amber rahim

Chronic illness: the parts we don't talk about

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David (us) Vs Goliath (Health Insurance Co.) or The whims of change

Back in September 2013 I wrote this post Stupid insurance company, now I need to do press ups for my fingers (go on and click, it’s a short one and it without reading it this post might not make sense).

Well, after finally building up the strength in my fingers to get them super strong (I now have hands like a giant), we are back to the original, easy snap version of these tablets.

So how were we able to defeat the bureaucracy of these insurance giants with their “No! No! No!”?

What amazing feats of ingenuity and persistence did we employ to be able to get these tablets?

Well, I’ll tell you.

One day, J mentioned to the pharmacist (different person, different establishment) that it was a shame that we couldn’t get the original tablets anymore.


That’s it. That’s ALL we did.

The lovely person behind the counter said “if you want those tablets, you can have them”.

We did not question they whimsy of this process, we just took the tablets and ran.

Final word:

It’s funny how easy life can feel when a seemingly small irritation is removed. It’s a funny truth of the world that small irritations are only small if they happen just once.


What’s different about chronic illness, No. 3: Becoming an Olympian of “Accept What You Cannot Change”

I have noticed that lately I have been avoiding writing about what it’s like to live with chronic illness.

At first it was because it was confronting and a bit scary to write it down. It was like it had become REAL all of a sudden, instead of just thoughts. Thoughts, that were like whispers of smoke, that you can send away with a wave of your hand, became solid, hard, here to stay.

Then I told myself “but life with chronic illness is not just about the illness. There is more to our lives”. This is true and I will continue to write about the whole life, not just that one part.

But there was something underneath that.

I had started thinking “who is going to keep reading this?” It’s depressing. It was getting me down. Surely I’m bringing everyone else down too.

Many aspects of life with chronic illness do get you down, wear you out.

Here’s an example.

F has a feeding tube, a Mic-Key button. There is a permanent hole in her stomach, an open wound that can’t close because of this silicone tube that is stuck through it. She needs it but her body knows there is a hole and wants to close it. There is a constant battle.

When she moves, it moves and sometimes it rubs, like the other day when she was playing in the sand with friends and sand got under her t-shirt and into the hole. What can I do? This is The Netherlands! Its almost 90% sand here! (ok, don’t fact check me on that but there is a lot of sand everywhere, you can’t avoid it).

Sometimes gastric acid leaks out and that burns.

Sometimes it just hurts, for no discernible reason.

For the first few years it leaked a lot, which hurt and made the hole bigger, which lead to more leaking, which made it hurt more … you can see where this is going. There was not a lot we could do and no matter what we did, it still hurt.

The frustration is indescribable. Your child is in pain and there is nothing you can do. Even after all this time it makes my heart sink like a stone into my stomach when F says “ow, my mic-key hurts”.

The sinking heart is not about her pain, it is about mine. Inside a voice is screaming to the world “what the hell am I supposed to do?”

I can’t do anything so I don’t really want to hear about it. I try to comfort her, to acknowledge her pain. I take care of it and relieve some of the discomfort but it doesn’t really help.

I think we all have a capacity to cope with the fact that there are horrible things in this world that we cannot change. When chronic illness is involved, there are so many things in life, from the teeny tiny to the big, that we get really good at acceptance. But there is so much opportunity to express this virtue that we use up our reserves of “Accept What You Cannot Change” and we become maxed out.

So one of the ways I try to manage is to hide away from the world news. I even get cross with J when he tells me about some new stupid rule the government are trying to introduce that will make the lives of the vulnerable worse. I get cross and ask him not to tell me. My “Accept What You Cannot Change” reserves are used up and that leaves only “Do Something About It”. And this is where it sucks. I don’t have the energy or the time to take action and “Do something About It” either.

That just leaves frustration.

So I don’t watch the news. I don’t talk about the state of the world or get involved in politics (housemates from Uni, you will not believe this is me). This works for me most of the time, helps keep things manageable.

I feel like I should say that I am working on increasing that capacity – finding patience or something. I will write about that soon, but not today.

I used to think we had the mic-key pain under control now  but I don’t know if that is actually true or if F has just stopped telling us. Today she said that it hurts everyday. Maybe she feels it too – that I’m maxed out and that there is nothing we can do – so she doesn’t say anything until it’s really bad, like that sand the other day. That just makes me cry.

accept what cannot change quote blue

Stoma / g tube care tip: About a year ago we starting using bamboo g tube pads. They are really soft, absorbent and reduce/prevent granulation at the site. We get ours from Patchwork Peddler. The redness, irritation, infection and pain has really reduced since using these. I am not affiliated with this company nor do I gain in anyway from promoting them. The pads are just really good and have drastically reduced the pain. F used to cry at some point every day from the pain at her g-tube. Now she doesn’t.




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On the Brink

Some people say that life is like a roller coaster. Mine is, or rather, what happens inside of me is like a roller coaster. One week content and satisfied and the next, not. As I journey through my life, trying to bring up confident children, trying to create a new career for myself as a coach or just manage to get through the day, I slip and slide between the two.

This week as been a “not” week so here I am On the Brink.


Standing on the edge of a very tall cliff.

Strapped to a glider.

Not knowing what I am doing, no one has taught me how.

Yet I am supposed to jump, leap, leave the safety of earth beneath my feet.

And my job is to NOT smash to the ground and crumble.

Stay in the air and get to my destination.

Navigate. Set a course. Live up to expectations.

I am scared to jump yet I have vertigo and standing on this edge is physically painful.

