The luck of the draw

Toddler sitting on sidewalk with little puppy kissing his face

I love my PALS visits with Jelly. I get to go to new places and meet new people and watch them adore my dog. Of course I love to tell them funny stories about her, but I don’t go on and on about her because it’s not all about us, especially during these visits. I have to find other topics of conversation instead.

I’ve long accepted that I’m terrible at small talk. Getting-to-know-you conversations are hard for me in general. I was particularly stumped at a PALS outing last week.

We had volunteered to visit a special nursing home. The residents there are hard-to-place older folks who would not otherwise be accepted into seniors’ homes. Many are alcoholic and/or mentally ill, and many once lived on the street. The alcoholic residents are given controlled amounts of alcohol at regular intervals. Without access to alcohol, these people would likely continue to live in poverty on the streets. The residence’s goals are to reduce these people’s run ins with the police and their need for emergency health care.

I’ve been in many seniors’ homes with Jelly and this one was more run down than others I’ve seen. (Imagine the challenges gathering funding for a place like this.) So were the people there, many of whom were socializing in the common area when we arrived. Still, this special residence gives them a roof over their heads and three meals a day, access to laundry facilities, and on-site medical care. There are significant daily supports in place, so they don’t need to be trying to survive on the streets anymore.

I didn’t know what brought these folks to this residence and my asking them would have been inappropriate. Of course I wondered about their pasts, though. Sometimes their mental-health issues were apparent, but others simply appeared poor and downtrodden. I hope my discomfort wasn’t obvious, but I felt even more awkward than usual finding common ground for conversation.

I often fall back on one strategy when I have no idea what to say. On all our PALS outings, people can choose to visit with the dogs or not, so those that do attend are clearly dog lovers (or cat lovers who are willing to accept second best). Their interest in animals gives me an easy inroad: I ask them about their experiences with dogs. That breaks the ice, probably for me more than for them. People love to talk about their dogs–I can relate to that–even if they may be sad recalling better times in their lives.

On this visit, our dog conversations reminded me that our lives may not have been all that different at one point. These people weren’t born mentally ill, although they likely were harbouring bad genes that would reveal themselves later. They likely lived with family when they were younger, just like I did. But at some point, poverty or mental illness or addiction derailed their lives. I expect they’ve had bad luck, while somehow I did not. Life is truly unfair.

I’m glad this special residence can provide these folks a home. Everyone deserves at least that, no matter what.

What goes down must come up

Once upon a time I was a dieter. I lost weight, sometimes too rapidly, for short periods of time, but most often I gained it back. I have come to believe that I cannot sustain restricted eating for any period of time. Eventually I fall far off the perpetually-hungry wagon. As soon as I start forbidding myself certain foods or food groups, I crave them all the more.

Some things I have been advised not to eat for health reasons, and I can live with those few restrictions. Grapefruit is a no-no with many of my medications. Organ meats are one of the worst things a gout-prone person can eat. Although chopped liver is a Jewish staple I consumed frequently in my youth, I’m surviving fine without the delicacy as an adult. I may be on a low-sodium diet, but I still eat the odd sodium-laden restaurant meal and I enjoy the occasional potato chip from J.’s stash.

Cookie Monster in Oscar the Grouch's garbage can saying "I hate cookies"Right now, I’m losing weight rapidly, but I can assure you I’m not dieting. Six weeks ago now, my hunger switch blew a fuse. I went from eating normally, sometimes excessively, to nary a hunger pang. Normally I’m one of those people who goes from zero to ravenous in seconds. I’m perplexed I haven’t been approached to star in one of those Snickers commercials. My hungry alter ego would be a hybrid of Oscar the Grouch and Cookie Monster. Currently my hungry-grumpy self is on vacation. I eat because I know I have to, but I’m full in no time. I’m oddly fascinated by this turn of events.

When I was discussing this problem with one of my doctors, she said that there is a fine line between lack of appetite and nausea. I have been straddling that line, but remain firmly on the lack-of-appetite side. I’ve told you many times that I am not a puker.

I don’t recommend this extreme approach to weight loss and I can’t tell you how to shut your appetite loss. I am not intentionally trying to lose weight; I am having trouble eating. There is a huge difference. It’s been a while since I’ve craved a particular food and felt compelled to satisfy the craving. I miss the old days when I ate with enjoyment.

