Lessons in the Rear-View

Lets face it, we start out with the best intentions, right? When I initially created this particular blog, I had the awareness that my life had forever been altered by whatever was going on in my body.  Before I was 3, I had already been hospitalized and some say miraculously survived spinal meningitis. My childhood was marked by several visits to doctors and specialists because of ear infections, allergies,  bouts of strep throat, mono, recurring lung infections, and my fair share of freak accidents – I’ve truly been a klutz and an enthusiast – my entire existence. I was diagnosed with hypothyroidism and rheumatoid arthritis by the time I was 19. Several years before I started this blog, I had been sent to the Mayo Clinic (Dec 2006) after I had failed several stress tests because I kept collapsing (passing out) before I could finish.

After monitoring my heart and collecting urine for 24 hours, enough blood draws to satiate the requests of the 3 or 4 different specialists that were consulting on my case  that primarily specialized in cardiology and endocrinology, and a tilt-table test that literally felt like it was out of the middle ages, their consensus was that I had Postural Orthostatic Tachycardia Syndrome (POTS). Their notes also suggested that they believed I had an active eating disorder (I was 5’11 and around 130lbs if memory serves), that I was lying (over-reporting) my history with alcohol because my liver function was ‘optimal’, and one of them even blatantly referred to me as a hypochondriac in his notes.

Fortunately, the PCP that followed my case from before I was 12 until just before I turned 35 (when he closed his private practice) knew that enough of my labs, enough of the medical tests were abnormal or just within normal ranges enough to be suggesting something was significantly off. He also knew that while I could appear to be anxious or even manifesting manic-like symptoms with rapid speech, I had survived my fair of traumatic events and I had extremely adverse reactions to psychiatric medications that had been administered when I was a teenager.  He was convinced that I had a medical condition that was systematically undermining my body – at one point, he openly admitted, he fully expected we’d find cancer hiding somewhere because my symptoms were impacting so many different systems. He also believed in treating patients like human beings, rather than lab rats or case studies.

Hindsight makes me think, I was his ground 0 patient – I mean he was a traditional pediatric doctor when he first treated me.  By the time I was 19, he was a doctor with a focus on holistic healing who also utilized traditional medication when necessary – as is the case with hypothyroidism. In his practice, he offered several alternative treatment options like frequency specific microcurrent (FSM), acupuncture, and antigen therapy. There’s no doubt in my mind if he hadn’t been my established PCP by the time I was 19, I honestly wouldn’t be here. He saved my life in more ways that I will ever be able to recount.

When I started this blog almost a decade ago, I chose “Striving for health – for life” as my title. There was intention. I knew that my health was not just going to magically improve if I continued doing things the way I had been doing them. Consider the definitions for striving: to make great efforts to achieve or obtain something OR to struggle or fight vigorously. 

I was already in over my head, treading water, barely able to breathe. I knew that it was a matter of life and death, between existing or truly living. I knew that it was something that was going to require continual commitment and concerted effort. I also thought we already ruled out the worst-case diagnoses, that we were through the darkest hours, that it was going simply going to require some learning and adapting. I knew that I was going to be striving to – maintain or improve – my health for the rest of my life if I had any hope of truly living.

Of the FOUR blogs I’ve conceptualized here on wordpress, this one appears to be the one I have the most to contribute to now that I’m looking in the rear-view. The past 5 years in particular have been fundamentally disrupted and defined by additional consultations with medical providers, more surgeries – some of which I probably should have seen coming or at least can admit were overdue by the time they occurred, and a lot of mere surviving at points when I didn’t have enough energy or strength emotionally or physically to muster anything but mere surviving.

There have been radical changes in my treatment team. Two of my primary providers (the above mentioned PCP and my OBGYN of over 15 years) both made shifts in their personal and professional lives in 2019 that eliminated them from my treatment team. After searching for years for an endocrinologist that wasn’t going to kill me by making dramatic adjustments to medications just because they didn’t like the way my prior providers has made their diagnoses, or who seemed to primary only focus on diabetes, I finally met one of the most compassionate, competent, and collaborative providers possible.

Also, after years of my old PCP circling around the idea that I really needed to avoid the ERs [because almost all advice given by the ER MDs was detrimental as was the potential exposure to viruses and bacteria at the hospitals], I desperately seemed to need the fluids they would administer via IV on a somewhat routine basis. By what I’m just going to call divine intervention, a place that specializes in outpatient IV hydration, cocktails infused with vitamins and medications designed to help with different things from dehydration to post-chemo treatment or to enhance athletic performance, opened within 5 miles of where I live. It was the first alternative therapy that my insurance agreed to cover – and therefore proved to be affordable.

This has not been easy. The struggle is REAL in the truest sense. I have literally fought for my life and flirted with death more days than I’d ever have imagined.  I have some days where it is easier than others to be intentional about making choices that are beneficial for my health. Realistically, every decision that is not beneficial, is at the very least not helping and its equally probable that it is actually hindering or detrimental to my health.  I’m desperately trying to LIVE better than I have while I’m not getting any younger. I’ve absolutely redefined what “normal” is for me – I’ve stopped trying to compare myself even to any former version of myself, let alone to anyone else. I know that what has worked for me will not necessarily work for another – but I do believe that we can absolutely learn and benefit from each others stories.

