The first time I remember leaving a doctors appointment feeling upset was in 4th grade. My scoliosis was pretty bad before my first "growth spurt" (I'm not sure you can use that phrase when referring to Italian people getting taller...) and I recall my doctor telling me that I would have to wear a back brace for a good portion of my young adult life and that I would not be able to play sports. Shortly after, I burst into tears and left that appointment full of anxiety that I would stick out like a sore thumb with a back brace on and couldn't pursue my love of sports. Thankfully, that doctor ended up being extremely wrong, as I never had to wear a brace and I grew up playing, and excelling, at pretty much every sport I played (aside from soccer... unless you consider my amazing toe-balls skillful :/).
Since then, I have had a slew of horrible experiences with doctors. I have been misdiagnosed, bounced around from office to office, dismissed, patronized, prescribed medication that gave me allergic reactions multiple times, and outright lied to. I have left doctors appointments sobbing, upset, angry, confused, and invalidated. Sure, I am an emotional person, but I can say with 100% confidence that these feelings were justified and brought on by doctors who simply just do not have people-skills.
Once I went through my IUD experience, and essentially was a zombie for five months with NONE of my current doctors able to figure out why I was literally morphing into an unrecognizable human being in front of my eyes, I vowed to kick these inadequate doctors to the curb. As such, I started empowering myself in a number of ways and took my health into my own hands. Since adapting this mindset my health has improved tenfold, and I have sped up my healing process during the most stressful time of my life ::pats self on the back::.
Even if you aren't currently dealing with a chronic illness, it's really important to develop this skill-set before an issue arises. It's hard to do research and put your health first when you're so sick that you can't think straight... Take it from me ;-) This information is also applicable if you are a caregiver for a loved one.
What I would like to cover today is what patient empowerment is, why it is important for your health regardless of whether you are currently healthy or not, and finally how we can all become our own best advocates.
What is Patient Empowerment?
Patient empowerment, as defined is "a generic term... for encouraging the active participation of patients and carers in choosing management options, including eliciting quality-of-life utilities and preferences by discussion, viewing of interactive videos, etc." (medical-dictionary, 2015).
In my opinion, it is so much more than that, and patient empowerment sometimes cannot be quantified or labeled, it is a feeling, it is an attitude, and it can become a part of who you are. Patient empowerment, to me, means conducting research, challenging your doctor (in a polite and constructive way of course), putting yourself first in your health journey (remember my tip on learning how to say "no"?), asking questions, being fearless and sometimes pushy to get the results that you want, and ultimately, being your own advocate in all healthcare settings.
Perhaps it will help to describe what the antithesis of patient empowerment is: accepting everything that your doctor says at face-value without doing research, letting your doctor speak over and dismiss you, being afraid to go to the doctors office, not asking questions, not speaking at all during an appointment, not being responsible for your health journey, and/or not sticking up for yourself in any healthcare context.
While the latter descriptions may sound harsh, that used to be me to a T, so I realize how hard it can be to make the shift from an inactive to empowered patient. I used to be afraid of doctors, didn't ask them the questions on my mind due to embarrassment or fear, and I ultimately blamed everyone else but myself for my illnesses. Today, I am happy to report that my attitude has shifted, and this paradigm shift is/was crucial to my healing process.
Why It Is so Important
I'd like to use an analogy here that hopefully will resonate with you all. In interpersonal contexts, we understand why it is important to speak our mind (in my case, sometimes too much... oops!) and stick up for our rights. While we may not always do that (I'm thinking of certain past relationships where I let people put me down and walk all over me...), I think we can all mostly agree upon the notion that if we don't stand up for ourselves to a bully, loved one, roommate, enemy, etc. who else is going to do that for us? We cannot count on others to constantly come to our defense. Well, this same notion applies in a medical setting.
On the other hand, while I may not be the biggest champion of today's modern healthcare professional, we do need to cut them some slack. Doctors are not mind readers. If we are experiencing side effects from a medication that a doctor prescribed yet we do not share this information, how can the doctor help? If we do not share symptoms that are lessening our quality of life, then how can our doctor help us move past them? Sharing every bit of information possible that is relevant to our health journey is a part of being empowered.
