Working on my health one literal step at a time

November 26, 2014

I’m listening to the rain/sleet/whatever-the-hell-that-is hitting my windows. It’s been a quiet day. Even from my apartment, I feel how empty the city is becoming. The streets have been quiet, no new email is coming in, and few people are commenting on Facebook. Tomorrow is Thanksgiving, and everyone is busy traveling or cooking, finishing work or packing a suitcase. Well, almost everyone.

Two weeks ago I decided to walk every day. I had taken 2 walks every day while I was dog sitting, so 1 daily walk seemed reasonable. My health has been improving, and I know I need to keep pushing myself, within reason. So I set a goal of 1 walk each day, 6 days per week. So far I haven’t quite managed it, but I’ve walked 5 days out of each week, so I figure that’s a good start. I’ll have to try harder to get it up to 6.

On this quiet, rainy, sleeting, slushy day, I didn’t have anyplace to be. No medical appointments or plans with friends. I’d pushed myself to run errands yesterday so that I could avoid today’s traffic, crowds, and lousy weather. I’d succeeded, but I knew I should still walk. I needed to take that walk. I did need to go to the post office. I could wait until Friday, but why wait?

I haven’t been counting my regular walking towards my goal. I want these walks to be in addition to what I usually do. They don’t have to be long, but they should be at least 2 blocks each way if I can manage it. So the trip to the post office doesn’t really count. It’s a walk I would take anyway, and it’s very short – just a block away. But something is better than nothing.
As I walked to the post office I decided it should count. Not because of the sleet bouncing off my umbrella. Not because of the cold whipping my face. But because of the slush under my feet. I walked slowly and deliberately. I focused on my gait, my posture, my limbs and joints. I was as careful as I could be. I knew that slipping and falling could be no big deal, or it could be disastrous. The walk was probably 12 or 15 minutes round trip because I was walking so slowly, so carefully. I held my breath, then had to remember to breath. I felt my ankle turn on some uneven sidewalk that wasn’t visible beneath the snow, and I was thankfully I didn’t injure myself. I felt my foot slip slightly, but I regained my balance.
With every step, I was nervous. But I was also proud of myself. The easy thing would have been to stay home. That also would have been the isolating thing. I needed to be out. I needed fresh air. I needed to see other people. I needed to feel that I wasn’t trapped. And I needed to know that I could keep up with my exercise if I tried hard enough.
There will be enough days that I won’t be able to take my walks. I will be in too much pain, have too much fatigue, or have some other ailment. I will have to choose between taking a walk and buying groceries, which is what happened yesterday. I will have to skip most of the summer, due to my heat sensitivity. So I’m very glad that today, at least, I took that walk. It wasn’t easy, and it wasn’t perfect, but I did it.

This never happened: When healthcare is about health

November 24, 2014

We (society) throw around the term “healthcare” a lot in political debates, media, and daily life. We use it to mean all care related to our health, but that’s not what “healthcare” really is.

Occasionally, though, someone flouts convention and choose to focus on actual health. I forget how rare this is until I 11-24-2014 10-18-13 PMregister my own surprise when it happens. Today was one of those days.

I’ve been having trouble adjusting to my new CPAP setup. The doctor suggested I get fitted for a different type of mask. The CPAP company has a guy, C, who handles this. I met with him for my original mask fitting. He came to my house to set up the CPAP the first time around. He came out to fix the CPAP when I had problems. He came back with the new setup last month. And today I saw him for another mask fitting. We greeted each other like old friends.

C showed me my two options and explained how they worked. He took his time, as if he had no other appointments. He answered every question. He never rushed me or made me feel bad for asking so many questions. Isn’t that how it should always be. But it isn’t.

I chose a new mask, excited, as always, at the prospect of improved sleep. C rummaged through a drawer, searching for the right type and size, and pulled out a new mask. He ripped open the bag, and I commented on how I didn’t expect to walk out with a new mask. He said, “This never happened,” and I grinned and agreed. It wasn’t the first time someone in the medical field had said that to me when giving me proper healthcare, and I doubt it will be the last.

