Meta alcanzada

Meta in Spanish means goal or objective, and alcanzar means to reach. In other words, I've met an important goal today that, a little over 3 months ago, I wasn't 100% sure I'd successfully meet. And how sweet it is.

The last time I wrote it'd been barely 2 weeks since surgery, and I'd just started physical therapy. I ended up being in physical therapy a little over two months, every day was a challenge, and I had to continually push myself. But I had an amazing therapist, Hugo, who believed in me and made me believe in myself and my capacity to heal, and here I am, amazed I've come this far.

At seven weeks post-surgery, in late January, I traveled to Guatemala for a ten-day work training and back. The bunk beds we slept in and the long days sitting alot were probably the hardest part. But a couple days in I started walking (birding) every morning at dawn, and it helped a lot during the day. I've only missed a handful of walks and physical therapy sets in the last few months- I pay in a little more pain the next morning if I miss them.

After a LOT of hard work in therapy, and a renewed commitment to walk every day, I've regained pretty much 95% of the strength and flexibility that I lost in my right leg. I'm able to do light chores and carry up to 10 pounds here and there. I'm driving again, even the stick shift. A full day of work isn't a daunting task anymore- in fact, today, our 18th training group at Peace Corps Mexico arrived, and I was there to meet and greet them- to me, that was a sweeter accomplishment than ever considering that back in last September I didn't see a light at the end of the pain tunnel.

I'm still working on trying to lose weight- after the first thirteen pounds, the scale hasn't wanted to budge. And I probably won't be picking up my daughter again, which makes me sad, though we get plenty of good hugs and lap time in. My scar tissue in the fascia in my back is still a little funny-feeling- although my therapist tells me that with stretching and patience it may go away with time. I still have some hip pain when I wake up and a little bit in the front of my leg when I've sat for too long.

But overall, when I look back on where I've come from in the last six months, I am amazed to think of how much pain I was in and how much better I'm doing now. It's a real motivation to continue getting stronger and keep up my renewed dedication to a healthy lifestyle. I've taken part in a small new movement at the office, where we go for a couple walks during our breaks at work- I hope it grows. It's had positive impacts not just in my physical health but also my mental health- with managing stress, etc... and so I really do hope these improvements in my life are long lasting.

I never would have made it this far without the continual support of my husband and daughter. My temporary disability definitely took a toll on them, since Mommy wasn't able to do everything she once could, but I couldn't have asked for greater understanding and support than what I received. It truly made my recovery possible.

Also, having the institutional support of the 3 weeks of disability, made possible by the Mexican Social Security Institute, was crucial. And the choice to do the surgery just prior to holiday season was partially luck but also good intentional timing (to hold off as long as possible)- it gave me the opportunity to finish up some important office work (though I'm still not sure how I pulled it off, thanks meds, I guess...), but then to have the right amount of rest time before heavy season was finally upon us in the New Year. My coworkers have been really understanding of my new limitations, and luckily, with time, things have gotten pretty close to "back to normal."

Finally, I'm happy to say that I am no longer as afraid of surgery as I once was. I had gotten my appendix out with emergency surgery back in 2011 but it was so sudden that I felt it didn't really count. This time around, I had a long time to weight the risks vs. the benefits and it took me nearly 2 months to go for it. I know there's a possibility there could be long-term effects, but considering the short-term benefits so far, I'm feeling pretty happy that it appears as if taking the risk has been worth it.

As one friend said in her well-wishes to me soon before I went in for surgery, "One of these days you will look back and think of your surgery as just one more thing that happened long ago" (as opposed to it completely dominating your life). I am so pleased that that day will happen sooner than I would have imagined.

Hello from the Other Side (of back surgery)

Been wanting to post an update ever since I survived back surgery 16 days ago (morning of Nov. 30th). I've started writing about it and had to stop a couple times in the past couple weeks, and today is the first bit of time that I am finally able to share the initial story.

I say initial because the day of my surgery was pretty much in the middle of the 6 month span that this process is likely to affect my life. On the front end, since mid-August, I've had >3 months of worsening symptoms from my sciatic nerve root compressed my herniated L4-L5 disk (plain English: burning, numbness, pain, and weakness in my right leg and foot, and up to 12 pain pills a day of 3-4 different types of pain medication to allow me to continue working). And now, ahead of me, 3 months of recovery (fine print: 3 weeks of temporary disability from work, 6-7 weeks of physical therapy to restrengthen my right leg and foot, back and abs, a month or two of no driving, two months of no strenuous exercise, an indefinite amount of time with no bending over, and 3 months for my sciatic nerve to gradually heal and the nerve pain to go away completely).

On one hand it's nice to know that there's a 3 month post-surgery recovery window in which I can relax and not feel like I have to be immediately better. On the other hand, since I am not particularly patient nor disciplined by nature, I have to work at controlling my mental reactions to the speed of my healing process.  But anything that doesn't kill us makes us stronger, right?

I had to breathe deep when I saw some initial reactions from friends to my posts about surviving surgery, to the effect of, 'of course you'd survive, but how's the pain now?' On one hand, very few people experience immediate and total relief of sciatica symptoms, and EVERYONE who undergoes surgery has a recovery period where the word pain-free is a joke. On the other hand, I really was terrified of surgery. I was partially afraid I'd end up worse, worried about general anesthesia, local anesthesia, you name it. And the truth is it's not always pleasant to be hospitalized in a foreign country, even a top-notch one, because when you're in your deepest throes of needing to feel safe and secure, a foreign language, even one that you're fluent in, can push you to the edge of anxiety when no matter how you express yourself, folks just aren't getting it, or in the least, they're just not able to communicate their reasoning to you.

On the day before and the day of my surgery, that was precisely what happened: language/culture blunder #1 began with an anti-anxiety and leg pain medication that was given to me the night before, but not the morning of. Every day for 3 months, I've been on pain medications for my sciatic nerve pain in my leg, but somehow it got left out on the morning of, and so during my wait to go into the OR I was suffering and this compounded my nervousness about surgery. So when he finally arrived in the OR, Language/Culture Blunder #2 ensued, and instead of giving me the two meds and putting me on local anesthesia like we'd agreed, in the end, the anesthesiologist ended up putting me on general anesthesia. And later told my surgeon that I'd asked for it, who of course believed him. At least that was the response when he boasted that the surgery had only taken 35 minutes, and I complained that how could that be when I'd been unconscious for 3 hours.

Putting those blunders aside, I set about firming up my mental state to go through the first few tough days of recovery. Truth be told, I was amazed that my back muscles did not hurt. The incision site stung a bit when I moved funny, and I had some serious weakness in my lumbar/sacral area for the first week, but beyond that, I was able to walk, sit, and stand completely unassisted within a couple hours of waking up. To me, that proved the claim of endoscopic surgery that's it's much less invasive and permits faster recovery and mobility than traditional open back surgery, where muscles are sliced by a scalpel rather than perforated by an endoscope. Sure, it was hard to walk the first two days, and I did not really want to, but with the urging of the nursing staff and my doctor, I hauled myself out with my IV stand and did my laps in the 1st floor lobby. Walking a few minutes every hour since the day of my surgery has contributed greatly to my recovery process.

