There are only two certainties in life. Death. And, Oh Ya, that other thing, whatever it is. I think maybe it’s called extreme anxiety.
For a lot of us right now, one of the biggest anxieties is about whether or not you or someone you love is going to get the coronavirus and die a horrible painful death. Can you imagine if you carried that level of anxiety about your health with you every day of your life?
This is precisely how I and many other people with serious chronic illness or pain live every day.
Waking up to a good day, when I’m not in so much pain, or simply in less pain, would be a good reason to celebrate. Or so you would think, but it isn’t necessarily so. If I’m not in serious pain right now, I’m probably super anxious about when it will start up again, since it’s seldom very long until the next session. Can you imagine being so fearful of your next bout of pain that you can’t ever be rid of the sense of dread that hangs over you.
And people who come in contact with me try to cheer me up by saying something like, “Don’t worry it, it can’t last forever, can it?” “Just get over it, you’re too obsessed with it.” As if I, someone with serious chronic pain wouldn’t part with anything I have to make it go away. And, well, yes, it can bloody well last forever, well, at least until I die from it, or some other condition that doesn’t happen to hurt, right now.
If I seem focused on feeling sorry for myself, just leave me alone. If you just can’t provide some comfort to me, exactly as I need it right now, then please get out of my face. I hardly need you to tell me to cheer up. And if you can’t handle it to see me suffering in pain, then just don’t. Leave. Piss off.
For me, and a lot of people with chronic pain, the coronavirus is just more thing to worry about, and make me more anxious about everything I have to do, everybody I have to see, and also more fearful about being able to obtain the bare necessities of life.
As if there isn’t enough to stress out about already, without the Damned Tsunami Pandemic, sweeping over the whole world.
To someone with a serious disease and chronic pain, death isn’t the scariest thing, it’s just the most certain.
The journey into becoming a diabetic is one that most of us join without knowing the consequences of what we’re doing. There are a lot opinions out there, even among doctors, as to what actually “causes” diabetes, but pretty much everyone I read knows that diabetes is highly related to obesity and carbohydrate overconsumption. And when I was diagnosed, more than twenty years ago, the information I was given was faulty and at the very least incomplete.
What no one ever said was that if I continued to eat what I thought of as a “normal” amount of carbohydrates and sugar every day, by the time I retired my life would be severely circumscribed, with many symptoms of diabetes and other metabolic syndrome related diseases causing continuing pain, physical exhaustion and emotional distress. I also suffer from chronic fatigue and despite having lost some weight, am still fighting the good fight doing intermittent fasting three days a week for 36 hours.
So what should I have been taught as a younger person, that might have protected me from getting full blown diabetes and other metabolic syndrome diseases.
Eat less carbohydrates. A lot less. On my current low carb high fat diet I keep my carbs below 150 grams a day. Eat even less added sugar. I try not to eat anything with added sugars, and when I do offend I eat very small portions of any sweet at all. Mind you, my appetite for sweet things has pretty much disappeared since I started avoiding them. Stay away from booze. Period. Lots of doctors and dieticians say that a one or two drinks a day is okay. I don’t believe them. Alcohol does similar things to the liver as carbohydrates, without the redeeming quality of providing me with any energy.
Always seek to reduce the amount of starch and sugar, and fill up on natural food if you are going to eat carbs. Eat fruit in season, in your area, and don’t overindulge even in fruit and vegetables.
Try not to get depressed because you can’t have any “real” food. Try to redefine what constitutes a meal, and understand that the meat and vegetables are really enough.
Starting today, January 6, 2020 It is my stated intention to achieve a BMI goal of 25% during the current calendar year.
Later in the afternoon
I started working on my blog earlier this afternoon, but was interrupted by a request from a family member for a ride from Burnaby, where I currently work, home to Langley. But I’m back at it now, and would like to upgrade my resolution to include a little more detail about this pledge, seemingly coming out of the blue.
I started doing intermittent fasting in July last summer, and promptly lost 35 pounds before the end of November, fasting for three days a week, 36 hours each on Monday, Wednesday and Friday. Pretty good results although most of the weight was lost in the first 60 days, and only a small amount during the last 60 days. In the last month I’ve pretty much given back ten pounds or so, depending on the time of day I weight myself.
Until Christmas holidays began I didn’t miss a single fasting day in my schedule, although I did start to cheat a little by eating Keto friendly pepperoni sticks and cheddar cheese sticks after a minimum of 24 hours into my fast. Checking my glucose levels shows me that the advisors are correct, and eating those two things, even combined, doesn’t raise my blood sugar at all, or not does having a handful of nuts. However, it does seem to have a negative effect on weight loss so I am going back to a more strict interpretation of fasting, which is eating nothing during the scheduled period.
