Tag Archives: Health

On my distinct lack of give-a-shit…

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There are a million things going on in the world, and if I’m brutally honest with you (and with myself), there’s not a single one of them I feel interested enough in to write about today. Sure, my privilege is showing or whatever, but I just don’t have it in me at the moment to be morally outraged, vaguely interested, heartbroken, or whatever appropriate response is dictated by the events of the day. 

All I really want to do – and therefore what I will spend my evening doing – is sitting here comfortably with a book. Jorah will inevitable be napping next to me. One of the cats (Anya for sure) will be curled up between my knees. Monday is bad enough on its own without trying to dwell too much on all the ills of the world. 

This is a thought I keep coming back to. I know it’s made an appearance here more than once. There are probably lots of valid questions – How engaged should we be in what’s happening outside our bubble? What do I owe the world if I’m keeping shit together inside my own fence line? Should I even be bothered by what’s happening out there beyond my immediate span of control? 

The last year has, somewhat of necessity, been focused internally – on what I’ve needed to do in an attempt to follow doctor’s orders and the various episodes of fuckery that resulted from that. While it hasn’t been a full-on shitstorm, it has been the better part of a year of the number of things I’ve had the bandwidth to care about being reduced pretty dramatically. Maybe that was self-preservation, but the downstream consequence seems to be that my naturally low give-a-shit level is almost nonexistent these days. Believe me when I tell you that any time you think you see me giving a shit (and it doesn’t directly involve animal welfare or mocking the feckless or stupid among us) I’m 100% faking it… and probably doing a piss poor job of that in the moment. I’m honestly not sure if I’ll ever adjust this attitude or if I even want to. Like so much else, that is apparently yet to be determined.

What Annoys Jeff this Week?

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1. A deferred milestone. I thought I was on track to hit the next weight milestone – 200 pounds even, or down 130 – on or about my birthday. Although I’ve started slowly creeping down again, the previous three weeks where I held all things equal has pretty much guaranteed I can’t get there from here unless I develop a pretty nasty stomach bug. It’s disappointing, of course. I was hoping to sit down to my traditional birthday lunch of crabcakes and hushpuppies and proceed to getting back to a “maintenance” level of eating. That feels out of reach. But I’m still damned well planning to have the crab cakes and hushpuppies.

    2. Foreign aid debate. You know what one of the most successful bits of foreign policy of the post World War II era? Yeah, that would be when the United States poured out absolute shiploads of cash, material, and expertise on Europe and rebuilt a shattered continent. It turns out prosperous liberal democracies bound together by deep ties of trade tend not to try to kill each other nearly so often as they did when international diplomacy was a zero-sum game. The weight of American troops and weapons arguably won the war, but it was the Marshall Plan that won the peace. It’s a pity that Americans consistently refuse to remember their own history when we’re talking about relatively paltry sums in the contemporary foreign aid budget. Every scrap of progress we can make by throwing money at the problem is far less expensive than anything that happens when we need to get involved kinetically. 

    3. Walking. Gods, even with the latest in listening technology, walking is just a deadly dull way to spend 30 or 40 minutes every day. Yes, the scenery in the neighborhood is nice. Sometimes I get to see neighbors doing something stupid in full view of the sidewalk. Aside from occasionally getting to interface with the local wildlife, I’m sorry, but there just isn’t much to recommend it. Living at the far end of the dead end street, there are only so many ways to make the path different… and after six months, I’ve trod all those down multiple times each week already. Look, I’ll keep doing it… under protest and purely because the doc says I must… but you’ll never convince me that there isn’t a more interesting or entertaining use to those 30 or 40 minutes of every day that isn’t called off on account of weather. 

    What Annoys Jeff this Week?

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    1. Water. The guidance from the medicos is to drink water and then when I think I’ve had enough water to go and have some more. That’s fine. Wonderful. But honestly, if you want me to drink 647 cups of water a day, water should actually have some kind of flavor. I never had any problem drinking copious amounts of tea, or coffee, or gin, but the common factor there was that all three of those things tasted like something instead of just existing as being wet and “good for you.” The amount of things I’ve spent the last nine months doing on the ephemeral promise that it’s good for me yet with no other obvious tangible benefit is honestly just a little bit horrifying.