Unfortunately, there were two more hiccups in my first few days. The first could also be considered a cultural blunder of sorts. I thought I'd prepared my small mountain of pre-surgery paperwork as thoroughly as possible. The insurance company had requested a quote in writing from the surgeon and his team (which was mostly adhered to, with the exception of a couple members whom insurance didn't end up covering) as part of the pre-surgery approval process, but hadn't requested a quote in writing from the hospital. I had a choice of two or three hospitals that the doctor operated at; I was told one wasn't covered by the insurance, and another didn't answer my calls. So I went with the third hospital that answered my phone call and gave me a quote— although it's known as one of the most high-end and pricey hospitals in the area, the amount quoted over the phone sounded totally reasonable. In retrospect, I really should have gone in person to get a written quote.

I started receiving phone calls from billing to my hospital room only a few hours after my surgery on Monday afternoon, telling me that Dr. so and so had left his invoice, and what would my form of payment be? I told them to call my insurance. They informed me insurance wouldn't be covering. I was annoyed but didn't think it was too big of a deal because I could probably take some more cash out. I told them we'd deal with it tomorrow. But on Tuesday, after my doctor had discharged me and Margo went to billing to cash out, came the biggest surprise. The total for the hospital's portion of services ended up being about 18 times (Yes, 1800%) more than I'd been quoted over the phone. This huge discrepancy was one that we weren't prepared to pay, even 14% of it, which was my copay. To our dismay, they were also unwilling to bill us, in other words, I had to pay in full immediately prior to leaving.

I didn't have enough cash to cover it, nor was my credit card limit high enough to charge it. So less than 30 hours after my surgery, I spent about 6 hours sweating profusely and making calls in an attempt to raise those funds. Those 6 hours were enough for another entire blog post. Then I pleaded with billing to accept the 70% we were finally able to raise by Tuesday evening and bill me the rest, but the heads of department refused. So my discharge was cancelled, and the hospital held me hostage for another night until we could deliver the rest the next day.

As a result of the stress, my temperature rose and I immediately came down with the cold that my daughter had had a few days earlier. Aside from stressing out me, my husband, our friend who was taking care of our daughter, our daughter, my family, Margo's family, and other friends, being kept prisoner by a hospital was incredibly embarrassing. Margo had to go home and collect our daughter and I spent that third night alone in the hospital. Before he did, he got me a coffee and a chocolate glazed donut, which helped me feel a tad more human for a moment. After he left, at nightfall, I worriedly tried to send away the nurses who came to my door offering to check my vitals, fearing I'd be charged more. Their eyes widened when I explained the reason why I was still there even after I'd been discharged. They, and the dietician in charge of my meals, assured me that it was "all included," and to not worry. I accepted. Then I remembered my surgery bandages hadn't been changed since Monday morning, and got freaked out that my fever was from a surgical infection. The nurse on call assured me my temperature was low enough to not cause concern. She mercifully helped me change the bandage free of charge. The meals kept coming. My fever got under control. In the midst of such a degrading experience, I felt fortunate that some hospital staff still had my best interests in mind, and I will always remember their kind faces and words.

I finally went home on Wednesday around 11 am. Whereas I had turned my nose up at the Krispy Kreme stand when I was admitted, I gobbled down another chocolate glazed and bought another couple boxes to give to the people who had helped with our daughter in our absence. It took a few days for my fever and cold to disappear, thankfully, because their symptoms was making recovery harder. I kept walking a little every hour, forcing myself out of bed even though all I wanted to do was stay there and watch Netflix.

The first week flew by. Aside from getting in and out of bed, sitting down for meals, walking, and showering, I was pretty much totally dependent on Margo for everything around the house and for assistance getting dressed and changing my bandage. My back didn't hurt but I kept getting shooting pains down my right leg every time I'd get up from sitting or laying down. They were so strong I'd have to grab something to hold on and use my deep breathing. But they'd subside in a few seconds and then I'd be fine. I was only on paracetamol that week, which is saying a lot when you compare it to how many meds I'd been on prior. After speaking with friends who'd had back surgery before or knew others who had, they were shocked that I was up and about so quickly and that my incision was so small. That made me feel a little better. But at first, I was still spending more time resting (laying down) than up and about (sitting or walking).

On Day 5 or 6, I was finally able to lay on my back without pain in my wound area.

On Day 7, one week after surgery, things started getting better fast. The weakness in my lower back was gone, and I was walking normal pace. I was upright for 5 hours without laying down.

On Day 8, Monday the 7th, I quit using a bandage—the gauze and tape were driving me nuts—and my wound seemed to be healing well. I went for a ride in the car for the first time since a physical therapy consult, and was told I was doing very well. I started Lyrica for the nerve pain, which I was told shouldn't last for more than a few weeks.

On Day 9, I was finally able to completely dress myself (including socks, which are still challenging). I was upright for the majority of the day, and only had to lay down a few times.

Day 10, I stopped taking paracetamol. So I was completely off the morning pain meds. It was a watershed day for me, and the first time in over 3 months that I hadn't taken pain medication upon waking. I had my first beer in 3 months too, man was it good! :-)

On Day 12, I went "out" for the first time (aside from physical therapy)—to our office holiday party—I was mostly fine but by the end I was feeling pretty tired, and achy in my lower back.

On Day 13, I went "out" again, this time to the mall, to get some lightweight walking shoes. I was out for a good chunk, and felt pretty darn tired afterwards. The morning after, I was achy in my hips.

Day 14 was my last day of antibiotics (Cipro), and a day of rest took the edge off my aching hips. I finally was able to lay on my stomach for a few moments, something I haven't done for a few months (it's almost always made my nerve/leg spasm bad). The lesson learned was to be active but to increase my activity gradually, not in large amounts.

Day 15, my physical therapist added a few new exercises, and my hip was sore the day after, and my nerve pain shifted from up high to down low in my calf. I have a hard time with backslides, but I tried to stay optimistic. I was given another week of disability, and am thinking I will probably be good enough to go back to work next week. I saw my neurosurgeon for my 2 week checkup, and whereas he is happy with the results, he prescribed me more exercises for my right foot and shin, which are still pretty weak (I have a hard time walking tiptoe and on my heels on the right side—am basically unable to do so).

Day 16 (today), I got up from bed without any shooting pain down my leg. To me that's huge progress. They say that if you are improving consistently during your first 3 months, that you will only continue to get better.

Now, as my neurosurgeon is trying to impress on me, it's more important to focus on my overall health rather than worrying about the consequences of my surgery (i.e. that a spacer was inserted, that I might have any mobility limitations). He's urged me to take steps to care for my other remaining, unherniated disks, by losing weight and, once I'm further along in my recovery, by exercising. He assures me that I won't have any limitations in my activities once I'm recovered, and I am trying hard to trust him. Based on my progress so far, I am inclined to keep the faith. Margo says I am walking much more upright and without a limp, and for my part, not having to take 10 or 12 pain pills a day is a big enough difference for me.

In retrospect, even though I would have preferred not to go through this, I am compelled to count my blessings in terms of having had access to insurance that covered the majority, a clearcut and supportive Mexican workers' comp system that allowed me sufficient time off work for recovery (and  free follow-up care parallel to my private doctors), family and friends who've lent big helping hands in these last two weeks, and most of all, my husband who has been taking care of every last detail and listening to my every last peep during my recovery process. My recovery has been a straightforward trajectory without any complications so far. I am truly grateful.

