Rosemarie

you've been through a lot

Last week I had a long-awaited appointment with a spine specialist at the University of Virginia. My neck has been getting worse and worse since my head-on car wreck almost six years ago. The last two years have been particularly hard, with huge muscle knots in my shoulder and middle back plus stabbing pain in my neck when I move the wrong way. 

I have long said I have a high pain threshold. I’ve learned this is common among people who have suffered trauma; we learn to just deal with whatever comes along without making waves. We keep it all to ourselves, all inside, no complaints. A high pain tolerance is learned and I have learned to mostly tolerate my neck.

This is the neck that has seen so many chiropractic adjustments, over a thousand dollars in deep-tissue massage, dry needling by two different practitioners, acupuncture that was supposed to cure the world, and a full course of PT in which I was advised to see a therapist, thank you I already do. It’s the neck that contains muscle spasms so hard my chiropractor referred to them as “other-worldly.” The neck that gets so exhausted during the course of a day I periodically have to lie down just so I can stop holding my head up. That neck.

The day started with a call from the Spine Clinic just two and a half hours before appointment time, telling me that they did not have an authorization for today’s visit. If you’ve ever had to work with Tricare (or any insurance company, for that matter), you understand my angst. I just knew we were not going to make this appointment I’ve waited literally months for.

But desperation drives us to try the impossible, so I first called Tricare to make sure there was, indeed, no authorization on file. There was not. The kind lady suggested I call my primary care manager.

With less hope than before, I dialed the number, suffered through the automated phone process, and finally got the human in charge of referrals on the line. I gave her the appointment details and said, trying to hide my frustration, that there was no authorization in place and that I had to leave for the appointment in 45 minutes, it being an hour and a half drive to Charlottesville. She asked a few questions to clarify, then said, “Give me five minutes.”

Imagine my disbelief when my phone rang moments later and I saw that it was my primary care office calling. My friend in the referrals department said brightly, “Mrs. Sargent, your referral has been approved by Tricare and faxed to the provider at UVA. Would you like me to give you the authorization number?”

Miracles do still happen. I thanked her profusely and tried to relax on the drive there.

We got to the clinic exactly at my appointment time so we didn’t have to wait long before they called us back. Walking down the hall, our escort said, “I’ll take you for your X-rays first, then to the exam room.”

My anxiety immediately shot up and I started stammering, not knowing what to say. I looked to Ben for some guidance. No one had told me I would have X-rays first thing, before I’d even seen a doctor, and I didn’t know what to think. I hadn’t expected it, and even though it was just X-rays, which is a completely reasonable request at a spine clinic, it was unexpected and threw me completely off guard. I felt myself choking on my breath and tearing up.

The escort noticed and asked, “Would you rather see the doctor first? That would be totally fine. Whatever you’re comfortable with.” She could see I was struggling. I looked back and forth between her and Ben and could not find words to express what was going on my body, which felt like panic.

Let’s stop here and remember that it is 100% normal to be at a loss for words when your body is panicking. We’ve talked about this before, but I’ll say it again to help you (and me) remember: the part of the brain responsible for language gets kicked offline when the nervous system is highly activated like this. It is not even accessible. It’s like that part of your brain has left your skull. You literally (in the literal sense) cannot find words.

Ben did not tell me what to do, but he was reassuring enough that I could go in the room and let them take a few X-rays of my neck. Both women were very kind and very patient. They let me take a moment to breathe and calm down. Then I was taken to the room where Ben was waiting.

At the time I had no idea what was so triggering to me, except that the X-ray thing was unexpected. That’s the only reason I’ve been able to figure out. I’ve had X-rays before. I’ve been in medical settings before. I’ve even been in that very clinic when Ben was a patient. None of those things was the problem. What you (I) need to understand is that our triggers don’t always make sense. Sometimes they seem “ridiculous” and it’s easy to jump directly into self-shaming. Do not pass GO, do not collect $200.