During the holidays I broke the fast program only on two days, except for the cheating I’ve already mentioned, but my weight fluctuated from 209 back up to 222 and then down again to 216 and then back to 222. It’s amazing to think that I could regain basically 12 or 13 pounds, even attempting to keep my carbs down and no sugar to speak of at all, except for Christmas Dinner. Losing weight and keeping it off is a challenge, that’s for sure.
In addition, because I stalled quite a while before I started to cheat a little, I’m going to increase the length of my fasting period from a three day a week fast, alternative days during the week, to fasting for five days on and then four days off. My current plan, which I started implementing today with Day 1 of my first 5 Day Fast, is designed to kick start my weight loss again, so lose the next 25 to 35 pounds and get a lot closer to my goal of a BMI of 25, which as I said at the beginning of this blog, is my goal for 2020. I’m going to run with this schedule until my weight takes the next step down, past my previous barrier of about 209 pounds where I bounced back up to 222 over the Christmas holidays. .
My weight this morning when I weighed myself was 222.8 so a 25 pound weight loss would get my weight under 200 lbs, for the first time in a pretty long time. At 200 pounds my BMI will be about 31.2 instead of the current 34.8 (222 lbs) or 38.4 (245 lbs) when I started the program in July 2019.
Over the next few days I am going to re-read Dr. Jason Fung’s book the Diabetes Code, and also review his book on intermittent fasting. My own endocrinologist, Dr. Kang at VGH isn’t planning to see me again until about May so I hope my weight is down substantially by then, and my A1C levels at least down to 6.0, but we’ll see about that.
This plan to reduce my BMI to <25 and my weight to <160 is highly purposeful, in that I am attempting to do on my own what Dr, Fung achieves with his patients, a dramatic reduction in obesity and blood sugar levels. In the meantime I’ll continue to take my course in Pain Mastery from the Institute, and report back to my faithful readers my progress and challenges both in my fight against diabetes, and my battle to manage my chronic pain.
Global Warming is not the most important crisis facing the world’s human population at the moment.
One of the things that really concerns me about the current mass political movement around global warming is that it is distracting the human race from several other issues that are of far more immediate concern, and which also require a global response if there is not to be catastrophic outcomes, some of which are already far advanced.
And I am NOT saying the Global warming isn’t a serious danger to the health and quality of life of millions of people around the earth, mostly in the mid to long term, anywhere from twenty-five to fifty years from now. And while I believe that it is important, if we don’t address several other, far more pressing issues, half of the population of the globe with sick and dying, directly because of these other issues.
I specifically referring to serious medical problems arising from really bad lifestyle choices being promoted by governmental agencies, national and international disease associations, doctors, international food industry giants, dieticians, and the public media.
So what the heck could I possibly be ranting on and on about? There are three health crisis catastrophes happening right now that can have a bigger effect on the human race, today and tomorrow, than global warming.
Antibiotic resistance and superbugs
The explosion in pollution of the world’s oceans
Religious and political fundamentalism in the political area, and erosion of political and religious freedom
Industrial corruption around the world, and its impact on the peoples of the world.
No one article could even begin to explore these five serious hazards to humanity, and the quality of our existence on the planet Earth.
Personally I’m optimistic that the human race will figure out how to reduce or eliminate the human contribution to global warming. It won’t stop the climate from changing, either continuing to warm for the next few hundred years, or crashing into a new ice age, which is what many scientists were concerned about only a few years ago. It took a lot of effort to stop using fluorocarbons in spray cans, which was attacking the ozone layer only a couple of decades ago. Global warming is more of a concern than fluorocarbons, and will require a much more consequential response if the human race is to find solutions that will resolve our contributions to it. But call me Pollyannaish but I do believe that we will find technological solutions to a problem fundamentally caused by technology. As someone said to me, “it’s not rocket science.” No, it’s harder. But it be done.
I’m far less optimistic about our response to Metabolic Syndrome. Only recently have scientists started to realize the breadth and seriousness of the syndrom, which is directly caused by the consumption of excessive carbohydrates and sugars by populations of all ages, and is a now a global problem facing all of the nations of the globe. Recent research and publication have demonstrated a direct causative relationship between the over consumption of carbohydrates and sugars to the following disorders and diseases.
