Canberra Day Two

12th September, 2016

Whatever else happened today, the photo of the day HAD to be of the weather! A fresh morning of 7 degrees with blue skies and gorgeous sunshine. The temperature climbing gradually to 17 degrees! Ahhh! I just loved being outside today, warm air stroking the skin then a cooler breeze then the cool and warm air mixing but never joining. If you were warm you could move to the shade and the breeze would be enough to soothe you; if you were cool you could step into the sunshine and be warmed up – my perfect kind of day!

The day started with tagging along to hubby’s work at 8.30am so that I could take the car for the day. I pulled out into traffic from his office and saw a sign for the information centre so I headed there for yes, more brochures. I do love brochures! I’m going to be the most cultured and knowledgeable Canberran there is! The info centre is on the banks of Lake Burley Griffin which was looking stunning in the sunlight. I heard the sound of a creaking door as I left the centre which can only be from a Gang Gang Cockatoo, so I tracked it to a pine tree and got a photo right there at the info centre! Definitely a highlight – we don’t often get them close around Melbourne. I could see where they’re setting up the flower festival right there as well, gorgeous beds of tulips! I’m looking forward to checking that out once its open.

I should mention that I was trying to find my way around without using a map or GPS. I do that; I don’t know why. It’s silly, you can’t intuitively find your way. I did okay for some of it but there may have been a couple of laps around the city having missed my turn! Ultimately I resorted to GPS!

I do love the days when I get up early. I feel so much more productive, and even if I spend a couple of hours on one thing, I turn round and still have hours to go. So at 11am, the day was still wide open. I wanted to get my bird watching off to a start so I headed to Black Mountain which is where the Telstra Tower is and went on a 2 hour walking loop. The signs being not all they should be, that turned into a 3.5 hour hike steeply up and down the mountain! I was pretty exhausted by the end, not to mention blisters on my heels and arches and chafed thighs. It’s amazing to me that I wouldn’t have considered that the path would be steep, the name of the place being Black Mountain. Another of my classic disconnects.

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So here’s my photo for Day Two. A perfect combination of the day: blue skies, sunshine, beautiful bush and birds, a stunning Crimson Rosella.

I’ve decided to put whatever photos don’t make the cut for photo of the day onto a new website that I’ve just been setting up these last couple of weeks. Bear with me while I do so, it’s very much a work in progress but you can see my other photos from today (and yesterday, forgot to say so) at my site. Click on Black Mountain Views or Black Mountain Birds to check out today’s photos.

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Fun and games

I have been having a really happy time lately. Somehow things have been going really well for me. And for the first time I do believe that my bike riding has something to do with it.

I’ve been cynical of the supposed serotonin-increasing effect that exercise is meant to have on a person. I have experienced severe depression and so many people have told me to exercise, encouraged me to exercise, told me how exercise would help, and asked me if exercise was helping, and referred me to endless articles that supposedly prove how exercise should help me and would help me by increasing my serotonin.

I never got it.

I never felt that I was “better” after exercising, and specifically after riding my bike. I think this is mainly because in my lethargy and weight gain, exercise was so difficult to get started and to maintain that the sheer effort of exercise was greater than any benefit that may have been lurking way back there in the background. I didn’t feel a buzz, I didn’t feel elated, I wasn’t flying high or whatever it was that I was meant to be feeling. What exactly was I meant to be feeling, after all? Exercise was meant to increase my serotonin, yeah? What was the effect or end result of that increase in serotonin meant to be, exactly? What would it feel like if I had it? How would I know I had it? Would it be a direct effect? Would it occur at the time or would the effect be cumulative? I’m sure there are some answers out there but I’ve avoided looking at them, because for a good long while my bike riding was harder than it was anything else, and I just didn’t believe in the serotonin thing.

Until now. I haven’t lost any weight as yet, but half a dozen people have told me lately that they think I’ve lost weight; I’m hoping that means I’ve put on muscle and lost fat but time will tell. I’m a lot less lethargic thanks to returning to work, and having a regular schedule, and places to go, and people to see. Regular bike riding has definitely built up some kind of stamina in me, more than I would have had 13 months ago when I did my first ride with Wheel Women, and thought I would die from it! I view bike rides a lot more optimistically these days, I’m happy to say. This is based on my cumulative experience of so many rides; 60 rides in 59 weeks since March 2015, when I first got back on my bike.

This increased stamina has been improved on recently when I did a 4 day bike riding tour with Wheel Women through central northern Victoria. Anyone who is friends with me on Facebook will have seen the photos! To prepare for the tour I rode every day for 3 days over Easter in the week prior to the tour. I did this to prepare for the anticipated soreness I might experience when getting back on the bike day after day, and to try to build up the endurance that I would need on the tour. I didn’t ride long or far, but riding every day really did something. Then riding 62km, 43km, 37km and 28km for 4 consecutive days  on tour built up another kind of stamina. Arriving at this level of stamina has brought my riding up to another level, and since I got back its been like I’m riding on a cloud. I think it’s because the 3 rides I’ve done since I got back to town are less kilometres, bar one 40km ride, and less strenuous, also bar one ride with a few “gentle” hills, but overall they aren’t as tough as the rides I did while I was away and so I’m riding within my limit, inside my reserves and so it all feels easier!

