Health

Categories Health

I’m not sick, just reactive

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I left work early on Friday and Saturday, skipped church and life group on Sunday, and skipped work and classes on Monday on the basis of some rather vague symptoms: headache, runny nose, sore throat, lethargy, and general malaise. Actually, what really had me worried was the way I was flushing hot and cold, feeling like I was breathing fire and my eyes were going to explode. The best thing we could come up with to explain my symptoms was flu.

Except that I definitely got my flu shot in the beginning of October. So if I had flu, it was a “non-compliant” strain. Which means the last thing I wanted to do was expose anyone to myself.

The difficulty with my little diagnosis was that my temperature never really got that high–high for me, but 99 at tops. What’s more, I only flushed hot and cold in the afternoon and evening. I didn’t have any problem with flushing in the morning. Friday it started around 2, Saturday around 4, Sunday at 8.

So I was sitting at the computer when the flushing started at 3 yesterday–and a lightbulb started flashing in my mind. Friday I took my meds around 6.
Saturday I took them around 8.
Sunday I took them at noon.
Monday I took them at 7.
“Just a minute,” I thought. “When did I start taking the different brand of that one med?”

I opened the bottle and counted out the remaining pills. 25. Add one for Monday, one for Sunday, one for Saturday, one for Friday, one for Thursday. 30. A full bottle.

So Thursday I switch brands for one of my medications–and starting on Friday, I start flushing 8 hours after taking my morning medications.

I’m not sick. I must be just reacting to one of the “inactive” ingredients in the new brand.

So I’ve called my pharmacist and she’s supposed to be receiving a faxed ingredient list for the new medication today. Once I get it, I can compare ingredients and maybe figure out what the problem ingredient is (which may enable me to avoid adding prescriptions that contain it.) Then, I’ve got some options.

  1. I can live with the flushing.–Not happening. If you’ve ever experienced flushing (similar to that experienced with high doses of niacin), you know that it’s not fun. Now imagine flushing that starts every afternoon and keeps going for at least FIVE hours (the longest I’ve made it before falling to sleep in exhaustion.) Yeah. Putting up with it is not an option.
  2. I can go to name brand meds.–At a cost of only $30 copay to my current $10. And that’s assuming the name brand doesn’t contain the “inactive” ingredient I’m reacting to.
  3. I can switch pharmacies.–I can call around to all the pharmacies in town to see who is supplied by Mylan (the maker of the version I know I don’t react to) and transfer my prescription there.

It’s a bummer that I’ll have to change pharmacies. I really like my pharmacists, and the ability to shop while my prescriptions are filled. I have my pharmacy on speed dial. But I’m going to have to say goodbye and find a new one.

But until I’ve got that all figured out, since I can BY NO MEANS discontinue this prescription, I’ll be red every afternoon. So if you see me looking hot and bothered, don’t worry, I’m not sick (and I’m not a sicko)–just a little reactive.

Categories Everyday Life, Health

The Ethics of Calling in

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There is definitely an ethic involved in calling in sick, or going in sick, or any of the above. Unfortunately, like most ethical dilemnas, it’s not an easy situation to ascertain.

Sure, if you’re vomiting, it’s easy to determine that you shouldn’t go in to work. If you’ve been diagnosed with an infectious disease, you shouldn’t go in to work.

But what about the more obscure cases? What about when you have a headache that isn’t responding to painkillers but is making you painfully slow? The headache isn’t catching. You’re still capable of doing the job. It’s just that every step hurts, every noise is amplified, and the normal levels of light in the kitchen have you squinting.

What about when you’re dizzy and reeling–probably from postnasal drip caused by allergies? You’re not contagious–unless the post-nasal drip is infected and finds some way of making it to others through poor personal hygiene. But you’re certainly not performing your job as you should.

