browser life

Ok. Confession time. I've caved.

The FedEx truck showed up in front of my house about 4pm yesterday. Had me sign for two letters from my beloved long-term disability insurance company (beloved being a facetious term of course). Each letter assigned me to a test with an "Independent Medical Examiner". The company claims they can do this contractually.

The tests in question are a functional capacity exam (FCE) and a neuropsyche exam. For each, I tried to get the company to allow me to go to a local practitioner who would be impartial. On the neuropsyche, the response was not just "no", but "hell no". (ok, it actually was, "we never allow that sort of thing", but you get the idea). For the FCE, I actually had my rheumatologist prescribe the exam with a certain physical therapist, hoping that would help. Hell no. I was assigned to a facility that has a reputation for exams biased in favor of the insurance company.

The FCE is in two weeks. It's expected to last FOUR HOURS. Most days I'm lucky to stay awake four consecutive hours; I don't know what the hell they think I can do for that amount of time. FCEs were originally a vocational rehab tool. Say you were injured, causing you to be off work for awhile and have completed physical therapy. Then you do supervised activities that simulate your job to see if you're ready to return. But an FCE in the hands of an insurance company can be horribly misused. For instance, I experience rapid muscle fatigue. This could be interpreted by an inexperienced or unethical physical therapist as lack of motivation or malingering. Another serious problem with FCEs is that they only see you the day you exercise, not the following day when the flare sets in. Most people with fibromyalgia can do a certain amount of exertion but experience a delay before the effects of that exertion are felt. I've made an appointment the day after my FCE with my primary care doctor so she can document my condition.

The neuropsyche exam is in six weeks. It is scheduled to last EIGHT HOURS. Good Lord. My previous neuropsyche only took four hours, and my brain just about collapsed after that one. This exam might not be used against me right away, but if there is any evidence in it that I have a mental disorder, the insurance company can claim my entire disability is mental and cut my claim off after 24 months.

And today I went back to see the doc that did the injections that didn't work. Since I experienced a recurrence of pain when I went back to my normal exercise, what they would like me to do is go to a physiatrist (a physical therapy MD) for treatment and then repeat the injections. This is a perfectly reasonable request, but for some reason, it was the last straw.

I just can't handle anymore procedures, tests, appointments, pills, whatever. I crawled into bed when I got home, not because I needed a nap, but because I couldn't face the world and wanted to hide. I have prescriptions to fill, appointments to make, forms to fill out or have someone fill out, and meals to eat on schedule. But I just didn't give a shit anymore. I know I'm depressed not when I'm sad, but when I don't care. That horrible inertia hits like an anvil and pins me to wherever I am. I know I still have a life to lead, but it doesn't seem important enough to bother about. I had to ask Dan to literally drag me out of that bed, or I would have stayed there all afternoon and night and would still be there when he came home from work. I forced myself to make a few calls. Everything I did seemed to be like walking through mud, because I didn't much care whether it got done or not. I put off eating until I started feeling hypoglycemic, and then once I started eating, my food compulsion kicked in (I'm a former binge eater) and I couldn't seem to stop eating. Then that would make me nauseous, and I'd lose interest in food again. And if I sat on the couch, I became glued to the spot.

I get very defensive about people telling me I'm depressed when actually the problem is that I am sick. That is because I was institutionalized as a teenager, so I know what serious depression feels like. I very seldom feel the way I did back then, but the past few days have been the real deal. It frightens me. If I just give up on getting out of bed each day and let the inertia suck me into nothingness, then the illness has won. Social Security has won. That good for nothing long-term disability insurance company has won. I let myself down, and worse than that, I let Dan down. I owe it to him to make sure that if I can't work, then I somehow obtain the disability benefits I have earned.

I guess it's a good thing I was angry last week. Generally, I avoid excessive or misplaced anger, meaning I don't come home and kick the dog because someone cut me off on the highway. But righteous indignation does have its place. That Social Security denial ticked me off enough to take immediate action, and I've got the appeal in place. But for me, anger also has its downside, justified or not, because it's extremely exhausting. And I think I'm experiencing the aftermath of last week's productive tantrum. Emotional exhaustion can be damned near as damaging as physical exhaustion.

I'm not sure I want to post this. What I really want to do is delete it and go hide in bed. But I'll be even more miserable if I do that. Maybe it wouldn't be such a horrible thing to let people see the uglier side of me. To see what I fight against every single day. And to maybe understand why I'm so damned tired.

"Yesterday is a wrinkle on your forehead
Yesterday is a promise that you’ve broken
Don’t close your eyes, don’t close your eyes
This is your life and today is all you’ve got now
Yeah, and today is all you’ll ever have
Don’t close your eyes
Don’t close your eyes"

-- from "This Is Your Life" by Switchfoot