Cancers of the pancreas, heart, liver, kidneys
Chronic lung disease and cancer
Heart disease including cardiac arrest, arrhythmia and death
May be related to several mental disorders underlying depression and mania
The number of deaths in the world from the above categories of diseases, in 2019 caused by carbohydrate and sugar far exceeds the projected loss of life in the world from Global Warming by 2050 or even 2150 assuming that we don’t do anything to stop it. There is now solid evidence that over a third of all human beings alive today are suffering from Metabolic Syndrome, and many many many people die from it every single day. Far more than from wars, automobile accidents, distracted driving, alcohol abuse and drunk driving – all put together.
Superbugs present a slightly less ominous threat, if you don’t think about the fact that without effective antibiotics we are all vulnerable to diseases we once believed we had wiped out.
One in four infections is already resistant to antibiotics and other known forms of treatment, and 5,400 Canadians died last year from infections that until recently had been treatable. That’s according to a comprehensive peer-reviewed report presented by the Council of Canadian Academies this week.
That’s roughly double the number of Canada’s annual traffic fatalities and homicides combined.
These infections range from pneumonia to infections of the urinary tract, the blood stream and the skin. And their numbers are rising everywhere as international transportation carries every infection-causing microbe to every part of the world.
The report, When Antibiotics Fail, was prepared for the federal government by an expert panel. I was a member of this panel, chaired by Brett Finlay of the University of British Columbia.
Oceanic pollution, including plastics and other waste
Ocean Pollution: The Dirty Facts
We’re drowning marine ecosystems in trash, noise, oil, and carbon emissions.January 22, 2018 Melissa Denchak
The fate of our seas is not only up to the government or industry. Our individual, daily actions matter, too. You can start by reducing water pollution and runoff at home, being more mindful of your plastic consumption, or organizing a cleanup of your local waterway. You can also support the work of NRDC and other environmental advocacy groups as well as other businesses and organizations that work to preserve our coasts and waters.
Religious and political fundamentalism in the political area, and erosion of political and religious freedom
The news is full of examples of political terrorism around the world, including bombings and individual acts of terrorism against innocent civilians. This is terror on a retail scale and pales into insignificance against the damage being done to our political and religious freedoms around the world as a result of religious or political fundamentalism that denies people the right to their own religious beliefs, personal development and gender identification, even the right to exist as ethnic minorities in various parts of the world.
There are more people in concentration camps today, than during the second world war, with the vast majority of them in China. We in the west have been negligent in this, but mostly because we are also complicit in our own attacks on minorities and aboriginals. The United States and Europe are split right down ideological and religious seams that threaten the future safety of the world because of the increasing intolerance being shown to people with different religious or political beliefs of large parts of the population. Christian, Muslin and Atheist fundamentalists deny the very right to exist for anyone who dares believe something different than they. The intolerance of a pulpit bully today is the concentration camps of tomorrow.
Industrial corruption around the world, and its impact on the peoples of the world.
A new report has alleged that international medical and pharmaceutical companies are complicit in China’s organ transplant scandal.
The report has, for the first time, named 20 global companies profiting from China’s transplant trade, where innocent people are murdered in a state-sponsored campaign of forced organ harvesting.
The report supports China Tribunal’s Final Judgement in June 2019 which exposed China’s ‘wicked’ organ harvesting crimes and murder of innocent people as ‘Crimes Against Humanity’.
Western companies allegedly involved
The new report emphasises that China’s transplant system is ‘dependent on the import of devices for organ preservation’ from the West and has accused the Western pharmaceutical companies of using Chinese prisoners for testing transplant products.
Over 1.5 million people detained in Chinese ‘camps’ are seen as ‘ideal source of organs’ according to the report and the authors are calling for companies named in the report to answer to allegations or for state offices to “investigate international criminal activity”.
Global pressure is now mounting on China to stop the brutal murder of prisoners of conscience in a scandalous industry estimated to illegally earn the People’s Republic of China over $1bn (~€0.89bn) per annum.
Susie Hughes, Executive Director, International Coalition to End Transplant Abuse in China (ETAC), stated: “These companies are in a very powerful position because China’s transplant industry would falter without them. It is imperative they withdraw from China immediately to help save innocent people who are being killed for their organs.”
Hamid Sabi, Counsel to the China Tribunal, who recently raised the issue of forced organ harvesting in China for the first time at the United Nations said: “I welcome all new research confirming this horrifying issue. Organ transplantation to save life is a scientific and social triumph but killing the donor is criminal.”
Industrial greed and complicity in the dangers to human survival, both individually and collectively cannot be pursued with enough vigor. Companies are responsible for causing untold health hazards and killing millions upon millions through smoking, dietary corruption of the food chain, false information distribution to the public over years and years.
Global Warming is a Safe Enemy
I started this blog by saying that I don’t think that Global Warming should be at the top of our concerns about the future (and present) of the human race. There are lot of things to be concerned about, and Global Warming is just one of them.
The massive obsessive focus on Global Warming is a little like the obsession in the 1960’s with the nuclear threat and the idea that the Russians were going to wipe out the human race in their global arms race with the USA and the West. The obsession wasn’t totally misguided, it just missed the point that there were other things which should have been addressed and were not. The consequence of obsessing over one significant challenge facing the world, without paying attention to many of the other issues is highly risky.
WEEK 2 More Relieving Skills for the Physical Intensity of PAIN
The second weekly lesson from the Pain Mastery Institute is about another set of skills designed to reduce the experience of pain in the body. These skills are to impact pain that is a result of muscles tightening up as a reaction to pain of any type, located in various parts of the anatomy.
What is taught is a series of tensing and relaxing of muscle groups, starting at the toes and working up to the head and neck of the body. I was told to tighten and then release systematically the tension I had created, and then relax after releasing, and then breath deeply.
These techniques are very similar to some exercises I learned many years ago, as part of creative visualization and meditation. Instead of focussing on achieving a receptive state of mental suggestibility, these relaxation techniques are designed for the specific purpose of releasing muscle tension underlying many of my experiences of pain – especially in major muscle groups in my body, such as cramps in my feet and calf muscles, lower back and upper back muscle aching and tensions, head aches from neck and head muscle tensions. And so forth.
After completing the lesson, and doing all of the tightening, releasing, and relaxing exercises for the various parts of my body I realize that this technique is intuitively a part of pain management strategy for most of us, but only used occasionally. The purpose of the course, I’m sure, is to create a conscious awareness of yet another technique that promises some relief from pain, which we have all practiced once in a while, and bring this technique into daily use, as a part of our Pain Toolbox of resources.
Even after only two of the weekly courses in the Pain Management Institute online course I am beginning to realize the efficacy of this program. It’s success will be in part a result of bringing into conscious control elements of knowledge and behaviour that help ameliorate pain. These techniques are a part of innate knowledge but without conscious awareness of their use and potential benefit we only apply them randomly, rather than on purpose to structure our response to chronic pain.
This is a good start to a realization than I may indeed have the ability to management and improve my experience of and control of pain, not necessarily all at once, or even ever completely, but incrementally somewhat better.
When I started this set of blogs related to pain I was looking for some real improvement in my experience of and control of pain. Even after only a few weeks of analysis and discovery I am more hopeful of making gains.
In this week’s lesson on managing pain, I learned some new concepts about how pain functions in the brain, as well as on how to take something I already knew, and provide a better and more purposeful way to use it to reduce my experience of pain in my body.
The main points of this lesson are as follow:
Pain is experienced in the brain, after information is sent to the brain through neurons transmitted through the spinal cord.
Passively attending to something in your body, other than the pain, will reduce the experience of pain to some degree or other. Sometimes this reduction in the experience of pain is significant, sometimes not.
Actively creating a mechanical distraction, especially in the area of the body which is experiencing the pain, can have a positive effect on that pain.
Interestingly, by creating a mechanical action, such as shaking your hand if you injure a finger or burn yourself, will reduce significantly the amount of pain actually experienced, by actively reducing the signal from the pain receptors in getting to the brain. This takes place in the spinal cord itself, rather than in the brain, so the reduction in the pain can be very effective.
Now, lets stop thinking about the theory of pain, and think about what the theory of pain is teaching me. If I can move my attention from focusing on a specific cause of pain to focussing on some other part of my body, such as my face or ears, for example, I can significantly reduced my experience of the pain. This reduction is my experience of pain is relatively mild, for me, at this point, but it serves to reduce my experience of neuropathic pain from excruciating to merely troubling, a huge gain since when it is only troubling I can often drift off into sleep, which is nearly impossible when my neuropathic pain in my feet is most extreme.
Through practice and the investment of some time I hope to increase the effectiveness of this pain strategy, which holds out some promise in being an active tool to improve my current experience of pain.
The second strategy in this chapter of the course on Mastering Pain, is about a more physically active method, and requires some mechanical actions to be taken. So, when the pain in my hands or feet is most severe instead of mentally focussing on another part of my body, I use an action to draw my attentions elsewhere. This action can be pretty simple, such as playing with my car keys or making a cup of tea, and really paying attention to what I’m doing, rather than dwelling on my neuropathic pain.
You’d be surprised at how often this helps reduce the experience of pain, sometimes by a lot, depending on how absorbing the actions being taken are, and depending on how seriously I focus on them.
Before I started taking this program I think I intuitively already knew some of this information, without knowing the underlying physiology of the spinal cord and the part of the brain responsible for experiencing pain.
A significant part of the benefit of taking this program is the development of a more organized and deliberate strategy for dealing with my everyday pain, in ways that improve my experience of life through my own conscious efforts, without taking opioids or other pain killers to deal with the pain. A major goal of Mastering Pain is to create a Personal Toolbox of resources to assist with what has become a major preoccupation of my life, the toleration and management of chronic pain.
For me, the alternatives to doing this program seem few and very unattractive. I have no willingness to go down the road of pharmaceutical solutions for my pain, unless I absolutely have no choice, in order to tolerate the ever increasing amount of pain in my life. It may be that at some point I won’t be able to function, whatsoever, without pain medications, but I intend to push that day off as long as possible.
Note on formatting
Up until this week I was using a Drop Cap for the first letter of each paragraph in my blog. I recently received feedback from a mobile reader, using her cell phone, that said that the Drop Caps were screwing up her ability to follow my blog, by throwing text all over the place, when viewed on her phone. So I’m not going to use them in this blog from now on.
It’s Thursday night, and I’m sitting in an airplane, about to take off for New York. I’m heading home from Las Vegas after attending Obesity Week 2019, the world’s largest obesity medicine conference, a collaboration between The Obesity Society and The American Society of Metabolic and Bariatric Surgeons.
I don’t quite know how to express my feelings and thoughts about this event, but the words ‘anger’ and ‘hopelessness’ immediately come to mind. My anger and hopelessness are best exemplified by the first keynote speech, delivered by Dr. William Cefalu, who is chief scientific and medical officer of the American Diabetes Association.
After accurately describing our country’s spiralling healthcare costs, and the morbidity and mortality associated with diabetes and obesity, Dr. Cefalu went on to discuss the benefit of low-calorie approaches for diabetes reversal. He also highlighted bariatric surgery and medications. But ultimately, he harped on one point, that is frequently repeated at conventional obesity medicine conferences:
“There is no best diet. The best diet is one that a patient can adhere to.”
The above article by Dr. Tro Kalayjian the physician behind Dr. Troys Medical Weight Loss and Direct Primary Care is a discussion about why it is so difficult for the medical profession to accept fundamental changes in medical understanding about diabetes and current treatments for it. It is why patients continue to get contradictory advice from doctors who really ought to know better than to recommend any number of established and well known dietary strategies that simply don’t work. It’s not that they don’t work anymore, it’s that they never worked, and there is no scientific basis for any of them.
This sounds pretty revolutionary to me. The esteemed Canadian doctor is joined by a number of US based colleagues who are challenging the status quo in the treatment of diabetes, and sending a message to their profession. Just stop! Stop misleading the public! Stop lying to patients! Stop killing your clients!
Of course, they are doctors and they don’t quite put it that way. But what else can you say when so many health professionals and authorities continue to promulgate misleading information, such as “moderation is the best strategy” when clearly, based on current information that is simply not true. Moderation will kill you if by moderation you include relatively mundate advice about carbohydrates and sugar. What sciences know is that consuming carbs in excess of certain pretty limited amounts leads to metabolic syndrome, metabolic syndrome leads to insulin resistance. Insulin resistance leads to diabetes. Diabetes leads to lots of really bad stuff that can kill you, or at the least, make you really really sick.
If you or someone you love is fat, obese, or has diabetes or prediabetes follow the link on this blog entry to the above article and understand what is being said. Doctors are willfully ignoring solid medical evidence in favor of standing by old, disproved theories because they are afraid of rocking the boat. Read Dr. Fung’s book, the Diabetic Code.
Stop believing anyone who says that eating many small meals a day is ok. Stop following advice so far heard that has led you to being overweight and obese. If you want to live and healthy, long life, fire your current endrochronologist if he or she disparages the most recent research and tells you not to follow Dr. Fung’s advice. Run away from anyone who says that carbs and sugars are not the cause of diabetes, metabolic syndrome, and many many many other life threatening diseases.
How has pain been a complex problem in your life? How has pain interacted with your movement, energy, sleep, social life, finances, identity, memory, and mood?
Mastering Pain Institute
After listening to and reading the materials in the 1st leasson of the Pain Mastery Class it asks the student to answer the above questions.
How has pain interacted with my movement? As pain from various causes has increased over the past few years I have observed that my ability and willingness to move has undergone an uncomfortable metamorphosis. Simple tasks like walking, bending over, picking up items, getting dressed, doing my toe nails, making the bed… etc. have all become much more difficult.