What about when you have an incredibly sore throat, can barely talk, and are running what TO YOU is a remarkably high temperature? In foodservice, sore throat with fever means exclusion from working with food. But what happens if your normal body temperature ranges from 95-96 and suddenly it’s 98? If my normal body temperature were NORMAL (98.6) and it suddenly jumped to above 100, I’d have a fever. But despite my severe jump, I’m still below “normal”.

It’s not ethical to call in sick when you feel fine. It’s not ethical to call in sick because you’re “sick of working”. It’s not ethical to call in sick because you have too many accrued sick hours. But what about when you truly don’t feel well–but just aren’t sure whether you’re sick enough to truly be considered SICK?

Categories Health

Housebound Health

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Remember how I told you I was going to do 60 minutes of physical activity this week? I said that equaled out to ten minutes over six days. Well, I didn’t have any problem meeting that on Friday (I parked at the grocery store and walked over to Menards to pick up the space heater that was on sale and back before getting my groceries–20 minutes) or on Saturday (I walked around the block on one of my fifteen minute breaks at work–15 minutes.) But Sunday I forgot all about it and yesterday was rainy. Today has been rainy too.

When I’m motivated and the weather is nice, it’s not that hard for me to get aerobic exercise outdoors. I love to walk–especially if I’m walking somewhere or with someone–and I don’t mind biking–especially if I’m going somewhere (and there are plenty of places that I need to go that are within reasonable biking distance.) But when rain is falling and snow is on the ground and it’s generally mucky outside, I don’t have many options. I don’t have any exercise machines. I am not a gym person. (Besides, who has time to go to a gym and change to get all sweaty and then shower and change again? You’ve got to spend twenty minutes preparing for a twenty minute exercise time. No thank you.) So what am I to do?

Today, I got on YouTube and searched various combinations of “aerobics”, “workout”, “aerobic workout”, “fitness”, and “exercise” until I found a video that was about ten minutes long and looked to be an aerobic workout. I scored a pretty decent one:

I can’t say that there was much “gospel” in this “Gospel Aerobics”, but it was a ten minute aerobic segment with simple choreography that doesn’t take too much room. (I did it in my bedroom, in the 3×5 foot almost clear space between my bed and my computer desk.)

If you find yourself housebound, but in need of a quick aerobic pick-me-up, this might be worth a try.

Categories Health, Politics

Rage against the system

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In case you didn’t know, becoming a health care provider isn’t cheap. The six to fifteen years of school and/or supervised practice isn’t cheap. The professional organization memberships aren’t cheap. The malpractice insurance isn’t cheap. The equipment isn’t cheap. Continuing education and the reading and travel that go along with it aren’t cheap. And that’s just talking direct economic costs.

I wish we could talk health care without having to talk about money. I wish we could all offer our services for free. Unfortunately, if all health care providers offered their services for free, we’d soon have no health care providers. It costs too much to become a health professional and to maintain professional standards as a health professional to not get paid. So somehow, we’ve got to get paid.

The majority of payments that come to health professionals come through insurance companies. They decide what they’re willing to pay for and how much they’re willing to pay for it–sort of. The sort of is because most insurance companies use Medicare and Medicaid as the basis for making their decisions regarding payment. If Medicare or Medicaid covers it, private insurance is sure to follow.

If Medicare/Medicaid covers Medical Nutrition Therapy (MNT) for a disease, then dietitians get paid. If the government isn’t willing to pay a dietitian for Medical Nutrition Therapy–neither will the private sector. So if dietitians want to get paid, they have to convince the government to foot the bill. It’s bad enough that money makes the world go ’round–even worse, too often it’s government money that makes the world go ’round.

I sat through Community Nutrition tonight biting my tongue and swinging my legs and wondering why it felt like I was being told to sell out. Contribute to the ADA-PAC. Sell your vote for support for nutrition-related legislation. Campaign for somebody on the basis of dietetics. Bribe your congressman. Join the lobby. Sell out.

