Powerless?

I’m typing this from my office computer, where I still retain power after Hurricane Irene.

But last night I dreamed that I lost the power to speak. I could hear and listen, I could see, ‘though I have no knowledge of taste (as I didn’t eat anything during this brief period). I was in unidentifiable, unfamiliar surroundings, but somehow did not feel uneasy. Even experiencing this loss felt familiar, like when I temporarily lost sensation in my left arm, due to MS, and was unable to dress myself. Powerless.

In the morning, the windows were open, and I felt the cool, dry air across my skin. I saw the beam of dust particles shimmering in the morning sunlight. And I heard my voice as I said goodbye to my husband, as he departed for work. Ahhh, all was well—my body was fully functioning.

The electric and telephone, however, remained non-functional. But all was not lost. I could drive to work, and get in touch with the world from there.

Even in the absence of modern life’s distractions—cut off from the Twitter tweets, the endless email, and the more pleasant indulgences of good music and movies, I had had to simply be. I had to give serious thought about what to grab from the fridge (I needed to act quickly to prevent the cold air from exiting). And I needed to sit and eat mindfully, by daylight or by candle.

My mind was freed for creative thought. Yes, 3 posts were written (by hand, I’ll add) yesterday.

Don’t get me wrong. Losing power has its downsides. I was hoping to bake those rugelach (http://dropitandeat.blogspot.com/2010/12/minding-your-eating-managing-your.html) to send to my son, but couldn’t without a working oven. And when the hot water that remained in the water tank was all gone, I wouldn’t be rejoicing in the cold shower. And for some, the consequences, no doubt were more dire.

But sometimes these little reminders are so valuable to remind us of what power we really do have. My body still functioned, even though the electric was dead. My brain filled the void, when it had free reign to create. There was much I could do, and enjoy, in spite of the temporary loss of power. And just doing nothing, an option I never consider, was now possible; imagine giving yourself permission to do absolutely nothing!

Some things are out of our hands, like the electrical service into my home. But sometimes we simply need to take charge of our situation—to find creative solutions, to appreciate what we do have that works, and to shift perspective.

And, we need to appreciate that we always have the power to speak and advocate for ourselves.

No, we’re not powerless at all.

So You REALLY Think I Can Keep This Up?

The verdict is still out, but I’d bet on Sally’s success. Over the past 12 months, this formerly mid-200-pound woman has lost 54 pounds, since we began our work together. But she’s done that before, without my help. In fact, she’s lost weight faster in the past, each of the past three times, even. These previous diets yielded a weight loss of 70 pounds, I’m told. Yes, in each of her decades of life, she managed to lose, and then to regain, approximately 70 pounds.

Back then, after about a year, she’d slip into old habits. She’d get bored with her eating routine, overeat, and then feel like a failure, letting the “What the heck effect” take over.  So I probed Sally, given her one-year anniversary working with me, to summarize what has changed, why this time is different. And here’s what I heard.

Clothes

Of course you’d expect her clothing size to change, with a more than 50-pound weight loss. But this time, she discarded her “fat clothes”. No sense holding on to things you hope never to need. But equally important, she tossed her unrealistically small sized garments. Sure, they were outdated. But she also recognized the importance of setting realistic goals, and living in the present, and appreciating her self and her body where it’s at, even as she continues to make changes. Sally has purchased a few new outfits that she feels good wearing. But she hopes to purchase some new items as she continues her progress. One step at a time.

Guilt

It’s hard to release yourself from feeling guilty after eating “treats”, particularly if you lived most of your years believing that you were not entitled to eat them. Overweight? You might believe you don’t deserve to eat ice cream; the stares alone, from strangers even, might convince you of that. Even if your weight were never out of range, you might have absorbed messages of caution around foods you’d love to indulge in. So perhaps indulgences occurred when your watchful parents or spouse or siblings weren’t around.

