I Finally Have Answers! If you Have Fibromyalgia and Are Hypermobile, Please Read!!

2018 has been extremely important in finally figuring out what is behind all of my health woes. I have been feeling markedly worse the past several months, with more injuries, more pain, and more questions as to what the hell is happening in my body. As my condition continued to slide, I became more adamant about figuring this out, once and for all. And this is one of those times when things have to get worse in order to get better, because I finally have answers and something that ties all of my apparently random symptoms into a single diagnosis that explains everything for me: Ehlers-Danlos Syndrome (EDS), Hypermobility Type (hEDS).

EDS also tends to bring Mast Cell Activation Syndrom (MCAS) and Postural Orthostatic Tachycardia Syndrome (POTS) along with it, which also seem to be what I have been experiencing, according to the specialists I have seen thus far.  We are still working on confirming the MCAS, as it is tricky to test unless there is an actual reaction occurring at the time of testing.  POTS seems likely per the EDS geneticist and the MCAS specialist, but I need to wait until January of 2019 to be seen by the EDS knowledgeable specialist who can test me officially for that.  A tilt-table test is likely to happen then.

In addition, Osteoarthritis (OA) also tends to occur in EDS patients because of accelerated wear and tear on the joints.  I have already been diagnosed with OA by my rheumatologist, after showing her my Heberden's Nodes which have formed on two of my fingers already.

After reading all about this connective tissue disorder and how it affects people who have them, I realized I have a lot on the very long checklists.  So I sought out a local genetics doctor who is knowledgable  and booked an appointment.  EDS is not well understood by the medical community, as it is complex and there is no real treatment or known cure as of yet.  That means there's really no money in it, so not many doctors invest the time and energy to learn much about it and treat EDS patients.  (Sad, isn't it?)  Despite these challenges, I had to know if this could be the cause of my health problems, so I could at least understand what is going on in my body and try to prevent further injuring it.  I set out to find out who could rule out or diagnose this condition in me, locally.  A local Facebook Group in my area was very helpful in finding resources near me.

In order to be properly diagnosed by an EDS knowledgeable genetics doctor, one must:

1. Discuss family health history, 
2. Have this doctor examine you for certain physical traits and characteristic reactions, 
3. Perform a certain set of specific physical tests in front of the doctor, so he can assess the Beighton Score for hypermobility, and finally, 
4. It may also be recommended to have genetic testing done to rule out or identify certain types of EDS.

Once the several months of waiting for my appointment passed, I finally went to see a local EDS knowledgable genetics doctor and did all of the above.  Everything points to EDS, and the Beighton Score, along with the genetic testing, pointed specifically toward the Hypermobility Type of EDS.  Thankfully, this is not one of the more severe and life-threatening types, but it can still be debilitating.  Unfortunately, debilitating is where I seem to be headed now.  I'm not sure if it's just my age or what I've been going through, but something has caused my body to take things to the next level of awful this past year or so.

Recently, I've been rolling my ankle just walking on flat sidewalk (couple times!), I've had painful shoulder tendinitis that required over weeks of physical therapy to strengthen, I have been having new problems in my hip that make bearing weight excruciating after a period of sitting, and my knees, which have always had a tendency to buckle painfully, are acting up more these days.

I've also been reacting with flushing for no apparent reason and developed new sensitivities to Hydrocodone and Xylitol, in addition to the new food allergy to apples that I've developed in recent years, and the new lip balm reactions I have had as well.

Now that I know what's going on, I needed to understand it.  I have recently been having an awful flare up that's been affecting my neck and shoulder, back, and knees for the past week plus now.  It's been a pretty high level of pain much of the time, and is apparently not being well managed by the Cyclobenzaprine and Low Dose Naltrexone (LDN), which has been helpful in lowering my "new normal" pain levels and giving me more good days between flare ups.  These flare ups, however, are terrible lately.  I have been laid up for several days, including last Saturday, just trying to rest up and heat the affected area.  All it takes is a few days of level 8 pain to make you wonder how you can go on.  I have had to keep talking myself down to get through it.

In my current, painful state, I did some quick research on my newest, and most important diagnosis. I found this page, EDS-H & JHS: Understanding Ehlers-Danlos Syndrome Hypermobility-Type and Joint Hypermobility Syndrome to be very informative and an excellent resource for understanding how all the little diagnoses I have collected throughout my life are all tied to the connective tissue disorder, Ehlers-Danlos.