    2. Better living through chemistry. I’m still adjusting to the most recent medication changes. It seems that this round is all about reminding me of the virtue of incremental change, as each day I seem to feel every so slightly better than the day before. The first day or so of the change was downright insufferable and now we’ve moved on to somewhere between annoying and obnoxious. The head fog and general feeling of disaffection is absolutely real. I’m trying to go along and remember that it can take a month or more to really adjust, but frankly sometimes that month really just sucks and it feels marginally better to say it out loud for an audience.

    3. All you can eat. I grew up in what I’ll always consider the golden age of all you can eat dining. Within a dozen miles from home we had a Western Sizzlin, a Western Steer, wings at every local fire department on various nights of the week, a Pizza Hut lunch buffet, and a whole damned salad bar at Wendy’s. There were buffets everywhere. I don’t remember them being particularly food safe but I remember them being tasty. I had a dream about a fictitious all you can eat joint that never was – a big neighborhood bar and grill that pulled out all the stops with everything from burritos the size of your head to every carving station imaginable. It was a happy dream… but as it turns out. I’m a little sad that my days of drinking there in this bar of my imagination are over (perhaps temporarily), but that my days of all you can eat are in all likelihood dead and gone forever.

    Revising the plan…

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    More than a decade ago I finally got around to asking a lawyer to officially draw up a will and do some end of life planning. Having something on file in the event of “what if” felt like the prudent thing to do in my 30s.  Honestly, I packaged it off to the county courthouse and then pretty much didn’t think of it at all for almost 11 years. 

    I’ve learned a lot about myself in the intervening years. More specifically, bouncing around between hospitals and specialists since last summer has absolutely focused my mind a bit about what I’d want to happen should things go sideways in a hurry. No one seems to think I’m on the threshold of keeling over, but I am on the precipice of falling over into the back half of my 40s. Dusting things off and giving it all an update felt, once again, like the prudent course of action.

    I don’t think anyone ever really enjoys peering through the glass at their own mortality. Going through the bits and bobs certainly wasn’t a laugh riot, but I feel better for having started the process. There is, if nothing else, some small comfort in having the ability to have your intentions known even when you can no longer speak for yourself.

    I assume it’ll take a little bit of time for the legal eagles to get things caught up, but overall I feel like I’ve done a good thing. If nothing else, may it was a good way to start drawing a line under my year of medical fuckery and getting on with things. 

    Overweight…

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    As far back as elementary school, I remember various “tests” aimed at assessing basic health. Is the President’s Physical Fitness program still a thing anyone does? I have some vague recollection of calipers and some kind of devious box we dutifully stretched our hands over to determine how flexible we were. Those and the damned timed mile run were the only tests I never really did well on in school. Gym classes are not among my cherished childhood memories in any case.

    I assume the calipers were there to make some measurement of our body mass index. As the years have screamed past, even the AMA has admitted that BMI is not a particularly unproblematic measure of health. The fact remains, however, that it is still what’s used by most of the American medical establishment to apply some statistical analysis to body composition. Like it or not, there is a correlation between high BMI and adverse health outcomes, so it endures.

    Here we get to a bit of surprising news. Apparently when I stepped on the scale Saturday morning, I magically qualified to be simply overweight instead of obese. Now, that’s still not medically ideal, but feels like it should be a reasonably significant improvement from ranging into the morbidly obese category. At least in terms of where I fall on someone’s wall chart, there has been demonstrated progress. I’d probably be more impressed if I the net result to date was, “well, I don’t feel any worse.”

    The helpful BMI charts online still say I should be somewhere down around 185 to be “normal weight.” I’m still not convinced that is in any way a reasonable target. The fact is, I remain a little sore at the doc for his latest bait and switch, so as far as I’m concerned 200 is the new “final” number. If I can manage to do that without chewing off my own arm, the saw bones just might have to learn to accept a final form of me being slightly overweight and devise his treatment strategy from there.

