Category Archives: Health

A tale about health, both mental and physical…

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For years, I listened to every medical professional I met tell me that I’d feel much better if I lost weight. Over the last six months, as you know if you’ve been following along, I’ve finally been following their advice. I’ve been following the very broadly defined advice of “eat less, move more.” In my case, that equated to about 30 minutes of pretty mild exercise – walking or time on the stationary bike – and a pretty fanatical devotion to tracking calories. Since July, I’ve been consistently losing right around 1% of my body weight every week.

Even as I’ve closed in on my initial goal of losing 80 pounds, I can’t say I felt better. Sure, I was a bit more flexible and found that taking the stairs wasn’t hell on my knees, but I felt increasingly awful. In fact, the more I lost, the worse I felt – physically and mentally. 

For the last six weeks, I felt like someone who was definitely not me. My head was in a constant fog, I was struggling to regulate my emotions, and was spending most days in a constant basket of worry and anxiety about everything and nothing. Even my blood pressure, which has been wonderfully controlled for months started to creep up past the “elevated” level towards hypertension. My primary care doctor preliminarily identified the problem as anxiety stemming from my cardiac health scare in June and July. He gave be a very small prescription for Xanax in hopes that would get me over the hump for the worse of the anxiety. I took it, but didn’t notice any difference at all. 

Last week, after a very tough weekend, I finally made an appointment with a behavioral health professional – a therapist – convinced that there had to be something going wrong with my head. My big beautiful brain has always been what I consider the natural gift I got – it certainly wasn’t athletic ability or good looks. Something messing with my brain has always been my nightmare scenario. 

In any case, the therapist I consulted with gave a preliminary diagnosis of generalized anxiety disorder and instructed me to get back with my general practitioner to discuss options for going on anti-depression medication. I wasn’t thrilled, but honestly by this point was pretty desperate to get some relief and get my thinking back under control. Fortunately, I was able to get an appointment the next morning to talk with my doctor. 

We met for almost 45 minutes Friday morning while I described all my symptoms and he asked some probing and uncomfortable questions. A few in office blood tests later, we had ruled out a lot of physical possibilities and we’re closing in on saying yes, my brain was sick… or at least we were until I mentioned how disappointed I was with my weight loss as it seemed the more weight I lost the worse I felt. 

That sentence seemed to hit the doc like someone throwing a light switch. After consulting my chart again and reviewing the bloodwork results, he noted that “You’re still taking metformin…” He went on to explain that in some case, dramatic weight loss can actually send diabetes into a form of “remission,” meaning that it was entirely possible that we were treating for a disease that was no longer trying to kill me on a cellular level. Even though my home testing had never caught any evidence of classically low blood sugar, he speculated that the medication was, in fact, causing my system to mimic the body’s natural response to low blood sugar – releasing stress hormones among other things. It’s possible, he seemed to think, that I was experiencing a form of pseudo-hypoglycemia rather than a true mental health problem. He instructed me to immediately stop taking the metformin and see if that resolved the issues over the next week or so.

Today is my 3rd full day of not taking meds for diabetes in a very long time. I’m keeping a pretty close eye on my numbers, but my head is definitely clearer and I’m feeling much more like myself. I don’t want to call it a comeback just yet, but I’d dearly like to believe the answer to two months of increasingly feeling off kilter is as simple as not taking four little white pills. 

That’s a long way of saying that I have a new appreciation for just how important it is to be your own most forceful health advocate. To our collective detriment there’s still a stigma attached to seeking mental health treatment. There shouldn’t be. The brain is just another organ capable of misfunctioning. Getting help for it is no more problematic than seeking out a cardiologist for heart troubles. Without taking to a therapist, it’s hard to say how long I’d have just stayed mired down in a bad place. If you don’t take anything else from this screed, take this as encouragement that if you need help or need to talk to someone, go do it.

Anyone who thinks less of you for it can fuck directly off.

Feel free to tell them I said it. 

Around the eyes…

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I went for my annual eye exam on Friday. Wilmer was well organized, prompt, thorough, and personal. It was not cheap, but I was pleased with the Hopkins approach to eye care. I supposed that’ll just be where I go from now on.

I got a good report of no eye disease present… which is a nice change from the rest of this year’s medical appointments. I have, however, earned a bump up of my magnification that will hopefully make the evening reading a bit easier.

I really hadn’t planned on my blog becoming all medical all the time, but that feels like it’s been my theme for the last four months. Maybe eventually I’ll get back to bitching and complaining about normal day to day stuff, but it feels like today isn’t that day… and tomorrow isn’t looking so good either.

