May Check-in

Me, in mixed white stripes on a sunny day.
It's important to have contrast, thus red shoes.
And for accessories, my black-and-white dog.

Today starts my 13th week on the weight loss meds. I started February 12. How am I doing? So far, so good! Things are going pretty well!

As of today, I've lost about 15 pounds. This is fuzzy, because I waffle on what my starting weight was. My weight is volatile on a daily basis. But since there is no official registry of my weight or weight loss, I have decided to measure from the single highest weight I have been this year, on January 24. That was right after my January vacation and about three weeks before I started the drug. But it's a choice that makes me feel good, because it shows today's numbers in the best light. And who am I accountable to for this? No-one, that is! So let's go with the feel-good choice!

Speaking of feelings, how do I feel overall? Pretty good, that's how! This is a big change from a couple of weeks ago. I got home from France having over-exerted myself and with a head cold, and felt crummy throughout the body a lot of the time. My internet buds tell me often the GLP-1 drugs lead to a decrease in arthritis swelling and pain, both for rheumatoid and osteo forms (I have osteo). But I felt crummy throughout my joints and muscles, all.

But that was two weeks ago! Now, I feel SO much better! What am I doing that might be helping this? 

- Prioritizing sleep. Rigorous go-to-bed times. On those occasions I'm awake in the middle of the night, tossing and turning, and I end up with less than six hours sleep, I take a nap. But that's happening less, the past couple of weeks. I've racked up some super slumber time.

- Prioritizing exercise. I've been doing a functional strength workout with a trainer twice a week for some time now, but I'm pushing myself harder and volunteering for heavier weights. And, significantly, I've added back a cardio component. I did this in February, then fell off the bandwagon in March and early April. On the trip, I was appalled at how out of shape I was for all the walking I did. So back onto a cardio machine four times a week now. It's for just 15 minutes right now, but I'm pushing my heart rate up high and keeping it there for most of the time. After three weeks of this, I'm able to keep up a much higher intensity for most of the ride. Nothing motivates me quite like actually seeing the improvement!

- Taking a supplement and a longer-term anti-inflammatory. For my frequent body pains, I take tylenol. I can't take ibuprofen because it ruined my stomach. Tylenol helps quickly with pain, but does nothing to change the underlying condition. But let's not discount dealing with the pain! I also had in my medicine cabinet from my knee doctor a vial of a prescription anti-inflammatory, Celebrex. It doesn't act quickly, but over time it is supposed to be very good at treating inflammation. I've got a couple of months supply on hand for daily consumption. In addition my doctor recommended, in an off-hand way, taking a supplement I'd never heard of, Co Q10. I still don't know what it does or how it does it, but I'm taking it daily. Of course I've googled it, but evidence on supplements is scarce and shaky. But it doesn't seem to be hurting me, at least.

Sleep, exercise, and tylenol make me feel better right away, and the first two also have longer-lasting positive impacts. But I'm not sure I'd stick with them without the immediate impact. I've always had a hard time believing in the impact of vitamins, supplements, and long-term remedies. You have to take them on faith, faith in the science and studies. But tracing how I feel right now to these longer term remedies is tenuous at best.

So I feel good right now! Yay! But I am suspicious, and I don't trust that this will continue. But I'm continuing with both the supplement and the drug, as an experiment. It's an experiment with a flawed design, since I changed a few things at once. But just in case it's making a difference, I'll continue for now. 

They say that 15 pounds is about a clothing size. The truth is, I was in denial about how heavy I was for the past year - I assumed I'd lose the weight in a week a or two. So I had bought very few clothes for my large size, and instead wore clothes that strained a bit. So now, those clothes are fitting much better! 

My wardrobe in retirement consists mostly of clothes in which I can hike, garden or sail. I have in my closet wedding/fancy clothes, but not much of nicer but not dressy clothes. When we went casual at work many years ago, I was wary of specific prescriptions of what constituted suitable clothes. I suggested a test: if, when you got home, you were going to mow the lawn, change the oil on your car, whip up a huge batch of floury bread from scratch, or hike a few miles on the Appalachian Trail, and you didn't feel a need to change from your office attire first, then your office attire was incorrect. Those very slightly nicer clothes are the ones I've been digging out of my closet and trying on. The picture at the top is an example. I'm still not sure I'm suited for white clothes, because my impulse to just drop to my knees outside and start pulling weeds is somewhat incompatible. I don't want to look like a fashion plate, but I'm trying to not look like I'm about to hike when all I'm doing is meeting someone for lunch.

Light and Dark

The entrance of a lava tube cave
in Iceland. The light at the end 
of the tunnel!

I'm very attuned to the light. I bought my house for its big windows, and I follow the light from room to room during the day. I wrote extensively about light in this post back in 2019. I still follow the same routine at home, following the sun each day. I'm very aware of seasonal changes, and as dark has come earlier this year, I though about adding more and brighter lights inside, as it has become difficult to read (from anything but a backlit screen) or do anything with details in less than full sunlight.

I decided to have my cataracts out of my eyes, as an alternative to buying more lights! I'm at the midpoint now, a week since I had the first eye done, the second to follow in two weeks. There were several reasons for doing this, but one of the most compelling to me was hearing from my neighbor about his experience. He noted how, during the time after the first eye was done but not the second, he could wink and see a huge difference in how bright the world was. This was very appealing to me! Another reason is that I am getting upgraded lenses, so that I'm likely to be able to avoid wearing glasses in almost all conditions! (At least for a while.)

It's been a mixed experience so far. The jury is still out on results. The actual operation was not a huge deal, despite high anxiety beforehand. In a rare case of collecting on all the chauffering I did in her youth, my girl picked me up at 6:15 am to go off to a surgery center across town. As I lay on my gurney, with an IV port in my hand, I wondered why I thought it was a good idea. But shortly, I was wheeled into the "laser room", where I received an injection near the eye, and then small metal fingers were placed in my eye to hold it open (!!!) and a large machine positioned over my eye made noises while apparently things were done to my eye via laser. It took 3 minutes. I guess it was pre-programmed based on photos of the eyeball taken earlier. Then I was wheeled to a different operating room, where I received an anesthetic via the IV port. I had been warned that while I wasn't going to be unconscious, the anesthesia would cause short term memory loss. Sure enough, the next thing I remember I was in the recovery room and a nurse was placing a perforated plastic patch over the eye (it was mounded, so nothing actually touched my eye, only the skin around the eye socket). In just a few minutes, my girl was escorting me out and driving me home. No pain, except for inserting the IV. 

The patch came off as soon as I got home, per instructions. It goes back on every time I lie down, because it would be easy to accidentally poke my eye or put pressure on it by burying my face in a pillow. That first day, I dozed, ate convenience food, listened to books rather than read or watch anything. I seemed to be seeing fine, and I went to bed early. Still no pain, and none since.

When I woke up before sunrise the next morning and peeled off the eye patch, everything was dark! I winked my alternating eyes, and with the old eye I could see via dim ambient light, but with the new eye I could see nothing! As I peered around in increasing panic, I could faintly make out a single bright LED marking something charging across the room. Everything else was pure black!

I switched on the light and things became more clear. I certainly wasn't blind in the new eye, but it was dim. Very very dim! The opposite of what I had been expecting. I subdued my panic as I went about my morning routine of coffee and the ipad. As I do when very upset, I wrote. Here is an excerpt: "It's as if there were several layers of smoked glass between me and the world." And: "I am terrified! I do not want this! I don't know if it will ever be better." And, finally, "I will not do the other eye if this this is normal. How can I go to Norway's polar night and look at Northern Lights?" Let's all cheer my catastrophizing! Who needs clear thinking in moments of crisis?

I had a nine o'clock check in at the doctor's office, and I drove myself to it. I wore a pair of glasses I found in my broken glasses drawer, already missing the right lens, but with the left lens intact to give me distance vision. As the sun came up (behind thick clouds), I could see decently, but when I pulled into the parking garage, it got very dim. Looking through both eyes was worse than looking through just the old one. 

I was upset! They had given me a list of things to not worry about and those to be concerned about, and it being dark was not on either list! A very brief foray onto the internet did not lead to any stories about darkness, just pain and loss of focus which were not issues for me. But when I saw the technician a few moments later, she said "your pupil isn't dilating, that's normal, of course check with the doctor, but I can see your pupil is tiny". So when I saw the doctor, she said the last thing she did was put in drops to freeze the pupil, so the shape doesn't change the first day while the new lens is settling in. I whined about how that wasn't on the caution sheet. She assured me it would be better by the next morning, Friday. I told her I'd call her if it wasn't. The actual test of visual acuity was an anticlimax - outstanding clarity both near and far! And, as the day wore on and it got lighter, my eye seemed to be settling down.