Moving forward, I intend to share some of my journey as it pertains to my challenges with living with a chronic illness that is rare, ‘invisible’ and one of the most prolific serial killers I’ve ever witnessed in my lifetime (claiming over 40 lives in the past year). According to the PET scan in 2016, there was absolutely no sign of cancer despite concerns that with my family history its inevitable, but I do have secondary adrenal insufficiency and  hypothyroidism. I am a trauma survivor. I will never have children.

I also jump from a poured porch to a board (before a sidewalk existed on a new build) in March 2019, that hindsight being 20/20 I never would have dared to leap if I had known how rough the landing would be. The simplified version is that I landed in such a way that I destroyed what remained of both of my ankles (I also literally had my vision turn ‘sepia’ almost instantly from the shock). Now that both ankles have undergone reconstructive surgery (6/11/19 and 12/17/19) – and I’m 90 hours into 6 weeks of non-weight bearing medical restrictions with 15 days until I return to work, it seems the most logical time to embark on sharing these lessons in the rear-view, as I continue to strive for health – for whatever number of days I will be gifted in this lifetime in this life of mine that has been forever altered.

So it continues

While I was in treatment (physical therapy) for my frozen shoulders, a strange symptom emerged tormenting my right forearm. I recognized immediately it was nerve related pain – just new and strangely isolated between my wrist and elbow. My physical therapist wisely told me to see the doctor. He ordered a test I despise, an EMG, but the doctor he referred me to was magnificently merciful in the administration of the test. He also asked me a straight-forward but alarming question. “If we were to cut you in half and we could only eliminate your symptoms on half of your body for the rest of your life, which side would you choose to intervene with?” Hands down, the right. His findings indicated carpal tunnel on my left, nothing that surprised me. They suggested an issue with nerve C6 were implicated for my right side symptoms.

Of course, the PT on my right shoulder was abruptly stopped and I was told to stop swimming (something I’ve been avidly doing since late April) while I anxiously awaited the appointment with the Spine Specialist.

Fortunately, that appointment was squeezed in before my husbands surgery this morning. The diagnosis is cervical radiculopathy, though the cause is suspected to be inflammation, the factors contributing to the inflammation are not fully known. The prognosis is manageable. For the next month, I’ll continue going to physical therapy twice a week but specifically for my cervical spine. I’ll resume swimming and rowing and all the stretching exercises to keep my frozen shoulder loose and maintain the range of motion I’ve regained in the last two months. I’ll also resume working with my chiropractor who has essentially kept me upright and walking single-handedly the last couple of years. At the end of July, I’ll consult with the Spine Doctor. They may consider steroid injections at that point depending on where things are at. The relief for us is that surgery is not in my near feature from the images of my spine.

Of course, my weight loss is hindered by the steroids I’m on to manage the adrenal insufficiency. The estrogen dominance that plagues me due to my body’s propensity for attacking my limited amounts of progesterone isn’t helping either. But ideally, within the year, I’ll have lost some of the body fat if not the weight.

We have acquired a few new tools that help us with things like tracking muscle quality and body % fat in specific muscle groups, activity and sleep trackers and devices that make working out more enjoyable. All in an attempt to strive for better health even as we continue to encounter challenges and very clear setbacks on the roads to “recovery.”

Frozen

For the last decade, I’ve faced a lot of health challenges. It began spiraling in July of 2014. I worked a third shift on a Friday night, I was due at work by 1100 am on Sunday. By midnight on Saturday, I walked into an ER with a fever over 104. I was admitted with horrid pain on my right side and extreme nausea that I would endure for the next 14 months. I was admitted under the pretense of something about my appendix, but within 72 hours with IV painkillers and non-stop fluids, I was discharged (I didn’t have insurance because of a glitch in the system – a mistake on the part of the government) and told it was an ovarian cyst that was culpable for the pain.

That fall, I underwent an upper GI and res tech, as they attempted to locate the cause of the nausea. Within ten days, I was put under again to permanently cauterize my nose. I had been having my nose chemically cauterized dating back to when I was 16, but it was determined that a more permanent solution would be more prudent. Randomly, getting watery bloody noses was not exactly a hazard I could afford with my job as an intake specialist at a psychiatric hospital.

By mid-December, the nausea was intolerable and the right side pain was again mounting. I underwent a week of diagnostic testing, being sent between a bunch of specialists before it was determined that my gallbladder needed to be removed. It was removed on December 22nd, 2014. The hope was that the right side pain and nausea would be fully resolved. It wasn’t.

I collapsed less than 2 weeks after surgery on a snowy driveway. I was transported via ambulance to a hospital, they administered fluids but ultimately were clueless about what had happened. Two months later, while at work I got extreme chest pain and I was transported via ambulance to a hospital. Ultimately, they could not determine what had caused the chest pain and they only gave me more Zofran to help with the nausea.

In mid-2015, I was diagnosed with Primary Adrenal Insufficiency, i.e. Addison’s disease. Suddenly, symptoms I had suffered for over a decade made complete sense. The sodium and potassium imbalances made sense. The constant walls I hit – the debilitating exhaustion. The weird heart symptoms. Even my hypothyroidism made more sense in light of Addison’s.

In September 2015, I was again overwhelmed by the nausea that had yet to relent since July of the year before. The pain was back and I refused to accept that I was suppose to suffer through recurring ovarian cysts on the same side incessantly. On September 30, 2015, my right ovary and my appendix were removed.