Easing towards the baseline…

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It wasn’t a great summer for reading. Honestly, it wasn’t a great summer for anything. From July through September, I had no attention span to speak of. “Long form” TiKToks pressed my abilities to focus. Anything I was trying to get done had to be taken down in extraordinarily short chunks. For someone who normally had the ability to sit down and lose three hours reading a book, it was not an ideal arrangement. Books that would have normally gone back on the shelf inside a week lingered on the nightstand for a month or more.

I’m happy to report that October, even though the 10 days of the great plague, has shown decided signs of the situation improving. I’m nowhere near back to form, but I’m at least finding it possible to sit down for an hour at a clip and really get into something. 

I knew I was off my stride, but I’m just now beginning to realize just how far off I was feeling. I don’t mind telling you that I spent a lot of the summer in full bore worry mode – concerned about my health, wondering when or if I’d stop feeling like hot trash, scared that it was just going to be what post 45th birthday life was going to be. 

None of my issues have really gone away – or even yet been properly diagnosed – but I find that initial fear of the unknown is increasingly giving way to annoyance. I can only assume that’s a positive sign since annoyed is practically my universal default setting. Maybe I’m starting to ease back towards the baseline. 

I’m doing everything the medicos have told me to do, so aside from “wait and see” and showing up for more follow-on testing when it’s called for, it’s well past time to start dragging myself up off the mat… even if my head is stuck firmly on playing out all the possible “what if” scenarios. 

The second week of COVID…

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It’s the second week of COVID. The good news is that I seem to have avoided hospitalization or death. That’s absolutely a win.

The bad news is that I still largely feel like chewed dick. Yes, it’s absolutely a better grade of crud than I was enjoying at this time last week, but I’m still hacking, wheezing, sneezing, and generally sounding like a plague carrier. I’m not the kind of company you’d want to come take a seat at your dinner table. 

It’s a busy week at the office and I tried to be a good remote trooper today, but by noon all I could think about was closing my eyes and having a good rest. I hung in a while longer, but don’t expect I did myself or anyone else much good after that point.

I usually manage to power through these sicknesses. There’s no time for a man cold when there’s animals that need tending and a household to run. My brush with the Great Plague though, has been a pointed reminder that sometimes you’re going to slow down whether the spirit is willing or not. 

Positive…

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After almost three years and every available vaccination and booster, it looks like the Great Plague has finally caught up with me.

Yay. I’m thrilled. 

I don’t have anything particularly witty to add here. I’m currently feeling like I’ve got a something between a mild to moderate head cold. My throat is sore and my nose is running more or less non-stop. I can sleep as long as I don’t mind doing it while sitting more or less upright. 

I dialed in to a video appointment with Hopkins “virtual care” team and got my marching orders. 

The plan for now is that I’ll be holed up here at the house for at least the next five days… in hopes that years of boosters will, in fact, be effective at “preventing the most severe outcomes from a COVID-19 infection” as or friends at the CDC so casually put it.

Fingers crossed.  

Thoughts at fifty down…

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The internet is chock full of sites about weight loss, exercise, and healthy eating. You don’t need to worry about this turning into one of them. Everyone wants to tell you about their “weight loss journey,” or how happy they are, or how it’s been the most wonderfully transformational experience of their life.

Yeah. I’m definitely not one of them.

As of late last week, I’m down 50 pounds. My reasons have nothing to do with looking better or giving much of a damn about having transformational experiences. My sole motivator is doing whatever is advisable to keep my heart from attempting to race out of my chest for no apparent reason while I’m sitting in the living room watching television on a random Wednesday night. Full stop. If we arrive at a final diagnosis that doesn’t include weight as a contributing factor, you can rest assured that I’ll go on a burrito, and cheesesteak, and lasagna eating binge the likes of which the world has never seen.

The simple truth is, I don’t feel any better. I don’t feel more energetic. I certainly don’t feel “transformed.” What I do feel is just about constantly hungry. I also feel mad as hell that recipes I spent 20 years perfecting are now in the ash heap because the “appropriate serving size to stay within your caloric goals” is a 2-inch by 2-inch square or 1/2 of a cup. 

If you happened to think my mood was a bit surly before, well, this new, lighter Jeff is just wandering around looking for a reason to pick a fight. 

Look, if you’re one of the people who gets thrilled and excited by this sort of thing, more power to you. I’m envious. For me, it’s more an experience to be endured while I ponder if what I’ve given up is worth the few extra unpromised miles I may or may not tag on the end of the trip. 

In time, maybe I’ll get to acceptance… but just now, I’m perfectly happy to sit here stoking the low-grade rage. 

Diagnostic tests, doctor shopping, and medical snobbery…

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Since my original diagnosis of “probable SVT” way back in July took place under the umbrella of the ChristianaCare hospital system over in Delaware, my first appointment with cardiology was also made within their system. That was fine. Their main campus is reasonably well reviewed and I could get seen by a cardiology nurse practitioner in August, which I’ve found out through this process is a fast turnaround for a new cardiology patient who isn’t inactively laying in a hospital bed. 

