Posts Tagged ‘migraines’

The Illness/Wellness Spectrum

I’ve thought about illness to wellness spectrum (above) a lot lately. Whenever I think about it, I recall civil defendants’ attorneys describing “a preponderance of the evidence” as meaning the plaintiff has to push a boulder over the top of a peak before a jury can conclude that the plaintiff has won the case. (Plaintiffs’ attorneys, on the other hand, will start out like an Olympic diver at the top of a platform with outstretched arms, but with more clothes, and begin see-sawing to explain that the scales just need to be tipped.)

Pushing a boulder up a mountain is not a bad metaphor for getting fit when you’re already chronically ill. Or, better, climbing an icy slope with a backpack. You gotta push up that slope, and any time you lose your grip or your balance, you start sliding back down that damn mountain, with the load of the past dragging at you.

And now I think I may have found an ice axe, which you use to stick into an icy slope to make sure you don’t slide any farther. The maneuver referred to as a self-arrest. I like that term: You stop yourself before you start picking up speed on your way down. From Wikipedia:

 The longer the delay of the climber before he/she starts to put weight on the axe’s pick the longer s/he freely accelerates down the slope.

Ariel Bravy learns to self-arrest with an ice axe on St. Mary’s Glacier, Colorado.

In the past I’ve worked out and thought, gee, I feel better now, but when I stopped, I had to think about it before I realized I kind of missed it.

That’s not the case any longer. These days, at the three-day no-workout mark I start declining and find myself in increasing pain. That’s when I use the ice axe. It is something that makes me say to myself that there is no more time for delay, no excuse, and that if I don’t do something now, even if it hurts, things will just get worse.

I’m not talking about the stiffness and pain of the morning. That’s one of the reasons I hate waking up. I start out sleepy and warm, and then the fog dissipates and, like a morning glory, my pain opens to the sun. But those creaks tend to even out (or at least recede into the background) as the day goes on and I warm up.

Nor am I talking about DOMS (delayed onset muscle soreness), the sore you get from breaking down and rebuilding muscles. (I almost like that pain; it means I’ve done something to push myself.)

No, the pain that is the warning arrives at night when I try to go to sleep that tells me I’m starting to fall. No anti-inflammatory will make it go away. I can’t reposition my body to ease it. Ice nor heat will beat it into submission. It’s a bone-deep ache that generally affects me from the hips down. And when it happens, I either have to be so sleepy that I could fall asleep while someone was amputating my leg, or I have to get out of bed and at least stretch in order to get the pain level down to the point I can sleep.

On those nights, I wake up knowing that no matter what is hurting me, I’ve got to do *some* sort of exercise. Time for the ice axe.

I’ve crawled out of bed, ate a little something and hydrated, then exercised, and crawled back to bed, completely spent for the day. I’ve exercised with a night mask and ear plugs (on better days, inside with sunglasses) because of a migraine (and had it get worse during the exercise). I’ve exercised with twinges in my knee that I jammed. I’ve had nausea and dizziness while working out (when light-headed, I try to make sure I don’t do anything that involves standing with a heavy weight). I’ve sneezed, hacked, coughed, wheezed and otherwise been an allergy queen during my workouts..

I’ve had a lot of what I’ve come to call fibro spasms (more intensely during workouts; they seem to lay off once I stop): the closest I can come to describing it is that an area along any muscle fiber of about 3 inches long and a half-inch wide that suddenly hurts as if someone pushed into a particularly tender bruise. It lasts for less than 30 seconds in any given spot, then wanders to kick a different muscle.

But none of that deters me once the three-day ache kicks in; it makes me  use all my will to plunge my imaginary ice axe into the side of the friggin’ mountain and say to myself, “Yeah, this sucks, but do you really want to hit the bottom of this slope at full speed?”

And I work out. It may be modified or scaled because of whatever is going on, but I get out of bed and move and lift and stretch.

Someday I’ll get over the top and let the backpack coast down ahead of me and spill out a million fragments. And then I’ll walk down the other side.

This last week I had a rather unexpected setback. I had a “minor” oral surgery procedure that managed to knock me on my butt for at least three days straight (advertised as “you’ll be up and going the day after”). I visited my wonderful physical therapist, Dr. Stephanie Thurmond, and after talking to her, and reading some blogs and comments from other folks in my position, I started thinking about CrossFit for “nonathletes” generally and what’s important for those of us who

  • are overweight to morbidly obese,
  • are over 50,
  • are congenitally awkward and remember PE as a torture chamber filled with humiliation,
  • have accumulated injuries that need accommodation,
  • are illness- or injury-prone,
  • have hormone issues (HRT, perimenopausal). and/or
  • have illnesses that make them hypersensitive to stimuli (fibromyalgia, rheumatoid arthritis, migraines, allergies and asthma, as examples).

I’ve discussed much of this in other posts, but I felt the need to sum up.

1. Get past the slogans and hype.

“Forging Elite Fitness,”  CrossFit’s official slogan, intimidates the hell out of most non-elite nonathletes. And lots of affiliates (aka boxes) like to up the ante. One I saw recently was “Blood is replaceable, Sweat is Expected and Tears are optional.”  At this point it made me laugh, but a couple of years ago I would have seen it as a “nonathletes need not apply” sign. Although my husband was really into it, and is level-headed about pretty much everything, I still saw it as a testosterone-marketed competitive activity.

