medicine that isn’t designed for complicated chronic issues. In those days, I hadn’t yet developed finger tremors or muscle twitches that confused and puzzled my knowledgable doctors. I hadn’t yet felt the terror of staring down the long, dark road towards a diagnosis.

I miss that trust I used to have in my body, the trust that I’d swiftly recover from whatever came my way. I miss having ailments that could be fixed with a simple round of antibiotics.

These days, the doctor’s office fills me with dread. I guess that’s just what happens when you’ve endured enough medical testing. Oftentimes, I’ll try to reason my way out of the panic, telling myself things are better now, that I’ve survived the hardest part. Even so, my logic typically fails me; the memories are still too strong.

By now, I’ve learned to stop fighting against these feelings. With the help of my therapist, I’ve practiced letting them come and letting them go, giving them the space they need to arrive, as they inevitably will. It’s another exercise of surrender, a releasing of the illusion more commonly known as “control.”

On the car ride there, I felt the awaited dread rise within me. I tried to tune it out with my calm meditation music, but the two clashed in a minor key; the dissonance was striking. The dread felt thick and aggressive, like waves from a raging sea, and the salty water filled up my car, all the way to the brim. With shaky hands and a shaky breath, I tried my hardest not to drown.

When I arrived, I took a deep breath before stepping out of my car. I straightened my denim jacket as if it were my armor. Alone and scarcely armed, I walked through the automatic doors.

I arrived at the office, found a chair, filled out forms. Before I knew it, I was standing on a scale, then sitting in the exam room with a blood pressure cuff wrapped tightly around my arm.

It wasn’t long before my internist walked into the room, carrying a warmth that neutralized some of the chill from that afternoon. After a round of small talk, she reviewed my blood work and declared I’m essentially “a healthy young woman, with POTS”. My shoulders relaxed a centimeter.

She stood up, began the physical exam, but not before commenting on my reusable liter water bottle–a staple accessory for anyone with POTS. “I never leave the house without it,” I joked. “You’re doing everything right,” she responded, with kindness and care.

Throughout the past year, I’ve learned how to take good care of myself, but still, that sentence filled me with relief. The invisible mountain of bricks on my back disintegrated, drifting to the floor like a cloud of dust. I took a deep breath, mostly because she told me to, in order to check my lung function, but it was partly involuntary too; for the first time in that examination room, I could breathe again.

My internist released me from the appointment with the remark, “no torture for you today.” She was referring to blood work and other medical testing, and though it was a joke, it rang true. With the feeling I’ve paid, if not surpassed, my medical dues, I collected my bag and gigantic water bottle. I let the door of the exam room shut swiftly behind me.

Walking out of that appointment, I nearly strutted down the hallway. I felt strong and resilient, as if I’d just slayed a thousand dragons. I think, in a way, I did. With shoulders squared and a head held high, I relished in my quiet victory.

Climbing back into my car, I took a moment to regroup. Even on a good day, that office is disorienting, with or without new covid-19 protocols.

My internist’s office is the place where a doctor first spoke the name “POTS” to me. It’s the place I’ve returned to again and again throughout this journey, each appointment a major checkpoint along the way. My internist is also the doctor who coordinates all of my care, and though this seems like it would provide a sense of structure and stability, in reality, I’ve found it does the opposite.

Because POTS affects my nervous system and because the nervous system controls, well, pretty much everything, my collective symptoms of heart palpitations, dizziness, GI distress, and more, each require specialists of their own. It takes a village to treat POTS, from neurologists to cardiologists to gastroenterologists, allergists, and more, and my internist is typically the one writing the referrals, shipping me off to my many specialists. This contributes to a sense of disorienting, fragmented care, and I now see seven specialists to help manage my condition (not including my PTs, my therapist, and my dietician.)

That office holds so many different versions of myself, and each time I return, it’s like bumping into all of them at once. They fill the stuffy waiting room, taking up space in the chairs next to me. It’s almost as if they’re all frozen in time, suspended in their silent suffering. I want to reach out to them, lock eyes, hold their hand.

There’s the 18 year old who was struggling to recover from mono; the tired musical theatre performer wondering why she’s tired all the time; the scared college student that sensed something was wrong; the exasperated full-time patient who was desperate for a diagnosis; there’s the freshly diagnosed college drop-out, fumbling around in the dark. And then there was me: the one who’s found her footing, who made it to 2021 somehow.

It’s a lot to walk into, and it’s a lot to leave behind.

I wish I could tell each of those versions of myself that I have finally made it to the “maintenance stage.” That all the medical testing does in fact end, that she will find the answers she’s fighting for and learn to live in the unlivable. I wanted them to know there’s a part of the story where it really does all get better, that I’m in it now, the falling action, living in an ending she dreamed of but didn’t know how to reach.