Neuropathic pain has combined with arthritis to make steering the car for long periods increasingly painful. I alternate from my left to my right hand constantly as I drive, because the pain builds up in each as it is used. Eventually the pain is too great in both hands and I have to take a break. The pain in my legs and feet make driving hard as well, and certainly limited my pleasure from doing so. Driving a car is one of my great pleasures, or, it used to be one of my great pleasures and it represented a kind of freedom that is now gradually disappearing from my life.
The same can be said for a lot of routine physical tasks, all the way from making the bed to cleaning the mirrors in my bathroom. I didn’t used to mind housework or gardening but it is now so painful to mow the lawn that I’d rather let it grow twice as long as I used to. These type of restrictions have inevitably reduced my freedom of movement, and my interest in and willingness to do routine, simple life tasks.
How has pain affected my energy? Anybody who suffers from chronic pain will attest to the fact that constant, unrelenting pain is exhausting. There is almost no time when I’m not tired and so sore I feel like I really just want to lay down and sleep for a while. Even a nap would seem like a relief, if I can sleep, that is.
The net available energy is a function of pain in my body. The more severe the pain becomes, the less energy I have. And not only to do life in general, but in having the interest and energy to participate in the things of life. A lack of energy is behind so many other deficits experience by people with chronic pain that it tends to blind us to how serious it actually is. Without sufficient energy to function properly nothing actually works the way it is supposed to work. How the hell am I supposed to do my job at work, when I hardly have enough energy to get there in the first place every day?
How does pain affect my sleep? To most of us with chronic pain sleep is seldom deep or really very restful. Not a single night of sleep goes by without being disrupted, again and again by waking fully or partially because of pain in the body. For me it is all sorts of different parts of the body and different types of pain, but it all hurts, and it all makes me awaken at some point during sleep. If I wonder why I’m so damned tired all the time, I simply have to remind myself that I really haven’t had a decent night’s sleep in years.
I’ve been diagnosed with sleep apnea, but sleep apnea really isn’t the reason I’m awake half the night. It’s the pain, the pain. Snoring is a part of it. Blocked airways aggravates it. But pain causes sleep interruption, over and over again, every single time I go to sleep.
How does pain affect my social life? What social life? Who really has the energy to maintain a social group or friendships when you’re in constant pain? It takes energy I don’t have and mobility that is a constant struggle, simply to get out and visit with people. I’m no longer the happy go lucky guy I used to be. I try not to spread my pain around, or make my kids and grandkids suffer from my experience of pain. But I wonder if my increasing isolation from them is at least partly because I do longer know how to overcome my pain for long enough to actually properly engage with people.
And being socially isolated also increases my experience of pain, because lacking real human contact with others is not only uncomfortable, but it’s also actually harmful physically because it encourages inactivity and passiveness. Instead of getting out and doing things with the people I love, I stay at home, watching television, at least partly because it’s less painful than the alternatives of getting out of the house, and doing the things necessary to have a life.
How does being in pain affect my finances? This is one of the things that is most humiliating about being in pain. Instead of being vibrant and capable, I’m tentative and withdrawing from challenges. I used to love going to the office and taking on new challenges, meeting new people, creating new financial opportunities for myself, and for my staff. Now I have no staff, and I’ve been afraid for years of taking on jobs that I know I’m qualified to do because I’m afraid that I’m going to let them down, or worse, prove myself to be incapable of handling the physical and emotional demands of the work.
In addition, my increasing health problems cost a lot of money, which I am now having to pay with a lot less income, due to my reduced employment capabilities. I struggle to manage my prescription deductibles and copays. And that’s for the prescriptions, which doesn’t actually include any pain medications I can trust. Nothing the doctor has prescribed for pain has actually helped very much, if at all. I know that opioids would be more effective than OTC drugs but I also know that they are highly addictive, and have major other problems that I don’t need to add to my pain.
And being chronically short of money, as well as in pain, means that I can’t take advantage of one of the things I used to do a lot, which was going out to nice restaurants and have good meals with friends. Shortage of money means that I’m socially isolated by it, as well as by my resentment over finding myself in this situation. I never wanted to be dependant on anyone else but I find myself in a situation that make this every more a fact of life.
How does pain affect my sense of identity? Truthfully, I don’t really recognise myself any more. I no longer feel like the man I used to be, and I certainly don’t have the confidence I have always had. I’ve always thought of myself as a highly charged, somewhat hyperactive and oversexed Type A personality. If I had faults they were likely the faults of thinking that I could do anything, be anybody, accomplish anything. A little bit of humility probably wasn’t a bad thing for me to learn, but pain has driven me to distraction. The amount and persistence of pain has now reached proportions that are disabling my sense of self to a point of no return. I don’t actually know what it would look like for me to be me, the way I have always been. So damage to my sense of identity is a real cost of being a victim of chronic pain.