I'll try to sum up what I know now, but if you or your child or children are hypermobile, you may want to read the above web page as well to see if you relate to other details. 

Okay, here goes...

Collagen is the connective tissue "glue" that holds our bodies together. When this connective tissue is defective and weak, as it is for EDS patients like me, joints can overextend (hypermobility) and less unstable than normal people's joints. When joints hyperextend, dislocations and subluxations (not quite full dislocations) can occur. When joints sublux or dislocate, the surrounding, and already weak tissues (muscle, tendons, muscle fascia, etc.), become overstretched, and can tear and stiffen as they attempt to repair the damage. All of this spells pain, in many ways, at the very least, plus various other problems in the body. For this reason, EDS patients need to protect their loose joints with various braces and limited activities. This explains my several ankle rolls and foot tendonitis, shoulder tendonitis, and carpal tunnel pains. It also explains how that car accident in 2006 triggered a world of hurt in me that never got better, but rather snowballed to where I am now.

When movements and activities lead to these painful and destructive episodes, those movements and activities tend to be avoided - have never been athletic - leading to weakened (doughy) muscles. Weak muscles can further destabilize joints, continuing in a vicious circle of pain and destruction. This explains my chronic pain and flare ups.

Weak connective tissue manifests many ways, such as Fibromyalgia, a syndrome that describes chronic pain, fatigue, sleep disorder, Irritable Bowel Syndrome (IBS), Migraines, Temporomandibular Joint Disorder (TMJD), allergies and various sensitivities, and lots of other odd little things that make my life extra challenging.

EDS is associated with 2 other conditions that are frequently comorbid: Mast Cell Activation Syndrom (MCAS) and Postural Orthostatic Tachycardia Syndrome (POTS).

Mast Cell Activation Syndrome (MCAS), has to do with histamine and allergies and sensitivities. Basically, any kind of physical reaction that can occur as a result of any kind trigger is fair game. For me, this explains my hay fever and allergies to tree pollen, weed pollen, grass pollen, dust, dust mites, feathers, animal danders, mold, fragrances, newspapers, apples, lip balms, nickel, scratches, pressure, Hydrocodone, sudden temperature changes, and who knows what else. My reactions include rhinitis (sniffling, sneezing, and nasal congestion), asthma (cat dander, mold, dust mites, fragrances), digestive cramping and dumping (apples, hydrocodone, and unidentified triggers), hives (Dermatographia from scratches, Delayed Pressure Urticaria from pressure), dermatitis (lip balms and nickel), and flushing red and burning skin (sudden temperature changes and unidentified triggers). A lot of "masties" may suffer anaphylaxis when exposed to some of their triggers. I have had a few episodes myself in the doctors office after a slightly too high incremental increase in my desensitization injections, and have had to do the Epi-pen and inhaler thing. It was quite a production!

The other comorbid condition is Postural Orthostatic Tachycardia Syndrome (POTS), a type of Dysautonomia, which has to do with blood pressure changes, heart rate changes, heart arrhythmias, and fainting or near fainting, that is triggered by one's change in posture. This is due to blood pooling at lower areas of the body rather than circulating more reliably throughout the body. It goes back to weak connective tissue causing weak blood vessels and heart tissue, which, in turn, results in poor circulation of blood in the body and brain. This explains my momentary blindness and dizziness when getting up quickly, my unexplained heart rhythm (tachycardia) episodes - the first one triggered by my bending down to pick something up at age 17 lasted hours and I had to go to ER - and an apparent heart rate change when I squat for a couple minutes then stand up straight, as a specialist tested. I also get migraines, which are caused by a decrease in pressure in blood vessels, which makes sense here.

Some types of EDS affect internal organs and can lead to weakened arteries and digestive tract organs, which can rupture. Vascular type is particularly dangerous, but there are 13 types of EDS and several of them carry serious health risks. Hypermobility type is what I have been diagnosed with, though many of the 13 types also present with hypermobile joints. Genetic testing helps rule out or diagnose the types which have identified genes. EDS is inherited and it is usually the same type that runs in families.

The gene for Hypermobility Type has not yet been identified, so testing is done to rule out the other types, which is how I was diagnosed, along with family history and a clinical Beighton Score test for hypermobility.

This turned out to be way longer than I expected it to be, but I hope it helps someone make sense of their symptoms or lead to a correct diagnosis and proper care. Please feel free to share with others. EDS is not as rare as it seems. Doctors and patients need to know more about it so people can get the care they need and patients can arm themselves with knowledge against unnecessary injury and pain.