In the driver’s seat, I attempted to collect my scattered thoughts, trying to settle into my new reality: the one where not all doctor’s appointments are traumatizing.

Putting the car in reverse, I drove to a nearby park where I celebrated with a short walk and sitting meditation. It’s a treat because I’m well enough to do this now, but also because anything is a celebration if you label it as one. I’m learning there’s a lot of power in that. Celebration is a powerful thing.

As I pulled into the parking lot, there was a boulder engraved with the name of the park. The sign read, “Champion Park.” I smiled to myself, chuckling a little, because it could not have been more fitting.

I am a champion, and I felt like one too.

Here’s to Hoping

By howellsalli

On January 2, 2021

In Uncategorized

At the beginning of 2020, I couldn’t stand for longer than 4 minutes. My life consisted of physical therapy, hours of Netflix, weekly visits with my therapist, and the occasional trip to the park.

Picture of my mom and me with lunch from P. Terry’s, taken after PT. #PTafterPT

I wasn’t in school, my mom drove me everywhere, and showers were vicious tasks that felt borderline impossible. I came into 2020 nursing a speck of hope that one day, I might eventually get better, but that was all it was—a speck. The rest of me was terrified, and rightfully so.

Left: picture of myself with face mask and sunglasses, the standard pandemic gear. Right: picture of myself lying down after said vicious shower.

When the pandemic hit, my life hardly changed. It felt as depressing as that sentence sounds. Having spent the 6 months prior debilitated and confined to my couch at home, 2020 was a year of even more isolation. I’ve never felt as lonely as I did this year.

Picture of myself at Vanderbilt hospital for a follow up appointment with my POTS specialist.

2020 was a year of grief and short tempers and learning how to be angry. It was a year of simultaneous suffering, everywhere, all the time. It was a year of trying and adapting, a year of growth and progress and recovery. It was a year of slow, quiet healing, and learning that healing is actually really hard.

Left: picture of my mother and me with masks on at a walking trail. Right: picture of myself with POTS brownies to celebrate hitting 4500 steps.

‘Twas was a year of overwhelm and underwhelm, the two curiously intertwined. It was a year of picnics and salty snacks and no fomo and no hugs. It was a year of eating take out in parking lots and by takeout, I mean P. Terry’s. It was a year of remembering, of rebuilding my life, of late-night writing and journaling.

Picture of myself with P. Terry’s bag for #PTafterPT.

It was a year of learning how to live with POTS and learning how to live without it, too. It was a year of bluejays and butterflies, cauliflower pizza, books, and blogging. It was a year of baby steps and giant leaps, of gazing starry-eyed at the moon and watching trees wiggle in the wind. More than anything, it was a year of holding tightly to hope, so much so, I dedicated an entire blog to it.

Picture with my father and brother taken December of this year.

I asked 2019 to be kind and it wasn’t. It was the worst year of my life. I asked 2020 to be different (whatever that meant) and good God, did it deliver. Maybe 2021 is the year I stop asking years to be anything at all, but here’s to hoping anyway.

Picture taken at Red Bud Trail in Austin, Texas.

2021, may you be a little more tame, a little more sane, and filled with more and more light.

Published first on my instagram, @allihowellsatthemoon.

In Another World

By howellsalli

On December 19, 2020

In Uncategorized

It was a Monday, I remember. Crisp and cool and cloudy. The gloomy sky casted a layer of darkness upon the house, but the clouds would later part to reveal a glorious winter day. Weather-wise, at least.

I started my morning with peanut butter and banana oatmeal, a meal notorious for making my POTS worse. It’s because of the carbs and unexplainable food sensitivities, but a year ago, we didn’t know this yet. We only knew that it increased my symptoms and we wanted all my various symptoms present for testing that Monday afternoon. So, breakfast was planned accordingly.

The directions said to shower before the appointment, so naturally, I obeyed. Doctor’s orders. I threw on baggy clothes as per requested, and when I was done, I crawled to the living room couch, where I blocked out the world with a Netflix documentary. Well, I tried to anyway but quickly failed as my eyes kept searching for the clock.

At noon, I was scheduled for autonomic testing. A medical technician in a room worlds away would conduct four series of tests to observe my autonomic nervous system. These tests would measure my nervous system’s ability to regulate sweating, blood pressure, and heart rate, hooking me up to various wires while strapped down to a Frankenstein-like table. All the equipment scared me, no doubt, but to continue to live without answers scared me even more.

Eleven o’clock came quick and my mother shepherded me to the car. When I made it to the front seat, I reclined to a supine position, my body’s favorite position, and turned the AC down as low as it could possibly go. My mother, who needs a jacket during August in Texas, zipped up her jacket and endured. She’s selfless like that, and I’m forever grateful for it.

