The best treatment

I've been living in a whirlwind of doctor appointments, medications, advice, daily routines, work, self-education, wondering, lab tests, work, and symptoms that are as random as they are transient.

My life as it is currently takes a toll on me--part physical, part emotional. It's one thing to be sick, but to know you're sick without knowing what you're sick with creates a constant low-level frustration and anxiety. It also becomes exhausting.

Awhile back, Dr. G suggested that I cut back at work. I told her that sounded like a great idea, except there aren't many things I'm qualified to do, and certainly almost none that would bring in my current pay. Besides, I told her, doing nothing, laying low, having no real action in my day would kill me faster than any illness.

It has been interesting to note that I'm getting better at doing nothing--or my version of nothing. I've been working on my sleep. The inability to sleep continues to make me miserable. I've been trying to be more disciplined about maintaining a routine and a set bedtime. I've been sleeping better this week, a week, I should point out, when I only had to work two days.

This morning my husband was talking to me and he said, "You look better." I was a little confused.
"Better than what?"
"Better than usual. You don't look so tired. You look more relaxed. Your color's better."

Oh. No, no, no, no. I cannot accept that a lack of rest is the thing that
is making me so unwell. I am not that person who is so delicate that she must not encounter stress.

Absolutely not. I am made of tougher stuff.

Not so much as a yawn.

Why am I always unable to sleep?

Tired most of the day, then wide awake at 3:00 in the afternoon. If I didn't take meds, I would stay up until 4:00 a.m. or so.

If I get six hours of sleep, I consider this an accomplishment.

This can't be healthy.

Obesity is going to kill us

A new report was released this week that concludes that the number one health threat to the U.S. population is obesity. Americans are getting fatter by the day, and the associated health toll is showing up in medical dollar signs.

The medical insurance companies claim they don't want to insure people who are obese. Let's face it, they don't want to insure anyone who isn't a specimen of perfect health and fitness living a risk-free life.

The thing is, my insurance company, Great West/Cigna, doesn't pay for anything except illness. The policy clearly outlines the many tools for wellness that are not covered including:
--Using the services of a dietitian or nutritionist
--Attending a university diet program (usually at a school's Center for Human --Nutrition)
--Personal trainer
--Gym membership
--Exercise education (classes)
--Fitness incentives

If you want to quit smoking, my insurance company, like so many others, will provide telephone counseling support 24/7, nicotine patches, literature, and if need be, consultations with a doctor. These tools will continue to be available over and over again, until the patient succeeds in quitting smoking or gives up trying.

My insurance will not provide any assistance toward my weight loss; however, it will pay for Lap Band surgery or traditional gastric bypass surgery, should I get to that point. In other words, if I gain another 30 pounds, I can have surgery, but at my current weight, Cigna is uninterested in my wellness.

I am not unique. The point here is that if obesity--which is expected to rise dramatically in the next few years--is such a serious and expensive health threat, wouldn't it make sense for health insurance companies to invest in just that--health?

I have taken a slightly different approach to getting what I need. For the most part, I have watched my weight spiral upward despite my many attempts to make it go the other way. I eventually stopped trying, and my weight, surprisingly, didn't change much at all. It hit a set point at 195 and seems to have found a home there.

This doesn't mean I'm content with that or resigned to it. Not at all. I recently made an appointment with a systemic wellness specialist who does a lot of endocrinology work. She's also a bariatric specialist, but I found that out after I got there.

I told her my story of frustration and fruitless attempts at getting skinny. I told her that being fit didn't matter to me. Being healthier didn't matter to me. I wanted one thing and one thing only and that was to look like an auburn-haired, purse-toting human toothpick.

She smiled. I was not the first to say this. She said something that took me by surprise. She said, "I believe you. I am sure you've tried. Before you can address the weight you're carrying, though, we need to figure out how it got there and we need to understand what your body is doing with its hormone and chemical processes. I suspect you have a lot of things out of whack, and a GP will tell you everything is normal, but as I'm scanning these lab reports you brought, I can tell you it's not."

Here's the thing. My insurance paid for this visit, but it won't pay for the nutrition plan and supplements needed to begin the repairs. Hormones, yes. Nutrition therapy, no. I'll be able to get some of that, but only because the doctor bills this kind of work as something that she knows will be covered. In other words, the only way to get it paid for is to lie.

Where I live, there is a large university with a hospital that does important research. One area they're known for is bariatric medicine. Several years ago, they launched a program to help very overweight (not morbidly obese) people reach a healthy weight through lifestyle changes, customized diet, group therapy, education, and behavior modification. The program has outrageously successful outcome statistics,but there is always a need for more participants. According to an article read, the biggest deterrent for participants is the price. No insurance company will pay for it.

I rest my case.

my moment

I'm going to be on TV Monday evening. The story will run nationally. I hope I don't come off as the total dork I am.

Later in the week, NPR. Seriously. I have faith I'll sound more intelligent in that interview.

Exposure

And before I knew it, I was seated in front of a television camera, giving an interview to a national network. It had been a matter of days since the tragedy, and in an almost surreal turn of events, I had inadvertently helped produce the story.

Sitting in the darkened room, I was aware of my lipstick drying out under the lights, the slight quiver in my voice, and the voice in my head worrying that I would say something stupid or forget something important.

A reporter from the local public radio station then contacted me about doing a different angle on the same story. I found myself sitting, oddly enough, in the basement of my house giving an interview along with three of the other women who also work on the nonprofit. We ended up in the basement after the reporter had inquired on the phone, "And where is your project headquartered?" I blurted out the first funny thought that came to mind, "In the basement of my house." For some reason, the reporter thought this would add a certain authenticity to the meeting. What it really led to was me spending an entire day cleaning up the space. Although you can't see the room on radio, I feared the reporter would reveal the truth in a description along the lines of, "In a dusty, cluttered, pigsty of a basement..."

The interview went well, although the four of us felt a little bit bad when our stories made the reporter cry.

The fruit of a strange whim
In a moment of boredom or distraction today, I decided to google the name of someone I knew as a teenager. This is an oversimplification. In 1975, I participated in a program that matched American teenagers with kids overseas for short-term summer exchange visits. My group was matched with a group in Sao Paulo, Brazil. Patty came to my home in 1975, and I visited her family in 1976.

The trip to Brazil while educational, was akin to a visit to another planet. It wasn't a cultural issue; this was all about class and status. I came from a highly dysfunctional blue-collar family. My parents were chronically deep in debt, and the financial stress of always being broke influenced everything about our lives.

Patty's family wasn't just well-off; they were affluent. Their lifestyle was beyond my comprehension. They lived a palatial house and had live-in staff, including two cooks, a driver, and a handyman. At night, the house was protected by three German Shepherds that were trained not just to attack, but to kill. During the day, the dogs were kept in gated kennels where they snarled at anyone who passed by. I was fascinated that the dogs had been trained only to respond to commands issued in German.

At 15 years old, it is still possible to let curiosity overcome self-consciousness. I enjoyed my time with Patty and her sister Silvia. We kept in touch for a few years, but once college started, we stopped putting in the effort needed to write letters by hand and send them via airmail.

For the past couple of years, I did attempt the occasional Google search to locate Patty, but I was always unsuccessful. Until today. Today it occurred to me to search for only part of Patty's last name, and there it was at the third hit: Her father. It was a professional biography, and although the name left me 50 percent sure I had the right person, the details of the biography erased any doubts about who this was.


I sent an email. I knew the message was going to a public relations mailbox, so I kept it brief and formal. It seemed prudent not to come off as a possible stalker or total wahoo, given the circumstances.

Two hours later, I received a response from Patty's father. It was that easy. Thirty-three years had passed, and in a matter of hours we were back in touch and getting up to date.

Just one more reason to love the Internet.

I stand corrected. Sometimes troubling things do come to light.

Sometimes, irony is evil

On Sunday, two massive bomb attacks killed 170 people in Bagdhad and wounded hundreds of others. Those are hard numbers to comprehend, let alone think of on an individual-by-individual basis. What does that look like? Who were those people? It was so far away, does it matter?

In the United States, war tends not to meet us on a personal level at all unless it is one of our own who dies--specifically, a soldier. In those cases, we get the full press treatment all the way from family reaction to funeral.

Well, yesterday, one of my own met the war head on and did not survive. You won’t read about it in the news and you certainly won’t hear the story singled out on television. That doesn’t make this loss any less significant. The war has a face and it is the face of Hadiya Ali.

Hadiya came here with her family in March, 2007. She was part of my life on a daily basis for almost a year until she was ready to enroll in school. She also took a free English class on Saturday mornings, a class that had been set up for refugee women living in on the east side of town.

Her participation in both classes is what brought her to be one of the first four women who became the core of the refugee women’s empowerment group. Hadiya was our champion. She not only learned the concepts faster than the others, she taught newly arrived women why it was good for them to be part of the group. She cried when she had her first speaking engagement, and then she asked me to help her write about the experience.

Hadiya was a one-woman public relations machine for women’s empowerment, and she was never subtle about it. She wanted everyone to know about the work we were doing, even after she left us to speak on behalf of Iraqi women and refugee causes.

Hadiya made friends everywhere she went. She met the Mayor and the Governor; she did two public radio interviews and she was the subject of at least two newspaper articles. She knew almost everyone it seemed, as well as a hundred more beyond that. She loved Barack Obama, books (and she read them in English), education, empowerment for women, and being as social as possible. She cooked many excellent meals for Frank because she felt sorry for him, knowing that I was too busy to cook for him myself.

