Stress is The Devil We Ask to Stay

Stress.

For a six letter word it looks small enough. It doesn’t sound particularly menacing. Like “scathing” or “mucous” or “Republican”, you know those are gonna be bad words just by their sound. (Just kidding Republicans). (Kinda). Stress is really too small and too benign sounding a word for what it actually is. Synonyms for stress: tension, strain, pressure, nary do the malignant power of stress any real justice.

https://thesaurus.yourdictionary.com/stress

Stress is a most wicked kind of sorcery. It takes many forms; it can sit idle in wait for long periods then suddenly manifest itself is such strange ways you would believe yourself possessed. And while you fight demons you are told to take a bath, write in a journal, take a walk. Self-care will exorcise the toll stress can take on your body and mind.

There are not enough baths, or walks or journals to write in sometimes. Stress too often becomes a multi-headed monster and no amount of self-care will slay the beast.

I support the idea of self-care, in fact I preach it often to my team and to my students. I believe in the day-to-day maintenance of one’s mental health through self-care. But when stress begins to wear your body and spirit down and it cannot be healed through your own attentiveness it is time to seek help. As wiley a shape-shifter stress can be, help can also take many forms.

The last few weeks have been particularly stressful for me at work. We are now in our fourth week of a COVID outbreak with a total of 39 infected. Though we are seeing light at the end of this long, dark tunnel one of my Staff continues to struggle to get well and I am fearful for her. This last week the basement has flooded several times with raw sewage. We have had to adapt and respond to provide meal service to our 112 Residents without access to our kitchen; I have been working there and from home (seemingly) around the clock to manage both crises.

Last night at about 10:30 pm, after the clean up crew had just left for the third time in as many days, the flooding began again. I had to jump in to crisis management mode once more. I am not unique as a leader in that often we just do what needs to get done, often not “feeling” stressed, despite being stressed. As I was making phone calls my upper arm started itching. I took a look when I had a chance and saw that a small patch of eczema was forming. This was the second one in the last month. The first formed on my décolletage (fancy word for between my boobs). Nothing sexier than scaly cleavage.

As I was scratching my arm and complaining to my Mother about the irritating raised patch of affected skin she said “that is stress”. I hadn’t thought of that. I am not actually prone to eczema, on the rare occasion it has been a problem, which I now realize was likely at the times when I was most stressed. As I write this I find myself absent-mindedly scratching my arm.

This blog is in no way intended as a “poor me” blog. I signed up for a stressful job. I might not have known that a global pandemic would come in my 15th year of service, nor with it all the other issues this past year has brought; as our building ages and fails and with very few resources I can only barely be reactive, never proactive. And there are many other challenges. I am writing this blog as a warning. I am still getting to know myself, to know when stress is taking it’s toll, I may be ignorant of small manifestations like the eczema patches, but now that I have paid attention I know I am in need of a break. By sharing I hope you will be mindful of the toll stress is taking on you without your knowledge.

I have been practicing good self-care throughout the last year but it’s not enough. Sometimes you need an extended break. Fortunately my husband John-Marc has booked a cottage for us in May. I will take small breaks, hours, a day, here and there until then.

At the very start of the pandemic, when there was so little known about the virus and what we were potentially in for, I was planning for worst case scenarios. Guided by several pandemic preparedness checklists for congregate living environments from different government bodies I was tasked with anticipating severe staffing shortages, with supply chain disruptions, the creation of isolation rooms, and the worst of all the sections of these checklists – how to create a morgue space in the home if the hospitals and funeral homes were at capacity. Never could I have imagined this would be something I would need to think about. None of us did.

While I was furiously typing up our new “pandemic policies & procedures” (our existing “outbreak policies & procedures” had become child’s play in comparison), my hands suddenly felt removed from my body. I stopped and concentrated hard to make my arms move, I could make them respond but they felt as if I was using puppet strings to move them, they were mine but not mine to move. I thought I might be having a mini-stroke. I willed my hands to hit the page button on my phone and somewhat calmly called my second-in-command Christine to my office. When she came in I said “I think I am having a stroke. I feel like my hands and arms are not connected”. She said “you are having an anxiety attack”. I said that no, I didn’t think that I was, that I did not feel particularly stressed despite everything being stressful. She asked if I had any Ativan (an “as needed” anxiety medication) on me – I did – she said “take one, you will feel better”. Unconvinced I took the Ativan and she was right. I regained myself, my arms and hands back under my management.

I was shocked. It came out of nowhere. There was no build up, I did not feel any kind of physical consequence of being stressed though I knew I was under quite a bit. I have Ativan on hand to help with racing and intrusive thoughts, that’s my regular kind of mental unwellness – this was a whole new ball game.

There have been days or stretches of days working at Vic Manor (the home for folks with complex mental & physical health issues that I run, or runs me, as this blog might have you think). My worst day was when we all watched one of our much-loved Residents die as he choked on an orange. My coping mechanism that night was to drink a gross amount of pink wine. My second worst day was at the height of what had been six really difficult weeks.

As I mentioned, our building is old and showing it’s age badly. Our elevator is so old that parts cannot be found for it when it breaks down, they need to be made. As you can imagine our elevator is integral to our provision of service to our Residents. We were without an elevator for six weeks awaiting a part to be fabricated. Without an elevator everything becomes exceedingly more difficult in a place where difficult is already the standard. At that same time the City had begun construction on our street, tearing up the sewers, it was a mess. The construction crew inadvertently hit a water line which then caused us to have a contaminated water supply and therefore leaving us unable to use our water. And then we were hit with a respiratory outbreak. The day that it all became too much for me was the day when (all of the above was at play in the background) two City Caseworkers from the Social Services department arrived unannounced in my office to investigate an anonymous complaint that we were withholding the Residents personal needs money.

I stared incredulous at the two Women in front of me – they were going to go through all of our files and documentation looking for something that might be evidence of our financial mismanagement of the Residents, but as the complaint was anonymous they had no name to look at specifically so they were going to “look for anything that might appear suspicious”. As they said those words I felt a painful tightening in my chest. I was nauseous. It took everything in me to hold myself together. After a day long foray into our files they left my office with no proof of wrong-doing (obviously) I was still feeling sick. My nursing staff checked my vitals. Heart rate was really high but my blood pressure was ok. For two weeks I felt as bad as I had in that moment. Twinging chest paint, nauseousness, general malaise, fatigue. I finally sought out my doctor realizing that these were all signs of a heart attack.

After a lot of testing the cardiologist I had been referred to said I had essentially “sprained” my heart. He was dumbing it down for me but what he explained was that my job requires me to operate at a high level of stress all the time, so as a muscle does, my heart has been conditioned for maintaining that level. But even athletes can overwork their muscles. I overworked my heart muscle with stress. He said I would feel better soon and he was right. He also warned me that I had gotten lucky, and that I needed to make sure I did not get that stressed again.

Cue a global pandemic.

There have been several times in the last year where I have felt that familiar twinge in my chest and I know I need to calm down – despite not “feeling” like I was stressed but knowing I was.

I have several other stress-related-health-issue stories I could share. I am clearly not a medical professional though I spend my days orbiting the healthcare system. I am not even particularly good at recognizing and managing my own stress (as demonstrated by the entirety of this blog until this point). But I do know from experience, that if I share my experiences, people sometimes learn from them. I am the teacher in the “those who can’t do, teach”. As I said earlier, I am hoping if I talk about the toll stress has taken on my health that maybe you will pay closer attention to the toll it is taking on yours.

The pandemic has seen a drastic increase in drug overdoses and in suicides. The second-hand health consequences of COVID life are only now emerging, no doubt we will see increased rates of heart disease and other chronic illnesses that can be linked to loneliness, which is still stress – unaccompanied.

No matter what you have been doing with your days during the last year, whether frontline or sidelined, the pandemic has created an amplifier for stress. We are not who we were a year ago – even at our best we are a bit worse. We are at risk of worsening if we don’t acknowledge when it’s all becoming too much. Whatever your too much is, there is no hierarchy of experience, it’s not how anyone else would feel about what you go through, it’s how you feel that matters. Admitting we feel stressed – admitting we are scared, sad, overwhelmed, lonely, tired – or, stressed – can actually be the first step to saving our own lives. Getting help is the next.

Feeling our stress is not weakness. Getting help is not weakness. We were created to live, not only to endure.

“Inspired by the HPA axis,” by Kanani Miyamoto

https://en.m.wikipedia.org/wiki/Hypothalamic–pituitary–adrenal_axis

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