Monday, 25 November 2013

Ups and Downs

It's Monday. I can't believe it's the last week of November already. I know I say it every month, but the year's just disappeared. 

The last few days have been draining. On Thursday I got a voicemail from the clinic. My GP found out that I rearranged the appointment to exclude the mental health nurse, and had moved the appointment again. I panicked and broke down, assuming she was going to corner me into seeing the nurse, that she wasn't going to give me a chance to talk to her first, etc.. When we tried to call she'd already finished for the day, which gave me ample time to think up all the worst possible scenarios.

The next morning she called back, saying she just had to move the appointment because she was overbooked. She's not going to ambush me with the mental health nurse, she understands where I'm coming from and that I need more information and time. I really wasn't expecting her to say that, but it was a huge relief after so much uncertainty and worry lately. 

Thursday was one of the hardest days I've had in a while, even before the GP stress, and I don't think there was even a trigger for it. I had my slice of toast for breakfast, but broke down halfway through my yoghurt. The best way to describe these breakdowns is that they're as incapacitating as a panic attack, but more depression than anxiety. I can't move, can't stop crying, can't even have a cigarette although they're right next to me. On Thursday it lasted from 8am-1pm, for no real reason. I'd only just managed to stop crying and calm down when we got the voicemail about the appointment, and I was a wreck again for another two hours. 

Amongst the stress, it hasn't been a great week for food. I've missed lunch more often than not, and I've only cooked dinner once. I made a new batch of stew last week (beef, tomato, carrot, potato, onion, flour, stock cube, herbs) that clocks in at 138 cal per cup/250g, so that's been dinner most nights.

Saturday was probably my best day mood-wise in weeks. I spent a few hours planning my next sewing project (which I'm quite excited about, but more on that another time), and did some baking for the first time in ages. I made two dozen banana bran muffins for mum, and had a small one warm for afternoon tea (132 cal). It's not something I could do everyday, but it was nice to get back in the kitchen, and I know mum always appreciates it. 

Anyway, I've rambled enough so I'll leave it there. I hope you all had a great weekend. 


Wednesday, 20 November 2013

Small Steps, and New Skirts

I saw the dietician yesterday, after my first week on 1,300 calories. Physically, I haven't really noticed a difference from the increase. I haven't changed my meal plan, Ensure still makes up the rest. Mentally, I'm struggling. I haven't consumed this much, this often for years. I hate seeing the numbers this high, but I know I don't have much choice. My intake was between 1,260-1,290 this week (400-600 Ensure), and miraculously enough, my weight didn't go up alongside my calories. 

I managed to talk with my dietician more than I have been lately. I told her that my only real motivation for raising my calorie intake is because my GP's making me panic. I explained how she was asking all these questions about past weight restoration, and said she was concerned about my weight dropping (which it isn't) and my BMI. She thinks my GP's just concerned about the losses I had in the first half of the year, and because I've kept it off. She asked if I'd be willing to gain back a few kilos, and I felt sick with dread. I know that a year ago I was maintaining a slightly higher weight and I was okay with it, but after having lost those 3-5kg, I can't bear the thought of gaining it back. 

She was just lovely and kind, and tried to make me feel less stressed about my GP when I was completely panicking. She thinks there should be less reason for concern because my intake's increasing again, which was a relief to hear. I also told her about the whole mental health nurse thing and how stressed it's been making me, and she said she doesn't think it needs to be rushed, so hopefully my GP won't mind my rearranging the appointment either (I haven't seen her to find out yet).

I also wanted to get her opinion on exercise, so I told her about my lung check-up, and she was shocked that he's still suggesting using a treadmill or exercise bike for an hour everyday. She said that when I do start exercising again, it'll be building up slowly, like five minutes a day or a few short walks each week. She still wants my intake a bit higher first, but she's going to talk to my GP about it again so we can figure out a balance between improving my lung capacity versus the risks of potential weight loss, injuries, overexercising etc., and start planning how to work towards it. 