And it may have been, at least in the beginning. But the CrossFit powers-that-be quickly saw that even if you’ve got motivated folks, not all of them are athletes, or, if they are, they’re specialized enough that they burn out in a CrossFit workout, which is generally designed to improve your ability to function in the real world. You read variations on it all the time: “Our specialty is not specializing.” So even competitive athletes had to have parts of their WODs (workout of the day) scaled.

So it seemed that as CrossFit expanded and evolved, many CrossFit coaches saw the benefit of making the program more inclusive, involving the elderly and kids. I mean, as long as you’re having to adjust WODs on a custom basis, why not do it for anyone?

2. Ask questions. Lots of them.

Membership in a CrossFit affiliate isn’t cheap, nor is hiring a CrossFit coach.  Boxes are cropping up everywhere (at least in my neck of the woods), so you may have some choices. Or you can consider working out at home, but you need someone who knows what they’re doing to watch how you’re doing things or you can easily end up worse rather than better.

First, look at staff bios if they’re available; I prefer being able to read them online. Most CrossFit boxes have at least a semblance of a web page. Ideally, you’d find a coach who has a lot of experience or special interest in working with people with whatever limitations you have, and, cherry on top, has professional training in biomechanics (like a physical therapist). Kelly Starrett is a well known CrossFit instructor who is also a physical therapist and he has tons of good information. But even his website can make you think it wouldn’t be a good fit, as he works with “elite athletes” and uses the term “athlete” to describe who his website is for. But I emailed the site, asking for clarification. I received the following response:

These mobilization are for everyone and everyone is an athlete!

Not my mindset, but cool, now I know that if I were in the San Francisco area, I’d definitely look at going there. And the response was from another physical therapist apparently working with Starrett.

But not every CrossFit box is going to have that attitude or that depth of experience. However, CrossFit central is very big on working with nonathletes, even if some individual coaches aren’t:

CrossFit is a core strength and conditioning program. We have designed our program to elicit as broad an adaptational response as possible. CrossFit is not a specialized fitness program but a deliberate attempt to optimize physical competence in each of ten recognized fitness domains. They are Cardiovascular and Respiratory endurance, Stamina, Strength, Flexibility, Power, Speed, Coordination, Agility, Balance, and Accuracy.

A bit stuffy, but the bottom line is that CrossFit is designed to improve anyone’s overall fitness. And affiliates and coaches who are members of CrossFit have access to materials to help them scale IF the coach is interested in working it out. Your job is to figure out which coach is going to be not just willing to work with your limitations, but who has an active interest in doing so.

So take the time to talk to the coaches before making a decision. Listen carefully to their responses. Tell them your particular concerns and ask them how they’ll be able to scale down or adapt the program for you.

3. Make consistency your first priority

Most injuries occur when people try to do too much too soon. Whatever your limitations, be willing to start slow and concentrate on being steady at it. When I started, I was really consistent for five months before a knee problem got in the way, and I let myself be sidelined for at least an equal amount of time. This last setback felt almost as bad, but I did what little I could within 3 days of my recovery. I’m bouncing back far more quickly than I have in the past.

And I have discovered that if I miss more than around 3 days in a row, I will start deteriorating in a much broader sense than being able to do fewer reps or less weight. Whichever illness has decided to start picking on me, migraines or fibro or seasonal allergies, it will get worse as well, and then my sleep is affected because I’m in pain or hacking, and things begin to snowball. If I suck it up and do what I can without injuring myself, which may be far less than what I was doing before whatever obstacle got in my way.

4. Listen to your body, and tell your coach what it’s saying

If your body is hurting, you need to evaluate it. I’ve written earlier posts about when to pay attention to pain and when to ignore it. Short version: If it’s sharp and new, stop and figure out whether you can continue or if you need to stop. Achey pains and cramps are generally not going to be things you’ll need to quit for.

But your coach cannot help you if you don’t communicate. I’m bad at this; I hate sounding like a whiner, particularly when other people are doing the same thing easily. But your primary goal should be getting yourself fit. That’s the whole reason you’re putting yourself through this stuff and why you came to CrossFit to begin with, so swallow your pride and tell your coach your problem. Sometimes it’s just a slight form problem that’s causing the pain.

For example, I started feeling a weird pain in my left knee (which is the bad one) while on the rower. It was on the outside of my knee, which was new. Turned out that I was opening my legs to give my gut extra room so I could get a longer push, which was putting torque on my knee. As soon as I corrected that, the problem went away. You will learn to troubleshoot some of the problems yourself, but often you need someone else to watch to see the form flaw.

5. Scale, scale, scale; form, form, form. Did I mention you should scale?

One of the aspects of a CrossFit workout is intensity: You need to push yourself. But that doesn’t mean overdoing it. What you are capable of doing is, to some extent, subjective. And it will vary from day-to-day. If you’ve tweaked a muscle, scale back anything that is the problem. Find ways to deal with whatever areas give you problems. Rule of thumb is that you should find the first round relatively easy and begin to start having difficulty (needing to take more stops, for example) around the third set. If you start getting sloppy with your form, you are increasing the chances of getting injured. On the other hand, if it’s just a lot of effort, but you can keep the form, then you’re on target.

This is what you’ve looked for in your coach: Someone who is willing to be creative to find solutions to your weaknesses. Use that creativity to scale appropriately. Concentrate on getting the form right and the rest will take care of itself.

6. Expect set-backs

Life happens, and things will get in the way of being as consistent as you’d like to be. Illnesses, vacations, injuries, surgeries, drugs: Any of these may cause a period when you can’t work out. It happens. Don’t flagellate yourself. Do what you can as soon as you can. This is the same principle as in weight loss. There’s a great post from LiveStrong’s The Born Reality that applies; here’s a taste:

Having worked with clients for more than 10 years, most people suffer from an extreme inability to fail on a small scale. When they screw-up, that’s it for them–they have screwed up permanently, and so they keep going.

Conventional wisdom tells us that if you find yourself in a hole, you should stop digging–that’s the logical thing to do. However, when it comes to nutrition, we aren’t logical or conventionally wise. When clients have a dietary faux pas, their impulse, paradoxically, is to make it worse; after they eat the brownie, they think, “Well, I’ve ruined today. I may as well just eat whatever I want and then be good tomorrow.”

That would be bad enough by itself; however, for many people, they carry the failure over to the next day, and the day after, and finally, “I’ll be good tomorrow” becomes “I’ll start again on Monday.”

The Monday Mindset

Historically, Monday is the busiest day at gyms. (In my facility, attendance is 30% higher than any other day of the week, and that is not unique.) A decade of looking at clients’ food logs makes it clear that Monday is also the day with the highest level of dietary compliance.

Which is ironic, considering this: In my view, Monday is the most dangerous day of the week. Not Monday, but the idea of Monday–a fresh start, always available, never more than a week away.

7. Remember that you are only competing with yourself

CrossFit encourages competition and working in a group. In a well-run CrossFit box, the other people working with you should be supportive, and the coaches should create a supportive environment. Of course, we live in a flawed world with flawed people. There may be someone who makes you uncomfortable or is smug about how much “better” s/he is at whatever WOD. Don’t worry about them, and don’t let the jerks get you down. Most affiliates keep records of your times, reps, etc., and will make a big deal when you achieve a personal best.

It is a big deal. Pat yourself on the back and keep going!

Even though the human brain averages a mere 445 square inches, the mind contained within it encompasses an immeasurable amount of space. You can time travel to the past or future, explore parallel realities (all the “what ifs” we regularly contemplate) and imagine the future. But this mind space is full of black holes.

When you’re full of energy and motion, hurtling through your days by physical and emotional momentum, you can avoid the pull of those black holes (for the most part). But when you hit the skids, whether emotionally or physically, you can find yourself pulled into the gravitational well of those lurking black holes.

Let me give you an example. I’m currently lowering dosages of various drugs that help prevent migraines (aka prophylactics) because of their side effects. As the most recent neurologist I’ve visited (still trying to find a successor to Dr. Nett, headache specialist and doctor par excellence) explained, there are the three basic groups of go-to drugs for migraine prevention.

  1. Calcium channel blockers, which are commonly prescribed as  for high blood pressure
  2. Antidepressants, also prescribed for depression (yes, I’m stating the obvious), perimenopausal symptoms, ADHD, OCD
  3. Anticonvulsants, primarily developed for epilepsy and other seizure disorders

All of these interact with the way your brain reads, transmits and builds neurotransmitters, the chemical components that are the equivalent to computer commands. So, as these drugs are going out of my body, I hit all kinds of funky withdrawal effects. (By the way, when it’s a prescription drug, docs tend not to like the term “withdrawal” because of its association with street drugs, but it pretty much amounts to the same thing. The pc term is “discontinuation effects.”) The discontinuation effects can be reoccurences of whatever the drug was supposed to prevent as well as any side effects potentials that were risks of taking the drug to begin with.

The best everyday analogy I can draw is the effect the hormones can have on you. Everyone knows about the nice hand that PMS can deal you.

So after being chronically ill, fairly isolated, and fighting the damn withdrawal symptoms, which have ranged from a day visiting the world of Alzheimer’s (really, I sounded like my grandfather did in the early stages of the disease, asking the same questions several times within an hour), I’ve been emotionally hydroplaning, which feels like this:

So I start drifting into some really old black holes that lurk in various corners of my mind space.

A basic one that keeps grabbing me is the “invisible woman” black hole. This one, like all black holes, is based on something I believe about myself, true or false. Ed Smith, E.Ed., has a ministry based on t he idea that most of our problems stem from lies we believe about ourselves. He says, essentially, that if you were Satan, why bother messing with someone’s head their whole life when you can just plant a few good lies in childhood, a gift that keeps on giving.

Whether you buy into the religious aspect of the theory is irrelevant to whether the underlying premise holds true. I think there’s merit to the principle. As a child, you believe the world revolves around you, and, thus, your actions affect all of your environment, a condition known as “magical thinking.” (Of course, some people never develop past this way of thinking.)

Some of these ideas become embedded into your thought-process to the point you are not aware of them. Cognitive therapy is based, at least in part, that if you identify and articulate these ideas, you can begin to recognize and change your patterns of thought. Meditation and prayer can also help you self-identify the lies you believe about yourself. Once identified, you can use reframing or self-talk to try to recondition yourself. Theophostic Ministries advocates going back to your first memory of believing the lie about yourself, and praying to recognize the truth of the matter (more accurately, asking Jesus to show you the true perspective).

However you get there, the truth is what will set you free. However, for it to do so, you need to begin integrating and internalizing the truth. Sometimes that is as simple as telling yourself the truth every time the lie begins to affect you.

So, for me, a precocious only child who didn’t understand the social rules of my peer group, I experienced a world in which other children didn’t get me, and therefore pretty much ignored me, and adults would be kind and tolerant, but (understandably) only interested in talking to a child for a short period.  In my childhood’s mostly adult-centered world, I felt seen and not heard (although my dad called me “Yak-Yak the Monkey,” so obviously I was making noise). Despite the fact that now I’m a very large woman, with, sadly, a very loud but not pretty voice (my entire family has mastered a “turn the volume down” gesture) which learned the trick of making statements sound authoritative, when I’m down, I feel invisible.

