From Pain to Equilibrium: This Really Is A Thing

A few peeps have emailed or commented to ask about how my “anti-inflammatory-esque lifestyle” is going, whether the pain is gone. I figure, at this point, I should approach the question more holistically than nutritionally because, while I understand my body differently, with more nuance in each passing month, I cannot attribute improvement to just one approach.

The thing about chronic pain (intermittent or otherwise) is that it often isn’t caused by one factor – and it’s generally resolved (or managed) by many solutions that take years to parse together. I’ve been on the anti-pain scavenger hunt for a few years now. In retrospect, I know I’ve had musculo-skeletal and nerve pain since childhood and it went entirely unheeded, because I didn’t understand what was happening and adults don’t assume that children are in regular pain. Then it went away, but would routinely recur in one form or another in my 20s and 30s– frequently in neck and head. Then I got pertussis in my early 40s and, man, that fucked me up. I’ve been dealing with the fall out ever since. Add some mid-life hormonal chaos into the mix and there’s my own personal factoral soup. (Note: It’s way more complicated than this but you get the gist.)

I spent the first 4 years of my pain-management experience focused on bio-mechanical fixes, diagnostics, body-work and supplements. The ones that have been infinitely most useful, depending on the day, include my Yoga Tune-Up balls, my acupressure mat and pillow (the bed and head of nails, as I call them), vitamin D, collagen powder, massage, acupuncture and my self-devised body-work plan (which focused initially on therapeutic yoga, traction/hanging, breath-work and fascial release).

I’ve spent the last year focused on diet, with the express aim of reducing systemic inflammation, specifically as I now know I have non-negligible osteoarthritis which is thought to be motivated by my genetics and a family history. Oh, and I’ve also given a lot of attention to neuroplastic techniques for pain reduction, which is more of a mental-shift than wholesale new activity, because all of my body-work is fundamentally neuroplastic.

Each of these things has reinforced the others while numerous other approaches seem to have had no impact, so they have been abandoned. It’s impossible to say whether – in the last year - a critical mass of techniques has finally started to yield more significant improvements than ever before, but I do believe that the dietary changes have been key. Mind you, so have all the others, as far as I’m concerned. The thing is, I may get a massage once a week but I eat multiple times a day. So I do think diet has created a kind of pathway to cohere all techniques – a metaphoric service tunnel in the house that is my body/mind.

Having said this, I still can’t quantify exactly how I am improved. I still experience pain and sometimes it is severe. I still crave sugar and that is emotionally very difficult. I’m still stressed out by all of the things in life that stress all kinds of people.

So what’s changed?

I’m glad you asked! What hasn’t changed? I’m older, I’m wiser, I’m more aware of interdependencies (of biochemical and other varieties). I now know why it is believed that I have pain (a diagnosis) – though I’m so naïve that I don’t realize there are many people with infinitely more gnarled skeletons than mine and they feel little or no pain. I have also come to understand how a mechanical issue (jaw malocclusion) has had rather significant impacts on my ability to sleep, breathe and pretty well do everything else one does with one’s mouth. I now have a bespoke mouth gizmo to undercut the negatives but I may need to get more extreme about the medical dental devices in the future.

There are people who spend less time on their careers than I’ve spent on my pain condition and I still have pain. But I’m less afraid of it than ever before because I don’t feel like it’s controlling me anymore. As we know, pain is something that happens in the brain, not in the muscles and bones and fascia and joints and nerves. Sure, all of those things express the impact, but the source of this issue is the best place to target it. I do believe that the huge shift I’ve undertaken – the essential flip in my ingestion of carbs and fat – has helped my brain tremendously but not in the ways you might expect. I don’t think my memory is any better. I’m still anxious (and BTW, I in no way begrudge my anxiety – it makes me who I am and I know it’s as protective as it is antagonistic). Anxiety is also comorbidly associated with pain – as are many of the other conditions I just naturally happen to have been born with. If ever there were a candidate for chronic pain, I am that individual. But I am mercifully introspective. My sensitivity and my intelligence (note: I’m not going to underplay this - I’m smart and I own it) have given me so many mechanisms for improvement. I feel everything, physical and otherwise. I feel all of the bad and all of the good. I feel it deeply and broadly and incisively in ways that sometimes threaten to smash me up. But my awareness will also fix me. Mark my words.

Somehow, stopping the sugar/grains/processed food, limiting the booze and legumes and amping up the fat has made me better able to understand the contingencies between my body and my mind. I feel the gear shifts in my brain that bring about the gear shifts in my body. And they are so calibrated, so nuanced, it’s bizarre. For example, eating fat has somehow allowed me to understand (convolutedly, of course) that I have to be less active than I’d like. Sure, I can do vinyasa yoga with the best of them but it’s not good for me. It looks good but it brings pain that lasts indefinitely because I by-pass all of the warning triggers that my biochemistry is sending. I’ve used body-work just as I’ve used sugar – as a numbing agent. If I don’t want to be in pain, I have to listen. I have to slow down. And that’s something I don’t do naturally. I’m not wired that way and it’s very hard for me, to vastly understate it. Fat curtails my natural impulse to act constantly. It’s soporific. For some people, that’s not helpful. For a person who is compelled by everything -it may be a saving grace.

I have one other ace in the hole. Another tactic that's vastly changed the pain situation for me, but I'm not going to discuss it on the blog. If you suffer with pain, you're a regular reader/I know you, and you'd like to reach out, feel free to email. What I will say is that, like fat, it targets the pain where it lives, and - along with the dozens of other things I do on a daily basis - it's been a game-changer.

Am I cured? No. Am I on the road? I suspect yes. I mean, if nothing else I am INFINITELY less puffy and I can wear my rings for the first time in 3 years. That's an external sign of reduced internal inflammation, which will eventually lead to reduced pain, I can infer. Moreover, when I have pain (even pain that would probably floor most people), I can generally live "normally" i.e. go to work and work hard. My family life, my non-work energy, definitely takes the hit, but no one said balance is easy.

So that's my update on this topic. I welcome any questions or comments - cuz sometimes these days, despite stats that prove I have many wonderful readers, I do feel like I'm blogging in a vacuum...

Recalibrate

I had one of those lovely opportunities to reflect upon my lifestyle today as, this morning, a formerly loose skirt fit - um - snugly. Oh, and further to yesterday's throw away comment about the skinnies, I sense technically I now am in need of a size up. I guess you can say that "opportunity" is the economical code word for "I totally lost my shit and quietly conceded that the jig is up".

Let me articulate this clearly: I have eaten everything I desired, chemical composition-be-damned, for the last three months. I have drunk half-bottles of wine at dinner routinely. I have had little exercise, other than walking, unless gardening counts. I have baked many an item and I am a very good baker. I have traveled to Europe and Montreal - lands of the yummy restaurants and boulangeries.

It is not surprising that I have gained weight. But it's still a shock that my not-thin skirt is not loose.

On the plus side, this turn of events has given me a chance to create my very own "diet plan" - which is actually quite a lot of fun to do (if not to follow). I'm in no way surprised that all kinds of celebrities and "nutritionists" are getting in on the game.

I've decided to call mine the "Fuck?! My Clothes Barely Fit Recalibration Plan" a) because I don't believe in diets (obviously) and b) it adequately sums up the motivator and the angst in one simple name. I can see the book deal in my near future, yes?

Let's start with the premise: Life is long. Metabolisms change. Lifestyles change. Appetites change. Metabolic homeostasis is delicate. (Doesn't it seem like I have a higher degree in nutritional science?) One's job is not to be ever static in one's size and shape but to be resilient in the face of change, when one decides it is necessary.

And really, what's the truest motivator for getting a grip? Those of you who said healthful longevity - get to the back of the freakin' line. The truest motivator is horror at the thought of needing to buy new clothes (or make them, or borrow them, or knit them etc.)... Who has piles of money and time for that shit? Who feels good about going out and buying her skinnies in the next size up (unless, natch, she's been trying to gain a bit of weight)? Um, hello, I already have good clothes in a size I can get with.

Another motivator: Actually feeling gross. How much can one indulge before it gets old, before it layers on all of the other indulgences and drags? I don't like this puffy feeling.

So, let me outline the Phases. (Of course there are phases. This is after all, a future best-selling weight-adjustment plan.)

Phase 1 aka the "Don't Go Gently" (Two Weeks): This is the phase that's supposed to be really effective because it hurts. I'm hoping that my plan somehow forestalls the pain while achieving the outcome but, if it doesn't, I'll have to make hurt for gain (I mean, loss) seem compelling.

It includes:

• Very few carbs (sob). Vegetables and the occasional small serving of beans, rice or slice of bread are encouraged, but this is about reverting to the low carb system.
• No booze. I know, I gasped just writing that. According to many women of a certain age (and by that, I mean my mother), alcohol is inefficiently metabolized by the forty-something woman and it goes straight to the waist. Fuck. But remember, this isn't forever. Just for a couple of weeks to rebalance things.
• Lots of protein. Read all the other books if you want to know why. Also, it's good.
• Daily ration of chocolate. It's my gimmick. And it's got phyto nutrients and can satiate while inhibiting appetite when used appropriately. Yes, I did just refer to chocolate "usage".
• Other than the chocolate, and the odd serving of berries or peaches (what, I'm only human?!), no sugar, refined or otherwise.
• Happily, all kinds of dairy, having varying fat contents, are welcomed in small quantities in Phase 1. Also welcome: reasonable portions of nuts, seeds and unsweetened almond milk.
  

Phase 2 aka "Does this mean Phase 1 is Over?" (Three Weeks):

• For better or worse, this the same as Phase 1 except you get to drink a daily white wine spritzer (2.5 oz wine). Can you believe I just came up with that?! You may think the spritzer is a tasteless relic of the 80s but, chances are, you formulated that opinion having observed a lot of people (your parents' age?) going into their 40s and dealing with this apparent "alcohol makes you fat" syndrome. To qualify: Half a bottle of wine, drunk routinely in early middle age, arguably makes you fat. Spritzers simply increase your hydration and support the bottled water industry.

Phase 3 aka "The Phase You Stick with Until You Don't and Eventually It's Time to Go Back to Phase 1" (Your call on duration):

• Occasionally, i.e. every third day but no more frequently than that, you are welcome to fool around with rations of carbs i.e. turn that serving of rice (and every other carb you intend to eat that day) into a slice of homemade flan. Or you can turn it into a plate of porcini pasta with cream. Lord, I want to be in Phase 3.
• You get 5 oz. booze per day. That's it. Drink it in 3 spritzers if you must and call it Pinot Noir Soda. Or, you can save up 2 night's ration and have 10 oz in one night. But no more carry over than that. For example: You can forgo your glasses on Wed. and Thurs. and have 2 glasses on Fri. and 2 on Sat., but that's the extent of it. You can't save up you week of wine and binge one day a week. (What is this, the Adolescent Diet?)
  

I'm tempted to bemoan the unkindness of age but, really, I've been pushing the envelope for quite a while and, till pretty recently, the centre was holding. I've enjoyed my immoderateness tremendously and I hope to experience it again many times in the course of my life. However, I don't want to be 20 lbs heavier at 50 than I was at 40 - if the equation is at all within my control with lifestyle moderation. Eating indulgently is a fabulous joy one should never regret. But regaining balance is another kind of pleasure. Here's to the best of both worlds.

The Conscious Carb Revolution (Turn, Turn, Turn)

I like to think of myself as a reasonable person. I figure, since nobody else does, I'm maintaining some metaphoric centre of balance by exercising my will - my extremely formidable will, that is, the one which knows no equilibrium. I try to be moderate. Sometimes I almost succeed. For example, a few years ago I decided to embrace nutritional and lifestyle balance as an antidote to completely losing my mind. I have to say, it was one of my better attempts.

This is all a preface to my update about eschewing carbs after Xmas. If you follow me on Twitter, you know that I haven't enjoyed that experiment. After reading a number of texts, I opted to eat 75g of carbs per day (by no means "low carb" in the Atkins sense of the term). It is a lower than average carb count for most. I also decided to increase my fat consumption, good fats, that is. And to cut out all processed foods and simple sugars - including almost all flour.

I cannot begin to tell you what an exercise in dullness this has been. You think that eating steak and cheese 3 meals a day is going to be exciting. And it is for about 72 hours. Then all you want is some fries. Or a piece of toast. Even if, like me, you don't actually like bread. And don't get me started on baked goods.

I kept it up rather religiously for almost 2 months, till I went to NYC in mid Feb. I didn't weigh myself, choosing instead to gauge the success of my experiment by taking body measurements. I do sew constantly, after all. My goal was to lose an inch or two in any of the core spots - bust, waist or hips. My primary objective was to become a bit lighter in the waist area, though I'm not fussy. I wanted to see if losing carbs, i.e. lowering insulin levels, would impact the distribution of fat stores on my frame.

As I've mentioned, I feel that perimenopause has begun to show itself, at least in small ways. I am adamant about retaining my current shape, hormonal fluctuations notwithstanding. Even if it means ditching the cake (sob).

My husband was the first to say that he thought this was a crazy idea. He's my biggest fan, btw, and tells everyone about how successful I've been in restoring balance to my life over the past few years with healthy diet, lifestyle habits and supplements. He sensed, from the get go, that my plan was extreme. Note: It's by no means extreme in the low carb sense of the term. But my "healthy lifestyle" diet was entirely varied and included all kinds of foods - both healthful and, ahem, enjoyable. The low carb diet of the past couple of months has been far less varied, as you would imagine.

The experiment has reminded me of many valuable lessons: cake is not good for you (except psychologically), eating sugar primes your body to want more sugar, protein and fat are satiating. It has also made me aware of my love of variety. I don't know about you, but when you start to feel guilty about eating a small bowl of full fat, unsweetened yogurt with a teaspoon of dulce de leche, I feel it's time to get a grip. When you need to choose between fresh berries and a glass of wine, that's just sad.

I know that cupcakes are the road to chubby, or at least a detour from Slimville, but there are many beautiful, moderately-carb rich, healthful foods (not containing a grain of flour, I might add), that shouldn't be sacrificed.

Or at least that's my view this week.

I was all ready to throw the low-carb plan out the window (despite losing an inch from my waist), when a few co-workers told me how lithe I was looking. The power in those words is scarily affecting. Nonetheless, the past few weeks have been carbs-as-usual. Or maybe even carbs-plus, as I seem to be making up for lost time. That, my friends, is the sign of an eating plan that doesn't fly.

Y'all know I got an iPhone just before I went to NY. Seriously, I don't know how I've lived without this thing - a freakin' extension of my brain - for so long. Like everyone else, I love surfing the app store for interesting buys. My latest find is a program called Low Carb Diet Assistant and it rocks.

See, I love to keep track of things with lists. But, in truth, I'm getting bored of my regular catalog. I mean, I know calorie counts in my sleep. Furthermore, I do believe that eating fewer carbs - especially the sugar-laden and processed ones - is a sounder premise than counting calories. One of the best things about this app is that I can determine and set my preferred daily carb count. I've set it at 90g per day.

Those of you who live low carb are probably laughing at this point. But that's ok, because I'm not doing your plan. Instead, I've decided to live the Conscious Carb Lifestyle (yes, I made up this name. Catchy, huh?). It involves eating the most healthy, delicious, low-sugar, not-processed foods I can manage. Of course, I will be challenged on the basis that I love sugar, flour and junk food. But I know how much better I feel when eating well. Which, to me, means well-roundedly.

My diet includes cappuccino, wine, cheese, veggies, chocolate and full-fat dairy. It contains healthy fat, burgers (with half a bun, let's not go crazy), other kinds of meat and soy, eggs and nuts/seeds. For the foreseeable future, it will aim to stay under 90g carbs a day. I will probably continue to monitor calories - because despite myself, I don't seem to be able to shake that habit. Calories consumed will stay in the very normal range, as they have always been (well, except when I was binging from stress).

So let's see how this works. I wonder if I'll be able to lose an inch on my waistline with this plan. One thing's for sure - I'll enjoy it. And let's face it peeps, you only live in this body once.

This Post is All Over the Map

A couple of updates before I consign myself to sewing:

The Foot:

Thank you all so much for emailing and commenting to find out how I've been feeling. Until about a week ago, while mobile, I had pain much of the time. Extremely happily, in the past week, that pattern has been shifting and the pain is greatly reduced.

I have regained most of my flexibility, though to use it all, I do hit patches of soreness even now. My strength is almost back to normal. I can walk long distances. Note: I generally don't walk more than one way to work i.e. no more than an hour a day. I find that a) the weather is terrible and it takes more consciousness to walk safely - foot injury or no and b) too much walking overtaxes the tendon where it meets my shin.

Balance is the weak point, it would appear. I'm fine when I stand on both feet, but when I do yoga to maintain/ increase balance on the left side, it's quite apparent that the left is not on par with the right side. Mind you, my left has always been weaker for balance than the right. It's just more evident these days.

What's been surprisingly hurty is my shin and lower leg in general. The tone there was very compromised in the 3 weeks I couldn't move. It's also the place where the injured foot ligaments and tendon attach to. That's the area that's finally calming down. According to my physiotherapist, whom I've now stopped seeing, at a certain point of injury healing, one hurts whether one moves or doesn't. In fact, the movement - which helps to redevelop strength and to create new muscle pathways - is necessary to finalize the healing. The key is knowing how far to go and how fast. Everyone is different. Even weekly, I noticed my healing was all over the map.

I'm not going to wear fun shoes any time soon. But, over all, I'd say I'm doing really well.

The Dress Form:

In a pique of frustration, I called the Fabulous Fit people yesterday to inquire about solutions to my foam fitting challenges. I am pleased to tell you that the woman whom I've been speaking with since the get-go (who intriguingly still didn't realize that my dress form had been shipped), offered excellent client service on the matter of fitting. She suggested I try a few things and then mentioned sending me a couple of extra breast foams (the one's I have are not up to the task, peeps). Apparently, she has cut up the foams if necessary, in the past, but she doesn't recommend that course of action so soon. Bizarrely, when I tried to put a bra on the form, the cups were swimmy but I couldn't do up the back. After hours of work and measuring, I was certain I'd recreated the correct underbust measurement, but it was somehow 2. 5 inches too big on the form. Let's just say it's not there yet. There's another option - not one I'm interested in pursuing at this point, which is a body wrap bustier. I don't think it's necessary, but at least it's there as a back up.


The Low Carb Experiment:

On the upside, I can't say I'm hungry. On the down side, I want to kill myself from boredom. How much meat and cheese can a person eat??? I've been extremely careful - almost non-consumptive - of sugar in its every form (you know, that thing I'd smack an old lady for, if she came between me and it). I've heard so many claims that this will diminish the urge to eat it after a couple of weeks. I regret to inform you, as I move into week 3, I want it as much as and as viscerally as I ever did. I now dream of cake. That other people eat.

Hilariously, when I do decide to eat a little treat - very rarely - I feel physically awful right afterwards. So I want it and it makes me sick. And I'm bored.

Have I ever mentioned that, in my book, boredom is almost the worst thing in the world.

I'm not going to go too far into this right now - I have a post brewing on the topic in detail - but I do feel there's something weirdly unbalanced about this. I am, while eating all the calories I generally do - though it's hard to get there some days, largely denying myself a whole food group. Of course, I eat the vegetables and the wine and the occasional bowl of berries. But seriously, I find it hard to vilify brown rice (a personal fave) and beans (something the old me ate much more frequently than I realized) and whole grain bread (and I don't even like bread).

Again, an experiment is just that. I'm intrigued by it more than anything else. BTW, note that I haven't mentioned any reduction in waist measurement as yet. (To determine this, I'm using, of course, a tape measure - my good friend, see above.) I'm not sure it's notable so far. I'm certainly not gaining any stomach mass, but it hasn't tipped into a visibly slimmer abdomen or looser waist fit in clothing. Remember, I'm not dieting and this isn't about weight loss per se. It's about a slenderer, more youthful, abdominal measurement.

So that's all I can say about me today.

Any thoughts or feelings about any of these items?

In the Name of Science

You may recall that I have embraced a (Gary Taubes-endorsed), low carbohydrate lifestyle - if only experimentally - so I thought I'd give you a bit of information about how I am acting as my own personal guinea pig...

It seems that the best way to determine whether (at least in the case of my own physiology) insulin imbalance is the cause of abdominal weight is to change up the composition of my diet - while (natch) preserving a key control.

You know how those scientists like to use control methodology. In this case, while considering the number of calories consumed is not an element of low-carbohydrate eating (remember, Mr. Taubes does not promote any particular diet, simply the science that underpins them), it's the only variable I have at my disposal.

(Sidebar: I've debated discussing my food diary in detail - the number of healthy, balanced calories I aim to eat daily - have aimed to eat daily for years. I'm loathe to dig into this, not because I'm coy, but because it's not the sort of information I'd like to see floating eternally upon the ethernet. Out of context, it might be used inappropriately. So let's leave it at, if you'd like to know specifics - because you are a woman working to develop your own conscious relationship to food - give me a shout. Otherwise, suffice it to say that I believe in vegetables and adequate (though not excessive) energy intake. My pictures confirm that I have no shortage of body fat...)

Now, according to the low-carb peeps, I'm misguided to be keeping a record of calories at all. Oh, carbs and protein and fat grams, I am welcome to chart all day, but calories - those are so 1989. Whatevs, I like lists and food diaries like calories, so there you go.

Fortuitously, though, if I want to see the impact of low carb eating on my own body, I can change the composition of those calories, while not exceeding the upper threshold, and see what occurs.

If you happen to be an actual scientist, reading this, and you disagree that my experimental method has any value - by all means, let me know. I mean, I was an English major.

Otherwise, we'll see how it goes as I aim to eat approximately 75 grams of carbohydrates a day (not even in the realm of Atkins' extremism), picking up the slack with 100-plus grams of protein and however much fat I come across. There are no refined foods on this eating plan. There is, however, red wine - because I don't choose to live without it. As a result, a good amount of my daily carbs are going towards my evening "chill out". (Note: Depending on what you read, red wine has 5 grams of carbs per 5 ounces, or 20 grams of carbs - if you include the alcohol. Different people metabolize alcohol with different efficiency. I'm assuming, conservatively, that I fall into the "not so efficient metabolizer" category, at least for now...)

If any of you have tried this experiment on yourselves - or would like to debate the merits of high protein, high fat (non-refined) diets, comment away!

I'm going to do this for 2 months - or till I determine that it might not be optimal for my body, should the evidence arise - and see what happens. If I become more lean in my midsection over that time, I will gradually return the carbs to my diet, till I determine a tipping point. After all, I'm not eschewing rice and cookies for no good reason!

So far, it's been interesting, if a bit drab. There's nothing I want so much as that which I've decided to forgo... I don't even like bread, and now I look at it with intrigue. Ah, that's deprivation mentality for you.