I haven't been sewing much this past month, but I have managed to slowly put together a few (very simple) projects. They're nothing fancy, but they're practical. I made a couple of plain cotton circle skirts (pictured), for the approaching 40°c days when it'll be too hot to wear much else. I've also made two pairs of track pants, which are hideously plain and boring so there's no photo, but they fit perfectly and are so warm and comfy.

I think that's about it for now. Sorry I haven't had much to say lately, but if I did it'd only be complaining about my mood.

I hope you're all managing to get through the week in one piece. 


Wednesday, 13 November 2013

Breaking News: Exercise makes you feel better about yourself

I had my check-up with the thoracic physician this morning. For newer followers, back in May I was diagnosed with Chronic Obstructive Pulmonary Disease (COPD), and was admitted to hospital suffering from an exacerbation and Bronchiolitis. Basically, I've permanently damaged my lungs from smoking.

I've been dreading this appointment. Don't get me wrong, he's a really nice guy, and he understands I have severe anxiety issues and tries to be accommodating. But I know I haven't been doing as well as I should be, and he's a little hardheaded when it comes to exercise.

He asked if I've been exercising, and I told him my dietician doesn't want me to. He kindly informed me that 'studies show' exercise helps with depression and self-esteem, as well as improving lung function, and recommended putting a treadmill or exercise bike in front of the TV for an hour every day. He basically said "you know, you'd feel a lot better about yourself if you exercised". I wanted to say "buddy, you have no idea", but I just repeated that my dietician doesn't want me to, adding that my intake isn't high enough and I'd lose weight, and that I have issues with overexercising. I think he got the point, but it's extremely confusing and guilt-inducing to have him telling me I should run for an hour a day, when my GP and dietician are concerned about my weight.

I told him I've been smoking 40-45 cigarettes a day, which is a new high for me, though he's still happy with my progress because I've barely been touching the green stuff. I also told him I've been on Zyban for about a month, though it's primarily for depression and hasn't reduced my urge to smoke yet. This recent depression, constant anxiety and subsequent inactivity are big parts of why I'm smoking so much. Whereas your normal smoker does things with their day and takes a break for a smoke, I'm the opposite. I sit outside in my armchair, chain-smoking for most of the day, only moving if I need to do something.

Honestly, it's hard to find motivation to quit smoking when I'm feeling so low. As blunt as it is, it's like; I don't really want to be alive right now, so why would I want to improve my health? That said, my lung capacity's about the same as it was three months ago, which is good, though my airways are still very noisy. All in all, I'm not doing too bad. 

And the dietician yesterday... ugh. I told her I was thinking of moving up to 1,250-1,300 calories. She said it would be fantastic if I felt I was ready, and I told her my GP's panicking me a little. It was a shitty day and I didn't feel able to say much more than that, so there's still a lot of questions left unasked. Plus I know she talks to my GP after my appointments and it made me apprehensive to say much. I don't know. I just couldn't say the things I needed to say. Maybe next week.

A huge thank you to everyone who's been reading and commenting lately. You guys mean the world to me, and I'd be totally lost without your support.

(I tried to make myself feel a little better today by putting effort into my outfit and doing my makeup. It didn't work, and I was straight back into my track pants within five minutes of getting home, but oh well. I'm definitely rekindling my love of stripey knee-high socks though.)


Friday, 8 November 2013

Reality Check, aisle 3

So, the appointment with my GP was nothing short of a nightmare.

She said that I "need to get some counseling on board". There's a Mental Health Nurse who she wants me to see. She said they come to my clinic, so I'd be meeting them in a 'safe environment'. She's arranged for this nurse to sit in on my next appointment, just for 10 minutes to introduce me. 

