With CAD, even seemingly small things can prompt medical trauma

I started trembling when I saw the tribal warrior approach with a wicked long spear. Yikes! How can I get out of here? I looked around the room and realized there was no escape. The man and his henchman were in the room with me, while reinforcements stood just outside the door. I closed my eyes and waited for the inevitable.

Ouch!

I held still as the “spear” went into my nose. The dermatologist injected a local anesthetic. I tried to practice slow breathing, but I don’t think I succeeded. I forced myself to remain motionless while the dermatologist took a biopsy of my nose.

What happened

Two weeks ago, I visited my dermatologist at the behest of some friends. Normally at this time of year, I’d be in Sentani, Indonesia. However, my friends were concerned about an injury on my nose and gave me airline tickets to my home in Auburn, Alabama. So not only did I undergo a biopsy for skin cancer, but also I did it while my sleep cycles were completely topsy-turvy. These would be traumatic events for anybody, but my cold agglutinin disease (CAD) always pushes my “window of tolerance” for trauma to the limit.

CAD is a chronic disease, meaning it is a constant companion that never leaves me. It lowers my immune response to other diseases as well as delaying the time it takes to heal. According to Stacey Feuer, a specialist in behavioral and mental health, trauma can be described as a “deeply distressing or disturbing experience.” She adds that chronic disease means chronic trauma.

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Somewhere between 300 and 3,000 people in the U.S. have CAD, which means it is a poorly understood disease, even by members of the medical community. This also adds to the trauma.

So my panic and traumatic response at the dermatologist’s office was only natural. On the surface, my response was a bit over the top. A biopsy for skin cancer is a simple procedure. My doctor looked at the slow-healing injury, frowned, and explained to me what he needed to do. I signed the consent forms and he proceeded.

“Thank you,” I said to the doctor and his assistant. I gathered the shreds of my composure and went to the front desk to settle accounts. (By that I mean I paid my bill. I did not “settle accounts” in the way that some novels describe it.) I made it out to the car, and then my trauma response took over.

My response and coping strategies

I felt as if I had been punched in the nose. The local anesthetic was wearing off, and the site of the injury started to tingle. I began trembling. Overwhelming fatigue set in. I waited a few minutes for it to pass before starting my car and driving home.

Feuer lists some physical responses to trauma, including dizziness, difficulty breathing, headaches, nausea, and weakness. I experienced all of these in the three days after having the procedure. I also noticed a change in my appetite, which is a behavioral shift she had listed as well. While I normally avoid food with lots of carbohydrates, I found myself eating fall-back comfort foods. This is a temporary change.

On the day of my biopsy, I held myself together until after a luncheon with a friend. Then I gave in to my trauma response. In an online forum, I wrote, “I just want to crawl under my covers and howl at the moon!” Everything was overwhelming: my sudden travel to the U.S., the constant adjustments to my CAD limitations, the painful assault on my nose, and the very real possibility that I might have skin cancer.

All of us “CADdies,” as we refer to ourselves, are dealing with some type of trauma. My response to the biopsy was perfectly reasonable. I’ve attempted to practice some of the coping strategies Feuer mentioned, such as breathing and grounding techniques and adequate sleep, but they don’t always work.

I prefer my own strategy: Tonight, I’ll howl at the moon.

Note: Cold Agglutinin Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Cold Agglutinin Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to cold agglutinin disease.