I don't have one of the new Kindle or Nook readers, partly because I don't want to spend the money on one, but even if I could I doubt I would purchase one. I see the logic in it - carrying my entire bookcase, (okay, bookcases), everywhere I go. Whether on the beach or on a plane, I could have my entire stash of books with me. And it would certainly give me way more wall space, not to mention the multitude of trees it would save some rain forest. But there's just something special about a book that can't be replaced by electronic readers. A favorite quote goes like this:
"I would be most content if my children grew up to be the kind of people who think decorating consists mostly of building enough bookshelves." ~Anna Quindlen
In the latest edition of Entertainment Weekly, The Pop of King, Stephen King writes about how the "Kindle certainly has its charms, but e-readers can never fully replace books." I so agree. There is something inherently special about the cracking open of the cover of a new book. Deeply, I inhale the scent of the fresh, heavy pages. A new book smells so divine. I run my fingers over the cover, matte or glossy? I especially love the sensation of the raised print title or author. And what about the thrill of browsing the bookstore, running my fingers along the spines of a row of books? Pulling one out, reading the flap or the back cover, and then replacing it when the next one catches my eye? Nothing can replace the pleasure of browsing a bookstore, piling favorite selections in my arms and then devouring them page by page when I get home.
Granted, I will probably have back problems early in life due to the carrying of heavy sacks of books my whole life. As an undergraduate majoring in literature, my book load was plenty. And I've never known how to limit myself in the bookstore or the library. Just last week I came home from the library with almost twenty books. Some might say it's a compulsion, or even a problem. I call it a passion. Though I hate that I can't underline my favorite passages and dog-ear the pages of the books on loan. Before I went to college, I kept my books in pristine condition, except for the ones that just eventually wore out because they'd been read a million times, or a few that were accidentally coated in Kool-aid or an RC cola. I never wrote in them or dog-eared the pages. Then I got to college and via used book purchases and observation I noted that people were actually writing and highlighting in their textbooks. Blasphemy! Offensive! Sinful! An utter violation! How could I be expected to write on crisp, snowy white pages that displayed the words of geniuses? It was beyond comprehension.
I soon began to gradually see the beauty in the marking up of a text, especially those that I fell in love with. I could underline favorite passages, circle words that filled my mouth, mark the pages so that, in a hurry, I would know exactly where to turn. Soon my books were brimming with lines and colors, too.
I couldn't do that with a Kindle. First of all, I understand they are in black and white. Which isn't that big of a deal, but half the pleasure of a new book is the examination of the color and art of the cover. At least it is for me. On occasion, I have been known to judge a book by its cover. Now, I'm sure that a color version is in the works, or that the new iPad will probably be above and beyond; however, I am convinced that none of them will ever measure up to "real" books. Even if I bought a Kindle for convenience's sake, I'd probably end up buying the paperback version, too. And if I'm going to spend twice as much money as I already do on books, I want to have twice as many books. Even if I do have to build a new house or an addition to this one.
Like Mr. King, I see the beauty of the e-books, but I'll never be convinced they are better than the real thing. I am a die hard Internet fan, and I love technology, but this is one invention that I can't get behind. I am also concerned about what it does to hurt the whole writing, publishing and bookstore industry, but that's an entirely other long subject. I can't imagine the eradication of books and bookstores the way that the CD has gone, and probably the way the DVD will soon go, what with digital downloads and all.
My heart will break if, someday, there are no bookstores. Books are my Eden, my paradise, my promised land. They hold the potential of taking me anywhere, anytime. No technology will ever hold for me the power of a book in my hands. For that is my bliss.
Saturday, March 27, 2010
Friday, March 26, 2010
The Very Best Chocolate Chip Cookies You'll Ever Make...
I'm still in the (bad) habit of sometimes comforting myself with a little chocolate when I'm down in the dumps. I also enjoy making cookies for friends when they are down in the dumps or even just feeling a little off. Nothing is better than something made from the heart. My dear friend received some disheartening news yesterday, so I baked up a little batch of the very best cookies I know how to make. Now, anyone who knows me knows I don't do much good in the kitchen. Kyle cooks most of our meals, which is why we still have a house that hasn't burned to the ground. However, this recipe is so easy that even I can make it turn out well. So, I thought I would share my recipe with my blog readers - all three of you :) And, I even made the effort to take some photos along the way, because let's face it - pictures make any story better.
First off, find a good sized bowl to pour your ingredients in, because this recipe makes a good sized batch of cookies. Soften one cup of butter and mix it with one cup white sugar and one cup packed brown sugar.
Next, beat in two eggs, one at a time.
Now for my personal favorite ingredient, vanilla. Pour in a teaspoon or two. And take a moment to inhale it's lovely scent.
Now for the goodies: dump in a bag of your favorite chocolate chips and some walnuts. I don't chop my walnuts because I love them, but it's up to you how chocolaty and nutty you want your cookies.
You may have to fold them in by hand, but your dough should be soft enough to stir them in.
I use an ice cream scoop to grab up some dough and put it on a cookie sheet. It looks like a huge portion, but it bakes up in a nice sized cookie.
Put a sheet of these lovelies in your preheated oven at 350 degrees. Bake 10 to 12 minutes, ten if you like chewy-gooey cookies and twelve if you prefer a little more crunch.
Ta-da! Now you have the perfect cure for whatever ails ya. Your batch should make about 20-24 cookies. In my experience, they taste better when shared with a good friend. Enjoy!
First off, find a good sized bowl to pour your ingredients in, because this recipe makes a good sized batch of cookies. Soften one cup of butter and mix it with one cup white sugar and one cup packed brown sugar.
Next, beat in two eggs, one at a time.
Now for my personal favorite ingredient, vanilla. Pour in a teaspoon or two. And take a moment to inhale it's lovely scent.
Dissolve one teaspoon of baking soda in two teaspoons of water and add to batter along with 1/2 teaspoon of salt. Dump in two and a half to three cups of flour, one cup at a time and stirring in between.
Now for the goodies: dump in a bag of your favorite chocolate chips and some walnuts. I don't chop my walnuts because I love them, but it's up to you how chocolaty and nutty you want your cookies.
You may have to fold them in by hand, but your dough should be soft enough to stir them in.
I use an ice cream scoop to grab up some dough and put it on a cookie sheet. It looks like a huge portion, but it bakes up in a nice sized cookie.
Put a sheet of these lovelies in your preheated oven at 350 degrees. Bake 10 to 12 minutes, ten if you like chewy-gooey cookies and twelve if you prefer a little more crunch.
Ta-da! Now you have the perfect cure for whatever ails ya. Your batch should make about 20-24 cookies. In my experience, they taste better when shared with a good friend. Enjoy!
Thursday, March 25, 2010
Creative Impulses...
I felt extra creative the last two or three days so I painted and embellished some picture frames. Here's a glance at them. Most of them I made for my God-daughter's birthday.
Wednesday, March 24, 2010
Prescription Medications...
In the midst of all this health care reform chaos, I am wondering how most Americans, even those with insurance, are managing the costs of their prescriptions. Kyle and I have decent health insurance through the state, but our copays for prescriptions are adding up these days, and I imagine the average household still struggles to pay for their medications, even if they do have a good insurance. My doctor prescribed a new medication today and I was shocked at the checkout to find out that my portion after insurance was $100! I've never had a copay so high. Usually they are $20 at most. It lead me to want to do some research when I got home.
I looked up the prescriptions I take on a daily basis on three online pharmacies: Walgreens, Drugstore.com and King Soopers (Kroger). I averaged the cost of my medications based on the cheapest price listed for the medication, and using generic when possible. I currently use four medications to control my bipolar disorder symptoms and anxiety. Here's what I would pay out of pocket if I had no insurance and ordered from one of these companies:
Depression/Anxiety Med #1 - $425/month (extended release)
Depression/Anxiety Med #2 - $70/month (generic)
Mood Stabilizer #3 - $823/month (extended release)
Anxiety Med #4 - $150/month
Grand Total: $1468 each month
Total with Insurance: $150 approximately
Yikes. Even with insurance I am paying out of pocket $150 a month in medications. And that is only for my mental health. I am on a variety of supplements that are necessary post gastric bypass as well. I would average the cost of those at about $65. Double that because Kyle takes the same ones, and add his own cocktail of diabetes, cholesterol and blood pressure meds and we are probably in the ballpark of $500 per month in medications.
How do Americans do it? No wonder people are ordering meds from other countries. And how scary is that to know that no FDA checked your drugstore order before it shipped? A great deal of Americans aren't doing it. They simply can't. Been there, too.