When I arrived at the neurologist’s office, I seemed to be the only one who was ready. A four month wait will do that to you, so I watched office staff hurry about from a cushioned chair in the waiting room. It’s funny really, waiting four months for a doctor’s appointment only to sit in a room designed for more waiting. That’s perhaps the hardest part of any diagnosis journey, waiting in the wreckage of an old life, loved and lost.

I wasn’t necessarily hoping for a diagnosis, except at this point, I pretty much was. It was more so that I was tired of wasting away in the Land of the Unexplained. While waiting on referrals and medical testing that was apparently in high demand, my sporty build had left me as my unknown condition worsened. As my inability to tolerate daily life grew, I felt like a shell of my old self, a vibrant girl withering away. Once, while watching television, I looked down and couldn’t recognize my legs. The strength I’d built up from ten years of swimming had gradually waned away, and to my horror, my legs now resembled twigs.

Those days, I was always so close to breaking. One harsh gust of wind, and–snap.

Eventually, the nurse called me back, taking my vitals before wiring me up. When I stepped on the scale, I noticed I’d lost ten pounds and in a weird way, I felt almost relieved. It was strangely comforting knowing some of my loss could be documented, not only my loss of weight but of my vibrancy, strength, and energy too. The numbers would get written down, saved forever in my medical chart, serving as some kind of evidence that I was no longer all I used to be, that I had lost some of myself in this lengthy, cumbersome journey.

That’s perhaps the hardest part of any diagnosis journey, waiting in the wreckage of an old life, loved and lost.

As the testing began, I felt thumping so strong it seemed to shake me. I chalked it up to likely footsteps of a busy nurse out in the hallway, but after several minutes I wondered whether the thumping was coming from somewhere within. My heart, it seemed, was revolting. Its pounding was almost painful.

Lying there on the medical table, I braced myself for what was to come. The autonomic testing would conclude with a tilt-table test, the most brutal test out of the four. From my supine position, the table would be raised to simulate standing, and over the span of ten minutes my heart rate, blood pressure, and symptoms would be recorded, unless, the technician explained, I fainted. If I fainted, the test would be stopped prematurely. I didn’t know which outcome to hope for.

Graphic explaining how Tilt-Table Tests are conducted.

For an average, healthy person, a tilt-table test is no big deal. Their body adjusts to the pull of gravity by constricting blood vessels in the legs, properly sending blood back to the brain with only a marginal increase in heart rate. For a person with POTS however, this test is borderline torture.

Not even a minute into the test, I began to struggle against gravity. Sweating, shaking, unable to breathe, I squirmed beneath the table’s restraints as each of my symptoms were recorded by the technician. I called them out, plainly, the way he asked me to. “Dizzy. Heart palpitations. Shortness of breath. Fatigue.” Later, I would learn, my heart rate was soaring at 150 bpm.

Strapped down to the table, there was nothing to hold onto. I had to find something internally instead, some invisible inner railing that would support me and the weight of that afternoon. As my heart hammered on, I began to translate each pulse; every beat of my heart was my body battling to keep me conscious and upright. For a moment, I felt thankful. I have never felt my body fight for me the way it did that day.

Around minute five, in a moment I can only describe as dreamlike, I looked out to the wall I was now facing, only it wasn’t a wall. It was a window. It had taken five minutes before I realized that in the raising of the tilt-table to a steep 70 degrees, I was now directly facing a giant, glorious window. Before me, there was a golden, shimmering tree, and its leaves shook in the strong wind like confetti for a celebration. For a brief second, it looked as if the leaves were waving at me. From the depths of rock bottom, I said a silent hello.

Staring at that gold tree, a sense of calm swept over me. In the cold, clammy doctor’s office, I found a trace of light and beauty. It was an unthinkable event, unnatural even. And for the rest of my life, I will never forget the way that tree muted my screaming heart. It gave me a minute of peace in a moment of hell and even still, a year later, trees everywhere do the same.

We were told the testing would take about two hours, but in the end, it was closer to four. Walking into that office, I had little left other than slivers of hope and sanity, but walking out, I carried pamphlets and at long last, a diagnosis. After two years of living in utter fear and confusion, I finally had a name to my bizarre collection of symptoms: Postural Orthostatic Tachycardia Syndrome.

Not only did my diagnosis give validation to my invisible illness, but with it came a plethora of resources that were essential in my recovery. I now had access to physical therapists, dietitians, school accommodations, and more. I also now had an explanation for when people asked me, “What’s wrong?” While for some, a diagnosis feels like the ending of a life, for me it was more like a beginning, a chance to one day live again.

