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!

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Saturday and Monday

I have been having some great days lately.

At my last visit with the psychiatrist he assured me that despite having poor energy and motivation, he felt I was 75-80% of the way to recovery.

He increased my lithium dose minutely and organised to have a blood level taken after 5 days at the new dose. That was Saturday morning. I see him this Thursday and I’m feeling so excited because for the first time in a long time I feel like I’m making real, sustainable, predictable, reliable progress.

I feel like I’m getting my life back!!

This is a big statement but it’s really, truly real.

I’m not all the way there but I’m so much better than I have been for a long time.

So Saturday I had the blood test. My long disused pharmacy knowledge is begging to be used so excuse the following jibber jabber.

Lithium is a tricky medication. For a lot of medication, you start at a certain dose, then increase by certain increments and the effect of the medication increases at the same rate as the dose to a set maximum dose.

For lithium and a few other medications, you start at a certain dose, then increase at ever smaller and smaller amounts because the removal of the drug from the body is limited and once the removal process is used up, more dose increases quickly lead to toxicity. For these medications there may not be a set maximum dose for all people as it depends on an individual person’s removal processes, or metabolism.

So a blood concentration or level is used to ensure that the medication is between under dose and overdose limits. These levels are determined during development of the medication for use or during clinical trials.

The blood test has to be taken at the right time so that the result is meaningful. In the case of lithium, the range we use to determine whether the drug is working but not toxic is established as a “trough” level. This means you take the blood test just before the next dose is due when most of the medication should have been removed by the body’s metabolism. If the body’s metabolism has been used up or “saturated” then the trough level will be higher than it should be and the patient is at risk of toxic side effects like blurred vision, unsteadiness, possible vomiting, diarrhoea etc. In fact the patient may already be experiencing these so the doctor will talk to the patient about side effects that they are experiencing plus look at the blood level result to get a clearer idea of what is going on.

The other part of taking a blood test is that it has to be timed correctly to when the dose was last increased. If the dose is increased today and we take a blood test today, the effect of that increase won’t be shown. If we look at the level and increase the dose based on that, we will have acted prematurely and risk the patient getting toxic side effects. So with each medication, there is a length of time between a dose change and when the level should be taken called the steady state. Consider it to be the time it takes for the higher dose to come to equilibrium or to spread out through the body so that it is present everywhere in the body to an equal degree.

For lithium, steady state is 5 days so the blood test must be taken at least 5 days after the last dose change.

Well that’s got that out of my system!

So to have the blood test at trough state, I have to be at the blood collection centre by 8.15am on Saturday. The reason for this is that I took my medications the night before at 8.15pm. Meaning I had to wake up at 7.30am! Good plan, very hard to follow through!! But I had the additional incentive that my hubby was going mountain bike riding and had promised to take me along so that I could go bird watching. I’d wanted to head out to King Lake for bird watching for a while so I was excited for that.

So I forced myself out of bed, through the shower and into the car without breakfast. I also had to have a fasting blood test. I packed my tablets and some food in with my fleece-lined coat and camera and off we went.

I won’t show a lot of my photos from Saturday at Smith’s Gully, just the new birds. But I wanted to say that we left home at 8am and returned at 4pm and I did okay!! This is so exciting for me! I didn’t tire out, I didn’t sit in the car and wait for the boys to get back, I didn’t feel exhausted, I didn’t feel like I couldn’t do what I wanted to do!

I did have a nap when we got home, then went out again for tea with my hubby. But I had walked and walked, I took photos for hours, it was pretty freezing cold, I didn’t have any lollies or chocolates or my other usual treats, I didn’t get grumpy or tired or feel worn out.

What a great day!!

The beautiful Queenstown Cemetery housing old-time gold rush prospecters

The beautiful Queenstown Cemetery housing old-time gold rush prospecters

Gorgeous yellow bulbs growing wild and free in the bush

Gorgeous yellow bulbs growing wild and free in the bush

I loved the beautiful gum bark, looks so much like a watercolour painting, and serendipitously shot an Eastern Rosella!