If you or your kids are hypermobile, please learn more about EDS and pay attention to these seemingly unrelated conditions and symptoms. There is a tie in!

When symptoms don't seem to connect, think connective tissue!

One Stress Declining; Another Rising

As my work project is finally coming to its fruition this very day, the buildup of mental stress is beginning to wane.  It seems everything has been going reasonably well and any problems that may occur with our project should be relatively minor and manageable.  I'm sure there will be unanticipated little snafus here and there, but thus is any IT project.  We learn as we go, maintain and fix bugs as we continue to find them, and make continual enhancements.  So, I do finally feel better about this.

Physically, though, I've got a new stressor.  Let me give you the background first.

Last Thursday, my employer threw a lovely picnic for us all.  I had a great time, sang karaoke, even danced and enjoyed life for a while.  It was surely confusing for all my coworkers to see me looking as if I wasn't in any pain at all - especially the ones who don't understand Fibromyalgia and it's ups and downs. 

Anyway, I had been developing a headache near the end of the party, though I ignored it as part of the deal for feeling great and having a few drinks.  I met up with my husband afterwards for water, coffee, and a half-sandwich.  I continued to ignore the headache, hoping the water would help keep it at bay.  I went to sleep expecting it to be gone or mostly gone by morning.

That night, I woke up around 1am feeling absolutely awful.  The headache exploded to a level 7 or 8 and I felt very uncomfortable.  I was nauseated, too, which happens with severe migraines, so I grabbed a couple of Triscuits and water from the kitchen.  Literally, after the first Triscuit, I had to run to the toilet.

I'll spare you the details, but it was pretty clear that this wasn't a typical migraine - it was food poisoning, and my body was getting rid of what I recognized as potato salad cubes, even though I'd only had a bit at the picnic, and it about 12 hours earlier - before my dinner sandwich meal.  I felt a little better after the explosive "episode" was over, but not fantastic by any means.  I assumed I was on my way to feeling better and went back to bed and slept a bit. 

I went to work the next morning, still feeling the workout of my guts and assuming they were just tired and recovering from that night's activities.  I had green tea to help chase away any bacteria.  I'd also found out others were ill from the picnic food, too, which confirmed my theory.  It was a hot day, so it makes sense.  I just wish I'd thought to avoid the "cold" foods.  (Lesson learned!) 

As the day wore on, I started feeling more pain in the guts again.  It was building up again.  I left work early and read about typical food poisoning and how to self-treat.  I assumed it was over that day, but apparently this thing can last a few days - and it is still affecting me today, three days later.  I'm hydrating and eating only bland foods and sparingly until things improve.  When the pain comes on, it gets hard to stand up straight, or tolerate any movement. 

At least I know this is one of those temporary things that normal people get.  If this was just some random Fibro symptom, I'd be much more confused about how long it would last or what it means.  I'll just try to rest my guts and body until this passes, though I still need to get to work to deal with any fresh problems with our new application.

Never fear, though, I've got vacation time scheduled in a few weeks and will be getting some R&R soon.  Just knowing that helps relieve stress.

Weird Weather and Possible Restless Legs Syndrome (RLS)

So, first a bit of good news... It gets hard to remember to notice the little victories sometimes. That cough I had that caused me some weird pain in my left side is finally done and gone. Also, I have backed off the Baby Steps quite a bit the last week or so (okay, that's kind of bad-ish news) but my tailbone is feeling much better, too. What's funny about these symptoms is that they are so very noticeable and bothersome when they occur, but when they finally leave, they just quietly sneak off and don't say good-bye. I noticed their absence much later than when it actually occurred. Good riddance, anyway!

Here's the latest bad news... It seems the weather has been making my symptoms flare up. We've been stuck in a weird low pressure system for the past few weeks, which has resulted in cold and mostly rainy weather. We've had hail and even a couple snowfalls in the past week! The snow arrived only about a week after we had 80+ degree weather here in Chicagoland. With the wacky weather I noticed more headaches, nausea, more overall pain and achiness, and a new kind of pain that seems to have settled in my legs and feet. I've been calling it bone pain. To make matters worse, I've also been dealing with added stress from work and stuff. Things at work are a bit on the crazy side, as we get closer to a major project deadline. I'm doing what I can to stay ahead of my own work, but I can tell my team is feeling stressed from problems and snags coming up this late and the probability of having to work longer hours to get everything done on time.

