A blog about my experience with chronic illness and finding hope in the darkest days

Tag: electrolytes

Shivering in the Shower: Girl vs Heat Intolerance

The steam was blinding. I inhaled it like it was cigarette smoke, inviting the vapor into my lungs and feeling it relax every tense muscle, one by one. The warm mist was like nicotine, soothing and addictive, and I came back every night to get my fix, eager and greedy. I was hooked, I was obsessed, I was completely dependent on a hot shower to keep me sane. 

A hot shower used to be my daily ritual, my nightcap and melatonin, but more than anything, it was my happy place; I adored hot showers. I loved the clean feeling I’d wear for the remainder of the night, the soft smell of strawberry soap diffusing sweetly from my skin. I loved the warmth that radiated from my body for hours, feeling snug and cozy and tenderly taken care of. I loved everything the shower stood for: relaxation, serenity, peace. My nightly hot showers were dear to me, a privilege I understood to be a joy. A privilege that, due to a chronic medical condition, was swiped from my grasp over the course of a year.

I used to always say “there’s nothing a hot shower can’t fix”. And for a long time, I believed this to be true. It could sooth heartbreak, rejection, bad moods and bad days. It could ease sore muscles, clear out sinuses, effortlessly untangling twisted thoughts and feelings. But when I was diagnosed with a debilitating form of dysautonomia last year, my beloved hot showers couldn’t make it better. In fact, they only made it worse. 

In December of 2019, a grueling tilt table test confirmed I was suffering from Postural Orthostatic Tachycardia Syndrome. It’s typically referred to as POTS, partly because it’s a mouthful and partly because Big Long Doctor Words tend to freak people out. POTS is a benign condition, but don’t let the quirky acronym fool you; this disease derailed my life. I went from performing in three hour musical performances and juggling college courses with rehearsals to struggling to wash my hair or walk up a flight of stairs. This type of dysautonomia is typically characterized by racing heart rate and lightheadedness when the body is upright, due to a malfunction of the nervous system that poorly regulates blood pressure and heart rate. This makes walking or standing for moderate to long periods of time difficult and exhausting, and although this condition is not life-threatening, its debilitating symptoms are certainly life-altering. 

POTS is usually managed by increased salt and fluid intake, medications, and a modified, consistent exercise program, but it can be triggered by many different things. Warm rooms, hot days, standing up too quickly or lying down for too long. POTS can be triggered by dehydration, alcohol and hormonal changes, even from eating a moderate to large sized meal or particular foods. It doesn’t take much to send my heart racing, but heat is a consistent trigger for me. Within fifteen to twenty minutes of sitting in the sun, I begin to get tremors in my fingers, my heart rate increases, and I start to feel woozy and lightheaded if I try to walk around. This is because heat is a vasodilator, so the warmth causes my blood vessels to widen, encouraging blood to pool in my lower extremities and forcing my heart to work harder to pump blood to the rest of my body. Because of this, I’ve had to say goodbye to hot yoga, long days spent in the sun, tanning and sunbathing. I’ve said goodbye to saunas and hot tubs, most outdoor summer activities, and last but certainly not least, my beloved hot showers. Stepping into the shower at the end of a long day quickly went from a cherished stress-reliever and a therapeutic experience to a whirlwind of symptoms that sends me stumbling to the floor. 

A picture of me lying down after my shower, taken in May. I still do this often.

Within two minutes of standing in a hot shower, my heart begins to pound, my fingers start to shake, I struggle to breathe, and my feet turn purple. Afterwards, I’ll feel drained of all energy, dizzy and fatigued, and become glued to the couch for the remainder of the day. It still baffles me the way a simple activity can be such a challenge, and I’d be lying if I said I didn’t have a few colorful words waiting for whoever’s up top, in charge of the universe. But because of my stubborn heat intolerance, and because I’d rather not use all my energy for the day on a simple shower, I’ve been left with no choice: begrudgingly, I’ve adopted shorter, cooler showers and baths, sitting down in the shower in an attempt to avoid symptoms. Showers are now a “get in, get out” operation, and there’s no longer time or tolerance for things I used to cherish, like singing in the shower. As a singer and music-lover for as long as I can remember, this has been one of the hardest joys to lose. Frankly, I’d give anything to belt showtunes in the shower again. 

Because of POTS, I went from singing in the shower to shivering in the shower. I went from running and dancing and singing on stage to feeling completely wiped out from simply washing my hair. It’s been five months now of this new bathing routine, five months of temptation to turn the shower knob to the left, to claim back the heat and wash like I used to. Slowly, I’ve adjusted and gotten used to the chilly water, but there’s not a day where I don’t miss when showers were no big deal. When I could hop in quickly to start my day, or take my time and unwind for the night. I miss when they didn’t have to be planned strategically with my medication regimen, aching to go back to the days when I had no idea what a beta-blocker did. I miss when water temperatures were out of preference and shower lengths were out of pleasure, when my bathroom was a private karaoke bar instead of a harsh, challenging terrain tackled day after day. There’s no denying my new shower routine is by far more eco-friendly, but I miss the privilege of a long, hot shower; a privilege that used to be mine. 

