What Can I Say?

   I have had a case of writer's block. Possibly writer's fear or anxiety. The world is so chaotic, I am a ball of anxiety and fear. Fear of the unknown. Fear of losing friends and loved ones, whether to the pandemic or differing feelings about the current state of our world. Not only are we in the eighth or ninth month of social distancing, lockdowns, and restrictions, but we are also in the midst of the most important election in a lifetime. In addition, there is social unrest due to racial disparities and injustices. Ultimately, I just have had no real, logical words to express myself. Had I attempted to write before now all that would be said would certainly be nonsensical, emotionally driven statements. I do not need to force my ideas on others and I am too sensitive for someone else to force their ideas on me. I finally decided I was rational enough to sit down and document where everything stands in my world today.

  Today is election day. Today we get to decide who our president will be for the next four years. Due to the pandemic, I voted by mail weeks ago. That took some weight off of my shoulders. As the day has gotten closer and closer, people have gotten less civil and more emotional. There is anger, fear, anxiety, righteousness, you name it. The tension has become so great there have been security measures set in place for riots and other violence prevention. We have a president who does not want to accept a loss and has said there will not be a peaceful transfer of power if he loses. We have a candidate who was once the vice president, and whose running mate is a mixed-race woman. Powerful things have been said on both sides. The outcome of the election is likely not going to be heard today. The country is in a serious state of unrest. I, for one, cannot wait for it all to be over with, no matter the outcome. Stop the insanity and bring back civility. That is all I have to say regarding our government.

  As far as I go, things are running as usual. One thing slows down and another thing arises. One of the best things that has happened recently is that I got a new insulin pump. Technology is always progressing making better and better tools for treating diabetes. This particular pump communicates with my continuous glucose monitor. It is called a closed loop system meaning it alerts me when my blood sugar goes high or low. If it starts to trend low, the pump can suspend insulin delivery for a short time to allow me to get fast acting sugar to correct it. This helps prevent severe lows and allows you to be a bit more active without having to prepare so much. Often before activity a diabetic will lower the amount of insulin they receive to prevent a low blood sugar. This pump helps. It also can predict a high blood sugar coming and adjust it by increasing insulin. For someone with gastroparesis, that is critical.

  Of course, I still have to monitor and manage my diabetes. This newer pump just adds that extra layer of protection. I have mentioned before how difficult managing diabetes is with gastroparesis. The food does not travel predictably through the digestive tract making it hard to fine tune insulin dosages. I often drop low too quickly and end up in the severe low blood sugar range. That is equally true of my high blood sugars. Part of the problem with that is the possibility of stacking insulin making it more likely, and more dangerous, that I will end up with a severe low. A common problem is a rebound effect. Your body recognizes your blood sugar is low, but it recognizes it too late, usually after you have taken some form of fast acting sugar. In turn, a few hours later your blood sugar sky rockets because it has corrected itself much later and you already treated with juice. Then a correction or extra dose of insulin is needed to bring it down to normal and often times that roller coaster continues. This new pump will not prevent highs or lows, but it will help reduce the occurrence of these roller coasters. Not only are they damaging, but they feel horrible too so it's a major score for me. (side note: inulin is not cheap and the government has not done anything to change that. Diabetics are supporting each other to help us all afford what we can get) But I can never forget that Type I diabetes is my only challenge.

  A few months ago I opened up about being diagnosed with osteoporosis at the young age of 37.  After a few months of doctors consulting and brainstorming they finally decided on a treatment to prevent the risk of more serious broken bones. It is an infusion called Reclast. It is given once per year so it seems easy enough. Well, yes and no. I went for my first infusion last week. It took almost two hours. I was in the infusion center alone because COVID is still spreading so there can be no additional people in the facilities. They warned me it may cause flu-like symptoms for a couple of days. What they should have said was, "You may feel like you are dying, but it only lasts a few days." The next day I woke up with a fever and every inch of my body hurt. I have a high pain tolerance and this HURT everywhere. I was vomiting and more. It was awful. Luckily it did only last about two to three days and luckily this will only be once a year. Now I will know what to expect. But wait, there's more.

  The evening I felt the worst I received an email from my gastroenterologist that said I had some antibodies in my blood work and she would like to do an endoscopy and some biopsies. Most of the antibodies are related to Celiac disease. I am very strict on my diet so there should be no active antibodies. At this point I have no plan. I want to hear from her exactly what the plan is and what she is looking for in particular. I also asked her to give me the worst case scenario and the plan that would follow. I have not heard back as of yet. My issue is simple. I am tired. 

  I spent almost a year in physical therapy for a labral tear in my right shoulder. Then I broke my foot four days later. I spent five plus months laid up. The last month of that I had surgery to replace my stimulator battery. I am in physical therapy now for my foot. It has been about five weeks. And last week I had one of the most difficult treatments with that infusion. I am not so sure I want to be put to sleep again, have biopsies done, wake up with a sore throat, and feel crummy for a few days. Honestly, I don't want more bad news. I am overwhelmed. I normally would face this head on and go for it, but not this time. I am just exhausted emotionally and physically. My thoughts are to wait for more answers before I agree to anything. And in the meantime I am going to spend some time with my son.

  So without further ado, I am signing off. My plan for the day is to watch Disney movies and avoid all news and commercials. We will sing, and laugh, and all that good stuff. As tough as it may seem to believe right now, God is here. He is asking me to be still and listen. That's what I intend to do. I pray that all of you are well. And go exercise your right to vote. The sun is shining, even through the clouds. Never forget that, especially on the hardest days!!

Self-compassion Is The Goal

   My goodness. I barely know where to start. The world is in chaos. I can openly admit I am exhausted. I am an extremely high risk person living in this pandemic. We are all experiencing COVID-19 fatigue, meaning we are so tired of it we are becoming a bit more reckless. This is understandable! Many are using the excuse that we cannot live in fear. The thing is, I am not living in fear. I am living in caution. I personally am not scared of dogs; however I would not walk into a group of dogs I am unfamiliar with because that would put me in danger of getting attacked. I do not live in fear, but I do protect myself from danger. This means as long as people are treating this virus as if it were as simple as the common cold, I cannot leave my house. I can wear a mask and wash my hands, but if those around me are not it takes away that crucial layer of protection for all who are high risk. I do go to the doctor or hospital if necessary, but those environments are the safest during this time. Even the physical therapy facility is taking serious protocols and following all CDC guidelines. I just would enjoy being able to rejoin the world beyond maintaining personal health.

