A bad day

**Usually I write in a very controlled way. I write on my good days, and although I access sadness and badness and evil, I do it in a way that I can manage easily without things getting out of control. Yesterday things were out of control. I was having a bad day and a bad moment of despair and crying into my pillow and thoughts just exploding all over the room and I thought, you know what? I need to write this down. If I can’t write down the darkness and disorganised-ness what am I really showing you of the “real” diseased me? So this is raw and I apologise if it’s too much of anything. By the time I am writing this, things have been sorted out and we’re back on track. There’s still the diet thing, I’ll get to that another day, but for now here is the thoughts as they spilled out of my head in my crying despair**

Stayingquiet

I’m the Monster. The one under your bed. The one that jumps out and scares small children and large adults alike. The obese monster, morbidly obese by the books. The one who side on, at a glance, could be confused with a large tree trunk or concrete pylon! Who has been asked TWICE this week if she’s too far into her pregnancy to fly! And another two times in that same week if she’s pregnant, once before a massage and once before a dress fitting. Cos that’s relaxing!

I’m the Destroyer. I start with memory foam beds and crush the memory and the foam out of them. I move onto brand new leather couches and triple my husband’s imprint in the first 3 months. Time to change sides! Then I grind the life out of said husband until he doesn’t care, or hurts so much from caring that he leaves. Well that’s my mental image of how this goes, in any case, and I’ve had a couple physical images to assist with the mental image; that’s the extent of his distress.

I break laptops, drop mobile phones, spill anything remotely liquid, trip over power cords ruining plug connections, slip down inclines, fall over pebbles, draw ink on bedspreads, stretch clothes in the wash,  wrench roof racks and bikes off the car roof bending the metal and stripping paint off bikes and car alike!

I’m fat, so fat, so very very fat and it’s ruining everything. I’m told. It’s hard to see from the inside. I’m ruining my marriage by being fat. I lost my job from the consequences of being fat. I’m slow, I’m too slow, I need to lose weight, I need to speed up, I need to change, change, change change, stop being me, be someone else. Someone not fat and not slow who isn’t ruining everything.

My husband is fed up. And why wouldn’t he be? 3 years of me being sick, 16months of being off work before, 9 months in a job and here we are, back at the beginning. And if I just lost weight it would fix everything. I wouldn’t be ruining the couch, wrecking the bed, sitting at home doing nothing. If only I would lose weight. Because it’s difficult for him, me being fat. Every day it’s hard for him, me being fat, he tells me. It’s hard on him. I’m fat and it’s hard. He says we can’t do things, be things because of it. It’s fair for him to ask me to lose weight, because he has to deal with it too. And me not losing weight makes him think I’m not trying, I’m not trying for us. Can’t I do it for him? Can’t I lose weight for him? If I won’t do it for myself. It’s been 6 weeks. 6 weeks since I saw the dietician and starting a food diary. And I haven’t lose any weight. Why? Because I’ve been snacking. Why? Because I eat in emotional situations. So instead I’m meant to be dealing with my emotion. Here you are, here is my emotion. I’m dealing with it.

thunder inside

I hate to cry. Crying is weak. I know, I know; I shouldn’t say that. Especially me, advocating for mental health. But to me it’s weak, I hate it, and I avoid it. But here it comes, crying, because of my diet. If I cry, I don’t store and if I don’t store, I don’t eat because of the store. Apparently. So I’ve cried twice since starting my diet.

I want to see that you’re putting in an effort. But you won’t see it; change is gradual and you don’t see weight loss for a while, a good long while. So what do you want to see? It’s such a lot of pressure, proving something. Proving you did, defending that you didn’t; proof. I’m trying. But I want to see that you’re trying. Well I am trying. Well how can I see that you’re trying? It goes round and round.

And now, one in the bed and the other one said I can’t stand this anymore. Is it cold? How cold? Who cares, I’m storming out. And I’m crying my tears because I have to put in an effort and one can’t bear it and the other can’t wear it, and it’s a mess. Royally a mess. What to a fix? I promise sincerely I will truly really do what I’m told, and I will make the numbers go down, and I will make them keep going down. And then we will live happily ever after because I’ll be able to energetically walk everywhere that I’m asked to walk, and I’ll enjoy physical activity and my fatness won’t slow me down and make me sluggish and I’ll be fixed. And if my condition and cures continue to prevent that from ever being realized? Well at least I’ll be skinny. Life is better when you’re skinny. Time for my daily walk and my diet jelly. Adieu.

Advertisements

Saturday Shoutout

I have hedged around this and hinted at in and mentioned it obliquely but it’s time for some straight speaking about an important part of my life.