Two weeks later, I went through what we now identify as an Adrenal Crisis. I was found unresponsive on the side of the road 500 miles away from home. It was horrifying. It was determined that I needed to have access to an injectable steroid to avoid future crises since ERs are not exactly equipped to deal with Adrenal Insufficiency, given that it’s extremely rare in developed countries. Further, it was clear that I would need to start wearing a medical ID so that if I was ever found unresponsive again, the first responders would know who to contact and how to intercede in a life-saving manner.

While I was relieved to know the identity of the disease that had plagued me for so long. I was discouraged that I would be reliant on medications for the rest of my life. I was not excited about the potential side-effects of taking steroids. I found myself feeling very depressed about having adrenal insufficiency and undoubtedly the depressive symptoms were partially caused by the adrenal insufficiency. I hit the worst low in January of 2016. I was feeling more and more depleted, my heart was acting erratic, and fortunately, my husband and I realized it was time to inject. We avoided a crisis, but I was in trouble. I was gaining weight – I put on 45lbs between November 2015 and April 2016.

The lie that I told myself was that it was solely a side-effect of the steroids. I would eventually determine it was actually because my body went into starvation mode even though I was eating. The bottom line, I wasn’t consuming enough calories and my body started turning everything into fat. I was disgusted with myself.

On Good Friday, I woke up determined to get to the gym to swim. When I went to grab my gym bag, it got stuck and my shoulder spasmed. I was now angry and frustrated. I went to the gym and swam, but by Easter Sunday, it was obvious my shoulder was in excruciating pain. Every motion with my arm was terrible. Opening doors, opening jars, washing my hair, sleeping… it didn’t matter. Two weeks later, my chiropractor found my spine had pulled to the right. He fixed that, but the pain in my arm was now incessant and there was clearly something wrong. We feared a torn rotator cuff. Fortunately, the MRI revealed something else – I was just 32 and I was up against a FROZEN shoulder in my right shoulder for the SECOND time in my life.

My doctor told me to educate myself and learn everything I could about Frozen Shoulders. Ultimately, I found out there’s 3 phases. It was evident, I was in the first, the freezing phase. From start to finish, a frozen shoulder can last up to 3 years. I also quickly realized my left shoulder was beginning to exhibit symptoms similar to the right. My doctor had said that not using it would contribute to it locking up which would intensify the pain.

There was absolutely no way, I was going to allow it to fully freeze…  and so for the last week, I’ve managed to swim 4,681 meters. I’m at the beginning of the next chapter of striving for health.

I have 45lbs to lose. I want to avoid my shoulder freezing. I want to correct my ‘disordered eating.’ To be clear, I do not meet the diagnostic criteria of any eating disorder – but my knowledge of eating disorders and my history with one tells me I need to be honest about the reality that my eating has not been normal or healthy.

I’ve flipped the switch: No days off. No more excuses. Whether it’s spinning, swimming, yoga, zumba – a minimum of 30 minutes a day. Additionally, it is now imperative to consume enough calories to support my body – and to consume the right balance of nutrients. So here’s to striving for health (again).

 

 

 

 

 

Chasing the Ghost

There have been symptoms, warning signs, numerous tests, lots of doctors visits, and countless other attempts to determine what was disrupting so many of my body’s systems for over a decade. I’ve fought for health – made dramatic lifestyle changes, altered my diet, followed the recommendations of trusted professionals. Yet, with each passing year, hope faded that we would ever have a name for the unnamed autoimmune disease countless suspected I had.

The ghost has a name now – primary Adrenal Insufficiency, or Addison’s disease. There’s ways to manage and treat it. I know it could be worse. Yet for me, with what I do & how I live, it feels somewhat like a straight-jacket. They’ve been telling me to “avoid stress” for over a year, but life is in it’s very nature somewhat stressful isn’t it? I got married in May and within the first 60 days of marriage, my husband had spent 5 days in the hospital and had two surgeries. A close friend of mine recently disclosed that they are on the verge of being homeless. I’ve had to defend one of my closest friends parenting skills to CPS several times in the past 2 years because her insane ex-husband keeps filing false reports. My family has faced countless hardships from house fires to major illness to job losses in the last 2 years. I care about people. I can’t stop caring about people. It’s not easy walking with people in their most difficulty and desperate times – but it’s something I won’t give up, even if it does kill me sooner.

I’m truly only overwhelmed by one thing: my school debt. I graduated with my Masters in December 2013, and since then, I’ve only been able to make interest payments and yet the interest accrues faster than I can pay it down. My medical bills mount and take away from what I can afford to pay toward my loans, and so I’m locked in a burdensome circle. Here’s my attempt to answer the question I’ve always had in my head. Do people truly care about other people enough to HELP in a meaningful way when it really matters or do they prefer to delight in watching people drowned…

[PREVIOUSLY GOFUND ME CAMPAIGN WAS HERE: AFFORDTOHELP]

Ailing Attacks

***TRIGGER WARNING: NOT FILTERED***

It was a Saturday in July. I had worked third shift the night before and was scheduled to Sunday afternoon. I woke up feeling incredibly under the weather and watched my fever climb into the 100s. It wasn’t until I noticed stabbing sensations in my back and abdomen and felt feverishly delusional from the pain that I decided to go to the ER right next to my apartment. I literally walked to the ER because I was in no state to drive.