Now the neutral news... I had an appointment with my fibro doctor last Wednesday. Due to my fibro fog, I forgot to bring the notes I always bring with me, but I made do with a portable pad and pen and whatever notes I could remember to discuss. The appointment was for 5:40pm and I was on time; the doctor was not. I ended up waiting over an hour before I could have my appointment. (The explanation was a new patient and a thrown off schedule. I am switching back to morning appointments after this.) Anyway, while I was waiting as patiently as I could, I noticed I could not bear to sit still due to the "bone pain" in my legs. I moved them around and tried changing my posture periodically to read and distract myself, but it was no use. After about 45 minutes, I couldn't stand to sit (hehe) any longer and started pacing the waiting area. It's a small area and there were several other patients there, so I hesitated to start pacing and make them feel uncomfortable, but then I realized: it's a pain clinic! Certainly they would understand. Pacing helped my legs, even though it was a tight area and felt a little weird.

When it was finally my turn, the doctor and I discussed the weather affecting my symptoms, my change in medications, and, as usual, the doctor asked me about my sleep. He asked me if I feel refreshed in the mornings, or tired. I blurted out "tired" as if he should have known, before I realized how rude it must have sounded. Since I'd already apologized for having forgotten my notes and mentioned my retarded brain functioning, he was formulating a hypothesis and continued asking me questions. He asked specifically about whether I am moving my legs at night. I wasn't sure, but didn't think so. He asked if my husband complains that I keep him up with my movements at night. I know my restlessness has impaired his sleep quality, which is why I try to leave the room if I'm too awake to fall back asleep (like now). But he's also a very sound sleeper most of the time, so perhaps he's not noticing what I'm doing in my sleep because he's asleep himself. Then, I was surprised to hear the doctor tell me that he suggested I undergo a sleep study to see if I have Restless Legs Syndrome (RLS), adding that RLS is very treatable and could help me get better sleep, and in turn, bring back some of my thinking skills and chase away daytime fatigue.

A sleep study? Me? I've never thought of doing one. Would I be able to sleep at all with all the strange hookups and people watching? Then there was the RLS. I never thought I'd had this, though I knew it was common for fibromites to have. I do know someone who has been diagnosed and is being treated for RLS, but I always thought I'd know if I had it. Now that I've had a day or so to chew on this possibility, I am noticing the aches in my legs cause me to move my legs around quite a bit. As the doctor explained, RLS also entails shifting the legs around to try to find a comfortable position for them, but not succeeding. I thought back and realized that I have a hard time with my legs while watching TV in the evenings as well as at work at my desk. Then there was the incident right before the appointment, which I shared with him. I guess RLS is much more likely than I had realized.

As I type here, I am up due to my waking up and being unable to find a comfortable position to relax and fall asleep. I woke up shortly after 3am and noticed my legs were aching and I was stretching my ankles and trying to chase the pain off with movements. Then I decided I wasn't going to fall asleep any time soon and didn't want to keep disturbing Don's sleep, so I snuck off to do something more productive. I suppose it would be nice if I could at least effectively treat this pain/discomfort, even if that means adding yet another drug to my regimen. As a fibromite, it's rare to have confidence that any drug treatment is going to be effective, so hearing that RLS treatments are helping people is very promising. I won't pin my hopes and dreams on it (yet), but it's a ray of hope for some improvement. I'll take that.

Oh What a Night

Well, wouldn't you know it?  The very day I declare things are improving for me, I start feeling shitty again.  

I developed a headache while still at work yesterday and it progressed into a monster migraine overnight.  I woke up about a thousand times last night, just to feel the pain in my head.  Of course, after waking up, I also got to feel that peculiar back pain - you know, that spot on the left side that kills when I sneeze.  Each time I woke up, I felt the need to flip over to the side (or other side) but first I had to deal with my back hating every second of the movement.  In anticipation of my back screaming at me for moving, I'd first try to adjust a bit by stretching out my ribs.  (I've been doing this for the past few weeks, hoping for that *click* in the sternum or back or wherever in the chest/back area so the pain will feel slightly better for a little while, but it's never enough.)  Anyway, flipping over hurt my back and my head was just looking for a different side to be touched by the pillow.  I'd sleep for a short time and have to do it all over again.  What a shitty night.