The consequence of sliding into the gravitational field of that particular black hole is that I begin to feel like nothing I do or say has any significance or meaning. As the gravitational pull becomes stronger, it sucks out motivation.

How do you escape that pull? Maybe you can do it yourself by identifying the kind of black hole you’re falling into. Often you need help, though. I’m a very fortunate woman. Regardless of the pain and weirdnesses of my discontinuation, I have caring family to pull me out of the gravitational field by telling me how I’m wrong (and giving me help when I can’t make myself ask for it), and helping me reframe the situation so that I can stay motivated.

Moral of the story: When you start feeling sucked into your own black hole, send out an SOS to those who love and support you. It’ll keep you on the path to overcoming whatever obstacles you need to overcome to reach your goals, be they fitness, diet, health, addictions, or fill-in-the-blank-here. And never rule out the possibility of seeking out a health care professional (including mental health care folks).

Reflecting on the pressures I feel while navigating through the challenges of escaping my poor health/fitness condition, I wondered if it was anything like what a 600 lb. octopus felt when squeezing through a hole the size of a quarter.

The ability of the octopus to compress like that could reasonably be considered a survival mechanism, although I can’t seem to locate any authority that states the reason for the behavior. Makes sense, though: Why else would you scoot through an unreasonably small opening, if not to get away to live another day? Or, to twist the question into the shape I’d like it to take, why else would you put yourself through all this pressure and/or pain except to stay healthy?

The other question I can’t find an answer for is whether this is painful for the octopus. Granted, it’s hard to ask them to rate their pain on a scale of 1-10, but their physiology should suggest whether it would be possible for the compression to cause pain.

This all came to me when I was joking about meeting the four horsemen of the apocalyptic workout–the day that makes you want to end all exercise forever.

I’d had a workout that left me sobbing in pain and frustration: changing my dosage and timing on one of the medications to prevent migraines had made me light-headed and light-sensitive, so I was doing my workout in the shade in sunglasses…and with my eyes closed whenever possible. Every squeak of the equipment and sound of the timer going off put my teeth on edge. I had flash migraines, where it felt like someone had shot me in the left eye with an arrow, but only for a few seconds at a go. I was cranky, because the changes had disrupted my sleep schedule.

Unrelated to the medication change, I was cramping in my left quad and gastroc. My body seemed to be screaming at me to quit, assaulting me on all fronts. I felt rather like the one time I’d had sunstroke, just before I passed out. And then, the crowning blow was a simple hamstring stretch.  This is usually the “ahh” moment, as I’m almost done and everything left to do is on my back on a nice foam mat.

Pain exploded in my right quad, radiating to my hip. That’s when I started crying. As I said before, pain for a purpose, to achieve a goal, is one thing, but there’s no sense in suffering needlessly. And, as often occurs, I began doubting whether I would ever progress.

The same thing happened for the next three workouts. I felt like I was squeezing my fat ass through a teeny hope, pressured by pain and fear. My husband felt a big knot in my quad. I set up for an early appointment with Stephanie the phenomenal PT, but, in this case, early meant five days away rather than three weeks.

In the meantime, Gary was rolling the knot. Foam rolling is the best way to do this for yourself, but it’s really difficult for me to get the balance right for most of these, so we’ve taken to using a rolling pin over the area. As I’ve mentioned before, muscle knotting is common in people with fibromyalgia. Usually neither Gary nor I can find the knots, although massage and/or physical therapists seem to put their fingers on them immediately. This one was big enough for him to find.

So we looked up how to deal with knots in muscles. The instructions basically said (in all the sources we could find) to stretch the knot away from the contraction. Since we had no idea how to figure out which way it was contracted, Gary and I decided to go with rolling along the same direction as the muscle fibers. Turns out that was the right idea, and that, yes, until you’ve had a lot of hands-on training, figuring out which direction it should be stretched isn’t that easy for most people.

So he put some pressure on the rolling pin and ran it up and down the knot, the IT band and the hip. I concentrated on breathing like I was in a Lamaze class (although when applied to childbirth, I gave up and asked for the epidural) so the crying incident would not be repeated.

The rolling (and some anti-inflammatory OTC meds) helped, but I dreaded the hamstring stretch each and every day after the first time my quad screamed. On something like the fourth workout after this ghastly newcomer showed up, I had finished the hamstring stretch and was into the piriformis stretch (which you do by pulling your knee toward the opposite shoulder) and there was something like a pop where the knot had been, a burning sensation, and then an immediate reduction in the pain.

Ahh. Is that what the octopus feels once it’s out of the hole?

I alluded to my recent health issues (well, more than “alluded” in some) in recent posts: Pain and other challenges, Pain and other challenges: Part 2 and Pain and other challenges: Part the third.  The problems kept piling up, and the key feature to improvement, consistency, has eluded me. I think I’m now on the way to surmounting the problem.

One of the issues that is only tangentially about me is that my migraine specialist, Dr. Robert Nett, died in a car accident back in February. His death was a loss to the medical community, as he was both a researcher and a practitioner, an M.D. and a pharmacist, and very attentive to his patients. It was, of course, even more of a loss to his family and friends, but I’m sure all of his patients felt the loss as well.