But then it got dark again! The second night was as bad as the first, but I just went to bed early, counting on it being all better as the doctor had promised. When I woke up the next morning, it was NOT all better! But, it was significantly better. I decided not to call her, knowing that meant not calling until Monday. I would give it the weekend. The day turned out to be shiny and bright, and my new eye seemed to be just fine in the light. It was Halloween, and our neighborhood has a children's parade and party, which started slightly before sunset. I went, and as it got dark, I realized the eye was still a problem. I winked away, comparing the view, and I resolved to cancel the second eye if it wasn't completely better by Monday. Catastrophizing was still in full flame, and I knew I couldn't agree to let myself become handicapped by having no night vision in both eyes!

 Fast forward through the weekend, where by Sunday morning, the eye was FINALLY totally equal to the old eye in (subjective) light transmission. Success! So no call to make on Monday.

Now, after a whole week, I'm pretty happy with how it is. It's supposed to continue getting better. I see the doctor again next week, and the week after that I'm scheduled to have the second eye done. I am mostly leaving off the one-lens glasses, instead relying on my new eye for both distance and close up. Though I wore them yesterday when driving, my driver's license says "corrective lenses". It takes maybe thirty seconds after I put them on or take them off, and several blinks, for my brain to snap to reading the signals clearly. I still wear the eye patch to sleep, put drops in several times a day, and have an exercise ban. I'm not supposed to bend over, nothing that will raise the pressure in my eye, so I've perfected my squat for picking things up off the floor. 

I will be discussing with my eye doctor about how to handle the adjustments in light transmission when I see her before the next eye operation. But, knowing about it, and knowing its temporary, I think I could live with the whole dark experience if necessary. 

Last thing, I may explore cosmetic surgery around the eyes once I'm fully healed. I have some growths on my lids, and my lids droop, especially the left one. If I don't hide my eyes behind glasses any more, I may want them to look better. 

Cardio

I love the routine I have for functional strength training. I've been working with my trainer for years now. When I met her she referred to her "boyfriend", and it was a big deal when she moved in with him (in his parents' house). Now, they are married, own their own house, and have a three year old! Adorably, the three year old is often on the other end of the video call, and she sometimes copies my movements. I love the movements, the strain on my muscles, the stretching and moving in every direction. I work out on my own between our twice-a-week sessions, but for my trainer I work harder than I do on my own. So this is a success, and I won't tamper with it.

But I need to work my heart harder, according to my doctor. I need cardio! She gave me specific targets of time and effort: twenty minutes of high intensity exercise five times a week!

I have not enjoyed high intensity exercise for a few years. I used to love it! My first brush with using machines, the basement Nordic Track, was the first time I consciously felt how good the body feels during and after working hard. It can be exhilarating! I believe the machine got me to a high enough cardio fitness level that finally I could start running. And I loved running! No, not every day, and not ever for the first 10 minutes. But the way it made my body feel was great! 

I was an early adopter of a heart rate monitor, back in 1998. I'd read about appropriate training intensities, and here was a gadget to help! My first one had a chest strap and a watch that displayed time, heart rate, and elapsed time. Nothing else- GPS hadn't downsized to live on wrists yet, and phones were flips that couldn't even text. I propped the watch up on the Nordic Trak so I could see it all the time. I learned that perceived effort each day did not tie to heart rate - I could feel like I was pushing myself to the limit, but some days the ol' heart just didn't want to pump fast. Interestingly (to me, any way) the day before I got sick was always a day the heart was sluggish.

I also learned that walking didn't get the heart rate up high enough to be in the high intensity zone. Nordic Track, swinging my arms in time to my legs, quickly did raise the rate. A walk has many benefits, but I cannot hustle enough to accelerate the pumping of my heart. Only uphill - which in the absence of a mountain to climb, is always going to be brief - begins to approach my target zone. My first tentative jogging steps taught me there is no comparison to walking - my heart got excited and pumped away! The mechanics of walking and running are really distinct from each other (jogging is simply slow running - no technical difference). I might be a slow AF runner, with young men passing me while walking, but the cardio benefits are real even at my pace.

When I stopped running, I stopped ever exercising in that intense zone. The last year I ran anything more than a token amount was 2019. My Nordic Track had long been retired, in a dusty heap in a corner of the basement. I still did small amounts of cardio on the machines in the gym, but that all came to an end in March 2020. 

But now I have machines galore! My BIL lent me (effectively gave me) his long-unused stationary bike. I bought a rowing machine in January 2023, and used it a lot the first couple of months, and only intermittently afterwards. I started up again this autumn, since I started on this cardio bout, and also because now I have a friend who is also starting to row. I have a mini-trampoline, which I use to bounce a bit in front of the TV. But on the tramp, I can't get going enough to get the heart rate high - my balance isn't what it was, and so I don't have the exuberance I used to, not getting a lot of air on the bounces.

Detailed stuff about heart rate:

When I first started using the heart rate monitor, I used the classic formula for maximum heart rate: 220 minus your age in years. So I was about 45, and my max heart rate was calculated to be about 175. There is a formula more accurate for old people, seventy percent of your age subtracted from 208 (208-(age*.7)). The two formulas give the same answer for age 40 and from then on the "208" formula gives a higher number as your max heart rate, and is said to be more generally accurate.

The reason for knowing your max heart rate is to be able to calculate training intensities. Cardio benefits really kick in at the higher intensities, 75-85% of max. Fat burning benefits kick in at somewhat lower intensities, 65-75% of max. 

But here's a wrinkle I only just learned - biking (an exercise that doesn't use your arms) will lead to lower heart rates than running (a whole-body exercise), but can yield big benefits at a lower number. Who knew? 

But I found that even though I was working very hard on the rowing machine, my heart rate (on the Apple Watch) was consistently lower than on the bike! I was confused, because the rower certainly uses my whole body. Was it a measurement error from the watch? I googled "why is my heart rate so low on a rowing machine" and found links into Reddit, where this very question was being addressed by the helpful nerds who hang out there. Basically, they said we must be using the wrong technique. We must be using our back and shoulders more than our legs, which is inefficient.

So here's the rowing technique tips in english: the first part of the motion is pushing back explosively with your legs. During that, your hands and arms are just along for the ride, with your legs doing the work to pull the bar you are holding. Only after your legs are fully extended should you lean back, and in the final part of the stroke use your arms to pull the bar up to your chest. The return is rest, no effort expended. And, do not try to go faster by returning faster! That should stay the same, a passive ride, until the legs are bent and you can explode back again. The faster you push back, the more strokes per minute. But strokes per minute doesn't need to get too fast; instead, raise the resistance.

So I tried that one morning, and the difference in my heart rate was signficant! I went up to a higher zone quickly, and stayed there the whole time. And felt my whole body aerobicized afterwards, a great feeling! It feels like a break through!

Stronger Next Year

My gym! Rowing machine along the back.
I just installed the bar to help with balance exercises.

I did not have a great year physically. It started with recovering from my knee surgery, carried on through a summer of increased migraines and still not up to snuff on my knees, and crashed and burned as a result of my vigorous (but fun!) sailing vacation, where I injured my rotator cuff and generally burned out my whole body.

Through it all I tried to keep moving and working out in my basement gym. (I love my basement gym, and I enjoy working with my personal trainer there.) But there were definitely days on the couch where I hardly left the house. I felt old. I felt feeble. I was fat, and nothing I did seemed to affect that. I woke every morning feeling like the Old Red Woman, bent over, stiff, wobbly, and in pain. I felt frustrated that my body was so frail. I was preparing myself for a new reality of being old and feeble. I told myself that I actually was old, almost seventy years old. Any time there was a news article that another celebrity had died, the first thing I did was check their age. So many of them younger than me!

But by late fall, I felt myself getting better. Stronger. More capable. Actually doing things. Feeling competent and capable. Walking still did not feel good, but I adjusted and spent more time in my home gym working with weights or my rowing machine or on the stationary bike my BIL gave me. I went back to the mental disciplines I had learned over the years of dealing with pain, meditating and observing the pain with kind curiosity. I had some adventures, on the water and on the scoot. I had some actual good days, where I woke up feeling good. Not stiff. Not bent over. Not feeble. Ready to face the day, get out there and do things.

The election results hit me like a gut punch. As I got out of bed the following morning, I was initially fine, but by the time I had walked the length of the house to let the dogs out, my back had tightened into a full fledged spasm. SPROING! I was bent over, leaning on furniture like a toddler doing her first cruise around the house. I pulled out my tool kit, things I know, deep down in my body and mind, to be true. First, mentally: "there is nothing wrong with you. You are safe. You are fine. Yes, the back is clenched, but it's not broken. Yes, the world has gone to shit, but you are safe. Your body is safe." Then I started my series of exercises/ stretches that I know deep down are going to help. I also reached for the tylenol, because comfort is an important part of feeling safe. 

This worked! It took a couple of weeks - the back clenched every morning for a while - but it got fainter, and gradually went away.

Around this same time, my primary care doctor told me that based on my testing, I have great lung capacity and a strong heart, but I have shit endurance. She prescribed aerobic exercise, specific amounts at specific heart rate levels of effort. The next week, my neurologist reinforced this - certain levels of aerobic exercise seem to have a protective effect on migraines.

The view my trainer has from my phone while we video.
I have all the toys! I bought my first weights in 1995,
and I've been adding equipment ever since.

So I'm all in on the cardio now, added to my twice-weekly strength training and daily warm up stretches. I have the devices to keep me going indoors this winter- a rowing machine, a (bottom-of-the-line no bells-or-whistles) stationary bike. I have a mini trampoline in front of my TV. And I dusted off my original, built of wood in Minnesota, Nordic Track ski machine from 1993! Using the NT was the first time in my life I enjoyed indoor cardio, back in the day. It needs refurbishment, but it turns out that while the old ski machines are no longer made, there are enthusiasts and through a sub-reddit I found a guy who sells refurbishment kits with the most common replaceable parts! It's on my list to get it fixed up - probably a few hours work.

I found that walking can't get my heart rate up high enough to meet my PCP's exercise prescription. I try hustling along, but the heart stays stubbornly beating slowly. Only up very steep hills does it go up- and I can't currently sustain that for long enough. This all may change as I get more aerobically fit.

Report Card

 The last time I published a report card was in January of last year, looking at 2022. I actually have kept up tracking myself primarily through apps and devices, and from time to time I sit down and go through the data trying to glean some meaning or insights. I haven't felt like I've learned that much recently, certainly not something worth sharing. I still haven't got any wisdom to share, and it's not that pretty a picture, but the data is what the data is, and there is a certain value in simply showing it. Keeps me honest with myself.

First, to get it out of the way, my weight is high and stable. No need to share a graph. I gained a bunch of weight in 2022 (Fuck You, Intuitive Eating!) and it's stayed on. I haven't been motivated to any kind of a big push to change it. And it's been remarkably stable - plus or minus four pounds. I do plan and track my food most days, but it's more part of planning how to spend my time than trying to morph it into fewer calories. And then, keeping me conscious of what I'm doing, to do away with mindless eating. I still weigh myself every day and it gets recorded on the internet, for whenever I feel like reviewing the history in detail. I chuckled one day recently when I got up and peed several times during the night and found the next morning I was two and a half pounds down from the day before! That's why I can't get excited about day-to-day fluctuations, the range I'm seeing is just water weight. 

First up: Activity. As always, darker is better. January was knee recovery time, and I give myself a pass for everything but workout days. My "workout days" focus on functional fitness, either in my home gym or with physical therapy (my PT experience the past couple of years has been a solid hour of working out followed by 15 minutes of massage and stretching). With PT from the knee replacement added to working out in the home gym, I was really doing a lot. It also paid off, as now my calories and steps are back to where they were last year (which was NOT a stellar year for activity, I admit). The walking mileage shown here is from taking a deliberate walk where I activate my GPS, not an accumulation of steps during the day. I'm currently pretty active in the house and garden, which keeps my steps up, but I haven't been feeling the walk as a way to spend time (and I only do short and slow training walks with the dog, not worth tracking.) I've added a new row since the last time I posted, "stand time". My apple watch tracks this - how much time do I spend on my feet all day. It seems worth looking at, since my goals involve being less sedentary. Here, I'm moving in the right direction!

Next, some health parameters. These are both controllable and uncontrollable things. The big worrying trend is migraines, which are up. I have fallen off the meditation bandwagon, and that might be a contributing factor. But my doctor thinks that perhaps allergies are acting up - and there is a connection between respiratory inflammation and migraines. So I'm trying to be more faithful on OTC allergy remedies. "Alone days" (still looking for a better descriptor) are days I don't talk to anyone. I might be texting or emailing, but it only counts if I talk to someone either in person or on the phone. I really enjoy days on my own, but I am aware it is not healthy to have too many. And besides, I enjoy my family, friends and neighbors! I continue to be a sleep champion, with a normal seasonal variation of less sleep with longer daylight hours. (These sleep hours are separate from time in bed, as the watch purports to distinguish between lying awake versus truly asleep. I am awake at least 45 minutes during the course of the night - but apparently, that is less than average for a woman my age.) Heart rate variability is meant to be an overall measure of stress, with a high number being better. I haven't been looking too much at it, but the apple watch keeps track, so I decided to add it to the list. Resting heart rate, as a reminder, measures resiliency, with a lower number better.

Lastly, how do I spend my leisure time? (Ok, it's all leisure time. I do a minor amount of volunteer work, but I'm not tracking that here.) This whole category is not necessarily "more is better", but it is what it is. I also struggle with whether the "year" column should show an average of the months, or a cumulative total for the year. It's currently a mixed bag. I've actually wanted to read fewer books this year, because I read a lot of fluffy entertainment and it gets in the way of doing more productive things. My TV watching is up recently, as I indulged myself with a season of my only reality TV show, "Below Decks". I haven't been watching movies, neither at home nor out. I have been traveling a modest amount this year, more shorter trips, which is suiting me right now. And I'm hoping for more sailing, as my partner has retired, which multiplies the number of possibilities of aligning our two schedules and the weather.

So that's the story in numbers. Looking at this does motivate me to move, so I'm off to do that now.

Excelsior!

New Knee!

 I'm very optimistic at the moment. Could drugs have something to do with that? Maybe? But drugs are part of the protocol, I'm supposed to be taking them!

Prep for the operation started well before Tuesday. I had a bunch of pre-op appointments to get cleared, and then there were elaborate instructions about cleaning myself the night before and morning of the operation, showers and special microbiome killing sponges to wipe everywhere. Surgery was scheduled for 8 am, but I had to be there two hours early. My BIL picked me up on the dot of 5 am, and followed me through the registration process. There became a standard call-and-response at every single stop - at least a dozen times that morning:  "What is your name?" "When were you born?" "Are you allergic to anything?". I had a qr code on my wristband that was scanned at every step.

In preop, (more wiping with special sponges), many people came by to introduce themselves. My surgeon came, (he signed my leg), a resident, a med student, and three or four members of the anesthesia team. ("What is your name?, etc., again!)

BIL stayed with me until they put the IV in, before starting the sedation. I gave up my phone, and they gave me a spinal block. By the time they wheeled me into the operating room, I was dead from the waist down. I couldn't feel a thing. The operating room was startling to me, not at all like Grey's Anatomy. Stark white, brilliant florescent lighting, almost shabby ceiling retrofitted with electrical mains and heating vents (my main view) and the room was really large - maybe they would have two patients in there at once? (BTW, they are opening a brand new surgical center next week, this was the swan song for the old side.) There seemed to be a lot of people in there! Shortly after arrival, they stuck my IV with sedation, and I was out.

I woke up still in the OR, still dead from the waist down. Whoever talked to me then said things went really well, and confirmed it was the partial (not a full) knee replacement, yay! I got wheeled down to recovery, where I stayed for a while, long enough to have two nurses because of a shift change. The goal for recovery, said the nurse, was to be able to bend both knees, raise both legs, and wiggle all my toes. Then they could move me on into a room, since I was going to be admitted. She raised my leg to demonstrate, and it was very disorienting to see my leg and feel nothing from its visible movements.

At first, recovery was AWFUL! I had the most awful shakes, shivering all over. Actually, the spinal block was still in effect so I have no idea if I was shivering below the waist. But above, my goodness! It came in waves, with a build-up, peak, and rapid fall-off. I tried to retreat to my mindfulness techniques, focused on my breathing, and that worked great in between the episodes, but when my body was uncontrollably shaking that was all I could think about. But then, sensation began to come back to my legs. First tingles, then the nurse said I was wiggling my toes. It was the weirdest thing - trying consciously to send a message to my toes to wiggle, and feeling no feedback that I was successful. But slowly, slowly, the feelings came back as the shivers abated. I got curious, and explored where I had feelings and what movements I could execute with my legs. It helped. All told, from shivers to feeling back in my legs, was about an hour. They had added a nerve block for the knee to take effect as the spinal block wore off, and so there was a magic moment when I felt great - zero pain! No shivers! And then they brought lunch, and I was hungry and scarfed down every bite. Then I realized I could have my stuff back and I got my kindle and phone and ipad, no boredom ever.

While still in recovery the PT folks came and got me up. It was good timing, I needed to pee, and really didn't want to use a bed pan. So I walked with a walker to the bathroom, and then to a stairwell, where I climbed two stairs - a hurdle I'd have to get into the house. When I got back to my bed, I was exhausted and in pain.

Finally I went up to the room. The nurses were really good at writing names down on the little white board in my room, I really appreciate that. Sadly, it was a very small double room and I had a fractious, noisy room-mate. We weren't allowed to close the door, so noise and light were constant. By the time dinner arrived, I had lost my appetite and "discomfort" had grown to pain. Over the course of the night, I had enormous heartburn pain, nausea, and stomach cramps. I had brought my noise-cancelling over-the-ear headphones, and a silk eyeshade, and that's the only reason I got any sleep at all. I listen to books, and all night I would tee up a chapter, close my eyes, and hope for sleep by the time the chapter was done. But I would open my eyes to realize my roommate was making a phone call (to Australia?) or complaining about something, or simply moaning. Of course, they came in to check vitals, give me drugs, and generally keep me from getting any rest. So I slept maybe twenty minutes at a time?

The following morning, I was awake at 5 and so was my roommate. But after the escorted trip to the bathroom and a new set of drugs, I actually got some deep sleep! An hour or two at least. All day, my knee hurt, but less than my stomach. They had added an anti-nausea med and also tums, and maybe that helped. I had PT and OT folks visiting, and they told me what to focus on for the next week, until I start PT. Two of my surgeon's residents stopped by, and they each emphasized how well the operation went. I mean, their eyes were glowing! I hope that bodes well for recovery. The hospital sent me home with twenty pages of discharge information and four pill bottles (to be supplemented with two OTC drugs at home). Helpfully, the medication instructions included the timing for the next dose of each. 

BIL, who had checked in on me many times, took me home. It was so nice to be swarmed by the doggos! He heated up some soup for me, but I couldn't manage more than a few swallows. I hurt all over. But I verified I could walk with the walker throughout the first floor, get into and out of bed, and go to the bathroom. BIL courageously stood by in case I needed him, but I didn't. Shortly, I took to my bed. In a few hours, my friend came over for the night, and it was comforting to have someone there, even if I didn't need them to do anything specific. Restless and uncomfortable all night, with intermittent books, but I took joy in the fact I could actually roll over to one side, off my back. (Other side not available yet.)

Another friend, who lives a ways away, came down later on Thursday. She made supper, and we watched a movie (NYAD! See it!). I was in bed by 7:30 pm (despite a couple of naps during the day). Again, a restless night, but at least five hours sleep (with ten hours in bed) according my tracking device.

Managing the medication is the hardest thing. I can take six different drugs, have to take at least three, and they all have different timings and limits. So of course I made a chart and I write it down. I am slightly addled from the pain meds, and I find I might not remember having taken a pill minutes after I did. So I am assiduous at checking them off. I am cautious on the strongest pain med, because it makes me woozy. I'm writing under its influence now, so please let me know if there is something here that's inappropriate. But by backing off some on the optional meds, I have got my stomach back under control, and my appetite is back. The fact is, the pain meds work, and if I don't take them there is a risk I'll do much less movement, which is bad in itself. So I'm taking less than the max, but not swearing them off completely. 

Today feels better than yesterday. I took a shower! (Hand wand and sitting on a stool.) No naps today, planning on a good night's sleep. Hopefully, tomorrow will feel better still.

The Twist

 So about a week into my trip, I got Covid. Ugh.

It came on me like a freight train, moving from afternoon fatigue requiring a nap, to shivering and putting on extra layers as I went to bed, then waking up in the middle of the night drenched with sweat, throwing off the covers and lying on top. My throat had been getting steadily more and more sore, and in that middle of the night session I felt like there was a knife down it, and a hammer hitting my head on top and in the back. I had been taking my temperature throughout, and it went one time just above 100, barely a fever. So I thought, maybe it's allergies. Maybe the headache is a migraine. But at first light, I dug out the test kit I'd brought along, and was frankly terrified when it turned positive. How many times in the past three years have I felt poorly, and tested, only to have it be negative? But here it was, and likely true. 

The fear wasn't for how sick I was going to get, it was the implications of being sick while on a ship in a foreign country. What was going to happen to me? How would I lose control of what would happen to me?

When, according to my daily schedule in my room, the medical office was supposed to be open, I masked up and went down. There was a Greek doctor and a Philipino nurse on duty. I told them my symptoms, but not about my self-test. At that point I had no more fever. They gave me a release to sign before giving me another test, and I hesitated several minutes before going ahead with the official ship's test. Again, the issue was, what will happen to me? How will I lose control over what will happen to me, once I'm in some system as being positive? But I went ahead, because I'm so much of follow-the-rules person. Of course, their test was also positive.

They told me I should isolate in my cabin. They gave me some kind of decongestant, to be taken at night. They gave me so tablets for a cough. They gave me some vitamin C. I asked what was in the decongestant, the cough tablets the ingredients, but I didn't understand the answer, and they seemed to think being told when to take it should be enough. They assured me the progression would probably be no worse than a bad cold, and they had no access to antivirals, but I shouldn't need them anyway.

So back to my tiny but cozy ship's cabin. They brought me menus, and took my meal orders over the phone, and delivered them by tray into my room. I took my Extra Strength Tylenol, religiously every 7-8 hours (no more than 3 doses per day) and took my temperature just before renewing each dose. Never again did I have even the tiniest fever. I did not take the nasal decongestant or cough medicine, never needing it. The nose dripped but wasn't plugged. My throat was sore, and I had brought a long a large collection of cough drops / throat soothers, which I partook of liberally. I had loaded up my kindle with books and my iphone with recorded books and my ipad with TV shows and movies before leaving home as I knew there wouldn't be internet available on the ship. The first day, I slept more than half the time away. I woke up the next day feeling almost normal, so time passed as I devoured some books, marched ten steps up and down my room, did a few desultory body weight exercises and stretches, sat on my tiny little veranda to get a glimpse of Greek scenery going by.

And I worried. I mentioned no internet. What I had was my cellphone with an international data plan. So when we were cozied up to the land, and I had connectivity on the phone, I had slow and small internet access. Generally at night we were at sea and there was no coverage. So I tried to look up international regulations about traveling with Covid, any regulations on the airline site, hotels in Athens, etc., and was more frustrated than satisfied. The first couple of days it was more formless worrying in between feeling bad and choosing to drown in some books rather than actually figure out any plan of action. I realized how having money makes everything easier - if I needed to stay in Athens for some days, it wouldn't ruin me. But I had done absolutely no research on Athens, since the only time I would have spent there would have been while staying on the ship. Hotels.com had 967 hotels available in Athens, and I had no notion about neighborhoods, properties, etc.. I felt I couldn't cope and just went back into my books.

The day before we were due to leave, I went back to Medical and asked them about leaving. The doctor and nurse worked for the ship, and they said folks from the tour company that chartered the ship would be contacting me. They said guidelines recommended isolating for five days, but there was no ban on flying, and in their experience most people just went home. So I reached out (not for the first time) to the program people on the ship, and they finally got back to me. Their main question was, "do you feel well enough to fly?" and for me, clearly, the answer was "yes". Except for a mild sore throat, a slightly dripping nose, I had no symptoms except tiredness. I wanted home, in my own house, in my own bed! So they made arrangements for me (and, it turns out, a few other covid-positive passengers) to be transported to the airport separately from the other passengers. I was able to check in for my flight on my phone, and there was a moment of trepidation about what questions I would be asked. But the airline asked many questions about documentation and paperwork, most of which did not apply to US citizens, and never about symptoms or test results. 

We had been divided into small groups for the trip, and on the last day one of the women from my group came by to ask how I was doing and if I needed anything. She had NOT been told I was Covid-positive, and I was ... embarrassed to tell her. As if it was my fault, and I worried that I might have infected the others.  We spoke through the open door of my cabin, distanced, and she didn't run away from me when I told her. 

The same sense of shame pervaded me at the airport. It's very inefficient to get from Athens to the US east coast. Basically, you have to fly to central Europe and then catch a US bound flight from there. In order to make the connections, you have to be on the first flights out of Athens in the morning (mine was 7 am). Because it was recommended being at the airport three hours ahead, and it took up to an hour to get to the airport from the ship, it meant leaving the ship at 3 am. The airport was crowded with many of the other 200 passengers from the ship all doing approximately the same thing. I was double-masked - surgical mask inside KN95 - put on headphones, stuck my nose in my kindle, and avoided any eye contact or acknowledgement. I *really* didn't want to have an out-loud conversation in the airport gate room about my flying with Covid. I also was not happy with the idea I was typhoid Mary spreading germs intercontinentally. I rationally thought the risk to others was low - Day 5, double masked - but I still feel like deciding to fly home was one of the more selfish things I've ever done. 

It was a tough trip on my virus-battered body. It might have been better for me, as well as everyone else, if I'd gone to a hotel for a couple of days. But that's behind me now, no longer an option. It took me several days after I got home to recover simply from the fatigue of the trip: up in the middle of the local night after 2 1/2 hours sleep, then 22 hours before I reached the front door of my house. I was masked all but about half an hour of those 22 hours which added to the discomfort. I switched out masks, going with a really good N95 with behind-the-head elastic straps on the long flight. During what turned into five hours in Frankfurt airport, I bought a sandwich and found a deserted section of the terminal with no-one around me for a big distance, and took off the mask and ate slowly. My nose was never so congested I couldn't equalize my ears on the flights, hooray, but still it was a slight drag to be breathing through the mask all the time. I ubered home, and the trip from the airport was double the normal time. I was so happy to get home and just fall into my very own bed.

I missed a big family wedding on Saturday to my great regret. Thanksgiving dinner is up in the air (so happy again to be a perpetual guest, not on the hook for hosting or cooking). I am likely to show up masked to chat for a while, and then take a doggy bag home to eat alone, unless I get negative tests by then. (Not yet). Still the little dripping nose and slightly sore throat, no fever.

As I assess my condition, I'm not sure what is fatigue, what is boredom, what is laziness. This is a perpetual battle for me. I've been for short walks, done small amounts of raking, worked out slowly, body weight exercises, with my trusted trainer over video. My big boy is living in my basement, did some grocery shopping for my empty refrigerator, leaves on Saturday. We've only talked in passing, me masked and keeping my distance. He turns THIRTY tomorrow, and we're going to have a partially outdoor celebration for him. 

So that's me. Poking along. Not terribly ambitious. But so happy to be in my sun-drenched room, in my favorite chair, not feeling too bad, puttering every now and then with my plants. Excelsior!

Knees Are SO MUCH Better!

Today I took what I want to be my "normal" morning walk - out the door, down into the park, back up through the neighborhood, about a mile and half, with some significantly steep but short hills down and up to the park. I've been doing this off and on for years, but recently I've fallen way off. The fact that it hurts before I even start, and will hurt more once I get going, has been one of many barriers. (Other barriers include my reactive barky dog, any weather less than optimal, having to get dressed, and sheer inertia.)

But this week, I've had to head out first thing, just as the sun comes up, to do a daily vacation backfill on a citizen science project, hyper-local network of national precipitation reporting, CoCoRahs.  It's on the "normal" route, so some days this week I've kept on going to complete the loop. Today was the first pain-free day in months! 

My knees have steadily deteriorated over the past several years. I tore my meniscus and had it repaired back in 2018. But now, it's a loop. The more the knees hurt, the less I move. I went to physical therapy a year ago, after they were really bad. Symptoms included not only pain, but also restricted mobility - I simply couldn't bend them all the way. The PT really helped with both pain and mobility. I was then motivated to keep moving by active vacations, in March and April. But perhaps from overuse, the knee pain grew enough worse that it grew increasingly easy to blow off the daily walk, despite my fantastic Iceland vacation coming up. After all, I had satisfied myself with what I could do in March and April, Iceland in July would be just as good, no?

Well, no. A couple of months off from active training eroded both the quality of my knees and also my aerobic fitness. I did a whole lot on the Iceland trip, but it was hard. I didn't do as much as I wanted. There were often options for different activities and I backed off the most active ones, hiking up volcanoes for example. I spent a fair amount of time in my nice little cabin, with my feet up and knees bent, popping tylenol and rubbing stinky and persistent but effective voltaren gel into both knees. They never once didn't hurt on the trip, and haven't really stopped hurting since.

When I got back from Iceland, I signed up for a trip to Greece. More about that another time, but everything I've read suggest all the places I'll want to go will involve stairs with no handrails. Time to fix these knees!

(As an aside, I am fully bought in to the mind-body approach to pain management. I can minimize suffering I have from pain, and even reduce and even eliminate some pain, through mindful meditation and somatic practices. It has really helped me avoid catastrophizing about issues, and my back pains and even migraines are less of an issue. These practises also help avert physical symptoms manifesting in response to external or internally generated stress, something I clearly used to do a lot. These practices include breathing, visualization, and self talk approaches that really help keep things on a more even keel. 

The way I think about these practices and my knees is this: my knees have mechanical issues that send messages to the brain. I can interpret these signals as pain, or call them sensations, and I can observe them from a distance with kind curiosity. All this helps, but there is value in also trying physical and mechanical things (exercise, strengthening, pain medications) to reduce the volume and urgency of the messages being sent to my brain.)

My previous sports-medicine doctor retired, and so I found an orthopedic surgeon to consult. My basic questions were, what could be done to help the knees short of replacing them, and was I damaging them them further as I used them? I wanted another prescription for PT because while I know many exercises for the knees, I find the skilled supervision helpful. 

The doctor said no, I couldn't damage the knees with movement, was happy to give a referral for PT, and also suggested cortisone shots in each knee, which he did right then and there. The actual shots were quite painful, but it only lasted for a few minutes until a local anesthetic kicked in. Then, over the past few days, the local anesthetic wore off and the steroid gradually kicked in. 

And hooray, they seem to be having an effect! 

The doctor said, and my independent reading confirms, that the only proven interventions to actually improve the knees (as opposed to alleviate pain) are exercise and weight loss. No supplements have been shown to have more than a placebo effect. So I can do whatever I want in exercise, if done correctly it will help, but the pain will likely be there. If I can bear it, I can do it, and if I keep doing it, I can keep doing it!  As to weight loss, that is a topic for another day.

I celebrated this improvement by putting in for a place on a short overnight sail on my schooner, about a month from now. I had held off, thinking about all the ladders on the ship. But now I'm ready to go for it!

Guinea Pig

 I decided to dedicate my brain to science. Why wait until I’m dead?

Actually, I have applied several times to be included in various medical studies and trials. As the National Institutes of Health are nearby, there are bunches of trials around. I was turned down for an early Covid vaccine trial, due to my migraines. The migraines have knocked me out of several trials.

A year or more ago I applied for a study on the effect of exercise on memory being done at the University of Maryland. I was disqualified because I was already an active exerciser - they were looking for sedentary old people who would start an exercise program. They would be studied longitudinally, for at least six months. 

I was contacted again by the same folks this February, where they were conducting a related study, looking at short-term effects of exercise on memory. For this, they needed old people who had a basic fitness level, so we wouldn’t drop dead exercising for the experiment. I was excited to be included this time! There was no compensation for participating, but also no expense. Three visits to the nearby University of Maryland campus, at least two hours each. 

It was an interesting experience. I had to be cleared by my primary care physician for exercise, and by my dentist for the MRI machine - to verify I didn’t have any big metal things in my mouth. The first visit was to get a baseline of both my fitness and cognitive level. I was met at the door by a personable young man, Dan, who was in charge of this experiment for his doctoral research. I was led into the basement of the School of Public Health, into a bleak cinder block and linoleum room with just a Formica table and a couple of plastic chairs, where I signed a whole bunch of releases. I was run through a number of standard memory and cognitive tests: “remember these five words” and “draw a clock face and put the hands at ten minutes past eleven” and “name as many words starting with “F” as you can in two minutes”. I don’t have a great memory, but I’ve done these tests before. I knew it was just to establish a general baseline to qualify for the real test - make sure I wasn’t impaired - but of course I really put a lot into it, wanting to do well. Then, we went down the hall to an exercise lab. They strapped a mask on my face, a heart rate strap around my chest, and put me on an exercise bike. I had to pedal until my heart rate reached 85% of my predicted maximum, to get a “VO2 Max”, used as a proxy for overall fitness. Again, they were only interested in establishing a general category of “fit enough”, but of course I asked to see my numbers and figure out what they meant. (Dan told me I was “toward the top” of his test subjects, but I was then disappointed when I got home and did more research to realize the number put me in the “average” category for my age and sex. I want to be above average, of course!)

The next two visits were to involve a lot of time having my brain scanned in an MRI, while performing a cognitive task and also scanning before and after and the task, while simply lying there in the tube. The difference between the two visits was that one time I would first pedal on an exercise bike for 30 minutes, and the other time while sitting still for 30 minutes, before going into the tube. The MRI was in a different building on the edge of campus, adjacent to  a veterinary facility, betraying U of Md’s land grant college roots. The MRI is a scarce resource - Dan told me several times that it was costing nearly a thousand dollars an hour, so he was excited to have a grant big enough to handle 40 people with two scans each. But also, the scheduling had to be exact, with no wasted time. They have sorted through a lot of test subjects that can’t do the long MRIs, either because of metal in their body or inability to tolerate the confined and noisy space. So Dan was very pleased that I was able to do this. There were a long list of requirements for clothing - besides the obvious of no underwire bra, but apparently a lot of exercise leggings that are shiny have metal in them. So cotton sweats and tees are the preferred attire, unless you are willing to be put in scrubs or a hospital gown. Even some tattoos are problematic for MRIs. Who knew?

The first day, I found the test site, arriving early, just as Dan was also pulling up in his car so he could lead me in. MRI machines are often below ground, always shielded from outside interference, so of course there was no cell or internet reception there. The building seemed empty except for us - me, Dan, another grad student assistant, and the MRI operator. I was the second subject of the day, starting at 10 am. That first day, I sat and pedaled on an exercise bike, in an empty cinder block room with no music or entertainment and my seat got sore - I haven’t been biking in a couple of years. Every five minutes they took my heart rate and asked me for my relative exertion level. After my exercise, I went into the control room for the MRI, where I was stripped of my watch and glasses and shoes, and then the MRI operator wanded me down with a metal detector, like a TSA agent. I was insulated with ear plugs and pads, effectively rendering me deaf. We went into the room with the MRI itself, where I lay down on the pad and had my head caged in and a display fastened on top. I was handed a small keypad with three buttons to use with my right hand for the task, and a bulb to squeeze in case of emergency, and a finger tip heart rate monitor anchored my left hand. I was slid into the tube, and they communicated with me by typing messages that appeared on a display above me. After a moment, they started with the scans. Each was announced with a typed message, like "this first scan will be 20 seconds. Are you ready?"  It took me a beat to realize there was a microphone in there, so while I couldn't hear them, they could hear me if I talked, and they needed to hear me agree each time.

I recall some previous MRI scans as being mechanically noisy, with whirring and banging. These scans were all noisy, but in a more electronic way, beeping and booping and squealing. I couldn't really assess how time was passing, except by what they typed about how long each scan would be. There were some shortish scans, and then I did my "task". They showed me a series of pictures, and I had to push a button indicating whether the picture was new, a repeat of one previous, or similar to one previous. The "new" versus "similar" was nuanced and a bit difficult. I'm not sure how long each trial was - five or ten minutes? - and there were two different trials.Of course I worked really hard to get them right. And then after the trials more scans, some really lengthy, with at least four that were eight minutes a pop. During each scan I made an effort to be truly motionless, and in between I could flex my fingers and squeeze my muscles a bit, but all told it was 75 minutes in the tube. After my task was complete, I relaxed and just drifted while they continued to scan. And each scan had its own song, either high pitched or low, steady or syncopated rhythms, monotone or two or three notes. Finally, they told me we were done and slid me out, uncaged my head, and I got to sit up. I was stiff from staying still all that time.

The second day was just like the first, except instead of peddling on the bike, I sat on it for 30 minutes. My seat got sore again! And they took my heart rate and my perceived exertion every five minutes. They strove to make the session as similar to the first as possible, except for the actual exercise part.

The scan was long and tedious again, except for the tasks. I had been feeling sluggish all morning, and I know I didn't do as well on the tasks - I was conscious of mistakes right after I made them. I don't know if the difference was at all due to the exercise, but I'm sure they'll be able to see a difference. After my tasks, I was nearly able to fall asleep inside the machine, despite the beeps and boops, but I thought actually going to sleep would be a bad thing for what my brain looked like, so instead I mentally sorted through my mess of tools in the basement, trying to come up with a better way of storing things so I can find them again.

So I did my bit for science. I am on a list of potential test subjects for future tests as well - they are always looking for guinea pigs, and apparently I was a good one for them.

2020 Report Card and Final Wrap-Up

 Herewith is my final report card for the year. After this, 2020 begone! I'm only looking forward!

 

First up: Activity. This past year was not great for my moving. Kim's friend Chris would be sad for me. I expended fewer calories overall, had fewer high activity days, fewer steps, more days very sedentary, and what I'm saddest about, many fewer days working out with weights. I got the bike out once, and tried running once. Only in "intentional miles" walking am I up slightly - and I think that is because I was more assiduous in tracking those miles. (In order to be logged, a "walk" needs to be at least 1 1/2 miles - no counting the incidental miles in the course of living my life.)

I have reasons and excuses, of course. The main one is I felt bad much of the time. Joint and muscle pain, headaches, upset stomach, all the things that are elusive and not subject to definitive diagnosis or fixing. But I'm extremely optimistic that I've now got a firm grasp on the mind-body approach to this, and this next year will be much better. 

 Next, my weight. I didn't achieve any big goals here, but I guess in the quarantine context I'm doing ok. I weigh slightly less than last year at this time, and (not shown) slightly more than I did in November, my lowest point of the year. Not coincidentally, I'm planning and tracking food much more often. I'm also really tuning into my hunger and satiation signals. I think I'm on the right track here, and again, I'm optimistic things will be even better next year.

 

On mind-body, it's a mixed picture. Not shown or tracked, I started serious therapy this year for the first time ever. First, in January, for twelve weeks I was in a structured (zoom) group, and following that, I started individual therapy over facetime. What I'm doing is geared towards somatic issues, specifically to address those with chronic pain of the types I have. On those things I do track, I'm meditating, less than last year (huh, if I didn't track it, I would have guessed different). My migraines are up for the year, but there were NONE in December and I think this is an effect of the emotional work I'm doing to re-train my brain. I am generally a champion sleeper, I certainly have plenty of time. My resting heart rate, which generally shows an overall fitness level, is slightly better than last year.

On the category I might term "self-actualization", if you are a regular reader, you know for sure I was a reading fool this year. I blogged more than last year, less than I would have liked. I started tracking "trips downtown" last year after I retired - generally trips last year were social, catching up with former work friends. Most of this year's trips were solitary dawn walks, reminding myself the city even exists. It feels like I sailed a lot this year, but seeing that it's less than last year, it must feel like more because it stands out so clearly in such a mass of otherwise undifferentiated days. Other accomplishments include a tap dancing class at the local community college (surprisingly effective over zoom) and several seminars and on-line short courses. I also got into sewing masks, and really engaged on the design and engineering creativity side while doing it.

I think I'm going to add movies watched to this list for next year - I would like to see a movie a week. This seems so very do-able, and I find setting a quantitative goal and reporting it here would be helpful. I want to do even more classes and short courses, tap class again, and sit down at my piano sometimes. I don't know I'll be tracking quantitatively here, though tracking can be part of the reward system that encourages me to keep going. I aspire to travel, but you know...

On the money front, I've spent some time working on the budget. My goals for this year were to get a handle on where the money goes, and specifically to reduce costs on food and clothes. Missions accomplished! This is the one area where the quarantine really helped. I cut food spending by 25%, mostly because I'm not eating out. Clothing was down by more than a third. (There was really no reason for me to buy any clothes at all this year, but I get bored and just want something new.) 

As another couple of money accomplishments, I did a final distribution to my family of the money from my mother's estate, and cut down on the number of different bank accounts I have. My mother's probate estate was something of a nightmare to deal with, and the IRS combined forces with the US Postal Service to screw some things up that created a great deal of angst for me. So when I close the estate's last bank account next week, I'm going to do a happy dance.

I tend to be analytic and want to be intentional about how I live my life. My current focus is trying to engineer my days to build good routines. When do I do what kind of exercise or other work? I've learned about habit formation so I'm thinking about this as another design challenge. What is my trigger to make me go work out? What might be the barriers? How can I make it easier to start? I know I hate going outside on days like today (grey and drizzling) so what can I do to get over the hurdle? Or is there something I can do indoors instead? Stay tuned!

Mid-Year Report Card

With my ambitions centered firmly on me for the next few months, it's time to check in on how I've been doing so far this year. The news is not great. First, the visual:

How to read this: Each green row is darker in the spots where it is "better".
For the red columns, I compare this year's average to last year's, red is "bad".

It may be a pretty picture, but it's a sad story.

I have been less active this year than last year by every single measure I use. I walk less, I'm not running or biking at all, and my gym workouts plummeted when the gym closed, even though I've got a terrific home gym and I continue to pay my trainer to send me workouts to do. I'm not even walking much. Our friend Chris would be severely disappointed in me.

My explanations and rationales are plentiful. "It's too [insert: cold, hot, wet, windy]. My dog can barely stumble around the block. I don't feel good. I don't want to get dressed. I don't feel like wearing a mask." 

This is entirely under my control, and I resolve to do better. The walking has already picked up. I'm doing a couple of things to motivate myself, including getting up early, indulging myself on fun things to listen to, and doing a virtual trip of the Camino de Santiago.

My weight is very slightly better than the end of the year, but the sad truth is I put on ten pounds after my mother died and I wallowed in self-pity. I am focused on my eating, and I'm not just tracking my food, but planning each day's food each morning. It definitely helps to not walk into the kitchen and ask myself "what am I in the mood for?". Instead, since I don't need to accommodate anyone else's schedule, instead I ask myself, "am I actually hungry? Is it time to eat?". The question of what I might eat is not on the table. This works for me almost every day. But evenings remain a vulnerable point for me, though I'm making some slow progress at self talk to convince myself otherwise.

The next group of measures in the report I think of as my mental group: meditation, migraine, sleep and heart-rate. These are tied together. Sleep hours are up, and resting heart-rate is down, but migraines have been a big issue and I haven't made meditation a priority.

The next group is entertainment: books, blogging, trips downtown, and days at the boat. I'm certainly reading an enormous amount, and I've taken the time to blog both here and on the garden blog. But I've cut back local travel, for obvious reasons. I don't go into town to meet folks for lunch, for example. I am, however, starting to get more sailing in. The previous restrictions have loosened, and my boat partner and I both see this as our preferred quarantine escape. So three Saturdays in a row! (We won't do any overnights where we share a cabin, just day sails for now.)

The last group, spending on certain things, is actually the area I considered hiding my numbers because I'm embarrassed they are as high as they are. The good news is I'm spending much less on food (not unexpectedly, since last year included work lunches out and hosting family for several days). Planning my daily meals in advance means I'm much better at using up my food - I'm wasting much less. I minimize trips to the supermarket - about every two weeks - and get restaurant takeout once or twice a week, usually enough for two or more meals when I place the order. Restaurants are expensive, and normally I would only go out with other people. Now, I rationalize how I have to support local restaurants, but the truth is I just get tired of my own cooking. I wonder how I'll feel about solo takeout once socializing resumes?

I was surprised to see my monthly average spending on clothes is about even with last year. My thinking behind why is tied to my weight gain - I decided I needed some clothes that make me comfortable now rather than counting on losing enough weight to fit. And my trips - the Utah trip in February and the cancelled Iceland one - tipped me into buying some cool weather active outdoor clothes that I wanted but really didn't need. They were expensive but I love them! I am ruthless these days about returning anything I don't like, but I should stick to what I have now and force myself to shop my closet for play clothes. I also have a lot of very nice work clothes and no place to wear them. I told myself to wait a year before purging. Since this year is so unusual, and I have hopes of getting my weight back down to where those clothes fit, I'm going to wait a while longer before figuring out which few nice things truly spark joy.

So there is my sad story. I an optimistic take on it: with such low scores in the beginning of the year, I should have a good shot at the "most improved" award at the end of the year! Parents: how would you react to such a spin on the dismal tally?

Food

My food intake (and thus my weight) have really gone the wrong way lately. I primarily blame the Whirligig, because it hasn’t entirely settled down and it keeps a constant low level of nausea just below the surface. Fewer trips to the grocery store and other isolation measures mean I’m thrown back on my own resources for putting together meals, which often requires me to cook.

I have white board material on the fridge
and keep a rough inventory as a reminder

I don’t hate cooking, I just don’t want to spend the time every day to do it. And while I have a few dishes I do well, I’m not a fabulous every day chef. I do continue to improve. I took an internet month-long class in it once, and that helped. I love reading cookbooks, but rarely do I actually use one to make a dish. Most likely when I have visitors, ie not now. More often, I use the cookbooks as inspiration, techniques and seasoning approaches. I’m in a kind of routine, and I often make big portions so I can just reheat quickly. I’m good eating the same thing for 2-3 days before I get sick of it, but I’m getting better at freezing extra portions right away, so it doesn’t get bad and I have quick food sitting in the freezer.

Way back in March, when were all preparing to hunker down, we didn’t know exactly what to prepare for. I assumed there was a good chance I’d get sick, and I’d be physically on my own during the illness because I wouldn’t just run to the hospital. So much of my early shopping was for quick and easy convenience foods for the cupboard and the freezer - shelf stable soups, frozen dinners, popcorn, granola, cereals, energy bars, apple sauce. Things I could either eat raw or pop in the microwave. This came in handy at the peak of the vertigo, once I was ready to try to keep food in me. At the outset, I also shopped for WTSHTF (prepper term, google it). Heavy on beans and brown rice and big shelf stable boxes of broth and tomatoes, which went down into the basement. I filled the freezer with bags of frozen veggies and fruit. I bought fresh veggies which were likely to keep a while, squash and cabbage and lemons and limes.

I started out well, keeping an eye on the inventory and usually cooking the next thing that might go bad. I was determined not to waste any food. I ended up using vegetables that in happier times I likely would have pitched right out. Tossed into rice and lentils cooked in the Instant Pot, and frozen into portions to provide quick, microwaveable food. I made two trips to the supermarket in April, and one so far this month, focused on fresh foods, but also replenishing any shelf stable things I used. That turns out to be about every two weeks. My girl (who goes more often to the grocery) has picked up a few extra items for me, and I got a smallish delivery from Costco, focused on big bags of coffee and some bulk organic meat for freezing. I’ve done takeout about every ten days, and I buy enough one time to last 2-3 meals. And at the height of my vertigo I ordered several pound of Gin-gins to be delivered.

But my evenings have been a continuous problem. And they wouldn’t be such a problem if I didn’t bring the treats into the house in the first place. When I buy chocolate or ice cream treats, I try to remember to ask myself, “What is my intention in buying this?” I have two themes playing out in my mind. My conscious mind is saying “No food has power over me.” Good thought. “No food is “bad”. Another good thought. “I can have just a tiny bit and stop”. NOT TRUE, at least this is not how things usually unfold. My conscious mind is an adorable optimist!

The other theme playing is simply a constant but mostly unconscious refrain, “Everything is awful so I’m going to give myself pleasure by eating this.”

When I got vertigo last month, that second theme just rose up and took over.

In my own defense, I had severe nausea, and my digestive system went wonky from top to bottom. I needed to eat what I rarely eat - white carbs in the form of white rice, pasta, toast. Microwaveable chicken soup. And, sadly, sugar also sat well. No fiber - no beans, no cabbage family, no crusty whole grains. I grazed gin-gins freely (they really work well for nausea, I use them on the boat), and squares of chocolate seemed to smooth things over.

While the nausea isn’t completely gone, my overall digestive system is much better. But I’ve got to get a handle back on my eating, aiming at the vegetables and whole grains and controlling my evenings. I have some ideas - stay tuned.

Whirligig

TL;DR I got dizzy. Time passed, and it's getting better.

So here was something new and, at first, truly horrible. I woke up Monday morning and when I went to get out of bed I couldn't because I was whirling around and about to be thrown off into space. I clutched at the mattress through my sheets and hung on for dear life. After what felt like hours, things settled down a bit, I opened my eyes and I tried again. Again, everything whirled at enormous speeds, things went black (probably because I closed my eyes) and I fell back down, not certain if I'd find the mattress or the floor or even land on a wall.

Breathe, I told myself. Feel the breath. It's coming and going. Breathe in through your nose and long and slow out by the mouth. Feel the mattress under you. Feel the covers over you.

Just then, I felt something else, urgently. My bladder was insisting it was time to get out of bed. Now!

Moving my head very slowly, I sat upright on the edge of the bed. Everything swirled, and started to go black, but I felt my soles on the wood floor and I braced myself and I rode it out. Clutching in turn the bed, the bookcase, the dresser, the sink, I made my way to the bathroom and managed to deal with urgent necessities. I stood up, and after the first several seconds, discovered I could walk. Moving slowly, afraid gravity would desert me at any instant, keeping one hand on the wall or furniture, I poured a cup of the already made coffee and sat down in my morning chair with the iPad.

It was then the nausea rose to the top. I was terribly thirsty, but water and coffee made me retch. I was rotating in my head in my chair, and fighting my stomach. I went for guided meditations and visualizations on my phone, and kept panic at bay. I really really did not want to throw up. It was taking most of my energy fighting it. I texted my brother-in-law to call me when he could, and took stock of my situation.

I reviewed what I know. People don't die from vertigo. But, it is extremely disabling. I had had vertigo for a couple of houra at this point, and already I could feel my life shutting down around me. I couldn't read, too dizzy. I certainly couldn't drive. I could barely walk. What did I actually feel? Sick. Aside from trying not to throw up, what was I feeling? What kind of dizzy specifically was it?

Both the nausea and dizziness came in waves as I sat there. Dizzy was definitely spinning, to the right. It was very different from the momentary light-headedness I sometimes get when I stand up quickly, especially if it's been a long time since I ate. There were moments between the waves when I felt almost all right. During those moments I decided to use the telemedicine option my insurance company set up last month. I also cancelled my garden consultation scheduled for that morning. I knew I wasn't dying, but perhaps there was something that would make me feel better.

It took over half an hour to work my through the telemedicine bureaucracy, get my info into the system, download their app to my phone, and get it the queue for a video consult. During that time I talked to my brother-in-law. He agreed to check up on me several times during the day. I was exhausted from trying to fight the nausea, and went to bed (with a basin) and the phone open to the telemedicine app and plugged into the charger.

I fell asleep and woke to a tone from the app. The video with the doc was basic, some more history, some moving around to see where the dizziness came from. She prescribed a medicine - basically, motion sickness pills. It would fight the symptoms, but not fix the problem, and was guaranteed to make me sleepy. She suggested certain videos on Youtube, how to maneuver your head to try to shake loose the little crystals in your ear canals and get them back in the right place. The assumption was this was positional vertigo, from displaced crystals. If the maneuvers didn't work, the symptoms should wear off in a month or two.

A month or two. OK, google. Show me some videos!

With the telemedicine, the prescription needed to go to a pharmacy in the same state as me (normally I go to one in DC) so I picked a CVS. In a little bit, I tried to get the prescription delivered. The CVS phone app was very buggy, and eventually I got up and went to the computer, where it worked.

By then, it was mid-afternoon and I was starving though still nauseous. When getting ready for the pandemic, I figured if I got sick I would be taking care of myself, so I had several boxes of Trader Joe's chicken soup, my go-to easy to digest, easy to make, food. I used up one from my precious cache. I was definitely feeling better, but still cautious. I performed the "half somersault" maneuver (designed to fix the vertigo) several times on the living room floor. As advertised, it made me really dizzy during it, and I couldn't tell if I felt better afterwards or not. 

So I puttered during the rest of the day, mostly listening to books and podcasts, watched a little tv. I ventured around the block with the dog. I woke the next morning much better. Some whirling as I got up, but not very disabling. I took it slow during the day, ate carefully of bland food, had my garden consultation, and did a bunch of laundry and stripped the laundry room of all portable things getting ready for a plumber the following day. Every trip up and down the stairs I kept a hand on the railing, even with a laundry basket. I went to bed thinking I had this thing beat.

Wednesday morning, blam, I was hit with the whirlies again, when I went to get up. Oh, no! It wasn't as scary this time, as I had been here before. It was extremely unpleasant, and I had to clutch the bed to keep on it, but it was not as purely terrifying. It was just something I had to cope with. I moved one way, wait one beat, whirl, wait for the settle, then move there, wait for it, whirl, settle, and I just kept going. Cautiously, with handholds, but steadily forward. I had a busy day of gardening (mowed the grass!) and I checked in with my chronic-pain-fighting facebook group. I searched on "vertigo" in the group, learned from past messages what kinds of things they had tried and what had worked. I posted my own query, and before bed got some very useful advice. I learned that it comes on when you are lying down, and some people avoid getting horizontal after an attack and instead try to sleep in chairs. That sounded too much like the torture of an overnight flight for me, but I was nervous about going to bed, normally my welcoming safe spot. I took one of the pills (my first one) before bed, and in bed did the Epley maneuver, carefully as shown on several youtube videos, before going to sleep.

This morning, no whirlies! But a general lightheadedness and wooziness, as likely caused by the drug as anything else. In fact, mid-morning I went back to bed, urged on by the weathercaster in the local paper, foretelling a very gloomy and very wet day. Based on the advice from my group, I'll be doing the maneuver every night in bed for at least a week, whether the symptoms come back or not.

In other news, I felt good enough to go out to the store this morning, first trip in three weeks. I was panicking at being down to my last package of coffee beans. I was woozy from the drug (taken 12 hours before) but not whirly-dizzy. (I practiced looking back over my shoulders to make sure I could.) Sadly, I was pretty disorganized, so I spent some money but missed a lot of stuff on my list. The good news is, I have food to eat without having to do serious cooking from scratch. I impulse bought some cookies, and got the planned couple of pints of ice cream, because sometimes, that's just what is needed.

Exercise

My relationship with my body continues to evolve, rationally and irrationally, as a result of my conscious actions and randomly. I’ve been much fatter, quite a bit slimmer, less fit, and more fit. I’ve been debilitated by a series of physical ailments I am not going to catalogue here and now.  I am intellectually convinced that there is no underlying physical condition in my body causing these ailments that needs to be fixed by medical intervention. I’ve intellectually and emotionally found the value in both strength and aerobic exercise. I am convinced exercise is the magic bullet that is both preventative and curative. I know that mental work - meditation, visualization, emotional discovery, self-talk - is the key to minimizing, heading off, and curing physical ailments that continually derail my exercise efforts. I’ve hated and liked what I’ve seen in the mirror.

It feels to me like I should be feeling better than I do right now. It feels to me like I should not be self-sabotaging my self-improvement efforts the way I do. I’ve actively been participating in an on-line live coaching group geared towards the mental work needed to leave chronic pain behind. It feels like I have all the tools, and all I need to do is pick them up and use them.

This is all preface to the post I meant to write when I sat down: what I am currently doing for exercise. Not that much, but today makes a streak of one day of really going for it! Yay me! Go team! And, I got out there and even had a couple of short runs last week - and am trying to gear myself up for another today. (As is typical for me, I don’t write about something during its slide down, but wait until there is some reason to note things are getting better.)

Our immediate neighborhood has no sidewalks and little traffic, so we all walk in the street and are able to keep distance without too much of an awkward dance. On Friday through Sunday, the two-lane curvy parkway along the near-by creek has 1- and 2- mile stretches of road closed to car traffic. Walking is nearly a religion to me and the highlight of my old dog’s day. So I’m getting out there and getting in some miles. Most days. There are still days I crawl into my hole and scarcely leave the yard, but so far in April I’ve only had one day with less than 5,000 steps, my benchmark of the absolute bare minimum to avoid fossilization. (There are studies that suggest daily steps of less than 4,000 is an excellent predictor of old folks’ decline into mortality. My recollection is there is nearly a straight-line relationship between steps and longevity between 4,000 and 7,000 daily average steps, and a less clear relationship beyond that.)

Last week, our on-line group assignment was “play” (among other things). We talked about what is and isn’t play. I struggled with this - I am not short of enjoyable things, and self-care and self-indulgence. But play? Here is how I’m currently thinking about this: Sitting at the piano to play a well-known piece, and then improvise and riff on it for a while, is play. But it requires a level of mastery to be able to do that, and much of the time spent achieving that mastery may be enjoyable, but it isn’t play. I used to love playing catch, and that was play. But it was only fun after I worked with a friend to coach me on how to throw and catch, so it wasn’t just a bunch of my chasing after balls I missed.

I never enjoyed running until I hit a certain level of aerobic fitness so I could actually run for a while. But then, I grew to love it, not just for how I felt afterwards and knowing how good it was for me, but I actually liked it while I was doing it. (Sometimes.) Now, I am willing to set my Garmin watch to regulate very short intervals so that I alternate between running and walking in a way that is sustainable for a while. A big point of the joy from running is using the rhythm of music I love to carry me along. So last Saturday, I strapped on the Garmin, the headphones, the heart-rate strap, and went down to the closed parkway. I ran a mile down it, and walked back. I did the same thing on Sunday. It was fabulous! I had made running playlists from my own music, so by definition everything I heard was something I liked.

I set out to run on a different stretch of closed parkway yesterday, but ended up listening to a book and walking a solid four miles instead. Not so bad. I’m going to go out a bit later (it dawned rainy but is supposed to clear) but am likely to be walking. Tomorrow, Sunday, is targeted for another run. If I sustain running, it will require “training”, not just “play”, but it will build that aerobic base that will enable more and longer play.

I have been working in the garden for a couple of hours nearly every day, and I kind-of thought it substituted for a more formal strength workout. I know that is not actually true. I’m still paying my trainer, who faithfully sends me a new workout once a week. But I haven’t actually been down to my workout room and done any training for THIRTY DAYS. (I love fact-checking - I initially wrote “three weeks” but then checked. Memory is always unreliable.)

Today’s workout was a solid hour of warmups, upper body and core workouts, and a nice stretching session afterwards. This may possibly be the most rigorous workout I’ve done on my own - I faithfully followed my trainer’s notes on weight and reps. Working in my garden is tiring, but it’s clear that I avoid certain moves and positions during the course of my day. The comprehensive prescribed workout gets me using body parts I normally try to protect or avoid. I definitely felt the erosion of mobility since I stopped training, even more than strength. There’s nothing like being hit in the face with experience to correct my thinking. Training will help me garden better, and everything else, too. Again, music was a big part of the enjoyment of the experience. Today’s stream was the Grateful Dead. I find myself flashing back to the seventies, my college years, more than later periods.

So I’m writing all this here to document this in my own mind, and for accountability. This blog was originally set up for accountability purposes, as I did a good, sustained, weightloss and fitness effort.

I’ve got nothin’ but time, and I would like to keep this up.

I’m curious - for those others who are also confined - are you able to find the motivation to keep moving? Even if it’s only in place? Are people going to emerge from quarantine all buff and fit? Or is that an instagram myth?