I loved the beautiful gum bark, looks so much like a watercolour painting, and serendipitously shot an Eastern Rosella! See top left corner

Mother and baby Eastern Grey Kangaroo across the paddock, as soon as I pointed my camera they all looked! So observant, gum trees, grass

Mother and baby Eastern Grey Kangaroo across the paddock, as soon as I pointed my camera they all looked! So observant

Large male Eastern Grey Kangaroo bounding across the paddock, grass, trees

Large male Eastern Grey Kangaroo bounding across the paddock

Beautiful country scene in Smith's Gully, lily pond under the gum trees, grass, reeds

Beautiful country scene in Smith’s Gully, lily pond under the gum trees

One of the many beautiful scenes of the winter sun showing through the gum trees

One of the many beautiful scenes of the winter sun showing through the gum trees

Group of Eastern Grey Kangaroos bounding across the green grass, gum tree

Group of Eastern Grey Kangaroos bounding across the green grass

A tiny litting bird that I've been trying to identify with a good photo for a while! I believe it is a Striated Thornbill; alternate opinions welcomed :)

A tiny flitting bird that I’ve been trying to identify with a good photo for a while! I believe it is a Striated Thornbill; alternate opinions welcomed 🙂

Striated Thornbill with a grub, the longest one sat still all day!!, tree branch

Striated Thornbill with a grub, the longest one sat still all day!!

Male Superb Fairy Wren in the bush, not new but always stunning!, grass, trees, bushes

Male Superb Fairy Wren in the bush, not new but always stunning!

A gorgeous Treecreeper that I have never seen before, I think its the White-Throated Treecreeper, tree branch, leaves

A gorgeous Treecreeper that I have never seen before, I think its the White-Throated Treecreeper

An accidentally amazing shot of a Grey Fantail in full flight!, tree, branch

An accidentally amazing shot of a Grey Fantail in full flight!

A day of rain, cloud, and the odd gorgeous blue sky :), dam, green grass, gum trees, clouds,

A day of rain, cloud, and the odd gorgeous blue sky 🙂

Mother and Joey Eastern Grey Kangaroo, so beautiful! green grass, eucalyptus

Mother and Joey Eastern Grey Kangaroo, so beautiful!

Beautifully delicate wattle sprig - looks like Spring!

Beautifully delicate wattle sprig – looks like Spring!

Sunshine, blue sky and everything is green, green, green, gum trees, shadows, green grass

Sunshine, blue sky and everything is green, green, green

Then Monday, after a slower Sunday. I’d organised to go for a walk with my Grandma at Blackburn Lakes. A couple of new birds, and so many kookaburras!!

A Noisy Miner is a very common sight but I just love this cute shot!, pink flowering gum tree

A Noisy Miner is a very common sight but I just love this cute shot!

I find these sky shots really fetching, I have taken a few lately but this one really draws me in, gum tree

I find these sky shots really fetching, I have taken a few lately but this one really draws me in

Australian Magpie, common but still awesome

Australian Magpie, common but still awesome

Juvenile Australian Magpie singing away, gum trees

Juvenile Australian Magpie singing away

A nesting mother Dove or Pidgeon sitting on its nest

A nesting mother Dove or Pidgeon sitting on its nest

Pair of Kookaburras sitting in a tree, gum tree, euclypt

Pair of Kookaburras sitting in a tree

Common Noisy Miner again, but how pretty are those wings? Sadly mis-timed! dead tree

Common Noisy Miner again, but how pretty are those wings? Sadly mis-timed!

Gorgeous pink native flower, not sure what but its so cute

Gorgeous pink native flower, not sure what but its so cute

Beautiful serene Blackburn Lake

Beautiful serene Blackburn Lake

Pretty Blue Iris flower probably sown by birds

Pretty Blue Iris flower probably sown by birds

Some kind of fungal growth on a tree

Some kind of fungal growth on a tree

Is this our state floral anthem? Its a type of native bell flower

Is this our state floral anthem? Its a type of native bell flower

A new bird to me, the Golden Whistler, a stunning bright yellow!, gum tree

A new bird to me, the Golden Whistler, a stunning bright yellow!

Pretty little Flame Robin showing off its bright colours

Pretty little Flame Robin showing off its bright colours