They offered me “something for the pain” I don’t even know how many times before I eventually relented after they had decided they were admitting me sometime around midnight, hours after I arrived. I was admitted to a surgical floor, my understanding from the ER doc was that my appendix looked inflamed in the CT scan and I may need surgery. I was also told I had an ovarian cyst. They administered narcotics throughout the night to help with the pain and in the morning switched it to a different, less addictive pain reliever. I was nauseous, theoretically as a response to the narcotics, but hours and hours passed and it became clear that the nausea (and vomiting) was part of whatever was ailing me. I was on IV fluids with an all liquid diet on Sunday, while sometime on Monday, I was allowed to start eating, which is when it became clear that I still couldn’t keep even water and juice down.

They brought specialty MDs into consult on my case, but no additional tests apart from some lab work were run. The hospital and I conspired together to get me discharged despite exasperation that I wasn’t being fully treated because I didn’t have insurance. I continued to struggle with nausea, an inability to keep food down and discomfort for another 5 or so days after I was discharged on Monday evening. I lost around 10lbs during the unexplained sickness, though the pain that was subsiding in my right side was blamed on the 2cm simple cyst on my right ovary – and I was told that when I went through the worst of it, the cyst was likely bursting (but they never had an OBGYN see me or instructed me to follow up with one).

***

Months later, I woke up early to go the bathroom, upon standing I found myself extremely nauseous. I attempted to sleep it off before the alarm went off, but I wasn’t going to be able to pull it together before my shift. I called in-sick and chalked the chills, the constant urge to throw up, and the fever up to some bout of food poisoning.

***

It was a much needed day off spending quality time with someone very significant to me. Faintly, I begin to notice some strange intermittent prongs of pain in my right side. Hours later, after eating dinner, I find myself extremely nauseous and the pain is more constant, stronger and distinct. In the middle of the night, I found myself staring at dinner swirling down the porcelain pot. Nauseousness not subsiding. A constant, dull pain settled into the right side of my abdomen, inconsistently (so it seemed) jabbing and stabbing me with fury.

The next day, a Friday night, I attempted to go into work but only two hours into the shift, I was crippled over with pain and increasing nausea. I left work and went straight to an ER (not the same one from July because my current insurance dictates another area health system as the preferred provider). They quickly administered Zofran to tame the nausea and repeatedly offered me “something to help with the pain.” I repeatedly declined something for the pain – I wanted to know what was causing the pain not mask it and put enormous pressure on my liver and kidneys with an unknown source of pain somewhere intertwined with my internal organs.

The CT, likely completed with the suspicion that appendicitis might be causing the tenderness in my stomach and the low-grade fever, showed a 4.2 cyst on my right ovary and the ER was content to refer me to an OBGYN and give me a script for Zofran to help with the nausea over the weekend and one more offer for “something for the pain”.

Admittedly, my pain was radiating and shooting in ways that made it difficult to pinpoint when they had asked me to point to the source – but I never pointed anywhere below my belly button and it was always distinctly on the right side of my abdomen.

I was in immense pain throughout the weekend, waiting for the OBGYN’s office to open on Monday morning to make an appointment. Needlessly, I was somewhat worried that if the cyst was causing this much pain, something must be horribly wrong with my ovary. The family history of (female) cancers flashed through my mind and yet, I couldn’t shake the awareness that I’ve implemented lifestyle changes that should make me healthier than I’ve ever been. I called the ER back on Saturday to indicate my pain wasn’t getting any better – they reiterated I needed to see the OBGYN and insinuated there was nothing else they could do to help me.

I woke up early on Monday to call and make an appointment. Of course, they didn’t have any availability until after I was suppose to be at work. Realizing I didn’t have enough Zofran to get me through a second shift Monday, I worked with my manager to do a last minute shift change with the understanding between us that I may be late depending how the appointment went.

The OBGYN had me point the pain on my side. He was clearly puzzled by why the ER had referred me to him. Nonetheless, he ordered an ultrasound to look at the cyst to definitively rule out his gut, which was that whatever was ailing me was out of his jurisdiction. Before the end of the first appointment, he had already alluded that even if there was something with my ovary or the cyst, there was something more going on and he’d want me to consult with a general surgeon. My pelvic ultrasound was scheduled for 4PM Tuesday. I went to work still with the constant side pain and the occasional stabbing and shooting pain in my side, but powered through (not so well that my coworkers weren’t somewhat alarmed) with the help of the additional Zofran at a higher dose the OBGYN had prescribed to continue managing the nausea. The higher dose was prescribed because I had started to demonstrate an inability to keep even water down again at only 4mg of Zofran.

Fortunately, I wasn’t scheduled the next 4 days (Tuesday-Friday) which hadn’t happened without a specific request from me at work since I started working at as a pool employee in April. I had fantasized that these four days off would either be filled with quality time with friends, getting things I’d been meaning to get done completed, or even going into work last minute to help out if people called out. I had never imagined they would be plagued with symptoms: nausea, vomiting, constant pain in my right side, or periodic stabbing that had almost caused me to drive off the road on my way home from work Monday night because it came on so strongly and unexpectedly.

By Wednesday, the OBGYN called and indicated the ultrasound had clearly demonstrated that the cyst in my right ovary was a simple cyst that was actually closer to 5cm but that it was not torquing the ovary and there was no reason it needed any kind of intervention. Additionally, my uterus and my left ovary were normal and there were no signs of cancer or any other abnormalities. He suggested I consult with the general surgeon or return to the ER as he suspected where my pain was located and my symptoms were better accounted for by my gallbladder.