How does pain affect my memory? My partner says that I’ve become a lot more forgetful than previously. I’m not sharp anymore, and I don’t automatically pick up on things so quickly. I don’t think I’ve lost my marbles, but I get confused more easily and mix things up, despite my best efforts to not do so. It means I slow down, because I can no longer count on my memory for important information. I’m a lot more cautious than I used to be, if for no other reason than I hate being unable to remember even the simplest facts or common words.
I’ve always been a prodigious reader, at one point reading more than a book a day, not to mention newspaper and magazines. Now it takes me a week to read a novel, and a month to work through a non-fiction title, no matter how interested I am in the subject. I don’t remember names very well, I never did, but I’m also losing the ability to remember what books I’ve read or which ones I liked or didn’t like. I find myself half way through the first chapter of novels only to realize that I read the damned thing six month ago. So yes, memory is being affected negatively, if only because I’m so distracted by the constant pain interrupting the flow of my thoughts and feelings.
How does pain affect my mood? I was diagnosed as being bipolar when I was about thirty years old, after a major breakdown and depression. After being hospitalized for six months I came out of the hospital with somewhat better emotional management tools than I had previously. Relatively quickly I abandoned the prescriptions for bipolar I had been given, because they made me feel like I was living in a fog. And I reconciled myself to living with vivid emotional ups and downs. So depression and mania have long been a part of my nature, and my life. I’ve done well in managing to live a full life despite these problems, but now it feels like depression stalk me, without the accompanying manio to provide any balance to it.
There are two kinds of depression with which I struggle, one of which is a direct result of serious and chronic pain. It’s tough to get out of being depressed when you feel like you’re under a constant pressure cooker caused by physical and mental pain. This past weekend, in addition to chronic neuropathic pain in my hands and feet, arthritic pain in my shoulders, fingers, hands, I was also slayed by a serious migraine headache. I haven’t suffered from migraines on a regular basis for years, ever since I started practicing a form of self-hypnosis that seemed to be effective at shortening their duration, and eventually led me to being able to predict and prevent the worst of them.
Even that ability seems to be beyond my control these days, because it’s pretty hard to meditate when I’m in so much pain that I can hardly sit still.
I don’t know if this exercise in counting the ways that pain affects me is supposed to make me feel better, but it hasn’t yet. I also suppose that to defeat an enemy I first have to understand the enemy and all the territory it has staked out in my life. This is the exercise from Chapter 1 in my program to begin to manage my pain. I hope the next exercises don’t leave me here.
DIABETIC NERVE DAMAGE (neuropathy) affects approximately 60-70 percent of patients with diabetes. Once again, the longer the duration and severity of diabetes, the greater the risk of neuropathy.
There are many different types of diabetic nerve damage. Commonly, diabetic neuropathy affects the peripheral nerves, first in the feet, and then progressively in the hands and arms as well, in a characteristic stocking-and-glove distribution. Damage to different types of nerves will result in different symptoms, including
• tingling, • numbness, • burning, and • pain.
The incessant pain of severe diabetic neuropathy is debilitating, and the symptoms are commonly worse at night. Even powerful painkillers such as narcotic medications are often ineffective. Instead of pain, patients may sometimes experience complete numbness. Careful physical examination reveals decreased sensations of touch, vibration, and temperature, and a loss of reflexes in the affected parts of the body.
While a loss of sensation may seem innocuous, it is anything but. Pain protects us against damaging trauma. When we stub our toes or lie in the wrong position, pain lets us know that we should quickly adjust ourselves in order to prevent further tissue damage. If we are unable to feel pain, we may continue to experience repeated episodes of trauma. Over the years, the damage becomes progressive and sometimes deformative. A typical example is the foot. Significant nerve damage can lead to the complete destruction of the joint-a condition called Charcot foot-and may progress to the point where patients are unable to walk, and may even require amputation.
Dr. Jason Fung, The Diabetic Code p.28
Diabetic neuropathy has led directly to my willingness to undergo a radical lifestyle change, including intermittent fasting, and major changes to my overall dietary behavior. In particular, major pain to my hands and feet has increased exponentially in the last couple of years.
This type of pain is almost invisible to the people around a diabetic. They often wonder, I’m sure, what the hell is wrong with me, as I stumble from step to step, at times looking for all the world like a drunk after one too many.
