the worst thing

[Author’s note: I wrote this over several days because I’m very tired. Please forgive any typos.] 

I’m a little bit anxious by nature. High strung, type A, whatever you want to call it. A true Enneagram 3 (3w2 to be exact).

My anxiety is definitely of the high-functioning variety, which means I often behave in ways in response to my anxiety that are rewarded with more anxiety-provoking tasks/experiences/etc. Insert joke about being a PhD student here.

My anxiety is so human, too. It keeps me alive and safe, serving its good, intended purpose. I tend to trust my instinct, she’s a powerhouse. But like many things, this high-strung hyper-vigilance overstays her welcome and makes things difficult.

I want to let y’all in on something I only really ever talk about with my counselor. My anxiety has some weird rules.

I, too, am a counselor, and my primary theoretical orientation from which I work is Adlerian theory (Individual Psychology). One construct of the theory is that folks tend to operate from their own private logic — their own way of seeing and making sense of the world that is informed by early life experiences. Everyone has their own private logic; the framework (or lifestyle, if we want to get real Adlerian about it) I use to see and experience and make meaning of the world can only be true for me.

So, my private logic has some rules. Somewhere along the way, I started following these “life rules” I made for myself (we all do this, all of us in our own ways) — and much of the time, the rules work. But sometimes the rules don’t help at all.

Here’s one of my rules: If I anticipate the worst scenario, I’ll be prepared for anything. If I imagine the worst thing, then if it happens, I won’t be caught off guard.

On the surface, it seems like a pretty good rule. Be prepared.

Here’s how it’s blown up in my face recently:

On May 7, I had jaw surgery. The weeks leading up to this surgery were extremely hard. I was constantly anxious, constantly thinking through the worst-case scenarios, and the anxiety was taking a serious toll on my body and mind. I cried often and easily. The lymphoma in my skin flared up. I had a hard time sleeping and a hard time waking up in the morning. It was tough to stay focused on important tasks.

Now, some of you may also be feeling this way whilst living during a pandemic. My COVID-19 anxiety was mingling nicely in this jaw surgery anxiety storm — add in a hearty dose of graduate student stress, and you’ve got a nasty cocktail for distress. The same can be said of all sorts of things so many of us are experiencing — parenting, school, work, job insecurity, job loss, grieving major milestones like graduations and wedding plans, etc. If you haven’t already, take a moment and write down all the things that make you feel sad and scared – just get it out on paper. Then cut yourself some slack when you don’t feel like you’re doing “enough.”

[Also: this surgery has been in the works for over a year. It’s why I’ve been wearing braces again. In March it was postponed, and then put back on the schedule at the end of April.]

Anyway, before jaw surgery: here’s an example of some of the thoughts raging in my head at any given moment during this time:

“The most vulnerable in our country are the ones who will suffer the most from this virus, and they will continue to be the forgotten and ignored. And we have to fight with people to wear masks and practice social distancing, because they think they’re above it all, or that it’s a hoax, and protecting the lives of vulnerable people infringes on their personal rights. I have no hope for humanity, none.” 
“Are my clients safe? Are they going to be okay? How will I know if they are okay if I can’t see them in person?” 
“Hey, not to bug you, but you’ve got two pretty important paper deadlines that you need to finish, like, yesterday.” 
“What if you hate the way your face looks after this surgery?” 
“Maybe you can just live with TMJ pain and wearing your teeth out, cause this is gonna be a tough procedure.” 
“You’ll probably have permanent nerve damage in your face. What if you can’t feel your mouth? How will you kiss Chris again?” 
“What if you have some crazy complication and die? You need up update your advance directive.” 
“What if you throw up with your jaw wired shut and start choking? And what if your nurse doesn’t get to your room in time, since you’re going to be alone?” 
“What if you get COVID-19 in the hospital?”
“You need to get a timeline for when you’re going to finish these papers because dissertation is here.” 