I was not about to go back to the ER. The OBGYN made the referral and ensured himself I had an appointment scheduled with the surgeon for the next day (after someone at the surgeon’s office called and was extremely rude and almost detoured me from seeking further treatment despite ongoing troublesome symptoms) as nothing was available that afternoon.

Thursday, I accompanied my uncle to his colonoscopy at a different hospital. I writhed in pain and pushed through nausea, after discontinuing use of the Zofran all together after starting to experience side effects from the 8mg of Zofran the day before. By this point, I had begun correlating my symptoms with activities of daily living (which PS is not as natural as MDs apparently think it is when they ask you if you notice it more before or after meals, when your laying down or sitting – questions I was asked on Friday at the ER just over 12 hours after the initial onset of symptoms). Realistically, I had the dull pain all of the time, the sharp shooting was worse when sitting (particularly in cars) or standing, but the nausea was constant. It was distinctly after eating or drinking anything, typically within 10 minutes that I began noticing the stabbing pain.

I met with the surgeon for the first time at 3PM Thursday (7 days after the onset of symptoms). He asked the first relevant question I had felt I had been asked in days, “Is there a family history of any gallbladder related issues?” The answer: My mom’s was removed when she was 28 and her brother had recently had his removed. The surgeon explained the different options for looking at the gallbladder and opted to bypass an ultrasound and go straight to a HIDA scan, which looks at the function of the gallbladder. That was scheduled for noon on Friday

Laying still in pain for 2 hours under a scanner listening a Pandora radio station with commercials was not exactly how I wanted to spend my last day off. However, Thursday night I had experienced the worst agony since the beginning of the onset of the symptoms a week earlier. I didn’t sleep because of the pain and the nausea was still a constant companion even when laying down. The first hour of the test, I was uncomfortable, but no more so than I had been the last 7 days, as a tracer lit up my gallbladder on the screen. The second hour, when they injected the CCK (?), or stuff naturally used by the body to tell the gallbladder to work, was torture.

Within 10 minutes, my nausea was worse and I had some of the most extreme shooting pain in my abdomen and back (the pain had spread to my back midweek). For the next fifty minutes, I went through waves of nausea and extreme pain, all while having to lay still. I cried because of the pain. I resisted the urge to ask the tech if she had any other sadistic tendencies. Before the second part was half way over, the tech had already scheduled an appointment with me to see the surgeon immediately after her torment, I mean, scan was done.

By 3PM Friday, exactly 7 days after I had originally gone to the ER, surgery was scheduled for Monday morning to remove my gallbladder and I had once again declined to accept pain killers to get me through the weekend. I was relieved that relief was within view.

I was never drug seeking. All I wanted to understand is what has been ailing me, depriving me of an appetite and punishing me when I did eat or drink. I wasn’t content with  temporary solutions, I wanted a definitive answer and resolution.

Accountability

We dread it, at least sometimes, don’t we? Especially when we’re having one of “those” … days, weeks… months? Or when you have a list of excuses or full-blown rationals or conspiracy theories for why you don’t have to watch what you’re eating or stay on track with your weigh-ins or workouts, you name it. Of course, holidays are the times we’re most aware that we’re going to over-indulge and we commit ahead of time, in our heads at least, that we’ll put extra time in at the gym or super-restrict ourselves in the weeks afterward. There is nothing healthy about our aversion to accountability in life. Perhaps, one of the greatest areas in our lives that demands accountability, is keeping a focus on our overall health (mental, physical, spiritual) and not allowing neglect or out-right self-destruction.

Let’s face it, we can’t be effective if what we put in our bodies disrupts our brains abilities to concentrate and stay focused; or when we’re carrying so much extra weight or shame or guilt around that we are too emotionally drained to exert energy in the areas it matters most. Our emotional health is just as important as our physical health – and if you think you can take a journey to reclaim your health [and yes, I think most people have at least one arena pertaining to health in which they would benefit from reclaiming or perhaps claiming for the first time – optimal health] without dealing with your “emotional baggage” or “regulating” your emotions routinely – you’ve got another thing coming. Foods are not created equal – I’ve said it before and I’ll say it again – what you eat determines how effectively and efficiently your brain and your body work for you. Deprive your brain – and your life will be negatively impacted. Deprive your body and you are depriving your brain and therefore disrupting how effective you are in all you try to do.

There is only so much we can do alone. We are humans – created for connection. Accountability is essential – and your accountability partner(s) are the people you go to when things are going well  to keep you on track and when they’re not going so well and you’re off the rails. The moment you begin thinking – ‘this isn’t something I want to be honest about -‘ you know you’re heading for trouble – and you need to reach out to one of your accountability partners where you’re straying in your thoughts and/or your behaviors. When you’re becoming ineffective in relationships, in maintaining routines you established for your own good, too emotional to think logically, etc. Support is vital for thriving. Social connection is important, even if you’re introvert [and we all know, I’m not].