  That being said, I did go to the doctor twice this week. I will start with the fun part. I had a follow-up with my podiatrist Tuesday. I have been doing physical therapy since September 15th, but I have still been in a boot. I really only worked on range of motion. At Tuesday's appointment I was cleared to graduate out of the boot. Funny thing is I had bought new shoes just days before I broke my foot. After five plus months in a boot and using crutches, most of my right foot shoes are really worn down. It was really helpful to have new shoes waiting for me in the box. I have to wear special orthotics. I will continue physical therapy to regain strength and range of motion. I am fine with that. 

  I am ecstatic to have the ability to sleep and walk without the boot. My foot does get tired easily. We take for granted all the work our feet do. There are muscles in places I never imagined. Again, I don't mind. I know with some work it will get easier. It is funny to watch it not move when I am concentrating so hard trying to move a muscle. If you know me, you know I like a challenge. I like to tackle and conquer challenges. That makes the rehab process for my foot rewarding. My physical therapist told me, "I'm so glad you are OCD. You are really trying to make sure you get it done right." It was part taunting and part complimenting. He is not the first to mention how rigid I can get so I took it with a laugh. He said many people go through the motions without making that mind to muscle connection so they end up hurt again. I cannot promise I will not hurt myself, but I can promise I will work to prevent it at all costs. That sort of connects to my earlier thoughts on COVID. Do not live in fear, but do what you can to prevent the worst. That baby step forward of graduating out of my boot was not the only excitement for the day.

  I was able to make it home for a quick lunch and some stretching exercises. Then my husband and I headed north to my general surgeon's office for a surgery follow-up for my gastric stimulator. She is about two hours away so it is a good time to blast some old music and enjoy the ride. This appointment was not nearly as eventful, but still productive. I am healing very nicely. I have not lost weight. She simply bumped up the voltage and cycles. This will make my stomach move just a little more. To put it into perspective, I was at a ten for voltage for the past 4 years. When she replaced the battery she had to start slow and low, at a six, to allow my body to adjust again. Now, I am at a seven but with a higher cycling time as well. The next best thing is that her office is near nutrition I love.

  Whenever we go out of town food is the main excitement. It sounds ironic because food is such an enemy to me. Her office is near a Smoothie King. Smoothie King is a smoothie joint that was started by a gentleman whose brother had similar digestive issues. He wanted his brother to have a place to go so he came up with this amazing business. They have smoothies of all sorts, but more importantly they make dairy-free, gluten-free smoothies. They also generally have snack food. We first came across this place in Dallas/Ft. Worth, but was surprised to find it had expanded to New Mexico. Then there is a burger joint my husband loves so he got his treat too. We drove home with the sun setting on the beautiful scenery of northern New Mexico. Since we drove south we enjoyed the sunset.

  All in all, things are looking up. I enjoy periods of time when I am showing improvement as opposed to frequent tough news. I will ride this high for a while. No one can take that away from me. I hold these feelings close to my heart. I still have the reality of being chronically ill. But I am a fighter.

  Let me tell you a little about me beyond "the sick". I enjoy most genres of music. Music is in my blood. Radio has been a huge part of my life thanks to my family working in radio for years. My grandparents met while my grandma was making money singing on radio commercials. My parents met while my dad was a DJ at my grandfather's station. I enjoy being active. Again, it runs in my blood. My dad loved surfing. My mom is a marathon runner. And my step-dad (hate that word) was a football player and coach. I have played and participated in sports all of my life. I love to read. I am that oddball that loves non-fiction, but I can soak up a fiction novel often as well. I really enjoy science, especially nature and human anatomy/physiology. I am known to break out in random acts of dance. I am a very faithful person. The Lord is my savior. I drive a truck because that's just who I am. I enjoy volunteering when I can, although in the past couple years I have not been able to maintain anything on a regular basis. In turn, I frequently find things to donate in any way I can. I mentioned earlier I like a challenge. I love the feeling of accomplishment thereafter. I am also stubborn. I can get passionate and the stubborn seeps in possibly causing a mushroom cloud. That's kind of a joke, but not really. I am very honest with my feelings. I could go on and on, but I will spare you.

  I just thought it was important to take notice of the fact that underneath all of this unbelievable medical issues is a bright human being. We all face challenges. We have all been given a hard deck of cards. The good thing is we have all been blessed as well. That is the joy of life. The up's and down's and what you learn throughout. It makes the high's even better. We are also all multi-layered creatures. We have gifts to offer. Celebrate your gifts. Highlight your blessings. Appreciate the challenges that teach you such valuable lessons. Be self compassionate. Focus on the good and the good gets better.

Recognizing The Good

  I am so proud. I have been able to get back to a lot of my normal activities since the surgery last Tuesday to replace the battery in my gastric stimulator. Having this thing working again is insane. I barely notice physical feelings from gastroparesis changing, but the underlying things you cannot see are remarkable. I do still feel overly full. That is constant but even moreso after a meal for a few hours. I have had some nausea with regurgitation. Last night I actually threw up twice. Although that sounds bad, it is actually somewhat of a good thing. It means my stomach is churning. Probably because I was so used to it being off, my body is reacting similarly to sea-sickness/ motion-sickness. That will subside. My belly does cramp. Again, that can be a good sign showing that muscles that have been stagnant are moving. just getting tired. I remember these from my last two surgeries and once they subside I am more comfortable. I will always have symptoms of gastroparesis since mine is so severe. That does not mean getting the stimulator or replacing the battery was in vain. There have been notable good signs.

  One of those welcome changes is my blood sugar. I did have a telemed (thank you pandemic) appointment with my endocrinologist last week. She helped me make a few changes, but overall thought I was doing very well considering all things. Our newest change was to give myself insulin for my meals 15-20 minutes after my meal. Most people need it before the meal, but since gastric emptying is delayed it is better to wait. So far that seems successful. But moreover, in general my blood sugar is reacting well to the food and insulin combination. I am not having random high blood sugars as often. That is so nice because high blood sugars do make you feel kind of rotten and the swings from high to low are even more taxing. I have had to lower my background insulin because I am not needing as much. This tells me food is not lingering as long in my stomach and small intestine. Eventhough I am not feeling this happen, my diabetes is welcoming the change.

  A big takeaway from my appointment last week was the praise the doctor gave me. Somehow in chronic illness it is easy to place blame on yourself. You feel like you brought this upon yourself. You also feel guilty for burdening those around you. And beyond all of that, as the disease progresses you feel as if you pushed it along as opposed to fighting it. To hear a doctor say she appreciated my tenacity and positive attitude spoke volumes. She expressed how pleased it makes her that I am on top of things and constantly learning and adapting. She touted my intelligence. All of this means so much. The day to day, minute to minute challenge can leave you feeling defeated as I have mentioned about myself in the past. Having someone who deals with a lot of people in the diabetes community recognize me for being a "great patient" makes me feel as if, as usual, I am too hard on myself on a daily basis. Have we mentioned Type A personality??

  The next thing I am hoping to see, since my blood sugars have changed, is my other blood work improving. My main highlight is cholesterol. With gastroparesis and all the comorbidities I literally cannot even think about eating animal fat without getting sick. Fat in itself is incredibly hard to digest, especially "bad" fats. On top of that, meat is incredibly hard to digest, particularly red meat. Yet, somehow my cholesterol is through the roof. My theory is a two fold. One part is that I take a lot of supplements to help with nutrition. Some supplements can give false results. Since my last blood test I have stopped taking those supplements for a short time. The second part of my theory is that cholesterol or triglyceride blood work needs to be done on an empty stomach. Although I have tried to go in on"good" stomach days thinking my belly may be empty, I bet it was not. If you drink even a tiny sip of orange juice, cholesterol will show up in your blood so imagine a full stomach. We will repeat the tests in a few weeks. I am hopeful we will get better results. No matter the situation the doctor does not want to put me on statins considering the fact that I am young, thin, exercise, and eat minimal fat. She suggested a supplement called Cholestoff, but I have not gone out and gotten it.

  In terms of the surgery itself, I am making good progress. I am able to do some chair cardio workouts and a little stretching. The wound is healing beautifully. And pain is decreasing daily. My belly is still a little swollen, but I seem to remember that part taking the longest to go away. I get tired easy. But I am sleeping through the night, which is awesome. I began physical therapy for my foot last week. None of the work they had me do caused any pain near the surgery site on my abdomen. I am proud of myself for all of this. I am helping my body heal by showing it some love and it is responding. Score.

  To talk about my foot for a moment, I'm going to jump subjects. I am actually writing this minutes before my next appointment. I am still in a walking boot for a while, but I can take off my boot for no impact work. I have done squats on a Total Gym machine, rode an incumbent bike, and today I will work on some resistance training. As much as I dislike physical therapy, I welcome the exercise and recognize its importance in the healing process., as well as preventing future injury. This is just another baby step towards recovery. The interesting thing is that I will see the podiatrist on October 6th to see if I can possible get out of the boot then I will jump in the car to head a couple hours north for a follow-up with my surgeon. Busy day, but killing two birds with one stone. I am encouraged I will get good news.

  As I write this I am feeling a little crappy from a sleepless night with some vomiting. I am feeling a little emotional for no discernable reason. But at the same time I am so happy with where I am. I feel like I am making good progress without pushing myself too hard. I am healing better than I expected. God is really working on me today. He has given me such a hard day yet so much positivity to balance it. I know tomorrow will be better than today. That makes things better. I am seeing what could be when all of this recovery is over. That is exciting. We all knew this was coming. It is just so difficult when you are in the middle of the whirlwind to believe it will ever end.

Acceptance is Key

  Today is 7 days out from my surgery to replace the battery in my gastric stimulator. It was such a difficult decision to make, but I have not questioned it since. I know I made the best decision for my lifestyle. I needed to gain better control of my brittle Type I diabetes while still being able to stay active. I was certain I was doing the right thing, but was waiting to feel that "buyers' remorse" type regret. I was afraid I would wake up from surgery and start thinking of the "shoulda done"s. That has not happened once which is such a relief!

  The dynamic of gastroparesis and diabetes is that of a toxic relationship. One entity trying to dominate the other. I have always been active. I was taught healthy eating at a young age and that just got more intense once I was diagnosed with diabetes. As a Type I we are able to eat like anyone else, we just give ourselves insulin to cover the carbohydrates in food. I began to limit simple sugars like candy once I was diagnosed, but we all should do that anyway. When being educated on insulin dosing and carb counting you learn there are different carbs like complex or simple. Simple carbs go through your body quickly causing a quick spike in blood sugar followed by a quick drop. Complex carbs are slow to digest so they help maintain a more even blood sugar. Think about pouring plain table sugar through a straw. It's like a pixie stick. Quick. Then think about adding crumbled oats to that table sugar and you would imagine it would disrupt the flow taking the sugar a longer amount of time to clear the straw. Same thing with your digestive system.

  Now, usually insulin starts to act within 15 minutes and continues working for about 2 hours. That would be great if you had a meal with protein and complex carbs like eggs with whole wheat toast. That would make a graph of your blood sugars look like rolling hills. If you ate Lucky Charms instead you would see the Rocky Mountains on that graph. The idea is to keep the rolling hills. So what happens when your body does not digest in the normal fashion? Mountains, valleys, hills, the works. Gastroparesis starts to win the battle over insulin.

  With gastroparesis food stays in my stomach for days. Yes, I said days. On top of that, sometimes things get pushed through by other food, sometimes it travels at a semi-normal speed, and sometimes nothing moves. Liquids are the easiest thing to move. We all know that fiber, fat, and protein slow the digestion process. Most healthy diets use them to help maintain steady blood sugars, even in non-diabetics. Typically a diabetic diet is high fiber, high protein, and good fats. Gastroparesis has limited me to 5 grams of fat per day, 10-15 grams of protein, and 10-15 grams of fiber per day. THAT IS NOTHING. Yet my stomach still is not moving food. So what does this mean?

  This means I am eating a diet that is 100% against the diabetic diet or the "Lauren" diet I used to love. I am eating only simple sugars with very little protein or fiber. But remember, my belly is not moving or digesting. I cannot give myself insulin right before I eat. It usually needs to be after because my body doesn't even begin to absorb the sugar right away. Usually 1-2 hours after I give myself insulin for a meal my numbers are fairly good. But wait an hour beyond that, then the next and suddenly my blood sugar is through the roof. Why? Well, because I gave myself insulin for the meal I was eating, not for the food that is in my belly. When food moves from the stomach to the small intestine, that is where most of the sugar is absorbed. Without knowing exactly what is moving from one organ to the next it is incredibly hard to predict what may be absorbed. All I know is what I just ate. Sound confusing? IT IS! And the worst part, no doctor can give you advice. They can monitor you, but they cannot tell you how to predict something or how to safely prevent more damage. Gut motility disorders are not well understood.

  When the battery went out on the gastric stimulator I had no idea. What did start to happen, and should have been my first clue, was my blood sugar would drop way too low after eating then spike way too high 3-4 hours later, remaining high for hours. If I tried to correct, it would plummet. I thought I was stressed out and adrenaline was causing some wacky things. Not the case. I was not digesting, moving, or absorbing properly. I could tell I was struggling to digest because the easiest things were starting to feel like bricks in my belly. I have said this before, but it feels like I eat an entire fast food meal plus a large pizza all by myself. I almost feel the fullness all the way in my throat. I don't even remember what it feels like to eat a regular meal and just feel satisfied. I always feel deprived, yet always feel incredibly full.

  As you can imagine, this wears on my emotions. Food is such an integral part of our culture. We have feasts for big holidays and cook-outs or gatherings to celebrate anything we can imagine. We meet up for lunch, dinner, or drinks just to catch up with a friend. Food is everywhere. As this disease progresses, and it is happening faster as I age, I am having to limit more and more while simplifying more and more. I spent hours on the computer last night looking up recipe ideas and anything else to help me feel more "normal". Of course, this is not the first time I have done this kind of research. Since so little is understood about motility disorders there is little to be found.

  I have discovered little tricks along the way. One of my tricks is exercise. More important is exercise involving twisting or crunching always involving the use of gravity to help break the food down while shaking it through my belly into the small intestine. Walking, yoga, pilates and similar exercises are my go to. The problem is I am having to do these things more than I want now. Most days I end up working out 2-3 times per day for at least 30 minutes. As much as I like to be active I also want to be lazy. On top of that, the exercise burns a lot of calories I just tried to consume. So I eat then exercise or just not eat at all. Neither of those options are good, mentally or physically. 

  I spent a lot of last night in tears. Then my ninja girl comes out and says "I will conquer this." Then I get mad. And the cycle often continues, but it ALWAYS passes. I just explained to my husband that I am envious of those of you who can eat regularly. I don't think I remember what a normal gut feels like. I want to run and jump and swim and hike. But I can't. Not just because of the gastroparesis,  but the other diseases limit me also. I want to be able to eat at a restaurant or leave the house without having to pack my own food. I miss baked goods so much. It is this all encompassing deprivation.

  My positive self comes out when I start to spiral like this. I have options. I spent today making chicken noodle soup, chicken with rice soup, and peeled and sliced potatoes I bake with a tiny amount of olive oil. My parents generously drove 2 hours to go to Whole Foods and grab me some unsweetened peanut butter and dairy free yogurt. I have plenty of frozen fruit I can use to make smoothies. I can tolerate eggs now that the battery has been replaced. Unfortunately, that is the extent of the excitement. Notice there is nothing crunchy on this list. Also, the soups do not have any vegetables because I cannot tolerate them. No beef or pork. No spices. No condiments really. So, I have options but not many. A human being instinctively needs to chomp. Eating pureed foods, soups, and baked potatoes does not give you that crunch. It seems like even if I do all the right things I will still feel deprived. It is overwhelming and unfair. Who said life was fair, right?

  The one tool I hang on to is gratitude. I do thank my body for allowing me to wake up everyday. I thank my body for the ability to move. I am proud of myself for continuing to fight this battle. I am proud of myself for finding something to smile or laugh about EVERYDAY. I hold onto my intention for every action. Sometimes my intention for a morning workout is simply to ground myself and not focus on the benefits it is having on the disease I fight. Sometimes my intention for an afternoon unplugged is to be present with my son. Most days my intention is to be me. I have so much to be thankful for. I complain. I whine. But I know my struggles are minuscule compared to so many others. As I enter this new chapter my intention is to accept. One of the biggest causes for depression is not accepting your challenges. I will learn and adapt as the diseases progress. I remind myself that I have faced similar challenges in the past and made it through. There is always a rainbow at the end of a storm. Usually that rainbow is that the challenge made me a better person. This too will make me stronger. I may desire more than I have, but when I look at how strong this has all made me I know the grass is not always greener on the other side.

Get 'er Done

  How amazing life can be. In the span of hours or minutes or even seconds you can go from the highest of highs to the lowest of lows. The trick is, ride the highs through the lows. The momentum from the high will often carry you through the lows. That's how I like to roll. Like any human being, I am not always perfect. Can you believe that?!

  Yesterday was a day to remember for sure. As most of you know, I am recovering from a foot injury. It has been four months now that I have been in a boot and completely non-weight bearing. I did manage to graduate from a tall boot to a short boot, but most would be healed by now. Not Lauren. So, yesterday morning I had a check-up. I was nervous hoping I could make a move forward, but prepared to hear I wasn't ready yet. To my surprise, I am now officially allowed to go without crutches. I still have to wear a boot for a while, but I can bear weight. It was such a feeling of gratitude, excitement, accomplishment, and all of the above. I also get to start physical therapy. Very light physical therapy, but I get to start. Baby steps towards success. Pun fully intended.

  I then had an appointment about 2 hours away with my general surgeon who monitors my gastric stimulator. It gave me a few hours to eat lunch, get a little bit of exercise and get things together. I was assuming not much had changed. The stimulator is turned all the way up so I knew there was going to be no adjustments. I also knew that my last stimulator battery lasted about 4 years. I have had this one about 2 1/2 so we knew it was just a matter of time, especially with the settings all maxed out. I am not sure exactly what I expected.

  As we have all become accustomed to, during COVID social interactions are being kept to a minimum so I have to enter all these appointments alone. This is a major struggle for me. I am a total introvert and horrible with small talk. I have social and generalized anxiety so sometimes it is almost paralyzing. That was where my focus was yesterday. My husband is a great buffer. He is a people person and a charmer. I just contribute to the conversation when I can otherwise I stay focused in on the issue at hand. My surgeon is a talker. How was I going to be able to be screened for COVID, enter the office and check in with a different person, be taken back by a nurse, and see the doctor without my anxiety taking control? I was giving myself out loud pep talks the whole way. My husband just kept telling me it would be over soon.

  We get to the office and I bravely made my way to the front entrance hobbling on my newly usable booted foot. I made it in, was quickly checked in, then quickly taken back to a room. Luckily, they are all comfortable with me and know my history so it wasn't as bad as my anxiety makes me think it may be. When the doctor finally came in she got her little device all ready, set up shop on my belly, and instantly said, "Yup. It's dead." I had no response. She stepped back and asked "What would you like to do?" My mind and body went into a small tornado of thoughts and emotions.

  We had talked in a previous appointment about what to do when the battery died. I need more surface area on abdomen to place my insulin pump and continuous glucose meter. The stimulator is about the size of a hockey puck on the lower left quadrant of my abdomen. It sticks out and sometimes hits my hip bone in funny places making it uncomfortable. I can't sleep on my belly and sleeping on my left side can get awkward. Because it was maxed out and I was still only getting very little relief from the gastroparesis I genuinely just wanted to take it out. The conclusion we came to at that previous appointment was to let it die, keep it in for 6 weeks or so and see how I felt after that just in case I was unaware of any benefits it may be having on me. At yesterday's appointment it showed that it died right about the time the world shut down, mid March to early April.

  Due to the timing she said, "Well, it has been a few months so what do you think?" Now, remember I had just gotten the news I was allowed to weight bear so I was on cloud nine not ready to come down. She then decided to talk this out with me to help organize my thoughts. It was at that moment that I think she realized I was better when I had that moral support of my husband or family. She went into what my options would be so that my decision would be a fully informed one. Here's what she laid out for me.

  First option is to remove the stimulator all together. If we did that she would simply remove the device, but leave the leads inside my body. Because they are connected to my stomach lining it is dangerous to try to remove them. It may perforate the stomach allowing sepsis to occur. There would be caps she could place at the end, but with no battery power there is no risk of shocking. I would still not be able to have MRI's due to the metal in the leads. That would be that and I would simply have the scars as battle wounds. That seems pretty straight forward. BUT imagine eating something like scrambled eggs yet feeling like you ate a super-sized McDonald's combo and a large pizza with all the toppings in one sitting. Do I want to risk having that feeling? I have been struggling with eggs recently yet they were all that kept me alive for years. They are so easy to digest when scrambled. Would this struggle get worse? Would I lose more weight? I lost 7 lbs since mid March.I was in the low 80's before the initial implant in 2013.

  Second option is to change the battery. This would allow us to at least set it at the voltage I had just a few months ago. I really hadn't notice a physical feeling of difference since I last saw her. I didn't know it had died. I knew I was starting to really struggle with the easy foods and I started to notice I was becoming less interested in eating. I would force myself, but just the minimum, I really hadn't craved junk food. We all crave sugar or salt at some point. Yet, I couldn't pin point a moment of sudden change. Would I just regret putting in a new battery just to complain about how much I hate the stimulator being there? Oddly enough, even my own pride slipped in wondering what would people think if I made a bad decision. Who was I going to let down?

  Third option is to finally give in to the feeding tube. She explained where it would be placed. It would leave my stomach available for "pleasure eating" but my nutrients would be coming from the feeding tube supplementation. I would have to feed for about 6-8 hours per day. She said most people do it at night so they can sleep through it and go about their day. Because I am a Type I diabetic the feeding may need to be broken up in 2 hour segments spread throughout the day. The positive of this would be a predictable stream of nutrients, including carbs, allowing me to better control my diabetes. With food randomly going through in bits and pieces, as it does now, it is really hard to get the right insulin dosages and timing to match when the small intestine will absorb the carbs that are ingested. This means, currently, I swing from high to low and back quite frequently. Now, hold onto that information. It is important to my final decision.'

  I brought up blood sugar control. I highlighted what I just laid out for you. Of course, she agreed because we have talked in detail about it for years. Then it hit me. "It died back in March or April, right?" I asked. She confirmed. My mind was a reeling movie of the past few months. I remembered having a conversation with my sister in early April about how stressed I was over the entire COVID-19 pandemic situation. I was additionally frustrated at the time because my blood sugars had suddenly gotten even more erratic than usual even though I was being extra diligent. I figured it was stress....but, if...huh? If the stimulator died around that time that meant that my fluctuating numbers could be partly due to the fact that the stimulator had died. Although it was not giving me much relief it must have still been moving food in a somewhat rhythmic pattern I could follow to dose my insulin better. Huh? It could be a possibility.

  That brought us to my final option. We replace the battery and if there is little relief we could put in the feeding tube and I would live with both. Wow. That would probably help a lot. I would love to be 10-20 lbs heavier and that option would get me there. It would also take up more belly space though. It would add additional attachments. Would I be able to cope with that in the long run? Or am I ready to try to cope with it knowing it is necessary? Tough one.  She asked again what my thoughts were. I decided to say, "I think I need to digest this information a bit. Haha no pun intended there. (literally just came out that way) Let me process it and get back to you." She ended that with explaining we could get this done in one to two weeks if I let her know by Friday (this was Tuesday). I told her I would definitely get back to her before then because the weight of the decision would be too much to carry around for very long. I was still taken aback even more when she said one to two weeks. In previous years it had been a few months of prep time.

  As I said earlier, this appointment was two hours away. That gave me time to think, but avoid thinking all at the same time. Again, just hours earlier I had received the great news that I could lose the crutches. I wanted to ride that high. I was enjoying it. The heaviness of this looming decision was allowing it to creep into my thoughts over and over. Getting rid of the stimulator all together would be ideal. I would love to have a little freedom over my own body again. But was it realistic? The feeding tube would help control my blood sugars protecting my eyes, heart and kidneys longer. And it would allow me to avoid force feeding myself. But it is a lot of maintenance. Then it hit me. It wouldn't affect my daily activities much, she had told me, but what about yoga and pilates? I have lived on chair workouts or floor workouts these past four months. I have to exercise. It is not a chore to me but a passion. I am not able to run so would I just have to take long walks for the rest of my life? I'd be walking like Forrest Gump ran. Could I lose another passion? I have already given up so much. These thoughts rolled on and on while I vocalized them as they came. I probably was not even talking in a linear fashion anymore, but my husband listened. 

