A Week Away and Still Going Strong - There is No Place Like Home (even if it is cold and snowy)

It is a wickedly windy Sunday morning here in New Hampshire and I am very glad to be here. It was a long week and even though I had gloated via Facebook about my trip to Clearwater Beach, Florida, I really prefer being home. The conference was on addictions. It was full of wonderful information that validated the work that I do, but the days were long, the chairs were uncomfortable, and I really only ended up with an hour each day to spend on the beach. I had one afternoon during which I walked and then rented a bicycle. I also got some great pictures of sunsets and pelicans.

One of the hi-lights of the conference was the chance to meet Joan Borysenko whose book I reviewed in my last post. I told her how much I appreciated her book and she was very gracious and warm. She comes across in person exactly how she does in her books. She gave a keynote on the mind/body connection and a smaller workshop on resiliency.

It was tough, but I did manage to stick to my food plan for the week. I had to pack my protein powder for breakfasts as the conference was only providing a continental breakfast. Continental breakfasts are a joke. Just coffee and pastries to get you all jacked up before the speakers start. There wasn’t a grocery store anywhere near where I was staying, but the pharmacy across the street had just gotten in some fresh fruit the day I arrived. I gladly loaded up with bananas, pears, and apples to supplement my breakfast.

When I checked in I asked the hotel clerk if there was a vegetarian restaurant nearby and she said that most of the restaurants had vegetarian items on their menus but there were no vegetarian or vegan restaurants. She recommended the Clear Sky Café, about 5 blocks from the hotel. That ended up being a good choice and I ate most of my meals there for the next four days. In order to get the protein I needed I ate plenty of fish (something I don’t normally do, but I did not want to eat beef or chicken) and the salad and veggie choices were great. My favorite was the Ahi Blacken Tuna Nicoise Salad. It had artichokes, hearts of palm, tuna, fresh salsa, spinach, cucumber, and seaweed with a great ginger dressing. I think I had that three or four times. I found out I really like seaweed salad. Yummy! I have to admit, though, I did have “pizza envy” one evening. There were a few people at the café eating what looked like an excellent pizza and all that melted cheese tested my resolve. Fortunately, I resisted.

I have noticed that, since I stopped eating sugar, everything else has so much more flavor. I am amazed at how much I am enjoying fruits and vegetables and I have even enjoyed some carrots as long as they were mixed with other vegetables. And, if you know me, you know that I really have a strong aversion to carrots. Blah!!

I am pleased. As of today I have been off of sugar, flour, dairy, and caffeine for five weeks. I hadn’t really meant to go this far without the dairy and caffeine, but now it seems to be such a good thing that I am going with it. I am going to see Dr. Jane on Tuesday and I am hoping to see some good results on the scale. If not, I will be okay because I know that I feel better and that as soon as all this snow goes I will be back on the hiking trails. I also have a new bicycle on lay-away that will get picked up as soon as the roads are clear.

Last year at this time, I was miserable. I felt like I was 70 years old and I had a medical provider who did not understand that I was not ill because I was depressed, but that I was depressed because I didn’t feel well. The progress I have made over the past year, especially since last May when I started seeing Dr. Jane, has been wonderful. The right health care provider makes a great difference. I may not necessarily be slimmer but I am now on the right path and expect to see even greater changes over the next year.

The Start of a New Journey to Wellness

Things have certainly gotten interesting around here. I don’t like to think of myself as getting old but my body is reminding me every day that it needs my attention.

Over the past few months I have gone on a rant about the lack of good medical care in my life. I wasn’t feeling listened to and felt some complaints were being disregarded. All of that has come to an end. I had some second thoughts about writing about all this, but it might help someone else once they read about my experiences.

On Tuesday morning of this week I spent three hours with a wonderful naturopathic MD here in Concord. I had waited seven months for this appointment and it was well worth it. She listened and responded to every symptom and concern I had and dug deeper when she sensed I was minimizing or trying to skim over certain issues. By the end of the three hours she had come up with a preliminary plan.

First of all – MODERATO has to be my new motto. I have a tendency to do a lot, then I have to crash. This even includes exercise. My pattern is to go out for a three mile walk and then need to rest for three days because everything hurts. I also work hard, travel a lot and then wonder why I am exhausted by the end of the week. MODERATO!!