This time last year, I was strapped down to a medical table with wires and electrodes glued to my skin. It was yet another diagnostic test that would be my last in a soul-sucking series, and I was scrambling to hold onto my sense of self within the exhaustion and medical machines. It’s been a year now of officially living with POTS and I’m delighted to report I’m doing much better now. When I think about how I feel towards my progress and recovery, “gratitude” doesn’t even begin to cover it; it is relief at a visceral level, an infinite stream of thank you thank you thank you.

A picture of me from October 2020, walking around Centennial Park.

Last Monday, I drove up to the pond near my house. I like to go there a lot and, well, look at trees… On my way there, I passed my neighbors who were collecting their mail at the mailbox. The two young girls, maybe six and eight years old, wore the kind of matching, neon jackets that only young children can pull off. They jumped up and down with glee, ecstatic about a simple errand shared with their mom. It was a moment that moved me to tears, but not in the way you’d think.

For a split second, I imagined them all grown up and strapped down to a medical table. Unable to hide my horror at the thought, tears poured down my cheeks as I (dangerously) unraveled behind the wheel. So clearly, I could see them hooked up to wires, awaiting a tilt-table test in all-consuming fear. I pictured their mom fidgeting out in the waiting room, wondering how she and her baby girl wound up in a neurologist’s office on a sunny Monday afternoon.

It’s possible those girls might get POTS one day, too. I hope to God they never do.

But if they do confront fates similar to mine, I would want them to know it gets better. It gets a whole lot better, even when it’s still hard. I would want them to know they’ll never believe how strong they will become, or how much joy can be found in the simplest, smallest things. I would want them to know this illness will change them in every possible way, and although they might resent that for a little while, eventually they’ll learn it also sets them free. More than anything, I’d want them to know about hope. How it saved my life and has the power to save theirs too.

If I could, I would tell all this to the version of myself strapped to that tilt-table, too. I’d kneel down to the side of that Frankenstein table, holding her hand through all she is about to endure.

In another world, I do.

Grief and Gratitude

By howellsalli

On November 27, 2020

In Uncategorized

Thanksgiving is universally weird this year and truth be told, I’m relieved.

I don’t think I had it in me to participate in a normal holiday season, sitting around tables full of food I can’t eat, trying to resurrect old traditions that were made by a much different version of myself. These days, traditions only remind me of how much I’ve changed, how much of my old life I’ve had to let go of, and how much my dysfunctional body continues to reject typical norms.

Picture of a sad turkey, in appropriate 2020 fashion.

Today is the national day of food and I’ve found myself nursing a flare of stomach issues. This is fine because I can’t eat large, glutenous Thanksgiving meals anyways, but nevertheless is a painful reminder that chronic illness gives no days off. POTS is my annoying plus-one to everything, showing up uninvited but aggressively announced.

Today is also the national day of giving thanks, which brings up complicated emotions for me.

I have a lot to be thankful for. Rarely is this lost on me.

I’m thankful for my family, for their big smiles and enjoyable company. I’m thankful for their good health as well as the improvement of my own.

I’m thankful for friends that send kind texts and funny TikToks. I’m thankful they choose to stick around, despite the many years passed or the miles between us.

I’m thankful I woke up this morning, that I saw a beautiful bluejay in front of my home and heard him call out to me.

I’m thankful that I’m still here.

I’m thankful that life got better.

But whatever I am grateful for, there is grief there too.

While I am grateful that unlike this time last year, I now have a diagnosis for my collection of symptoms, a name to my pain that unlocked life-changing resources, I am also devastated that I needed a diagnosis in the first place.

While I am grateful for my therapist, as well as my physical therapists, my dietician, my doctors and anyone else that helps me be well, I am also filled with heartache that it took two years of medical trauma in order to find them.

While I am thankful for all I have learned from POTS, for the wisdom found within hardship and the knowledge of how to take care of my body, I am also deeply sad that it’s been three years of symptoms, tainted holidays, and enduring what should be fun events.

My gratitude and grief exist together, intertwined. They are a package-deal that can’t be separated, and believe me, I’ve tried. But I have found that when I stifle my grief, my gratitude weakens, becoming diluted and flimsy. Without my grief, my gratitude means little, and without gratitude, I only have grief.

So on this national holiday dedicated to Thanks-giving, I try to make space for my grief too, alongside all the other emotions that aren’t traditionally acceptable at holiday gatherings. I invite grief to the socially-distanced party, set a place for it at the table, letting it know it’s welcome here, with me.

Wanna Trade?

By howellsalli

On November 15, 2020

In Uncategorized

Yesterday, a worker at Whole Foods caught my eye. It wasn’t so much that I was attracted to him except yeah, probably a little. It was more so that I was attracted to what he was doing: standing outside the store’s entrance, sanitizing grocery carts and noting how many customers walked through the doors.