Sally stated that while she did have sweets before, while losing weight, she would always be thinking that she should be having a carrot instead. Hmmm, cake or carrot, cake, or carrot.  Which would you choose? Now, she includes sweets, as part of a healthy diet, and with a lot less guilt. She doesn’t limit them to when she is alone, or driving, or eating mindlessly. Now she can put a dessert on a plate, sit down with it, with or without others present, and enjoy it. Really enjoy it. Now she bakes, sometimes modifying a recipe, while still allowing for a satisfying and delicious product. She no longer awaits vacations to include the foods she enjoys. Instead, she chooses what she likes—but eats in portions more appropriate for her body’s need.

Doing it for Sally

Sally always had to be accountable when in a diet program. But this time, while she may still care to be a good student and do well at our visits, something major has shifted. “I’m doing it for myself now”, she shared. More than needing to show me a weight loss, Sally is determined to maintain her progress, which impacts how she feels—her ability to move her body, to feel comfortable after a meal, to go clothes shopping.

Thoughts and Actions

With past weight loss there was the before and the after, weigh in periods. Hours prior to that stressful moment, you know how it goes. Those struggling with overweight restrict more, to save face at their weigh in; and those of you struggling to gain, may push out of your comfort zone for those few remaining hours or days before the weigh in. And unfortunately, the weigh in lady would reward you simply for the loss of weight (think Weight Watchers); and similarly, those nurses or doctors inexperienced with eating disorders would reward you for your gain.

No one explored how the weight change occurred, whether through healthy or unhealthy measures; few bothered to ask. Rarely did anyone inquire whether you were struggling with the recent changes, and whether they were sustainable. Progress was measured strictly in pounds lost or gained. Some things, regrettably, never change. You might have changed your actions, but not your thoughts, making the eating behaviors less likely to be lasting changes. 

Unlike many medical professionals and weight loss program leaders, Sally now does know better. She can appreciate that her weight is only one small part of who she is, and how she is doing. She knows that her thoughts and eating behaviors are what’s most important. They built the foundation to support her progress.

In the past, losing weight required pain and suffering—at least as I heard it described by Sally and many others. “Isn’t going to bed hungry a good thing?” a teen patient recently inquired. That’s what she was taught. That was the gold standard. So why should she think otherwise?

At our most recent visit, I heard something I don’t always hear; Sally described how proud she was of how she handled a recent slip. Rather than focusing on what she failed to do, I got to hear the other side, the side that I am usually working hard to get patients to acknowledge. And without any prompting, Sally shared her accomplishment, pulling herself back up after a recent slip. Instead of dwelling on her excessive dinner portion when socializing with friends, and the seemingly unnecessary dessert which followed, in spite of not being hungry, she didn’t beat herself up, as she had for decades past. She described how she was able to put this eating in perspective, realizing she is only human, and move on, which she did just beautifully.

Slipping is not the problem, when it comes to changes in eating behaviors. It’s the ability to shift gears, to see the positive, and to appreciate your ability to continue to move forward. And to learn from our mistakes.

Yes, that’s why I’ll put money on Sally’s success.

Hope or Despair? Only You Can Decide. But I Chose Hope.

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us…” 

Charles Dickens

Taken after surviving my 9th annual 150+ mile bike ride for MS

I barely understood A Tale of Two Cities when I read it as a young teen. Yet somewhere in my memory the very first sentence has stuck.

Ten years ago I experienced 2 years of Hell. The list of craziness included, but I can assure you was not limited to, the following:

My father was diagnosed with lung cancer. He was a non-smoker with no environmental or genetic risk factors that we know of. He died 14 months later, at the age of 68.

My dog died the day after my dad’s funeral.

I experienced double vision leading to a diagnosis of MS 4 months after this symptom.

My husband lost his job and was unemployed for the better part of a year.

I hired a part time secretary who sued me after 6 weeks for a reported slip and fall; suing was apparently her second career.

Does it get more fabulous than this? Provence!

My then 13-year-old son went in for routine elective adenoid surgery, under general anesthesia. He was supposed to wake up after 40 minutes. Seven hours later after being hooked up to a breathing machine he awoke. We learned he had a rare enzyme deficiency preventing the breakdown of the anesthetic.

There is more, really, but I’ll stop here.

Recently, a patient of mine, having heard this list, asked me how I managed during that time. I thought it a strange question at first, especially as her life, to me, seems to include more trauma than any one person can be dealt, and she has done exceptionally well in her recovery from anorexia and bulimia, the very conditions that in many ways helped numb her pain.