She also validated that mindfulness meditation and yoga is excellent and should be a part of my daily routine.

Then we moved into new territory. Here is what I learned about medication for depression and anxiety. I have been taking Celexa for a few years and it helps with anxiety. Without it, I am bouncing off the walls, can’t sleep, and ruminate over everything from the Viet Nam War to oil spills. However, even with the Celexa I have some low grade depression that just never lightens up. Even when I am having a good day I can still feel blue.

The doctor explained to me that the Celexa only regulates Serotonin and Gaba and helps to decrease anxiety, but that it lacks the dopamine and nor-epinephrine which are needed to relieve depression. She said that from what I was telling her she could tell I needed something to increase dopamine. She explained this all in a way that I understood. I know from my research on the effects of trauma that the brain can use up dopamine and have difficulty producing more when a person has been under prolonged stress. She has given me a supplement that will work to increase the dopamine and I hope to feel some improvement by the end of the week. She is also going to help me get a good deal on a light box before winter sets in. I do feel more depressed from November to March so a light would be very helpful.

She also gave me information on some inserts for my shoes to help with plantar fascia.
The most important thing she did, though, was take my complaints about fatigue and general overall exhaustion seriously. She looked at my family’s medical history and asked me about heart disease and when I talked about having times when I felt some pressure in my chest she did not allow me to minimize it. She took it all seriously and had an EKG done. She explained to me that women do not feel chest pain in the same way that men do. She said that women are more likely to feel pressure. I told her that I usually felt it after going up these damn New England stairs (there are ladders in ships that are less steep) and it went away after a minute or so. Very calmly, she explained that is exactly a symptom of a possible blockage in an artery and that she wanted to have an imagining stress test done. She was so calm and yet concerned, that I knew it was necessary but I was not anxious.

I left her office after having an EKG. I had a plan, orders for a lot of blood work, a kit to submit saliva and urine samples, and the promise that the nurse would get back to me with an appointment for the stress test.
Over the next 24 hours my schedule opened up and the diagnostic center was able to get me in to have the test over two days. I stopped drinking caffeine and eating chocolate (yes, Boo is still alive, but it is a damn good thing I live alone and had the Chris Botti concert to attend on Thursday evening) and didn’t eat after midnight before the test. On Thursday morning I was injected with a radioactive dye, swaddled in a blanket and was allowed to take a 20 minute nap under a gamma scanner. It took pictures of my heart while it was in normal mode. The next day I was hooked up to an EKG machine while walking on the treadmill. As soon as my heart rate reached the targeted heart rate of 142 (220-my age X 85%), they injected me with the radioactive dye again, had me walk another minute and then I was allowed to rest and have a few sips of water. After about 20 minutes I was able to take another nap under the gamma camera. For some reason the pictures didn’t download onto their computer, so I was given time for a second nap. Not a problem. Afterward, they unhooked me and let me go. I left , went into the Starbucks on the second floor of the hospital, got a chai latte and went home feeling that all went pretty well. I hadn’t felt any problems during the stress test and I was convinced I had passed with flying colors. My denial was even working so well that I convinced myself that since I hadn’t felt any effects from not eating breakfast that my blood sugar must be stable and that I didn’t need to worry about the glucose tolerance test coming up this Monday.

I had a great Friday. I spent it working on the novel and taking some time off of work. I was just settling down to a plate of scrambled eggs with feta and spinach (there is irony here) when the doctor called.

I don’t have much experience with doctors calling me. In fact, my last PCP’s office told me that the doctors do not make phone calls, the nurses do. So when I heard the doctor on the phone I knew something was up. She said, “How are you?” I said, “You tell me!”

She explained that the tests show that I have signs of Coronary Artery Disease. Fuck NO!!! But she also explained it was good because it had been found and that there were steps to take care of it and I was already doing some things I needed to do. She said she will be conferring with my new PCP and they will be setting me up with a cardiologist ($$$$$$$$$$$$$$$$$$$$$$$) and I will probably need to have a catheterization. Whew!!! – they won’t be cracking my sternum open like a lobster. PLEASE!! - I will do anything – but not that!!! She also said that she was calling in a prescription for nitroglycerin (oh, damn, I have to carry that stuff around with me all the time and I can barely remember my car keys) and that I needed to start taking an aspirin a day – for the rest of my life!