And I love that!

There’s a saying in cycling, and probably in all sports, and maybe in life too that a certain thing doesn’t get easier as you develop your skills in it, you just get quicker at it. But at the moment I’m not only quicker at riding, but it feels like it’s easier too. And that feels awesome! Not all of it of course, hills are still a bit of a nemesis but I’m even going easier up hills! And I’ve changed my philosophy about hills since the tour. We did 40km or so one day that was more or less flat; my ideal situation, I thought. But now I think differently. Flat terrain just means that your legs go up, go down, go up, go down, rub in the middle on the bike seat, chafe from the bike shorts however comfy they are to start with, get tired, have no chance for a break unless you want to slow down, and it all gets tedious! I thought it was ideal, but now I can see the downsides to flat, and the upside to undulating and even hilly!

At least with undulations or little hills, you get a break while you’re rolling down the other side. It can be quite fun actually, a little up then a little rest on the way down. A little extra work for a little less work; it feels worth it. Plus it’s kind of a challenge for this girl from Flatlandria to operate the gears correctly to get up the incline without changing pedal rotation speed…it can be one way to keep your brain going when your legs aren’t loving the effort.

So here I am, having fun and games on my bike 🙂 I’ve even recently bought a T shirt that says ‘I want to ride my bicycle’. And I’m even heading out on my own after publishing this to do a ride that really sucked a month ago, just to test out my new theory that with the new stamina I’ve built up lately, it’s gonna be a whole heap easier, faster and more fun this time.

Wish me luck!

Minor issues

[Started Tuesday 27th October, 2015; continued Wednesday, Thursday, Friday, and finally got to the point, sort of, on Saturday!!]

SOo I’m over my deadline again! It’s Tuesday, not Monday. And it’s Tuesday night! Oh dear.

I’ve been trying, but the other two pieces that I’ve been trying to get publish ready are just not ready. I need my chief editor, my husband, to review them and he’s away…poor me! Of course I’m joking about poor me, no poor me whatsoever.

But, since I’ve had some minor issues lately, let’s talk minor. I’m not sure who it is that decides what’s minor and major. I’m guessing someone who doesn’t have issues either major or minor, because if it was anyone with any issues, they would no doubt rate their own issues as major a fair bit of the time.

That’s what we’re like, isn’t it? Whatever affects us, feels like the most important thing going on. There’s nothing wrong with that, it’s just how we are. It’s hard to feel for an issue that doesn’t actually affect us, without a great deal of thought and effort, which we don’t always have to spare.

The issues that I’ve been having are medication related. Side effects; well side effect-ish. Sometimes they’re non specific and vague, or even unexpected and the dots don’t get connected.

You know that I’m a pharmacist, and therefore you expect me to know the side effects of medications. I expect that of myself as well, and I do know them; it’s my job. Naturally I can’t know every single one. The aim is that pharmacists know the majority of side effects, definitely the vital ones, and know where to look for the others in our reference books. Our mantra is: until proven otherwise, assume every symptom is a side effect. Umm, did I read that right? Hmm, seems that I may have forgotten that in relation to myself. Oops!

Side effects are ranked as common, uncommon and rare with a special mention for life threatening effects. Common side effects are those that we expect in around or upwards of 10% of patients; uncommon means around 1% occurrence; and rare is 0.1%. Something like that, as a general rule.

When I counsel a patient on a new medication, we talk about all of the common, and some of the uncommon, side effects, and we discuss rare side effects if they are very severe. Must say, I have been surprised at how much of this information I’ve retained despite such a long time off work! I quite expected to have forgotten a lot! But that part of my brain is still alive and kicking, fortunately! Learning it again would take a great deal of time and effort, and I think I’d give up before I began! So I’m glad that all I have to do is remember the path to that information, and it’s all sitting waiting for me.

Side effects don’t occur exactly as the math indicates, obviously; the math just gives us a ball park of what to expect when a patient takes a medication. Some patients never get side effects, some people get a really rough go with lots, some have one or two, and some people can’t even breathe the air of the pharmacy without developing severe side effects. It depends on all kinds of things; genetic, psychological, race, age, number of medications, how you process the medications through your kidney and liver, and more.

I know the side effects of my medications. But the pharmacies I’ve been to don’t know that. Some gave me CMI leaflets, some mentioned a side effect or two; but I’m ashamed to say that most of my pharmacy encounters have involved a pharmacy student or intern or practicing pharmacist handing me my medication and asking, have you got any questions? This is infuriating! How do people know what they don’t know, and therefore how can they ask questions? Pharmacists really need to pull up their socks on this! The responsibility is on the pharmacist to ensure the patient has enough knowledge to safely use the medication, and if I wasn’t a pharmacist myself, this would not have been the case with a single episode of having a script dispensed.

Did you know that 1 in 3 hospital admissions are medication related? That’s a very serious statistic. Imagine how that could be improved by pharmacy staff just taking a little extra care! I know they do care, and I understand that the sheer volume of workload is very oppressive, but surely we can do better.