Fascinating, isn’t it? Just enthralling, right?

Kidding, though only partly because I actually was intrigued.

I was intrigued because as he leaned against the wall, drumming his fingers on the beige concrete, I was peering out my car window, thinking of all I would give to trade places with him.

He probably didn’t know his job is a challenge for someone like me. He was probably unaware that while he was standing in the sun with ease, I was watching from afar, boiling with raging envy. Frankly, he probably takes his whole gig for granted, and for that, I really can’t blame him.

I know with absolute certainty my old self would’ve done the same. Without even closing my eyes, I can see 17-year old me leaning against that wall, checking my phone periodically, willing the time to move faster. Years ago, I was unaware that standing is a privilege, that it could and would be stolen for me, over and over again. My old self took it all for granted too, each and every day, and to that I say, of course she did. She didn’t know how much she could lose.

Even so, in my envious state, I’m convinced if it were me in that job, I’d cherish every minute of it. My yearning persuades me that for the rest of my life, the art of standing will never be lost on me; that every successful hour on my feet will feel victorious, euphoric even. I know I’m being generous, and eventually the novelty of standing will wear off. But staring at that Whole Foods worker on a warm Friday afternoon, I felt assured that what to him is probably considered mundane, will forever feel miraculous to me.

It is worth noting my stop at Whole Foods took place following a physical therapy session, so POTS was certainly heavy on the brain. But it always is, that’s nothing new. POTS is with me wherever I go.

I’m aware, all things considered, that I could do that job, right now, if I wanted to. I’d need a stool, maybe a fan, but I could do it. And that would be okay, to need a stool or other accommodations, except that I don’t want a stool. I want to stand in the sun in front of Whole Foods, greeting people for hours until everyone went home. And I want to feel well, up on my feet, without the dizziness and high heart rate that usually ensues. And I want to leave that shift without feeling utterly exhausted, and I want to wake up the next day and do it all over again.

I want to do that job and I want it to be easy. I want to feel so well, sanitizing those carts, that I dare to bravely deem myself bored. I want to feel so normal, standing there in the glorious sun, that for the first in a long time, I take it all for granted too.

If I were more brave and cared less of what others think, I would tell people these things. I would walk up to them and scream into their face, “Don’t you know how lucky you are?” In my daydreams, I do.

But in real life, I sit inside my car, nursing my longing, swallowing my rage. I fiddle with the radio, tuning out words I never say, waiting for my mother to eventually return with the groceries.

She does, puts them in the trunk, I put the car in drive. I hear the click of her seatbelt next to me, and then, we drive away.

What POTS Looks Like: Making the Invisible Visible

By howellsalli

On October 25, 2020

In Uncategorized

If you passed me on the street, you’d probably think I was a normal 20 year old girl. Well, actually, you’d probably think I was a normal 16, 17, 18 year old girl because I’m short and little and have a young face. (I get mistaken for 14 year old more than I’d care to admit…) Either way, if you saw me on the street, you would assume I was like all the other young adults you know: immature, maybe a little irresponsible or reckless, but nonetheless, fully healthy and able-bodied.

You wouldn’t know I had a disability that makes walking a challenge. You wouldn’t know that I can’t stand in showers, eat large meals, or that it takes an average of three hours every morning before my body tolerates gravity. You wouldn’t see me in an hour’s time, stretched out on the couch because outings wear me out. You probably wouldn’t even know about POTS and to that I’d say, “lucky you.”

But even if you knew I had a disability, you might still be confused because my disability doesn’t look the way you’d expect it to. I don’t have crutches or a wheelchair to symbolize my limitations (although some people with POTS do use wheelchairs), and I can walk to some extent, as long as I’m not in the middle of a flare. However, my ability to walk is limited and fleeting, and all it takes is a big lunch, a rough night of sleep, or ten minutes too many in the bright, hot sun before this privilege is taken from me. In this way, POTS is a series of losses over and over and over again.

Graphic of what different types of disabilities can look like, created by StandingUpToPOTS.

Living with an invisible illness often feels like living a double life. With clean clothes and a full face of makeup, I can pass as a vibrant, abled young person, and on a good day, I feel like one too. But makeup or no makeup, POTS is with me wherever I go. There’s no universal sick or disabled “look”. POTS can look like anyone; POTS looks like me.

Sometimes I feel grateful that my illness is invisible. It gives me the freedom to pretend, the ability to delude others into thinking I’m as well and able as them. Other times, it feels burdensome, like a dark, twisted secret, and I find myself tempted to tape an “OUT OF ORDER” sign to my front, craving some kind of tangible way to make my illness visible, validated, and seen.

Graphics created by StandingUpToPOTS, explaining the chronic, invisible nature of POTS.