  About 2/3 of the way home I just said "That's what I have to do..." After a long pause I laid out my logic. I am not ready to give up yoga, pilates, or floor barre workouts. They make my body feel so good releasing my mind and keeping me grounded. It's meditation and prayer. It would be like losing running and basketball. Devastating. That means the feeding tube is out. I am not ready. The battery has been dead about the same amount of time as my blood sugars have decided to go haywire. I cannot afford to lose more vision. I cannot afford to lose my sight. I cannot treat my organs as if they are expendable. I have to make a decision that is beneficial to my health overall. I hate having to wear an insulin pump. It is uncomfortable and highly inconvenient as well as a lot of maintenance. Yet, I do it because I have to control my diabetes. I have to look at my stimulator as if it were a different form of medication/treatment. Just because it is uncomfortable and inconvenient is that a reason to bury my head in the sand and toss it to the curb? No. My blood sugars were better prior to March whether or not my belly felt any different. I have to replace the battery. I decided to sit on that decision and sleep on it. AND PRAY...HARD!

  That's exactly what I did while barely sleeping last night. I woke up and got my son ready for school and my husband set out to work. I started one of my favorite chair cardio videos. This one is challenging and long, perfect for a lot of thinking to be done. Somewhere in the middle it hit me clear as a bell. I can still do chair cardio while recovering. See, I had been worried that any surgery was going to interfere with my foot rehab as well as taking away physical activity for a while. That won't be the case. I can do it all, just balance it. The battery replacement is an out-patient surgery. The first week or two you have to take it very slow, but the recovery time is 3-6 months. That's what I recall from 2017. Physical therapy for my foot was scheduled to start next week. I could still do that rehab while recovering from my surgery because it is my foot and ankle that need light PT for a few weeks before moving up to a more rigorous rehab regimen. Chair cardio places no impact on your feet AND it is not pulling, twisting, or bending your body so my belly can heal. In time I will be able to walk and do yoga and pilates. On top of that, we have a beautiful new elliptical machine gifted to us days before I broke my foot. I will have that option as well. Yay for sanity! "That's the best choice. That's what I need to do." So, as soon as I was done working out I called the doctor's office before I lost my emotional strength. "I want to replace the battery." I told the nurse.

  About two short hours later I get a call from my surgeon's office. The voice sweetly said, "Are you available Tuesday?" Surprised I asked, "This Tuesday?" My face was fully twisted. "Yes. Tuesday the 8th. Let's do the surgery Tuesday the 8th." I knew I had nothing scheduled that day so before I let my mind go too far and my frightened emotions take hold I agreed. She gave me some instructions I am sure I will forget. My mind was spinning. I just kept thinking "What is today? Wednesday? Yeah, Wednesday. Next Tuesday?! Really? Ok." Same thought going and going as she went on. I jotted down a few notes, but told her I assume someone will walk me through this as the week goes on. I quickly called my husband once we hung up. His first words "WHAT? TUESDAY?" then silence. Uh oh. What did I just do? I suddenly panicked. He took a breath, explained he was just caught off guard, but let's do it. He had literally only told his boss minutes before that a possible surgery could be happening this month. We didn't expect 6 days from now. 

  Here is the interesting thing that is so very important to document. We are living in the COVID-19 pandemic of 2020. I have to self isolate for 5 days prior to the surgery. That is no problem. Being high risk I am already self isolating. I also need to get tested for COVID-19 before the surgery. Remember me going into these appointments alone. Well, surgery is no different. Like anyone who is entering a hospital these days, I will be going into this surgery alone. I will fall asleep with only medical professionals surrounding me. I will wake up with only medical professionals surrounding me. You know how I get incredible anxiety in social situations? This will be insane. I will be at my most vulnerable in one of the most terrifying situations in my life. I may sound dramatic, but the struggle is real. This will be an interesting experience to say the least! All I can hold onto is that this will make me a better and stronger person in the end. I may suffer from shyness and anxiety my whole life. Oh well. It will be hard. Oh well. I will come out better because of it; better for my health, better for my family, better for taking care of me. 

  I will walk away from this with better blood sugar control. I will be preserving my sight, heart, and kidneys. I will be a strong example for my son. I will be here longer for my son. I will have faced a fear and overcome it. I can do this. I will still have my exercise to release all the pent up energy I have. I will be able to eat eggs without the feeling of bricks in my belly. There is always a rainbow. I will come out the other side brighter and prettier inside and out. Let's get 'er done!

  e

(insert name)'s awful, terrible, no good, very bad (insert time frame)

   We are all familiar with the children's book where the main character Max has one of those days where nothing seems to go right. At this moment in our lives many of us are going through this, but in a Groundhog Day fashion. All of our normal habits and rituals are all skewed. Humans, like most animals, are creatures of habit so this has been a big challenge. Understandably so! As the world changes and evolves animals usually follow suit. The thing is, this evolution happens over time allowing animals to adapt. The year 2020 tuned into a warp speed version of this...yet we humans are not able to adapt at warp speed. This is leading most of us to feel imbalanced. There is always positive in change. But try spinning around and around then focus on something you love. That positive thing you love is blurred for a few seconds. 2020 has spun our heads so fast it is difficult to stay upbeat all the time.

  Our household has been no different. There is so much good surrounding us. We are lucky in that my husband has a job that is essential so he has maintained his job. He is a pharmacy technician. He has health insurance and paid sick leave if needed. Because of this and the help of family our cupboards have stayed stocked. We have clothes on our backs and shoes on our feet. We obviously have access to the internet as I write this blog. We have two working vehicles. We have a home we are not at risk of losing. We have three church communities to rely on, one of which is my son's school. He attends a private Christian school we are able to pay for through tuition assistance. And to top it off, his school is prepared and ready for the new school year. How blessed can we be?

  Just like everyone else, we have all been sent into a whirlwind. Most days are good. We have found a new normal(ish). Since I am high risk I am really not able to get out much. COVID-19 is not a fight I want to be a participant in. My son stays home with me most of the time. Although he is 14, his autism keeps his maturity level a little low so he still needs more attention. My husband works at a grocery store pharmacy so he picks up groceries. What he cannot get there my parents get through an app that allows curbside pickup. We don't always get our preferred brands of stuff or all items we need. Nonetheless, we are still well taken care of. But in all reality it is driving me bonkers!

  I am a typical Type A personality, an introvert, and very independent. For decades I have been running my own errands, getting my own groceries, cleaning my own house, and so on. COVID has brought most of that to a halt. My acrobatics that broke two bones in my foot on Mother's Day made sure to top that list off. If I were the one going to the store and not being able to get a certain product it would be irritating but ok. When someone else can't find something I feel like if I had just gone I would've found it. Intellectually I know that is most likely not the case, but my controlling ways tells me it is. In comes the balancing act of making sure my frustration and anger are directed at the situation NOT the other person. I am not always good at that, but I am good at correcting myself when I realize I overreacted. So, where do those negative feelings go? 

  In view of the fact that I am an introvert, I struggle to really open up. I might share some surface stuff, but the real issues stay locked inside in a vault. Blogging helps give me an outlet. It is similar to journaling, yet the world can view it. It seems counter-intuitive. The thing is, I have a goal in mind. I am journaling outwardly to help people who are like me. When I was struggling so bad in my twenties with unrecognizable diseases and emotions I had no one to look to so I could tell myself "see, they got through it". That's what I am doing. I intend to compile this all into a book, but in the meantime the mission of my writings needs to be available to whomever needs it right now. So, it acts as a multi-tool. It is an outlet for me and a window for others.

  I think it is important to talk about mental health. It has always been an important issue that is getting more and more attention in the past several years. Like most things in 2020, it has hit warp speed and we all need to recognize it. I personally struggle with social and generalized anxiety, PTSD, and depression. That is really the first time I have openly admitted that in full. The thing is, it is real. Just like I take insulin and exercise to help control diabetes, I need to take steps to control my mental health as well. This year has really tested me....and continues. My best coping skill is putting things into perspective. "Where do I fit in all of this?"

  I cannot take anti-depressants. I have tried and tried, but the side effects are not worth it to me. Even on small doses I feel numb. I don't want to feel numb. It takes the joy out of life. I do have some medication for situational or acute anxiety, but I avoid those as much as possible because addiction happens quickly. Another fight I am not willing to partake in. A scientific note, most "feel good" hormones come from your gut. You would think they are in your brain exclusively. Not the case. Could my aversion to anti-depressants be due to my gut not working properly? Good possibility. But medication is not always the answer. Validation and acknowledgement is where it starts. Eliminating the stigma and accepting someone fully. Perfection is a word, not reality.

  I ran into someone yesterday who bravely disclosed to me that he had been suicidal for 12 years. The thing that pulled him out of it was the word of God and he returns to that more and more now as the pressure is on. The word of God is not for everyone, just like medication. I have known others who simply started exercising more consistently and it pulled them out of a hole. Exercise induces endorphines which your brain loovves! I also know several family members who rely on talk therapy. All of these avenues are being used at remarkable rates during the pandemic. I ask where I fit into all of this and the answer is right here. 

  I have no answer to solving the world's problems. I have no magic trick to calm everyone's psyche. What I do have to offer is an open door. I can empathize with those struggling. I can tell you, the struggle is real. The positive in all of this is that we do still have choices. We feel stuck or paralyzed, but we're not. We are all like snowflakes. No two are alike. What works for one of us will not work for all of us. But you do have to try. I am a layman. I can only speak from my own experiences. I have highlighted some good tools that can be used when nothing else works; medication, therapy, exercise, a higher power. None of this works without coping skills, though.

  I could write for days on this topic. So, to wrap it up I just want to say, be self-compassionate. Do not beat yourself up. We are all struggling. Find a creative outlet to grasp onto. Try adult coloring, learn a new skill, craft, DIY, write poems or songs, journal, watch or read the funny things, get dressed up, you do you. Keep yourself informed, but do not watch or read every news brief that comes out. Take a beat when you are in a tough situation. Try to name your emotion whether it be frustration, anger, sadness, panic, etc. What got you there? This way you can direct that emotion in the right place and calm it. I cannot direct my negative emotions at the pandemic because it is not tangible, but I can let those around me know what I am upset about. This prevents them from internalizing my negativity. I am not always mad at my husband, but he is there which makes him an easy target. When I tell him I am upset at the situation, he knows I am not taking things out on him. This is not easy. Practice makes progress. Remember, perfection is just a useless word.

  When you have an awful, terrible, no good, very bad day just stop. All it takes is three seconds to shift your processing. If you take those three seconds, maybe make it 30, you can find something good to focus on. When you focus on the good, the good gets better. I told my son today "It is like looking at a beautiful tree with a broken branch. Don't focus on the broken branch, acknowledge it. But focus on the beautiful tree." It is much easier to say than to do, especially when the negative you are facing is something as terrible as losing your home. In those tough situations acknowledge it is hard and emotionally unbearable, but what good do you have at that moment you can focus on. Maybe it is just a simple "hello" from someone walking by. As tiny as that seems, it is good. A building is built from bricks or wood, not as a whole but in small pieces put together in such a way it provides shelter. Continue to collect the bricks of the good you see around you so you can provide shelter from the struggles you need to overcome. I don't care who you are, you are a champion in your own right. Dig deep. If you need to, comment on this post and I can reach out to you personally and privately. Again, I am no professional, but I have two ears for listening, two eyes for reading, two arms for hugging (when that's allowed again), and tons of empathy and compassion. 

   

Osteoporosis Won't Break Me

  Osteoporosis. That is an interesting word to hear at 37 years old. That's what I got. I had to do a bone density scan last week. Not just because my broken foot is taking its sweet time to heal, but I am also very thin, malnourished, and I have ovarian failure. Yup. You read that right too. Ovarian failure. These are two things someone in their thirties rarely has to think about. This is now what I face. Although a little frightening, I see this challenge as a learning opportunity. It isn't a great deal of fun for a man to read about ovaries so I will keep that short and simple.

  For years I have had irregular periods. For a few years I was treated for ovarian cysts and that worked out great. When we moved from a metropolitan area in Texas to a rural area of New Mexico I kind of brushed it off not wanting to find an OB-GYN because, let's face it, who does? After 2 years and a serious lack of periods I finally broke down. I would love not to have one, but I am smart enough to know it is not good to not have them. There is not a chance of pregnancy. I had my tubes tied back in 2011 due to my fragile health. I found an OB-GYN. After a detailed exam and discussion she knew things might be more complicated. She ran some blood work and called back a few weeks later to notify me that I have ovarian failure. What's that?

  Well, I had been warned since my early thirties that many auto-immune diseases cause early menopause. My assumption was that may be what is causing me to be irregular. I have never heard of ovarian failure.  The Mayo Clinic refers to it as ovarian insufficiency. That word again, "insufficiency". Seems to be one of my running themes. Basically, my ovaries are not producing enough estrogen and/or eggs. This is not normal for women under 40. It is different from menopause in that women with ovarian failure or insufficiency can have periods on and off and possibly even get pregnant during this time (not me). Women who have premature menopause  stop having periods completely. Glad we got that sorted out. So the next question is what do we do about that?

  The doctor talked about hormone therapy and a few other things. All of which I listened to but barely understood. This is not in my wheel house and I have never even researched them. I am such an information junkie, I am usually ahead of the curve. She then explained she wanted to consult with an endocrinologist (specializes in hormone and hormone glands) as well as my primary care physician to go over options for any possible treatment. Her concern, of course, was starting something that may be dangerous considering my complex medical history. She heard I broke some bones in my foot so she decided to have a bone density scan done.

  I had to go to the local hospital. All diagnostic imaging is done there in our small town. That is a scary experience during COVID and I have been there several times since I broke my foot for different scans. A side note to this is the woman who checked me in was not wearing a mask. It is state mandated and it is a hospital. That made me uncomfortable. The scan took hardly any time. She did have to take my official height. I am proud to say I am officially 5'3". I am the tall one in my family haha Due to the pandemic, results get to the doctors faster. Radiologists are not having to do as much since healthcare is focused on necessity right now. The very next day the OB-GYN called to let me know I have osteoporosis.

  Now that was not what I was expecting. I am pretty good at being prepared for a new diagnosis. My gut instincts are good at knowing even before I consciously know myself.  Not this time. Because it is not something that was on my radar and no one in my family has really talked about it, I honestly had no concrete idea on what the different bone diseases/disorders meant. She explained and I listened, but I can't relay what she said. I don't think it registered at the time. Again, she wanted to consult with my endo and primary care doctor before starting any treatment, but some treatment is needed. I do take a calcium supplement and vitamin D because I do not absorb them naturally. She believes some hormone treatment may be necessary at this point.

  Osteoporosis literally means porous bone. Bones do have a blood supply. They also have two very important cells called osteoblasts and osteoclasts. The osteoblasts break bones down. Osteoclasts rebuild. Diabetics already produce more osteoblasts than osteoclasts which is why it takes longer for our bones to heal along with poor circulation. In osteoporosis there are also more osteoblasts than osteoclasts causing the body to lose more bone than it can reproduce. This makes the bones porous and brittle. Sometimes something as little as a sneeze or minor bump can cause a bone to break. The main concerns are the spine, hips, and wrists. I have read that even just sitting there a vertebrae may crumble. How do you protect yourself when you are a 37 year old mother?

  Strength training, impact exercises, and nutrition. So, we know I can only do so much nutrition wise. I eat as healthy as I can within my limitations. My body does not absorb all nutrients. I take supplements to help, but it is not a fix all. I am limited in protein intake due to my gastroparesis. Most of us know, protein is crucial for repair and development of the body. That one gets me. I have always exercised. In the past ten years it has really only consisted of long walks and yoga. Since my broken foot I have had to become more creative. I do a lot of floor or chair work which really strengthens your arms, abs, butt, hips, and back. Little did I know, that strength training is exactly what is necessary for osteoporosis. Score one for Lauren. The impact exercises will come in due time. They are things like walking, running, and jumping. But at least I know. Now, I can be sure to do a variety of exercises even beyond my foot injury. 

  I have mentioned this before, but I found some great content on YouTube for "hurt foot" workouts. Donovan Green (Dr. Oz's trainer) and Caroline Jordan are my two favorites. They make chair cardio videos. Caroline also makes floor barre and total body non-weight bearing workouts. I have come to really enjoy them. I used to be a long distance runner and basketball player. These workouts get me to that level of intensity. Who would've thought? Walking and yoga are peaceful, but nothing beats a runners' high. I am strengthening muscles I didn't know I had yet are so crucial to preventing injury. They have even gotten my shoulder feeling great. I had a labral tear last August and have struggled through physical therapy and more to rehab. These exercises really strengthen your posture muscles in turn strengthening your shoulders. I highly suggest you try it before you knock it, especially during this pandemic. It will reduce anxiety, help you strengthen, possibly lose weight (if needed), and as my son puts it, "It's somethin' to do". I recruited him for my evening routines. It has changed my life for the better.

  That is what is so cool. We all say, "there is always a rainbow at the end of a storm" or "the sun will come out tomorrow" yet it is difficult to really internalize. We also know there is power in positive thinking. Well, the shoulder injury and then the foot injury seemed horrible, but have now proven to actually be a blessing. They have made me really slow down. I tend to push myself beyond my limits then pay for it. These injuries have reset my mind reminding me to not push so hard. They also brought me to new exercises. I learned I really enjoy things I normally passed up. That has made me rethink trying other new things in other aspects of my life, These two trainers are incredible at educating while not judging. They are motivational. I have learned to be compassionate with myself. I am constantly reminded to be grateful for how incredible the human body is. It is one of the rare things that can heal and get stronger. I am better at pushing away negativity. I am better at focusing on my health. That helps all else fall in to place. 

  As I sit here with my foot propped up and no end in sight, I do feel thankful. I am excited for the day I can walk again because that just means I can add more to my arsenal. I will never get bored with the variety of exercises I can do. I may not be competing anymore, but I think I am stronger than when I was. I talk about exercise so much because I love it. Movement is medicine. Having a bad day> Exercise and get endorphines. Feeling tired? Exercise and get endorphines. Bored? Don't eat. Get up and move. The endorphine rush is real. The best natural remedy on earth. As long as you are doing it right and for the right reasons, there are only good side effects. Even as sick as I am, I think I was born with far too much energy and I have to get it out some way. 

So, welcome osteoporosis and ovarian failure. I am here to fight and win.