Since the overhaul of the health insurance system started, I have been a believer that before we look at health insurance we need to look at the root of the problem - the outrageous costs for treatment and prescriptions. If I'm having trouble paying for meds with insurance, I can't imagine what families without insurance are going through. Actually, I can. I was without insurance most of my life until I got married. Many people, both those with and those without insurance are going without or adjusting the amount of medication they take so that the prescription lasts longer. Before we can make adequate health insurance coverage, shouldn't we look at what that coverage is paying for to begin with?
A mother shouldn't have to choose between her needed prescription and milk for her kids.
Fortunately, many of the pharmaceutical companies are providing programs for low income families to help them afford prescription medications. This is a great help to many people, myself included when I was in college and couldn't afford my prescriptions and was not covered by insurance.
It's dismaying how reliant we've become on chemicals to change our lives. And don't get me wrong, I am very grateful for the medications that improve my life. But I find it overwhelming to experience the constant changes in medications. Each week there is a brand new medication on the market approved for this, that and the other thing. Watch television for an hour or two and note how many commercials you see for various medications.
As consumers we are often placed on and taken off medications without the proper amount of time passing to even determine what they can do for us. Many providers are handing out samples like candy on Halloween night, because they are pressured by the big companies to write those scripts.
It's all a bit alarming to me. And anyone who has taken medication for depression or mania knows that there is no rhyme or reason to figuring out what works and what doesn't. Unlike many conditions, there is no blood test to determine which meds are right for which patient. It is all trial and error. And it can take up to six to eight weeks for some medications to work to their full potential. So many of us are on this med for six weeks, pulled off it slowly when it isn't working and starting on the next one. The cycle can go on for years while doctor and patient work together to determine the perfect mix.
It's an issue that affects nearly every person in America. Who doesn't need a prescription at some point in the year? Whether it's an antibiotic or treatment for a chronic condition, all of us visit our pharmacy sometime.
I don't know what the answer is, but I know that the current system for cost of prescribed medications just isn't realistic for the average consumer. Everyone deserves to feel his or her best.
I looked up the prescriptions I take on a daily basis on three online pharmacies: Walgreens, Drugstore.com and King Soopers (Kroger). I averaged the cost of my medications based on the cheapest price listed for the medication, and using generic when possible. I currently use four medications to control my bipolar disorder symptoms and anxiety. Here's what I would pay out of pocket if I had no insurance and ordered from one of these companies:
Depression/Anxiety Med #1 - $425/month (extended release)
Depression/Anxiety Med #2 - $70/month (generic)
Mood Stabilizer #3 - $823/month (extended release)
Anxiety Med #4 - $150/month
Grand Total: $1468 each month
Total with Insurance: $150 approximately
Yikes. Even with insurance I am paying out of pocket $150 a month in medications. And that is only for my mental health. I am on a variety of supplements that are necessary post gastric bypass as well. I would average the cost of those at about $65. Double that because Kyle takes the same ones, and add his own cocktail of diabetes, cholesterol and blood pressure meds and we are probably in the ballpark of $500 per month in medications.
How do Americans do it? No wonder people are ordering meds from other countries. And how scary is that to know that no FDA checked your drugstore order before it shipped? A great deal of Americans aren't doing it. They simply can't. Been there, too.
Since the overhaul of the health insurance system started, I have been a believer that before we look at health insurance we need to look at the root of the problem - the outrageous costs for treatment and prescriptions. If I'm having trouble paying for meds with insurance, I can't imagine what families without insurance are going through. Actually, I can. I was without insurance most of my life until I got married. Many people, both those with and those without insurance are going without or adjusting the amount of medication they take so that the prescription lasts longer. Before we can make adequate health insurance coverage, shouldn't we look at what that coverage is paying for to begin with?
A mother shouldn't have to choose between her needed prescription and milk for her kids.
Fortunately, many of the pharmaceutical companies are providing programs for low income families to help them afford prescription medications. This is a great help to many people, myself included when I was in college and couldn't afford my prescriptions and was not covered by insurance.
It's dismaying how reliant we've become on chemicals to change our lives. And don't get me wrong, I am very grateful for the medications that improve my life. But I find it overwhelming to experience the constant changes in medications. Each week there is a brand new medication on the market approved for this, that and the other thing. Watch television for an hour or two and note how many commercials you see for various medications.
As consumers we are often placed on and taken off medications without the proper amount of time passing to even determine what they can do for us. Many providers are handing out samples like candy on Halloween night, because they are pressured by the big companies to write those scripts.
It's all a bit alarming to me. And anyone who has taken medication for depression or mania knows that there is no rhyme or reason to figuring out what works and what doesn't. Unlike many conditions, there is no blood test to determine which meds are right for which patient. It is all trial and error. And it can take up to six to eight weeks for some medications to work to their full potential. So many of us are on this med for six weeks, pulled off it slowly when it isn't working and starting on the next one. The cycle can go on for years while doctor and patient work together to determine the perfect mix.
It's an issue that affects nearly every person in America. Who doesn't need a prescription at some point in the year? Whether it's an antibiotic or treatment for a chronic condition, all of us visit our pharmacy sometime.
I don't know what the answer is, but I know that the current system for cost of prescribed medications just isn't realistic for the average consumer. Everyone deserves to feel his or her best.
Monday, March 22, 2010
Anxiety and Fears...
In addition to the many other wonderful and not so wonderful aspects of my life, I have social anxiety and generalized anxiety disorders. In a nutshell, I am fully of anxiety over anything and everything. Yes, there are medications that help, but the biggest challenge of anxieties is that the best way to "fix" them, or to help myself, is to confront them and do they very thing I don't want to do. It's really better said by Eleanor Roosevelt:
"You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face. You must do the thing which you think you cannot do."
In addition to worrying about real-life concerns, i.e. how to pay the mortgage, how to buy groceries, save for the family reunion and meet out-of-pocket expenses for doctors, I tend to worry about a million what ifs. And generally, what ifs are a huge time and energy waster. Because 99.9% of what ifs never materialize. So I worry for the sake of worrying. What if the plane misses the runway at the nearby airport and instead hits our neighborhood? What if I never get the bill because it got lost in the mail and I don't know it is due and it gets sent to collections because they think I ignored it? What if Kyle gets hit by a truck on the way to work tomorrow? What if Pip gets stolen? What if Kyle lost his job? What if.....What if.... What if... It can seriously lead one to a state of panic. Why do we do this to ourselves?
Everyone worries, and all of us catastrophize at times. But some of us make it a full time job. We act as if the world is going to fall apart unless we stay vigilant and prepare for every single possible event that we might ever face. And that gets to be exhausting!
Sometimes I think people like myself worry because that way we don't have to think about "real" worries. I get so caught up in what-ifs that I lose sight of the issues that are really bothering me. Then the trouble is compounded because not only am I not dealing with the root of the problem, but I'm adding imagined catastrophes to the pile. As Dr. Phil would ask, "How's that working for ya?"
It's not.
I decided today to list my real fears. Not the "wouldn't happen in a million years" fears, but the ones that show up in real life and smack me in the face. The list is pretty short.
1. Spiders
2. Clowns
3. Anything happening to Kyle.
4. Anything happening to Pip.
Essentially, the only real worry I have is spiders. I never see clowns wandering around the neighborhood, (unless it is Halloween and in that case I sit on the bed with the quilt over my head, reading a book by flashlight). Kyle sees his doctors several times a year and his health is maintained to the best ability of all involved. Pip has his shots, has been on antibiotics and is clearly on the path to recovery. Spiders have overrun my house despite my attempts to spray them dead. I have declared war on them, and my next move is to call in my dad who mixes lovely batches of chemicals for Weed and Pest of Platte County. Perhaps he can mix a potion together that might eradicate the spiders from my house.
And get off my back, PETA. I am all for letting creatures live. Except spiders. (And maybe pigs and chickens).
When it comes down to it, obviously I have nothing to worry about. But how to stop??? I am addicted to worry.
What senseless things do you worry about? Leave a comment with your silliest worry.
"You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face. You must do the thing which you think you cannot do."
In addition to worrying about real-life concerns, i.e. how to pay the mortgage, how to buy groceries, save for the family reunion and meet out-of-pocket expenses for doctors, I tend to worry about a million what ifs. And generally, what ifs are a huge time and energy waster. Because 99.9% of what ifs never materialize. So I worry for the sake of worrying. What if the plane misses the runway at the nearby airport and instead hits our neighborhood? What if I never get the bill because it got lost in the mail and I don't know it is due and it gets sent to collections because they think I ignored it? What if Kyle gets hit by a truck on the way to work tomorrow? What if Pip gets stolen? What if Kyle lost his job? What if.....What if.... What if... It can seriously lead one to a state of panic. Why do we do this to ourselves?