Despite my best efforts to appear normal, it is sometimes impossible for me to avoid an outburst from a sudden onset of sharp pain in my hands or feet, without any advance warning that my chronic pain will suddenly become extreme, even if only for a few moments.
Dr. Fung mentions that it is worse at night while a diabetic sleeps or rests. Well, there are many times when neither is really possible, and my partner lays across from me worrying as I toss and turn in pain. And neuropathic pain is only one of the causes of pain in my body at night. Others are arthritis, bursitis, and severe muscle cramps.
Combine these with fibromyalgia and I guess that I have won the sweepstakes of pain, so far without winning the big prizes, premature death or paralysis. Even without the immediate threat of dying, chronic intense pain is exhausting, often leaving me so tired that days go by without being able to accomplish even the smallest things. Even I tend to feel like a lazy sonofabitch because my progress in so many things is fractional or even non-existent.
I wish I were faking it, of which I have been accused at times. If I could make it go away, I would indeed. The best thing my doctor ever told me about neuropathy is while I can still feel the pain, it is still at least possible that my nerve damage may partially recover as I reduce my diabetes and stop making it worse. Once the nerves are deadened to the point where my feet are simply numb, there would be no hope of ever recovering any of the la\ost sensitivity in my feet or hands.
This is one of the reasons why I am so determined to take any measure that has even a promise of helping me eliminate or radically reduce the effects of diabetes in the future.
I’ve been bipolar all of my adult life. I equate being bipolar, in some ways, with being out in the weather. Some days it is sunny and bright, all things are possible, nothing can get me down. Some days are stormy, threatening lightning and thunder, and I’m afraid to get out of bed. So in addition to having to deal with diabetes, I also have to manage my emotional state. One of the best things about Intermittent Fasting is that it is another way I gain positive emotional feedback, by taking control of my health, as well as my emotional life.
Years ago, after several years of psychiatric medications, I decided that I couldn’t live with the “deadness” I felt while medicated. I felt like I was living in a fog, without any connection at all to the real me inside. I’d given up everything that made me “me” and was stuck inside a pseudo human being, without flavour, without emotions, without any reason to live at all. I don’t want to live that way, and so I’d rather live with my extreme emotional roller coaster than depend on meds to keep life in balance.
Before you decide to abandon your medications, and go it alone, consult with your doctor and make sure that you have a professional to provide you with ongoing care, just in case things don’t go the way you think they should.
Building mastery gives you a sense of accomplishment, Van Dijk said. What activity you choose “will just depend on where [you are in your] life and what will create that feeling of being productive.”
For instance, she said, this might mean volunteering, getting out of bed at 9 a.m. instead of noon or going to the gym three times a week. Or it might mean checking “the mail if that’s something you’ve been avoiding, … gardening or going for a 5-minute walk.”
Bipolar disorder is a serious illness. The illness itself along with treating it can feel overwhelming. But by taking small steps every day, you can effectively manage and minimize symptoms and lead a healthy, fulfilling life. If you’re not involved in treatment, contact a doctor or mental health practitioner. The strongest and healthiest step you can take is to seek professional support.
So, what then? I can’t rely on emotions to be an accurate guide, either for behaviour, or commitments. I can’t maintain relationships as an on-again, off-again basketcase. So I decided that my behaviour would be governed by my personal values instead of my feelings at any given moment. Whether I’m happy as a kite, manic and unstoppable, or in deep depression, I choose to respond to external input based on what I really want in the long run. This means that I’m always willing to be supportive and listen to others, whether I feel like it or not. It’s not about me, it’s about them and the kind of a man I really want to be. My actions are governed by my intentions, not my feelings.
That’s not to say that I don’t completely “fuck-up” everything sometimes, either in my personal or professional life. It’s especially true when I forget what’s really important to me, and don’t live up to my higher purposes.
But the other part of living is that I have to be completely accountable for my actions. That’s easier said than done, but I own my mistakes and forgive myself, rather than going over things again and again and again. Instead of being proud of myself only when manic and ashamed of myself the rest of the time, I accept myself, good and bad.
Neither be a God, (as I sometimes thought of myself when in a manic phase), no nobody, (
which is how I often saw myself during a serious bouts of depression. Instead, I’m just a human being striving to live my highest and best life. I no longer live in judgment, either of myself or others.
I feel for your pain, I really do. But live with it, and have a life worth living, regardless of temporary emotional states that come and go without any useful purpose. Ironically, over time you’ll come to be a lot happier with who you’ve become. Self respect and personal accountability trumps bipolar, at least, for me.