Salt in the Wound
This is a non-fiction narrative I wrote Fall of 2019 when I was about to graduate from the University of Maryland. In this piece I discuss my medical condition that affected me greatly during my years as an undergraduate.
Should I give up? I ask myself, sitting at the kitchen table re-reading the email that finally arrived with the distinct high pitched “ping!” I requested to drop two failed classes from my transcript, and according to this email the dean denied my request. My eyes well up with tears and the words in the email begin to blur. I slam my laptop shut and my body feels numb. For a second it feels like if I don’t move everything will stop, but then the first wave of tears start to flow and they are running down my face forming long shiny trails on my cheeks.
“Mom! I’m frustrated! I can’t have a 1.87 GPA,” I stammer. My mom listens to me as she stands at the kitchen counter cutting up the cucumbers for dinner. She is used to my outbursts of anger and knows to just let me vent it all out. “How do they not get it?” I add between frantic gasps for breath. I need to calm down, but I am in the middle of one of the most difficult years of my life, and I deserve a moment. Sometimes it feels like I am mourning the loss of a loved one, but in my case it is my loss of being an average 20-year-old college student. I want to be able to cope with normal problems like studying, struggling over essays, dealing with boys (or one boy in my case). Instead I am dealing with problems I never fathomed: failing classes, chronic pain, passing out in showers and working hard to maintain a relationship for which I sometimes felt I was too sick to give the attention it deserved.
I am one out of 1-3 million people who suffer from a poorly understood and incurable autoimmune disorder called Postural Orthostatic Tachycardia Syndrome, or P.O.T.S. for short. Basically what this means is that my body’s autonomic nervous system wasn’t built correctly and therefore my body cannot regulate itself properly. Simple things like standing up are difficult because my blood pools at my feet and my heart begins to beat faster to move the blood back up. That part is what occurs in a normal human body, but the part where my body screws up is that the blood cannot come back up and instead I get tachycardia and then pass out. To combat this I am prescribed medicine that spikes my blood pressure, ordered to drink a gallon of liquid a day and consume 6-8 grams of salt a day. This may not seem like a lot of salt, but the average American eats 3.4 milligrams of salt a day, and the recommended amount is 1.5 grams. Passing out is not the only symptom of this condition. Additionally, I deal with chronic pain, brain fog, memory loss, extreme fatigue, and a compromised immune system. Although passing out is traumatic, it is not the reason why I failed two of my classes in my fall semester of 2016.
“My fall semester started off fairly normal, I moved into an apartment on campus with three of my closest friends and I was taking 17 credits of classes for my two majors: studio art and computer science.” I am sitting across from the associate dean for the college of computer, mathematical and natural sciences in her office. After receiving the email where my request was denied, I set up an appointment to meet with Dr. Klemko to try and change her mind. “Also, I began the process of being diagnosed with my current condition.” I pause to catch my breath trying to deal with the adrenaline rush.
Dr. Klemko took my pause to mean that I finished my point. “I understand that, but why didn’t you drop the classes by the November 7th deadline?” She continued to talk about the rules of dropping classes, basically reiterating what I had already read in her email. I listen respectfully while trying to slow down my adrenaline. I look down at my watch and discreetly tap on the heart rate app. 170?!?!?! How is it so high? It must be the adrenaline rush, I just have to calm my nerves. I continue to look at Dr. Klemko as she is talking, hoping that the panic doesn’t show on my face. Breathe in. Breathe out. Why are you breathing so loudly! The number on my watch begins to drop. 160. 130. 110. 95. ...Alright...it’s over. I go back to listening, just in time to hear her ask me a question. “Can you explain to me how you got diagnosed?”
I take a deep breath. This is your last chance to make her understand. Don’t screw it up. “Yes. According to my various doctors this condition was probably wreaking havoc in my life for a large part of my life, going undiagnosed and instead being attributed to mild anxiety, stress and teen angst. However the first time anyone noticed something out of the ordinary was the summer of 2016 at a sleep away camp where I was the pool manager and head lifeguard.”
