When I'm faced with a big decision regarding my health, as I feel I am now re: the choice of starting a big gun medicine like Methotrexate, I tend to follow a pattern. In fact, my modus operendi looks something like this: Resist, Educate, Listen, Decide.
Step 1: I "resist" the change to begin with, be it a new drug, a lifestyle change, or an alteration to my routine. Whatever "it" is, I don't like the sound of it the first time it's suggested to me. Sometimes, I reject it outright, like I did years ago when it was suggested that I order my groceries online. I was sure online ordering was only for the sick and disabled...and it wasn't until I wised up a few months later that I realized having my groceries delivered was designed exactly for people like me (the sick and disabled!) Other times, when faced with a new suggestion, I turn up my nose at the idea, but reluctantly agree to consider it. Either way, an immediately welcomed change, it is not.
Step 2: I decide to "educate" myself about whatever change has been suggested - forcing myself to research, talk about, or explore the pro's and con's of said change. I used to not enjoy this research part very much...but now I actually find it very empowering. The longer I have lupus, the more comfortable I am probing other people for information, be it patients who've experienced the same thing, or medical professionals who could weigh in on the situation. If I think someone might have a morsel of information that could teach me something about the subject, I ask.
Step 3: I open myself up to "listen" to signs and signals that point me in the direction of a decision. I will myself to become more attuned to coincidences, and make an effort to make connections that I might otherwise dismiss. Like the time I happened upon a story in a magazine where a woman was talking about her struggle to decide to go part time at work. I was, at that very moment, struggling with my own decision to take a part-time position at my office. I could have just brushed off the occurrence, convincing myself that the circumstances surrounding her deliberation were surely different than mine. Instead, I read the entire article, and took it for what it was: a sign that if this random woman in a magazine could muster up the courage to go part time, so could I. In instances like these, I attempt to embrace the coincidence - chalking them up to fate, divine intervention, or what have you. I figure I can use all the help I can get! (Here's another example of acknowledging the signs around me - in my decision to start Cellcept years ago.)
Step 4: I "decide" on a course of action, based upon the process above. By the end, the choice to be made has usually become so crystal clear that I have very little difficulty making the call in the end.
Of course, sometimes I wish this little ritual of mine wasn't quite so predictable. I wish I could break away from the structure of my decision making process and just spontaneously come to a good, solid conclusion within moments. But it doesn't work like that. And it probably shouldn't, if I'm to make prudent, well-thought out decisions. And so I've learned to expect my ritual. I know the steps to take, and I know how the process is going to go.
And so it went with my decision on whether or not to start a big gun drug like Methotrexate: I resisted, then researched, then randomly picked up a book club book, only to read about one of the main characters being on, drum roll please, Methotrexate. Thus, I decided that everything was pointing me in the direction of starting the drug, including the fact that my prednisone taper wasn't working. I went back to my doctor, and confidently told him that I was ready to start Methotrexate. It just took about two months for me to realize it. Not bad in the grand scheme of things. I'm just glad the book I read was THIS month's book club book...rather than our casual summer reading!
In an upcoming post, I'll tell you in detail the plan that came from that most recent doctor's appointment. Never a dull moment in lupus land, I know that!