    At some point, likely sooner than later, I’m just going to decide I’ve had enough of this and get on with things on a maintenance level instead of giving a damn about whether I’m losing weight or not.

    Bait and switch…

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    Back in July of last year, when the medical appointments were coming fast and furious, the doc advised me to, among other things, drop 100 pounds. I weighed in at 330 that morning. I can’t argue that I hadn’t been carrying around too much weight for too long. 

    At last week’s follow up, I tucked in about 8 pounds short of the goal. I was feeling reasonably proud of myself for not immediately reverting to old habits the moment I started feeling a bit better. 

    That’s when the old boy did a bait and switch on me. 

    I know we talked about an even hundred, he said, but I want you to take it down another 30 from there. 

    Two hundred pounds flat is where they want me now. I’ve been trying to play along with all this like a good little trooper, but fuck me. 

    I was close enough to taste a meal that didn’t have to have every ounce of joy sucked out of in an effort to stay under an 1800 calorie daily limit while not being ravenous enough to ponder gnawing off my own arm. And then they moved the fucking goalposts. 

    I woke up this morning with 33 pounds left to drop instead of the 3 I was expecting. Bet I’m not just a little bit salty about that.

    What Annoys Jeff this Week?

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    1. Plant based. I like my GP. I’ve been seeing him since I returned to Maryland and in that time I’ve never felt rushed or blown off. As I’ve started losing weight though, he’s gotten a bit fixated on the “value of a plant based diet.” I’ve had to remind him repeatedly that I’m not in any way on the cusp of going veggie. I like beans and lentils well enough, but not as an absolute substitute for proper meat. Chicken features prominently and I’ve dramatically cut down on red meat and pork, but I need this guy to come to terms with the fact that every so often I’m going to have a cheeseburger or a good slice of roast. I’m willing to compromise and adapt, but I’m not entirely forgoing the best things in life indefinitely. Otherwise we’re not so much prolonging my life as just making it feel longer while every ounce of pleasure is sucked out of it.

    2. Egg whites. I like eggs and used to eat a lot of them. A three or four egg omelet wasn’t unusual for breakfast. Because of the seemingly unsettled science of dietary cholesterol I’ve made an effort to cut back to just 3 or 4 eggs a week. But, they say, you can use egg whites and miss the cholesterol completely. Sure. I tried that. It’s hard as hell to turn egg whites into dippy eggs though. Egg whites make the worst egg salad I’ve ever put on a plate. An egg white omelet. Hard pass. I’ve given it the college try but I’m so very much not impressed with cartoned egg whites. They may be “better for you,” but in my estimation they’re not worth needing to clean the damned skillet.

    3. Star wars. When I was a kid, one of America’s great presidents stood up and proposed a Strategic Defense Initiative to shield the United States from Soviet nuclear missiles. Never mind that the technology wasn’t there. Never mind the incredible cost to deliver it. Never mind that it would take decades of research to deliver on the promise of securing America from the ballistic missile threat. The very existence of SDI made the Soviets absolutely nutty and helped send them into a spending spiral from which their already questionable economy never recovered. So when, in 2024, I hear vague news reports of Russia wanting to put missiles in orbit, all I hear is history rhyming. I still like our chances of being able to spend this new Red Menace into oblivion if it comes to it.

    What Annoys Jeff this Week?

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    1. Insurance. For the most part I have had very good luck with my health insurance provider. Presently, though, they’re picking a fight over the bill for the 30-day heart monitor I got to enjoy last year. “Not medically necessary,” they say, though the cardiologist who called for it seems to disagree with their assessment. Just now I haven’t been billed for anything yet, so I’m on the sidelines while Phillips, my doctor, and Blue Cross throw shade at each other. I assume at some point they’re going to fling a $9,000 bill at me just to see if maybe I’ll pay it on spec. Being a professional bureaucrat, though, I’m entirely prepared for whatever paper drills may come. Hopefully, though, this doesn’t devolve into a full-blown pain in the ass… but I’m not overly optimistic.