My peeps.

Specifically, my psychologist, my psychiatrist and my GP.

My support crew.

Without them, I don’t know where I would be. Literally and figuratively. Would I be in a psychiatry ward in a hospital? Would I be in rehab? Would I be doing a lot worse than am I now? Would I be a vegetable in bed? They have stood by me, held me up, dealt with me, kick-started me, bucked me up and saved my life.

I don’t say this lightly.

They saved my life! They’re that important.

Everything I say here has what to me is an obvious unwritten addendum: as well as my husband. He is the most important person in my life and has been my most supportive friend through every hill and valley, through every new discovery and every boring pushing-on day, through every heartache and excitement. He is so critical in my life but there are times in life when you need to call in the experts!

And these times have been the last year!

My aim today is to give a shout out to my current team because I truly do owe my life to these people. There are other people who have also been hugely helpful to me and I acknowledge them mentally; they might get a write up another day.

Starting with my local doctor, my general practitioner or GP, Dr Richard Young.

I came to see him accidentally after a false start with the GP that I used to see back when I was at uni. She charged a fortune and didn’t give me any confidence that she knew what she was doing. In fact she said to me, I’ll ask my colleagues and check some textbooks; can you come back next week? Well no I couldn’t wait a week, I needed help now! I complained to a colleague at work that I didn’t know where to start looking for a good GP and that I wanted to find one close to work.and who didn’t cost me so much and she handed me a business card for this doctor. I rate this as the best recommendation I have ever had and am always so thankful to her for this!

I didn’t tell this colleague why I needed to see a doctor and yet she gave me a recommendation for a doctor with a special interest in mental health, and who sees many patients with depression and anxiety. That was lucky number one. Lucky number two was the location of the clinic, within a 5 minute walk from work! Could anything be more perfect? I could easily slip away from work in my lunch break, between discharges, after ward rounds etc for my 15 minute appointment. And lucky amazing number three is bulk billing for mental health patients! That is, no fee to pay for each visit! Thank you infinity for this amazing policy that has benefited me and my husband so much!

Richard is a young enough doctor to have passion for his job in spades, old enough to have experience and knowledge and confidence, and has bedside manner and compassion like you dream of in a doctor!

His knowledge of the health system is unsurpassed. I have attended many different GPs in my old clinic last year as well as here, and have never experienced such thorough care! I have cervical migraines; I get Medicare subsidised visits to a physiotherapist. I’m gaining weight on medication; I get some of those visits changed to see a dietician. I have deficiencies; I get treated. I have risk factors; I see the practice nurse to develop a care plan for how I will reduce my risk factors. I have depression/anxiety and need help managing my symptoms; I get ten Medicare subsidised visits to a psychologist, and when I use them all up, I get more! We need help managing the medications; I get Medicare subsidised visits to the psychiatrist. And most importantly, when I’m suicidal he doesn’t let me go home; he sends me straight to the hospital where I can be cared for and a new plan can be made for my treatment.

You get the picture: this doctor is amazing! There is nothing I have that he can’t fix me up with the appropriate health professional or service!

After 8 months of seeing Richard once a week every week I have no complaints! I have had to wait on occasion, I have had to be rushed through on occasion but I have proved abundantly that when I have acute and severe needs, I will be given as much time and attention as I need and be cared for exactly how I need. How I want not always; but always how I need. I think you do need to give credit where it is due and understand the limitations of the medical system and within those limits I have been wonderfully and carefully looked after!

I would absolutely recommend Richard to anyone!

It is due to Richard’s amazing insight and care that I was first given a referral to see a psychologist. Unfortunately the first lady I saw did not connect with me at all, and in fact I left worse than I arrived!! Crying going down the steps is not the right way to go. So Richard promptly organised for me to be assigned another psychologist and I have loved her since the first meeting!

Patty Sabbagh from the Nexus Psychology group is her name and place.

She has seen me through all kinds of scenarios. Happy, sad, suicidal, excited about life, demotivated, purposeful and everything in between are the ways that I have turned up at her door and she has adapted and given me real help and hope and a new way on from every problem! She has helped me to deal with all kinds of issues, she is so resourceful and like a good friend. Sometimes I have gone and its just been a good chat with an understanding fellow human that I needed, and she has been a listening ear, a shoulder to cry on and a clever therapist able to give me a better way to fight on. A mother, a friend, a support; all labels I could give her and more!

She listens and considers and recommends the best approach. Sometimes talking about it really does solve the problem, sometimes a new way of looking or thinking about an issue is needed, sometimes there is need for meditation, or mindfulness, or cognitive behavioural therapy. Whatever is needed, this talented psychologist and counselor has the remedy!