Obviously, there are certain times and some activities that simply have to be executed, for one reason or another, alone; but that does not nullify that accountability can be established to account for these times. I love working out with others, I loved when I could afford to go to a gym and had availability to do group classes, or when I can find a friend or a family member who wants to go on a bike ride or join me in a work-out game with the Wii. My current reality is that my gym consists of a spin bike, a yoga mat, and some space on the floor in front of a TV connected to my Wii (with all my Wii work-out games which include Gold’s Gym Cardio Workout, Active, Zumba, Just Dance, to name a few) in my parent’s basement. I have a nice road bike that I got for my birthday last year, but I only got to ride it with someone else a couple of times and I wasn’t too motivated to go riding by myself – so it spent most of the riding “season” hanging in the garage). My friends work crazy schedules because we’re in different industries. In fact, I’m about to start a “pool” position for a hospital – so I could be working as little as 1 shift to 5 shifts a week and they could vary between 1st, 2nd and 3rd shifts. So it’s not practical for me to work-out with anyone on a regular basis.

Fortunately, I have a number of health-conscious friends and we support each other through “liking” facebook statuses touting work-outs or healthy eating or weight-loss achievements. I have other friends that routinely check-in via text or calls or in coffee houses and we share status updates, set-backs, current goals, etc. It’s important to celebrate achievements – and to learn from set-backs. It’s important to seek out accountability when and where you want it least.

Who knows what you want to accomplish or what you do to get or keep yourself healthy? Is accountability easy or challenging for you? Where do you derive motivation when you don’t have your “ideal” situation around you? When’s the last time you were honest about slipping up, falling behind, or giving up? Who knows how committed or whimsical you are about your current health-related goals? I challenge you to take accountability to the next level – whatever that means for you.

 

 

 

Zzzzz(s) are important

I don’t know about all of you but I have admittedly had plenty of nights, sometimes consecutive nights, where I burned the midnight oil. I have had periods where I was on a relatively set schedule that allowed for approximately 5-6 hours of sleep a night. Then there were those “seasons” or “times” in my life that my body seemed to be demanding way more sleep than I had time to get. My upcoming position will potentially impose challenges to setting any form of sleep schedule since I’ll be working “as needed” and could be working 1-4 (on average) shifts a week, but they could vary between different 1st, 2nd, swing and rarely even 3rd shifts.

I’ve certainly experienced what felt like I imagine driving drunk would feel like – without a drop of alcohol in my system; sleep deprivation can be deadly on the road. No amount of caffeine or cold air or any other trick employed apart from actually sleeping will undo the hazardous effects of sleep deprivation.

There are countless reasons that sleep may be less than ideal for any one of us. The bed, the pillow, the person sleeping next to us (with their noises and flagrant fouls), noises in the house, roommates with different routines and schedules, continuous thoughts about what didn’t get done today or what needs to be dealt with tomorrow, needing to finish this assignment, this project or this chapter (and the next ten) or episodes (or season) before bed, and on and on and on times infinity.

As we get older, out body is less forgiving when we don’t get an adequate amount of sleep. Employing solid sleep hygiene sooner than later is definitely the healthier path.

Finding ways to correct the environmental factors that disrupt falling or staying asleep is imperative. For instance, I need it dark especially if I need to sleep during day light hours – I’ve used black out drapes or sleep masks. I have roommates that can be obnoxious in the mornings – waking HOURS before I need to start thinking about getting up – I absolutely love the app by Banzailabs, “Brainwave: 30 Binaural Programs” which provides both ambient noise and sounds that mimic the brain wave patterns I want to evoke to induce different results including, but not limited to, power nap, deep sleep, dreamy sleep, even lucid dreaming. I’ve definitely invested in and tested more pillows than I care to admit, but I’ve found that my “perfect pillow” which is some memory foam version and my buckwheat pillow are my primary two. My bed was too firm so I bought a pillow-top mattress pad because I couldn’t afford a new mattress.

There’s also those times when you may have to alter when you consume certain things in the day. Clearly, consuming stimulants within a few hours of bedtime is not advisable. The typical half-life of caffeine is somewhere between 5 and 7 hours. Consuming a traditional alcoholic nightcap is counter intuitive as well, you may be able to fall asleep but you’re unlikely to stay asleep as long as you intend.

Clearly, there are times in our lives when we want to defy the need for a solid night of zzzzzzs, but proper sleep hygiene is an undeniable facet of healthy living. What do you need to change to improve your quantity and/or quality of sleep?

How much do you watch?

Yesterday, I found myself in a conversation with an old acquaintance  and we compared the lists of shows we currently watch. I recall him saying, “American television has never been better.” [Qualifier, my old acquaintance is literally  older than I am and blatantly British]. I have to admit while he articulated it out loud during that conversation, I have been guilty of “binging” on shows (watching entire seasons in a weekend or in one night) more times than I dare to say out loud. My good friend could attest that while I stayed with his family the last week in January, I managed to catch up on a certain series I missed while it was airing ten years ago before I even knew a movie was coming out this year.

In another recent conversation with my significant other, he proposed a simple question, “Why can’t you just spin while you watch?”

I confide, I literally am ashamed to admit how many shows I currently “keep up on” and how many others I’ve essentially “caught up on” through binges – hours upon wasted hours. Granted, I don’t tend to watch shows on TV, so I avoid the extra 20-30 minutes of commercials packed into prime time shows, but still. It’s ludicrous.

In my defense, as my old acquaintance pointed out, there’s some really riveting shows on that you feel compelled to keep watching. Kudos to the forces (writers, actors, producers, etc.) behind these shows for a job well-done.

