Category Archives: Health

Baby Steps

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I went for a walk yesterday. A short one, to be sure; calling it half a mile would be generous. But I went. I went the day before too.

People who have been in severe depression know this is important. Doing anything is important. Commercials for antidepressants know it–as annoying as I find them, they are on target with this. The patient is out doing simple things like walking a dog or watching a child’s soccer game, and this is progress.

The other thing I find on target is that the actress in the commercial (why is it always a woman? Men suffer from depression too) usually still has a faraway look on her face most of the time, as if she is not quite present. She’s still at least partially phoning it in, but she’s showing up and trying.

Since starting my new meds, this is how I feel. Not sure about any of it, but a little more able to show up. So I am taking my meds, and going for walks.

I’m carrying a heavy emotional backpack on my walks, because taking this body out and moving it means being acutely aware of the damage it has suffered recently. Various parts of it ache, and I need to sit down and rest sometimes. I feel frail, and am careful where I put my feet. I miss the freer and stronger stride of even 30 pounds ago.

Intellectually, I know that if I continue to move my body it will get stronger. I want to be strong, not only for practical reasons but because it would be a kind of acceptance. I want to say all right, I accept the weight I am now and everything that goes with it. I accept that, right now, I must carry this weight, and I want to be strong to carry it.

Gratitude is important too, and the lack thereof is dangerous for me. I need to appreciate that I can still walk around my apartment complex and sit on a bench and watch ducks. Not everyone can do this; I have many privileges mixed up with my problems.

Vitamin Diplomacy

I imagine “normal people,” whatever they might be, do a lot of things differently from the way I do them. This imagining may or may not be accurate, but I do it. I imagine them getting into the shower without a great deal of internal debate, simply because it’s the thing they do every morning. I imagine them opening the mail before the stack gets so tall that it topples onto the floor. I imagine them answering the phone with an air of curiosity rather than dread: I wonder who that is? instead of Oh, God, can I handle a conversation right now?

I imagine them taking their vitamins without conducting a negotiation.

I have a simple regimen containing just a few high priorities: a basic multivitamin, Omega fatty acids, and extra vitamin D. Three items, once a day, in addition to my psych meds. So why do they get ignored so often? I have managed to be consistent about taking my psych meds for a long time now. Those don’t get negotiated. So I’m standing right there, at the counter, taking those, and the three other bottles are inches from my hands. What keeps me from taking them?

There’s something inside of me that gets in the way. I think of it as the part that wants me to be sick, or maybe the part that wants me bound, stuck and ashamed. Most of us have one. My vitamins are my symbol of it today because they’re an example of how illogical and power-hungry this aspect of me is. I got up, took my psych meds, made breakfast for my daughter, worked on a poem and haven’t done anything markedly stupid today…and the vitamin negotiation goes on. It goes on as a way of showing me that I can’t get away with taking care of myself too much. It wants me to know that it hasn’t lost the power to sabotage me, even if it’s only in a small way at the moment.

There was a time when my blood sugars were under very poor control because of my weight, food choices and inconsistent compliance with my meds. I would walk by my diabetes meds on the counter, pause, look at them and walk on. I was prescribed a cholesterol lowering drug: the bottle sat in its unopened pharmacy bag for months. An earthquake–not as severe as the recent 6, but a good 5–failed even to get me out of my chair. During this period of my life, the self-destruction was winning. Aided by drugs and severe depression, it had conditioned me into helpless apathy.

Things are different now, but it clings to life and occasionally roars recollections of its past glory. Like a hostage negotiator, I have to try to get concessions from it, and I often don’t succeed in resolving the situation completely. As I said above, the psych meds are high priority and tend to get “released” first. Vitamins, while important, don’t have severe consequences for missing one or two days, so I am more likely to let them slide. They mock me from the counter, sitting in plain sight and silently asking why I’m staying away. I don’t like it because it reminds me so strongly of the times I was ignoring more vital things.

Sometimes I push through the resistance and take the bloody vitamins. Down they go–the oblong multi, the round white Vitamin D, and the aesthetically pleasing golden Omegas. But what is the price? The price is danger; the danger inherent in feeling virtuous. Because they’ve become such a symbol of doing well, succeeding with them kind of invites the other shoe to drop…

See? This is how I think. This cannot be normal.

And if you think my attitude about vitamins is bizarre, you might not want to ask about exercise. Same weirdness, with added complexity because it requires much more effort. Something I desperately, vitally need for my health is held hostage. I belong to the Y near my home. I own a freaking treadmill, which is apparently guarded by an invisible giant spider that wraps my psyche in a strangling web if I venture too near.

Should I go with the metaphor and try actual negotiation? I could say, “Please, let me exercise today and I promise to skip the vitamins all week.” “I promise to bite my nails until they bleed if you let me stay away from binge eating for the day.” I could bargain for the things I want most that day, and pay with other ways of harming or neglecting myself. Let’s face it, I already do a lot of that, consciously or unconsciously.

My drug addiction uses this dynamic to try to woo me back. It whispers: just start using me again, and this frustrating negotiation will be over. The fact that it goes on is proof that you’ll never be able to handle life without me. The vitamins join the chorus, singing their little song from the counter. We are for people who love their bodies, they sing. We are for people who walk firmly on the side of life, they sing. We are for people who don’t harm and neglect themselves.

We are for people who are not you.

49 Minutes, 32 Seconds

Several days ago, I challenged myself to celebrate my recovery and my life at the weekend convention I attended, in spite of the old tapes that make me hesitant to do so. In that spirit, I announce that I showed up for my first 5K and crossed the finish line with a time of 49 minutes and 32 seconds. I announce that I cared enough to do the math afterward and find out that my average speed was 3.72 miles per hour.

To a runner, of course, this is not even on the graph. But remember who we’re talking about here: someone who weighed close to 300 pounds for much of her adult life. Someone who was a semi-invalid for years. Someone who, in general, wouldn’t have been caught dead moving faster than one mile an hour unless it was to reach a bottle of pills.

I had two goals when I arrived at the site: not to stop moving and not to come in the very last. I was optimistic about being able to achieve the first goal if I paced myself, but as I looked around at my peers I was not at all sure about the second.

I knew I had gone to bed earlier than most of them. Put a thousand-plus recovery types in the same hotel and hijinks tend to ensue, albeit clean/sober ones. There had still been dancing and karaoke going strong when my overstimulated brain called a retreat, but you couldn’t tell it by looking at them. I saw some serious runners who seemed prepared to do some serious running: stretching whipcord muscles, adjusting iPod rigs and monitors, and pulling on specialized-fabric outfits that probably went for three figures at REI.

I had expected something a little more social–people chatting as they jogged or walked. Camaraderie with a little aerobic exercise thrown in. But one of the first instructions given at the starting line was to get into single file as soon as possible because we were running on a dirt path at one side of a bike trail. Yikes. It’s okay, I told myself. Just have fun. Even if you are last it’s fine. It’s a beautiful day and you’re doing something you never, ever thought you would do.

Ever. You see, jogging and I have never gotten along, almost from the moment we met. Like many, I had my early experiences with running in PE class. We were timed, compared, and assigned extra laps around the track as punishment. It didn’t help that I was in the Los Angeles area and we ran during extreme heat and third stage smog alerts (there are less of these now, and schools are required to respect them more.)

My feelings about jogging also go back to a specific moment when I was thirteen. I was finishing up my laps, hauling my awkward and unfamiliar body along in the heat, when I passed my first ever non-childhood “boyfriend” and he said “You sure jiggle a lot when you run.”

Later perspective suggests he was making a teen-boy reference to my breasts, which was rude enough, but at the time I heard it differently. Excruciatingly uncomfortable with the new layer of fat that had appeared with puberty, I took it to mean that when I ran everything was jiggling, and in a ridiculous way. That my stomach, thighs and body in general were an embarrassment and that I should never allow myself to be seen in any high-impact activity again unless I morphed into a much thinner, denser person.

Even during the times I was active as an adult, I never broke out of a brisk walk. Although I was comfortable with a little more bounciness when dancing, the rhythmic up-and-down bounce of jogging was to be shunned.

So the stretches of jogging I did during the race to make the time I did–as sporadic as they were–represent not only improved fitness but improvement in my attitude. Because here’s a news flash: now I do jiggle a lot when I run. I probably look as jiggly as that embarrassed thirteen-year-old thought she looked. Everything, and I mean everything, goes up and down thanks to the extra skin from my weight loss, and nothing short of a carbon fiber corset and leotard would do much about it.

I can’t picture myself ending up a hard-core runner, or having running be my most preferred form of exercise. I prefer hiking and dancing. But what a gift to even try it; to break into and out of a jog without giving much thought to how I looked. To challenge myself. To compare myself to myself and take pride in having done something new.

There was no such thing as finishing last. That being said, there was also nothing wrong with letting the little kid in me enjoy the fact that I wasn’t the last to cross that finish line. Nothing wrong with letting her enjoy being part of the crowd cheering on the 5 or 6 people that came later.

Girl Who Cried Wolf

Making amends is an important part of recovery. Masochism is not.

I’ve mentioned how lucky I am that the surgeon got to my appendix before it ruptured, and how fortunate I am that being clean caused me to go to the hospital instead of self-medicating. What I haven’t admitted is that, looking back at that awful night of pain, I can see I probably waited at least six hours longer than I should have. The results could have been very bad indeed.

Why did I do that? Why did I hide in the bathroom of our hotel room, and rock back and forth with pain, and use the shower spray to try to ease my pain like a woman in labor might do, while my family slept? I know I wanted them to get some sleep, but I think there was also some baggage behind my actions.

I did it because I have so much shame about being a burden to my family in the past. About being a semi-invalid sometimes; about being the one who has to go to the hospital. Being the one who talks a lot about pain and illness and stays home from family outings. Near the end of my last relapse, my physical and mental health had reached such a low ebb that I could keel over, or be constantly nauseated, or talk of suicide without causing my husband a great deal of alarm. It had become normal.

In recovery, I’ve tried really hard to take better care of myself and get out of that semi-invalid role I was in. I can do so much more now, and I’ve slowly improved my health in important ways. But when there is something wrong–when, despite my efforts, I need help–I feel like the girl who cried wolf. For so long I exaggerated symptoms or weakness, even to myself, that it’s hard for me to take myself seriously when I hurt or to believe that others will take me seriously.

When the doctor in the ER told us that it was appendicitis, there was a tiny corner of my mind that was relieved. Not only because it meant there was a solution, but because that little girl who cried wolf actually had a wolf to show for it this time! I had been dreading the feelings I would have if they sent me away with a diagnosis of gas pains and the knowledge that I’d messed up our vacation for nothing.

When it was all over, that same part of my mind hoped that the experience would help to show that I wasn’t the person I had been when it comes to pain anymore. That I don’t seek help or attention lightly anymore. Perhaps I thought this would heal some of the frustration I must have caused.

I don’t know. What is clear to me is that I must deal with this baggage and reach a place of balance around getting medical help when I need it. It’s not okay for me to endanger my health or neglect an injury out of some need for atonement! Right now I am having trouble with my shoulder; the physical therapy has not helped and it has worsened considerably in the past month. I have finally gone back to my doctor to get some imaging done–and I feel guilty about it.

There is no need for this. This is destructive. Showing a lack of love and care for my body will not wipe out one iota of the past. I need to balance duty to myself and to others. Balance the need to make amends for past behavior with the humility to know how much I can do without making things worse again.

Balance, balance, balance! Will this quest for balance in recovery ever end?

(Spoiler alert: NO.)
(Well, technically yes, but the rest of life also ends then.)

Probably Nothing

I’ve never been good with things that are pending. In recovery, and the more functional life that comes with it, there are usually many things in process, and they aren’t going to be resolved by one day or one action. Instead of the single-minded drive of an active addict, my mind contains a hundred worries, a hundred dreams, and a hundred tasks that need to be rated in importance and broken down into smaller steps. The learning curve can be exhausting, and it’s one reason it is so important for me to recenter myself with meetings or other times focused specifically on recovery.

Last week, I was diagnosed with a Probably Nothing. You know, when the doctor says. “It’s probably nothing, but…” and they send you to someone else to Take a Look. Like many who have been in similar situations, I’m supposed to go on with my normal life until the specialist appointment. Only a week to go now.

Logic dictates that I not spend too much energy on this until I know more. Yeah, my brain is all about logic. The truth is, a situation like this wakes up that negative, critical, doomsaying voice I recently featured in Intervention. “Aha, told you so,” it tries to say. “Told you there was no point in trying to change. Everything you’ve been doing is pointless; you were wrong to hope and this is the proof.”

“Do you think being in a phase of change makes you immune to the random cruelty of the universe?” it goes on. “Remember the woman who spent nine years becoming a Jungian analyst and was diagnosed with terminal cancer two weeks after graduation? In three months she was dead; all her work wasted. That’s what happens.”

It’s good that I am fairly quick to identify that voice these days. Naming and describing it helps to remove some of its power, and I can talk back to it: Oh,  you again. Yeah, yeah, heard it before. And by the way, even if the worst happens, it was all worth it, because how I die matters, and how that woman spent the last years of her life matters too, so fuck off.

But there’s a new flavor added to the anxiety I feel. It’s not as if it’s the first time I have been faced with a potential, or actual, medical problem. So what is different about this time? Since I’ll need to live with this feeling for a while yet, I’ve been trying to get familiar with it.

Does the thought of serious illness scare me more now because I have more to lose? Do I fear the regret of having to leave this level just as I begin to experience it more fully? Or is it just that I’m more conscious and aware of my feelings and fears?

Both of these are probably at play, but there is something else. I think it has to do with the fact that, possibly for the first time in my life, I am actually taking care of myself physically. Not perfectly, but I am not engaging in any self-destructive behavior or any forms of dangerous self-neglect. I’m not pouring toxic drugs into my system. I’m not a heart attack or stroke or organ failure waiting to happen because of sky-high cholesterol, triglycerides and blood sugars. I’m not ignoring the important medications I need to take.

Why would this make me more worried? It’s paradoxical, but I think I get it. In the past, if something was wrong, it tended to be at least partly my fault. Or, at the very least, there was something I was supposed to be doing to make it better that I wasn’t doing. So, in a weird way, I had control. Now I don’t–if this Probably Nothing isn’t, then it is truly not in my control. It’s not a punishment or a consequence of my neglect; it just falls into the category of Shit Happens, and it’s happened to me because it can happen to anyone.

That makes me feel vulnerable. Guess it’s lesson #8,323 in my remedial, accelerated curriculum on being a human.

What time is recess again?

Safeword

I have a new and weird relationship in my life. Twice a week, I slip away to meet a younger guy who likes to hurt me. He praises me when I can take a lot, and he encourages me to try harder when I resist. When I come home, I’m aware of my body in a whole new way…and I keep going back, even though I ache from our previous meeting.

Physical therapy is not easy.

When I began this treatment for my shoulder problems, I didn’t realize it was going to hurt so much. My previous attempts at physical therapy, for my lower back problems, had involved more passive techniques. But I had a very different attitude back then, and if I’m honest with myself I see that there are many things they wanted to have me do or do with me that I simply refused. I would not consent to endure any discomfort, even though it might bring healing, and I wanted immediate relief. And, quite frankly, a part of me probably just wanted to get more painkillers and go home.

What I and this gentleman are doing now is aimed at improving my range of motion and building strength in new places…constructive action. I’m truly interested in treating the underlying problem, and I am willing to endure discomfort in order to do it. Even as I ache, I feel gratitude for these signs of the changes recovery has made in my outlook.

During the sessions, he tells me to let him know when the pain is too much.  Like someone engaging in consensual pain play who has a “safeword,” I have the ability to stop something when I judge that I must. It creates a dilemma for me, though: I don’t always trust my perception of pain.

Painkillers were my drug of choice when practicing my addiction. This meant that I habitually overestimated my pain level, even to myself, in order to get more of them. This habit sank into the levels of my consciousness, aided by the destructive effects of opiates on the body’s natural ability to process pain, until my pain threshold was pathetically low and I responded to any degree of pain with overwhelming anxiety.

My personal experience of recovery involved becoming willing to be in pain if that was what it took to stay clean, and I’m grateful to say that my average pain level has declined over time. Today, because I am so aware of my previous habits, I think I might have a tendency to underestimate pain in a situation like this, or try to take intense pain because I think it’s the mature thing to do.

So when do I call out my safeword as he digs into scar tissue or rotates my arm through agonizing arcs? How do I know when my pain at home is bad enough to justify skipping an exercise? It’s that balance thing again. No real answer, but it helps to be aware of the question.

This feels too much in my head as I read it…I don’t want to leave it like that.  I want to admit that I feel scared. And vulnerable. And I worry that it won’t improve. Though I may have a safeword with him, I don’t have one against the constant aching or the sudden jolts of pain that answer movements. I’m powerless, and I don’t get to take a pill or push a button for quick relief from distress.

When I feel vulnerable, I want to distract myself from the feeling. But after I’m done running through the potential distractions and saying either “won’t do that” or “did that, didn’t work” to each one, I have no choice but to relax into the sensation. Soften. Yield. Be human, damaged, imperfect and in pain. After a while, if I soften into it, I am not afraid any more.

Pain We Obey

Yesterday I got a new follower who deals with a quite high level of chronic pain and illness, and uses a lot of meditation and other mindfulness techniques to improve her ability to enjoy life as well as possible. I felt a lot of empathy reading posts on her blog, such as What Acceptance Really Means to Me, and I fell into some sense memories of times my average pain level was much higher than it is now.

Even at its worst, the pain from my cracked vertebra was not that bad compared to what some endure. But when it’s your pain, and you have it all the time, it feels consuming. I know what it’s like to plan my days around pain; to decline activities I used to enjoy. Not to be fully present in the moment because I’m counting the minutes until I can lie down and take painkillers. My addiction clouded the issue as time went on, making it more difficult to judge the true level of my pain and causing me to neglect the things that might help it.

I’m glad that many in pain are still able to use painkillers to take the edge off, even though I know the side effects can suck. I’d still be doing it if it worked. I’d still be doing it if my body and brain had not developed ever-increasing levels of physical tolerance and psychological need. Why not? We’re wired to seek pleasure and avoid pain. That’s not wrong, it’s human.

When it became clear that I was an addict with a capital A, rather than simply being physically addicted to the meds, I felt so sorry for myself. My black-and-white thinking painted the future as an infinite desert of unrelieved pain and bleak depression. It felt so unfair. I had to change my attitude a lot to have a chance of staying clean, as I mention in Compassion With A Twist.

When I became willing to live, and went to rehab, I was told that for every year I had used opiates it would take about a month clean to figure out my true pain level. I’d used them for eleven years. Didn’t sound like much fun. Rehab, with its constant classes and groups, was very physically challenging for me. I’d sit on pillows, rocking and fidgeting often, feeling as if someone had jammed a screwdriver into the base of my spine. I must have dried ten thousand dishes, because it was the only one of all the chores that I could do without triggering my back too intensely.

Today, I can say with gratitude that it appears the doctors at rehab were right. My pain level is far lower than it was before I got clean. I still have occasional episodes of bad back pain, but I pause and remember that I used to feel that way all of the time. Recovery has also brought me other improvements in health that lower my pain, such as weight loss and the ability to exercise more. That’s only my story about recovery, and I know that not all pain is the same.

Living with chronic pain, like living with mental illness or being in recovery, opens us to trying things that might not have been on our agenda. Spiritual exploration. Meditation. Trying to find and do small things that give pleasure in the moment. Examining our ideas about what we are if we’re not our jobs or our productivity. All of you who make this necessity into a quest for growth inspire me: how amazing it is that we perform, however imperfectly, this mysterious alchemy that turns pain and despair into something beautiful.

“To goodness and wisdom we only make promises; pain we obey.”
–Marcel Proust