    2. Clothing. I almost never have a reason to do something like put on a dress shirt or, god forbid, a suit, but almost isn’t never. What I’ve discovered this week, while raiding my closet looking for something to wear is that even the suits I held over from my long ago time working in DC no longer fit. In fact most of them have me looking like a kid trying on his father’s clothes. One or two of them might be salvageable, with a tailor who knows their business, but otherwise, I’m going to have to go shopping for clothes… and there’s honestly no variety of shopping I want to do less.

    3. Congress (and the average American). If it weren’t tied directly to my ability to make a living, watching the ongoing fuckery that is the United States Congress would be entertaining as hell. There seems to be no hope of passing a budget. Republicans in the Senate just shot down the most conservative border security bill proposed in my lifetime. Republican leaders in the House of Representatives can’t manage to muster votes from their caucus to do… well… anything at all. It’s certainly the most dysfunctional government I’ve lived through – and it has no real signs of improving any time soon. But, we’ve gotten the government that the American people, in their wisdom, have voted for… which I suppose just goes to prove how deeply stupid the average American is.

    On normalcy and not hitting the panic button…

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    For as long as I can remember, every medical professional I’ve encountered told me that I’d feel better if I lost weight. Having lost a not inconsiderable number of pounds, I think they may have sold me a pig in a poke. The fact is, as far as I can tell, I don’t feel any better in February 2024 than I did in February 2023. How much of that is reality versus looking backwards with rose tinted lenses, I couldn’t tell you with any degree of accuracy.

    I can say with some confidence that I’m feeling better today than I have since the end of June when all my latest health fuckery kicked off. I’ve worked myself off of being medicated for diabetes. I suspect the next time I see my GP, I’ll be instructed to start back off blood pressure meds. The anxiety, which at times was just about debilitating, has receded into a background hum which mostly crops up when I have the occasional odd ache or pain or when some vital sign pops off with an outlying reading.

    Since none of my extremely well credentialed doctors seems to be concerned beyond “continue to monitor,” trying to get my head into a place where I don’t hit the panic button on a daily basis is probably the right thing, but it’s been challenging. Being someone who as a child was perfectly capable of worrying himself sick, this is a bit of a work in progress.

    Even if none of that were true, I know I’m feeling better than I was in the summer and fall because my reading pace is picking up. Instead of sitting here in the evening holding a book and idlily flipping pages and being entirely distracted, I’m actually reading, comprehending, and burning through pages. My attention span is coming back. I’m intensely grateful for that… it’s been a long time coming.

    What Annoys Jeff this Week?

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    1. Metrics. One of the things the medicos have had me doing for the last six months is a much more frequent bit of at home tracking. Blood sugar, heart rate, blood pressure, blood oxygen, everything gets tracked. It’s a fine bit of trivia and something that could theoretically be helpful for them, but all it seems to have done for me is generate a new obsession and a lot of fresh anxiety when a rogue value pops up or I see an unanticipated trend develop. While I don’t dispute the value of knowing a more granular level of detail, I can tell you with certainty that even though I was certainly less healthy six months ago than I am now, I absolutely felt better before I knew any of the specifics.

    2. Time. By my calculation, it should be December 29th. Somehow, though, the calendar says it’s February 2nd. That can’t possibly be right, can it? I don’t know exactly the age I was when time started to speed up, but I seem to be noticing it speed by at an almost alarming pace these days. Oddly, it doesn’t make the work days seem any shorter, but the pace of moving from one week to the next is getting quite out of hand. I have no idea how one cuts back on the throttle there, but something must be done.

    3. Taxes. I switched my Roth IRA from one institution to another this year. During the transition, I managed to add in about $50 more than is allowable by law. The penalty, if left uncorrected, is something like a 6% fine for every year the extra money remains in the account. It was easy enough to fix with a call to the company who holds the account, but the real absurdity is how little our common Uncle Sam will allow you to put away to grow for untaxed future withdrawals. There are articles posted regularly decrying how the Average American will be woefully unprepared for retirement. It seems to me that one way to get after that issue would be to dramatically increase the amount that people can legally shelter from the long arm of the tax man.