The insurance coverage of a CPAP is incredibly complicated, but at best they replace the mask and tubing once every three months. The filter only gets replaced every 6 months, I think, and the machine should last for several years. I figured I was 6 weeks away from qualifying from a new mask. I asked C about that, and he explained that this never happened, and that he’d submit the paperwork next month, when the insurance would cover it. I suppose I’ll have to make this mask last longer than it should so that my supply schedule will line up with the insurance paperwork. But for now, I’m just so excited to try out the new mask tonight!

C knows his job. He knows what boundaries he can push. That’s clear. But he also clearly wants to help patients. He didn’t have to give me that mask. He gets nothing in return, except the knowledge that he’s helping me. So why did he do it?

No, that’s the wrong question. The question is, why doesn’t everyone else do it?

Nope, wrong again. The real question is, why is it necessary to do it? Why must someone break the rules to provide good healthcare? Why doesn’t our system focus on health as a top priority?

If our system focused on health, a new CPAP mask for me would be covered. So would many other things. I began to list them here, but why bother? We know what they are. I’ve discussed them so many times before. And they aren’t the point, at least not individually. It isn’t simply about what’s paid for, but an attitude. I would like medical appointments that aren’t rushed, doctors who don’t have to worry about malpractice suits at every turn, and practitioners to consult with their colleagues on every case to be sure that nothing is missed. I want to see a system where the goal of every examination, test, treatment, and discussion is optimizing the patient’s health.

Because what’s healthcare, if it’s not about optimizing health?

Sharing too much and not enough

November 19, 2014

I get tired of answering the same questions about my health and insurance woes from my family and friends all time, and they feel awkward about constantly asking. It would easy to just have them follow this blog, but I’m keep this blog anonymous, and only a select few know about it. So I send emails.

I don’t send too many emails, and the last one was several months ago. I always find it tricky. I want to include enough information to answer everyone’s questions, but not so much that the email is cumbersome to read. I want to cover everything, without overwhelming anyone. I want to share enough, but not too much.

There’s no guideline for this. There are online tutorials for writing the perfect business-related email. There are tips on writing difficult emails to a friend. But I’ve never heard anyone mention a group email to update friends on a chronic health condition. I try to keep the tone light, but informative. It’s serious, but not too heavy. I only started this a couple years ago, and most of the earlier updates were insurance-related, so it was easy to make fun of the system. It’s harder to make jokes when I’m writing about my health.

And then there’s the audience to consider. Close relatives and less close friends and everyone in between are all on the list. They’re all people with whom I feel comfortable sharing this info, so privacy isn’t a concern, but their knowledge is. The people who I’m closer to know a lot more about my health conditions in general and often the specifics that I’m dealing with at any given time. A good friend who I speak to less often won’t know these things. I know I need to include enough details for the latter to understand, but I don’t want to bore the former.

Now let’s say I find a balance for all of that. There’s still the issue of my own shyness around this stuff. I’m happy to answer questions, but feels so self-centered of me to send out these emails, as if everyone wants to know this stuff. I know that’s irrational. I know that they want to know – most of them get this email because they asked to be kept in the loop. I guess I’ve just never been good at being the center of attention for any reason.

I’ve been meaning to write this latest email for over a month. I’ve thought about it from time to time, but I just never got around to it. Today’s the day. I’m going to write it right now. I just wish I knew what I was going to say.

Watching my life change

November 13, 2014

A funny thing happened when I was busy just trying to survive: my health took a big step forward. And suddenly, instead of being in one of the negative health cycles we all know so well, I’ve practically fallen into a positive health cycle.

First I left the hell of benefits applications. I got the last approval letter this week. I’m done (for now, at least.) That reduced my stress level more than I could have imagined.