Any major surgery is an experience that brings your mortality and aging into clear focus, and of course for someone who loves life and being incredibly active, it's a hard thing to face and deal with. But considering that I am only one of billions who deal with this on a daily basis, I'm going to keep focusing on the positive, the small victories, and the sweet things in life that help us rise above the pain. Although I still have the road to recovery in front of me, it feels good to be emerging on the other side.

Shades of Pain

About a month has passed since my last blog post, and whereas before I was taking only 2 types of medicine daily for my (sciatica) leg pain, I am now taking 3, sometimes 5. New levels of pain = new thresholds for pain.

The pain meds allow me to continue on with the majority of daily activities, I still go to work, can still bathe and dress myself, but that's about it. I haven't been able to pick up any of the slack at home, can't cook for myself, can't drive, no exercising or stretching, and sleeping through the night without having to top up my meds has become a rare occasion.

I also had an EMG taken of my legs, which revealed that I have nerve damage in the right leg. This led my rehabilitation doctor I'd been seeing for 6 weeks to finally give up and tell me that he thinks that surgery is the only route to solve this problem now.

By the time he told me that, it wasn't a shock. I wasn't as closed off to the idea of surgery as I was in early September. It'd been almost 2 months of treatment with no effect (in fact, only worsening). I had become worried I might occasion permanent damage to my leg, even if I could wipe out all the pain in my leg (which even with the 3-5 meds is still rare).

Both surgeons I saw subsequently (for yet another set of opinions) agreed, that surgery is my only remaining option. And also, fortunately, I am a candidate for endoscopic surgery, which is relatively less invasive than open back surgery, with less recuperation time as well.

The hope is that surgery, by removing the herniated portion of the disk, will relieve the pressure on the sciatic nerve and allow it an opportunity to heal. Both surgeons predict that I will be able to recuperate 95-100% of lost function (which luckily is not that great- some strength in my right leg and some range of motion in my shin and toes).

I definitely still have trepidations about this, as I realize it has its risks and I would have preferred to avoid the surgery route. On the other hand, I am eager to give my body a chance to continue on its way with healing from this, and regain a lot of the quality of life and independence that I've lost in the last 3 months. I'm trying to look at it as just an example of something that can easily happen to any active individual and that any person or athlete, etc. would want to obtain the care that best allows them to recover in the least possible amount of time.

Getting off the meds will be another important effect of the surgery, I hope. Even if it weren't for the EMG results showing nerve damage, I am concerned about the long term effects of so much medication for months.

Another good thing is I happen to be insured doubly- both private insurance through work as well as the state-sponsored insurance which ostensibly will provide the "temporary disability" status to allow me leave from work for the weeks I'm in recovery. Thus, in terms of timing, it really does help that I have a way to get this done without incurring significant costs that, if uninsured, might have been cost prohibitive.

A side benefit of this issue is that I decided to take my health by the reins in terms of my weight, and have lost 5 kg/11 lbs in the last 5 weeks. I am not sure if this has helped with improving my symptoms, if it has, I haven't noticed, but it will be helpful in the recovery period and long-term in my quest to reduce the likelihood of this occurring again in the future.

There are a number of administrative hurdles I have yet to clear in the coming weeks, and I hope that my instincts in navigating this unchartered medical territory will serve me well. If all goes well, next time I write I will be in recovery from what was a wildly successful intervention to get me back in the saddle again. I am pining for days where my threshold for pain can come down from "sky high" and go back to "normal." Wish me luck. 

The Chronic Pain Club

There was a YouTube channel that Bee used to like to watch when she was a little younger and was starting to learn nursery rhymes: The Mother Goose Club. It has a catchy jingle that sticks in your head which I suppose is what you want when you're promoting language acquisition. For adults, luckily, it fades from the memory before annoyance hits. But the song keeps popping into my head every time I think of the latest clubs that I am now a card-carrying member of.

I wish I could say the same about the rhythm that's colored my life as of late: sciatica. The name of the condition is cool sounding, latin in origin and pronunciation. Back in the day, when I used to have low back pain that was largely stress-related (but in poring over old results, probably did have a physical component that's rearing its ugly head today), I used to come across the term sciatica in my Google searches and, although some symptoms are hard to completely rule out, sciatica-like leg pain was always off the list. The problem occupied a "type of back pain other people have" sort of category, one that mystified and slightly intrigued me, but as long as I didn't have to deal with it, fabulous.

Fast-forward to this summer, when a lot of different things were happening. I was traveling a lot with my family and for work. I went to the Yucatan Peninsula for the first time with my parents and brother, and to a nearby National Park with Bee and her Dad and some close friends. I went on 3 long distance trips by myself (without colleagues- y family accompanied me on the last two). The nearly 3 months of heavy traveling was sandwiched in between training high seasons at work- long days with relatively higher stress levels (Good stress! But stress nonetheless...). It was a heady summer. I was feeling great.

But most of August, which is when the last two work trips occurred, I kept feeling this burning sort of pain in my right leg that wouldn't go away. It was weird because it was a pain I'd never felt before. But I didn't pay much attention to it- first, because I was busy traveling, and second because I often have pains that come and go. Just that, this one wasn't going away, and it took me a while to realize that. Actually, I never did fully come to the realization that something serious was happening on my own. My body had to sort of whack me over the head and smack me around seriously in order for me to pay attention. I am sorry I didn't listen sooner.

The weekend after an important training week at work was a three-day one, and I was jazzed because I'd finally made an appointment for acupuncture in San Miguel, and to go to the hot springs as well. (See, I do practice self-care... ;-) The stretches and physical therapy exercises for my hip that I'd been trying all week weren't doing much to help my leg, and in fact, my middle lower back had started to ache as well, which was somewhat concerning. I was unaware of the physical train wreck I'd been holding off for a month.

The Sunday before Labor Day, I woke up in terrible pain in my lower back. I basically could not sit straight or stand unassisted. I was only able to go to the bathroom with my arms around my husband's neck. I sort of freaked out too, because this was not my first time my back has gone out, and I know how it can sideline you. But once my tears of embarrassment, and of frustration, had abated, the tears of genuine pain were ushered in. This level of pain is on par with childbirth. After trying several different kinds of medication, none working, and a humiliating 30 minutes on the floor at one point in a botched attempt to crawl to the bathroom (Lest you think otherwise, Margo did try to prevent me from trying), I knew I had to do something else- I was picturing myself getting carried out of my house on a stretcher, and really did not want that to happen. I made a few phone calls, finally spoke with a doctor who recommended a specific medication, which ended up working, and I was able to sleep through the night.

This apparently, in the case of what occurred to me, was somewhat of a miracle, because the next morning I got up out of bed and was able to walk without assistance. Various trips to the doctor and MRI results later, the verdict was in: I had a very large L4-L5 disc hernation and sciatica. And just like that, I was unceremoniously inducted into the Sciatica Club.

I won't get into the gory details of my less-than-pleasant exchange with a rather knife-happy orthopedic surgeon who wanted to operate on me immediately (hey--maybe he'll end up being right in the end, but where I'm from we don't take the recommendation of surgery by scaring, insulting, threatening, and making ultimatums to patients very well, and so no, you are off my doc list although you did recommend quite a nice medicine, thank you very much). Or another questionable doctor who I went to see the day after, desperate for a second opinion, who was the closest thing to a quack that I have ever experienced personally.