This experience is not all bad, of course. I can leave the house unconcerned about missing a meal. I no longer need an emergency snack ready for consumption at all times. And I am miraculously slipping into clothes that haven’t fit for some time. Whenever I clear out my closet, J. encourages me to hold on to some smaller-sized clothes just in case. I must be going through a just-in-case phase.

I may sound too cavalier about my shrinkage, but my doctors have reassured me there is no cause for concern. So long as I’m feeling alright (which I am), and my blood work is largely unchanged (which it is), I am not worried. I expect my appetite will come back with a vengeance once I figure out how to replace the fuse. With my renewed appetite, my lost weight will miraculously reappear. In the meantime, let me enjoy a few weeks in my skinny jeans, alright?

 

Yeah, sure, sometimes I’m grateful.

Let’s start this post by saying that I don’t buy a lot of clothes. But a few days ago I bought a t-shirt, size medium. (Hopefully it will still fit me when my unintentional hunger strike ends.) It says #grateful across the front, which I find a little Oprah-esque, but I liked it anyhow.

I don’t like to preach gratitude but occasionally I do find myself thinking of things I’m grateful for. Being alive is the most obvious one.

Soon after I bought the shirt, as if by fate, I had a texting exchange with a doctor friend, my second debrief of sorts with him following last week’s adventure at the urgent care clinic. He was kind enough to check in the evening of my incident, and somehow we got to texting again on Friday afternoon.

I was worried my friend might be angry with me for what I’d recently posted about my visit to the clinic because he’s the kind kind of guy (no, that was not one of my frequent editing errors) whom I imagine feels responsible for anyone’s mistreatment by a medical professional. That’s quite a burden to bear, don’t you think? I reminded him that he can let that go.

When I asked him whether he was angry with me for what I’d written, he responded: I could never be angry with you. To say I was touched by his response would be a gross understatement. The sentiment actually brought tears to my eyes. I know, you’re not surprised.

Sometimes someone says something to me that I know I will never forget. Some are traumatic moments, the ones where someone has blurted out something very hurtful or mean. We all have moments like those, interactions where we feel shamed or belittled or bullied. I try to let these incidents go because I don’t find stewing about them helpful. Sometimes I am successful but sometimes I am not.

But the moments where someone says something that so kind and supportive, those are moments I want to hold on to. I must have reread the text several times before I deleted it. It has been a great comfort.

Has anyone ever told me that I could never evoke anger? No one, ever. I understand why. I spend my days infuriating people with my irritability and cluelessness and rigidity and all my other tiresome quirks. Maybe this dear friend doesn’t know those annoying sides of me that would drive him crazy were we to spend too much time together.

Or maybe he does know how difficult I can be, and he still chose these words of support. That’s a true friend. So everyone should know how grateful I am. Thanks, dear friend, for debriefing with me after your very long day of work. And thanks for your continued kindness when we caught up a few days later, even if you were disinhibited by your first vacation beer. This post’s for you, bud.

And now I must go put on my new t-shirt, to drive the point home.

 Beer stein filled with beer on a wooden table at a pub

 

My 500th blog post, and I am speechless.

What makes this occasion momentous? My having published 500 excessively wordy posts? Or your kindly read 500 instalments of my mind’s random meanderings? I give you a lot more credit for your persistence than I give myself. My job takes will and dedication, yes, but yours takes endurance. By now, you must feel like you’ve run one of those ultra marathons in the desert.

You’ve persisted despite never knowing what’s going to arrive in your inbox. Occasionally Sadness makes an appearance, or I seek a silver lining in some crummy situation. Too often I drag you through the mundane details of my latest medical trials and tribulations for 500 words (x2 or 3 or 10). I drone on and on. But you’ve endured. You deserve credit for that.

You likely thought the time commitment I’ve demanded would be freed up by now. So did I. Plus my memory is so poor that I’m surely repeating myself more than I realize. “Oh, not that joke again,” I hear you muttering. Or, like J., you might be moaning, “Not that dead horse (or painful finger) again.”