Everyone worries, and all of us catastrophize at times. But some of us make it a full time job. We act as if the world is going to fall apart unless we stay vigilant and prepare for every single possible event that we might ever face. And that gets to be exhausting!
Sometimes I think people like myself worry because that way we don't have to think about "real" worries. I get so caught up in what-ifs that I lose sight of the issues that are really bothering me. Then the trouble is compounded because not only am I not dealing with the root of the problem, but I'm adding imagined catastrophes to the pile. As Dr. Phil would ask, "How's that working for ya?"
It's not.
I decided today to list my real fears. Not the "wouldn't happen in a million years" fears, but the ones that show up in real life and smack me in the face. The list is pretty short.
1. Spiders
2. Clowns
3. Anything happening to Kyle.
4. Anything happening to Pip.
Essentially, the only real worry I have is spiders. I never see clowns wandering around the neighborhood, (unless it is Halloween and in that case I sit on the bed with the quilt over my head, reading a book by flashlight). Kyle sees his doctors several times a year and his health is maintained to the best ability of all involved. Pip has his shots, has been on antibiotics and is clearly on the path to recovery. Spiders have overrun my house despite my attempts to spray them dead. I have declared war on them, and my next move is to call in my dad who mixes lovely batches of chemicals for Weed and Pest of Platte County. Perhaps he can mix a potion together that might eradicate the spiders from my house.
And get off my back, PETA. I am all for letting creatures live. Except spiders. (And maybe pigs and chickens).
When it comes down to it, obviously I have nothing to worry about. But how to stop??? I am addicted to worry.
What senseless things do you worry about? Leave a comment with your silliest worry.
Sunday, March 21, 2010
Simple Abundance Exercises...
Ten Things I Love About My Body
This is not an easy exercise for me. I used to think that I hated everything about my body. But that's not true.
1. HAIR - I've always loved the color and texture of my hair. It's blond with a bit of reddish hints. I was born with bright red hair that later fell out and was replaced by almost white blond hair. I've never dyed my hair because I love the color that it is.
2. FEET - I have tiny feet. For a girl that grew up overweight, it's nice to refer to at least one body part as tiny. I can wear super cute shoes, and am a shoe-holic. I can sometimes buy shoes in the kids section.
3. HANDS - I love the way hands can tell a story about a person. Rough hands indicate hard work, soft hands can speak volumes, too. My hands are pretty small, and even smaller post weight loss surgery. My hands are always busy - writing, typing, sewing, crafting, etc.
4. SKIN - I used to dislike my pale skin because tans are so in, but I learned to love my milky white complexion eventually. I would have been in back in the 1800s when so much as a freckle was looked at with dismay. I don't tan, I burn, so I never do get that tan look. And that's okay!
5. SMILE - Since my weight loss surgery I have smile lines on my face that are kind of reminiscent of large dimples. I love this. I'm not sure why, but I think my smile is better since I lost so much weight.
6. EYES - Like our hands, our eyes convey so much about us. My hazel eyes get very pale when I am sick and sparkle when I am happy. My lazy eye is a character trait passed on to me by my dad, and I love it. It allows me to see my genetic link to him.
7. HEIGHT - I'm 4 foot 11 inches tall. Sometimes that stinks, but I've gotten used to it. And I like it.
8. EARS - I love my small, pierced ears. Mostly I love that they allow me to hear beautiful music, nature, and my husband's voice.
9. NOSE - My nail lady tells me I have a cute button nose and that I need to pierce it. Well, I have no plans to pierce any body parts other than my ears, but I do kinda like my nose. It is small and it allows me to smell lilacs.
10. MIND - Is this really a body part? One can't actually zoom in on the mind and what it looks like. But I'm going to cheat and list it here because it is so important to me. I love that my mind allows me to think, learn, create and experience life.
This is not an easy exercise for me. I used to think that I hated everything about my body. But that's not true.
1. HAIR - I've always loved the color and texture of my hair. It's blond with a bit of reddish hints. I was born with bright red hair that later fell out and was replaced by almost white blond hair. I've never dyed my hair because I love the color that it is.
2. FEET - I have tiny feet. For a girl that grew up overweight, it's nice to refer to at least one body part as tiny. I can wear super cute shoes, and am a shoe-holic. I can sometimes buy shoes in the kids section.
3. HANDS - I love the way hands can tell a story about a person. Rough hands indicate hard work, soft hands can speak volumes, too. My hands are pretty small, and even smaller post weight loss surgery. My hands are always busy - writing, typing, sewing, crafting, etc.
4. SKIN - I used to dislike my pale skin because tans are so in, but I learned to love my milky white complexion eventually. I would have been in back in the 1800s when so much as a freckle was looked at with dismay. I don't tan, I burn, so I never do get that tan look. And that's okay!
5. SMILE - Since my weight loss surgery I have smile lines on my face that are kind of reminiscent of large dimples. I love this. I'm not sure why, but I think my smile is better since I lost so much weight.
6. EYES - Like our hands, our eyes convey so much about us. My hazel eyes get very pale when I am sick and sparkle when I am happy. My lazy eye is a character trait passed on to me by my dad, and I love it. It allows me to see my genetic link to him.
7. HEIGHT - I'm 4 foot 11 inches tall. Sometimes that stinks, but I've gotten used to it. And I like it.
8. EARS - I love my small, pierced ears. Mostly I love that they allow me to hear beautiful music, nature, and my husband's voice.
9. NOSE - My nail lady tells me I have a cute button nose and that I need to pierce it. Well, I have no plans to pierce any body parts other than my ears, but I do kinda like my nose. It is small and it allows me to smell lilacs.
10. MIND - Is this really a body part? One can't actually zoom in on the mind and what it looks like. But I'm going to cheat and list it here because it is so important to me. I love that my mind allows me to think, learn, create and experience life.
Wednesday, March 17, 2010
Pieces of Me...
My heart is torn
It aches so much
Each beat makes it throb;
Pieces of it break, and scatter.
I am not whole,
I too am in pieces.
I weep.
I mourn.
What is my destiny?
What purpose have I?
Living each day,
Just to die?
I’m scared to go forward,
I wouldn’t go back.
I tread water, my head just above;
I’m losing myself.
Or am I already lost?
What happened to me,
That bright-eyed girl,
No endeavor or dream too big,
Determined, eager, hopeful?
What happened to me,
All of those goals, those desires?
Enthusiasm has drained,
Hope’s turned to ash.
Even determination has its limits.
Will she return, that bright eyed girl?
And if she does,
What will she look like?
Will her eyes shine again, or are they forever dimmed?
Tuesday, March 16, 2010
Not Another Weight Loss Blog...
Since I've already posted about my weight loss surgery this week, I thought I would stick with the theme and address another angle of gastric bypass surgery - compliance. Let me just say, that the further I get away from surgery, the harder it is to stick to the eating and drinking guidelines. I am breaking some of the rules of post-surgery.
Now, some people (and I won't name any names, in order to protect the guilty) believe that the bypass is the "easy way out" of obesity. Trust me, it's not. The life changes this surgery requires have definitely been a challenge, and at times, an all out major accomplishment. However, it is all very worth it and I would do it again tomorrow if I had to. It's been life altering.
Here are five rules I am breaking:
1. I drink with my meals.
2. I drink carbonated beverages.
3. I still skip breakfast. ( A no-no for anyone, not just bypassers)
4. I eat sugar. (Well, not sugar straight from the canister. But sugary foods).
5. I still love carbs more than my proteins, and I don't always eat my proteins first).
Here are five rules I am following:
1. I eat very slowly and chew, chew, chew my food.
2. I am (fairly) consistent about taking my vitamins and other supplements, along with my monthly B-12 injection that I do myself.
3. I attend support groups.
4. I try to get some decent exercise or at least walking in.
5. I try to fit more proteins into my diet.
Many people who believe the surgery is the easy way out fail to realize that there is more to the weight loss process than merely the surgery. Patients have to follow a pretty structured diet plan for life if they want to reach and maintain goal weight. Because of absorption and related malnutrition issues, patients must take vitamins and supplements for life. Because of the limited amount of digestion, patients must chew their food to mush before they swallow for life. And because of the tendency to wash food down with drinks, the patient cannot drink within 5 minutes before and 30 minutes after for life. Now, these guidelines are of course only that - guidelines. They can be broken, and as earlier stated, I do break the drinking while I eat rule. But they are guidelines for success, and breaking any and all of them can sabotage weight loss and weight maintenance. This surgery guarantees nothing, but it does give me an edge.
Many people have gained back all their weight and more after gastric bypass. Singer Carnie Wilson is most well-known for her gastric bypass weight loss and then regain. Some folks have had lapband surgery and then later gastric bypass surgery. Some people have had a second bypass after stretching their stomach by overeating. (Most good surgeons will not complete a second bypass for this reason because the problems are not solved through the surgery. Other action must be taken). Nothing promises success, but compliance helps. And it is hard! Anyone who says it's easy is either lying or hasn't experienced it.
I can still overeat. I can eat any sugary substance I dare to try, with the exception of my once beloved ice cream. I can eat greasy foods. I can eat pizza. Thankfully, my desire for these foods is minimal, and my stomach's capacity to hold them is also minimal. But the stomach is remarkable in its ability to expand, so another important part of post-bypass eating is to stop eating the instant I feel satiety. Learning to feel satiety can be an experience for patients if they ate for comfort before surgery. Comfort eaters often and usually eat well beyond the point that they are full. They ignore fullness. They don't feel it. Post-bypassers have to learn what satiety is, and learn to listen to their bodies and know when enough is enough.
It's weird, and I don't know if there is a medical explanation for it, but tastes change after surgery. I've experienced this and others in my support group have experienced it. Food doesn't taste as good and I don't crave the sugar the way I used to. Ice cream makes me sick, which is probably a blessing since ice cream used to be a major comfort food. I've never been big on cooking, but it especially seems senseless now to cook a meal because it takes so little to feel full. Eating out isn't much fun because I'm full after eight bites and I am not a fan of leftovers. In all honesty, eating has become a chore, and it isn't at all the pleasure it once was.
This is a good thing, really - because food no longer rules my life. I don't organize my life around my meals and I don't plan my meals in advance merely because I can't wait to taste them. I plan them now for how much protein - how much nutrition - they can give me, which is why we eat in the first place.
Food is a tough addiction, because unlike drugs or alcohol, I can't completely give up food. If I were an alcoholic or drug addict, I would be required to give them up in order to recover. I can't, however, give up food. I can give up certain kinds of food, obviously, but I still have to eat. It's a complicated part of recovery.
I don't drink sugary pop, but I still love my diet Sunkist. The carbonation doesn't kill me the way it does some bypassers, so I can't use pain as an incentive to quit. Studies show that diet pops cause obesity because they trigger sugar cravings, so I have to be aware that, although my pop may be sugar free, it's doing a number on my teeth and potentially sabotaging long term success. I acknowledge this, and it's a risk I take. It's hard to break all of one's habits.
Most insurance companies, mine included, required six months of monitored weight management. This means that once a month for six straight months I went to my surgeon's office, met with a nutritionist, weighed it, and met with a nurse practitioner who instructed me and made notes of any weight related health issues. For most people, this six months can be annoying, agonizing and seem pointless after a lifetime of diets, supplements and exercise programs. I believe that it is key to success. The six months allowed me a gradual progression through the various changes I had to make to my life. Changes that are for my lifetime, not just for the surgery. Going into surgery one day and coming out the next with all these guidelines would have been really overwhelming. Instead, I was able to incorporate a few changes at a time over six months so that my rate of success and my chance of maintaining those changes long term were higher. I'm so glad I had the six months!
So much negative attention is focused on weight loss surgery and the first few weeks and months afterward. And granted, they are hell. But there is so much positive, too! My life is so different now, and so different for the better! Simple things that many people take for granted, I revel in! Here is a list of my milestones, or "wow" moments so far:
*Crossing my legs.
*Clothes shopping in the "normal" person's section.
*Being able to sit in a booth at the restaurant instead of asking for a table.
*Jogging.
*Zip my jeans without performing acts of contortion.
*Wrap my arms around my husband.
*Allow my husband to wrap his arms around me.
* Perfect cholesterol, triglycerides and other bloodwork.
*Wear a swimsuit.
*Walk around a mall, zoo, or other large place without sitting to rest or being winded.
*No more joint pain.
*No more back pain.
*Wear heels.
*Fit in an airplane seat.
*Put on my seatbelt in an airplane.
*Fit in carnival/amusement park rides.
*Had people look at my picture ID and do a double take, ask if it's really me, or ask how come I look so different. (I'm thinking of hanging onto this photo ID for a looong time :)
*Completely replacing my wardrobe.
*Wearing colors I love because I love them, and not not wearing them because they make me look fat.
*Meeting people who haven't seen me in a few years.
*Letting other people take my picture - and not minding who might see it.
And many, many more!
Now, some people (and I won't name any names, in order to protect the guilty) believe that the bypass is the "easy way out" of obesity. Trust me, it's not. The life changes this surgery requires have definitely been a challenge, and at times, an all out major accomplishment. However, it is all very worth it and I would do it again tomorrow if I had to. It's been life altering.
Here are five rules I am breaking:
1. I drink with my meals.
2. I drink carbonated beverages.
3. I still skip breakfast. ( A no-no for anyone, not just bypassers)
4. I eat sugar. (Well, not sugar straight from the canister. But sugary foods).
5. I still love carbs more than my proteins, and I don't always eat my proteins first).
Here are five rules I am following:
1. I eat very slowly and chew, chew, chew my food.
2. I am (fairly) consistent about taking my vitamins and other supplements, along with my monthly B-12 injection that I do myself.
3. I attend support groups.
4. I try to get some decent exercise or at least walking in.
5. I try to fit more proteins into my diet.
Many people who believe the surgery is the easy way out fail to realize that there is more to the weight loss process than merely the surgery. Patients have to follow a pretty structured diet plan for life if they want to reach and maintain goal weight. Because of absorption and related malnutrition issues, patients must take vitamins and supplements for life. Because of the limited amount of digestion, patients must chew their food to mush before they swallow for life. And because of the tendency to wash food down with drinks, the patient cannot drink within 5 minutes before and 30 minutes after for life. Now, these guidelines are of course only that - guidelines. They can be broken, and as earlier stated, I do break the drinking while I eat rule. But they are guidelines for success, and breaking any and all of them can sabotage weight loss and weight maintenance. This surgery guarantees nothing, but it does give me an edge.
Many people have gained back all their weight and more after gastric bypass. Singer Carnie Wilson is most well-known for her gastric bypass weight loss and then regain. Some folks have had lapband surgery and then later gastric bypass surgery. Some people have had a second bypass after stretching their stomach by overeating. (Most good surgeons will not complete a second bypass for this reason because the problems are not solved through the surgery. Other action must be taken). Nothing promises success, but compliance helps. And it is hard! Anyone who says it's easy is either lying or hasn't experienced it.
I can still overeat. I can eat any sugary substance I dare to try, with the exception of my once beloved ice cream. I can eat greasy foods. I can eat pizza. Thankfully, my desire for these foods is minimal, and my stomach's capacity to hold them is also minimal. But the stomach is remarkable in its ability to expand, so another important part of post-bypass eating is to stop eating the instant I feel satiety. Learning to feel satiety can be an experience for patients if they ate for comfort before surgery. Comfort eaters often and usually eat well beyond the point that they are full. They ignore fullness. They don't feel it. Post-bypassers have to learn what satiety is, and learn to listen to their bodies and know when enough is enough.
It's weird, and I don't know if there is a medical explanation for it, but tastes change after surgery. I've experienced this and others in my support group have experienced it. Food doesn't taste as good and I don't crave the sugar the way I used to. Ice cream makes me sick, which is probably a blessing since ice cream used to be a major comfort food. I've never been big on cooking, but it especially seems senseless now to cook a meal because it takes so little to feel full. Eating out isn't much fun because I'm full after eight bites and I am not a fan of leftovers. In all honesty, eating has become a chore, and it isn't at all the pleasure it once was.
This is a good thing, really - because food no longer rules my life. I don't organize my life around my meals and I don't plan my meals in advance merely because I can't wait to taste them. I plan them now for how much protein - how much nutrition - they can give me, which is why we eat in the first place.
Food is a tough addiction, because unlike drugs or alcohol, I can't completely give up food. If I were an alcoholic or drug addict, I would be required to give them up in order to recover. I can't, however, give up food. I can give up certain kinds of food, obviously, but I still have to eat. It's a complicated part of recovery.
I don't drink sugary pop, but I still love my diet Sunkist. The carbonation doesn't kill me the way it does some bypassers, so I can't use pain as an incentive to quit. Studies show that diet pops cause obesity because they trigger sugar cravings, so I have to be aware that, although my pop may be sugar free, it's doing a number on my teeth and potentially sabotaging long term success. I acknowledge this, and it's a risk I take. It's hard to break all of one's habits.
Most insurance companies, mine included, required six months of monitored weight management. This means that once a month for six straight months I went to my surgeon's office, met with a nutritionist, weighed it, and met with a nurse practitioner who instructed me and made notes of any weight related health issues. For most people, this six months can be annoying, agonizing and seem pointless after a lifetime of diets, supplements and exercise programs. I believe that it is key to success. The six months allowed me a gradual progression through the various changes I had to make to my life. Changes that are for my lifetime, not just for the surgery. Going into surgery one day and coming out the next with all these guidelines would have been really overwhelming. Instead, I was able to incorporate a few changes at a time over six months so that my rate of success and my chance of maintaining those changes long term were higher. I'm so glad I had the six months!
So much negative attention is focused on weight loss surgery and the first few weeks and months afterward. And granted, they are hell. But there is so much positive, too! My life is so different now, and so different for the better! Simple things that many people take for granted, I revel in! Here is a list of my milestones, or "wow" moments so far:
*Crossing my legs.
*Clothes shopping in the "normal" person's section.
*Being able to sit in a booth at the restaurant instead of asking for a table.
*Jogging.
*Zip my jeans without performing acts of contortion.
*Wrap my arms around my husband.
*Allow my husband to wrap his arms around me.
* Perfect cholesterol, triglycerides and other bloodwork.
*Wear a swimsuit.
*Walk around a mall, zoo, or other large place without sitting to rest or being winded.
*No more joint pain.
*No more back pain.
*Wear heels.
*Fit in an airplane seat.
*Put on my seatbelt in an airplane.
*Fit in carnival/amusement park rides.
*Had people look at my picture ID and do a double take, ask if it's really me, or ask how come I look so different. (I'm thinking of hanging onto this photo ID for a looong time :)
*Completely replacing my wardrobe.
*Wearing colors I love because I love them, and not not wearing them because they make me look fat.
*Meeting people who haven't seen me in a few years.
*Letting other people take my picture - and not minding who might see it.
And many, many more!
Monday, March 15, 2010
Addiction Transfer - Or, What Happens When You Have Gastric Bypass Surgery And You Can't Eat for Comfort?
Every two weeks when I go to Weight Loss Support Group, I have one piece of advice for those who are about to undergo gastric bypass surgery: Deal with your need to eat for comfort, because you will replace your food addiction with another addiction when you can no longer eat for emotional reasons. This is one area associated with the surgery that isn't stressed enough when patients prepare for their new journey post bypass.
Gastric bypass is an amazing opportunity to begin life anew. It really is a rebirth for many people, myself included. I have been overweight since around the time I hit puberty at age 11. Until then I was thin, athletic, and "normal". I won first place in the high jump, first place in the hurdles, and played volleyball with passion in fifth grade. By sixth grade I was packing on the pounds already, and although I still played volleyball, comments from my peers and my own self-consciousness made it miserable instead of enjoyable. I fell in the hurdles that year, and was so embarrassed. I didn't participate in sports after that and I dreaded PE. Not because it was exercise, but because I was so "fat". I was sure everyone saw me as a lazy pig.
Around that same time, I was experiencing a great deal emotionally. Of course there are all the hormones that hit at puberty, but on top of that a lot was going on in my family at the time, and it became easy to fill some emotional voids with food. We lived in the country, far from school and friends. I would come home from school, grab a package of crackers and a cup of Kool-aid or an RC cola and retreat to my bedroom to read until dinner. I often read at the dinner table, then back to my room to do homework or read some more. It got to be a habit that I would want to eat while I read. And I read a lot. It was the perfect combination of comforts - a full mind and a full stomach. My nutrition was horrible. I didn't have the first clue about eating healthy and living on a ranch meant that dinner was usually beef or pork and some kind of potatoes. I hated vegetables (still do!) and craved carbs (still do!).
If I remember correctly, I was around a size 12 jean in seventh grade. And I'm 4 foot 11 inches tall now, so I am sure I was a little shorter then. I knew I was overweight, but I had a handful of friends who didn't treat me differently. However, halfway through my seventh grade year, we moved, and I had to go to a tiny rural school. I went from a junior high of probably 1000 to a class of ten. And not only was I biggest in my class, I was the most overweight female in school. It was excruciating. Food continued to be a comfort, even though it seems odd that when I dreaded my weight and gaining any more, I continued to feed the problem - no pun intended. Due to more moves and emotional ups and downs in high school, I just kept getting bigger.
I denied the severity of my habit for years, and I was embarrassed about it. I never even considered it could be an addiction. I dreaded eating in front of people. I imagined horrible things that people must be saying behind my back. And I tied my self worth and worth as a human into my weight. Because I was so harsh on myself about my weight, I was harsh on myself about everything else. The way I treated myself was far worse than the way anyone else treated me. In fact, rarely was I blatantly mistreated because of my weight. More often than not, I was merely excluded from the activities and experiences of other girls my age. And that was almost worse than someone just out and out saying something derogatory.
I'm certain I have probably had some level of depression since somewhere around age 10. I have also had an eating problem since around the same time. So, at age 27, when I finally had the gastric bypass, I had been eating for comfort for 17 years. Not an easy habit to break. No, not an easy addiction to break.
When one prepares for gastric bypass surgery, any good surgeon requires a psychological evaluation. This evaluation is for several reasons. Most importantly, the surgeon wants to know that the patient has realistic expectations about what this surgery will do for her. It is not going to immediately change her life. It is not going to take away her need to self medicate. It is not going to make her worthy, acceptable, or change any of the ways she thinks of herself in and of itself. It is not a miracle surgery. Another reason the evaluation is required is to pinpoint areas that may need work before and after the surgery in order for the patient to succeed, because there are many ways to sabotage the surgery. It is not a quick fix nor is it an easy way out, so the patient has to realize there is much work involved in order to maximize weight loss.
I knew going into surgery that my love for chocolate, bread, and all those "filling" foods like pasta was coming to an end. Those first few weeks after surgery can be really depressing for anyone, regardless of whether they struggled with depression before. For about four weeks I was on a liquid died, gradually changing from clear to pureed. It is miserable! I longed to bite something, but everything was sipped, and carefully swallowed. That new tiny stomach needs time to heal. Now, the plus side is, you see the pounds melt off dramatically right away, so there is a payoff. But it is still incredibly hard and I got incredibly cranky. Poor Kyle. I have joked that if a marriage can make it through this surgery and the few months after it, the marriage will make it through anything!
I am about 15 months out from surgery, and I can eat just about anything I want in moderation. Nothing makes me sick except ice cream. Some people experience dumping syndrome and can't eat anything sweet. Other people become lactose intolerant. Others can eat bread or pasta because it seems to swell in their tiny stomach. Pop is forbidden because the carbonation is thought to maybe enlarge the pouch over time, allowing for more food to go in and obviously more calories. Most people find carbonated beverages uncomfortable at the very least. None of these potential effects have been true for me. Which sounds good, but really makes it harder to be "good" about my eating habits. I tend to slip back into bad habits and losing these last 28 pounds to goal has been DIFFICULT. However, despite my being technically able to eat anything, almost nothing tastes good. It certainly doesn't taste like it used to. I didn't like chocolate for about a year after surgery. Some foods taste better again, but the vast majority of food holds no appeal for me anymore. This is good for me, but hard, too, because I have lost a major aspect of my life that was once emotionally filling.
Last August I was under a lot of stress, trying to determine whether to return to work, and just experiencing many emotions. And because I am still learning how to appropriately deal with emotions, and because I couldn't eat to fill that void of uncertainty anymore, I found another release: shopping.
Without realizing it in the beginning, I started to go shopping when I felt down or stressed. It began with clothes, which was actually okay at first because I essentially had to replace my entire wardrobe. I've lost over 100 pounds and am literally wearing clothes that are half the size (or smaller) than some of my pre-surgery clothes. Better yet, shopping for clothes is finally FUN! I could find cute tops and skirts in my sizes and in a much wider selection than when I was confined to a tiny corner of the store labeled "Plus" or "Womens'" sizes. But my spending didn't stop at clothes. I bought excessive amounts of certain items. Journals, books, and pens. I would argue one can never have enough journals and books, but apparently there is a healthy limit. I bought little objects for around the house, or gifts for friends or family. I was done with Christmas shopping by September.