Since then, I´ve also been inducted into the world of IMSS specialty medical services, where state employed doctors maintain their private practices and skim off the patients who have private insurance and want better care than the government is prepared to provide. I was out from work for a week on sick leave, another week on temporary disability, and a few days of personal leave. I have attended 8 physical therapy sessions, have had better days and worse days, but I have not had a day yet where my symptoms disappeared.

In retrospect, the sciatica was happening most of August, I just didn't recognize the symptoms. We can't really pinpoint when I herniated my disk, but it's likely that it happened on one of my trips in June, where I fell twice, and also lifted something rather heavy by myself. The natural history of herniated discs and the evolution of sciatica is something I've read more about in the last two months than I probably did reading for my Masters thesis project (Ok, maybe I'm exaggerating). But suffice it to say it's an incredibly complex process that is not yet fully understood.

Part of what's not understood is a large discrepancy between pathology and symptomology. That's to say, some people who have very small hernias have more pain than large ones. And what's more, some people can have large hernias with no symptoms at all, and some people with no hernias have terrible symptoms. Finally, some people spontaneously heal with little downtime and intervention, whereas others go on to have symptoms for years. Doctors and medical researchers do not have a full grasp as to why this is although many theories are being studied in clinical settings.

Going back to the first doctor's threat of this being an immediate surgery situation... Having had a history of stress-related pain and other disorders (IBS, situational depression), it has been hard for me to move to a mindset where I can accept a situation that's not mind over matter, and that surgery might be necessary. I am overweight, I am not always careful with my diet, and so I feel that there is still a lot that I can do to "lessen the load," so to say, on my hernia, and allow it to heal. I am also concerned about potential negative effects of surgery, or even worse, the possibility of a botched or useless surgery (in case you don't believe me, search "failed back surgery syndrome"). Having the appendix out for emergency surgery is one thing, but messing with the spinal cord is another. I am not alone in my concerns...most online literature that I've read, either on spine institutes, research papers, or medical websites, cite that only 1 out of 10 herniated disk patients require surgery.

This must seem like poppycock to most orthopedic surgeons in Mexico, especially that first doctor, but I have find, quite serendipitously, a couple doctors who share my opinion- albeit with reservations. In a number of different online sources, I've read that surprisingly enough, the largest disc herniations tend to be the ones that are resorbed (healed) to the greatest extent. The reasons for this, again, are not fully understood, but do give me a great deal of hope.

However, the caveat is that for those patients whose symptoms do not improve in 6 weeks to 6 months, the longer you postpone surgery, the higher the chances are that surgery will not resolve your condition. This has to do with the potential for nerve damage- in sciatica, the prevailing theory is that the herniated disk presses on and compresses the sciatic nerve, which runs from the tailbone down to the knee (where it splits into 3 branches that run down to the ankle and foot). Most of what I've read explains that the higher risk situations are where the patient has significant muscle weakness or loss of sensation in their extremity- the classic emergency situation is the cauda equina syndrome, where one loses control of bladder and bowels. The worst I've had so far is leg, gluteal, or calf pain at a moderate level that just doesn't go away, or a tingling sensation in the top of my foot, back of my calf, or side of my thigh, so I am not too worried about permanent damage (although it's definitely made my list of troubling possibilities about this episode) although the annoyance factor is a totally different story.

I've never been good at accepting when I'm sick, much less hurting, but I managed to get through several years of occasional bouts of back pain in my twenties. But these bouts never last more than a few days to a week, and so these two months of nearly non-stop pain have been a new realm for me. Even though the one terrible Sunday in early September was the only day I had severe, disabling pain, in the last two months, a day hasn't gone by that I haven't had pain or numbness in my leg. And that's even though I have been on medication as well- and I probably haven't had another severe event for the same reason. I haven't been able to get comfortable or go back to regular activities, and that's taken a toll on both me and my family physically and mentally. Not being able to lift heavy stuff or perform load-bearing activities (read: my daughter, laundry baskets, doing dishes, or luggage), creates a challenging dynamic. Not being able to sit in one position for more than a half-hour, and needing to lie down regularly to take pressure off the disc has led to awkward situations and difficult conversations at work. Being dependent on others, when I have always been highly independent, is just plain hard.

The idea of taking disability or being disabled is getting wider acceptance in our society especially as self-care and patient advocacy increases, but at the end of the day, the stigma remains, and the stark truth that you're just not as productive as you normally are brings it own set of complications to the recovery scenario. How are you possibly supposed to focus your energy on healing when all you can think about is; how much have I paid in medical bills this month, will I get reimbursed, will I make it through the work weeks once temporary disability is up, how can I make it up to my husband, my daughter, when I can I start to exercise, will physical therapy work...will I ever get better?

The whole situation is enough to depress anyone, even if you're taking a peck of supplements, watching your nutrition, and getting enough sleep. After exhausting my readings on disc anatomy, sciatica mechanics, physical therapy, surgery options, hernia resorption, sciatica forums, ad infinitum I have drifted into the "chronic pain management" websites, because, like it or not, I have a de facto membership in the Chronic Pain Club.

There are often silver linings in situations like these, and my case, is no exception. I need to lose weight, urgently, and although I continue with thyroid issues, this will motivate me more strongly to control calories in the hopes of shedding some pounds and taking some load off my back. To help with this, I have also looked into the anti-inflammation diet by Dr. Weil, which is largely vegetarian, which is a goal I'd been wanting to move toward anyway. Money issues and pain will be a factor, but I am going to try and join a gym to start swimming regularly. If I can, it will be meeting a goal for regular exercise that I've also been wanting to accomplish for some time.

Finally, although it's always important to be mindful and compassionate with others, there is nothing like a time of illness or pain for you to become more aware of what others in your same boat, or worse, are dealing with. The forums I've lurked on in the past month are filled with individuals going through so much pain and suffering that it's almost shocking to think that I don't run into more people with these type of issues on a regular basis- or perhaps it's our tendency as a society to minimize these types of issues for the same stigmatic reasons I mentioned above.

In any case, if there's anything I have realized as a result of this, is that I am definitely not alone in this, it's quite a common condition, and what a shame, because for how painful and disruptive it is to life, I really wouldn't wish it on anyone. Human evolution to walk upright was an amazing and wonderful thing, but the long term impact on our discs and spine of being vertical was one thing evolution really got wrong. Believe it or not, it's believed that disc degeneration begins in adolescence. I can only pray with time science and medicine--and popular culture--can implement ways to prevent and treat these type of problems, starting in early childhood, because no one deserves membership to this club when it could be avoided.