It was a Sunday morning and I was standing at our outdoor church service on a mild Ohio summer day. It was shady, there was a light breeze and no humidity, a rarity in Maryland but the usual in Ohio. Suddenly I started to feel off, my legs got heavy, my vision began to blur and I started to feel like I was swaying along with the wind. My mother stood next to me and noticed me swaying and immediately grabbed my hand and took me over to a bench to sit down. The camp doctor ran over to me and rather than attributing my fainting to dehydration, like my past doctors had done multiple times, he decided to take my pulse. As he held my wrist and looked at his watch his eyes got larger. “She’s thready,” he said. Thready? What does that even mean?
“A thready pulse is when the heart beats abnormally fast and the pulse feels like a small thread. This was the first sign that something was wrong with my heart and so I made my first appointment to see a cardiologist,” I explain to the dean.
“When did you have this appointment,” she inquires.
“August 8th, 2016, right before school started.”
“Then you must have been diagnosed in time to withdraw from the semester.”
“I had my first appointment, I was still far from being diagnosed. First, I had to get an electrocardiogram, wear a 30-day heart monitor, get blood drawn for a blood test and do a stress test. My first diagnosis was…” I rummaged through the thick stack of medical papers I had on my lap, trying to find the one with the date for when I met with a second cardiologist. Found it! “I met with Dr. Healy August 26th, 2016. He diagnosed me with IST which is Inappropriate Sinus Tachycardia. Which is a condition where the heart races for no apparent reason. He said I should grow out of it.”
“So you were diagnosed with something. At the very least you should have lessened your class load.”
“I would have if I had known my class load was going to be too much. Dr. Healy informed me that regular exercise and lots of movement could help my heart rate so I assumed my strenuous schedule would help me and not hinder me.”
“I understand. Now can you tell me when you were diagnosed correctly?”
“It was right before finals week, uhh December...11th?” I look at the after-visit summary from Johns Hopkins. “Oh, sorry I mean December 9th, 2016. I had a referral appointment with Dr. Calkins who performed the test that would finally give me an answer to all my problems.”
It was a cold December early morning and I was yawning for the fourth time. My feet dangled, unable to touch the floor as I sat on the examination table. I wiggled my toes in my shoes, a nervous tick I developed when I was in physical therapy for a torn Achilles tendon. I was waiting for the familiar tap tap tap at the door, signaling that the doctor was there. I had moved on to my second nervous tick of playing with the pink gemstone cross around my neck when that tap tap tap finally came. “Hi my name is Dr. Calkins and this is my assistant,” he said jovially as he walked into the room, picked up my chart and put on his gloves like he probably has for hundreds maybe even thousands of other patients. He gave a brief overview of his medical specialty and then asked me a list of pre-determined questions. “First thing we are going to do is measure your heart rate while lying down, sitting up, then standing.” I laid down, I sat up and then I stood up. My eyes started to get heavy, I started feeling anxious and I started to wiggle my toes again. It felt like I was standing for hours, but it really was under 5 minutes.
“Alright you can sit down” said Dr. Calkins. His assistant scribbled down the rates into my chart.
“Did I pass?” I laugh nervously.
“No. You have P.O.T.S.”
“I finally got the correct diagnosis in December and Dr. Calkins informed me that what I had been doing to treat the IST was making my P.O.T.S. symptoms worse, which is why I did so poorly that semester,” I confidently conclude. I look at the dean hoping to see her face full of sympathy.
“I am sorry that you went through all this,” responded the dean. Her face showed no sign of sympathy. “I understand now that you couldn’t drop the classes by the deadline.” She understands! That’s a good sign. “However..” Uh oh. Not however. “...I cannot approve you dropping two classes from your transcript.” I start to feel my heart pounding in my chest. “I can only approve you dropping the entire Fall 2016 semester from your transcript. Do you want to do that?” My stomach drops. I have to give up. I nod my head.
I’m sitting at my kitchen table. The same one where I read the email stating that my request to drop two classes from my transcript was denied. The same table where I wrote an email asking for a meeting with Dr. Klemko. The same table where I barely touched my food the day I dropped my entire Fall 2016 semester from my transcript. The same table where I realized that I had to stay an extra semester at UMD. Today, I am applying to graduate. I stare at the confirmation button. All I have to do is click. I hover the cursor over the button. *click*