I have way too much to do at work and can't afford to recuperate at home (again), so today ought to be "interesting".  I just hope the Aleve helps the headache, the way it usually does.  Come on, Aleve!  Wish me luck.  :P

Bunny Versus Human Resources

Remember "Bunny"?  It's the homemade heat wrap I created from a soft pair of socks, some dry, white rice, and a little bit of sewing.  I pop it into the microwave for a minute and use it to soothe my neck, shoulder, back, hip, or whatever hurts most.  A few months ago, I brought Bunny to work so I would always have it ready at the office.  I have been using it all day long lately and it has been very useful in keeping me just this side of sane while trying to get my work done while dealing with the usual plethora of symptoms from Fibromyalgia, Chronic Myofascial Pain, Sacroiliitis, and whatever other typical things might be going on with me that minute (headaches/migraines, nausea, fatigue, IBS, etc.).

Last Friday, without any warning, I received the following e-mail message from the Human Resources Manager at my work:

"Hi there;

As you know, with cold and flu season upon us, people are generally germaphobic (with good reason).  I've been asked to respectfully ask you to not warm up your neck warmer in the microwave anymore.

My apologies for the inconvenience."

I just read it over and over, stunned.  My inner frustrations raged within me.  There was no discussion or hint of any sort of a problem - just the e-mail.

Okay, I thought, so maybe it's not apparent that I'm using this thing out of medical necessity, rather than for some sort of luxury or convenience comfort item.  I have mentioned my Fibromyalgia to the HR manager in the past, but it's a complicated condition and without having to deal with it herself, perhaps she'd forgotten.  After all, I "don't look sick".  Taking the high road, I decided to give her the benefit of the doubt and explain to her, in person, that I do need this heat wrap.

I walked into her office with Bunny in my hand and asked her "are you grossed out by this?" before she had any time to think about it.  She assured me that she is not.  She said that she had seen me walking around with it on my neck and never gave it a second thought, but she'd heard some offhand remarks from one or two people about it.  Then she got this "complaint" from the still-anonymous person.  I made it abundantly clear to her that Bunny is what allows me to work - I need to be able to continue using it, otherwise I would need to use a heating pad or something (however a heating pad is not as versatile as Bunny is for my ever-changing pain locations).  Bunny is the best option for my shoulder and neck pain, as well as my Sacroiliitis hip pain, since heating pads can't really get around those corners as well.

I wanted to be reasonable, because I know it's not easy to be the HR person involved in a dispute like this.  (Our company actually sells liability insurance, so it's even more apparent that disputes between coworkers can turn very ugly and expensive.)  She came up with the idea to use a Ziploc bag or some other sort of containment for the rice-sock for microwave heating, but needed to discuss the idea with another manager first.  Fine, fine - whatever it takes to keep Bunny available to me.  I even agreed not to use the microwave until I heard back from her.

Hours went by and apparently she'd forgotten to have that discussion until she saw me in the Ladies' room.  She announced to me that she forgot and was reminded by my presence.  I'm sure my expression was pathetic enough, but I also uttered a genuinely disbelieving "what?!" and my pleading "please help me" to make it clear to her that I was making a real sacrifice during all this nonsense.  I also replied to the e-mail she sent me, so she would remember that I was waiting for her:

"Please let me know ASAP on what conclusion you reach on this.  I'm always in pain and not having my warmed rice-sock available to me is not helping. :(

Thanks for your help.  Let me know if you need anything else from me, or want to discuss this further."

Well, when I finally heard back from her, it was, again, in the form of e-mail... 

"Lets do this...first of all, you still have access to the 4th floor, so go ahead and use the microwave down there - chance of being seen is far less.  Secondly, just for perception sake, could you put it/wrap it in something (like a plastic bag or other) when microwaving it?

Thanks."

She had mentioned, in an earlier discussion, that another microwave is available in another, very small office of ours.  It's on a different floor but I really think that's not fair to me at all.  The way I've been doing the Bunny warm-ups in the past is by putting it around my neck, grabbing my empty cup, and stopping at the kitchen on the way to the nearby washroom.  I'd pop Bunny into one of the two microwaves in the kitchen, set down my cup, take my washroom break, then return to fill my cup and take Bunny back to my desk.  I usually lean against Bunny in the chair for my back, or put it wherever the heat is most needed.