I want dietitians to get paid for what they do. Why? Because they provide an invaluable service to health care. Dietitians have the knowledge and skills to prevent disease rather than just managing it. Medical Nutrition Therapy is incredibly cost effective from a medical standpoint. It prevents the occurence of disease in the well and prevents the development of complications in the diseased. Medical Nutrition Therapy means fewer drugs, fewer diseases, fewer costly medical interventions, and ultimately fewer deaths. That’s a lot of bang for a little buck.

The problem is that if dietitians are going to get paid for what they do, the government is going to have to pay it. Congress is going to have to approve MNT for Medicare/Medicaid patients if MNT providers are going to get paid by anyone for any of the work they do. Which puts me in a very difficult situation.

I’m a fiscal conservative. I’m a true believer in free market. I much prefer the invisible hand to the “Wonderful Wizard of Washington”. I don’t believe that throwing government money around solves anything. The Robin Hood complex is a mental illness, not benevolence. Stealing from the citizen to support the system isn’t my way of going about things.

So what am I to do about dietetics? I want to get paid. I want my profession to get paid for its legitimate work. I just don’t want the government to be doing the paying.

Our economic system depresses me. We’ve messed it up so much that it’ll take a MASSIVE restructuring to return us to free market principles. Unfortunately, when even the conservatives start throwing government money around in an attempt to “save” the economy, how can we hope to ever have a stable economy?

I almost think it’d be best to just never mind the short-term consequences. Knock off all government intervention in the economy and wait for things to equalize. Then, once we’re dealing with a free economy, we can rebuild the way the American economy was first built–on hard work, civic responsibility, and innovation.

Categories Health

Physical Activity Guidelines for Americans

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Chances are you’ve heard about the Dietary Guidelines for Americans–or if not that, at least you’ve heard of MyPyramid. But you probably haven’t heard of the newest governmental health recommendations: the 2008 Physical Activity Guidelines for Americans.

The Physical Activity Guidelines for Americans were released for the first time ever this last Tuesday, October 7. For adults, the main recommendations are 1) to accumulate 150 to 300 minutes of moderate intensity aerobic exercise in intervals of at least 10 minutes over the course of a week and 2) to perform strengthening activities that impact all parts of the body on two days per week. Children and adolescents should do even more: an hour of moderate intensity physical activity accumulated every day and vigorous and strengthening exercises at least three times a week each.

By meeting the recommendations for physical activity for adults, you can decrease your risk of early death, heart disease, stroke, type 2 diabetes, high blood pressure, bad blood cholesterol, metabolic syndrome, and breast and colon cancers. By meeting the recommendations, you can also prevent weight gain, lose weight (if combined with a healthy diet), improve your cardiovascular and muscular fitness, prevent falls, and reduce depression. Evidence also suggests that you can decrease your risk of osteoporosis (and the accompanying risk of hip fractures), improve your sleep, and lower your risk of lung and endometrial cancers. And that’s just the health benefits.

Let me confess right now that I DO NOT meet the Physical Activity Guidelines for Americans. I don’t even come close. I probably average 30-60 minutes a week in moderate intensity aerobic exercise. But that doesn’t mean that I have to stay that way–and neither do you. Amazingly, health benefits can be obtained from ANY increase in physical activity. So let’s get up and move around.

As for myself, I’m going to set a goal of 60 minutes of moderate activity this week. That means 10 minutes a day on 6 days over the next week. I dare you to join me in setting a goal and going after a healthier life!

Categories Faith, Health

SAD Promise

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Seasonal affective disorder. SAD. The acronym is fitting. SAD happens when light dwindles as winter approaches, causing some people to slump into a depression.

I’ve fought subclinical levels of SAD for a good portion of my life. I remember how awful it was the year I took my PSAT for real. When I got my scores, I was sure SAD had lost me the National Merit Scholarship. In the throes of the worst year yet, my score had dropped eleven points from the previous year. I remember my senior year of high school, suggesting to my roommates and housemom that I should just lay on the floor and die. They were worried–they should have been, and they shouldn’t. I didn’t actually want to die. Not enough to be suicidal. I just didn’t know if I could go on living. I remember college years, when I didn’t emerge from my room for weeks on end except to go to the bathroom. I didn’t want to do anything, just sleep.