Discoveries around "The Diet Cure"

I posted a while back about a fascinating book I read, "The Diet Cure" by Julia Ross. Ever since I read this book, I've made a number of discoveries about my health.
Inspired by the book, I was testing out several specific food groups to see if I had any adverse reactions to them. I did a week without refined sugar and white flour products, a week without any gluten products at all, and a week without dairy. At the end of the weeks without the specific foods, I introduced them back into my diet gradually in order to observe if any adverse reactions such as headache, weight gain, bloating, digestive complaints, etc. arose.
The first thing I discovered was that sugary and white flour products did have some slight to moderate reactions for me, including headache and some bloating. I also lost several pounds after the week without them.
Then I went on to "test" for a gluten reaction by eliminating all foods containing gluten (wheat, oats, and rye). At the end of the trial gluten-free week, I was expecting (perhaps dreading) bells and whistles when I re-introduced them (in the form of whole grains) back into my diet. But to my surprise there really were no noticeable symptoms. The same happened with dairy—no problems that I could notice. I was sort of relieved because wheat and dairy are big parts of my diet and I wasn't looking forward to possibly having to eliminate them. My naturopathic doctor isn't 100% convinced of my self-testing results because I did the tests one at a time rather than all together. But for me, it's a good start. I say this because when I first heard about checking for this kind of stuff, I was very closed off to the idea of an elimination diet. In fact, I remember almost laughing at my doctor when he suggested the idea.
Now, however, the few things I discovered about my reactions to refined sugar and white flour/rice products were enough for me to start making an effort to avoid refined sugar when possible and replace white flour products with whole wheat, and white rice with brown rice, etc. I'm happy with the results, and also knowing that I'm getting more fiber into my diet.
I'm also interested in doing a week without corn, to see what happens.
Perhaps the most interesting discoveries were two things I found out about myself around the time of this self-testing. In her book, Ross suggests that once your diet is balanced in favor of proteins and vegetables, with just enough healthy carbs and fats for satiation, the pounds should begin to melt off. The caveat is that this can only happen if you're biochemically stable. And should the initial weight loss peter out (or never occur), you might need to get checked out for imbalances such as low thyroid. I noticed my weight loss occurred when I removed the refined products from my diet, but then tapered off. It didn't bug me too much because I am more in favor of exercising than dieting, but it did catch my attention.
It just so happened that I had decided to get my thyroid levels checked during my yearly checkup, around the time I had finished this elimination diet. When I went to discuss the results with my doctor, he told me I had thyroid dysfunction. I was sort of shocked because I've been getting my thyroid checked for years because both my parents have low thyroid, and I've always tested normal. But according to my doctor, it's often underdiagnosed, and in my case, although my T3 and T4 levels are normal, it's the TSH (thyroid stimulating hormone) that's too high—working harder than it ought to trying to stimulate an underactive thyroid, in his words.
There's more: he ordered a test of my cortisol levels, which apparently are also connected to thyroid function. I just found out that they came back "low," but have yet to discuss the implications of the results with my doctor. Rather than feel upset, I'm actually relieved that there may be some underlying reasons for my sluggish metabolism (and my cold extremities, and possibly even joint pain among other things). I'll have a lot to learn about how all these puzzle pieces fit together: diet, metabolism, hormonal levels, stress. But I'm up to the challenge and grateful to have found a practitioner who seems to be willing to think outside the box and find the root of the problem (finally).

A Closer Look at My Nutrition | My First Few Weeks with "The Diet Cure" by Julia Ross)

It's been an interesting "food month." Last month I read a compelling book called "The Diet Cure" by Julia Ross, MA. director of Recovery Systems in Northern California. It was so compelling that I decided to test if I had a gluten insensitivity and went off gluten for a week. Today I'm reintroducing it to "see what happens." It just happens to coincide with a visit we're getting from our very own private chef—yes, you read right: I won a raffle at a local supermarket and a private chef is coming to our home tonight to prepare food using their special cooking equipment (which they'll of course try to sell us and I'll politely decline...but it'll be fun in any case :-)

About the wheat-free week, as I said on my Facebook page when I first decided to put this book into practice, "I'm not really a "diet" person—I buck the fads in favor of common sense & nutrition. That being said, I do have some "issues" I'd love to improve: extra pounds, joint pain, and occasional depression. The book I'm currently reading has me convinced that there's more than meets the eye to 'everything in moderation.' As a result, yours truly is now investigating her body's relationship with refined sugar & wheat (among a number of other substances)."

And it's true: I'm not really a diet person. But I have struggled with being anywhere from slightly to moderately overweight for a good part of my life. And many of my relatives have suffered from obesity and obesity-related illnesses such as diabetes or low thyroid on both sides of my family. So although I'm not attracted to fad diets, or crash dieting, I am very aware of what I put into my body and am a big health advocate. Most of my friends know that I'm an amateur herbalist and swear by my Nutritional Healing book for being able to get rid of ailments, like nixing colds with Vitamin C and garlic.

So it wasn't too much of a stretch for me to be convinced by Ross that there are eight basic nutritional imbalances that individuals can have which can affect their health—both physical and mental.  She asserts that by answering a series of questionnaires you can start to detemine which imbalances might be affecting you.

What were most interesting to me were arguments that sugar and refined grain products like white flour can be addictive. Ross discusses the brain's chemical reactions to certain food substances and why we can become "addicted" to foods that are actually adverse to our health—in a very similar way as we do to substances like drugs or alcohol. The chapter about re-regulating naturally mood enhancing brain chemicals through healthy eating (NOT undereating the right foods or overeating the wrong foods) was most fascinating to me. She also went on to talk about other imbalances that often go undetected, such as thyroid imbalances or systemic yeast overgrowth, which are harder to diagnose but that plague people all the same until they undergo comprehensive testing.

In my case, I decided to first cut out extra sugar—it seemed the easiest, fastest, and most important thing to try. It wasn't as hard as I thought it would be, and I think it'll still be okay to consume it in moderation, just with more awareness. Toward the end of the first week, I cut out refined grains products—white flour and white rice—also, not as hard as I expected. The reason why it wasn't so hard was because I was making sure to consume a lot of protein, vegetables, fruit, and healthy fats. Ross believes that undereating/malnutrition is more common than we think and leads to a depressed metabolism. This is a tactic I never quite understood, or at least couldn't get to work for me, but I think it's because I wasn't eating enough nutrient rich foods.

I wasn't doing this for the weight loss effect, just for the health-enhancing effect—Ross believes that gastrointestinal upset and joint pain, two things I often complain of, can be caused by certain foods. But I didn't mind when, two weeks later, I checked the scale and saw that I'd lost 5 pounds.

This next week, I go off dairy, again, "to see what happens." I've gotten a skin allergy test before for hayfever allergens, and it came up negative for most major food groups, except a slight allergy to soy. But Ross explains that some internal adverse reactions to foods go undetected by the skin tests, which is why they promote the elimination diet approach. I like this approach in that it's learning a little more about my body, and I'm only doing one food at a time, not all at once. I especially like the unexpected effect it's had on my cooking—having to go a week without bread, pasta, or crackers meant I had to obtain a few more interesting grains for my kitchen like amaranth flour and make garbanzo flour patties. I made my own mayonnaise with a fresh egg from our chickens and olive oil, great because regular mayo is made out of soybean oil (and even better for how delicious homemade mayo is!). I also made Thai food for the first time in years to go over brown rice. Any excuse to spice up the action in my kitchen is welcome around here, and if it has the pleasant side effect of losing a few kilos in the process, all the better!

I'm a little nervous about the upcoming week without cow's milk because I am quite beholden to my dairy products—yogurt, cheese, kefir, etc—I love probiotics. But I got some goat cheeses to hold me over, and if the wheat-free week was any indication that depriving yourself of one food can lead to embracing several others, then I should be excited about what the week ahead has in store.

One More Step: Healing What Ails Me

This post has absolutely no relation to what I set out to write about this chilly morning, but that's the nature of the artist's pledge to follow their inspiration. It produces things you least expect. In my case, for more than the last month, I was inspired to find out what was causing my back pain.

And now, just like that, it's gone. After plaguing me non-stop for a month, with constant hip pain for almost 7 months before that, my back pain simply disappeared. I don't mean all little aches from overdoing it or sitting in a chair too long, but the inability to carry my baby or bend over and brush my teeth without spasms...no more. Such is the nature of that type of pain. I wrote a few posts about it and what I believe its root to be (unrelieved tension), but I didn't really note what the specific day was that it stopped. Oh well, it's not important—the good thing is it's gone for now.

The funny thing is, I remembered that when I got up early this morning and carried the laundry basket downstairs. While my back was hurting, my husband would have had to do it for me. All I did this time was peek over my shoulder to see if he or the baby had stirred from slumber while I hauled it up and off the floor, reveling in the fact that less than 2 weeks ago that would have been impossible. And how great that felt. It's funny how little you appreciate certain things until you don't have them anymore, like simple physical abilities. Of course I would be amiss if I didn't reflect at least a LITTLE on what I think might have been the key to getting it to hit the road.

A full acknowledgment that it was stress-related tension was the first step—realizing that not just the back, but the hip was involved was also key. That way, when it started to switch back and forth, I didn't get too worried that something was wrong with me, which I think perpetuated it over the last several months.

A sincere effort to get into a regular exercise routine was also important—one that I haven't even started yet, mind you, but plans are laid—I signed up for swim lessons at the local pool that will start next week. And I also got my bike fixed up and out on the road after collecting dust for almost two years. I'd been walking a lot until my hip started hurting, and that really put me out mood-wise. Just knowing that I'm getting back on track with physical activity makes me feel better about myself, which spreads like ripples.

Regular journaling, and reflective time, whether it be in meditation, affirmation, or prayer, seems important also. Writing gives me an opportunity to process and externalize things that well up inside. The reflective time allows me to either "let go" of things out of my control, or recognize things that I can influence.

There were also a couple miscellaneous things I had to deal with internally, like my mindset about some things. The closest I can come to summing this up is along the lines of the "God give me the serenity" adage. Or, something I believe the Dalai Lama said, which to paraphrase, goes like "If something is in your control, why worry about it; and if something is out of your control, why worry about it?" In other words, don't pretend you can't do something about a situation—have the courage to change it if you can. And if you really can't do anything about something, try to let it go. This is really hard because we get into habits of truly believing something is out of our control when in truth it's in our hands. Indeed, we have quite a bit more power than we think we do, and even that acknowledgment can be frightening because it means we have no choice but to act. The converse is also often true—we attempt to change things that are really outside our influence. Perceiving the difference between these two things is truly a life skill honed with time and intention.

For non-believers, this last piece might be the hardest part to embrace, but I also think that a little daily prayer (to whatever spirit you decide on) is wise in order to align your perspective to the greater context of the universe. Tapping into that source of universal power can be of great comfort... it's not just you who's holding the reins of your life in this world, and you can't always know what's waiting for you on the other side of a struggle.

Coming Into My Own

The past two weeks have been a challenge because an old problem I thought I'd gotten rid of reared its ugly head. Since the night before my daughter's 1st birthday, I started having terrible lower back pain. Since the pain inevitably affects my life, I posted on my Facebook page that my back was out & what I thought was behind it—a psychogenic pain syndrome. Judging by the response (0 comments so far), either my friends and family think I'm loca, or this is too heavy of a topic for social networking.

But if I were crazy, so would be Jeannette Barber, John Stossel, Howard Stern, and Dr. John Sarno, M.D., as well thousands (if not millions) of people that this venerable but controversial NYU medical professor who developed the TMS theory believes the disorder affects every year. John Stossel, 20/20 correspondent, talks more about the pain syndrome here.

I've been having bouts of incapacitating back pain off and on since the spring of 2002. Back then, I thought my back pain was due to an on-the-job injury. I visited the doctor, who prescribed NSAIDs and bed rest. The pain became practically paralyzing. The MRI said I had bulging discs. The physical therapist prescribed exercises. The bodyworker helped me breathe deeper and visualize a protective shield. This went on for months. Then I saw an acupuncturist, who balanced my energy meridians. Ironically, the stress relief treatments worked better than the pain relief treatments. The massage therapist said I was tense. The chiropractor adjusted me and told me I had an instable SI joint. Still no long-term relief after four years. Finally in 2006, I read the book Healing Back Pain by Dr. John Sarno, which told me my back pain was psychogenic in origin: Tension Myoneural Syndrome.

Reading that book was the only thing that really reduced the length and frequency of my bouts of pain—once I really accepted its role in my life, I went an entire year without a major pain event, and when I did again it only lasted for days, when for the past four years, I'd have at least 3 bouts of pain that lasted from 1-2 weeks every year. To me, the book was the most powerful medicine I'd encountered so far.

On the TMS wikipedia site, TMS is summarized as "a condition in which unconscious emotional issues (primarily rage) initiate a process that causes physical pain and other symptoms. [The] theory suggests that the unconscious mind uses the autonomic nervous system to decreases blood flow to muscles, nerves or tendons, resulting in oxygen deprivation, experienced as pain in the affected tissues." According to Sarno, TMS manifests most commonly as back, leg, or neck pain, but can also lead to disorders such as Irritable Bowel Syndrome (IBS or colitis) and others. Sarno also considers fibromyalgia to be synonymous with TMS.  The personality characteristics of people who are most susceptible to TMS are, from the introduction to TMS wiki: perfectionists, people pleasers, very self critical, and very ambitious individuals.

This whole topic is both fascinating and embarrassing to me at the same time. Fascinating because although it's not the first instance where I've come in direct contact with the power of our mind, it's definitely the most in-my-face example of how my subconscious can control me, and how I can often take control of my own pain. Because of this, I've made great strides with this and other difficult aspects of my life.

However, telling people that I believe I "have this" condition can sometimes still be embarrassing for a couple reasons: One, there's still that stigma against mental disorders in both the United States where I'm from and in Mexico, where I live—in both countries a psychological condition is often seen as an imagined apparition (it's all in your head) or a personal debility. And there's a part of me, probably that very perfectionist, people-pleaser side, that doesn't want to appear weaker, or anything less than "on top of" my own issues, no matter how hard things get. I can remember a time in high school when we used to mock the concept of psychosomatic disorders, i.e. people who "do it to themselves" or "bring on their own problems." Kids are cruel, adults pretend not to be, but many of us hide our true feelings, which sometimes makes it harder for us to be genuine with each other (or even ourselves). But let's face it—all of us have struggled with unpleasant emotions—anger, jealousy, sadness, frustration, or worse— for our entire lives. To deny it would be ingenuous at best.

Second, I was trained as a biologist and a skeptic in the scientific tradition, and Dr. Sarno's TMS theory is more controversial—it smacks of pseudoscience. Although many prominent alternative physicians support his theory and believe it could relieve a large burden on the payout system for Workers Compensation (of which I was a part of, and back pain sufferers are a majority recipient), Sarno acknowledges that the vast majority of the medical community rejects his hypothesis. This is mainly because a major clinical trial has not been performed. Some researchers claim that his education program, which teaches people that their subconscious repression of unpleasant emotions leads to pain and that learning about the process can alleviate pain, is merely placebo effect.