I found out when in a different specialist’s office. I’d listed Dr. Nett as the doctor treating me for migraines, and the doctor’s assistant asked me a couple of times who was taking care of that. I repeated the answer a couple of times, a bit confused. Then she realized I hadn’t been told.  When she told me, my first thought was “What a waste!”  My second was “His poor family.”  And my third, I’m a bit embarrassed to say, was “What will I do now?” Selfish much?

But there’s been some validity to the concern. I’ve been heavily medicated to prevent the migraines, and I was developing some sporadic and odd side effects. He had planned to reduce them at some point after they’d done their job of resetting the sensitivity of my brain to stimuli. However, you basically had to audition to get an appointment with him because he was in such high demand. Now that he’s gone, pretty much everyone here in San Antonio that specializes in migraines is slammed and we’re looking at, ohh, August, maybe, before I actually see one of them.

So my internist (whom I’ve called “wonderful” several times, and realized I use “wonderful” way too often, so let’s say she’s amazing — because she is) has been temporarily dealing with my migraine meds as well as my grab bag of assorted illnesses. I had an appointment with her because of a hacking cough I couldn’t shake and managed to have one of the side-effect “spells” that  periodically plague me. I won’t bore you with the details, but she sent me straight to the ER, and on the follow-up appointment said that I was acting as if I’d “had three bottles of tequila, and [she] knew [I] hadn’t done.”

So what with the actual migraines, the recurrent hacking cough, and the spectrum of light-headed to stoned beyond belief, I’ve been extremely inconsistent with my exercise.

So at said follow-up, I talked to her about reducing all of the drugs to zero and asked her if she thought I was being overly simplistic in thinking that diet and consistent exercise would take care of the problem. She nixed reducing everything, even over a lengthy period of time, and pretty much told me I could expect to be on X, Y and Z for the rest of my life. On the other hand, she was in favor of reducing to eliminating some of them.

But we both knew that the ones that were first on the chopping block were those which were preventing the migraines, as they’re also the ones probably responsible for my problems. So I kept thinking, well, what about the exercise if I’m in the middle of a migraine?

She did agree that exercise and weight loss would/could eliminate (or at least ameliorate) most of my medical issues. But I was stuck on the “How can I be consistently exercising if I’m having all these problems?” and not expressing it well and we kind of went in a circle for a bit.

It took me a while to formulate the right question (because of all the foggy brain problems), but I finally came up with it: Is there any reason I should stop if I’m having a migraine, feeling wobbly or hacking like crazy — or do I just need to suck it up?

She smothered a chortle (or at least that’s what I think it was), and said, “Well, basically, yes. Suck it up.”

Fair enough. My fear has been that I’ll make things worse. Now, if necessary, I’ll go workout with my earplugs and sleeping mask, and if it makes any one migraine worse, I’ll deal. I plan on having the hubby coach on standby, of course, but as far as the pain, well, it’s just pain. I don’t mind suffering in the short term if, in the long term, I’ll actually get better.

So, sports fans, the race is back on.

So, gentle readers, all that I mentioned yesterday happened at the end of last year.  I’d written that post back in January on a good day. They were pretty infrequent, so I put off posting until I had something more encouraging to report (at least in the end).

Just before Christmas, things got even worse, although, for once, the injury was completely not my fault. The water heater decided to lay a trap for me. Our washer/dryer is in the garage and the water heater is just beside the door from the kitchen to the garage. We’d been in and out during the day. My mother was coming in for Christmas, and, an hour before we were to pick her up, I went out to the garage to get some laundry out of the dryer.

I was sitting in the puddle at about the same time I realized I’d fallen. I didn’t feel anything at first, which alarmed me a bit because all of the worst injuries I’ve had in my life didn’t hurt right away (unlike a paper cut, which is a dramatic little screamer).  I fell hard enough my husband heard it reverberate through the concrete (the same thing happens when anyone drops a weighted barbell in the garage). I was able to get up; nothing broken.

But it made the fibro critter incredibly pissed off. By Christmas day, I couldn’t lift my arms to brush my own hair. Overwhelmed with pain and frustration, I think I cried pretty much every day for at least a week. (Of course, there’s always menopause to blame).

Let me digress for a second. Fibromyalgia is one of many syndromes that result from neurochemicals getting crosswise with each other. Dr. Wonderful  told me that it, along with migraines, crop up because your brain is hypersensitive to various stimuli. Given all these interactions, the chronic migraines returned in force. All my medications were upped. Whee.

And the migraines receded, but I was still so crippled by pain that walking or standing was a challenge. I went to my internest, and she checked me out and said, “Well, there’s nothing more I can give you because of all the medications you’re already on.”

Argh. One of those moments where your heart drops and you think you’re doomed.

But then she sent me to back to Stephanie, my ever-so-awesome physical therapist, giving her pretty much a free hand to deal with my fibromyalgia as needed (I think it’s technically “assess and treat”).  The first few visits were murder. I’d cry during the therapy, which, although I freely admit in writing that I cry over stuff, I rarely cry in public. It’s pretty ingrained that crying in public is an invitation to abuse. I don’t like being that vulnerable; generally I hole up when I’m in pain. (Which is another reason I haven’t posted in ages).

One of the things that fibromyalgia can do (or is responsible for creating fibro–the experts won’t agree) is create knots in your muscles:From

I’m not endorsing the site that created this image; it’s a nice illustration, though. I don’t know enough about it to give an opinion. However, I’ve been warned by several doctors (some friends of the family, some treating) to be careful when choosing treatments for fibromyalgia; just like any other chronic ailment, there are some treatments that are possibly useful, but not scientifically studied and others that are downright hokum.