Nausea. Dizziness. Spinning.

It is unbearable to stay here and I must move.

The destination is too far away, I can barely see it.

What can I see? Right in front of me.

Focus on my feet.

Put my fancy shoes on.

Take the first step.

That is enough for today.

Tomorrow will bring another cliff.


fancy shoes



What’s different about chronic illness? No.2: Disturbance

On Tuesday evenings a nurse comes to our house to look after F so that J and I can go out. We mostly go together and sometimes we each go our own way with friends. You know, try to have a social life.

This Tuesday I came home to find her on her chair in her room, wrapped up in her quilt. Eyes closed. Disturbed. Her bed was wet and so the bedding was being changed.

I stepped into the room to help out and the only thing she said was “can I go back to bed?”

Every night around this time we get her out of bed to take her to the bathroom. Due to Bartters Syndrome she pees so much that, even with super absorbent night pants, we can’t keep her clothes or bed dry without this nightly trip out of bed (and sometimes not even then).

I often wonder what it is like for her, to never be able to sleep through the night undisturbed. Never.

I think I got a bit of an answer when I saw her there on the chair, eyes closed.

We delight in the beauty of the

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Rare Disease Awareness Day 2014


28th Feb 2014 was the 7th Rare Disease Day.  I only found out about it this year so although a lot of work has been done (over 1000 events in 70 countries have been held) there is still work to be done.  So this is my first contribution.  Go and have a look at what they have to say (but first finish reading my post ;0).

What is a rare disease?  I wrote about my definition in a previous post and the people at Rare Disease Day have a more scientific definition but when you get to their common problems bit you’ll see the similarities.  Nobody knows much about them.

In addition to the obvious impact of this lack of knowledge there is an underlying problem that we don’t really look at: empathy or rather, the lack of.

Let’s start with my lack of empathy. A few years ago whenever I heard someone talk about their child having a cold or being sick there was a part of me that muttered “oh puh-lease!  That’s nothing.  You have no idea how lucky you are”.

I couldn’t listen to their stories, I didn’t understand what that was like: to see your child healthy one moment and then suddenly change and become sick.  My baby was sick all the time.  I couldn’t relate. I had no empathy for them.

It took a little patience on my part (and isolating myself from other people and feeling pretty alone, to be honest) for me to realise that we do have something in common: being a parent of a child who is sick.

Every parent worries. It’s never nice when your kids are sick.  I don’t mean just the cleaning up the puke and poop. Seeing your child in pain, with a fever, knowing that you have done all you can and you still can’t take away their pain. These are the really crappy moments.

So, although I don’t know what your life is like when your child is healthy and ok most of the time, I do know what it is like to see my child suffer so I offer you my empathy, parent to parent.

In honour of Rare Disease Day I ask you to offer your empathy to all those people who have a rare disease.  You may not know what their disease is or what impact it has on their lives or even how much harder life is for them. But you do know what it is like to get sick or look after a sick child. You can relate, you can empathise.

Let them know that.

p.s. it’s not sympathy we are looking for, just some understanding.


You know your illness is rare when…

1.  The doctor gives you medicine, hoping for the side effects.

There are no medicines designed for Bartters or Gitelmans Syndromes (B&G).  Every patient is on a mix of medicines known for certain side effects and we hope that you will “suffer” from them.  For example, diuretics can lead to increased potassium levels so most people have to be careful.  Us B&G folk?  That’s what we are hoping for!  We lose potassium like our kidneys are leaky buckets and we’ve got to plug the holes.

2.  Most specialists haven’t even heard of your condition

Sadly, many people with B&G are being treated by physicians who don’t really know that much about these syndromes.  Often you are the nephrologist’s first patient with this condition.  Yay! You get to be a guinneapig!

3.  You know everyone on the FB or Yahoo support groups by name

There just aren’t that many of you in the world.  Genetics Home Reference estimates it at about 1 per million people. How special is that?

4.  Prognosis is not known.

There is such limited information that they don’t really know what the future holds.  “If you follow your treatment, you will probably be ok”.  Um, hello?  Remember number 1?

Well, to be fair, who does know what the future holds for them?

Bartters Syndrome, the kidney disorder that my daughter has, is a strange illness and pretty young.  It is named after Dr Frederic Bartter who first described it in 1960.

There are some standard treatments but they don’t really know why they work – just that a lot of the times, they do.

We have had 6 very “interesting” years with the first 3 being a relatively experimental approach to finding a good treatment plan.  For the last 3 years her condition has been stabilising so now finally, at the age of 6, she is doing pretty well.

Now we are at the tough choice time.  Do we change anything in her treatment plan?

For the last 4 years we have been giving her potassium and sodium supplements on an hourly basis.  That’s right.  We give her medicine every hour, of every day.  (We are not martyrs to her illness, we use a medical pump at night).  It is tiring for us but we have developed an amazing ability to know when an hour has passed, without looking at a clock.  In my science class at school I couldn’t even estimate when one minute had elapsed.  Now I am a time master.

More importantly though, it interrupts her day.  Can you imagine someone coming up to you 12-14 times a day asking you to stand or sit still?  How she stays so patient with it I do not understand.

She is stable now, so we could change to say, medicine every 2 hours.  But I hesitate.

  1. Can I retrain my brain to this new schedule?  I might actually have to think about what I am doing!
  2. More importantly, what if this de-stabilises her?  Is the potential benefit of fewer interruptions to her day (and ours) greater than the potential risk to her health?

I just don’t know.  I think I’m going to enjoy this feeling of control a bit longer and leave things as they are.