Last year, I was officially diagnosed and began medication to treat the depression. I had actually been dealing better than normal. I still went to classes. I still maintained what looked like relationships. I maintained such a good facade that no one even realized that I was depressed. It took an awful, awful day to convince me that I needed treatment.

Treatment began and things improved almost immediately. I could cope. I didn’t feel disconnected. I was living life instead of just watching it pass by. I didn’t like taking medication for it, but the benefits were just too great.

Spring came and I started to discontinue the antidepressant–and suddenly another health problem flared up beyond control. It seems the medication had been doing more than one thing–it wasn’t just treating the SAD, it was controlling my blood volume too. Without it, I was graying out with alarming regularity–several times an hour. My PA and I decided to continue with the medication over the summer.

But now, with winter approaching again, I’m scared. I’m scared for it to start all over. What if the meds don’t handle it this time? I’m starting to gray out again more frequently. The lack of oxygen to my brain producing the grayouts is only a metaphor for what depression does to my soul. The gray begins, I brace myself to keep from falling. Dots swim before my eyes and I see nothing. Nothing but gray. I feel nothing but the queer lack of thought, the inability to reason. Terror. Entrapment. I can’t do anything about it. I can’t fight it. I can only brace myself for it and hope I can pick up the pieces once it’s over.

I’m scared, but by God’s grace I’m hanging on to a promise.

This is Isaiah 60. Check out verse 20: “Your sun shall no longer go down, nor shall your moon withdraw itself; for the Lord will be your everlasting light, and the days of your mourning shall be ended.”

When I read this a couple of months ago, it jumped out to me as a promise for SAD. My sun won’t go down–no winter–God is my light and he doesn’t hide. The days of my mourning will end.

Hope. That’s what this verse is. SAD won’t last forever, because God is my light and He’s going to be my light forever. He doesn’t change with the seasons.

I was sobbing on my bed last night, scared and helpless, when God reminded me of this Scripture. It took me what seemed like forever to find it. I was frantic, hanging on to the very last string of hope. When I found it, it was a floatie for my drowning soul to cling to.

I read the whole chapter. It calmed me a bit. Then I wrote it out, the whole chapter. “Arise, shine….darkness shall cover the earth…but the Lord will arise over you…then you shall see and become radiant and your heart shall swell with joy…”

It’s a promise for me. A promise for SAD. A promise that, really, there is hope. I am not bound for the abyss. I am bound for heaven, a place of unceasing joy, in the presence of my ever-bright Sun.

Categories Faith, Health

Coming off the happy pills

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It was sometime last November that I realized I needed help. The day was Thursday–it was a day that seemed straight from hell. I woke up and went about my morning activities feeling more than a little off kilter. I ran into a wall, and tripped over my own feet on the way down the stairs. At 6:30, I left for work. My whole body felt tense and my reactions times were slow. I felt sure I was going to hit someone. I parked my car and began my walk into work. I clung tightly to my bag and stepped carefully, sure all the while that I would fall off the bridge and break my head open.

I made it to work, but I was strung so tightly I could have snapped any moment. My boss noticed my tenseness–but I couldn’t tell her what was going on–only that I seemed really paranoid that morning.

It took twice as long as it should have to prepare my assigned recipes because I kept having to search for my ingredients. I was into the walk-in three times before I found my spaghetti sauce ingredients–on the stack in the corner where they always are.

I rushed from work to class–ate my lunch in lecture. Forgot an apron for the cooking lab so I got points docked. Class got out early–I had two extra hours before I had to be at my next job. Usually I only had a half an hour.

I went home and took a nap–and even though I had set my alarm, I overslept. I was awakened by a call from a coworker. I was 45 minutes late to relieve him from his shift. I felt awful. The day kept running through my head until I finally got off at 9.