Anyone in trouble needing someone to help would be well advised to seek the help of Patty from Nexus Psychology or one of her colleagues.

Lastly my newest support crew member, and one who has changed my life. Another big statement but well deserved! My psychiatrist, Dr Ian Katz.

He entered later in the picture because I initially saw a psychiatrist as part of my outpatient follow up from being in the emergency department of the local hospital. He was the one who suggested cautiously that bipolar was indeed a possibility and who first started me on a mood stabiliser. However his role is to see patients in the short term then send them back to their GP to be managed. Which is what happened.

My GP and I went along with the plan for Seroquel and for a while we seemed to be winning. Then that started to fall apart and my GP gave me the referral for Dr Katz. He picked up the pieces, made a sensible picture out of it all and gave me a ‘wait and watch’ directive and asked me to come back in a few weeks. I returned with a history of the most manic-like state that had happened to me so far coupled with a long period of depression and the diagnosis of bipolar was complete. He prescribed lithium, one of the best things that has happened to me in a long time, and things have been improving ever since! He calls it “the game changer”; I call it a life changer!!

I have been so impressed with Dr Katz because of his huge capacity to listen, and hear all the information then process it in a logical and helpful manner. He will then set out a considered, clinically sound plan and make everything clear and easy for me, the patient. That takes a huge lot of knowledge, skill, patience, kindness and clinical experience to attain and I think there are very few other clinicians like him. In addition, his commitment to his work amazes me. I have had appointments at 6.45pm, 8pm and 9pm!! Thank you for that!

I have a very high respect for his opinion and his directions and am just so grateful to him for being the one to really turn my life around!

So there you have it. The three most important people in my life just now, besides my husband. Three people who have left a permanent impression on my mind, and my heart really. Conditions like bipolar absolutely need to have this three pronged approach, which in the past was not such a priority but I would not give up either one of these three for anything! Each has a separate but vital role, and each one contributes in a different way to my overall mental and physical health.

I don’t think I could step into any of their shoes, even assuming I had the appropriate training. They each have some strength of character to do what they do that is beyond my understanding but its so important to me that they continue to do what they do.

I don’t know when they take holidays, I don’t know how their families cope with their dedication to their jobs but I know that without them I wouldn’t know where to go or who to turn to and I am forever grateful to them, and everyone like them who works for us, the patients.

Day One

swing, girl, book, 'Today your efforts will be rewarded'

My inspiration

I love this poster!!

It inspires me every time I walk past it at my local shopping centre.

It’s actually an advertisement for HSBC insurance, somehow, but I love the thought that the effort I put in will absolutely bring results. It keeps me feeling like there is a point to what I’m doing, and that the goal isn’t so far away.

Okay, time to get serious.

Yesterday I had an appointment with a dietician. Yes, a dietician. To discuss my diet.

Oh boy!!

My GP was lucky. He did some blood tests and found some nutritional deficiencies. Quite a few actually!!

So all he needed to say was that he wanted the deficiencies corrected through diet rather than by adding yet more tablets to my current regimen, and referred me to a dietician on that basis. This is why he didn’t want to add more tablets, and this is just the morning!!

capsules, tablets

My morning kickstart!

He escaped having to go through the process of telling me, ‘you’re fat”! Lucky him! Although we both knew that underneath the conversation that we were actually having was another silent conversation along the lines of “since we met 6 months ago you have gained a tonne of weight and you really have to do something about it, starting now!”

But coming at the subject from a less obvious angle made it a lot easier for him to bring it up, and for me to accept it. Clever!

I’ve seen a new side to being a health professional lately; the ‘getting patients to see things from your viewpoint without thinking they’re being forced there’ skill. It’s vital to successful relationships with patients, and to achieving the outcome that’s best for them. Even when they may not think so.

Kudos to the excellent health professionals that have cared for me over the last year! I respect and appreciate your negotiating and information-giving skills in hindsight, even if I was a difficult patient back when we met. Thank you!

So the dietician. A lovely softly spoken slim fit-looking girl who told me I was beautiful and had amazing eyes! Nice work!! Just like that she had me feeling flattered and accepting of everything she was about to say; well done. Seriously, I’m impressed! And I’m learning new skills in people-management.

So, what did she have to say? Nothing that I wasn’t expecting, to be honest. I knew the ‘what’ of the appointment, although maybe not quite the extent.

Here’s the facts:

1) On October 24th 2013 I weighed 77.65kg. I had spent 14 months from August 2012 to October 2013 losing weight, and had dropped 9kg which I was pretty proud of.