In addition to the unexpectedness, my window of tolerance (which I wrote about here) had already been challenged that day with the whole trying-to-get-an-authorization-in-a-hurry thing plus the long drive to get there. So I was working with an already-activated nervous system. The X-rays just pushed me outside my limit.

But there I was in that little exam room with Ben, crying and asking the same old stupid “what is wrong with me?” question, and Ben said gently, “There’s nothing wrong with you. You’ve been through a lot.” And that right there is the million-dollar answer.

You’ve been through a lot.

You are (I am) allowed to be human. Your nervous system is allowed to do whatever it does at seemingly random, inexplicable times in its never-ending quest to keep you safe. It is the giant red-flag carrier that goes through your whole life with you, from birth to death, always ready to signal anything that doesn’t feel safe. You won’t always see the “unsafety” that your nervous system sees, but you can always thank it for working on your behalf. (I am preaching to myself.)

So in the few moments before the doctor came in, I did some 4-7-8 breathing and rubbed the little bone behind my ears, all to activate my vagus nerve and help me get back to a calmer state.

Then in came the happiest little orthopedic surgeon I’ve ever met, who introduced herself to us as Rosemarie (no last name). She saw right away that I was struggling and her demeanor changed from bubbly to gently compassionate in an instant. She pulled up her little rolling stool, gave us all her attention, and asked, “What can I do for you today?”

I inhaled and immediately began crying.

Again I couldn’t understand what “my problem” was, why I couldn’t get words out, why I couldn’t even interact with this person whose job was to figure out why my neck was such a mess.

Ben began explaining and Rosemarie asked some questions, but honestly, I don’t know if I’ve ever seen so much compassion in a doctor’s eyes. She was not at all bothered by my emotions, and I finally found my words and we got through the appointment with a plan of action I am somewhat comfortable with. Her words and demeanor were a big part of the reason I was able to come back inside my window of tolerance so quickly.

An hour later, sitting in Bonefish Grill talking about the whole thing, I realized I was crying because of the overwhelming sense of relief that I was finally going to get some help. Someone was going to take care of me.

I have spent my whole life taking care of everyone else. From childhood I have tried to manage the emotions of everyone in my presence, keep them all happy, meet every need in an effort to prevent things from getting out of control. I have felt like the happiness of the whole world is on my shoulders and they are just worn out. It’s not that no one has ever tried to take care of me, it’s that I have never let them. I’ve taken that job on myself for reasons that are even now being uncovered in therapy, but what it boils down to is that I am a chronic people-pleaser.

And here I was, on the other side of the fence, being the one getting the care, and I didn’t know how to handle it other than to cry with relief.

So what’s the point of this story? It is this: Your body is speaking; are you listening?

When my body panicked over being told I was getting X-rays unexpectedly, it was saying, “Hold up! I didn’t know this was coming. I am mentally unprepared. I am not in control here, so who is? Can they be trusted? Is this situation safe?”

Once my body understood it was in a safe place with safe people, I could get the X-rays taken.

When my body was flooded with relief and broke down in tears, it was saying, “Finally! I have been so strong for everyone else for such a long time. Finally I can stop being strong and be taken care of.”

Once my body understood it was going to be cared for and that was okay, I could stop being overwhelmed with relief and have a conversation with the doctor.

In both cases, my body had to be reassured before I could continue. It was not my logical, thinking brain that was struggling in these situations—it was my physical body, my actual nervous system. My body reacted before my brain did. My body wanted my attention. My body wanted to know it was safe.

Friends, this is how God made us. When your body has been unsafe once, the next time it senses anything familiar to that experience, it assumes you are unsafe again, and the familiar thing it senses may not be within your consciousness. In fact, often it is not. That’s why triggers can be so unnerving: we don’t understand where they come from because we are not always conscious of them.

So when you are triggered, don’t self-shame. It is not helpful.

What is helpful is to meet yourself with compassionate understanding that your body is doing the best it can to keep you safe. Have a few tools to help bring you back to a more regulated state.

Aundi Kolber, therapist and author, recommends this evening practice: “Hand on heart. ‘May I honor everything my body carried today.’”