Before my diagnosis, I struggled a lot with the discreet nature of POTS. It was so discreet in fact, even my doctors couldn’t see it. It took over a year of sorting through patterns of symptoms before I landed in the right doctor’s office with at last, the right diagnosis. The subjectiveness of POTS symptoms (such as dizziness, fatigue, and nausea to name a few…) perpetuates the disease’s misunderstood nature and frequent misdiagnosis; for over a year, I battled against thoughts of, “what if it’s all in my head?” and, “what if they don’t believe me?”

But for an illness that is invisible, POTS physically manifests in many ways. It looks like salt tablets and medication bottles and stacks of broth in the pantry. It looks like compression stockings, electrolyte tablets, sitting on curbs and nearby benches. It looks like liters and liters of water, fit-bits and heart rate monitors, even the towering stack of journals in my bedroom. POTS isn’t as noticeable as crutches or a wheel chair, but it’s evident if you know what you’re looking for.

Picture of various medical devices and foods that help manage POTS

Despite this subtle visibility, I often I feel like I divide my time between two separate identities; one that’s neat, energetic and socially acceptable, and one that’s hidden, drained, weary, and spent. There’s the raw, gnarly side of me that only my couch and immediate family see, typically at the beginning and end of my day, and then there’s the presentable part reserved for strangers, friends, and brand new acquaintances. When I’m all dolled up, I look as healthy and able as anyone. But at times, a face of makeup feels like a mask, my clean clothes a costume for someone more well than me.

Sometimes POTS makes me feel like Hannah Montana, although admittedly less like a rockstar and a little bit more like a fraud. Coming home from outings with friends, the bubbly, chatty version of myself slides off like a wig, falling away once I’m within the safe walls of my home. Shuffling to the couch, I begin to claim my second self, feeling my personality abandon me as my body hits the worn out leather. During that swift moment of transformation, I’ll wonder which persona is closer to the truth, and how much of my character is merely an act.

Picture of Hannah Montana, a character on a television show that was popular on Disney Channel.

Not many people see this version of myself. They see the side of me that’s well enough to attend the party, the outing, the lunch with friends. Coming home to this drained part of myself often feels like coming home to a festering secret, and for a while, these identities felt separate and conflicting. I was convinced that the existence of one identity completely invalidated the other, that I couldn’t be the bubbly person I’ve always known myself to be and the depleted girl I’m left with once my illness takes the reigns. But the longer I navigate life with POTS, the more I understand that they are connected, that I am both. And with time, I have learned that I’m not the only one that lives this way. That all of us carry struggles that are camouflaged within.

We all harbor some kind of hardship. We all inhibit this Earth with pain that’s cloaked, covered, and concealed.

I used to think my invisible illness made me less-than everyone else, but really, if anything, it’s made me more like everyone else.

Big thank you to StandingUpToPOTS for creating the helpful graphics used in today’s blog and for expending consistent effort to raise awareness about POTS.

Snotty Sob Sessions

By howellsalli

On October 6, 2020

In Uncategorized

With it being the beginning of Dysautonomia awareness month and having had a pretty rough flare this weekend, POTS has been on my mind a lot lately. (Or at least more than usual, I should say.)

Because of this, I found myself knee-deep in a big, fat, snotty sob session this afternoon. It was as if the pitch-black rain cloud that’s been steadily building overhead parted, dropping bucketloads of rainfall on parched, crunchy land. It was the kind of cry that feels like a workout, that drains you but leaves you feeling lighter. Emptier too.

I cried because as much as I preach about hope, I still can’t believe this happened to me.

I cried because as proud as I am of my resilience, I’m exhausted of hearing the words “you are so strong”.

I cried because POTS is a lot to manage and tears are just the inevitable outcome of living with a disabling, chronic condition.

I cried because I don’t know what it’s like to go to college without ER visits and doctor’s appointments and dizzily wandering through hospital corridors alone.

I cried because some people get mono and get over it. Because they’re not on their third year of chronic illness, trudging through thick mud and grief on the twisty road towards recovery.

I cried because chronic illness is too much to deal with, and it’s lonely and isolating and even after all this time, scary.

I cried because if it weren’t for POTS, I would still be a music student, learning vocal scales for school, growing, refining, and polishing my craft.

I cried because progress is still so hard, even when there are people who congratulate and applaud you.

I cried because sometimes moving forward feels like a curse, because I have to bring all of this brokenness with me–this dysfunctional body that’s been through hell with its muscle twitches and tremors and dizziness and fatigue.

I cried because even though I’m doing better, recovery is still so tough.

I cried because on a bad day like today, POTS feels simply impossible to live with.

Today I also cried for everyone else who knows the pain of POTS. Who knows its physical, emotional, and spiritual toll, who’s participating in Dysautonomia awareness month right alongside me.

