Melvin & Me, Part 29: So there's a Pandemic and I'm Immunocompromsied...

I have a self-depricating joke that I like to make about myself, when someone worries about me getting sick by getting too close to them:  "oh, don't worry--my immune system is so good it attacks me."  

That's the core of what my Crohn's Disease is, that my immune system is a wee bit overzealous.  And in this very good objective of protecting my body from harm it has collectively destroyed parts of my body, to put it bluntly.  

It's about balance.

Naturally, then, a considerable portion of my treatment plan involves therapies to inhibit my immune system, trying to slow it down enough that it no longer attacks my own cells but still robust enough to fend off any legitimate danger.  I am actively taking medications that inhibit my immune system, some are systemic and some are targeted just to certain areas.  There have been other times where I've been on a couple of systemic immunosuppressing medications at the same time.  This is a balancing act, at best.  Too little and we head back into a flare-up, where Crohn's symptoms roar back violently and dangerously.  Too much and a cold sends me to the hospital when my body cannot fend it off.  And, of course, it's a moving target, meaning that I'm regularly sending bloodwork to my doctor's office in case we need to make any adjustments.  One particular medication that I'm taking needs at least three months in my system to have any therapeutic value--this means, too, that any adjustments we make to it will take time to show results.  

So what does all this mean?  

The short version:  I have a predisposition to come down with some interesting things and potentially recover from them more slowly.  

The long version:  Well, in a normal day, I have a few restrictions on what vaccinations my doctor signs off on for me, that I cannot have any attenuated vaccines--i.e. live, weakened strains of a pathogen as compared to fully dead ones; it's a rather unlikely chance for anything to go wrong for me now, but my levels have been much more volatile at different points of my treatment.  Ergo, we just don't risk it.  I use the joke to help diffuse concern or guilt, but that doesn't mean that I don't take some simple precautions where I can.  I monitor any symptoms and check-ins with my body extensively, bordering on obsession.  I am VERY proactive in my care, including sensical preventative measures and many early bedtimes.  I struggle with the question on when to stay home from work (because comparatively whatever I'm experiencing is probably "not as bad" given that the top of my scale involves ruptured organs), but once I have made the decision to go to the doctor, it's all action.  

Now, let's add in our friend COVID-19:  I'm concerned, but I'm not worried.  I wash my hands like Lady Macbeth, but I continue to live my life.  I'm not going to church right now--in part because I have some people I very much want to hug but don't want to risk being a vector for them either.  Small changes, but not panic.  I've taken microbiology in the past, meaning I know there's a point where I cannot expect supreme victory over microbes, partly because of how helpful they are in our own bodies (e.g. bifidobacterium in your colon, that helps you fixate Vitamin K--no microbe means no absorption of Vitamin K), which is very freeing and daunting at the same time.  It's about balance.  

So, yes, I'm limiting my time in larger groups.  And I'm washing my hands, and limiting touch to my face, and finding that my favorite non-touching greeting is either a smile and deep nod or a smile, nod, and hand-over-my-heart combo.  I decided to work from home when given the chance.  But I'm also relatively relaxed.  I go out when I need to, avoiding any peak times if possible.  I'm still getting work done that I need to and assessing the timeing of "need to" as applicable.  I have a couple flavors of hand sanitizer because I like the different scents and get bored with Purel.  The more people who ask me if I'm okay, the more I start to second guess that calm. 

ONE MORE THING:  There's no way you can know that I have an autoimmune disease to look at me.  I am emphatically not the only one--just a very vocal one.  Even persons in the "safer" age bracket can be susceptable in ways that are not readily obvious.  Related:  we don't know whom anyone is going home to, meaning that while the individual in question may not look or seem vulnerable whomsoever they live with may be.  What we do is for the community as a whole, protecting the least of us in whatever form that means today. 

The takeaway:  I think it's fair to say that everyone is sitting on a lot of uncertainly and a lot of disappointment.  Whether you're sad that your favorite restaurant is closed or your vacation/study abroad plans fell through or you're not sure if you'll have enough work hours to pay your rent/mortgage this month, there's a lot of fear and uncertainty floating around out there.  People can cling to silly things in uncertainty, trying to find safety in a pile of toilet paper.  And others can take a breath, acknowledge the fear, and find ways to support each other.  Are you avoiding being a vector by only sticking to small groups?  Can you call a friend in a nursing home instead of visiting?  Does your elderly neighbor need anything from the grocery store while you're going?  Is your favorite local business selling gift certificates that you can use to put money in their pocket today and use later?  Can you teach your coworker how to use the online tools available to them for videoconferencing?  I'd rather put my energy into these places than worry if I'm going to get sick.  I'm going to get SOME kind of sick eventually--again, freeing but also disturbing.  So it's balance, concern but not worry.  Alert but not anxious.    

And in the meanwhile: