Monthly Archives: May 2018

still benched

I went to the doctor on Monday to check in on my foot, which continues to go from Fairly Normal at the start of the day, to Bloated Puffy by the end of the day.

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First thing in the morning, minimal puffiness.  Or puffins.

On Monday, by the time I got to the doctor at 4:30pm, it was puffing out of the top of my ballet flat shoe like rising dough. I took it to the specialist I saw back when I first sprained the ankle, and he pressed down on the swelling with a concerned expression. “Hm. This shouldn’t be,” he said, and I felt my heart sink.

“So the swelling isn’t normal?” I asked

“Nope. Let me just see how you’re healing. This may hurt,” he said, and then poked my ATFL tendon, where the tear is, connecting my leg to my foot. I winced and exclaimed, “OW!”

“Yep, that’s the ATFL we talked about. This isn’t recovering as much as I’d expect for six weeks in.” He asked if I had been doing the exercises he suggested, and I told him I had, and showed him the range of mobility in my foot. That was actually better than expected, as the doctor was quite pleased with my ability to rotate and flex my foot. He asked me to walk across the room and stand on one foot, and I did. Then he looked at my foot critically, and said, “I’m going to prescribe you an AirCast”

“Oh,” I said, “you already issued me one.”

“Then why aren’t you wearing it?”

“It was slowing me down?” I said, and then started laughing. The AirCast was making it hard to walk quickly, but I did wear it for the two weeks I was supposed to wear it. Now I’m supposed to wear it if I’m leaving the house, again. I’m also supposed to ice my ankle (which I’ve been doing!), elevate it at night (ditto), and wear a compression sock (which I already own). And, most of all, I have to stop pushing myself into activity and telling myself I’m “working my ankle for recovery”. I did manage to regain a lot of mobility doing that, but not a lot of actual healing has taken place.

So yesterday, Tuesday, I dutifully put on my compression sock and AirCast and went to fetch my son from school and take him to a dentist appointment for a chipped tooth. I took Lyfts when we could have walked (we did walk a few blocks here and there, but less than we usually would). I THOUGHT that would be the end of the physical stress on my ankle for the day, and settled back in to work, ankle propped on a stool under my desk, while Ben worked on a school project.

Then Ben managed to slice open his thumb with a knife cutting a carboard box – and I ran with him to Urgent Care, a half mile away. It was only after the adrenaline wore off that I realized how exceptionally bad an idea it had been to run with my bleeding son, his hand compressed and elevated in a dishtowel, across Prospect Heights.

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I got him to urgent care for stitches within twenty minutes of the cut!  Parenting win!

Now I have re-trashed my ankle. Even if I wasn’t committed to resting it and getting better, I would be now because it hurt more today than it has in weeks. The bright side is that it actually isn’t puffy at all: the compression sock and the rest for the past two days has actually reduced the edema. The original ATFL tear, however, is still there. There will be no hiking on Mount Misery this weekend (it’s quite pleasant despite the name!), but there may be a trip to the MRI if it doesn’t improve.

 

Return of the Cankle

My wedding night, I was six months pregnant. I still danced until my feet gave out. I remember after a night of celebrating, both ankles were so swollen that they had disappeared into my calves, a phenomenon charmingly referred to as “cankles”. Today, I didn’t even get the fun of dancing but still, after walking a mile and sitting at a desk, here we are with one cankle:

I still went to the gym tonight, but only to swim. Being in the water meant activity without weight on my ankle. I kept it to 20 minutes on the pool, 200 yards of laps, just enough for me to feel like I did something and to see if that negatively impacts my recovery at all. The ankle hurts, especially since I went off my painkiller/NSAID medication this week, but it’s a pain I can live with.

Also, it was nice to get the swim time in. I have to do some sort of cardio to keep my endorphins up. In my toolkit of Ways I Manage my Brain, cardio is one of the tools I don’t reach for enough. Then on nights like tonight when I do use it, I remember it’s extremely helpful and I should pick it up all the time. It would be smart of me to do more cycling and swimming while recovering enough to run. I just need to get back in a daily habit of prioritizing that time.

Also, I got to see how my new Fitbit tracks swimming! The answer is: in stalker like detail

Like most people, I have a bad habit of dithering time away on the unimportant, which means work takes longer, which means I don’t get to the gym until after 7pm and then end up heading back to the office to take a Scout planning call instead of getting on the subway, which means in turn I don’t get home until 11pm on a Wednesday, which means I can’t get up early enough to work out because I have an 8am appointment to get my bangs trimmed in SoHo. This has nothing to do with my sprained ankle of course, and everything to do with bad habits, the kind of habits that allow me to put off self-care and fitness time under the guise of work, which in turn has been dragged out by a lack focus. Which is why I’m on a subway at 10:30pm on a Wednesday.

In the interim, I have bloody cankles, and my entire right leg is twinging with the effort of balancing on one leg this evening as part of my requisite physio recovery process. But at least I went swimming. I got the start of a better habit in place. I prioritized that activity even if it wasn’t well planned. The cankle will eventually go away, but maybe, just maybe, I can use this time of recovery as impetus to be more mindful and deliberate in my physical activity.

optimizing my brain

It has become fashionable, the past few years, to attempt to “hack” one’s brain.  This is an attempt to get one’s brain to run better, faster, smarter.  It is also a great way to sell something called “nootropics“, a futuristic, Orphan Black-esque term for a new wave of vitamins (mostly amino acids and vitamin B derivatives) that are supposed to aid with such “hacking”.

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This is your brain…ON THE FUTURE

I believe, to an extent, that there is some brain “hacking” that can be done, although I do not love the term.  To me, it smacks of Silicon Valley bro-ness, the kind of toxic masculinity that has made the tech industry deeply awful for women.  I prefer to think of it as brain optimization, rather than hacking, as optimizing my brain is really about understanding the 2+ pounds of electricity and protein that lives inside my skull, that contains everything I am.  If I can better understand the mechanisms that govern the electrical impulses that make up my thoughts, then can I get a better grip on the efficiency of those thoughts?

I recently read Stealing Fire, a book on the use of substances or other methods of altering one’s brain for extraordinary results.  While it does focus extensively on the use of mind-altering drugs, it counts everyday substances in that category, everything from coffee to prescription medications. We may not all be using ketamine for out of body experiences, but most of us are using some form of chemical to alter our brains.  It was an interesting perspective, much more on the metaphysical plane, putting the quest for brain control and mind altering more into the realm of philosophy (“I think, therefore I am” sort of meta-ness), telling a universal human story rather than limiting the results to th emore prosaic productivity boost that “brain hacking” promises.  “Stealing Fire” was a more grandiose picture of mankind’s ongoing quest to lift up our mental and spiritual energy through physical substance (see also: Half Asleep in Frog Pajamas), and it contextualized the “brain hacking” trend as really just being a small corner of that quest.

My own quest falls somewhere in between the metaphysical and the mundane, as it’s directly related to the mental and spiritual effects of having a chronic depressive condition.  For the decade plus that I took Wellbutrin, from 2005 until, well, six weeks ago, I grappled with its effects on my actual being.  Was being on this substance altering who I was, in any way?  My ultimate answer to that question was that not only did that particular non-SSRI antidepressant not change who I was, it actually allowed me to be the person I was meant to be.  It was a substance that unlocked my brain.  The Wellbutrin reduced the paralyzing depression that had previously impacted my ability to live my life on a consistent basis.   Problem solved, I thought, at the time, as I went on to build my life, meeting my husband, building my career, moving to Brooklyn, building the Scout organization, building my friend circle – my life is extensive, expansive, and has few limits on how much I can do in it.

Reducing the impact of the biological condition of depression actually brought forth who I am as a person, allowing me to explore my own mental and spiritual state without the intervening detriment of poor mental health.

The problem is that the substance I relied on to make me, well, me, wasn’t consistent.  My depression flare-ups became longer and increased in frequency over time.  When I changed my body’s response to food by switching to a Paleo food lifestyle in 2013 , the condition improved again.  And over time, rather than change my dosage, I began to try to identify more and more ways that weren’t the Wellbutrin that would net similar results to the antidepressant: cardio or HIIT exercise, being in sunlight, not drinking, avoiding grains and dairy, avoiding sugar, getting a good night’s sleep, meditation, journaling, etc.  Some of the tools made more difference than others, but overall, I began to understand what had an impact on my brain, and began to understand the links between the mental, the physical, and the spiritual.

All these physical, mental and spiritual factors are interconnected, and we cannot separate them if we wish to be whole and happy.

And then I finally faced reality.  The antidepressants I had been taking weren’t working.  They likely hadn’t worked for some time.  In fact, in November, my brain wouldn’t recognize the anti-depressants or the caffeine I added to them each day,   I thought I had Lyme disease, I was so exhausted, until I finally cut back on caffeine, added some nootropics, and felt better for a while.  I made it through the winter, and then as soon as we hit the March equinox, I went off the substance I had been using for thirteen years to alter my brain chemistry.

Needless to say, it was unpleasant.  The first few weeks, I could only stay awake until 2pm.  Twenty-five years of caffeine reliance plus thirteen years of using a stimulant as a basic part of my brain chemistry did not allow me to remain at one 8oz cup of coffee per day.  Instead, I felt like a puppet whose strings had been cut, drooping and looking for the system that had pulled me through my life.  I started eating for energy, as working from home gives me endless access to snacks, many of them of the higher carbohydrate variety from Ben’s snack assortment.  I could barely drag myself to the gym or through workouts, I was so tired, yet I couldn’t sleep at night. It was a textbook withdrawal.

Two weeks of this and I was almost in tears at the lack of productivity and the lost time.  A month in, and I sprained my ankle and had to weigh in at the doctor on my visit and realize, it wasn’t just that I’d lost time, I’d gained almost ten pounds of weight that would have to come back off if I was to fit in my client visit suit or my tick-proof camp pants ever again.  This isn’t just about vanity or societal pressure, but about not having to replace my utilitarian clothing in a larger size.

So now I have to not only hack my brain to run without antidepressants, but also have to “hack” my own EXTREMELY STUBBORN biology to lose the weight.  Which is a whole other entry as well.

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Yep, this about sums it up.  Thanks @lacomtessejamie

And I have to recognize that despite all this “hacking” or “optimization”, or whatever I wish to call it, there are going to be days when I just…can’t.  Last night, I had a rough day “at” work, in that I made a major misunderstanding on one of my new accounts in how I interpreted an agenda topic as related to the client’s business.  I also failed to move outside the house, choosing instead to rest my ankle.  I was also tired by 4pm as a result, and I just felt hopeless.  How am I supposed to live my life, I thought, if I can’t stay awake until 4pm even with a good night’s sleep, if I have an ankle that will seemingly NEVER HEAL, if I can’t even understand the job I am supposed to be good at

There are always going to be days in which I feel like I can’t.  And it’s going to be hard to change that and say, I can, without having a stimulant to get me all hyped up and enthusiastic.

So now, what I have to work on, is getting up every day and saying, “I can,” and pushing myself through the work that will optimize my brain to replace the load of stimulants that I cranked through it since I was a twentysomething junior digital media buyer living in Venice Beach.  I am a different person now: I acquired several additional layers of person along the way, including a husband and son.  I built a life in which many people rely on me: my friends, my colleagues, my community.  I built that life using a brain I used a commercial antidepressant to optimize.  Now I have to achieve the same results without that medication.

Most of the time, I feel like this is a story where the moral is that the Wellbutrin didn’t actually work, and therefore was really only a “magic rock” kind of thing: I did this all by myself and the antidepressant was believing in myself all along!  And then I’m tired at 4pm or can’t sleep CLOWN’LL EAT ME and think, why did I give up the stimulants that gave me the energy to push through this, even if they weren’t actually fixing the problem I took them to fix?

The answer is, because those antidepressants, while they worked great to correct my perception of my condition, weren’t fixing the actual problem that causes my depression.  I have a genetic biological condition that alters my brain chemistry enough to impact my mental state.  The NRI was just pushing me through that condition by effectively overriding it.  The most recent research on depression suggests it is more akin to a flare up of a biological condition than just a matter of “being sad”.  Taking a stimulant every single day may have forced my brain to remain in an upbeat state by altering my brain chemistry and increasing the amount of norepinephrine floating around in it, but it doesn’t fix the underlying physical flare-up that caused that mental state to occur in the first place.

And that physical aspect of the condition – that I can optimize.  For that, I can take physical, real-space actions to reduce the impact on my mental health.  That’s where all this brain “hacking”, optimization, whatever one wants to call it – that’s where it comes in.  It’s a quest for the “true self” on a higher level, but on a day to day basis, it’s “what actions can I take to keep my brain in a healthy state where it will crank out client presentations and not sink into a state of despair?

