To me, one of the most difficult parts of recovering from PANS is how, just when you think you’re done having symptoms, your life can change again in a day. Sometimes, I feel like with PANS, the only certainty you have is the uncertainty of the course of the illness.

Last week, I’d been doing great in every way imaginable, but on Monday, I started having tics again. At first, I didn’t think much of it because, sometimes, I have a few here or there, and then they go away. Unfortunately, this time they were the most pronounced they’d been since the summer, and I was even having vocalizations again.

By the next day, I was constantly sniffing and grunting and making all sorts of strange noises and doing repetitive movements with my head and arms. At times, I could barely finish a sentence without being interrupted by a vocal tic.

But PANS had even worse things coming to me…

The day after that, while walking home to my apartment (and sniffing all the way there), I felt my legs starting to get heavy. I tried to keep walking normally, but they would stop responding to my brain. All of a sudden, my knees were buckling every few steps, just like they used to do all the time when I was at my worst.

Over two days, I’d gone from being 100% functional to being physically disabled and having severe tics. Why was all of this happening to me? Was this the beginning of a relapse? Would I be spending this spring break getting another IVIG, just like last year?

Most of the time now, I don’t dwell on my illness or feel sorry for myself. But this week, it hit me all over again just how unfair it is to have a disease that can leave you handicapped without warning. No one deserves to live with this possibility hanging over their head all the time.

Over the last two years of recovery, I’ve often been in denial of my illness. I used to blame myself for every flare and every tic and every obsession and every treatment I needed to have. I never told anyone, but I always wondered if maybe, there was somehow a part of me that didn’t want to get better, and that this part of me was making me continue to need treatment. I felt bad for putting my family through what they went through because, somehow, it was my fault.

Deep down, I always knew that I didn’t want to be stuck with my illness, but by blaming myself anyway, I could claim some control over the disease. If I’d been responsible for preventing my recovery, then, at any point, I could’ve decided to stop having symptoms. I didn’t have to deal with the uncertainty of having no control—or with the truth that I was doing everything in my power to get better, yet I was still sick.

But there’s nothing like involuntary movements and partial paralysis attacks to prove to you that you have no control over PANS—and that even if you felt certain you were well, you can’t be certain you won’t have symptoms again.  This week, I was faced with the reality that my wishes to get better (or my false suspicions of wishing not to) had no bearing on my recovery.

After a few days of being disabled and utterly discouraged, my tics started dying away, and I was able to walk normally. I do consider this a good sign, since I improved without any treatment. However, I’ve since developed new vocal tics (though they only happen occasionally), and I’ve had a couple nights when I could barely walk again. But interestingly and fortunately, I’ve had no cognitive or psychiatric issues, so I’m counting my blessings. For now, I’m just waiting all of this out to see if it goes away.

Still, I’d be lying if I said I wasn’t worried about what these reemerging symptoms may or may not mean.

Nevertheless, I’m slowly learning to accept the uncertainty of PANS—and my lack of control over it. I’m okay with not knowing what might happen next, because, through everything, I’ve always had an inexplicable conviction that everything will turn out right in the end. I struggle with my faith sometimes and am not always certain of what I believe, but this one conviction may be among the closest things I feel to certainty… Besides uncertainty.