Then I started with a new CPAP setup for my sleep apnea. With a couple weeks I was noticing a difference. I still have some problems with it and, with a couple of exceptions, I haven’t been able to use it for more than a few hours each night, but it’s helping. (As a side note, I saw my sleep doctor today and I’m hopefully we’ll be able to fix those problems soon.)

Then, as I was feeling less stress and more energy, I spent a week dog sitting. I took 2 walks each day and was more active in between walks. And while it was tiring, I actually felt pretty good!

Yesterday I saw my naturopath and today I saw my sleep doctor. Unlike many of the other doctors I see, each of them ask a lot of questions about how I’m feeling take the time to consider all of the details. And that means that I have to take the time to consider how I’m feeling and to answer their questions thoroughly and thoughtfully.

I knew before this week that I was doing significantly better, but when I compared how I feel now to how I felt at my previous appointments with each doctor I saw the change more clearly than ever.

And the thing is, it’s not just that I feel better. It’s that because I feel better, I’m doing more! So you know that health cycle I mentioned at the start of this blog post? Well, it goes something like this:

Feel better physically –> Be more active –> Feel happier from extra activity –> Feel even better physically from extra happiness and from extra activity & exercise –>

Isn’t that a wonderful cycle? I won’t know how long it will last, but I hope it lasts a long time!

Suddenly I’m going out with friends more, doing more volunteering for a couple of groups I’m involved in, helping others more, exercising more (I’m trying to take a medium walk every day) and generally feeling happier! It’s not perfect. My doctor today asked if I’ve thought about going back to work. I know I’m not ready. I’m not keeping up with a lot of things around the house. I haven’t been writing here as much as I’d like. There are so many things not getting done. If I can’t find balance between extra socializing (which is still less than what most people my age do,) extra exercise, household chores, and a couple of hobbies, how can I possibly add work to that mix? I’m still hoping to get there, but I’m just not there yet. And that’s ok.

It’s ok because right now I’m seeing positive changes. I want to embrace those for all they’re worth. I’ve dealt with a lot of shit lately. Loved ones have died. I’ve had excruciating pain. A promising relationship ended suddenly. There’s been some tough stuff. But now, finally, things are looking up. And I’m going to focus on that and enjoy it as much as I possibly can.

What dog sitting has taught me about my health

November 8, 2014
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It’s time to get out of bed and play!

It’s been an interesting week for me, to say the least. For the first time in years, I’ve recently begun to have less stress and more time, but that also coincided with extra pain and other symptoms and with some family issues. But this week, I was doing ok. I was feeling pretty good health-wise. My “to do” list feels overwhelming, but only because of the quantity. There’s nothing really horrible on it, like dealing with insurance companies. So it wasn’t such a bad week for watching this cutie.

I was nervous about this. I’d promised a while ago that I’d watch this adorable little guy, but as the time approached, I wondered if I could really do a good job. I’ve always wanted a dog of my own, but it was never feasible. First I was working and traveling too much, and I had landlords who wouldn’t allow dogs, and then my health problems prevented it. Recently, though, I’ve started to think that I might be able to handle dog ownership if I could find a landlord that would allow dogs. And this week was my test.

Now, if I got a dog I’d have a yard (it’s the only way I’d do it) so that would make things easier. Still, it would be a lot of work. This guy is 11, so he doesn’t need as much activity. Plus, he’s the easiest dog I’ve never known. He rarely barks, he lets you know clearly when he needs to go out, he doesn’t pull on the leash, etc. He’s great! And he was exhausting. So how much more tiring would a younger dog be?

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Look how cute I am! Don’t you want to share your dinner?

Last night I never finished washing the dishes. I was too tired. But the pooch still had to go out. There was no choice. So out we went. Down the stairs and outside, and he peed, and then back up again. Now it’s 9:30 am and I’m exhausted, but he hasn’t had any exercise today, so we’ll be taking a walk. And I still need to finish those dishes. It’s just what happens when there’s a dog in the house. I’m completely worn out and, after a full week, I’m glad I’ll be returning him to his owners today.