2) On May 23rd 2014 I weighed 95.4kg!! Nearly 18kg gained in 7 months!! Oh dear…

3) My cholesterol level has been borderline high since my first WorkSafe health check in 2010, at that point due to 4 years of chocolate bingeing. Unfortunately in the last 6 months it has gone from borderline high to do-something-now-before-you-have-a-heart-attack-or-stroke high!! At this point, it’s due to 8 years of chocolate bingeing!! My LDL cholesterol (so-called “bad” cholesterol) is 7.5, and the upper level of the range is 5.5! So, quite high!!

Question from the dietician: “do you want to live a long life with your husband?”. Me: “yes, of course!”. Dietician: “then you really have to do something about your cholesterol”!!

4) My vitamin D level is getting progressively lower. It was normal last year and at the start of this year and low a couple of years ago so I guess it fluctuates. Spending the last 3 months at home and not getting out much has not helped my incidental sunshine exposure! So back on supplements.

5) My iron storage level (ferritin) is low. This one puzzles me and everyone else because there’s no obvious cause. So diet, you need some change. More meat, but no more fat…interesting conundrum!!

6) My waist measurement is 100cm!! The safe upper limit of waist circumference to prevent heart disease in women is 80cm…quite a bit of work to do there! Oh, and I look like I’m 5 months pregnant!!

7) Most relevant fact: I now have 3 skirts left that fit (ish)and 90% of my wardrobe no longer fits!!! Or it squishes my waist into weird shapes and bulges, or clings to wide parts of me – not nice for anybody!!

So we know the what. Now for the why.

I know this one too.

Binge eating, comfort eating, boredom eating, drug-induced craving eating, habit eating…are there any other kinds? Oh yeah, guilt eating, shame eating etc.

Food has always been a weakness with me. I love it, I enjoy it but it has gotten to be a habit and comfort to me.

While I’ve been really sick it was one of the only things that I could still get enjoyment from when I’d lost interest in everything else. It was nice to be able to enjoy the flavour, texture, taste when everything else had lost it’s interest and enjoyment.

In times of severe depression when I have lost all my energy, motivation, and was tired, flat and struggling to do anything, I would eat sugar after sugar after sugar to try to get just a little scrap of energy so that I could do SOMETHING!! Sour straps, chocolate, licorice, berries, frozen yoghurt…the list goes on!

The rest of the time, just having the food near was enough reason to reach out and eat.

Did it work? Did it give me energy? No. But it made me feel good for a little bit. And I kept doing it, because I like it!

But then it would make me feel bad. Guilty, ashamed, embarrassed, feeling over-full and gross.

The dietician gave me a diagram that perfectly describes how I’ve found over-eating:

a diagram of the cycle of emotional eating

The Vicious Cycle of Emotional Eating – perfectly described!

But it’s time to stop. Time to break the cycle, for once and for all.

I’m (hopefully!) past the worst mood swings and have a bit more energy and time to put into Project Danika. So here we are, Day ONE.

And here’s the plan.

My cholesterol is shocking so it’s the first thing to be addressed. I’m trying a radical new meal plan: eat breakfast, lunch and tea. That’s all.

Hmmm. It’s a long time since I’ve eaten 3 meals and nothing else in the day!! I’m allowed morning and afternoon tea but from today, no more mindless snacking, eating from boredom, for sugar hits, mood improvers or anything else along that line.

What I eat for my main meals is actually fine, no dietician amendments needed. It’s everything in between that needs to be eliminated. So here goes, no snacking!

A few things I learned yesterday: cravings last from 9 to 12 minutes therefore if I can keep my mind and body busy for 10 minutes whenever a craving hits I will be able to get through feeling the need for food to feeling satisfied for food. Such a great tip!! Now I feel like I have an active plan that I can work on to achieve my goals.

I now know the ‘how’ of the equation! I love it. I have strategies and goals and it feels achievable. I’ve been letting myself have a free run but no more. Time for the better me to have a go at life.

The next dietician strategy if I get as far as the fridge; start asking questions! Why am I eating? Will this snack make me feel healthy? Am I hungry? Should I have a glass of water instead?

And if I get as far as actually eating? Next lot of questions: am I enjoying this? can I stop? Did I really taste that?

Failing that, just finish what you’re eating, put it down to experience and try again from now on. I’m psyched!! Having someone give me all these plans and strategies makes the biggest difference to me. I guess it may seem obvious to others, but I really need to have it broken down for me.

So with a fruit bowl full of mandarins and kiwi fruit, some celery sticks and baked bean cans, and a new approach of not buying anything that has more than 2g of fat per serve, off I go. I’ll keep you posted along the way to the 3 week mark when I revisit the dietician.

Wish me luck!