I got in my car and turned it towards home on autopilot. But I couldn’t go back to my house. I knew that if I did, I would crawl into it as if into a hole–and never come out again. Instead, I went to my parents house and spent the next two hours bawling.

That’s when I realized I needed help. The next day I cut my hours at the one job and gave up as many weekend shifts as I could at the other. And I set up an appointment with my physician assistant.

I came away from my appointment with a diagnosis of depression–most likely seasonal affective disorder–and a prescription for Zoloft. Within a week on the meds, I was coping much better.

This morning I took my last half pill of Zoloft. I’m going off the happy pill for the summer–maybe longer. I don’t know. The questions and judgments surrounding drug treatment of depression–and even the diagnosis of depression itself–rise in my mind once again. I had pushed them down, ignored them during the winter because I couldn’t afford to be philosophical–I needed the pill.

Now, when the sun start shining again and I can wake up without three alarms, when I have energy to carry out my daily activities, and even to dream and plan for the future–Now the demon reemerges to condemn me for my reliance on a drug to see me through. “Don’t you trust God? Can’t He heal you? Depression is all in your mind. It’s all your fault. You weren’t even really depressed–you just didn’t want to face the music. You’re a hypochondriac. You did it to yourself. And now you’re relying on a quick fix drug to ease your pain. How different are you really from someone who drowns his struggles in the bottle?”

Depression is a diagnosis that I’ve feared, hated, and gladly welcomed. Antidepressants are a cure I’ve despised, despaired over, and depended upon.

I fear that I’ll never have a winter of relief–that I’ll have to rely on my happy pills every year. I fear that it’ll extend–and I’ll always be depressed, not just in the winter. I fear that maybe the cause isn’t physiology–that maybe the problem is me. Maybe I just can’t cope, can’t manage. I fear that I’m deficient. I fear that depression is a sin–that all it means is that I’m not trusting God.

But the Bible says that perfect love casts out fear. Lord, may I bask in Your love. May I trust that Your arms will hold me fast even as the enemy attacks my mind with condemnation. “There is therefore now no condemnation to those who are in Christ Jesus.” I believe. Help me in my unbelief.

Categories Health

Built in Barometer

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Yesterday was a beautiful day, with blue skies, sun shining, just warm enough, with a brisk breeze but no humidity. This morning, I woke up to a gray sky

and muggy, unmoving air. But was I surprised? Of course not. I knew yesterday that the weather was changing–due to my nifty built in barometer.

I discovered the barometer a couple of weeks ago when I had to go home from work because I was feeling ill. I couldn’t explain why I felt so awful–or exactly what it was like–but I felt awful. My head hurt and my ears were ringing and the rest of me just felt queer.

I went home and went to sleep. The next morning, I was just fine–but a huge storm system had rolled into town.

Realization began to dawn. I started to watch to see if a pattern would emerge. And emerge it did. Before any change in the weather, my sinuses and ears would get plugged–creating a massive headache. My allergy medicine would seem to stop working after only four hours or so. After four hours to a day of discomfort, the symptoms would disappear and I’d be just fine.

It makes sense, if you choose to think about it. Due to allergies and perhaps something more, my sinuses are continually plugged–and my eardrums have perpetual pockets of fluid surrounding them. So, when the pressure outside changes, it takes a long time to equalize the pressure inside my sinuses and ears. Thus, I feel sort of like you do when you’re gaining or losing altitude in an airplane. My ears get that really full feeling, and my head starts aching. Only since I have so much gunk in my head, chewing gum or yawning doesn’t really help. I’ve just got to wait it out.

I used to want to build my own barometer, but I never seemed to get the supplies I needed. (Someone was always throwing away my trash stash before I had everything together! Grrr…) Recently, my younger sister made herself a barometer–I was pretty covetous until I realized that mine is infinitely superior to hers. She has to remember to look at hers in order to figure out what’s going on with the pressure. Mine has auto-alerts!