Overall, it is necessary to engage in a dialogue with healthcare professionals, and to have a give and take, to truly be invested in our health and start to feel better. Yet, I do realize how challenging it can be to have a conversation with certain HCPs (healthcare professionals) who treat us like a number and shoo us out of their office feeling more confused and defeated than when we left. So, let's move to some steps and practices that I have used in doctors appointments that have left me feeling happy and healthy :-)
How to be Empowered
1. First, find a doctor that you can vibe with, which I admit can be quite the challenge.
2. DO YOUR RESEARCH before and after appointments!
3. Keep a journal full of notes and questions for your doctor's appointments.
4. Learn what it means to be an informed consumer, and enact these practices when making any health changes
5. Share your story with others. The power of narratives can be cathartic for you and help others feel empowered too!
Okay, so I hope you all feel a bit more confident and empowered after reading this post because that was my goal :-) Patient empowerment is a skill that takes a lot of time, energy, and practice, but it is so worth developing and honing for both yourself and taking care of loved ones.
Do any of my readers have thoughts on this topic? Have you ever enacted any of these practices before? Do you have any suggestions that I left out on how to be more empowered?
Until next time!
Anderson, R., & Funnell, M. (2011, June 1). Patient Empowerment: Myths and Misconceptions. Retrieved February 25, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879465
Patient Empowered Care: You Are At The Center | CTCA. (1, January 1). Retrieved February 25, 2015, from http://www.cancercenter.com/ctca-difference/patient-empowered-care/
Patient Empowerment - Living with Chronic Disease. (n.d.). Retrieved February 25, 2015, from http://www.enope.eu/media/14615/a_series_of_short_discussion_topics_on_different.pdf
I think it makes more sense to have this post be on Sunday instead of Friday, and it makes it easier on me to get a post out to you all, so let's just agree that recipe day will now be Sunday... ;-)
So, cooking this week has been a bit interesting considering our oven is not working. This means I have to put my bacon obsession on hold for a week. Let's hope that I'll be able to survive ;-) I've gotten "creative" by relying on our crock pot and using the microwave more often. An oven breaking might not seem like a big deal to all of you non-AI/paleo eaters, but for me, I do ALL of my cooking and meal prep., so I've been trying my best to keep calm and cook on without it haha.
Anyway, I'll admit that as a result I haven't really experimented with too many new recipes this week, but the ones that I have tried came out awesome and taste great. That's not me tooting my own horn, rather, the amazing bloggers that I follow always pump out wonderful recipes! Yay!
I've been feeling pretty overwhelmed lately with everything that I have going on, but I feel like this weekend has helped me get back on track. Sometimes it's really hard to balance everything between graduate work, teaching, advising, working out, cooking, this blog, and having some semblance of a social life. I think I'm juggling everything as well as I possibly can though!
Okay, so enough about me - onto the recipes/dishes that I really enjoyed this week.
1) Tuna salad
2) Pumpkin puree with BACON! <3
3) AIP-approved Mint-Chocolate Truffles
4) Cod with Red Cabbage and Zoodles
5) Roasted Garlic Mashed Rutabagas
Have any of my lovely readers tried a new recipe this week? Let me know in the comments! :-)
Until next time!
This marks the second post on Chronic Illness Chronicles that is about depression, and I hope you will continue to read on whether you have ever been depressed or not. The first post I wrote was about Seasonal Affective Disorder and can be found here, but this is going to focus on how I have discovered the causes of my depression and how that has helped me push past and fight back against the stigma associated with depression.
According to the World Health Organization in 2012 upwards of 350 million people were living with depression worldwide. While I am just one of those human beings, I know a handful of others who have struggled with this condition, and have spent hours, days, and possibly months, researching and exploring this topic to better my own mental health. While what's to come is a mix of objectivity and subjectivity, I urge you to peruse this article, because I am going to be open and candid. I am going to share a part of myself with you all in the hopes to help someone else who may be alone and afraid and miserable.