Please know, dear readers, that I’m okay with your calling it a day. I’ll keep writing whether you continue to read my ceaseless drivel or not. Writing helps me to work through what is happening in my life. Through my writing, I gain perspective on the absurdity of living with an illness that is incurable, but, to this point, not deadly. Sometimes I find that I’m less scared of my leukemia when I write about it here. That’s why I keep at it.

And so, early this morning, imagine my panic when I was locked out of my blog for the very first time. I wanted to write this post, but I could not access the blogging site. What an opportunity I was granted to remind you, for the 45th time, that not all anxiety is bad. Sometimes people become anxious because they are facing a genuine threat. If you were face to face with a tiger that had escaped its cage at the zoo, even you, brave one, would likely find yourself anxious, and your anxiety would be well founded. And so, this morning, I was paralyzed, with reason I believe, by the thought of losing all the hours I’d devoted to my magnum opus.

But within seconds, I envisioned the worst possible scenario, as is my anxious nature. Had I been hacked? Had I lost my blog forever? What kind of idiot doesn’t back up her life’s work? A few hours and a downloaded malwear program later, I learned my computer was fine. And then, magically, I could log in to my blog again. From what I could tell, everything was intact. Most likely the blogging program was down when I’d tried to visit earlier.

So my blog was saved, but my idiocy is still problematic. And so, in honour of this 500th post, may I remind you to back up your work. You’d hate to lose everything you’ve worked so hard on forever and know you could have prevented the disaster. Now I must learn how to back up my blog. Better late than too late, I say.

Man clutching head on down on computer keyboard

 

Pride comes nowhere near the fall

Woman who has fallen off bike, bike lays on ground

If a woman stops eating in the forest, will anybody notice her pants falling off? Does it matter?

I am here to confirm what the research has been saying for years: your stair master is lying to you. Weight loss is about eating less, not exercising more. Trust me, I know. But keep exercising because it’s good for you in so many other ways.

Many moons ago, I was dating an avid cyclist. I made the mistake of trying out one of those fancy road bikes with the skinny wheels at the prohibitively expensive cycling store. Of course this bike had fancy clip-on pedals, so I sported an ill-fitting pair of those absurd looking clip-on shoes for my trial ride down the block. Needless to say, I did not make it far before I teetered over and, unable to unclip my shoes, fell to the ground. It was not pretty. No bikes were purchased that day.

Things haven’t changed all that much over the years. I no longer need the fancy bike or the clip-on shoes to fall to the ground, however. On Wednesday, for example, I took Jelly out for her morning constitutional. As we returned to the house, I failed to properly negotiate the small rise from our lawn to the driveway, a rise that has been there since the cement was poured 15 years ago. Somehow I found myself flat on my face, with skinned hands and knees and badly mangled glasses. Surprisingly, my recent weight loss did not seem to lighten my fall.

Thankfully my trusty therapy dog was at my side, as she often is when I fall, since I do most of my walking with her. She sighed, “Oh mom, not again.”

Jelly has has been PALSing around for 6 months now. She has visited retirement homes, hospice patients, university students, and a variety of special-needs populations. She has offered wags and kisses far and wide. People marvel at how calm she is in even the most chaotic of settings.*

She had an especially successful visit with a hoard of high-needs preschoolers. Somehow, in the midst of all the activity, she napped. One of the children saw Jelly sleeping, and observed, “She looks dead.” He repeated this statement several times. I was ineffective at disabusing him of this notion. I even placed his hand on Jelly’s belly so he could feel her breathing, to no avail. At least he wasn’t upset about Jelly’s apparent demise.

When she has her little PALS outfit on, Jelly is an equal-opportunity love sponge. She will take affection from anyone who will give it. I wouldn’t say she’s one of those miracle dogs who is drawn to the person who needs the comfort the most, but I may need to reconsider in light of my mishap.

After my fall, Jelly immediately rushed to my side, started kissing my face, and then waited patiently until I got up. I collected myself and arose slowly. Other than a few bruises, I’m absolutely fine. J., on the other hand, believes, for good reason, I am unsafe to venture out so I’ve been grounded.

Happy Canada Day! And be safe.

 

*I too marvel at how calm Jelly is in these special settings, since she’s often utterly frenetic at home. Remember the dining room table incident?

 

Running, or walking, or crawling on empty

Car with hood open getting tune up, hands visible working on car

I didn’t manage to publish a post last Friday, despite my best intentions. I was caught up at the doctor’s office for longer than I had expected. No, nothing was wrong, I had been recalled for regularly scheduled maintenance with Dr. Family. Even we sick people need to ensure we’re not going to get a flat tire on long, hot summer drives.

More often than not, when I go to see my master mechanic, I am seen by one of the many apprentices training under her expert wing. This time, my apprentice was a week from graduating with her ticket, so she handled my tune up with the expertise of a seasoned professional. Still, any apprentice takes longer to get the job done, and has to run everything by the boss before the car is allowed back on the road.

After a thorough review of my hefty file, Dr. Apprentice completed the routine checks from top to bottom. She ensured all my fluids were filled to appropriate levels, that my spark plugs were firing and my motor was functioning, and that my tire pressure was adequate. Then she inspected me all over for any unusual dents or markings.

Before we were done, we discussed the issue of my gas tank, which seems to have shrunk, along with the rest of my body, in recent weeks. If this lower gas consumption continues much longer, I’ll be reclassified from sedan to compact for the first time in years. I confessed I’d been having trouble filling’er up past the half-way mark, which is highly unusual for this Little Miss Piggy. Dr. Apprentice looked at my current weight, which had eked its way into the healthy range, and showed little concern. I imagine I’d have garnered more reaction from her had I stopped filling my tank altogether, or if I’d confessed that parts (or is that “pants”) had started falling off while driving, but since I still seemed to be running fine on half a tank, she barely raised her eyebrows.

I was sent off with the usual blood and body work, and told that the office would contact me with any recall notices. Sounds good to me.

Stalled car with hood up by side of roadThen the weekend came and, for the first time since this lowered gas consumption started, I tanked. I could barely turn over my engine. I virtually stalled by the side of the road. That’s when J. decided to start the force feeding.

In case you were wondering, I haven’t voluntarily adopted a calorie-restriction diet in order to live longer. You’ve heard of those, haven’t you? Crazy people are actually choosing to go hungry in order to extend their lives. Doesn’t sound like much fun to me. I am not them, I can assure you.

This Friday, I will be seeing Dr. Joint, or Dr. Goutfire, or Dr. Uri–so many options, so little time to decide!–and we will discuss the gout-busting pills that seem to be making it hard for me to fill my tank. Hopefully Dr. No Name Yet will support a medication adjustment so I can resume eating again, assuming my gas tank has not shrunk permanently. That leaves me four more days to fit into those favourite jeans….

Lest she forget

Where oh where has my appetite gone? Who cares? I’m on the easiest diet ever, one that doesn’t involve any planning or effort. Let me revel in it while I can. Don’t be jealous; losing an interest in food isn’t much fun. I don’t recommend it. I’m headed out for lunch today with friends and wondering what I’ll not eat.

Today I can assure you that my appetite loss is not a sign that my health is in peril. Yesterday Dr. Blood confirmed that my blood test results were a-okay. I’m fine.

Enough about that; we had many other more important things than my health to discuss. Dr. Blood is leaving for her overseas adventure at the end of July, so this was my last appointment with her, for now.

I’m going to miss her. We discussed the young hematologist assuming her practice in her absence–I’ll need yet another new name, folks–whom she’s no doubt chosen very carefully. Dr. Blood would not leave her patients with someone she did not trust. She assured us that she’d be back, and I believe her. She told us she rented out her home here for a year; she didn’t sell it. That’s a good sign, isn’t it?

I promised myself I wouldn’t cry and I didn’t, or at least not once I’d arrived at the Cancer Centre. (The drive there is another story.) J. and I asked Dr. Blood about her plans because we’re genuinely interested and we wished her well because that was the appropriate thing to do. I did not plead with her to stay, not even for a nanosecond.

Then I gave her the thank you card I should have written years ago telling her how grateful I’ve been for her diligent care. I reminded her of when we first met and how she saved my life. It’s a great story, and one she should never forget.

I’m an awkward hugger at best, but I was planning to ask if I might hug her at the end of the appointment. She preempted my awkwardness altogether. As we were parting, she asked if she could give me a hug. It was a significant gesture from someone who has been such an important part of my life for the past five years.

Changing of the guards

Just imagine these are doctors.

I am genuinely excited for her, and I hope she has a wonderful year. At the same time, I feel sad that she will not be here to care for me. Am I a bad person for thinking of myself and my needs in this situation? No, I don’t think so. Still, I’m glad I refrained from bringing Sadness into the room. I will miss Dr. Blood, but I will welcome her replacement and put my trust in him. I’ll adapt to someone new because I’ve been through the changing-of-the-doctors drill many times now.

Dr. Blood has also left me with a new goal to strive for. (We cancerous folks like setting goals for our futures.) The new goal? I now have to stay alive until she gets back. Dr. Blood seems convinced that I will still be here, and since her judgement has been 100% thus far, why start doubting her now?

Introducing the incredible shrinking woman!

Shot from the movie The incredible shrinking woman, tiny actress on big armchair

Thanks to all of my witty and creative readers who forwarded inspired names for my new doctor-to-be. (Take a look at last post’s comments if you haven’t already. I guarantee you will laugh out loud.) I may call a vote to decide the winner. Don’t worry, contributors, you’ll be able to vote anonymously for your own brilliant submission.

Today we have something even more remarkable to discuss, if that is possible, since I try to intrigue and delight with every post.

My weight has always been the bane of my existence. I insist I’m large boned, but that excuse will only go so far. I have likened myself to a pufferfish, and have spoken of my 75th trimester pregnancy (“trimester” may not be the appropriate word here). I generally watch my weight, but do not do anything about it, i.e., I am not a dieter. I may try to modify my eating if I fall off my Great Sugar Revolution wagon, for example, but I do not deprive myself of anything. Deprivation leads to bingeing, folks, remember?

For the past few years, my weight has been largely unchanged. I am overweight, but not excessively so.

But no more. My appetite has been MIA for two weeks now. I ate very little breakfast this morning, and now, at 1:20 p.m., I must have missed the lunch bell. I’m making myself consume small portions to keep myself going–I’d hate for my large bones to start protruding–but I have not experienced a hunger pang in some time. This is odd. My large pants are loose, and I even look a little less pregnant (which can happen if you’re not pregnant). I have re-entered the healthy-weight range for the first time in two years.

Normally I love food and I love eating, so why are the pounds are falling off me? I am not intentionally restricting my intake. I can assure you I don’t have an eating disorder. I’d eat if I felt like it. I don’t feel like it.

Of course this change of events could mean that my health is amiss, but there’s no sign of that. I feel absolutely fine, although I’m not sure how I’m functioning on so little food. Rather, I’m wondering if my latest combination of medications is to blame.

Many of my medications list loss of appetite as a possible side effect, but I never have the pleasure of experiencing that. I gravitate toward the tired side effect instead. Whatever combination of pharmaceuticals I’m consuming, I’m always famished. In fact, when I was speaking to Dr. Family the other day about my many medications, I told her I was hoping for the possible nausea from one, since I’d like to lose a few lbs. She looked at me quizzically, and then, despite herself, she laughed.

Perhaps the answer to this mystery is in my blood work, which Dr. Blood will review with me tomorrow. Whatever the reason for my incredible vanishing appetite, I’m hoping to extend my disinterest in food for a few more weeks. By then I should fit into my favourite jeans again.

 

Musings on avocado toast

Avocados have gotten a bum rap of late on two fronts. In case you missed it, an Australian real-estate mogul had the gall to assert that the younger generations cannot afford to buy their own homes because they are wasting their money on frivolous items like $19 avocado toast. Needless to say, the social-media backlash was fierce.

Don’t tell me you’ve missed the trendy toast movement altogether. FYI, it’s not all melted margarine slathered on highly processed white bread anymore. The toast I’m speaking of has fancy toppings, including but not limited to avocados, smushed on thick slices of organic sourdough toast. You can order it in restaurants with a variety of additional toppings, at unfathomable prices.

I’ve read about the toast movement but I’ve never gone out to a restaurant in search of avocado toast because I don’t eat out, remember? Since I was placed on a sodium-restricted diet in 2004, I have largely been restricted to reading about the hot new restaurants in town on the internet. Sometimes I salivate at the pictures, but God would punish me if I deigned to consume their wares. Did I mention how much weight I gained on my last vacation, despite my only eating only one pain au chocolate over two weeks? No? Well, let’s keep it that way.

The mogul’s lame argument was countered by a respected business writer at the Globe and Mail. Said writer noted that young people would need to consume over 33 slices of overpriced avocado toast daily to spend the $180,000+ dollars Toronto house prices have risen over the past year alone. Anyone consuming that much avocado toast has a bigger problem than covering her house payments. I suspect a binge eating disorder, but I’d need more information to make a definitive diagnosis.

If these house-less restaurant-going kids decide, instead, to make avocado toast at home in order to save a few dollars, they need to be aware of the second strike against the poor avocado: the potential dangers of avocado-pit removal. According to recent medical reports, a phenomenon dubbed avocado hand is showing up increasingly in ERs everywhere. The injury results from a missed stab at the avocado pit, where the knife slips off and pierces the palm of the hand. These cuts can be deep, and may therefore result in serious infection. A local emerg doc noted that his hospital sees approximately one case of avocado hand weekly.

Thankfully we have socialized medicine in Canada, so that your ER visit will not cost the you anything except your pride. Rest assured the ER docs will view you as one of those earthy millennial types who needed a healthy snack following hot yoga to sustain you through the afternoon.

I’m not that person–I prefer to keep my yoga sweat to myself–yet I confess that I too like avocado toast. I often slather half an avocado on my morning toast, sometimes topping it with an also-trendy poached egg. It’s a surprisingly filling meal. But I’m too cheap to pay $15 for all this rigamarole at a restaurant. I’ll pit my own avocado, thank you very much, very carefully, and pray for no deep-tissue injury since I’m infection prone. Already I’ve cost the health system much more than my share.

Picture of avocado on toast topped with poached egg and herbs

The dangers of dependence: a tale of two doctors

A tree that is unbending is easily broken

Did I happen to mention that my beloved Dr. Family will be heading off on maternity leave in August? The gall of that fantastic physician to place her family ahead of her patients, placing her family ahead of her patients. I was diagnosed with leukemia during her first maternity leave. Who knows what will happen this time she leaves?

I don’t talk about Dr. Family much because she is, in some ways, a peripheral member of my care team. By necessity, I spend more time with my specialists than with her. She has always diligently reviewed my file before I do visit, though. She is an astute diagnostician and has cared for me well over the years I have known her. She has arranged for excellent coverage during her two prior leaves.

Her upcoming departure for baby #3 happens to coincide with Dr. Blood’s leaving for her year-long sabbatical. That’s a lot of change at one time for a change-averse gal like me. Thus I considered becoming completely overwhelmed when I first saw Dr. Family’s baby bump, but I’d recently reached my fretting threshold over Dr. Blood.

That’s how I decided to approach to Dr. Family’s leave differently. I recalled my shutting my practice temporarily–unlike me, my clients had no opportunity to ready themselves for my departure–and how, unsurprisingly, my clients survived without me. I’d expect no less of them.

As a clinician, I am always walking a tightrope between assuring my clients they can rely on me when they are distressed and encouraging them not to become overly reliant on my support. From the outset, we discuss those supports available to clients outside the occasional hour that we meet. I’d never want a client to think he needed to talk to me and only me in a crisis because that would set him up to be overly dependent on my care.

I’ve always known I’m not the only psychologist in town. Other highly competent clinicians jumped in when I got sick because they had to. I redirected clients that asked; others muddled through in their own way. Some clients may have ditched therapy altogether to see how they’d do without a therapist’s support. I trust they managed well.

Those who transferred to someone new may have had to share their story from the beginning, which is certainly harder than returning to someone who knows them. Nonetheless, unexpected change like this can be good for clients. I may have missed something or focussed excessively on one domain when they could have used a different kind of support. I realize my former clients may have found a therapist who was better suited to care for them. Sometimes a client reaches an endpoint with a psychologist and a new perspective is beneficial.

If my clients can survive or even thrive without me, maybe I can do the same with my new physicians. I’d hate to become a needy patient, and I trust both my physicians will find solid interim replacements. Who knows? Maybe the change will give my flexibility muscle a good workout. I may even learn that there’s more than one doctor in the world who can keep me alive. That would be reassuring.