I cried for everyone who came down with one little virus and spent years of their life trying to recover.

I cried for everyone who’s left jobs, careers, schools and universities in order to prioritize their health.

I cried for everyone who’s sacrificed dreams, plans, and social events in order to tend to and cope with their illness.

I cried for everyone who’s ever had to choose between seeing a friend and taking a shower, who’s suffered through flares in dark rooms, alone.

Mostly, I cried for everyone who knows how much one single virus can change a life forever.

I don’t share this blog post as a way of seeking attention or praise. I share it because in order to truly raise awareness about a misunderstood disease, I must first be transparent about the reality millions of people face around the globe.

Chronic illness ain’t easy. It’s about as fun as it sounds. And I am a big believer in the power of positivity as well as the steel-like strength of unbreakable hope, but that doesn’t change the fact that chronic illness is a beast. A gruesome monster I, along with millions of others, never asked to meet yet live with day after day after day after day.

If you’ve ever battled the bullies disguised as disease, know that I understand. That I rage and cry with you, and for you.

I know how much of a warrior you are, and let me be frank–that’s not a term I use lightly.

A Year Ago

By howellsalli

On September 26, 2020

In Uncategorized

Yesterday was September 24th. I woke up, took my meds, ate breakfast and started on school work. It was a typical, ordinary day for me, filled with online classes, PT exercises, and journaling in my spare time. I’ve gotten used to both working at home and my dysfunctional body, and I’m settling into the “new normal” I once swore I would never obtain.

But this time last year, September 24th was anything but ordinary. It was a hard day that was chillingly easy, the day I moved out of my college apartment and officially withdrew from the university of my dreams.

I look back on this day with a stabbing pain inside my heart. A year ago, I was riding in a car packed to the brim with my fragmented life. Suitcases were arranged like Tetris in the trunk, stuffed with outfits I’d never wear for memories I’d never make, along with college spirit gear I suddenly had no use for. I was headed towards home, where I’d wait on referrals that were months away, wondering what would become of me while I wandered into unchartered darkness.

A year ago, my mother was overseas when I called, when I sputtered out the words, “met with my advisor”, “decided it’s best”, and “I can’t do this anymore”. I felt the words crawl through the phone, heard them plop out the other end, rippling across the vast Atlantic Ocean. Instead of catching a flight to Nice as planned, she booked a last-minute trip to Nashville instead, cutting her well-needed vacation short in order to help her debilitated daughter move out. She should’ve been walking along pebbled beaches in Southern France, catching up with longtime friends, but instead bore the brunt work of loading up my CR-V.

A year ago, my roommates surprised me with a dinner party. It was really a goodbye party, the only one I’ve ever had, and maybe I’m biased but it was also the best, filled with joy and laughter amidst our heavy sorrow. It hadn’t set in quite yet, that I would really be leaving–for now, for forever, for who knew how long. Up until this point, I was too focused on survival, how to make it to the next moment, to the step, to the next seemingly impossible breath.

Picture from said dinner party. 503 girls forever <3

A year ago, I turned in my keys to the RA. For five weeks, that little dorm room was mine, filled with symptoms and sleep and phone calls to my mother. I watched as the RA quickly closed the door, feeling the rattle of the doorframe reverberate in my bones. She took the keys, turning the lock, and as she did, I heard a small knocking, coming from a piece of myself stuck behind that door forever.

A year ago, I stood in the kitchen of that apartment, fidgeting, stalling, doing anything to stretch out time. My roommates and I looked at each other from across the table, daring one another to be the person who said it first–that one word, those two syllables. “Goodbye”. “Good-bye”. If it weren’t for my condition, I could’ve stood there until the end of time, suspended in the last moment of my old life.

A year ago, I left a university I adored. I abandoned plans, hopes, dreams, versions of myself I never got to become. The frightening truth is how easy it was, how easy it is to leave when you’re left with no other choice. With a sturdy composure, I gave a final wave to my roommates, shutting the car door, saying softly to my mother, “maybe this is what it takes for me to finally get better”.

My roommates saw someone brave, calm, and collected that day, saw their friend facing the unimaginable with an emotional armor made of steel. But the truth is, that armor was fleeting; when the spotlight turned off and the audience went home, my epic costume unraveled, leaving me bare, naked, and entirely defenseless.

These days, I’m so focused on moving forward with my recovery that the act of looking back feels unbearable and draining. My healing still seems fragile, as if one wrong step will shatter all the precious progress I’ve made. I worry that if I’m not careful and wander too far into the past, I’ll get lost there forever, reverting back into my crippled state, becoming frozen in moments I worked so hard to get out of.