She was wonderful. She asked me how I was, she let me know she was available to talk to me any time and that she really felt that this was a good thing to have found now. She explained what to do when I felt pressure, when to take the nitro, when to call 911, and asked how I was going to spend the weekend. She also reiterated how heart symptoms are different for women and to not take the absence of pain as a sign that everything is okay. She urged me to do my normal activities, take walks and do yoga. No hills or mountains, though.

I spent the evening in a fog and near tears. I called my friend, Barbara, and she gave me a great pep talk. I had thought of canceling out on a yarn shopping trip but decided I was going to have fun. But I also experienced a lot of anger because I have been complaining to various medical professionals about these symptoms for at least three years and have not been taken seriously. Then I let it go. I realize that everything comes at the right time and now I have a doctor who is listening and taking me seriously. She said that this explains my exhaustion and the catheterization should be able to help.

Yesterday evening I remembered that I have an aunt who has been living with heart disease for probably thirty years so I know this doesn’t mean I am going to die any time soon. That was reassuring. However, having my chest cracked open with rib spreaders frightens me even more than death, so I will do everything I can to avoid that.

This morning I talked to my nurse friend, Darcy. She knows me well to know that I could be on the floor and out of breath and still questioning whether or not I should call 911. Darcy made me agree that if I felt like I should take a nitro to give her a call and she will use her nurse voice to convince me of what I should do.

I am definitely blessed in the friends department.

I also have a cat that likes to give me Kitty Reiki. She lies down on my chest and purrs so loud that I can feel the vibration go all the way to my heart center. I know that has to be healing.
I am going to continue to post on this journey. It helps me to process and I also hope it will help someone else down the line. As of right now, I feel pretty good because I think I have good medical, friend and family support and all will be well.

Music and My Soul

I seem to have almost fully recovered from the nasty virus I had over the past couple of weeks so it is time to sit down again and write. I also am energized from my writing group meeting yesterday. Now I just need discipline and a lack of distractions. I often wonder how much of the novel would get written if I found a cabin in the woods with no internet or television, stocked up on tea, bread and peanut butter and just stuck with it for about a week or two. Would I go crazy or would I actually get it written? These characters are all living in my head. I know them fairly intimately. At times they demand to get out - usually at 11:00 at night when I am trying to get to sleep.
Feeling physically better means I am back on track with my health plan. I shopped for good food yesterday and have done my yoga and meditation for the past few days. The cello has also seen the light of day and is sounding fairly good. These are all signs that I am on the mend.
However, today I feel a little tender. Not physically, but emotionally and spiritually. I was finishing my yoga routine and resting quietly with my legs up the wall when Beethoven’s Moonlight Sonata started playing on my CD. It was so moving and sweet that tears came to my eyes and I lost my breath. It was overwhelming and I have no idea where that emotion came from. I am often moved by beautiful music but this seemed to have gone to a soul level and I am still feeling the effects. I am now listening to Yo Yo Ma’s Appassionato CD and find myself stopping to listen to musical phrases and imagining the movement of the bow across the strings. Music has been one of the greatest pleasures of my life, both listening and playing.
I wanted to play music from the time I knew what a piano was. However, my parents both said that they weren’t going to pay for something I would probably play for a few months and then drop. I think they realized I was serious when I started playing the trumpet in fourth grade and even after two months of barely being able to get anything besides the sound of percussive farts out of the instrument I hung in there until I was placing first in music competitions in junior high band. I started playing piano when I was 12 or 13 and fell in love.
My piano teacher was like a character out of a strange novel. Her name was Betty and she was very eccentric, lived with her parents and was of an unknown age. She dressed like a gypsy in flowery dresses and skirts over crinoline and peek-a-boo toe high heels. She had long black hair that hung over her shoulders and her features were somewhat exotic under layers of blue eye shadow. Betty also had very long fingernails that were painted fire engine red. When I imagine her I can almost hear the sound of the nails clicking on the piano keys while she played.
Betty was also one of the brightest characters of my childhood and adolescence. I think her loveliness and eccentricity played a large part in my growing love of music. One day she stopped me while I was playing a Chopin nocturne and asked me if I saw auras. I replied that I had no clue what she was talking about. Then she told me that when I played Chopin my grey eyes turned brown. She said it was my passion for the music that caused this change. For some reason, I believed her. I knew that I loved Chopin and I would not have been surprised if deep cellular changes occurred when I heard his music.
I continued to play piano on and off over the years. My trumpet, unfortunately, went into its case after high school graduation and appeared very rarely after that. It was eventually sold during one of those periods of my life when a few dollars was more necessary than a battered instrument.
I love hearing music played. I have always loved hearing symphony orchestras and pianists. And I love playing music. When I turned fifty I needed a new challenge. I had reached my thirty year goal of visiting the Himalayas and had even managing to have a border skirmish with the Chinese, but needed a new challenge. I had always wanted to play a string instrument. I assessed the situation and decided that a violin would be too hard on my hands and neck so I went with the cello. I have not regretted it since. I am not a prodigy by any means, but I have managed to learn to play well enough that I can enjoy a good hour of playing on my own. I have had a couple of wonderful teachers but neither have the eccentricity of Betty. I wish she was around to hear me now.
When I listen to classical music I am particularly struck by the mellow sounds of the cello but I also love the oboe. When I think about it, the oboe’s lower notes sound very similar to the cello. I think they are often interchanged in some orchestras. I wish one of my grandchildren would play it. Katie plays clarinet and Molly plays flute. Caleb will probably play drums or a brass instrument. Maybe Lizzie will play oboe or a string instrument.
When I went to the Boston Symphony a few weeks ago to see and hear Yo Yo Ma I was seated where I had a direct view of the lead oboe player. Since the director was blocking my view of Yo Yo, I watched the oboist instead. He moved with the music, levitating slightly with the higher notes and dipping down in front of the music stand with the lower notes, swaying gently while counting measures when he wasn’t playing. I think his eyes were changing colors when he played.
Music brings out tenderness and awe. It moves me in ways I really don’t understand but I am willing to ride out that vulnerability and be in the moment that each note is played. If it makes me sad, so be it. If it makes me want to dance, so much the better. I can’t imagine life without it.