On the other hand, I have a very open mind. It doesn't surprise me that it's not only hard to test for this effect, but that there's a lot of money to be lost on the chronic pain industry were this theory to be proven (for example I avoid long term use of painkillers).  Just because something hasn't yet been definitively proven through clinical trials doesn't mean it can't exist. Great strides are being taken to demonstrate through Western medicine what Eastern medical traditions have long since known—the intricate mind-body connection and the importance of approach to life in health issues. For example, Dr. Dean Ornish who showed that coronary artery disease could be reversed not only through a vegetarian diet, but also through meditation.

For many years I've self-diagnosed and treated with diet, herbs, and vitamins, and normally I've had a great track record—I'm usually in very good health. But when you're having a recurring problem and it comes down to the nitty-gritty of getting proper professional support with it, it can be a lot harder to heal when you're doing it on your own.

Which might be why, even though I haven't had a bout of back pain in almost two years, I'm coming to terms with the fact that I'm still struggling with this problem. August 2007, February 2008, and December 2009 were the last times I had TMS-type symptoms. In Dec. '09, I had a short-lived bout of back pain that both disappeared as soon as I figured out what was stressing me out. Since that was the last time I had actual back pain, I figured I was "cured."

But now I'm realizing that there were two other things that happened since then that very well could have been TMS in disguise: a brief bout of IBS in October '09, severe morning sickness in early '10, and hip pain that started five months after I gave birth and worsened daily until two weeks ago when it suddenly disappeared and the back pain started.

I'm going to save the story of how my hip pain progressed, how I thought it might be a degenerative joint problem, how it "coincidentally" morphed into back pain (and then back again a few times), why I became convinced that it was TMS after all, and what I think I need to do to get "back on track" for another time. But suffice it to say that I have my work cut out for me, in terms of coming into my own, yet again, and finding a way to heal myself.

Because I know I have something to learn from this struggle, and I don't want to needlessly miss out on another moment of enjoying my life.

Commemoration

Some things turn out to be harder than you expected. And some things turn out when you least expect them to. Sometimes those things are one and the same. My husband just says, "September is a tough month for us."

We're referring to my recent obtaining of Mexican citizenship, and my daughter's first birthday. Both things seemed to be happening according to plan, with no kinks. But then for each event, in the eleventh hour, all hell broke loose. Miraculously, everything DID turn out "okay." But for both, it was touch and go until the very last moment.

In the case of my Mexican naturalization, I could have done like most of my expat friends here and just kept renewing my visa (the FM2, for legal stay in this country) until I got permanent residency. But for me, there was an irresistible draw to "no more trips to immigration (INM)" (only 2 years of renewing the FM2 vs. 5), and the ability to vote. As I saw it, I could be here indefinitely, so why not be a full-fledged member of society?

So the papers were dutifully gathered, submitted, and accepted over the course of months, from late 2010 to March of this year. It was a difficult, expensive, and sometimes stressful process that led me all over Queretaro and Mexico City jumping through bureacratic hoops to properly document my existence and qualifications for becoming Mexican by marriage. Then began the waiting game. In late July, we heard back that my application was approved. I figured it was just a matter of time before my naturalization certificate was delivered, and I was good to go—and put it out of my mind.

As August came to an end, my radar touched back onto the question of my naturalization certificate. Where the heck was it anyways? August is the time when, for the last five years, I start getting my papers together for the visa renewal—up to thirty days before its expiration date. But since my citizenship was on the table, I assumed I wouldn't have to renew this year. I was finishing up a chapter in Amor and Exile, and making plans for the baby's first birthday party, in other words, busy. So I merely shot an email off to my contact at the Secretary of Exterior Relations (SRE) to "check in" and continued to hope for the best.

When he got back to me, still no printing of the certificate. By this time it was early Sept. My visa expire(s/d) on the 18th of Sept., so I started to get a little worried. He told me to wait until the last minute if possible—which is not my style, but who wants to pay $300 more for a document they won't need if the one they're waiting on is almost ready? I decided to try and relax, and play a little roulette.

Meanwhile, plans were going well for the baby's birthday bash. When initially weighing how much to take on, we'd voted down dipping into savings for various home improvement projects prior to the party in favor of a low-budget bash. At first, I meant to keep it on the small side. But I love parties, hadn't had a really big one since the baby shower, and that invite list sort of took on a life of its own, so the budget got pushed to the limit. Luckily, a bunch of friends had committed to chip in with time and effort. But the amount of stress over preparation and expenses approached a level I wasn't quite expecting.

Normally, I am fairly conservative in my estimates when planning for parties and life in general. However, I indulged in a few fantasies that, in retrospect, I probably shouldn't have: First, that my baby would know (or care) that I was throwing a party for her, and would demand any less of my attention in the weeks leading up to it. Second, I assumed we'd have income around the time of the party, but then in a random stroke of bad luck, my husband was out of work for the two weeks prior. I also didn't have the cushion of the long-hoped for contract for the book (I know, I am crazy! But that's why I called it a fantasy). I also assumed that I wouldn't be reapplying for a visa in the days prior to the party—those of you who've done it before know that it's almost like a full-time job for the week before the renewal date.

The week before the party, and my visa's expiration date; which ironically are one and the same, I decided I couldn't just "wait until the last minute." I went into INM and SRE to beg them to give me clarity about what was going to happen: would I in fact get my naturalization papers in time, or would be I be dipping into my savings for a useless document that I'd have to reapply for on a technicality (in order for it to have validity, the naturalization certificate's print date must coincide with a date prior to the expiration of your visa)?


The possibility of running out of money hasn't occurred to me for at least 10 years, back when I was struggling to get on my feet as a recent college graduate. But when they turned me away at the SRE doors and I sat down on the bench outside with the baby, after 5 years of underemployment, and contemplating the possibility that my application for citizenship had been for naught, I wondered if heartless bureaucrats would continue to empty my pockets until I failed to even qualify for either a visa OR citizenship—and then how would my husband and I be together? I broke down in tears. So as to not get stuck in the paperless limbo land that my husband lived in the U.S., I decided to go ahead and reapply for the visa at the eleventh hour, on September 15th, the day before Mexican Independence Day. It was the last day I could submit my papers.

We were down in the commercial district making our way to the bank to transfer money to the INM coffers for the right to be here another year with my family when I got a phone call from my contact at SRE. Only that I couldn't answer because I'd just dropped my cell phone on the ground and I could hear nothing on the other end. I ran outside to get my husband's cell phone, ran into the grocery store to put credit on the phone, and ran back out to call my contact. "Is Syracuse spelled with a 'Y'?" he asked. I stammered yes, wondering if this really meant my wait was over. Half an hour later, at the bank, before I had to get in line behind 40 others before business hours ended for the next 4 days, I got word that the certificate had been printed, and I wouldn't have to renew my visa.

I couldn't believe things had turned out this way. The only problem was that I'd still have to wait to get my certificate in the mail, as it had been printed but not signed. So until then, I'd be unable to get a Mexican passport, and essentially unable to travel (back into Mexico is the catch—there's no problem going up into the States because of my U.S. passport). I wavered but after conferring with family, decided it was worth the risk. I hope I don't eat my words.

It was Independence Day, and I was officially a Mexican citizen. I should have been elated—and I was—I went out and partied like I hadn't for a long time that night with friends downtown. When I got home during the wee hours of the next morning, the baby had been up wailing for an hour with my husband, who'd stayed home to watch her. But I had no regrets. However, I had only two days to go before the party—I had to get my act together, raging hangover or not. I set about taking care of the last minute details and gathered a small army for the food preparation the day prior.