Her proposed change would entail my taking my key card with me (which I keep in my purse, so I never forget it), some sort of plastic bag or whatever, the cup, and Bunny when I need to take a washroom break.  I'd have to take the elevator down to the fourth floor (we're on the eighth floor), swipe my key card to enter the office of three people I hardly know, put Bunny in a bag, use their microwave (while they probably wonder what I'm doing there at all), then use the bathroom on either floor, return to the kitchen on the eighth floor, fill my cup, and return to my desk.

Does this seem reasonable to you?  

This is all for the sake of appeasing some anonymous coworker who apparently does not understand the germ-killing powers of the microwave oven.  This also puts me in the awkward position of having to kind of sneak the whole heating thing from someone who has not been identified to me, even though that person will very likely still see me using Bunny around the office, especially if it is a coworker who works near me or on the way to the kitchen and washroom.

Well, since I still wanted to remain reasonable and willing to cooperate, I decided to visit the fourth floor and give it a try.  Firstly, I had no container or acceptable bag.  What's acceptable anyway?  I'm dealing with erroneous assumptions of someone who won't tell me what exactly is wrong with putting my rice-sock in the microwave in the first place.  I asked the HR manager for a bag or something acceptable, since she's my only connection to the complainer.  She, also, had nothing handy for me to use.  She made and executive decision to allow me to use the fourth floor microwave that afternoon without any sort of bag or cover.

Well, I went to the fourth floor office and guess what - it was locked.  I couldn't even use my key card to get in.  So much for that plan...  (You can probably imagine my frustration at this point.)  I was sick of going to HR all day long and decided to skip it and just to bring in my own container on Monday morning.  I would still refrain from using the microwave without any container around Bunny, in case mysterious idiot were to see me and report to HR that I was not compliant.

So I just did without - for the idiot's and HR's sake.  Looking back, I should have just used our  microwave one last time (for my sake), but I'm such a nice person that I didn't risk causing any further trouble that day.  I was already very stressed and distracted already, and I didn't want to add any more crap to the pile.  (I was actually hoping that the stress could trigger a palpitation episode, so I could finally make use of this heart monitor of mine, but no luck there.)

This is all so very stupid.  I announced this to the HR manager during my most recent discussion with her about all this.  I even sent her a link to an article about microwaving the germs out of kitchen sponges, since I had mentioned this to her earlier and she said she'd never heard of anyone doing that.  I do this at home all the time and I thought most people did as well, but apparently that's not the case.  (She did not reply to that last e-mail.)

Well, today I brought in a large, oblong Glad container that is now dedicated for use with Bunny in the public microwave.  It seems to be just the right size to accommodate the whole thing and even allow me to close the lid on it.  I tested it at home a few times with success.  I have already used it several times today on my floor, here, at the office.  I have had no comments, strange looks (that I noticed anyway) or interactions with HR personnel (so far), so I'm hoping this is the end of this very stupid problem.

It still bugs me that the person who complained was given so much power over me.  Apparently, being misinformed about things allows one the right to remain anonymous, while greatly inconveniencing anyone they want.  That kinda sucks, doesn't it?  What if I had complained to HR that someone's checkered shirt gave me migraine auras, or that someone's perfume gave me headaches and made me nauseous, or that the conversations that people have around me distract me further from my work?  These are examples of real problems for me, yet I have decided that it would unreasonable for me to go to HR and formally complain about these things.  I've kept them personal or just dealt with them on my own.  I don't want to be seen as an unreasonably high-maintenance employee.  Nobody appreciates this, I'm sure, but this is how it goes.  We all know that life is unfair.

Someday, I may have to deal with the very real possibility that I am physically unable to do full-time work.  I am barely able to maintain my job now, but press on, for multiple reasons, including:

• health insurance benefits (very important),
• self-esteem and feelings of self-worth,
• distraction from my symptoms,
• keeping me in driving practice, and
  
• keeping my brain as fit as possible.  

It's complaints like this whole Bunny thing that remind me how fortunate I am to be able to work at all, and that I may have to cut back drastically on expenses to live without the insurance benefits and income that I enjoy today.  I know many of my fibromite friends are not so lucky, and are struggling with their symptoms and financial burdens.

I'm not looking forward to the day when I have to decide to stop working full-time, nonetheless, I know it is a decision I will likely have to face someday.  Until then, I am going to do what I can to help keep myself in at least the minimally acceptable condition that allows me to continue to feel somewhat human in this world.  If Human Resources, some ignorant coworker, or anyone else stands in my way, they better be ready for a fight because I will not be defeated easily.