Telling on Myself - Looking for the Middle Way

It is one of those mornings when the sun is shining so brightly through the patio windows that it shows off every bit of dust and dirt in the living room. I don’t have the energy to really care about it this morning. Doing the laundry and putting dishes in the dishwater is about as much as I can do right now. I need to save my energy for making the bed.

I am trying to find a way to say this with as little self judgment as possible. Let’s just say that things did not go according to plan this week at all. Yoga fell to the wayside as I dealt with a cold that had me off my feet for three days, I haven’t touched my cello in two weeks, and I haven’t been as careful with my food as I would have liked. Being ill usually throws me completely off the wagon but it could have been much worse.

There was a part of me that wasn’t going to blog on this today but then I thought – “Hey, this is what got you started in the first place and if you stop writing about it you might as well go out and buy a McD’s Double Quarter Pounder with Cheese and a pint of Ben and Jerry’s Brownie Batter Ice Cream.” So here I am presenting my human condition to the blogging world in hopes that it will re-inspire me to get back on the path to wellness. However, given how I am feeling today, that path may just lead to the couch with a book, dust bunnies surrounding me in the light of the sun. I am going to have to feel much better to even get to knitting group today and that, in my opinion, is tragic.

If there has been a theme in my life lately it is that life has its ups and downs and as long as I remember that nothing is permanent I will be okay. What I should also remember is that when I start to feel myself rising out of the ditch I should take it a little slower rather than trying to charge to the top of the rise to plant my flag. I was so grateful to feel better on Friday after three days of being miserable, that I charged through the day and activities and rose again on Saturday to do it all again. By last night I was starting to realize that there is a reason for moderation and the middle way. However, I never remember until it is too late and I am flat on my back again.

I love telling on myself. There was a point in my life when I was involved in all sorts of craziness and I realized that I was keeping secrets. I made a decision at the time that if I was doing something I couldn’t tell my mother then I shouldn’t be doing it. My mother didn’t know much about my life in my twenties and thirties but once I pulled it together she knew a whole lot more about me.

