Well...I Did It

I’ve been waiting to say that for a while. I finished my PhD! I even got the job I wanted - I am officially a professor doing qualitative research. I wanted to leave it at that and say I lived happily ever after, but this journey has been a little more complicated than that. I hope that what follows doesn’t read as a complaint, but rather as an examination of some underlying issues that I’ve only recently become truly aware of.

I was happy when I graduated in December - I really was! But it was unexpectedly mixed with anxiety and health concerns that started shortly after I defended my dissertation in late October. In fact, that event was what really signaled the end - doing final edits and submitting my dissertation would rather easily fall into place. I would consider my feeling going into the defense controlled nervousness - it was a huge milestone and I knew it, and I wanted to do well. I presented my research to a small, but intimidating, room of my committee and my family. I said everything I wanted to the way I wanted to, and did pretty well fielding questions. After my presentation, everyone but the committee left the room while they decided my fate, and shortly thereafter, we were asked to come back in. They immediately told me I passed, and there were lots of hoorays and congratulations, along with immense relief on my part.

Me with my committee after the defense.

I celebrated with my family at dinner that night, and when we got home afterward, I remember feeling sort of unsettled, and a little anxious about it because I thought I should have felt nothing but relief and calm. But we were getting ready to go to Ohio the next day, so I sort of pushed it aside and got ready for our annual fall trip.

As the weeks went by, I still had a lingering sense of anxiety, sort of like a cloud hanging over me, but I couldn’t figure out why. As November came around, I started having some physical symptoms that I couldn’t really figure out, like something that sort of felt like a heart palpitation, but a little stronger and just  different than what I’ve felt in the past. I also felt like my breathing wasn’t great, but my asthma occasionally flares up, so I just thought that’s what it was. In addition, I was having mild chest pains, but I thought maybe it was related to the asthma somehow. I went to my primary care provider (a nurse practitioner), and she ran a bunch of tests and asked me some questions, but generally didn’t think it was anything serious and suggested anxiety may be a part of it and asked if I had anything really stressful in my life recently. "No!" I practically yelled, informing her that this was supposed to be a completely stress free time in my life because I just finished my dissertation and grad school. She only half jokingly said that it could be a little PTSD, and I laughed, but also kept that in the back of my mind.

My graduation posse - this happened in December and I was so glad it was officially over!

As my symptoms continued and preliminary tests were clear, I made my way to my GI doctor, thinking maybe it was something with my esophagus since my dad had something a doctor referred to as a "twisty" esophagus that used to occasionally twitch or spasm. When I described my symptoms to the doctor, he immediately suspected reflux, even though I never really felt heartburn, which I thought was the same thing. So he scheduled me for an endoscopy, which ended up being one of several test I'd have, including a chest x-ray, an echocardiogram, a breathing test, a barium swallow (basically an x-ray of the esophagus), and a basic physical neurological test. Everything kept coming back normal, although the endoscopy revealed minor reflux, so I continued taking the PPIs (acid reducers) that I had begun prior to the endoscopy. I had also started seeing a psychologist to help deal with the stress of all of this, and perhaps work other areas of my life that I had neglected while I was busy raising babies or focusing on grad school. She suggested doing mindfulness practice (basically meditation), and I have been doing that since January. (I love an app called Headspace, which guides you through it).

Ultimately, I ended up seeing an ENT doctor, who finally gave me a diagnosis. It was actually a nurse practitioner at my allergist's office who suspected the problem, because I kept saying that I had trouble breathing IN sometimes, but not out. She did the breathing test differently, with me inhaling instead of exhaling (usually with asthma it is exhaling that is problematic), and she briefly mentioned vocal chord dysfunction and referred me to an ENT. I couldn't understand how any of this related to my vocal chords, but I was able to go to the ENT that day. He did a nasal scope to see down my throat (through my nose - not fun), and he said that I had laryngeal reflux (reflux in my throat), and that can cause dysfunction of the vocal chords, which in turn can cause constricted breathing because they don't always open properly, allowing for air to come through the airways they're next to. It can also cause throat tightness, hoarseness in the voice, possible chest pain, and possible muscle spasms around the throat, which may be what I thought were heart palpitations. So he switched my PPI medication and gave me a handout on breathing techniques to help "retrain" my muscles to breath properly. He also sent me to a speech pathologist, who would looked at my vocal chords through something called video stroboscopy (which is basically looking at them live with a little camera while your talking/breathing/swallowing). She gave me more exercises and strategies for helping the condition, and I felt a renewed sense of positivity.

