Chronic illness: The tells and the pass

The Invisible Illness Pass

I can pass for healthy.

You look at me and you might not be able to tell a thing is wrong with me.

I know because while I have fibromyalgia and chronic migraines no one at work can tell when I have a migraine. Which is always. And they can’t even tell when I have a pretty damn severe one. I fake it pretty good because I’m in customer service and sales so I have to. I have the finest fake smile you have ever seen. Natural, smooth, and honest. Because I’m honest about being pleasant and happy. Just happens I’m hiding all the pain expressions and behaviours that come with it.

I have lost all the normal pain behaviours that come with pain. With chronic pain, it just happens as we adjust to the minutia of it all. We do not make a fuss about what our new normal… our tolerable pain and we mask that pain exceptionally well. We pass. We pass because we have adapted. We pass because socially it is easier to mask our pain around other people and in the workplace.

And we pass with fatigue as well. And we pass with numerous symptoms people cannot see that we mask. As best we can.

So I can ‘pass’. At work. But we all have Tells and people who know us well know them.

Our Invisible Illness Tells

We all have them. Although with chronic pain we are used to dampening those pain behaviours for various reasons, we still have less noticeable tells. With migraines, they can be quite migraine-related.

Here are mine:

  1. Loss of the ability to communicate is a tell. Whether it is brain fog from the prodrome or aphasia from the aura… loss of communication that is quite noticeable is a tell.
  2. Rubbing my neck all the time is a tell. Because my neck hurts so damn much I just want to try and relieve the tension.
  3. Violent nausea and vomiting… big old tell. My relentless nausea has definitely been noticed by my co-workers as I lose weight and can barely eat. I have also thrown up but have been as discrete as possible about that. This one… pretty obvious.
  4. Vertigo is a tell but more precisely when it is severe or when I have a drop attack. A drop attack is sudden, and I will lurch to the side it is one often either falling or falling into a wall, chair or whatever happens to be there. Severe sudden vertigo, on the other hand, I will grip onto things and immediately find somewhere I can sit safely. It is a tell something is wrong.
  5. Then when the pain is climbing up into the 8 range lack of smiling, or difficulty maintaining a smile, lack of laughter, silence until I have to talk… is a big sign for me.

I think if people are not familiar with migraines they simply do not see the signs. Can’t recognize the tells. Think you are seriously ill, even though you explain it is just the migraines. Or don’t notice at all.

I do not have many fibromyalgia Tells. The main one is adjusting my position frequently because it is painful to sit in any position for long. One might think it is fidgety but it is just to… shift the pain around. Another obvious one is my fibro fog but that comes off as really absentminded. And I am absentminded, coincidently, even without illness. So people just assume it is that. Or a bit flustered and out of sorts.

It is just that our Tells are different than Normal Pain Behaviours that we lost when we developed chronic pain. So our Tells are unique to us. Subtle and only those who really know us can really decipher that code.

But I have had people tell I am in pain by my eyes. And I do not know how. I think they are more empathetic. Because most never see that. But some… just do and I can’t hide it from them when it is in my eyes. Smile doesn’t mask that, does it?

See more

The facade

Not miserable? You must not have pain

5 things chronically ill hear about appearances 
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2 thoughts on “Chronic illness: The tells and the pass

  1. This post hot SO close to home. I’m literally sitting in my car on my lunch break bc I can’t keep up the “I’m fine” act in the office. Great post, thank you!!!


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