Another thing I have learned by telling on myself is that I am not alone!! It was so refreshing to call a friend last night and say, “Do you ever have times when you feel like you could just eat everything in the house?” and she said “Yes!” That felt so good. It stopped the momentum immediately. I just needed to tell on myself to someone who also understood. She had me laughing in a few minutes and I was able to go to bed without eating the bag of pita chips that was sitting on the kitchen table.

For today, I will move a little slower, give myself a little credit for realizing that downtime is necessary and rest. The laundry will get done and I may wipe down the kitchen counter. Food will be less of an issue today as my stomach appears to be rejecting any input. Later, if I feel like I can get down on the floor without falling asleep, I will do some gentle yoga just to be kind to my body. There is no need for me to rush anywhere today, so I will spend the day being mindful of what my body and spirit needs.

The Mindful Cowgirl

The next step on this journey towards a healthier me is mindfulness. I approach each day as a to-do list, always living in the next step rather than the one I am currently taking. It is time to slow it down a bit.
Mindful eating is the first key. I eat 2-3 meals a day while sitting at the computer. Up until I stopped eating those McDonald’s biscuits every morning I was eating 1-2 meals a day in the car. My dining table is more of a repository of the day’s mail and my tote bag than it is a place to sit and enjoy a mindful meal. I watched my cat, Boo, this morning. She is a perfect example of mindful eating. She focuses completely on her dish of salmon and gravy with only an occasional turn of her head to make sure that I am not going to step on her tail. When she is done, she cleans her face and paws and goes over to the patio window to check out the birds and squirrels in the trees. She does not insist that I move her dish over to the window so she can be entertained while she dines. She eats first. I realize you may think she does not have the ability to tell me that she wants her dish moved, but, believe me, she made it quite clear this morning that she was not going to let me brush her anymore unless I used the brush she nudged with her nose rather than the one I had in my hand. She is one smart cat and I plan to learn a lot from her.
Mindful eating consists of removing any distractions and focusing completely on the food. Each mouthful is to be chewed until it is completely soft and almost liquid. It is not to be washed down with water, soda, or coffee. Water and other liquids tend to dilute the enzymes needed for good digestion. Therefore, it is best to drink a glass of water 15-30 minutes before eating and then another glass 15-20 minutes after. Putting lemon in the water is a good idea and it is also good to drink it warm or hot. Another key is to put the spoon or fork down between each bite and not pick it up again until the food has been completely chewed and swallowed.
DO YOU HAVE ANY IDEA HOW HARD THIS IS????? This morning I got up and did yoga first thing as it has been suggested that yoga be done on an empty stomach. By the time I had breakfast made I was ready to gobble it down. I sat down at the table and started to eat. I wasn’t perfect, but more about the nonjudgmental stance later. I wasn’t always conscious of putting the fork down or chewing thoroughly. However, I found that I felt full faster and did not eat all that was on my plate. If I had been at the computer I would been in auto mode and it all would have been gone before I knew I was full.
The hardest part of this is staying in the moment. Without the distraction of the computer, my to-do list was running through my brain. Brush Boo, clean litter box, vacuum, wipe down the kitchen, fold laundry. My mind was running amok and raising havoc with my mindful eating. What do I do then? I bring myself to the moment and try very hard not to judge myself for having diverged from the plan. If judgment becomes a big part of this journey I will judge myself as a failure before a week is out.
As I was doing yoga this morning I was able to spend some time being mindful of the sensations in my body. I could tune into discomfort, make adjustments, listen to my body and move on to another pose that would release any tension. Occasionally my mind would go back to the to-do list and or to writing this post in my head. Working mindfully, I was able to bring my attention back to my body. I am in this current state of health because I did not listen to my body and it is time to honor all it has done for me by being mindful of its needs. It needs me to pay attention.
I have not always been mindful of my body’s needs. One of the reason my health has gotten to this point is that I took it for granted. I have always been a large woman but it hasn’t really slowed me down until the last two years. I was always able to still do a lot of physical activities that other people of my size would have found too strenuous. Unfortunately, it was like driving a car very hard for a lot of miles without attending to the regular maintenance. I am worn out and I can’t trade myself in for a new model. This is what I have and I need to listen to what it needs in order to help it last for the rest of the trip.
The next challenge is to apply this all to the work day. The hardest part will be the adjustment to my morning routine of eating my breakfast at the computer (or in the car). I plan to eat lunch away from my desk and without distractions. And when I do reach for a piece of chocolate, I will eat it slowly and mindfully.

Going to Cowgirl Up!

I am feeling a little disappointed by the medical community and am going to have to cowgirl up and take a more active role in the management of my health. Posting to this blog regarding this journey is going to be a way of being accountable and tracking my progress.
I have a few health problems. Morbid obesity is the number one problem and is probably the main contributing factor to how I feel. However, I also have clinical depression and sometimes it is hard to determine which came first. I have experienced both for most of my life and there appears to be a significant genetic factor.
This is not meant to be a confessional where I reveal my bad habits and how my life has been affected by my excesses. Out of the two issues of obesity and depression, one is highly visible and the other is probably suspected by a number of folks who have known me for a while. Any other details will be saved for my memoirs.
After trying to get help from the doctors regarding pain and a number of other issues, I am feeling a little done with Western medicine. After running up a big bill for medical tests I am no further along than I was before. I think that my error came in believing that the tests would find something medically wrong with me, the doctors would give me a pill or perform a surgery, I would feel better and life would miraculously improve. It’s not happening and I am still in pain, still depressed and still very fat.
The real corker for all of this is that I am not uninformed. I have books about nutrition and health and have read them. I have talked to nutritionists and tried a number of diet plans and support groups. I am full of information and I think it is time for me to get down and dirty and actually apply some of that knowledge and learn more about myself in the process.
Here are the challenges –
1) The depression reduces my motivation at times but I find once I get moving I am glad I did so.
2) The extra weight I am carrying seems overwhelming and will take months to years to disappear if I take care of myself properly. I have lost large amounts of weight quickly before and gained it back even faster so I know the trap of the quick weight loss schemes.
3) I have a couple of medical issues that make walking difficult for me. To be blunt – I usually have to pee a couple of times during a walk and there isn’t always a place to do so. And, I have heel pain after walking for a while.
4) I have a sugar addiction that usually manifests as cravings for chocolate and breads.
5) I live alone and am only accountable to myself.
Here are my strengths –
1) I have knowledge of nutrition and holistic/allopathic medicine.
2) I love yoga.
3) I use mindfulness techniques and other practices (cello, writing, knitting) as means of relaxing and reducing stress.
4) Except for my health, I have few stressors in my life. My job provides healthy stress, I live in a stable home, I have a cat, and I have a car that runs well.
5) I have supportive close friends.
6) I see my wonderful chiropractor, Dr. Sam, once a week and the pain has been greatly reduced over the past six months of weekly adjustments.

Here are the current changes –
1) I have recently decided to try being a pescetarian by cutting out meat and eating fish at least two to three times a week. That has cut out the morning run to McDonald’s for sausage biscuits and increased my vegetable intake.
2) I have started a Yoga for Weight Loss class and am going to work on incorporating yoga into my daily routine.
3) I have an appointment with a Naturopath/M.D. in May but am on a waiting list to go in if there is a cancellation before then.
4) I am not taking any pain medication other than Ibuprofen as needed.
5) I don’t drink, smoke or hang out with people who do.
6) I am using mindfulness meditation and yoga nidra regularly to manage any symptoms of anxiety.
Here is the plan. I will maintain the current changes, continue to research new things, consider advice, and report back on how it is going. I will be gentle with myself by continuing to search for my strengths on those days when I somehow miss the mark.
At 53 I don’t have many choices. I can’t afford to get older if it means more and more medical bills. I am not going to enjoy the next 20-30 years if I don’t feel better. And I don’t think I can count on anyone else besides me to get this under control. Contrary to what you see on television and the internet, there is no magic formula for losing weight and feeling better. If there was, there wouldn’t be so many varieties of dietary aids out there.
I am not going to lie about this. I am scared. I have tried and failed at this endeavor many times but I have also not always given it my full attention. I don’t want to experience the disappointment of failure again. Each time I lose weight I gain back even more and I gain it back faster than I lost it. There is a lot at stake here and I find myself discouraged every day by the long road ahead of me. I think I knew this day was coming. I have run out of choices and I need to take responsibility.