In brief, however, I did not consistently feel better - I had good days and bad days, and I couldn't seem to predict when either would happen. Sometimes things felt even worse. There were days when it just seemed like the throat tightness and difficulties breathing would take hold of me, and it took everything I had to calmly work through them all day. I continued the breathing exercises, but they didn't always seem to help. This was also all happening during the peak pollen season - a  particularly bad one I'm told - and the combination of allergies, asthma, and VCD became very confusing to figure out, as each affects the other. This made my anxiety even worse (did I mention that I was told anxiety can make VCD worse?). It was also hard because Gabe was out of town on several one-week work trips over a period of a few months, and I worried about being able to do everything I needed to - for myself and the girls - on my own. I realized at several points throughout this time that my anxiety was starting to get out of control, but if you've ever had bad anxiety, you'll know that the advice to "calm down" or "stop worrying" is the last thing you feel able to do. But I began to focus as much as I could on working through my anxiety so that I could at least better handle my symptoms. I was doing meditation at least once a day, visualizations, appreciating my ability to spend time with my family, journaling, and exercising. I was getting 30 minute massages every week or two - partly to help with relaxation but also to help with all the tight muscles around my neck, which can affect all the small muscles around the vocal chords. I also learned a breathing technique that Lee found online and shared with me, and it has been really helpful (I highly recommend it). I started acupuncture a few weeks ago as well, and I can't tell for sure if it's making a difference, but I at least get to lie quietly for about 30 minutes during the process and focus on rebalancing my energies and "unblocking," as my acupuncture doctor would say.

I have seen noticeable and consistent improvement in the past month - something I began to think I'd never be able to say! I'm definitely not back to normal, but I'm having more normal moments during most days, which is good enough, given that I haven't breathed normally for a whole day since some time in November. I have become very aware of the way I experience stress, and of the way anxiety breeds anxiety and can certainly lead to physical symptoms. I'm a full believer of that now. I don't know know for sure what caused what, or why I suddenly had the kind of reflux I had, but I feel more open to seeing it all now and not resisting it, not just trying to force it all away (which doesn't work, by the way). I tried to downplay the major transition that was happening in my life - finishing a 7-year journey that was wonderful in many ways but one that was also stressful and left little room for down time, which I sorely need. I also tried to rationalize that my new job was not a source of stress because it happened rather seamlessly. I had been working there part-time as a grad student for two years, after all. But this role is different, and it is new, and I have a big learning curve (not to mention little support on getting started). It is going well overall though, and I am definitely not taking it too seriously. It is work, and it is rewarding in a lot of ways, but it is also a pretty lax environment, and I will take advantage of that as much as everyone else does (which seems to be a lot). Here's my work profile: http://cfs.cbcs.usf.edu/faculty-staff/detail.cfm?id=1300.

I realize I didn't mention many of the wonderful moments that have happened during this time - like seeing friends and family in Ohio, Thanksgiving with my family, my graduation, Christmas with Gabe's and my family, beach trips in the winter in Florida, celebrations at the girls' school, reading lots of books for fun, and a general renewed focus on celebrating time with loved ones on the weekends - mostly obligation free. I have cherished all of these things probably even more than I normally would have because of my heightened sense of not knowing what the future holds.

For all I know, this may be as good as it gets, and I may never be able to expect to have this condition completely under control. And I am working on accepting that. But I'm also working on understanding all aspects of it and doing the treatments that I think are best for me long term. My psychologist reminded me that, even though nobody should have to struggle a lot for a long time, we often learn new tools or ways of doing things through struggle that we can carry with us the rest of our lives. I have definitely done that throughout this ordeal, and if I have to go through everything I've been going through in order to learn those things, maybe it will be worth it.

We are a little more settled into our new routine now, with me working at USF from 9-3 each day and then picking the girls up and having the rest of the afternoon with them. That was definitely a change from me working about 10 hours a week from home while Eleanora was only in half day preschool and Evie was in full day school. Now they're both full day, so Eleanora has had some adjusting as well, but it has mostly been good because she is so social. She surprised us with how eager she has been to learn. She's started reading readers regularly, and she loves math! She is constantly asking us to "give her plusses" or math problems. Evie is blossoming in her first grade class and has made a couple good friends, but has one BFF in particular. Although she started reading later than many of her peers, she seems to be making up for lost time. She has been devouring chapter books lately, and she especially loves Amelia Bedelia and wants to point out all of Amelia's silly misunderstandings. Although Gabe has been out of town a lot, he is building his brand, as they say, as an Agile coach, and has been an invited presenter or panelist at several conferences. And we recently bought a new minivan! Gabe's car was 17 years old, so it was time. Gabe is inspired to go on a road trip soon, so who knows where it will take us?!