In the intervening days and weeks, though, I had a follow up with my primary care doctor, who operates as part of the Johns Hopkins system. He was less enthused about my decision to use Christiana for my cardiology needs – explaining that their cardiology department, while fine, is “not ranked” whereas Hopkins cardiology is currently ranked 13th in the nation with the hospital consistently ranking very near the top of any list of “America’s best hospitals” that’s ever put together.

Yes, my primary care doctor is a medical snob.

Despite his cajoling, I kept my original appointment, which led through a series of tests and reports that I was going to need anyway. I also reached out to Hopkins Cardiology to get myself on their waiting list for new patients and ended up with an appointment scheduled deep into October. It wasn’t ideal, but since I was going through all the preliminary tests and could then hand over a pretty good sized file, the timing wasn’t a major issue for me. I was able to take advantage of their wait list option to get my first appointment in the books last week – with a guy who has been practicing for 40+ years and has the look and feel of someone who has seen just about everything. In other words, he’s exactly the guy I want even if all we’re doing at the moment is preventative and exploratory. 

With all other things being equal, if being able to access some of the best cardiologists in the country means driving 45 minutes west instead of 25 minutes east, ultimately it feels like not much of a decision at all. 

It turns out, like my primary care doctor, I too am a medical snob.

So, I’m going all in. My optometrist recently retired. Instead of going over to the doctor that took over his practice, I’ll let Hopkins run the show for my eyes too. I’ve got my first appointment set up with the closest branch of the Wilmer Eye Institute later this year. That puts all but one doc under a single banner… and when the time comes sometime in 2024, I’ll bring that one into the fold too.

All of these new faces on my medical team are a little further away than I’d like, but I feel like what I’ll lose in adding a few minutes of extra travel time, will pay me back in the convenience of having them all working under the same organization. I was woefully unprepared for the level of coordination I’d need to do myself when my primary care doc and everyone else had electronic records systems that refused to communicate with each other. 

I’m in no way fool enough to believe that being “nationally ranked” is any guarantee of better outcomes. For now, it appears that most of my problems are fairly benign, but should something become more involved or I develop a novel condition over time, I’m going to put my faith in the big name going forward. Hopefully they’re not just riding their 135-year-old reputation. 

Some people would take this opportunity to rail against the American healthcare system. Undoubtedly, it has challenges – but I’ve been absolutely amazed by the level of services and the array of options that have been presented to me over the last three months. Don’t think for a moment I’ve failed to realize my great good fortune to have both the geographic proximity to one of America’s great medical centers and an insurance plan that makes walking through their doors possible. There hasn’t been a day go past recently when it hasn’t been at the forefront of my thoughts.

Security blanket…

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For the last five weeks I’ve had an electronic security blanket. Far away, wherever Philips giant data center is located, computers monitored the output from their Mobile Cardiac Outpatient Telemetry (MCOT) devices, and their algorithm has been plugging along keeping a remote eye on my ticker. 

The only feedback this little wonder device gave me was that occasionally one of the leads came unstuck and needed to be reaffixed. I’ve just been operating under the assumption that if there was something catastrophic happening, someone might have called or cut the testing short. I have no idea if that’s true or not, but in the absence of clear guidance, I’ve created my own. 

I hate to admit it, but I felt just a little bit better with this little bit of plastic and silicon chips quietly doing its thing in the background.

The fact is, these last two months have been the only time in my adult life I’ve honestly been bothered by living alone. The only difference from June 28th to today is the fact that I now have evidence that something could go horribly wrong rather than simply knowing it as a purely intellectual exercise. That evidence is enough to leave me feeling decidedly uneasy now that my security blanket has gone away. 

Taken as a whole, the last two and a half months have been disconcerting in a way I’d haven’t previously encountered. I don’t know that there’s anything to be done about it other than to accept that I’ll now have a new nagging thought in the back of my head for the foreseeable future. Moving someone in just to make sure I haven’t accidentally dropped dead as I go about my day-to-day activities, feels like it’s probably a wildly excessive overreaction… but don’t think the thought and a hundred other derivative ideas haven’t been banging around my head this weekend. 

Anyway, I kind of miss my security blanket. 

Good news… it wasn’t a heart attack…

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There are, as you know, things that I don’t discuss on social media. It’s an old fashioned notion, even sharing as much as I do, that some things at least ought to remain private. I say that only to note that what follows is an incomplete telling of the tale. The salient points, however, are unmolested.