Hadiya used to love to sit and talk. We would talk for hours sometimes. She knew when I was hiding something, and she gave me a hard time about a lot of things. Sometimes she was a major manipulative pain in the ass and when that was true, we didn’t get along at all; of course, it was probably just because we were both hard-headed and opinionated.

Hadiya loved to travel, and her sons made it possible for her to go overseas to visit her other family members. On this trip, she said she would go to Germany and then to Jordan. She stayed far longer than she had said she would, and many of us were wondering if she was planning to come home at all.

Unbeknownst to her family, Hadiya sneaked into Iraq late last week. She was so close and the temptation was too great to ignore. She had some unfinished emotional business she needed to take care of. Hadiya’s elderly father was murdered while Hadiya and her family were in exile in Jordan. The crime was unrelated to the war and it remained a cold case. Hadiya never had closure—she had no way to say goodbye to her father, and she was always pained that he didn’t have a proper funeral. As his only child, she felt his loss keenly. She often spoke of the day she could return to Iraq to visit her father’s grave and to say goodbye properly.

When Hadiya called her husband to say she was with relatives in Baghdad, he was furious. He told her to get out of the country immediately. Who knows what Hadiya was thinking. Perhaps she thought the conflict had eased to the point that it really was safe enough to visit. Apparently, it wasn’t.

Ironically, Hadiya was at the travel agent’s office making arrangements to return to the U.S. when the bombings occurred. Her relatives who survived the blast called her husband, Majeed, to tell him that his wife had been killed.

Hadiya was outgoing, creative, tenacious, stubborn, witty, amazing, and full of personality—probably enough for several people. She had many friends and many fans. It was easy to be impressed with Hadiya.

All who knew her and who have heard the news are mourning. Frankly, most are heartbroken. We work with refugees and we understand more than most what the true cost of war really is. We know why refugees aren't supposed to go home during an active conflict, and we know that for many, never going home again is the deepest wound of all.

Hadiya had said numerous times that when she died, she wished to be buried in her homeland, a country she loved and missed deeply. Unintentionally, she has truly gone home to stay.

Hadiya was buried in Baghdad yesterday, in a grave alongside her father’s.

Must be October

Medication realities

You're losing all your highs and lows,

Ain't it funny how the feeling goes away?

--Desperado

The Eagles, D. Henley/G. Frey

Let the games begin

Tomorrow: Physical therapy and then an appointment with the ear-nose-throat doctor.

Next week: Dr. G and more PT.

The week after that: Even more PT and a trip to the neurologist.

Later that week: The brain MRI. I want framed copies.

Sometime after that: Quality time with the bariatric endocrinologist mystery illness wellness lady MD PhD overachiever.

I remember when I used to spend my money on shoes and makeup.

brrr

OK, seriously. This freezing cold weather in not-quite-mid-October is tweaking my nerves. I hate cold weather. Hate it. We had a little snow this weekend, for chrissake. Grrrrr. I ordered a jacket from Land's End (one that will actually close and cover my ass) but it hasn't arrived yet. It can't be this cold--I don't have a jacket that fits.

The only way I can keep it together during the season change is to have the light adjustment first, and the temperature change later. The meteorologic gods really need to listen up: May cannot survive shitty winter weather if it's going to start in the first half of October and grind on through April. It is for this reason I do not live in the far north or Mid-Atlantic East.

Perhaps this is nature's plan for me. Survival of the fittest, elimination of the SADdest.

Holy crap! That HURT!

Things happen to me that don't happen to other people. My luck is strange, both good and bad. Today was...bad.

I woke up 35 minutes late and had to rush to get to work. I came out of the parking garage, walked a half-block, crossed a side street, took four steps along the sidewalk, and suddenly felt a horrible crunching sensation on the sole of my foot. And then it felt like I was standing on a lit charcoal briquette for just a second. I took a deep breath and attempted to resume my stride.

As soon as my foot hit the sidewalk, my situation became clear: Something was broken. I limped my way the remaining three blocks to the office. I hoped I could make it across the six-lane street with the 20-second walk signal.

At 12:30, I limped my way to physical therapy. Oddly enough, Monday is not my regular day, but there was a schedule glitch for this week, so I was moved to a different slot. Good timing. Toni took a look at my feet and let me know that my right foot was not broken, but torn. I tore the small tendon that connects muscle just behind the first metatarsal. Its proper name is the flexor hallucis brevis tendon.

Ouch. Walking. I was simply walking and while wearing good shoes, as a matter of fact.

I should be on crutches or wearing a boot-style walking cast, but since I feel like such a dork already, I refuse to add to that problem. Yes, that's right. I am eschewing medical treatment in the name of vanity.

There goes my dance career.