So you’ve got this contracted muscle. It’s freaked out and won’t relax. Notice the biceps in the illustration below from Human Locomotion at Connexions:

When the bicep contracts, it bulges in the middle and strains at the insertion point. When this goes on for too long, it begins to become inflamed. So it’s a bit of both happening all at once. The trick is to convince your body that it’s okay to relax.

Physical therapy has helped. I have to spend a couple of hours a day doing home exercises to improve; at least an hour to stay even and start going downhill if I miss a day. Unfortunately, I still have days with migraines and the fibro flare still makes its presence known. My social life consists of seeing health care professionals and my immediate family members.

Among the various discussions about what I could do in the way of working out, squats came up. At the physical therapist’s location, I was doing squats on a Total Gym. Basically, it takes the load off the knees but allows you to do the same motions as a squat, leading to an exchange that went something like

“So, can I start doing air squats at home?”


“I mean after I’ve improved.”


“After I’ve lost weight?”

“Which part of ‘no’ are you not getting?”

[laugh; pause]


“Not with your knee.”

Bummed me out. She went on to explain that if I didn’t do every single squat perfectly, I’d end up reinjuring myself. She agreed with CrossFit’s position that it takes several years to master the squat. I’m in a situation in which the arthrogenic (read: Getting Old) changes in my knee won’t allow me to go through the learning process.

However, SCALING still applies. So I’ve got a new toy. CrossFit isn’t big on equipment, but for those of us who are overweight and aging, sometimes you need something to scale down lower than zero weight. (Again, I’d like to put a fat suit weighing a hundred pounds on some of these guys and say, “Go ahead. Do a friggin’ air squat.”)  I got a home version of a Total Gym, although not the trademarked one. My husband did the comparison shopping and we invested in a Jillian Michaels Body Shop. It’s not nearly as sturdy as the one at the therapist’s office, but it’s at least one-tenth the price.

So far, I’m only using it to do the squats (in 8 minute stretches) and working at the pullups. I use the next to the lowest setting, which allows you to do the exercise carrying less than your total body weight.  I’m having to accept that I will max out on what I can do with squats, and weighted squats are a no-go for me.  Running is also off the table.

But that doesn’t mean I can’t work toward other goals.  For me, I’d define it as wellness, a bit shy of the CrossFit fitness model. More on that in the next post.

Elegy on a migraine

Posted: August 26, 2011 in Health
Tags: , ,

Oh bitter pain, why do you stay and stutter in my head,

You’d left to dry up and seek me no more; why return?

You know I like you not, to encourage your attentions,

Yet you pound against me like the sea’s rough hands,

Battering all the senses, leaving nothing but your touch.

The bright lights I crave you banish,

Thoughts turn to decayed insect wings

And the best intentions die of starvation.

No matter that I know you will turn surely as the tide,

While you ride my skull, time is jellied eternity.

Things pass by as if I were already in my grave,

Yet they snag on my brambled temper and fray

When I would have them cheerfully whole.

A celebration, the laughter loud in the distance

As you amplify my hearing to pain,

Makes me empty and wondering what is yet possible.

In anger and pain, I tally my disappointments;

Is there yet time to mend my mistakes?

Or has the time passed for hope?

Only the pounding surf of blood in my ears answers,

And I seek darkness once again.

So, it’s been a tough month so far. It actually started the last week of June. I alluded to the problems I’ve been having in “Why 20:42 is my best time ever, ” but now I’m going to come out and deal with it head on.

What prompted this? I was lying in my self-made sensory deprivation chamber (okay, it’s just me in bed with my CPAP mask; a stellar sleep mask my wonderful daughter-in-law, Laura, gave me; ear plugs; my head sandwiched between two huge pillows and the covers pulled up over the whole shebang), and I realized I was alternating clenching my jaw and grinding my teeth.

This was not good, because the reason I’m lying in there is that I have a migraine, and the tense muscles in my jaw and neck don’t help. I’ve taken all my rescue medicine, and the light hurts us, precious. And the sound. And pretty much everything. And the reason I have a migraine today is because I’ve been sleep-deprived because of problems with my CPAP (which were finally solved last night, but the cumulative effect caught up with me at the same time).

But I realized that I was allowing all the things that I’ve set as goals for myself become  masters rather than servants. The fact I’ve been blogging more irregularly bothers me; I’d set a goal to do it every day. I’m behind where I think I should be in the part time job I started three weeks ago, even though the hours are flexible and I telecommute. I’ve missed some work on a volunteer gig, and I feel like I’m letting them down. There were dishes piled in the sink and laundry I hadn’t dealt with.

And CrossFit? Well, I’ve been doing more like one day on and two days off lately, all because of the multiple health issues. And so I feel guilty and stressed about that. And, because I’m not feeling great, I’ve slacked off being as careful about logging what I eat and when I’ve exercised and all the other stuff I’m supposed to log.

So here I am, trying to do a little to get all those worries off my back. Took care of most of the dishes and laundry, checked email from work and vol stuff, and am blogging, well, now.

And my head is now worse, and I’m doubtful CrossFit will happen today.

What am I trying to say here? I’m trying to convince myself that I really can do the things I’m trying to do and that the fact that I’m struggling right now only means that: I’m struggling right now. That it isn’t some sort of premonition of failure.

So I just remembered something I’d read about a while back: The Imposter Syndrome. Caltech (yes, the home of  really smart people, including physicists and engineers like those on The Big Bang Theory) Counseling Center puts it like this:

Impostor syndrome can be defined as a collection of feelings of inadequacy that persist even in face of information that indicates that the opposite is true. It is experienced internally as chronic self-doubt, and feelings of intellectual fraudulence.