And that – that is another entry, for another day.  Probably tomorrow.  Because one of the bright sides to being benched with the ankle this week, is that I have extra commute time to re-invest in writing blog posts – one of the other many things I’ve identified that makes my brain a little happier.  A few days of writing, a return to a solid meditation practice, it’ll all help optimize my brain.

don’t touch it, don’t look at it

I can’t remember which of my childhood stories that’s from, but it’s from something my mother found hilarious enough to quote whenever she was trying to get me to allow her to apply an aloe vera leaf to a scraped appendage.    It’s how I feel now when I massage in the various ointments I’m applying to my foot.  I started applying a CBD oil based pain relief cream as well as an arnica ointment for bruising and swelling three times daily.  It’s getting easier, but I’m still unable to walk more than a few blocks without setting myself back days of recovery:

May 1st, May 2nd, Mayy 7th.  Swelling down overall but still present at ankle.  No amount of hippie remedies will fix that overnight.

This has been insanely frustrating because spring showed up in NYC literally overnight last week…and then jumped straight to summer.  And then bounced back to spring.  It’s pleasant outside, the trees are in that beautiful light green early leaf, and all the blossoms are out everywhere:

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Prospect Avenue between 8th and Prospect Park West, May 7th

I did get out for almost a “normal” Sunday yesterday: Paul and I went to visit a home that had a bathroom reno completed by contractors we are hiring for our own bathroom renovation project.  We re-did the kitchen in 2016, now we’re re-doing the bathroom.  We’re adulting!  However, this required walking an extra half-mile around Windsor Terrace to get to and from the visited home – even with car service, a “suspicious package” related street closure (read: very likely a burrito wrapped in tinfoil) meant walking an extra quarter-mile on either side of the town-home we were visiting.  By the time we got home, my foot was swelling and the pain in my ankle was reaching a very insistent whining pitch, so I went back to sitting on the couch with my foot on a chair, which seems to be a position from which I can still do things while placating my ankle.

I also biked around Prospect Park later in the afternoon, which was glorious: after two weeks of barely being able to walk, it was like being given wings.  I had arranged to spend some time working out the 2018-2019 Brooklyn Scout planning with the Group Scoutmaster from the former 5th Brooklyn group (now known as 5th Prospect Park), while our sons played baseball at their team’s weekly game.  We got a ton of planning done, our kids’ team tied, and now we have a roadmap for our projected five groups and 200+ Scouts in the borough for the fall (This is a whole separate entry, because Scouting never stops when you are district commissioner for NYC).  To get to said “meeting”, however, I had to bike down to the baseball diamonds in the south end of the Park, and then I figured, why not just finish the loop around the Park instead of taking the bike path back up Prospect Park West.  Why not just cap off a productive afternoon by riding four miles?  So I did, and it reminded me I need to start bike training again for the Epic Ride, and also that while my ankle isn’t as strained by cycling, four miles is plenty.

However, all this activity and normalcy did not come without a price: I ended up having to flat-out lie down to reduce the swelling in my foot by the time I got home.  The swelling is the most painful thing aside from the ankle tendon itself, and having my foot swell up after days of less swelling is extremely painful.  So that was it for productivity for the day: I literally put my foot up, with an ice pack, read a true crime book, and went to bed early.  Today, it’s still painful and prone to swelling, so I’m benched again for the day.  There isn’t much else to be done, right now, until I can heal up enough that a day of light activity doesn’t set me back.

I was also worried that all this activity would add up to be worse in the long run for healing, but based on Internet reading (because we all know the Internet is the best for non-professionals to do their own health research) I think it may actually be OK.  I have setbacks in pain and swelling but that also means I’m exercising the ankle as it heals.  I also do the rehab exercises I was assigned in the hospital: drawing the alphabet twice daily with my foot, stretching it back with a towel, and balancing on my bad leg.  It may take longer to heal, but I’m hoping that it will heal with more usability, and, hopefully, without being too prone to future sprains. This may, however, be purely wishful thinking because I don’t want to have to stay inside with my foot up through a beautiful May weekend.  I could stay home, but then I’d really be missing out on life in general  – and I love my life so much and have so much going on in it that psychologically, that’s not helpful.

Thankfully, I can work from home, so now it’s 9am on Monday and I’m in my “office”, without having to walk the half mile to the subway.  This is one of the things I have gratitude for, every day: that I have a job flexible enough that I can stay home and work.  I can spend a Sunday in “normal” activity and then, since that was too much, take Monday to recover from it.  I’m thankful to have the privilege of being a knowledge worker who isn’t tied to a physical location right now.  That’s been a huge help in healing.  It may make me miserable to be inside all the time during all this spring weather, but at least I’m inside and healing, which is a privilege in itself. Just a few more days, and hopefully, my ankle and foot will be back to normal.