I am going to cover how my depression manifests itself and the causes of my depression. I will write a follow-up post with how I manage my depression with diet, supplements, and lifestyle at a later point in time. I don't want this to turn into a novel :-)
As I mentioned in my SAD post, the first time I realized I was depressed was 8th grade. I have dealt with mood imbalances on and off ever since, but since going on the autoimmune protocol my moods are stabilizing and I'd like to think I am a happier more energized person as a result. Note: my depression has never gotten in the way of me going to school, going to work, or performing day-to-day tasks, so my perspective may be different from others (except for that time that my doctor prescribed me a bunch of Xanax when I had my IUD in and couldn't sleep. Benzos + Julie = one miserable human being).
For me, my depression is a little dark cloud that follows me around and zaps my ability to be optimistic. I become quiet, reserved, and spend a lot of time up in my head over analyzing conversations, relationships, mistakes I've made, and so on. I don't want to hang out with friends, I don't want to do school work, and I typically find myself forcing a smile and counting down the hours until I can be alone in my room with my music.
These days, my depression is not that bad compared to many people's, but I've had some dark times in my life: crying spells, panic attacks, withdrawing from everyone in my life, having an inability to properly channel my emotions, lacking energy to heal, and constantly feeling alone, afraid, and hopeless. There was also a period of time where it got so bad that I wanted to end my life. Obviously, and thankfully, I did not.
It was not until I seriously took my mental wellbeing into my own hands that I was able to break free from depression's claws and start healing. Those who have ever been depressed know how challenging this task can be though. If I can't even find the energy to pretend to be happy how am I supposed to cognitively restructure my thoughts? It can be a daunting task. Thankfully, there are other things we can do aside from cognitive behavioral therapy to get better. First, it is crucial to figure out in true Sherlock Holme's style why you, the unique individual that you are, feel depressed.
The other day I came across an article that compared depression to a drug and an addiction, and I could
not disagree with this notion more. A lot of the time people accuse those who are depressed as being lazy, unmotivated, and all we need to do to feel better is to look at the world around us differently. Huh... I never thought about doing that - thanks for the insight. Yet, this couldn't be farther from the truth in some people's cases. There have been days where everything in my life is going well and I'm being as optimistic as possible, but the sadness still lingers and creeps into every fiber of my being, dragging me down and affecting my mood. I tell it to go away, I push it out of my mind, I do a countless number of things that make me happy, but the depression persists.
Thankfully, I have started to accept that this is a part of me, and it's not because I'm fragile, crazy, messed up, lazy, mental, weird, etc. It is for a slew of other reasons.
1) Genetics - depression runs in my family, and both sides of my family at that. I believe that the MTHFR gene mutation runs in my family as well, just based on my research and illnesses that I have, but I'll have to come back to that at another point in time. Regardless, mental illness can be passed down through genes, it is not just some socially constructed mindset that pops up out of nowhere.
2) Hormonal imbalance - I have been on birth control since I was 17. As such, my hormones have not had the chance to stabilize and occur naturally for quite some time. Estrogen, progesterone, and testosterone, when in balance, work together to keep you happy and healthy. I am working to overcome estrogen dominance and a progesterone deficiency thanks to coming off of birth control and being essentially poisoned with copper due to the IUD Paragard. This combination can result in mood imbalances and disorders. Thankfully, I have made huge progress with this endeavor with a lot of help from the supplement Estroblock.
3) Adrenal fatigue - I've been working to correct years of adrenal damage from eating crappy, being super stressed, treating my body poorly, and dealing with copper toxicity. Your adrenals help to control your cortisol levels and keep you energized and happy. When your adrenals reach the point of burnout, your cortisol levels can dip so low that you feel sluggish, unmotivated, and ultimately, depressed. My adrenals have been put through a lot and I'm happy to report that they're getting better, but I will address that at a later point in time.
4) Heavy metal toxicity - Needless to say, having a copper device inserted inside of you can lead to suffering from heavy metal toxicity. My body has gone through the ringer because of the Paragard. My organs have worked to push out the excess copper and keep all of my other mineral levels in check. Unfortunately, that was not possible for a very long time. The copper deposited itself in my brain, tissues, fat, bone, and wherever else it could lodge itself. As a result, my mental health plummeted as copper took over and all the calming minerals like zinc and magnesium were overpowered. Even if you aren't suffering from copper overload, heavy metal toxicity might be a piece of your depression puzzle.