But then family hit the fan—Margo's side had a small crisis of their own and infighting had broken out, making me fear no one would show up at our party for not wanting to see each other. That made it sink in how upset I was that my own family couldn't be there with us to celebrate. Our situation doesn't make it easy for them either—the distance is considerable, tickets are expensive, mail is tough, internet is erratic. We'd had to make a choice—have them visit either this date, or Christmas, and pinned our hopes on the latter. But as the big day approached I felt more and more sad that we'd be apart for this one.

It's weird, because I don't usually feel this bad for my own birthday. Nostalgic, yes. Sometimes wishing my husband would do it up for me like only my family and friends can, also. But never with the dark cloud of dreariness that I felt creeping up on me like I did as my daughter's 1st birthday without my side of the family present. That caught me off guard.

So much so, that I woke up the morning of her birthday with paralyzing back pain. I'd been worn out the day before, and I'd been having hip pain for months, but having my back go out was completely unexpected, especially since I'd managed to make it all the way through pregnancy without that happening. What was going on? I tried to get my frustrations out with my therapist, who graciously spoke with me that morning. After skype didn't work ten times while trying to set up a happy birthday phone call with my parents for the baby, I had an embarrassingly upsetting incident with them and my husband. It became apparent how raw I'd gotten, or how the stress I'd been desperately trying to avoid had finally caught up with me. All of my attempts to hold it together—meditation, affirmation, visualization, gratitude—seemed to be simultaneously imploding.

On our way down to town to pick up the cake, I felt ashamed for the way I'd spoken earlier that morning, and could only look at my daughter next to me, who laughed as tears and snot streamed down my face. And I realized how silly I must have looked to her, and began to laugh myself. What felt like emergencies minutes prior seemed wholly insignificant, if only for a moment.

In the end, I was able to carry on and we were able to pull off a very fun, memorable party with plenty of friends and family present. My parents were even able to watch the piñata being broken and the cake being cut via Skype—the gods were willing this time. As a friend had predicted a week earlier, it was a celebration not just for our daughter's first birthday, but for us all having been able to make it through one more year—together. The pain may have yet to be resolved, but the commemoration is complete.

Allergic to Injustice

A good friend of ours was staying with us this past week.  He was here to discuss our plans for collaboration on a writing project which I am very much looking forward to.  So in a way, it was more than just a vacation stop -we were "working"- but even so we got the typical tourist looks while we were showing him around town, well, the backpack and fair skin with blue eyes are usually a dead ringer.

One of the things I enjoy most about having friends visit is the inspiration it gives me to fire up all burners in the kitchen.  I mean, we eat well when it's just the three of us, but somehow we get into a predictable routine of certain staples, I guess they are our comfort foods.  But when we have company, I feel more compelled to go the extra mile and show off what some of the most delicious local dishes are, such as those I compiled in my cookbook.

This time around, I was especially lucky that I knew several corn-based recipes, because our guest has a gluten intolerance that precluded him from joining in chowing down on any foods that had wheat or wheat derivatives as ingredients.  When he first told me this, I nodded and made a mental note, but I must not have registered the gravity of this requirement, because I kept slipping up and offering him things with wheat, especially beer.  Once we finally got the hang of it, eating mostly corn tortillas, gorditas, and anything of the fruit, vegetable, or dairy variety, I felt like we had it down pat.  Then we were preparing a meal of arrachera (skirt steak) and potatoes, when my husband threw in some worcestershire and soy sauces.  My friend happened to notice (thank goodness), and told us he wouldn't be able to eat it.  We were shocked but he was right.  Sadly, the brands of sauces we had both contained gluten, and so we guiltily ate our meal while he ate some quickly made quesadillas. 

After that incident, I said I'd have to write this down.  He claimed I'd refer to him as the annoying friend, but quite the contrary, I appreciate his stay because I never realized quite how many foods had wheat in them.  I mean, breads, pastas, cookies, sure- but beer and soy sauce?  The ingredient really runs deep in our culture, much like corn syrup, sugar, or salt- as that last two are something another friend is trying to avoid in the preparation of her baby's food. 

There are so many things that we ought to avoid in our diets, you'd think that food is the biggest problem in terms of health.  Anything we put into our bodies- the water we drink, the air we breathe, are all suspect these days.  GMOs are the latest consumer item that we could really stand to suffer from- hopefully the government will step in to protect us from the pressures of industry to water down consumer safety standards.

Although I have a mild allergy to soy, and have seasonal hayfever, these are things that can be controlled.  I avoid or limit my intake of soy, and I take an antihistamine in the late spring and early summer.  But what about other, more intangible forces to which we can be allergic to?  How do they affect our health and mental well-being?

I got the undesireable answer to this question the day my friend left.  The topic we had been discussing has to do with my husband's undocumented immigrant status in the U.S.  It's a subject that brings me great distress, since it's affected our lives so harshly and in every aspect.  For that reason, I don't talk about it regularly, and pretend to have mostly resolved in my mind. When in fact much pain still lingers below the surface.  I happened to mention something about how I felt it was unfair that most of our ancestors in the U.S. had such an unfettered access to immigrating to the States, before harsh law controlling immigration were passed, and how now it's so much harder for people to move back and forth.  I said how I didn't feel as bad for myself in having to live in Mexico as a result of my husband being unable to get papers as I feel sorrow for him not being able to realize his own dreams.  Tears sprang to my eyes, but I pushed them away as quickly as they came.  The discussion ended, and I forgot I was feeling so bad.

The next morning, the feelings resurfaced  but I tucked them away again so as to not appear overemotional.  Even my husband feels bad when he sees I am so bummed about certain things.  But my attempt to hide my true feelings had its consequences.  My back began to throb in pain and by the time I tried to walk down the stairs, my posture was contorted to the side with spasming muscles.  Unfortunately, this is a condition I know all too well, since 2001 when I first moved in with my husband.  After visiting many modalities of physical therapists I finally read a book lent to me by a friend called Healing Back Pain, and realized my pain was due to repressed anger.  The author describes the causes much differently than I do here, but a way to see it is almost as if swallowing my distress causes an allergic reaction in my body.

The thing I'm reacting to is a perceived injustice, something that upsets me, but that I feel I have no control over.  At first it's a conscious effort to not think or talk about it, but over time it becomes second nature.  A buildup of suppressed feelings for me can lead to disabling back pain.  Luckily I knew this is how my mind and body interact, and I reminded myself it was important to not fear the pain, and focus on clearing my mind.  At first, I was lying on the living room floor.  But later, after a good cry, I was back on my feet.  In the past, I'd had bouts of pain that lasted for 2 weeks.  I missed work because of it.  One time it got so bad that my husband had to carry me.  But today, after making the connection, I was almost back to normal by the evening.

It's a little scary to think that our minds have so much power over our bodies, to the extent that we feel we may lose control.  It's instructive that we need to be sensitive to the influences we subject ourselves to, or at least be open-minded about what can affect us, and not lose sight of the connections between things.  I do not just get sad about my own personal problems, but feel a real indignation when rights are infringed worldwide.  They can plague me just the same.  My allergy to injustice is real and not just perceived.  But rather than stick my head in the sand and ignore issues, or take some pill to help relieve my "symptoms," I must address the root causes and work toward healing ourselves of these ills.