My trouble started on a Wednesday night. I wasn’t doing anything more dramatic than sitting in the living room watching TV after dinner. Out of nowhere, my heart revved up to a roaring gallop and stayed there. No pain. No trouble breathing. No light headedness. I’ve never understood what people meant when they said they experienced an impending feeling of doom. I do now though. All in, the trouble lasted maybe an hour or 90 minutes before it began subsiding.

After first trying to power through it and then consulting the family medical professional, I eventually conceded that it was probably something I needed to have checked out. Shortly thereafter, I was being given the once over at the local emergency department, where they quickly ruled out a heart attack and monitored me for four hours before sending me on my way.

The next night, same time, same place, same experience. Well, not quite. It wasn’t as bad and didn’t last as long. It was still deeply disturbing and I spent the rest of the night felling like absolute trash.

By Friday morning, I still felt decidedly “off,” for lack of a better description. I later described it as feeling like someone had filled my head with wool and then pressurized it. I knew if I called for emergency services they’d just dump me back where I had been on Wednesday night. That wasn’t an especially comforting thought.

Whether it was entirely advisable or not, I drove myself over to the “main campus” facility of the local hospital system. After many of the same tests given to me two days earlier, but finally having met with two cardiologists, they confirmed that I wasn’t having and didn’t have a heart attack. Their most likely diagnosis was supraventricular tachycardia (SVT) – essentially a (probably) not life-threatening electrical problem in one of the upper chambers of my heart that can cause an erratic heartbeat.

They prescribed some new meds to slow my heart rate and scheduled me in for a proper cardiology appointment after which I assume we’ll start the full battery of diagnostic tests and determine a long-term treatment plan. My first proper cardiology appointment is later this week. 

I haven’t had any more incidents, but I spent the better part of a week feeling entirely wrung out. If it wasn’t for needing to feed the herd, it’s hard to say how little I’d have forced myself up off the couch. All told it was every bit of two weeks before my head stopped feeling wooly and I was able to concentrate for any length of time. Even the meds they gave me as a temporary expedient aren’t entirely benign. Over the last week or so a couple of side effects have gotten more pronounced and working with the medicos to get that dialed in has been significantly less than fun.

Look, I’m thrilled that the diagnosis is “not a heart attack,” but going into the second month of feeling like warm trash isn’t exactly the summer adventure I envisioned for 2023. I’ll know soon enough if this week marks the end of the beginning or if just kicks us right back to go. Given the abuse I’ve hurled at my body for 45 years, I should probably be impressed that it’s just now starting to seriously object. I only wish the good times would last a little longer. That not being the case, we’ll just have to play the ball from where it lies.

An entirely unplanned month of down time…

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Some of you may have noticed that I basically took the entire month of July away from posting here. I didn’t exactly give up writing – my proverbial cup of post it notes and electronic memory aids runneth over. Whether anything will eventually become of those snippets remains to be determined.

When I started off this self-imposed sabbatical, I was wading through a health issue that left me decidedly unmotivated and challenged my ability to string together any kind of coherent paragraph. My attention span for a couple of weeks was just about nil. I doubt I could have written well with either a proverbial or literal gun to my head. Instead of forcing the issue and inevitably being frustrated by the results, I opted to just not.

What I wasn’t going to do here was half ass my way through it. That’s the kind of thing you reserve for writing you have to do – like in the office. It’s not the way you treat a blog you’ve been tinkering around with for well over a decade. If I couldn’t give it a fair shake, I’d much rather just bide my time until I was in a better and more editorially competent head space. 

There are still days when I feel I’ve mostly got cotton between my ears, but I’m happy to say that I do seem to be over the initial hump. I’ll give you a bit more information on that next time, but for now suffice to say that I’m feeling mostly like myself again. More importantly, I feel like the words aren’t a constant struggle to get down on the page.

Back in early July, when I made the decision to take a pause, I was afraid I’d miss the day-to-day rhythm of these posts. I missed the writing to be sure, but it turns out I didn’t miss the self-imposed daily deadlines. Knowing that, I’m taking the daily deadlines off the table for the time being and intentionally scaling back from five posts a week to a more manageable schedule of posting on Monday and Thursday (with the inevitable extra thrown in when the mood or breaking news begs for something more immediate). 

I’ll be keeping What Annoys Jeff This Week? as a regular Thursday feature. Monday’s post will be the usual wide-ranging sort, but hopefully will make use of the extra time to flesh out ideas a little more fully and exert some additional editorial control over the final products. As time and other circumstances allow, I fully expect to bring more days back into the schedule over the coming months. For now, I want to use this as an opportunity to focus on improving quality versus simply hitting quantity goals.

So, as we prepare to slip into August, I’m pleased to be back and eager to begin once again dispensing full-throated snark into the void.