But I'll get back to that in a moment. It wouldn't have panicked me quite so much, if it hadn't led into this conversation. 
"How many times have you been admitted to hospital for weight restoration?"
I told her once, two and a half years ago. She asked if it was helpful, which hospital I was at, how the nurses treated me. She said she's concerned that my weight's been slowly dropping. I snapped back that it's been the same since July. By this point I was a panicking wreck, so when she started going on about my BMI, I had to ask if we could please not talk about it right now. 

So, back to the mental health nurse. I wouldn't be upset if my GP had offered it, discussed it with me, or asked me to think about it. But she didn't, she forced it. She arranged this appointment with the nurse even after I said I didn't want her to. The next day we called and canceled it, and booked one with just my GP.

I'm not saying that I won't see the nurse, but I won't see them under these circumstances. It will not help me in any way if it's forced. I will panic, and I will flee. It is the worst way to introduce a mental health professional. Initially, I said I wouldn't see them. After I calmed down a bit, I realized that I'm not really being given a choice. But I at least need to talk to my GP more about it, find out more information, have time to consider it and figure out how to do it in a way that's actually safe. 

One big flaw in her logic; she thinks introducing a mental health professional in a safe place, at a safe appointment, makes it safe. It doesn't. It makes my appointments with her no longer safe. She is making the one safe place I can go completely unsafe.

And why is my weight suddenly such a big issue? I've been maintaining since July, and I've had literally 10 appointments with my GP since then. I know it's a low weight, but why is there suddenly so much concern? Why can't I just be left as is?

I think I might have to move up from 1,250 to 1,300 calories next week. I fucking hate it, but there's too much 'concern' right now. It's the only thing I can do to try to ease this pressure. I can't lose everything I've worked so hard for. It's only an extra scoop of Ensure, but jesus, it's so hard to convince myself to. I'm also going to ask my dietician why the hell this is all suddenly happening, when I've been maintaining for months and it's been fine. I am fine.

Sorry this post has been so long and rambley, and probably sounds totally pathetic. I've been a wreck ever since the appointment, I can't stop crying about it, I'm panicking and nothing is okay. I'm going to talk to my GP more about the mental health nurse, get more information, and hopefully she'll let me slowly work towards it in a safe way. Between that and raising my calories, I just hope it gets them off my back again.


Tuesday, 5 November 2013

Another Week, Another Month

I've been trying to focus on just getting through each day, one day at a time, one moment at a time. Something must be working, because I've somehow made it through another week.

Dinner's becoming a problem again. I've been having soup most nights, in an attempt to keep stress levels down. There's a mechanical routine to my other meals that dinner lacks; the same breakfast every morning, two different lunches on alternating days, two different snacks on alternating days. Dinner's different, especially since I started cooking family dinners again, and sometimes it's just too much. 

Saw the dietician this morning. I went in teary-eyed and can barely remember what we talked about. It means a lot to me that she still sees me every week, even when I'm not making any progress. At the moment I just don't feel able to change my food routine, and I'm still maintaining my weight and drinking my Ensure, so I don't see what the problem is. 

I've been on my new antidepressants (Zyban) for nearly three weeks now, and I'm seeing my GP again later this week. Depression's taken over every part of my day. I don't feel able to do much at all, I'm constantly crying for no reason. The most I leave my armchair is when mum takes me out for a drive to distract me and calm me down, like a child.

I did start sewing some track pants over the weekend, after three weeks of doing nothing. It's not much, but it's something. 

Next week's my quarterly check-up with the thoracic physician (aka, the lung doctor man), and I'm dreading it. I've been chain smoking a lot, mostly due to depression and the inactivity it's caused. Over the last 3 months, I've gone from averaging 30 cigarettes a day up to 40-45, some days are as high as 50. I also have to explain why my dietician doesn't want me exercising, which could be interesting. 

I can't believe it's November already. Where did the year go?

P.S, good luck to those of you doing NaNoWriMo this year, as I know there's a few of you (I'm hoping to get back to it next year).