These days, I can’t go outside without an ice pack or a fan. I can’t stand in the shower, take a hot bath, enjoy a long day at the beach, or sunbathe in the summer. Sometimes I feel overwhelmed by all the constant “can’t’s”. I get sick of the “used to’s”, of the “not right now’s”, of the “maybe’s”, and the “one day’s”. I feel like I’ve been waiting forever for the “one day’s”. For the day I’ll be able to stand in the shower again, belting and riffing to my heart’s desire. For the day I’ll run a mile and not think twice about it. For the day I won’t have to worry about hot days and ice packs and whether or not a lovely afternoon outdoors will spark a nightmare of symptoms. I don’t know if I’ll ever be able to truly express the strain of living restricted by your body, spending day after day dictated by an illness. I hope one day I’ll finally be free, and there is a part of me that’s brave enough to believe it, but sometimes “one day” feels perpetually far away.

But within the past few weeks, something beautiful has happened. I’ve noticed myself singing again, mindlessly, as I move about my house. A few nights ago, as I grabbed my pajamas and drew up a cool bath, I noticed myself humming an old favorite Taylor Swift song, something I haven’t done in quite some time. I stopped for a second, realizing it’s been over a year since I’ve had the energy to do this, to hum and sing like the music was a part of me, an extension of my spirit. To feel comfortable enough walking around my house, with fewer symptoms and much more ease, to express peace and contentment as music into the air. These days, thanks to physical therapy and my medication regimen, I’ve been able to move through the world almost how I used to, with lyrics and melodies and catchy tunes pouring out of me. For a moment I was struck by this facet of myself, the one that has energy for singing, for creativity and artistic expression, was here again, and it had defied the odds and risen from the wreckage of a life I loved and lost. It was a simple moment shared with no one but me, yet instantly I felt unified, whole, like all the broken parts of me were mending together. Like my emptiness was beginning to fill, like all the love I thought I lost was finally coming back to me. 

Sure, it’s still not singing in the shower, but I’d say it’s better than not singing at all. 

You get used to chronic illness, but you also never do.

It is a typical Tuesday morning, and my mother is knocking on my bedroom door. She comes bearing breakfast, carrying a vibrant red tray that holds a plate of fried egg and potatoes, a small, ripe orange, salt tablets and an electrolyte-filled water bottle. She’s wearing a smile and summons the sunshine, opening up my blinds to let the light in. “Good morning” she says, delivering a kiss to my head. She leaves me to wake up, and heads back downstairs.

I nibble on the kind food, waiting for my medicine to kick in before I can rush to the bathroom. I am grateful for her generous labor in the kitchen, aware of how much thought, time, and energy she put into making this food, but I also feel angry that I couldn’t walk downstairs and cook breakfast myself. I juggle this gratitude and resentment as I lazily circle my feet, stimulating blood flow and nudging my tired, cranky body to begin this new day. 

My mornings weren’t always so slow, and it didn’t always take an average of two and a half hours to get my body functioning, but everything changed after being diagnosed with a chronic, disabling health condition last December. Vaguely, I can remember the days where I’d spring out of bed, throw on my sneakers, and head out for a two mile run before school. Those mornings seem like ages ago, like memories that belong to someone else except they don’t. They’re still mine. I have to remind myself of this often.

 It’ll be at least another hour of circling my feet and waiting, an hour of getting up just to sit back down all the while chugging oceans and oceans of water. I’ve gotten pretty good at filling the minutes, taking up journaling, meditation, and games of Words With Friends, but some days I can’t help but loathe my demanding illness and the way it steals time from me, daily. Some days I’d trade the extra hour in bed in a heartbeat for those dingy sneakers and early morning runs. Some days I’m tempted to scream, “Screw it!” to the salt tablets and the water and the waiting, throwing on a pair of workout clothes and running out the front door. But I know I wouldn’t make it very far. I know with my condition and these early hours, I’d hardly make it to the living room, let alone down the street. On these days especially, my body feels like a cage.

Picture of my old running shoes.

It was December of 2019 when I was officially diagnosed with a common yet scarcely known medical condition. After over a year of debilitating fatigue, dizziness, heart palpitations, and other miscellaneous symptoms, my doctor confirmed I was suffering from a form of dysautonomia called Postural Orthostatic Tachycardia Syndrome (also known as POTS). This condition affects my heart rate and blood pressure whenever my body is upright, making it difficult to walk or stand for long periods of time. Things like dehydration, heat, or extended periods of inactivity can intensify my symptoms, which is why mornings can be such a particular challenge.

With POTS, every morning is a battle. After lying horizontal for eight hours, it takes a lot of time, salt, and fluid for my body to tolerate being vertical again. A good, long night of sleep means waking up dehydrated, and waking up dehydrated means it’s even harder for my stubborn, misbehaving nervous system to regulate my heart rate and blood pressure. On good days, my body will wake up within the hour. On bad days, it can take up to five hours before I am finally functioning. On flare days, I never reach “functioning” at all. It’s been almost a year and a half of these fluctuant mornings, and waking up into a flare day is still an infuriating letdown. 