The answer is that I feel rather grateful, perhaps because I have chosen to identify all the ways I have been fortunate. Yes, I have MS, but I function better than anyone might imagine, given this condition. The unemployment? I was fortunate that I could increase my hours and grow my business, so we were not in financial distress. And my kids enjoyed having my husband around after school then. My dog of 16 years lived a long, good life.  My father didn’t suffer long. 


And the blessing in disguise was with learning of my son’s pseudocholinesterase deficiency. This enzyme has only a couple of functions—to break down this anesthetic and to break down cocaine. In other words, had my son of middle school age decided to experiment at some time in his life with, let’s say, cocaine (not a terribly crazy concept), we learned he would have died of cardiac arrest. So 7 hours on a breathing machine resulted in the advance warning that perhaps saved a life—if he had ever chosen to try cocaine and we had not chosen to have this elected procedure. Yes, I was rejoicing.

Chagall painting, ceiling of the Paris opera

I doubt that I’d be able to find the strength to survive the trauma of the 3-limbed amputee, mentioned in my recent post. And I certainly don’t share my history for the sake of getting empathy or pity. Truth is, many of you have survived worse situations. 

But perhaps you’ve done so using your old friend—food, or eating disorder behaviors. And I must confess—those do work—but only temporarily. Eating large quantities of food can make you feel drugged, detached, numb. It can allow you to feel that you’re in charge—that you can eat—and do—whatever you choose. Except that then you’re left feeling awful. You can be healthy and still eat whatever you like to eat (don’t you believe that by now after 90 or so blog posts?). You just can’t eat without tuning in to your body and its need, your hunger.

Alternatively, you can surely restrict your food intake, or get rid of your food, can’t you? Don’t get me wrong—I’m not recommending this, of course! But when things get tough it can be very appealing to stop feeling, to lose the sensations of hunger and of emotions. It’s like disappearing, right?

But there’s a price you pay for coping this way. You miss out on life, on relationships, on connections with people. You place yourself at risk. You cause yourself harm physically, emotionally, psychologically. You stay stuck in an unhappy cycle. You put your life on hold. Helpful, perhaps, but just for a moment.

This is what I found after a long day at the office!

Life isn’t always easy—I’ll be the first to agree. But perhaps you can shift your perspective? Or maybe utilize other coping skills besides the old standbys.

Linda related the following after her MD visit last week:

So it has apparently been 5 years since my last physical with Dr. D. I spent the morning with unwanted anxiety for whatever reason (I just hate going to the doctor!).  I was swept in from the waiting room and within a flash moment I found myself standing on the scale.  Surprisingly, when I saw the nurse begin moving that thingy more and more to the right, I instinctively looked away (go Linda!)

All was well, right?

Nurse Sandy then takes me into the little room and proceeds with the usual routine questions.  She told me how much better I seem, that we all go through "phases"... uh, phases?  And then, with utmost enthusiasm, proclaims loudly "WOW, your weight is the HIGHEST I've ever seen it!!!!"

What. the. hell.

I never intended on going in discussing any weight issues, I even looked away on the scale.  This was a physical, damn it.

So, Dr. D asked me about my weight and has it been stable.  Yup, I told her.  Then I mustered all the courage I had in me to tell her what Nurse Sandy said.  Her response?  Laughter.  Yes, LAUGHTER!

This was not supposed to be funny.  I do not see the humor in this.

Instead of faxing the blood pressures and weight, she wrote it down and handed it to me (so much for the strength of NOT LOOKING AT THE NUMBERS WHILE ON THE SCALE!).  Can doctors and nurses be THAT OBLIVIOUS???

I wish I could undo the damage from all the thoughtless comments you hear.

While I can’t, believe it or not, you can. You could choose to accept the distortion your mind bends it into, or you can fight. Yes, you can counter those thoughts with some healthier reality checks, about what your healthy eating and behaviors are getting you.

This can be a season of hope, or of despair; you can appreciate that you survived another season intact, and are now that much stronger to move forward. Really, only you can decide.