It’s been a year since that day and so much has happened since then. I feel like a different person now; stronger, sturdier, more sane from the rest that was long overdue. But in my weakest moments, I transport right back into that apartment, where the sorrow and pain were acute and so raw, where I’m still the girl who’s terrified of what her life has become.

I don’t have any words for that version of myself. No advice, words of wisdom, or genuine encouragement. If I could, all I would do is wrap my arms around her; tightly, like a promise, never letting her go.

We’re All In This Together

By howellsalli

On August 28, 2020

In Uncategorized

“What team?”

I hope you said wildcats.

Don’t know this reference? Why, that would be the one-and-only, iconic line from legendary crowd-pleaser and my personal childhood favorite, High School Musical: A Disney Channel Original Movie.

Gif of High School Musical cast jumping in graduation gowns.

Still confused? Well, I started my fall semester this week and the mild first day of school vibes on Monday had me rising a thick blue wave of nostalgia. High School Musical was a childhood staple of mine, and I walked into every school year secretly wishing it might reach the grand expectations set from the revered Disney trilogy. I never did get the tasteful cafeteria flash mob I was after (although I was a participant in multiple zombie flash mobs for my theatre department’s Halloween fundraiser. Not exactly the same thing…), or the angsty teenage romance with Zac Efron I’ve been wanting for years, but that’s never dulled my love for the iconic High School Musical movie. Or Zac Efron. Let’s be real.

Monday was easily the weirdest first day of school I’ve ever had, and if you would’ve told me nine months ago I would be beginning my sophomore year of college entirely online in the midst of a pandemic while battling POTS, I wouldn’t have believed you. Partly because there was a part of me that was truly terrified I’d never be well enough to return to school, but also partly because a pandemic? Really? No way. (Yes way, unfortunately.)

As I mentioned above, all of my classes are online this semester due to COVID-19, so the first day of school felt anticlimactic to say the least. Logging into an online seminar in the quiet of my childhood home doesn’t quite have the same effect that walking into a crowded, chatty classroom filled with new students and old friends does. As far as kickoffs for a new school year goes, this was easily the most underwhelming.

When I close my eyes, I can still remember my many ‘first days’ of elementary school. I can still smell the new Expo markers, the freshly sharpened pencils, the melting pot of scents that was the school cafeteria at lunchtime. I can still taste the Goldfish and fruit snacks that were tenderly tucked into my lunchbox, can still feel the peanut butter sandwiches on soft white bread glued to the roof of my mouth. Still, I can faintly hear the dull fog horn of the school bells, the squeals of children on the recess grounds, the rattling clatter of pencil boxes before they got worn and broken from careless use. These memories fill me with a heavy sense of warmth, and they’re the equivalent of a blanket wrapping around me on a winter night.

In these memories, I was fully healthy and able. In these memories, I ran around playgrounds and the school gym, dashing to and fro choir, orchestra, and theatre rehearsals, comfortably on my feet. Minus my senior year of high school, my time spent in primary and secondary school are mercifully untouched by chronic illness. I had not yet been knocked down by the beast that its POTS, had not yet been held back, reduced, or broken. I miss these memories more than I ever thought possible.

It’s both distressing and a relief that my life wasn’t always this way, that I didn’t always live with symptoms of some sort, with daily fatigue and discouraging limitations. These memories fill me with both grief and gratitude, with both joy and heavy sorrow. In this week’s wave of nostalgia, I find myself aching to go back for a day, for an hour, for a brisk minute in my body from before. I never thought I would ever say this, but I actually wish I could go back to public school once more, merely to bask in the ordinary that wasn’t ordinary at all.

In a way, these memories feel like a gift from my past self, an offering of respite I can return to as I move forward. These days, I find myself searching for the past in my future, trying to catch a glimpse in my reality of a life where I’m fully able and free. These memories are like a baseline I am trying to get back to, and also a reminder of how good and simple life can be.

It’s been a year since I’ve been in school, and a lot has happened since then. I’ve gotten diagnosed, I’ve spent nine months in a physical therapy program, and I’ve traveled into the crevices within me that are deep and dark and roughly jagged. Enrolling in school again, even if only online, feels like a triumphant switch from full-time patient to part-time, and it’s exciting to see a life, my life, finally building upon the rubble.

But alongside this excitement is a heavy grief of all I’ve lost. In these trying days, I know I’m not the only one who feels robbed of the college experience I wanted or planned for. I know I’m not the only one who mourns over the life changes that rippled ruthlessly through the masses this year. To those of you crying hot, angry tears over the changed plans you still can’t stomach, know that I’m crying with you. To those of you working your hardest to salvage what’s left of your school year, know that I see you and I understand. To those of you who can’t help feeling robbed or cheated of the year they worked so hard for, know that I am here, fuming right beside you.

In the wise words from High School Musical: “We’re all in this together”.

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