On this typical Tuesday, I have physical therapy in the late morning. After all my tedious preparations, my mom and I climb into my car, her in the driver’s seat and me riding shotgun; a switch that is now routine. I sneak a quick glance at my mother sitting in what used to be my seat and feel my heart twinge with longing. As a twenty year old, I miss the freedom of sitting behind the wheel, and the independence that comes with a license and a set of wheels. I miss coasting down wide Texas roads, belting all my favorite songs, and mindlessly heading wherever I needed to be headed. These days, I’m scarcely headed anywhere, save physical therapy and my favorite local burger joint, and even before the entire nation locked down for a raging pandemic, I’ve been essentially homebound, my life revolving around physical therapy, doctor’s appointments, and sitting in the park. How did this happen? I wonder yet again. When did I become so boring and sad and crippled, and how do I make it stop? Turning my head, I look out the window, knowing the unchanged answer to these persistent questions. Still, I can’t help wishing it was different. 

Picture of me after physical therapy with lunch from my favorite local burger joint, P. Terry’s; My family likes to call this “PT after PT”.

I stroll up to the front desk, signing in for my session and beginning my usual small talk with the charismatic receptionist. “What did you do this weekend?” she asks, innocently and unassuming. Considering how it rarely varies, this question shouldn’t be so hard, but I find myself scrambling to think of anything significant. “Uh, honestly, I can’t remember. Just a typical weekend I guess.” I reply, paired with a basic shrug. My weekends are quiet now, given that I’m still quite physically limited and because of this they blur together, usually consisting of the following three things: reading, writing, and completing my at-home physical therapy exercises. It’s a routine that still feels novel and odd, another aspect of my new life I’ve yet to settle into, and I often find myself embarrassed of its stark simplicity; it’s painfully uncomfortable to admit how physically limited I currently am. 

My illness has changed many things about me, including what I can and can’t do, and this new life I’ve been thrusted into frequently feels like it was meant for someone else. Even in the forgiving privacy of my bedroom, I am constantly surrounded by pictures, clothing, trinkets and trophies curtly reminding me of the life I’ve had to let go of this past year. I can’t get dressed in the morning without seeing t-shirts representing programs and communities I used to be a part of, or hop in the car without seeing college bumper stickers that were once filled with pride and promise, but now burn with the sour taste of sorrow. Every new day of mine starts and ends in a shrine of my old life, while the hours in between burst with reminders and recollections of everything I’ve lost. For the past eight months, I have fumbled around my childhood home, trying to accept this new version of myself, all the while resenting that it even exists. 

I’ve become a regular at the physical therapy clinic over the past five months, consistently coming twice a week for my hour-long sessions. I’ve never really been a regular anywhere, and I certainly never expected it to be here, of all places. As I set up in the gym, waiting for my physical therapist to finish up with a previous patient, I take in my familiar surroundings and wonder how this accustomed routine can still manage to feel so foreign. A year ago, I was in class at a university I adored. A year ago, I was juggling homework assignments with rehearsals, singing Italian arias in practice rooms and wondering what musical might be chosen for the upcoming semester. Now I’m sitting in a gym at a physical therapy clinic, peddling my feet on a recumbent bike and doing exercises that are designed to help me stand in the shower and go to the grocery store. The change is enough to make me dizzy, or maybe that’s just POTS.

Despite the overwhelming change, I’ve discovered the remarkable capacity to adapt that every human carries within. I’ve learned that it doesn’t take long to latch onto the in’s and out’s of chronic illness, and I’ve quickly gotten used to the salt tablets and electrolyte drinks and slugging liter after liter of water. I’ve gotten used to my medication regimen, the slow mornings, even having to sit in the chilly, shorter showers I’ve begrudgingly been forced to adopt. But I’ve never gotten used to the loss illness brings, the persistent canceling of plans, and all of the sacrifice that comes with putting your health first. I’ve not yet gotten used to the novel post-diagnosis life, the “new normal” people speak about that’s never once felt normal to me. I trust one day it’ll click for me and I’ll find a way to live beside or without my illness, going through my days unchained, but for now, I’m still figuring it out, half heartedly trying to get used to things I frankly don’t want to get used to. 

An assortment of my favorite salt tablets and electrolyte drinks.

I can get through a Tuesday with my eyes closed, and I can recite the sodium content in various different electrolyte drinks without missing a beat. Off the top of my head, I can tell you the average time it takes for someone to get diagnosed with POTS – a lengthy four years – and I can also probably crush you in a game of Words With Friends (I’m kind of a pro by now…). But the one thing I can’t do is get used to the realm of chronic illness, and all the sacrifice it demands. I can’t get used to the world of symptoms, the too many days spent feeling unwell, and the holidays and birthdays shared with my condition. I still have yet to settle into the unforgiving flare days, the laundry list of limitations, and all the stolen time that’s taken from me daily. I can’t, I won’t, and I don’t think I ever will.

You get used to chronic illness – after all, it is chronic – but you also never do.  At least, I certainly haven’t.

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