It is basically feeling that you are not really a successful, competent, and smart student [of course, you can substitute "student" with whatever role you want~jgm], that you are only [pretending to be one.] … The impostor syndrome is associated with highly achieving, highly successful people.   This makes impostor feelings somewhat different from the concept of “low self-esteem” because there is a discrepancy between the actual achievement and the person’s feelings about the achievement that may not be present in low self-esteem. People in different professions such as teachers, people in the social sciences, people in academia, actresses and actors, may all have impostor feelings. It was originally associated with women but recent research indicated that men suffer in similar numbers.

One such highly successful person who appears to suffer from this syndrome is Jodie Foster. Since we share the same first name (even if she spells it wrong) and are close to contemporaries, she’s someone I’ve always compared myself to, so it was kind of a relief to see that she, too, is plagued with the need to do in order not to be caught out as an impostor, as reported by the blog “Women and Talent“:

Years ago, [Jodie Foster] was also experiencing these feelings, saying in a tv interview [CBS, 1995] that before her Oscar-winning performance in “The Accused” she felt “like an impostor, faking it, that someday they’d find out I didn’t know what I was doing. I didn’t. I still don’t.”

Wow. And here I am, feeling like a CrossFit imposter. But I am doing it, even if not as often as I’d like of late, and even if not today.

Mary Ellen Bates, blogging at “Librarian of Fortune,” has some good suggestions in her post on “Fighting the Imposter Syndrome“:

• Imagine talking with someone who has your qualifications, skills and abilities. Would you really call her incompetent?

• Learn to appreciate your own accomplishments and successes. The ability to reward yourself rather than waiting for external feedback is a critical skill for any info-entrepreneur.

• Let go of the need to know everything about everything. Our clients hire us because we know how to apply our skills to their need.

Go, girl.  I’d add “Let go of the need to be everything you can be right now. Take it one day at a time, and appreciate what you’re doing in the now. If it’s not your best, remember that one day is not your whole life.”

And now I’m going back to my sensory deprivation chamber. Maybe now I can relax and let go of the headache, too.

Hello, my name is Jodi McMaster and I’m a sodaholic, and its been almost a year since I had my last drink. I had a six-pack a day minimum habit.

Hmm. “Sodaholic” looks kind of kinky written out;  it sounded fine.

The point is that up until  about a year ago, you’d be hard-pressed to talk to me when I didn’t have a soda in my hand. As a kid, it was Coca-Cola. When I became a teenager I started drinking Tab. When I got pregnant, I went back to “real” Coke, because I was more worried about what the artificial sweeteners might do to my developing child than I was of the sugar. In between pregnancies, Diet Coke had taken over enough of the market that Tab was becoming obsolete and hard to come by in your average vending machine, so I switched to Diet Coke after my first pregnancy, returning to it again after the second.

When I had a horrific breast biopsy due to fibrocystic knotting (which is exacerbated by caffeine), I went to decaf Diet Coke, which was kind of a pain because it, too, is infrequently found in vending machines. The only thing that made me perservere, at least for a while, was the desire to avoid another biopsy.

I have never figured out why the doctor thought it was okay for me to endure eye-watering, teeth-clenching pain when the anaesthesia wore off because she was “almost finished.” Wow. My pain was not worth the time it would have taken for another injection. To top it off, the site hurt like hell afterwards, and when I called to ask about it, they told me it shouldn’t and to check under the Steri-strip. When I peeled off the blister that had formed under it, taking several layers of skin with it, I learned that I was allergic to them. Not just Steri-strips, though; if I leave a regular adhesive bandage on for too long, it’ll start blistering, too. I rip them off on my way out the door now.

Throughout the years, I tried to give up the Coke habit, but I always came back to it. My stepfather, Al Lang, once asked me why I drank decaf Diet Coke with the comment, “What are you getting out of it if there’s no sugar and no caffeine?” He had a point, but I didn’t quit then. I’d read articles that suggest that even artificial sweeteners trigger appetite, but, as Mark Sisson’s post “Do Artificial Sweeteners Cause an Insulin Spike?” on “Mark’s Daily Apple” blog says:

The notion that artificial sweeteners (and sweet tastes in general) might produce an insulin response is one of those murky memes that winds itself around the blogs, but it’s never stated one way or the other with any sort of confidence. I briefly mentioned the possibility of non-caloric sweeteners influencing satiety hormones in last week’s diet soda post, and a number of you guys mentioned the same thing. Still, I’ve never seen unequivocal evidence that this is the case.

In an interesting article from CrossFit Journal, Robb Wolf, a former research biochemist and student of the guy who wrote the Paleo Diet, gives his take on the artificial sweetener problem, but adds an alternative explanation:

[A]rtificial sweeteners can create insulin spikes via signals between the taste buds and organs such as the pancreas and the brain. Furthermore, the body is wired in ways that allow some people to get insulin spikes just by looking at pictures of food.

In 2007, Reuters reported an even more disturbing risk:

Sodas — even diet ones — may be linked with increased risk factors for heart disease and diabetes, U.S. researchers said.

They found adults who drink one or more sodas a day had about a 50 percent higher risk of metabolic syndrome — a cluster of risk factors such as excessive fat around the waist, low levels of “good” cholesterol, high blood pressure and other symptoms.

