Holding It Together (Literally): Working Full Time When Your Body Keeps Rebelling

Chronic‑illness contortionist 24/7… human when able.

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I love my job. I love helping clients untangle their substance‑use disorders, breaking down barriers, and—now and then—being the human equivalent of a warm hug. But some days? My body stages a full-blown attack on my existence, my autoimmune diseases throw curveballs, and self-care feels like a cruel joke that will never work out. Here’s what “maintaining a full-time career” looks like for someone whose own body isn’t on her team… or any team for that matter.

Morning Alarm vs. Morning Ache

My nightstand is not this tidy.

5:45 am: My alarm blares. I stumble out of bed, joints screaming louder than my phone, on my way to revisit yesterday’s lunch in the bathroom. I want to roll over, pull the covers back up, and negotiate with my immune system: “Can we please reschedule this flare-up for next Tuesday?” But I can’t—I have a family to feed, work to attend, school to slog through, and animals (the staples of my sanity) to care for.

Yes, my partner helps, but, as they say, “a mom’s job is never done.” Plus, I’m a bit of a perfectionist—if you hadn’t figured that out yet.

So, I show up. I limp to the kitchen, brew my coffee(s), and gulp it like liquid pep talk. I swipe on “professional‑smiling” makeup over my puffy eyes. I slap on whatever clothes will fit over my bloated, sore stomach. I take some anti-nausea meds and hope I make it to work without redecorating my car.

Oh—and because of the stress on my body, vasculitis decides to torch my skin with burning pins‑and‑needles sensations that won’t subside until they feel like it. I’m literally getting pricked no matter which way you look at it.

Self‑Care: Best friend or worst enemy?

At 6:29 am, my brain whispers, “You’ve kept children alive; you can make it through today!”

At 6:45 am, my body replies, “How optimistic of you—get back in there and throw up.”

Between staff meetings, therapy sessions, notes or research, and the occasional vomit break courtesy of gastroparesis, there is zero time for a nap, a heating pad on my stomach, or a fresh fruit smoothie that my gut might tolerate. Some days, my self‑care looks like:

• DoorDash coffee and a bagel because my brain fog led me to forget my mug and lunch on the counter, despite it being packed and ready for the work day.

• Taking my medications when I’m supposed to.

• Hiding in a bathroom stall for two minutes of mindful breathing—provided the air isn’t revolting.

  
  

If I try for anything more elaborate—journaling with aromatherapy, 30-minute yoga sessions, weekly meal prep—I end up too exhausted to do anything else of substance. That’s the autoimmune norm: ten minutes of feeling powerful, then an instant crash with no warning. I really am my own worst enemy. In more ways than one.

Disability? Not an Option.

I’ve run the numbers. Disability pay + 2025 bills + being one of the household pillars = not enough to cover rent, groceries, and all life requires. As the primary breadwinner (and emotional glue) in my home, tapping out isn’t feasible. My kids, partner, and uncle count on me—even on the worst days. I have to show up, I want to show up.

So, I swallow the guilt, tighten my resolve, and pack extra makeup to camouflage the pale and red patches on my acne-filled face (from meds and hormones)—determined to be “that dependable therapist” who tries not to cancel. Sometimes, though, I make the tough call to lie in bed for a day. Then I feel the guilt of canceling on clients and looking like a terrible employee. There really is no winning.

Diet vs. Deadline

Working 9–5 (and sometimes later) means meals happen at odd times. If you’ve ever worked in the drug‑and‑alcohol field, you know how unpredictable your day can be. I might scarf a granola bar at my desk, or—if I’m lucky—microwave chicken and rice during a five-minute break and hope my stomach agrees. I don’t understand carbs, fats, and other dietary nuances. I probably need a nutritionist, but I barely have time for work and appointments, let alone more tasks.

Result: mismatched meals, bloating, energy crashes, and self-loathing about my lack of nutritional know-how—especially when I get sick from gastroparesis or autoimmune flares. I’m slowly learning to stash crackers and applesauce at my desk, but it’s hard. It’s not for the weak—and boy, do I often feel weak.

Unpredictable Flare‑Ups: The Unpredictable and Quite Rude Boss

The worst part? The unpredictability. I can feel “like death” on Monday, then somehow descend further by Wednesday, but better by Thursday. If my boss saw my body’s schedule, they’d hopefully understand—but invisible illnesses wield power that those without them can’t see.

So, I power through, smiling in sessions while stifling destruction-level fatigue. I wave good morning to coworkers as my Rheumatoid Arthritis‑racked hand trembles. It’s an endless cycle.

I don’t mean to complain—I’m in a better place than I used to be, and I’m grateful for that. But loneliness in illness is real. If you’ve ever felt unseen in your suffering, I see you. Let’s be alone together.

Coping (Because Survival Is the Goal)

1. Micro‑breaks are sacred. My two-minute car‑breath sessions or quick bathroom pauses are the only self-care I can consistently manage—and they help.

2. “Good‑enough” results. I’ve learned to ignore my perfectionist streak. Some days, good enough is victory—at work, school, or home.

3. Snack arsenal. Crackers, applesauce, protein bites—easy fuel for brain‑fog days when I forget my lunch (more often than I’d like).

4. Mental‑health team. I see my therapist and psychiatrist regularly. I can’t pour from an empty cup, but believe me when I say I have tried. It truly doesn’t work out, for anyone involved.

   
   

The Untold Truth

Balancing a full-time career with unpredictable health issues is like juggling chainsaws on a unicycle—blindfolded and without hearing. It’s messy, exhausting, and often unfair. But it’s proof I can keep going when my body and brain beg me to quit—because I’m a fighter who refuses to back down.

If you’re in the same boat—bossing up for family, clients, or whoever needs you—know this: you’re not alone. Some days you’ll feel invincible; other days you’ll be a crumpled, coffee-stained mess. Both are valid. Both are enough.

At the end of the day, we do the best we can with the bodies we’ve got. Sometimes that means celebrating small wins—making it through a session without throwing up, typing notes without locking up, or simply surviving the day. Those are victories.

So, here’s to us: the feral therapists, chronic‑illness warriors, parents, and partners who refuse to back down. We survive—and sometimes thrive—and that’s more than enough.

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HowToLiveWhileDying is about admitting that while we’re all headed toward the end of our lives, how we live—and where we put our energy—matters. Subscribe and join this pack of feral people just trying to survive and live their messy, beautiful lives.