But then there’s the flip side. I’ve gotten more exercise than I have in ages, and I actually feel good about it! Now, the truth is that this is coinciding with some health improvements that I’ll write about another day. Still, even with those improvements I wouldn’t have done so much walking if it wasn’t for this guy. Not a chance. I might have taken a walk every other day. Instead, I’ve been taking 2 walks every day! Look, I even wore him out!

There have been studies about how petting an animal lowers blood pressure. For someone with hypotension that’s really not a concern, but it’s so relaxing to have him curl up on my lap. It’s just the best! I haven’t done much knitting this week

Thanks for the walk! Now goodnight!

Thanks for the walk! Now goodnight!

because my hands have been otherwise occupied with petting this adorable dog. Look at him! Who wouldn’t want to pet him? He helps my stress more than I would have thought.

And then there’s having someone else to focus on. No matter how tired I am or how much pain I’m in, I have to think about taking care of him. It’s good to shift my focus. I think we’ve all experienced this is in different ways. I know that I have. I teach a friend how to knit, or I give advice to someone, or I do some volunteer work, and it’s a great distraction from my own issues. But having someone here who needs my attention every day, like it or not, brings that attention shift to a new level.

It’s been a fantastic week. I’ve absolutely loved it. And while it’s shown me that I’m not ready to have a dog quite yet, I can tell that I’m getting close. And that when I do, it’ll be more beneficial to my health than I ever would have thought. Now if you’ll excuse me, someone wants to play fetch. Hint: it isn’t me.

Do you have a pet? How do you handle its care on your worst days? How does it help you?

More things your doctor doesn’t tell you: temporary handicapped parking permits

October 31, 2014

I can’t believe how many times I’ve had different versions of the same conversation. First there was this one:Handicapped Parking

Me: There is absolutely no excuse for parking in a handicapped parking space without a permit.

Him: Well, maybe there are some.

Me: No. None. There’s just no excuse at all. If you need the space, get a permit.

Him: What do you think about pregnant women using those spaces?

Me: I have had plenty of pregnant friends who could walk around just fine up to the time they delivered. They sure did better than me!

Him: Well, my sister had some complications.

Me: Then she should have gotten a temporary permit from her doctor.

Him: Oh, I didn’t know those existed!

Then came this one:

Me: There is absolutely no excuse for parking in a handicapped parking space without a permit.

Her: I totally agree. Usually. I mean, I did park in them last month when my foot was healing. But that was different. I needed it.

Me: If you really needed it then you should have gotten a temporary permit from your doctor.

Her: Oh, I didn’t know those existed!

And there have been others. Why is it so hard to understand that there is no excuse whatsoever for parking in a handicapped parking space without a permit? Why don’t people realize that if they have a legitimate need then they should get a temporary permit? Oh, that’s right, because doctors never offer them! Shouldn’t a doctor suggest to a patient with a broken foot or some other temporary condition that they get a temporary permit? I don’t know if temporary permits are available in every state, but they definitely are in Massachusetts. (If you want proof, check out #6 on this site.) But the average ambulatory person does not know this. Why would they?

Doctors should know it, though. They should know it, and they should tell their patients. I am not suggesting that these temporary permits be handed out like candy on Halloween. However, like so many other issues in the world of illness, education will help everyone. People who need temporary permits would be helped so much if they could actually get them. And people with a legitimate need to park in those spaces would be helped by people not assuming it’s ok to park there if they themselves judge their own need to be worthy.

So I will continue to say this to people, and I hope you do, too:

It’s not up to you to decide if you “need” or “deserve” to park in those spaces. If you have a legitimate need, get a permit. Otherwise, leave those spaces for people who really do need them!

Have you had similar conversations? Please share some in the comments below!

Why do you judge how I use my food stamps? An open letter to “news” writers

October 29, 2014

Dear Judgmental “News Writer,”

Since I’m too sick to work, my financial situation isn’t so great. So I applied for SNAP, formerly called food stamps. A couple weeks ago I got the letter stating I’d received the benefit. I went to the grocery store and, lo and behold, food stamps covered everything I bought, just like they’re supposed to!