Yesterday, I decided to re-purpose the netbook I purchased during my undergrad to take to classes for taking notes as the spin bike monitor. I hardly noticed that I was spinning for just over an hour. I’ve had times where I struggle to go 20 minutes when I’m only listening to music. I’ve committed to myself that while watching 1 show a day without spinning may be acceptable, my time will be better spent if I am spinning anytime I’m attempting to “catch up” and/or “binging” on shows. Essentially, I think I plan to watch shows in my Hulu Queue while spinning, only sit out 1 of multiple shows I watch on CBS.com if I’m going to watch multiple episodes in one interval.

I’ll deal with the shows I watch on PBS next year when the new seasons of Sherlock and Downton Abbey are available.

Are there things you do, perhaps in excess, that could be accomplished while working-out? Do you have guilty pleasures, in addition to foods, that work against your goals to maintain an active or healthy lifestyle? How many shows or movies do you watch in a day, a week, or even a month? Remember when going to a movie or staying in for a movie was a special occasion? How many of your habits or behaviors are you ashamed to admit?

I challenge you to consider a way you can combine something unhealthy you do with something healthy, turn a negative into a positive. Get creative. Share your ideas in comments.

Why is working out consistently so challenging?

We all have our reasons, our excuses, our account for why we don’t work out as often as we intend to or we know we should.

I’ve always enjoyed sports. I was decent enough to “excel” in PE courses in middle school and high school in just about any sport that was thrown at me, even the horrifying field hockey I was introduced to when I transferred to a high school on the east coast.

From the time I came into middle school already 5’5″, it seemed the adults in my world were convinced basketball was suppose to be my sport. I didn’t really enjoy it, and ultimately, I sprained and broke my ankle so many times playing it, I was advised to switch sports, hence my shift to Cross-Country and Soccer in high school. I qualified for State by placing in the top 10 at Regionals as a Freshman, but I would never get to race at State. Turned out that I had been running on a stress fracture likely most of the season and it finally occurred to everyone when I crawled across most of our regional course that something wasn’t quite right.

I was good enough to make it onto the JV soccer team Freshman year, the first year I ever attempted to play soccer. Due to shifting between Wisconsin and Massachusetts a few times during high school, I got to play on my JV team as a Freshman and Sophomore in WI, and practice with my MA Varsity team Sophomore and Senior year, and practice another WI Varsity team my final semester of high school. I played more time during my last team’s alumni games over the last 10 years. My not getting to play much was mostly political, but nonetheless, I love the sport of soccer. I even played on adult co-ed leagues in-doors when I could afford it in my early twenties.

Ultimate Frisbee has to be one of my favorite pick-up games and as my twenties have progressed, I have found myself picking up fewer and fewer games. Reality for me, is that I need to respect my body’s limits… and my body has legitimate, real-life limits.

I have spent more time that I want to recount in walking casts, in physical therapy relearning how to walk because of a combination of complications from previous injuries, naturally small ankles that are prone to sprains and brakes, and my pushing through pain that was a clear warning to stop.

Sometime in the last couple of years, I was essentially told by a physical therapist that if I kept running, I could find myself unable to walk by my mid-thirties. In high school, when I could run 5-14 miles a day without even thinking about it, it was easy to maintain my weight, my physique, and many others things that contribute to physical and mental health.

The last decade has been marked with an attempt to find the ways to get in the work-outs that will give me the results I need without further damaging my body. Swimming was the most appealing alternative and it was possible so long as I could afford to maintain expensive gym memberships, since swimming is not an outdoor sport 365 days of the year in Wisconsin. Last year, one of my doctors recommended cycling, and admittedly, it’s been drawing me in.

I bought my first road bike last year with my tax refund for my birthday. [Yes, I have to rationalize making “big” purchases to myself]. I honestly road it less than a handful of times. For several reasons like I don’t enjoy riding alone. I have a very difficult time being in direct sunlight for more than about 20 minutes due to a medical condition we’ve known about since I was 14. Therefore, I essentially need to ride as the sun is rising or setting, and again, I don’t want to ride alone. I was in the middle of writing my Masters Thesis last year, so that absorbed a lot of time. It’s a lot of work to pack up a road bike in the kind of car I have along with all the gear to get to a trail to go for a ride. We all know I could go on and on, but it’s pointless. Clearly, I have a limited amount of time in WI that using a road bike is practically possible, so there was no potential of it being a year-round thing pending buying a trainer, and I just couldn’t commit to that cost.

I went down to help a friend through something and she had a spin bike at the house. The light bulb went off. For years, I wanted an elliptical at home, but they were so expensive. Her spin bike was super steady and I really liked it, and she said she had gotten it for under $300. My boyfriend realizing I was truly committed to spinning paid for over half of the spin bike as a graduation gift in December.

I do enjoy spinning, but it was more enjoyable on the main level of the house with a window looking outside, than in my parent’s basement. I can’t exactly read while spinning, and I haven’t yet attempted to bring something down to watch. Music helps most of the time, but let’s face it, when our work-out plans are too routine, they get boring. It’s why when I was a member at a gym, I took kick boxing one night a week, and did yoga a few days, and swam or did the elliptical others. I have to get creative to stay interested.

I have a ton of work-out games for my Wii and they all have their perks, but my mom bought me this Gold’s Gym Cardio Workout around five years ago and she managed to find “boxing gloves” that were made for the Wii nun-chuck to go on the left glove and the remote to go on the right. It gives me a great work-out, tons of options, and it provides a fair amount of a variability in your work-out inherently.

