....And a million miles...

Hello, It's Me




To [run] over everything



...

Hello from [my back] side
At least I can say that I've tried.



Heavy

I had an appointment with my primary care provider, Dr. F today to touch base on all of the fun medical stuff going on with me (tl;dr -- 4 months of pain underneath my right ribs, reflux, vomiting, etc.).  

She reaffirmed that I'm doing everything as I should be doing, but that I might be one of those "medical mysteries" that you read about in the Post.  In other words, multiple doctors have run all the standard diagnostics (blood, CT, ultrasound) for the most likely causes for the pain (friggin gallbladder), but they're not yet able to explain why I am in pain.  Doctors even did the next level of testing (HIDA, EGD endoscopy, gastric emptying study) and couldn't find a cause for everything going on (just confirmed some symptoms).  So we're moving into more focused tests (abdominal MRI (Jan. 13), endoscopic ultrasound (Jan. 25)).  We briefly discussed the possibility of needing surgery down the line to help with a diagnosis.

It could still be my gallbladder, could be a Sphincter of Oddi dysfunction, it could be an alien just biding his time in my gut before he breaks out in song, it could be (though unlikely) a muscle tear in my side. 

One moment that kind of took me by surprise was the concerned face she made when we talked about my losing weight.  She knows that this number represents 2 months of throwing up (September/October) and 4 months (September–present) being skittish around food and not exercising.  She knows that I haven't been taking vitamins, feel really weak/tired because I'm not eating enough calories, and that generally I feel like shit.  She'd rather me weigh more and feel better than to see the scale go down and me feel so broken.

In other fun news, based on my blood work/pap smear at my annual obgyn exam, I got to have a colposcopy on 12/23.  They took two cervical biopsies. I got the results back today and.... benign squamous epithelial cells. So we'll keep an eye on that going forward, but a little good news today.

#GoTheDist 2016


Stephen King wrote in his book "On Writing: A Memoir of the Craft,"  "You can, you should, and if you're brave enough to start, you will." (emphasis added)  He called this a "permission slip." Couple this with Ranier Maria Rilke's "Letters to a Young Poet" (which I talk about here) and the whole picture emerges:  when faced with the questions of who we are and what we want to be, we need to harness our passion (Rilke's "I must"), couple it with the strength of our heart (courage), and not get in the way of our own potential.

Excuses become victories to overcome.
Obstacles become challenges to meet head-on.
Failures aren't disasters, but stepping stones.

That last one is important.  I know so many people who are afraid to evolve, to try new things, to go new places, to meet new people because they fear the failures that may await outside of their comfort zone.  That's an oppressive way to live -- and it's self-inflicted!  There's such great freedom in detaching yourself from expectations (of failure or even success).  It a beautiful blank canvas where anything can happen (Bob Ross: "We don't make mistakes: we have happy accidents"). 

#GoTheDist 2016's theme hopes to inspire and encourage the greatness that is within all of us.


Are you ready?




How to Join #GoTheDist 2016

Exhausted

A few months ago, I wrote about my fun trip to the hospital because of abdominal pain that I was feeling.
Timeline
9/1 & 9/2 - Hospital
Bloodwork, Ultrasound, CT, HIDA (nuclear test of gallbladder function). Left hospital with anti-nausea meds (Bentyl and Zofran). They recommended a follow-up with a gastroenterologist. 

9/11 - went to Dr. C.; didn't have best impression of him (he didnt even touch me/investigate during first exam). Gave me trials of Dexilant (GERD meds) but no prescription. Recommended that I take Prilosec (over the counter anti reflux meds). Scheduled me for endoscopy.

10/9 - Upper GI Endoscopy (EGD) (camera down my throat to view esophagus, stomach, and duodenum).  Revealed irritation (erythema) consistent with gastritis/reflux. Biopsies taken during EGD came back negative for ulcers, cancer (Barrett's Syndrome), Crohn's, celiac, and Heliobacter pylori.

I pretty much was throwing up every day or every other day in September and October. I am on a low acid/low-to-no fat diet (with a few other nos: caffeine, alcohol, gum, onions).

took a nap under a Geiger counter. 
11/5 - went to new doc (Dr. Z). He prescribes a stronger anti-reflux meds and a gastric emptying test. Stronger anti-reflux meds help for the most part. I only throw up about once a week now and it is largely based on me and my diet. Drinking too many liquids is usual the culprit.

11/18 - Gastric Emptying Study (see photos) (eat some radioactive eggs and see how long it takes to move through upper GI). Just got the results and they are normal. This rules out gastroparesis (slow motility of stomach)

12/14 - follow up with Dr. Z.  [Edit:  we talked about life since on omeprazole -- which has been better, but not perfect.  I'm still waking up with acid in my esophagus.  He's prescribing something for overnight.  We talked about my diet. He said that I should be able to eat some of the restricted food groups in small portions, but I told him that I've not had any luck with that.  I still have the pain on my right side.  He said at this point it might be musculoskeletal (i'm dubious about this...).  But that there are more tests we can do that could help figure out what's going on (and could also help determine if it's musculoskeletal) -- an endoscopic ultrasound and an MRI.  If those prove to be inconclusive, it may be the time to talk to a surgeon.]

Complications
During all of this, I had a ton of stuff going on at work as well as an office move.
Thanksgiving made me terribly sad cause it is my favorite holiday and I couldn't eat my favorite foods so I didn't go. Glad I didn't go. Spent most of the day in bed crying between trips to throw up.

Thoughts
I have been really frustrated because it is 3.5 months later and we are no closer to a diagnosis. Chronic pain (back) + chronic illness (gut) has been a really tough one-two combination. Feeling beat up is an understatement.

As drinking liquids tends to trigger my nausea (no matter how slowly I drink), I have been operating pretty dehydrated and this hasn't been good for my back. I tried holiday shopping yesterday and after 30 minutes and one bus ride I was already limping (and was without my cane).

I spend a lot of time in bed because I have no energy or desire to engage in life any more than I have to. At least Jack is a cuddle monster.

I had myself a good cathartic cry yesterday. I know many people in the world have a harder life than I do -- no doctors, no medicine, no sick leave from work, no insurance, no cuddly cat, no warm bed, no roof.... but as people keep asking me what I want for the holidays, it is abundantly clear that I don't want or need trinkets. I just want my health.

Underwater

So two things led up to this post -- a post that will mix metaphors and have your heads spinning:

1.  I saw #RunChat a week or so ago and popped my head in.  I love how supportive David (@RunningBecause) is, but the fact is that I'm already motivated -- that has rarely waned (except when it comes to diet because pizza is delicious).  I've been champing at the bit. Perhaps my running life movie (see below) shouldn't be titled "Out of Gas" but rather "Broken Down Jalopy."


I was okay when it was just my back.  But now it's gallbladder(?) + back.  I feel very overwhelmed by this.  I just want (1) a healthy day (without feeling like I need to vomit all the time) and (2) a day without pain (either my gallbladder or my back--which is feeling the effects of the dehydration) (and (3) a day without my ear ringing... but that's not wearing me down so long as I have a kitteh bent on purring in my ear at night).

2.  I've been reading Martinus' blog (@300lbsandrunnin) lately and really identifying with what he's been going through. Life is hard sometimes. It's messy. It's ugly. And always having to start over is excruciating because it's not like starting with a clean slate at the start line, or as  I said to Martinus, "I see it like wanting to climb a mountain but first having to dig your way out of a cavern with your bare hands." You exhaust yourself even before even getting to the point where you feel like you can once again take up fight.
I feel like I'm underwater and unable to get my head above the surface. Is it depression? Maybe? I guess? I feel very much like I'm never going to get to a place where my body and mind are in the same place. It's frustrating. I'm angry. I'm in mourning. And I'm also terrified. I don't know the way forward.  

I was thinking about the tweets above when I remembered my swim lessons as a kid. They taught me the survival float -- face down floating for when you're in open/rough water (floating on your back only works in calm water). This strategy conserves energy for when you need to use it.

Perhaps I need to remember that I'm using my energy to handle the waves and that pretty soon I'll be in calmer water.
 

Fat Slob

The tweet linked to this ESPN article

Let's break this tweet down a little:  a former NFL Tight end (Giants, Patriots, Cardinals) that retired after 3 seasons due to injury (i.e., a GROWN ASS MAN) is calling a HIGH SCHOOL TEENAGER (17) (John Krahn -- who is fairly new to football and knows he could compete better at a lighter weight and is addressing that already) a FAT SLOB.

Of course I took Jake Ballard to task over this. I mean that other chick at least recognized how her video wasn't intended for minors and how her words could be detrimental to vulnerable kids.  Here's a selection of the interactions with JB (versus his followers who don't realize how fat shaming doesn't actually work): 


Funny thing is that the whole time this was happening, I was sitting in a bar next to two NY Giants fans:  an elementary school gym teacher (from NY) and a 6th grade teacher (from MD).  They told me about this thing that is all the rage with school teachers apparently -- PBIS (Positive Behavioral Interventions & Supports) -- that helps change the environment that kids are in by giving them the tools and encouragement to respect themselves and others while applying themselves to their responsibilities and goals.  You know -- the antithesis of bullying. 
We KNOW (i.e., more than just theories and opinions) that fat shaming kids doesn't work.  We KNOW that celebrities/athletes (even former ones) (1) have large audiences (2) have a lot of influence (that is to say, they can use their words and actions to actually affect positive change).  And we KNOW that an adult fat shaming a minor isn't some act of benevolence -- it's ignorant and harmful. 

It really bothered me when he used the hashtag "#everyoneisavictim" -- dude did not back down at all from his stance that calling a teenager a "fat slob" is okay to do.  It showed (1) no compassion and (2) arrogance that his unsolicited evaluation of a teenager was somehow not hurtful to the kid or even other people reading his tweets. Kids who are bullied are victims.

BUT in the end, I actually did try to follow his suggestion.  I think I found John on Twitter and said "hi :) I would love to chat with you some time about health, fitness, and being a positive role model." (He followed my account shortly thereafter.)

So this post is a 2-part call to action: 
1.  Tell Jake Ballard how fat shaming doesn't work (tell him your story, send him studies, send him links of football players actually helping kids be fit (NFL Play60), etc.)

2.  Do what you can to help end fat shaming in your communities and/or help share what you've learned about nutrition/exercise with someone receptive to making a positive change in their life.

Baseline

On September 27, 1994, my mother passed away from a cerebral aneurysm that put pressure on her brain, hemorrhaged, and put her in a coma from which she never recovered.

Some doctors and scientists think that there might be a genetic/hereditary component to aneurysms. As such, my primary care doctor has wanted me to get an MRA for quite a while. The test is like the reverse of an MRI.  An MRI's image filters out the moving parts of your body to create a picture of what is not moving.  An MRA filters out the still parts to create a picture of what is moving (i.e., my blood).

The result is this:
looking straight at my face
 I think my brain is rather photogenic.

Looking at the right side of my face
I am expecting an unremarkable radiology report to come back from this.  But I thought the stills were too cool not to share.

Not Dead Yet

So...  I've not been writing that much on my blog mainly because I feel like I'm repeating myself regarding the back stuff and then I worry about my blog turning into one big buzzkill.  Well I'm going to try and rectify that for everyone that hasn't seen on social media.

On September 1st, I called Teladoc because I had some pain in my upper right abdominal area and wasn't sure whether that was a "Go to your PCP" type of issue or "Go to ER, you're about to explode" issue.  Teladoc went with the former so I called my PCP and asked if I could come in sometime that week.  I get a call back to come in immediately.

She poked around a bit.  She knows that I live on the higher end of the pain scale, so for me to say that something is painful means that it's (1) new pain and (2) above my regular threshold.  She wants me to get tests, but says that I can get them faster if I go to the hospital.  So that's what I did.

I got in a cab and took myself to the hospital where I had blood drawn by a really hot nurse (and almost threw up on him/fainted).  In addition to the blood tests, they sent me for an ultrasound, and a CT scan.  Everything came back pretty unremarkable except for a few elevated blood levels that could be explained by having thrown up the night before.  So they decided to admit me to run a test the next morning.

The most frustrating part of being in the hospital was the lack of communication between the ER doctors, the surgeon, the nurses.  They would ask me what the other ones said.  Um. Don't you have my chart?  

Second most frustrating part was the speculation.  They were throwing out possibilities of pancreatitis and pancreatic cancer.  For a good 20 minutes I was having a serious talk with myself about my own mortality and what I had yet to do in my life.

At that point, I called my brother and asked him to bring me a change of clothes and my glasses (so I could take my contacts out), my external phone battery, and of course my otter. He sat with me in the ER for a bit and we had a really good talk about life and stuff.

The test the next morning was pretty effing cool.  It's called a HIDA.  They inject me with a radioactive isotope (technetium 99) while lying underneath a Geiger counter.  They record how well my liver passes the 99Tc to my gallbladder. So yeah... for 6 hours I was radioactive. Sadly, no spidey powers. (notice the metal syringe in the photo below -- that's so the technician limits his exposure)


Fortunately/unfortunately, my liver and gallbladder did their job.  We were no closer to an answer. Odd thing was that I was in quite a bit of pain before the scan (they couldn't give me anything stronger than Tylenol the night before the test and I hadn't eaten in 24 hours at that point) and after the test I was in less pain.  They offered to keep me at the hospital and give me more fluids, but at that point, we still didn't have a diagnosis. I was discharged with instructions to follow up with a gastroenterologist.

I went to the gastroenterologist on 9/11 and he reviewed my blood work and test results. He wants to do an endoscopy (on October 9th) of my upper GI tract to get a better idea of why I'm still in pain (and can't really handle meat, fats, alcohol, carbonation). He thinks I may have some biliary sludge that just didn't show up on the tests.

My gut instinct (see what I did there?) is that my gallbladder will be removed.
I just want to get this over and done with because I'm just tired, irritable, and hungry.

But not dead yet.

Dogfight: Isn't it funny?

Two Fridays ago, my neighbor called and said he had spare tickets to the Keegan Theatre's performance of Dogfight -- the musical version of the movie by the same name.  The basic plot is that on their last night in the U.S. (San Francisco) before going to Vietnam, 4 Marines decide to have a dogfight:  the guys all put money in a pot to have a party and the guy who brings the ugliest date (unbeknownst to the girl) wins the pot.  


8th Grade
6th Grade
I was never a thin girl with cool clothing or a perky personality that put me in the middle of every clique.  I was trying to rock that whole fat and awkward look as best as I could.  Back then, I was also quite gullible/naive, wanting to always see the goodness in people. 

So when I was in 6th grade at my first dance, and an 8th grader asked me to dance, it never dawned on me that I was a walking punchline.  I had kind of known him from my brother's baseball team, and I guess I must have thought that he recognized me too and wanted to be nice to me.  He pulled me in the middle of the dance floor and as I started dancing, I could see from the corner of my eye his friends huddled together, laughing. 

I spent most of the first act with tears in my eyes -- especially the song where Rose (the female lead) reacts to what happened at the party:  "Isn't it funny? Isn't it funny? Isn't it funny you believed that it was real? Pretty funny.  All disasters have an upside. You can find one if you tried. You went dancing, you were dancing, you were dancing with a guy."



Dogfight kinda brought up all these feelings -- of inadequacy, of being an outsider, and learning to be distrustful of men and their intentions.  After my mom died (8th grade), many of the "popular" boys started being nicer to me (I'm not sure why but I think one of the boys' moms had something to do with it).  I was thankful, but still not trusting.  I was shocked, but not trusting, when in 9th grade gym, one of the most popular kids in the whole school (the older brother on the boy I had a crush on for most of my life) wanted to be my gym mixed-doubles tennis partner.  I was shocked, but thankful, when my crush came to my Sweet 16.  

Time for juxtaposition! 

So I realized that this whole jaded, distrusting thing that started in middle school lingers still.  
For example -- 

I posted this (and many other online dating first message disasters — #wtfokcupid) to my personal FB and a dear friend said "At least he finds you attractive. That's a type of compliment." And not only did I disagree, but I felt my stomach tangle into a knot.  In my world wanting to fuck me doesn't qualify as a compliment. 

I'm sure that many of my female overweight friends know what it's like to have a guy just come out and say that they're "throwing [you] a bone" or that it's only pity sex, (i.e., they think fat girls are easy targets that will take whatever they can get).  The sad thing is that some girl will say yes to this guy, or guys like him, not because she's interested in casual sex (no slut shaming here!), but because she thinks that it's a compliment and/or that it's all she deserves. 

I may still be a fat, awkward girl but through all of the taunting and teasing, the jabs and arrows, I have still managed to learn to believe that I deserve to dance (because the world is full of music) and that I deserve to be loved (because I am worthy and lovable for more than just a night).  But despite that I'm still wary of guys and their intentions.

One of the few guys in HS that I actually came to trust and adore said that one day I'd make everyone wish they were nicer to me.  I always thought it was because I would change.  I think I'm realizing now that he didn't mean that I would change -- it's that all the mean people would realize that underneath the fat, I was an actual person.

[ugh.... this was a hard one to write... took 2 weeks to really wrap my head around it.]

[Edit -- a friend from HS helped me to remember that not all guys in HS were assholes -- so shout out to ND who saw me walking home from school one day in the middle of winter and offered me a ride home.  Thanks to JH for picking up the phone the day I needed him.  And thanks for JE/PE for making the first xmas without my mom that much more bearable.]

The Problem(s) with "Dear Fat People"

**POSSIBLE TRIGGERS:  Please proceed with caution!!**

So... the whole Nicole Arbour "Dear Fat People" video thing... 


**deep breath**


1.  Obese people are fat, not blind.  We know we're fat.  We don't need some chick with a big mouth and a rabid following not talking to us but rather yelling at us as if we're complete idiots.  It's not like we need some Youtube channel to provide the same epiphany our very own eyes can provide.  


1a.  She makes a joke about fat people not being able to chase her down... LOL.  She doesn't know about us athletic fat people -- you know, the ones that finish marathons, IronMans, Tough Mudders, etc.  And she also doesn't know about sneaky, light-on-our-feet fat people that don't need to be fast because we're so nimbly bimbly after all those Zumba, yoga, and barre classes. She forgets about the strong ones who could dead lift her heartless, humorless body. 


1b.  There are many of us who aren't strong enough to weather the gale-force bullshit spewing from her mouth ("You have to be really f*cking slow to be offended by satire," she says in the [follow-up] video. "If you can't handle the truth it means you're a psychopath.").  And for as much as she thinks her "truth bombs" can help people, there's collateral damage for which she doesn't seem willing to take responsibility.  She offered some lame ass apology, "I never intended for kids to be watching it and I'm sorry if any kids who didn't understand that I'm a comedian were shocked or upset."  As if kids are the only ones who can be hurt by her words.


2. Yay! Another skinny person telling us how our fatness offends them using the transparent guise of "helping us."  **eyeroll**  If you want to help people, you ASK what they need.  And not all fat people are created alike, and not all fat people need the same help.  Some people need easy things like motivation, accountability, recipes.  Some people need experts (see below).


2b.  No where in her video or links does she offer actual help.  No online resources or support groups.  No recommendations to go see your doctor and get a physical, work with a dietitian, work with a NASM-certified trainer.  Nothing.  


3.  Her OPINION (i.e., not really a "truth bomb") really misses the mark.  In my opinion (based on talking to a lot of people, reading a lot of books, studies, and other materials) excessive body fat is a symptom more than it is a disease. I have said time and time again that I think that obesity is more often than not the byproduct of trauma (physical, mental, psychological, sexual).  And the more I started thinking about it, the more I came to believe that most food/exercise/body disorders (as they're interrelated and on a spectrum) are as well. (And if it's not trauma, there's still other outside forces that can influence a person's size, shape, and health -- but I'll leave it to other people to argue socioeconomic and other points.) 


3a.  Making fun of the survivors of trauma makes her an asshole, not a comedian.  


3b. Making fun of the survivors of trauma for not being able to wrap their heads/bodies around the trauma in their lives doesn't help people to address the trauma.  It re-traumatizes them.   For example, look at how many people gain or lose weight as a barrier between them and the people who sexually abused them.  You wouldn't yell at a bulimic to eat a cheeseburger when the real issue was someone violating their body.  Equally, you shouldn't tell a fat person to put down the cheeseburger when the real issue was someone violating their body. 


3c.  People who have endured trauma should probably start with professional help. 

(a) Cause you never know what trauma is lurking underneath all the layers of fat, and sometimes what's lurking needs a safe place to make its debut.
(b) It's really easy to transfer one harmful behavior to another.  For instance -- people who go from being food addicts to exercise addicts is not a myth.  It's an actual thing.
(c) People have been known to do some pretty harmful things in order to chase down their unrealistic goals. 

I'm sure there's more... but I'm kinda annoyed with myself for even giving it this much time/thought when really I should have just said "Bitch please."

Old photo is a perfect salute to Nicole.

here are some other responses: