It’s such a benign question, and probably something you hear several times a week… “how are you?”  The standard and somewhat expected answer is “I’m fine.”  But when you live with a a form of dysautonomia or any chronic illness, you may dread answering this question.

If you answer truthfully, revealing the litany of symptoms you are dealing with at that moment, some people may interpret this as whining or being negative.  “I’m so lightheaded I can’t stand up without losing my vision to a field of grey, I’ve puked twice today, I’ve had a migraine for four days and the pharmacy ran out of my beta-blocker so my heart rate is hovering around 135.”  Speaking the truth about how you are really feeling rarely goes over well, unless you have very understanding friends and family.

If you give the standard “I’m fine” response, this creates expectations that you may not be able to live up to.  Maybe you can’t go Vegas with your college friends this weekend, because you really aren’t “fine.”  If you say “I’m fine,” people may assume you’ve recovered from your illness, because they haven’t grasped the concept of “chronic” illness.

Given how complicated this simple question can be, we asked patients how they deal with the “how are you?” question. Humor and vagueness seem to be popular choices.

“Hanging in there.”
“I’m not dead yet!” in your best Monty Python voice.
“Cured! Just kidding.”
“Meh.”
“No comment.”
“Today is a good day.”
“Good days, bad days.”
“Some days are better than others.”
“The same, but staying positive.”
“Do you want the real answer, or the polite answer?”
“Don’t ask, don’t tell.”
“Same —-, different day!”
“Blessed to be here, but I still feel like —-.”
Ignore the question and ask them how they are doing.
Say “how you doing?” like Joey from friends.  Crack a joke and avoid answering!

However you chose to respond, just be thankful that someone cares enough to ask you!

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