But apparently, this is evil and will destroy our society. Or at least, that’s what you seem to think.

As I mentioned a couple weeks ago, I wasn’t sure what I could buy with food stamps. Toilet paper? Toothpaste? Vitamins? No, no, and no, as it turns out. The SNAP web site answered some of my questions, but not all of them. So I turned to Google and typed in a few search terms. What I found was horrifying.

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This screenshot is from the first page of search results. The first few items were all government web sites. The last one here is a very useful post by a blogger. And the three in between from “news” sources? Oy! I clicked on “11 Things You Didn’t Know You Could Buy With Food Stamps” thinking, oh-so-foolishly, that I’d find some helpful tips. Instead, what I found was an insulting, arrogant, judgmental article about the horrible things people like me buy with food stamps. “5 Surprising Things You Can Buy With Food Stamps” was more of the same. So were several other articles I clicked on. Apparently, it’s everyone else’s business what I buy and what I eat.

I want to pause for a moment to note that “10 Things You Can’t Buy With Food Stamps” is wonderful. It points out that, yes, SNAP benefits are meant for food, but things like toilet paper and toothpaste are necessities that aren’t covered. Take a look when you’re done reading this.

Now, I know that people feel they have a right to say what “their” tax dollars are used for. But that’s not how society works. I don’t get to choose whether “my” tax dollars are used to pay for a war, local schools that I don’t use, or road maintenance that I don’t particularly care about (actually, I do care, but that’s another story.) The idea is that society supports society, and then everyone benefits. So yes, my tax dollars support local schools even though I don’t have children, and that’s ok because one day the children who are educated in those schools will be our police, scientists, doctors, and teachers. You see how that works? Again, we all support each other, and then everyone benefits.

Unless someone is on food stamps or getting social security or receiving some other “benefit,” at which point they’re demonized by society. By you.

Apparently writers like you feel justified in calling out someone who buys a bag of chips or a pastry with their food stamps. Oh the horror! They aren’t being healthy enough! And the “N” in SNAP stands for “Nutrition” so this can’t be allowed! You get that this is sarcasm, right?

So who defines what’s nutritious? Is that sugary cereal you feed your child nutritious? Do you know how much sugar is in a glass of milk? Is there too much salt in a frozen dinner? What about a freshly cooked rotisserie chicken? Oh wait, that chicken isn’t covered by food stamps. Ok, well what about that carton of ice cream you like to dig into after dinner on a hot summer night? Oh, it’s ok when you eat junk food because you pay for it with your hard-earned money, but I can’t eat it because I’m on food stamps? Really? What if you’re a government employee and my taxes pay your salary? Then do I get a say?

And again, who decides which foods are nutritious? Maybe you have hypertension and need to stay off salt, so a mildly salted food is bad for you. But I have hypotension and multiple doctors have told me to increase my salt intake, so for me those foods are better. Then again, sugar is a problem for me, so I need to avoid that, while a small amount of sugar might be ok for you. They say red wine has health benefits, but it’s not covered by food stamps. Maybe that should change. And dark chocolate is good for you so does that mean food stamps should cover chocolate bars? What about chocolate cake? Who draws that line? Should it be you, cocky “news writer”? A doctor? A medical board?

Or, I don’t know, maybe me, the person who is eating this food?

And by the way, what happens when, after years of gorging on unhealthy foods with your hard-earned money and righteous attitude, you get sick? Who will pay for your medical care? Who will support you if you can’t work? And how will you buy food if you can’t work? You better come up with a plan that doesn’t involve any government support or “benefits” because you’ve made it quite clear how you feel about those!

Now if you’ll excuse me, I’m off to have some homemade chicken with apricots, rice, and steamed green beans. Followed by a bag of Cheetos. Because I want them and it’s my choice, not yours.

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