But that wasn’t enough for me to kick the soda habit. I switched from Diet Coke to regular Coke when I had a bad siege of migraines around a decade ago to see if the reduction in Aspartame intake would make the migraines go away. It took about three months to clear my system completely, but the migraines did start becoming more infrequent. But now I was on Coke, and it had evil residing in it: high fructose corn syrup.

To me, the best argument that high fructose corn syrup is bad for you is that the epidemiological studies show a rapid increase in obesity when it became the sweetener of choice. But that doesn’t actually prove a causative connection. In addition, corn and any of its byproducts are foods that induce all sorts of fun GI symptoms for me. Did I give up sodas? Nope. I bought the ones bottled in Mexico, because they still use cane sugar there.

Nope. What finally got me off sodas was the same drug given to me for my migraines that made me daily consider checking myself into a psych ward: Topamax. It made the damn things taste weird. I was on Topamax for what seemed to be an eternity, but really was probably a total of four or five months ramping up and then back down. (I knew right away that the side effects were too miserable for me to ever be able to deal with them, but the neurologist I was seeing at the time would not be swayed from his protocol just because I was complaining. Wow, I’m kind of bitching about doctors in this post; let me say now I don’t consider either of these examples to be representative of the profession, or even their specialties, as a whole. I stuck with the same gynecologist until she retired, had the same pediatrician for both my kids until they outgrew him, and have had the same internist for over a decade now.)

The duration of the Topamax experiment was enough to get me off Cokes altogether. I had been able to stay off them for a maximum of a couple of months in the past, but I always inched back up after the first one. Coke really is like a drug for me; even one is the doorway to destruction. I associated certain foods with Coke, like popcorn, and it would be the food that would make me want the Coke, too, and then I went. Popcorn is now also a no-n0 for me because of the food sensitivity issue, but I still want them with burgers.

I appear to have company in my tendency to eat higher-calorie foods when I drink sodas.  A recent study has shown that

Consuming just two sugary drinks a day can dull the taste buds and lead to cravings for high-calorie food, a study claims.The research suggests that within a month those who drink sugary beverages are left with a dulled sensitivity to sweet tastes. This leads to an increased preference for high-calorie and sugar-laden foods, creating a “vicious cycle” as consumers look for their next treat.

I didn’t really notice a weight loss when I gave up sodas (unlike all the men I know who have boasted of 20-25 pound drops once they kick the habit), but once I started thinking about it, I have maintained a slightly lower weight since I gave them up. It’s only about ten pounds, but that’s still something.  What it has done for me is taken out a lot of extra calories and the undoubted insulin spike a real, sugar-laden Coca-Cola gives you.

And yet, after writing all this and knowing they’re not good for me, I kind of want one. Won’t, but  the temptation is always there.

We’re in San Antonio, so it’s not surprising that we’re Spurs fans. Even after they fall apart at the end of their best season *ever.* (The only thing that makes me feel better is that the Lakers are also out of the running; I think that makes us look a little better than if we were the only major upset.)

Anyway, in years past, there was a player on another team that my daughter dubbed “Whiny Wallace.” I don’t remember which team he played for, whether that was his first or last name, how he spelled it, or what season it was, but I do remember that he would gripe to the referees, the camera, the stadium, his coach — I wouldn’t have been surprised to see him whip out his cell and cry to his momma, who was probably the only one who would have cared.

At any rate, today was my turn to be Whiny Wallace. I hurt. I had a headache of the regular kind, but was worried about it turning into a migraine. I didn’t sleep well last night. It was hot. So I called Coach Husband, who was at work, kind of hoping he’d let me off the hook. I basically said all of the above to him, and the conversation continued:

Hubby: Just make sure you hydrate well first.

Me: [almost audible whine] But what about my headache?

Hubby: You’ll feel better after you work out.

Me: [almost a bitch-out] Have you ever worked out with a headache?

Hubby: Sure. Lots of times.

Me: [considering whether this was actually a possibility, and deciding it was]: And did it feel better after?

Hubby: Sure.

Me: [whining evident in my voice] But I still don’t want to.

Hubby: [wisely, silence]

Me: What will you give me to work out?

Hubby: [laughs]

Me: [now whining like my daughter's chihuahua-pug mix (don't ask; he's evidently the product of a mad scientist's failed experiment)] Tell me something to motivate me. Tell me I’ve been wonderful.

Hubby: [again, wisely] You are doing great. You’re doing wonderful. You’ve improved.

Me: [slightly astonished by the multiple rephrasings; I wouldn't have been surprised by a verbatim repetition of what I said] Okay. I guess. [not done whining, but down a notch]

Hubby: Just worry about getting it done today. Some days are like that. Don’t worry about increasing your intensity; just concentrate on your form.

Me: [Still not convinced and still a little whiny] Okay.

I hung up, cranked up the exercise mix, and got Billy Joel’s Second Wind. Someone has a sense of humor, I thought: The lyrics begin with “You’re having a hard time and lately you don’t feel so good.” I reluctantly got on the treadmill, set it to my blazing speed of 2.5 mph, and began walking my ten-minute sentence.

Five rounds of eight reps each of overhead presses (hyperlite bar only), situps, squats with my helper box (that I pretty much took a pause on between going up and down), and shrugs with the 10 lb. medicine ball, I was done. Took me a total of 25 min. and 45 seconds, a full minute and a half longer than yesterday, but I did it, damn it.

And then I saw this video, which put my whines in perspective:

So, goodbye again, Whiny Wallace. I’m afraid I’ll probably see you again, but I hope it’s a while from now.