5) Thyroid issues (hypothyroidism and Hashimoto's) - I believe that this is one of the main reasons for why I sometimes deal with depression. My mother has hypothyroidism, as well as other women in my family, so who knows when my thyroid truly started to crap out on me (it's okay though, I forgive you, it's not your fault dear thyroid <3). The thyroid controls our hormones, and an underactive thyroid struggles to create enough thyroid hormone, which in turn keeps you happy and energized. The thyroid also works hand-in-hand with your adrenals, so as one starts to be overworked, the other one must pick up the slack.
6) Leaky gut - If your stomach lining is all messed up (that's the scientific way to explain it...) it's going to have a hard time absorbing nutrients and minerals from food. As such, you will be malnourished and this can lead to mood swings and mood imbalances, among other issues. My stomach lining has been getting better with each passing moment on the autoimmune protocol, but I still rely on many supplements to make sure I am meeting the requirements for all vitamins and minerals.
My stomach issues likely started for me when I was on a long round of antibiotics thanks to a horrible urinary tract infection. I was also a sick little baby and always struggled with ear infections, which also led to being prescribed antibiotics before I could even walk. Not to mention, my diet up until a few years ago consisted of mostly gluten, dairy, processed foods, and all other sorts of inflammatory meals. Oh... can't forget those rugby years and rugby beers :-o I probably should write my stomach a heart-felt apology letter for all I have put it through.
7) Personality traits - I love to psychoanalyze myself (which sometimes annoys the hell out of my closest family members and friends, for that, I apologize) and I like to attribute my behaviors to past events and personality traits. Some of these traits have developed due to positive life events, and others through negative life events. I am a perfectionist, I can be impatient, sometimes I am pessimistic, I am extremely passionate about a number of things, I am super receptive, I am sensitive, and ultimately, I am a hopeless romantic.
All of these quirks and habits can either create an energized and happy Julie or a down-in-the-dumps, I'm going to hide in my shell Julie. Thankfully, I have become so introspective that I have begun to work on channeling my energy in a positive way, yet, I'm not perfect and sometimes I take a comment too personally and it ruins my day.
All in all, I realize this post is pretty long and somewhat all over the place, but managing my depression has been one of my biggest triumphs in life, and has taken a lot of research and reflection to start the process. I triumph over this "disease" well (most days) and am proud of the progress I have made, but there is always more work to be done. I hope that in sharing my story and how I began to solve my mystery that that this information resonated with you. Depression should not be stigmatized in our society anymore. The number of people that I know who deal with it or who know someone else who lives with it is so widespread.
In my mind, one of the major ways to combat this illness is to speak out and share our stories, lend a helping hand to someone who is having a horrible day, be compassionate, be understanding and empathetic, and ultimately not judge or label someone who has the courage to admit that they have depression. Just because I do not have a wound that you can see on the surface does not mean that I am not hurting, does not mean that I am not worthy of anyone's help or concern. I may be a bit biased, but those of us who wake up every morning and work to overcome our mind's natural frame of reference are not weak as society would like to describe us. We are strong, we are empowered, and we are warriors :-)
Thanks for reading, and I apologize for my serious tone. I tend to enjoy writing my posts in a goofy way, but I'm very serious about this topic. Did anything resonate with you in my post? Do you have any ideas as to why you struggle with your moods? Did I leave anything important out? Please leave me some feedback - I'd love to hear from you all!
Until next time!