These scary thoughts serve a purpose, according to my rule. But I do need to take a moment and deconstruct the true meaning of this life rule.

If I anticipate the worst scenario, I’ll be prepared for anything. If I imagine the worst thing, then if it happens, I won’t be caught off guard. 

actually means

If I worry about everything, I won’t be afraid and I won’t get hurt if something really bad happens. 

Ah, see, now that doesn’t make sense, does it? Can you see how the rule is flawed? Worrying does not equal protection. It’s overstepped it’s place. A little dash of anxiety keeps me aware, and my awareness may protect me — but worrying about the worst things will not protect me from them.

Anyway, May 7 rolls around after a week of emotional agony. I arrived at the hospital (after being tested for COVID-19 the night before) and hugged Chris goodbye as they made him leave the surgical waiting room. I was so scared. I cried hard for a few minutes in the waiting room and texted my family and dear friends to try to calm down.

My surgery lasted around 7 – 8 hours, and it was successful. The worst part was waking up in PACU and spitting up blood that was draining down my throat from the nasal intubation — but no vomiting! The second worse part was getting a CT scan before I left the recovery room. I didn’t know how to move my head, I had several IVs, and going from the bed to the scanner was tough. I spent two nights in the hospital and then came home to recover.

Then, four days later, I woke up in the middle of the night with a stomach ache. At first it felt like any old annoying stomach ache, so I tried to do things to get comfortable and find relief. I wasn’t taking the narcotic pain medication that was prescribed to me because I really wasn’t in much pain at all — and I was trying to be proactive about my gut health during a time of liquid diet and surgery, if you catch my drift.

The pain got worse, and eventually Chris called my doctor. He said I might be having a case of gastritis due to the NSAIDs I was taking, and to take something like alka-seltzer or drink some ginger ale.

[Side note: I could write (and I just might) a novel about Chris and the ways he has cared for me and loved me these past two weeks. When I tell you that he helped me with every single activity of daily living, I mean it. If you want to experience depths of love you didn’t know you could reach, go through a major medical crisis with your person (ugh but don’t, please be safe). This is “wash the blood out of your hair, prepare food and feed you through syringes because you’re too tired to move, go to Walgreens as soon as the doors open and buy every single medicine designed to alleviate gastrointestinal distress, keep your water cup full, help you to the bathroom” kind of love.]

After Chris returned with the full Walgreens stock of GI medicine, I took some and tried to sleep the pain off, but it kept getting worse. Eventually, it got to the point where I was crying and moaning, and I felt completely out of control. It was like those sounds where just escaping from my mouth, I had no authority over them. Around noon, Chris called my doctor again, who told me to go right now to the emergency room.

The ride to the ER was a painful blur. Every movement make me hurt. The pain was truly the worst physical pain I’ve ever felt in my entire life. Outside of the ER, I remember holding on to Chris to keep from collapsing.

As a reminder, my jaw is wired with a splint and banded shut. Communicating was extraordinary difficult. Chris stayed with me and insisted he come with me to the ER if any of the staff want to know what’s wrong with me — and he was absolutely right. If he hasn’t been there, I’m not sure how I would have communicated my issue. All I could do was moan and sob and mumble through a closed mouth full of wires and metal and plastic, and Chris was able to give the nurses and doctors a very detailed explanation of what was causing me distress and what I had been through the past few days.

Chris held my hand and encouraged me while we waited for a room. This, too, is a painful blur, but I do remember him saying things to keep me focused — “they’re just waiting to move someone out of a room, and then you’ll get some relief…we’re almost there, and as soon as we get to a room you’ll get help.” All I could do (for what seemed like hours) was moan and cry and scream. My vision was blurring and starting to black out. It was truly awful.

Eventually we got to a room, I got some morphine, and was able to feel some relief for the first time in almost 12 hours. Even with the morphine, I could still feel stomach pain, but with the morphine it was manageable. Some blood work (with a very high white blood cell count) and a CT scan later, and one of the doctors (very nervously) told me I had appendicitis, and it was bad. I could opt to take antibiotics to help, but the success of that treatment was highly unlikely because I’d been on strong antibiotics already for a week. I needed surgery, and soon.