Some of the side effects I’ve had have been textbook examples, and I actually find this very satisfying! It impresses me when what I’m experiencing is exactly what someone has described in the medical literature. How clever of them, and how observant! Of course when I say I’m impressed, I don’t mean that I like it, or appreciate it. But I think that the person who wrote it down was very intelligent, and perceptive especially for the era that they worked in which was often centuries ago, and the fact that we still find their information relevant however long later is such a testament to them.

So my textbook issues impress, but frustrate me: sweating, hunger, weight gain, sedation, increased blood pressure and cholesterol, suppressed thyroid, heart burn, memory impairment. And the consequences really get me wound up: chafing thighs, red face, jiggly bits, lethargy. Not all minor, of course.

But as an example, I would never have thought sweating was a big deal. So what? Everyone sweats. It’s just natural. Or perspires; if you’re ladylike! You’re exposed to heat, you exert yourself, you sweat. You wear deodorant to prevent smell, you take a towel to the gym, you shower as often as necessary; and that’s the end of the story. There was this one guy at my old job, an orderly, and by the time I walked into work at 8.30am he already had enormous arm pit, neck and back sweat patches going on. I felt very sorry for him, only a young guy! He is really a candidate for botox injections into his sweat glands to block them permanently and give him some dignity! Or aluminium deodorant, much easier and available at your friendly local pharmacy.

And now it’s me. As always the subtleties fascinate while irritating me. I don’t sweat how you’d think: armpits, back, neck line, like you get from exertion. I sweat like a normal person, with the addition of sweating on my face! Nice and visible, up front and prominent! In defence of this sweating I armed myself with a whole host of clinical anti-perspirant products: under arm roll-on, face gel, leg and groin gel, and used them liberally. Under arm: success, leg and groin: success, face: fail!! To be honest I’m not sure that the others do a lot, cos I don’t sweat there anyway…but the one I really need fails! Or just doesn’t work as much as I want it to, I guess! I’m a bit hap hazard with remembering to use it, but at the end of the day if its slightly warm, if the sun shines, if I have a shower, if I wear too tight or too much polyester clothing, if I get stressed or upset or nervous in any way, I sweat from my face!

sweating, cooling

My doctor recently gave me the medical reason: my core temperature has been increased by as much as one degree Celcius by my anti-depressant. It’s to do with the increase of serotonin. It doesn’t happen with all antidepressants; mainly the class that I’m on that also increases noradrenaline. 1 degree isn’t much as far as the outside temperature goes; I doubt you’d notice it. But our body is extremely finely tuned and our core temperature should always sit between 36.5 and 37.5 degrees. If you’ve ever had a fever you’ll know how crook you feel when your temperature is about 38.3 degrees. But that’s where I am all the time! I get hot, prickly, sweaty, slightly nauseated, and irritated at the rolling sweat beads multiple times a day!

My new comfort zone is when the outside weather is below 20 degrees. I’ll be the one in a T shirt deliberately sitting outside just soaking up what its like to not be hot, not be sweating, and just comfortably existing!

Is there a solution? Yes. It involves a maximum of two layers of thin cotton clothing, fans, air conditioners, face gel (might as well keep using it!), tissues, handkerchiefs, anything that will mop a brow, a bicycle to create my own breeze, and suppressing my pride. For every time someone looks at my forehead while talking to me, asks me if I’m okay because I’m sweating, every painful time I’m forced to use my hand to mop my brow because I’ve run out of nicer options, for every time I’m counselling a patient at the bedside with my hands full and sweat is starting to roll down my face! ARGH! I know I’m not the only one, but you can only feel your own problems, can’t you? No one else sweating makes me hot and prickly!

But, this is the only antidepressant that has ever truly worked for me, so I’m sticking with it! Reluctantly, unfortunately, but the show must go on. And if I’m not on this medicine, the show will rapidly cease to go on. This brings up an interesting concept: what side effects are you willing to exist with, in order to get the benefit of your medication?

A lot of people have asked me whether I’ve considered stopping my medication. The answer is distinctly NO!!! Seriously, without knowing anything about my condition, my medication, and the subtleties of mental health, how could you ever ask that? And IF you ask it of anyone, you have to be responsible for the outcome, which may be dire, just like a doctor would be!! I understand that you are asking out of care an concern, I do. But it’s not an option with me.

Some have asked whether I’ve considered natural therapies: well NO, I want medications proven to work. And the ONLY natural therapy with evidence for depression is St John’s Wort which is only recommended in mild to moderate depression, which is not what I have.

So this is life. I sweat, not that big a deal when you consider the grander scheme, but oh so degrading on a day to day basis. A minor, but not so minor problem. Still, it’s not a suppressed immune system, or clots in my legs, or a physical disability. I can live my life, mostly do what I want, and be functional. That’s a pretty good hand to be dealt!

I promise I won’t hate you if you can’t resist looking up when we next talk. I won’t be annoyed at you for noticing. It’s just how I am now, and I’m trying to roll with it. Because in the end it is worth it, you know? I couldn’t live before; now I can live pretty happily. It’s just this one thing, and that other thing, plus the other one that take some dealing with, but it’s okay. It’s worth it!