At times I balanced the checkbook, saw how much I had spent, but couldn't really account for where the money had gone. This is when I began to realize that one addiction had been replaced with another. I had, and have, a compulsion to spend. I get an adrenaline rush from spending that I used to get from eating. I lived on virtually no money for most of my life - especially in college. I was so good at getting by on nothing. So I couldn't quite grasp why I suddenly had to be shopping all the time. I still struggle with the concept of addiction and willpower. Logically, I know that our addictions can be bigger than we are, but that critical part of myself wonders why I can't just get over it. Just stop going to the store. Just STOP. It scares me. I don't like to feel out of control about anything, especially money and finances. And I am out of control in this respect.
I address it in therapy, and my medications for bipolar and depression address it. But like any addiction it is a day to day struggle. I can't properly explain it, because it doesn't make sense to me. I don't understand completely how compulsion works. But I do see how it is possible to go from one addiction to another. I made it a point to talk to other bypass patients about this because it is a really distressing issue for me, and it is not one often addressed. It is also something that isn't an immediate affect of the surgery. For me, I was a good eight or nine months out from surgery before I saw the problem. I wish I had dealt more with my need to self-medicate in those eight months before the need to spend became so great. This is why I feel like it essential to warn people before they go under the knife. The minute recovery begins for the physical self, recovery must begin for the emotional and mental self.
Regardless of the many challenges I have faced post surgery, I still couldn't be happier with the decision to undergo surgery. It has been life changing in many ways, not in and of itself, but because of my own ability to try to make the most of it. I try to focus on the successes I am having and not rehash my, as I see them, weaknesses. Because I try to remember that I am a sum of my strengths. And gosh. It feels good to be thinner!
Gastric bypass is an amazing opportunity to begin life anew. It really is a rebirth for many people, myself included. I have been overweight since around the time I hit puberty at age 11. Until then I was thin, athletic, and "normal". I won first place in the high jump, first place in the hurdles, and played volleyball with passion in fifth grade. By sixth grade I was packing on the pounds already, and although I still played volleyball, comments from my peers and my own self-consciousness made it miserable instead of enjoyable. I fell in the hurdles that year, and was so embarrassed. I didn't participate in sports after that and I dreaded PE. Not because it was exercise, but because I was so "fat". I was sure everyone saw me as a lazy pig.
Around that same time, I was experiencing a great deal emotionally. Of course there are all the hormones that hit at puberty, but on top of that a lot was going on in my family at the time, and it became easy to fill some emotional voids with food. We lived in the country, far from school and friends. I would come home from school, grab a package of crackers and a cup of Kool-aid or an RC cola and retreat to my bedroom to read until dinner. I often read at the dinner table, then back to my room to do homework or read some more. It got to be a habit that I would want to eat while I read. And I read a lot. It was the perfect combination of comforts - a full mind and a full stomach. My nutrition was horrible. I didn't have the first clue about eating healthy and living on a ranch meant that dinner was usually beef or pork and some kind of potatoes. I hated vegetables (still do!) and craved carbs (still do!).
If I remember correctly, I was around a size 12 jean in seventh grade. And I'm 4 foot 11 inches tall now, so I am sure I was a little shorter then. I knew I was overweight, but I had a handful of friends who didn't treat me differently. However, halfway through my seventh grade year, we moved, and I had to go to a tiny rural school. I went from a junior high of probably 1000 to a class of ten. And not only was I biggest in my class, I was the most overweight female in school. It was excruciating. Food continued to be a comfort, even though it seems odd that when I dreaded my weight and gaining any more, I continued to feed the problem - no pun intended. Due to more moves and emotional ups and downs in high school, I just kept getting bigger.
I denied the severity of my habit for years, and I was embarrassed about it. I never even considered it could be an addiction. I dreaded eating in front of people. I imagined horrible things that people must be saying behind my back. And I tied my self worth and worth as a human into my weight. Because I was so harsh on myself about my weight, I was harsh on myself about everything else. The way I treated myself was far worse than the way anyone else treated me. In fact, rarely was I blatantly mistreated because of my weight. More often than not, I was merely excluded from the activities and experiences of other girls my age. And that was almost worse than someone just out and out saying something derogatory.
I'm certain I have probably had some level of depression since somewhere around age 10. I have also had an eating problem since around the same time. So, at age 27, when I finally had the gastric bypass, I had been eating for comfort for 17 years. Not an easy habit to break. No, not an easy addiction to break.
When one prepares for gastric bypass surgery, any good surgeon requires a psychological evaluation. This evaluation is for several reasons. Most importantly, the surgeon wants to know that the patient has realistic expectations about what this surgery will do for her. It is not going to immediately change her life. It is not going to take away her need to self medicate. It is not going to make her worthy, acceptable, or change any of the ways she thinks of herself in and of itself. It is not a miracle surgery. Another reason the evaluation is required is to pinpoint areas that may need work before and after the surgery in order for the patient to succeed, because there are many ways to sabotage the surgery. It is not a quick fix nor is it an easy way out, so the patient has to realize there is much work involved in order to maximize weight loss.
I knew going into surgery that my love for chocolate, bread, and all those "filling" foods like pasta was coming to an end. Those first few weeks after surgery can be really depressing for anyone, regardless of whether they struggled with depression before. For about four weeks I was on a liquid died, gradually changing from clear to pureed. It is miserable! I longed to bite something, but everything was sipped, and carefully swallowed. That new tiny stomach needs time to heal. Now, the plus side is, you see the pounds melt off dramatically right away, so there is a payoff. But it is still incredibly hard and I got incredibly cranky. Poor Kyle. I have joked that if a marriage can make it through this surgery and the few months after it, the marriage will make it through anything!
I am about 15 months out from surgery, and I can eat just about anything I want in moderation. Nothing makes me sick except ice cream. Some people experience dumping syndrome and can't eat anything sweet. Other people become lactose intolerant. Others can eat bread or pasta because it seems to swell in their tiny stomach. Pop is forbidden because the carbonation is thought to maybe enlarge the pouch over time, allowing for more food to go in and obviously more calories. Most people find carbonated beverages uncomfortable at the very least. None of these potential effects have been true for me. Which sounds good, but really makes it harder to be "good" about my eating habits. I tend to slip back into bad habits and losing these last 28 pounds to goal has been DIFFICULT. However, despite my being technically able to eat anything, almost nothing tastes good. It certainly doesn't taste like it used to. I didn't like chocolate for about a year after surgery. Some foods taste better again, but the vast majority of food holds no appeal for me anymore. This is good for me, but hard, too, because I have lost a major aspect of my life that was once emotionally filling.
Last August I was under a lot of stress, trying to determine whether to return to work, and just experiencing many emotions. And because I am still learning how to appropriately deal with emotions, and because I couldn't eat to fill that void of uncertainty anymore, I found another release: shopping.
Without realizing it in the beginning, I started to go shopping when I felt down or stressed. It began with clothes, which was actually okay at first because I essentially had to replace my entire wardrobe. I've lost over 100 pounds and am literally wearing clothes that are half the size (or smaller) than some of my pre-surgery clothes. Better yet, shopping for clothes is finally FUN! I could find cute tops and skirts in my sizes and in a much wider selection than when I was confined to a tiny corner of the store labeled "Plus" or "Womens'" sizes. But my spending didn't stop at clothes. I bought excessive amounts of certain items. Journals, books, and pens. I would argue one can never have enough journals and books, but apparently there is a healthy limit. I bought little objects for around the house, or gifts for friends or family. I was done with Christmas shopping by September.
At times I balanced the checkbook, saw how much I had spent, but couldn't really account for where the money had gone. This is when I began to realize that one addiction had been replaced with another. I had, and have, a compulsion to spend. I get an adrenaline rush from spending that I used to get from eating. I lived on virtually no money for most of my life - especially in college. I was so good at getting by on nothing. So I couldn't quite grasp why I suddenly had to be shopping all the time. I still struggle with the concept of addiction and willpower. Logically, I know that our addictions can be bigger than we are, but that critical part of myself wonders why I can't just get over it. Just stop going to the store. Just STOP. It scares me. I don't like to feel out of control about anything, especially money and finances. And I am out of control in this respect.
I address it in therapy, and my medications for bipolar and depression address it. But like any addiction it is a day to day struggle. I can't properly explain it, because it doesn't make sense to me. I don't understand completely how compulsion works. But I do see how it is possible to go from one addiction to another. I made it a point to talk to other bypass patients about this because it is a really distressing issue for me, and it is not one often addressed. It is also something that isn't an immediate affect of the surgery. For me, I was a good eight or nine months out from surgery before I saw the problem. I wish I had dealt more with my need to self-medicate in those eight months before the need to spend became so great. This is why I feel like it essential to warn people before they go under the knife. The minute recovery begins for the physical self, recovery must begin for the emotional and mental self.