An emergency appendectomy 5 days after jaw surgery was not an experience I considered.

I was in so much pain, I couldn’t really think or process anything. Later that night, I was admitted again to Emory and had to part with Chris as I prepared for another surgery. It was a total blur.

I was told my appendectomy would be at 3pm the following day, but around 5:45am, my nurse woke me up and told me they were ready for me for surgery. I frantically texted my family and friends and was wheeled down to the OR. I had to do another COVID-19 test, which (other than the appendicitis pain) was probably the worst pain I felt during this whole ordeal.

Having another surgery so soon after jaw surgery was risky for intubation. I was intubated through my nose for the jaw surgery (hence painful COVID-19 test and spitting up blood in recovery room), so things were kind of a wreck up there (I’m still not allowed to blow my nose, by the way). But intubation through my mouth requires my jaw to move when it has been banded down to heal.

In what I can only understand as divine intervention, my jaw surgeon and his team had to cancel their Wednesday case due to issues with parts inventory. [They’ve had cases almost every day for the past several weeks — lots of folks like me needing sensitive procedures.] My doctors walked in the pre-op room to tell me they’d be there during my surgery to make sure everything went well with intubation. I’ve been giving my jaw surgeon “elbow high-fives” when I’ve seen him over the past few months, but when he walked in the pre-op room, I reached out and grabbed his hand before I could think to stop myself.

I was so scared, so unhinged, and so without my protective “armor” of “oh I already thought to worry about all of this so it’s not a surprise to me.” Instead, in those moments before another surgery, I found solace in the prayers of others for me, with the brilliant, caring doctors, nurses, and techs who went out of their way to comfort me, and with this prayer one of my amazing priests shared with me the night before my first procedure:

This is another day, O Lord. I know not what it will bring forth, but make me ready, Lord, for whatever it may be. If I am to stand up, help me to stand bravely. If I am to sit still, help me to sit quietly. If I am to lie low, help me to do it patiently. And if I am to do nothing, let me do it gallantly. Make these words more than words, and give me the Spirit of Jesus. Amen.

Looking back, so much of what was required of me during this time was sitting still, lying low, and doing nothing. I was at the mercy of my body and of the medical interventions required to heal it.

“If I am to worry incessantly about hypothetical situations in hopes to feel prepared for the worst, let me wear myself out with mental distress” doesn’t work here. At all.

And in spite of my life rules, through the support of my family and friends, strength from God, and strength to draw on my own inner strength — not my anxiety — I made it through.

I made it through the appendectomy (and the intubation) just fine. I spent another night in the hospital, and was discharged immediately to my 1-week follow up at the clinic with my jaw doctors. My jaw is healing well, I’m managing the full liquid diet well (which really isn’t as bad as I thought it would be), and in two more weeks, I’ll be out of the jaw cast and on to the next phase of recovery. My stomach is healing well too — the incisions are almost completely healed.

The moral of this story isn’t “don’t be anxious!” For anyone who lives with anxiety, having someone tell you “don’t worry” is like someone telling you “just don’t breathe, you’ll be okay.” What’s worse is when folks tell you your anxiety means you don’t trust God enough (that’s spiritual bypass folks, and I don’t have the time or energy to write about it now, but it’s just bad theology). You can trust God and still feel anxiety! (and doubt! and fear! and lots of things!)

Instead, I hope one thing you can take away from this is to be mindful of your rules, and how they will fail you, and how you can re-evaluate the rules.

And when you’re feeling overwhelmed with all of this — with life in a pandemic, and all of the grief and stress and anxiety that comes with it, imagine trying to float instead of continuing to tread water. I don’t know what that looks like for you, but I hope you can find peace in moments with abundant grace.

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