So most recently, last night, I opted to do the cardio boxing with my Wii while spinning and it was AWESOME. Challenging, but a great work-out. I may have even multi-tasked and talked with my friend on the phone while I was spinning and the game was on pause.

TAKE AWAY: We all have reasons we’re not consistent with working out. Some are more valid, like having injuries. Others are a bit more imagined or created in our minds to avoid something we dread. The problem is, there’s no reason to dread working-out. It doesn’t take a genius to realize there’s tons of benefits physically and psychologically to working out on a regular basis. It is far more detrimental to your health to be completely sedentary. So whatever it takes, finding a work-out partner, investing in equipment, joining a gym, whatever you can practically afford both financially and with time (and make time), to make working out as fun and rewarding as possible. No more excuses.

While I would love to say that because I’ve worked-out for two days in a row, I’m on track; I know that I haven’t established a solid enough routine. It takes somewhere between 10-14 days to establish a “habit” that has a chance to last. I also know that stretching, or Yoga in my book, has many of the same benefits as other forms of exercising for your mind and ultimately your body. So I hope I rework Yoga into my future work-out routine.

Perhaps the times we should work-out are the times we are most consciously aware that we don’t want to. I dare you to work-out the next time you tell yourself you don’t have the energy, you don’t want to, you will later, etc

Calories

There was a time in my life that I was strictly taught never to count calories. At the time, I was in a treatment program for an eating disorder. I was already morbidly preoccupied with avoiding calories.

Over the weekend, my boyfriend and I made huge salads with the veggies and fruit I had brought over.  Spring mix, kale, broccoli, blueberries, cherry tomatoes, and a cucumber. We split a can of solid white tuna, threw on some pumpkin seeds, and shredded some cheddar cheese on top (we are Wisconsinites after all). I mixed up a rather pathetic amount of Basil Olive Oil and 18 Year Balsamic from Oro di Olivia.

As we were working our way through our meal, my boyfriend who has never counted calories, pondered aloud about how many calories were in the huge plates before us. I somewhat jokingly suggested that it had to be less than the Chicken BLT Salad sandwich from Starbucks that I eaten for lunch (470 calories). I only knew what lunch had been, because when I do purchase a meal on the go, whether from a place like Starbucks or a grocery store, I read the label mostly to ensure I recognize the ingredients and there isn’t unnecessary or unnatural ingredients present. I tend to glance at things like calories, amount of protein, whether other things like iron are present, as well.

My loving boyfriend called what he presumed to be a bluff. While he went down to make popcorn, I did a quick online search to estimate our calories.

1 cup, chopped Kale = 33 calories
50 blueberries = 39 calories
1 stalk broccoli = 51 calories
1 oz (85 seeds) Pumpkin seeds = 126 calories
2 cups spring mix = 15 calories
1 can solid white tuna = 130 calories
1 oz sharp cheddar = 111 calories
6 cherry tomotoes = 18 calories
1 cucumber = 47 calories

The thing is, we may have had a bit more kale and spring mix. I don’t think we had 50 blueberries between the two of us. We split the stalk of broccoli, the can of tuna and the cucumber. I doubt we had 85 pumpkin seeds between the two of us. We both had about 6 cherry tomatoes. We used a fine cheese grater on the cheddar, so maybe we had 1 ounce each, perhaps a bit more. I know that the oil and vinegar we use has about 25-35 calories per tablespoon, so we both might have had a little more than that each.

My boyfriend is more the authority between us on natural remedies and the health benefits of different foods and oils. He was the reason I used my 2003 tax refund to purchase a Vitamix. The reason I started getting away from foods that had preservatives. He eventually convinced me that I couldn’t afford not to eat right. Yes, organic foods cost a bit more in most instances, but eating highly-processed food has consequences that will haunt you for decades.

However, I can probably estimate calories a bit more accurately than he can. It doesn’t hurt that I have a photographic memory, so I do actually remember what labels I’ve looked at recently, like the Starbucks Chicken BLT and the can of tuna.

The bigger take away for me was that the only possible way that salads become high-calorie items on a menu is when they are drenched in dressings that have unnecessary ingredients and/or weighed down with excess use of meats and cheeses. It would be impossible for the average American to gain weight, and it’s more probable they’d lose it, by replacing at least one meal a day with a salad. At first, I ordered my salad dressing on the side and only dipped my fork, which I still do in restaurants. I tend to choose a vinaigrette or Italian if there’s an option opposed to a French or Ranch. At home, I exclusively use oil and vinegar – I mist with the oil and I drizzle with the vinegar. If all I can taste in a bite is dressing, I’ve failed to live up to my own expectations.

There’s a commercial right now that I’ve seen a few times that has a guy in the back saying, “Salads are delicious” and it’s obvious that his coworkers do not concur. In reality, there are so many amazing things berries, nuts, seeds, in small quantities cheese and meat that you can add to a salad that have amazing flavors. Not to mention, how many different varieties of lettuces, kale, and cabbages that can contribute to a flavor profile. Dressing should simply compliment the already present flavors in a salad.

If you don’t already, I challenge you to work more salads into your weekly routine. For those of you who already do, are you creative enough to make sure you’re not growing bored with your routine?

If you’re looking to cut calories, cut the yeast, the highly-processed, the super sweet and sugary, the sodas, and eat more greens!