Regardless of the many challenges I have faced post surgery, I still couldn't be happier with the decision to undergo surgery. It has been life changing in many ways, not in and of itself, but because of my own ability to try to make the most of it. I try to focus on the successes I am having and not rehash my, as I see them, weaknesses. Because I try to remember that I am a sum of my strengths. And gosh. It feels good to be thinner!
Friday, March 12, 2010
A Controversial Treatment: Electroconvulsive Therapy
If you've seen many movies about mental health conditions or about people with mental health conditions, you've probably seen the administration of Electroconvulsive Therapy, or ECT. It's generally pretty terrifying to watch - and nothing at all like ECT treatment really is today. ECT has been depicted in Hollywood since the 1940s - almost as long as the treatment has been around. When we think about ECT, most of us picture people being tied down or wearing a straight-jacket with anything from a sock to a stick placed in the mouth between the teeth. Animal sounds, screams or grunts are vocalized while electrical currents are sent through the patient. The scenes that will be forever in my mind are that of John Nash's treatment in A Beautiful Mind, and the ECT scenes from One Flew Over the Cuckoo's Nest.
But how realistic are these depictions? Like everything in Hollywood, ECT has been given very little accurate reflection and a whole lot of dramatization. Yet, it remains a controversial treatment that continues to receive both rave reviews and unfavorable warnings. So what is it, anyways? And who decides who gets it? My explanation today of ECT applies to ECT as it is administered today. Although applications of ECT have been barbaric in history, today's use of it is far more humane.
ECT is used for the treatment of antisocial behavior, depression and manic depression when other treatments have failed. Informed consent is gathered before its use. Proper channels for receiving authorization in those cases where the patient is unresponsive for any number of reasons vary state to state.
Although most movies depict the patient (victim?) thrashing and terrified, anesthesia has been used since the 1950s, along with muscle relaxants and sometimes a medicine to reduce salivation. Two electrodes are used, and they are either placed both on one side (unilaterally) or one on each side (bilaterally) of the head. Unilateral use can sometimes minimize side effects, so that is usually tried first, but generally bilateral use is what is required to see some positive results.
The ECT machine then delivers a brief electric pulse, usually one and a half times the power of a seizure, which is different for each patient and generally a trial and error type assessment based on sex, age and weight. The ECT shock induces a seizure and the patient convulses for at least 15 seconds. The patient generally has a series of these treatments over a sustained period of time. It varies by patient, doctor, etc.
So how effective is ECT? According to the 1999 Surgeon General's report, it was believed that ECT had a 60 to 70 percent rate of remission, but most of those patients later relapse, usually at around 6 months unless other treatments are used in conjunction with ECT.
What are some of the adverse effects of ECT? The biggest concerns seem to be confusion and memory loss, though the degree is varied. Some people complain of minor muscle aches. Memory issues is the main concern for both providers and patients. Memory loss can be memories from before the treatment, or it can affect memory after treatment. Sometimes it reaches back years, sometimes only months. Some studies have shown that these memories are recovered within 7 months post-treatment. Other studies have shown that up to 50% of patients never recover some or all of the lost memories. Brain structure has been studied to determine the effect of ECT on brain tissue, but no determinative results have been found.
How do people chose whether to have ECT? It's a huge decision for anybody. Lots of pros and cons must be considered. The surgeon general's statement is this: patients should be warned that the benefits of ECT are short-lived without active continuation treatment in the form of drugs or further ECT, and that there may be some risk of permanent, severe memory loss after ECT. However, many situations exist where ECT is a last resort for better health after many, many other approaches have failed. By the time one gets to ECT, a variety of medications, different types of psychotherapy, and countless alternative treatments have been tried at one point or another. ECT can truly be the last hope for a patient when everything else has failed.
The memory loss issues alone are enough for me to decide that I will never participate in ECT, but that is my own personal decision based on other input as well. Recently, at a mental health conference, I met a woman, Linda Andre, who held a PhD and had been an ECT patient. Due to ECT treatment that she did not give consent to receive, she lost all memory of her education, her marriage, and many other life details. Think for a moment about that. Imagine you hold a PhD, but have no recollection of the eight or more years of education you required to earn it. Imagine you have a loving husband whom you don't know nor remember anything about. You don't remember graduating, getting married, or even getting treatment. Who are we without our memories? The sum of our existence is our memories. I can't imagine that all being wiped away.
For some people, little memory loss has resulted and their conditions have improved dramatically and they advocate for continued use of ECT and reduction of the stigma surrounding it. While I don't agree with ECT for myself, I certainly agree that depictions of ECT in movies and other entertainment would better serve us if it more accurately depicted ECT.
What about people who can't give their informed consent? Can someone else consent for them? Most states in the US require a judicial order following a formal hearing before patients involuntarily undergo ECT. I have filled out a psychiatric advanced directive which clearly indicates that under no circumstances do I consent to ECT. General advanced directives are commonplace - they tell your doctor and/or family whether to keep you alive by artificial means, etc. Psychiatric advanced directives do the same, only in regards to your mental health instead of physical health. However, they are not always recognized, depending on state laws, etc., and some states allow your spouse or others to override your personal decisions under certain conditions. Because of this, I have discussed my wishes with my providers and Kyle so that everyone is on the same page regarding my treatment if a situation arises in which I am not able to participate. This is the best approach to any condition, whether physical or mental. Make sure your spouse and your providers know what you want!
Many sources exist on both sides of this issue. I'm just combining what little bit I know here: obviously there are much better authorities on the issue! Linda Andre, who I mentioned earlier, has a book entitled "Doctors of Deception: What They Don't Want You to Know about Shock Treatments". It is a real eye-opener, and very well written. She autographed a copy for me when I met her in October, and let me tell you, I admire her passion on this issue!
Here are a few well-known people who have received ECT and whose stories might provide you further enlightenment on the issue:
Kitty Dukakis - wife of Michael Dukakis
Dick Cavett
Carrie Fisher
Judy Garland
Ernest Hemingway
Marya Hornbacher
Vivien Leigh
Michael Moriarty
Robert M. Persig
Sylvia Plathe
Bud Powell
Yves Saint-Laurent
David Foster Wallace
Monday, March 8, 2010
Depression and Bipolar Support Alliance National Convention
The Depression and Bipolar Support Alliance (DBSA) is a patient directed national organization focusing on the most prevalent mental health disorders. It promotes awareness of the impact and management of these mental health issues. I have long relied on their website for information and awareness about depression and bipolar disorder.
I was excited to learn this week of their national convention next month in Illinois. I applied for a scholarship to this convention, as I believe the key note speakers and breakout sessions would be perfect for me as far as where I am at personally and professionally and how my bipolar disorder affects those aspects of my life - all aspects of my life.
I have looked for a local chapter of DBSA but I haven't found much satisfying information about it. One of the opportunities I would like to take away from the convention is information necessary to start my own chapter. Wyoming has a major shortage of available mental healthcare and support. The waiting list in Cheyenne for Peak Wellness, the only facility that charges based on income, is often upwards of nine months. This is outrageous! By starting my own chapter of DBSA, my hope would be to provide some peer support for individuals in-between treatment, just starting treatment, or uncertain about whether to seek treatment.
I am over the moon excited about the speakers at this conference. Let me tell you a little about them, even though they are pretty well-known.
Kay Redfield Jamison, PhD: I believe I referenced her in one of my recent posts. She is a researcher, author, and most importantly, a consumer of mental health services. I have read several of her books, and especially found benefit in An Unquiet Mind: A Memoir of Moods and Madness. Two other books, Exuberance and Touched with Fire: Manic Depressive Illness and the Artistic Temperament, the second of which addresses the creativity/mental health connection I discussed last week. I admire her greatly, believe she is one of the finest minds in the mental healthcare field, and it would be a dream come true to see her speak.
Jessie Close: The sister of actress Glenn Close, who has a book coming out soon abut the history of her own mental illness as well as that of the family. She has worked with Bring Change 2 Mind, an organization that is devoted to minimizing the stigma of depression.
Marya Hornbacher: Wrote Madness: A Bipolar Life and Wasted: A Memoir of Anorexia and Bulimia. She is an amazing woman who has been to the brink of hell and back. She experienced bipolar disorder as a child, which I can't even begin to imagine, since treatment was in its early stages at the time. This survivor inspires me, because it's hard to feel sorry for myself when I see how truly remarkable she is, and how much worse things can really get. Her story makes me grateful for how insignificant most of my problems really are.
Not only are the speakers exciting, but the line-up of breakout sessions appear to have been designed with my specific needs in mind! Among many sessions, these are the ones I would like to attend:
Reentering the Workforce - Tips for those whose careers were interrupted by mental illness.
Acting on Impulse - Addressses the causes and consequences of impulsivity during mania.
Rediscovering Your Passions - Reconnect with the joy in life, reflecting on what makes you you.
Creativity and Healing - demonstrates how healing art therapy can be in fight of mood disorder.
Women & Mood Disorders - Addresses issues specific to women dealing with mental disorders.
Start a DBSA Support Group Workshop
So, I'm really keeping my fingers crossed about this scholarship, and in the meantime thinking I might start selling some of my handmade cards to raise some of the money so that the scholarship could go to another deserving person.
If you are interested in knowing more about the Depression and Bipolar Support Alliance, check out their website at http://www.dbsalliance.org.
Friday, March 5, 2010
Finding Purpose...
Like most people, I am continuously undergoing a process of self-discovery. I am at a critical juncture in my life and therefore making decisions that are the foundation for my triumph over bipolar disorder, my well-being, and my general happiness and success.
One of the biggest questions I am contending with right now is, "What is my purpose?" Everyone confronts this question at some point in his or her life, and sometimes the answers are apparent, while at other times we have to devote a little more time and reflection to divine the answers. It is a question that deserves and necessitates thoughtful reflection.
At many points in my life, I believed I knew the answer to the purpose question. For most of my life, I thought I would be a teacher. How I admired my teachers over the years, and how I reaped great benefits from my relationships with them! I put them on pedestals and worshiped the ground they walked on. And still do! I, too, wanted to teach so that I could be as amazing as them, and also because they had played an important role in my life and I wanted to provide that same gift to others. I also loved the engagement in academics. It filled an important void in my life and left me thirsty for more knowledge.
Near the end of my undergraduate studies, depression, along with my many anxieties convinced me to abandon my teacher education program and complete my degree in Literature. Bottom line, I was dreading student teaching. My perfectionist mindset made the idea of student teaching under the thumb of an experienced teacher excruciating. I was so afraid that I would not do a good job, and I was struggling to be around people and make it to classes. It was not the right time to undertake such a stressful endeavor.
I finished school, married, and moved back to Wyoming. I quickly discovered that there is not a great deal to do with a literature degree here unless one has a teaching endorsement. So I found a program that would allow me to work in the public high schools while finishing the requirements for secondary certification. Better financial stability, a sort of remission of many of my depression symptoms, and a bypass of student teaching that the program offered encouraged me to get back on track with the dream of teaching that I had always had. Towards the end of my program I landed a teaching position for half a year, and I was so excited. I seemed to be doing all right.
Unfortunately, my vision of what it is to teach today was a little too much "Little House on the Prairie" and not enough "Dangerous Minds". I had a quaint vision of standing in front of eager pupils raising their hands in anticipation of answering my questions. My vision didn't entail arguments with students about homework, parents who didn't care, inept administration and absurd laws that regulated my every move in the classroom. And it certainly didn't entail the level of intimidation that some students would demonstrate. I had panic attacks in the morning before school, and I was awake late into the night, dreading facing that sea of faces the next day, dreading the conflict that was a constant part of teaching. Sundays were my own hell.
While I have had many positive moments working in education over the past four years, I have quickly come to realize that the education system, at least the way it is here and now, is not the right fit for me. My values don't align whatsoever with those of the schools I've been in and the administrators I've worked with or observed. It took me a long time to realize that as the crux of my dismay over teaching, but I finally realized that it's impossible for me to work in a place that constantly strikes to dismantle the core of my beliefs and understanding of what education is and should be. Every day was a battle; against myself, against administration, against parents, and against the students. It was just too much.
The journey of finding purpose requires me to delve deep inside and determine what sort of life will fulfill me. What sort of life will allow me to sink into my pillow at the end of the day, content that I have made a little mark on the world and, hopefully, an important one. Depression sometimes robs me of a sense of fulfillment, and I really struggle with that currently. Nothing feels important, and nothing feels interesting. Many days I have a sense of detachment and numbness. It is very hard to try to "feel out" my life's purpose when I often feel passionless. I was once very passionate about becoming a teacher, and for a long time that passion flowed in many aspects of my life. I set high standards for myself and others, achieved many of my goals and overcame some tough obstacles. But somewhere along the line, the flame burned out.
I have to find a way to reignite the passion. Without passion, purpose lies hidden. Purpose remains dormant, waiting for me to excavate through the layers of my heart and soul, until I uncover the spark that will light a fuse. Somehow I lost myself in the last ten years. Somehow I went from being a young girl who was full of hope and expectations and energy to a young woman burned out, dismayed and disappointed. My current job is to find a way to inspire myself; to motivate and enlighten myself with hope and encouragement. For without purpose, life is very bleak.
One of the biggest questions I am contending with right now is, "What is my purpose?" Everyone confronts this question at some point in his or her life, and sometimes the answers are apparent, while at other times we have to devote a little more time and reflection to divine the answers. It is a question that deserves and necessitates thoughtful reflection.
At many points in my life, I believed I knew the answer to the purpose question. For most of my life, I thought I would be a teacher. How I admired my teachers over the years, and how I reaped great benefits from my relationships with them! I put them on pedestals and worshiped the ground they walked on. And still do! I, too, wanted to teach so that I could be as amazing as them, and also because they had played an important role in my life and I wanted to provide that same gift to others. I also loved the engagement in academics. It filled an important void in my life and left me thirsty for more knowledge.
Near the end of my undergraduate studies, depression, along with my many anxieties convinced me to abandon my teacher education program and complete my degree in Literature. Bottom line, I was dreading student teaching. My perfectionist mindset made the idea of student teaching under the thumb of an experienced teacher excruciating. I was so afraid that I would not do a good job, and I was struggling to be around people and make it to classes. It was not the right time to undertake such a stressful endeavor.
I finished school, married, and moved back to Wyoming. I quickly discovered that there is not a great deal to do with a literature degree here unless one has a teaching endorsement. So I found a program that would allow me to work in the public high schools while finishing the requirements for secondary certification. Better financial stability, a sort of remission of many of my depression symptoms, and a bypass of student teaching that the program offered encouraged me to get back on track with the dream of teaching that I had always had. Towards the end of my program I landed a teaching position for half a year, and I was so excited. I seemed to be doing all right.
Unfortunately, my vision of what it is to teach today was a little too much "Little House on the Prairie" and not enough "Dangerous Minds". I had a quaint vision of standing in front of eager pupils raising their hands in anticipation of answering my questions. My vision didn't entail arguments with students about homework, parents who didn't care, inept administration and absurd laws that regulated my every move in the classroom. And it certainly didn't entail the level of intimidation that some students would demonstrate. I had panic attacks in the morning before school, and I was awake late into the night, dreading facing that sea of faces the next day, dreading the conflict that was a constant part of teaching. Sundays were my own hell.
While I have had many positive moments working in education over the past four years, I have quickly come to realize that the education system, at least the way it is here and now, is not the right fit for me. My values don't align whatsoever with those of the schools I've been in and the administrators I've worked with or observed. It took me a long time to realize that as the crux of my dismay over teaching, but I finally realized that it's impossible for me to work in a place that constantly strikes to dismantle the core of my beliefs and understanding of what education is and should be. Every day was a battle; against myself, against administration, against parents, and against the students. It was just too much.
The journey of finding purpose requires me to delve deep inside and determine what sort of life will fulfill me. What sort of life will allow me to sink into my pillow at the end of the day, content that I have made a little mark on the world and, hopefully, an important one. Depression sometimes robs me of a sense of fulfillment, and I really struggle with that currently. Nothing feels important, and nothing feels interesting. Many days I have a sense of detachment and numbness. It is very hard to try to "feel out" my life's purpose when I often feel passionless. I was once very passionate about becoming a teacher, and for a long time that passion flowed in many aspects of my life. I set high standards for myself and others, achieved many of my goals and overcame some tough obstacles. But somewhere along the line, the flame burned out.
I have to find a way to reignite the passion. Without passion, purpose lies hidden. Purpose remains dormant, waiting for me to excavate through the layers of my heart and soul, until I uncover the spark that will light a fuse. Somehow I lost myself in the last ten years. Somehow I went from being a young girl who was full of hope and expectations and energy to a young woman burned out, dismayed and disappointed. My current job is to find a way to inspire myself; to motivate and enlighten myself with hope and encouragement. For without purpose, life is very bleak.
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