Adrenal Function in Mild Depression. (2015, January 1). Retrieved February 18, 2015, from http://www.adrenalfatigue.org/mild-depression
Borchard, T. (2014, May 5). Have Depression or Anxiety? Get Your Thyroid Checked. Retrieved February 18, 2015, from http://www.everydayhealth.com/columns/therese-borchard-sanity-break/depression-bipolar-disorder-and-hypothyroidism/
Bowthorpe, J. (n.d.). MTHFR genetic defect - Stop the Thyroid Madness™. Retrieved February 18, 2015, from http://www.stopthethyroidmadness.com/mthfr/
Depression. (2012, October 1). Retrieved February 18, 2015, from http://www.who.int/mediacentre/factsheets/fs369/en/
Kesser, C. (2011, February 24). 9 Steps to Perfect Health - #5: Heal Your Gut. Retrieved February 18, 2015, from http://chriskresser.com/9-steps-to-perfect-health-5-heal-your-gut
Personality. (2013, October 1). Retrieved February 18, 2015, from http://www.blackdoginstitute.org.au/public/depression/causesofdepression/personality.cfm
Smith, P. (2013, February 1). Heavy Metals Detox. Retrieved February 18, 2015, from http://www.balancingbrainchemistry.co.uk/23/Heavy-Metal-Toxicity-Depression-&-Anxiety.html
So, I've kind of been slacking on the recipes this week, and it's mostly because I can finally eat an array of fruit again without having a distended stomach and/or breaking out! Hallelujah! Perhaps my fructose malabsorption issues are starting to go away??? Either way, I've been able to grab an apple, orange, or figs to hold me over in between meals instead of second breakfast, lunch, and dinner, so that means less time in the kitchen for me. Well, at least some days.
I want to experiment with some desserts in the near future, since that's where I'm kind of lacking, but one thing at a time, and all the fruit I've been eating is definitely making my sweet tooth happy :-)
I'm still obsessed with bacon and have been pairing it with everything and anything, so that's nothing new, but we'll get to that in a second! Without further ado, here are some awesome recipes that I experimented with this week.
1) Coconut milk and fruit deliciousness (apparently called cranachan)
2) Red Cabbage, sweet potato, and leek skillet
3) Pumpkin puree, plantain bread, and fruit
4) Ground turkey meatloaf
5) Slow cooker chicken with garlic and honey
Okay, so that's my weekly roundup. I'm going to experiment with some AIP truffles soon, so expect that to be up on the blog next week, but here's the recipe for now, so you can make a Valentine's treat (thanks Grazed and Enthused for being so wonderful!).
Any suggestions on what I should try to make next week? What has been your favorite meal this week?
Until next time!
Rose are Red, Violets are Blue, You're Pretty Awesome, but I Love Myself Too: Engaging in Self-Love this Valentine's Day
Since Valentine's Day causes the general American population to be inundated with notions of romance, love, belonging, sappiness, and in many cases, unrequited love, I thought it would be a great idea to write a post about self-love. I have flashbacks to one of my worst Valentine's Day in college after my boyfriend and I broke up a few months before (admittedly, it takes me awhile to get over things). I went to the gas station on campus and bought as much chocolate and sweets that my wallet could handle in addition to a bottle of wine. That night alone probably gave me a few cavities, and definitely was not a proper way to channel my emotions, although I still like to eat my feelings here and there. I am a human being after all :-)
Anyway, whether you are in a relationship (no matter what the context is... who knows what constitutes a "real" relationship anymore) or not, it is always important to love yourself first. This is a concept and practice that I have struggled with my entire life, but I think I've been making some pretty good progress with treating myself kindly these days :-) Maybe the insight that I have to offer will help you out too! Even better.
On this health journey I have had to REALLY force myself to be loving for many reasons. When you wake up one morning and don't recognize the person looking back at you, it's a tough pill to swallow, no pun intended considering I take a boat load of supplements every day :-) My image took a huge hit as soon as I got the IUD in. I lost most of my hair, I gained almost 40 pounds, I couldn't workout to lose the weight, I broke out in cystic acne, the list goes on. I also couldn't think properly or logically anymore. I had to be very patient and loving toward myself to get through this scenario. Unfortunately, that wasn't always the case, and I spent a lot of time putting myself down, feeling like I was ugly, and devaluing my self-worth.
Over the past few years I have tried to implement a few tactics that help me realize how strong and passionate I am, among the other qualities that I value about myself. This is of course not an exhaustive list, but hopefully I will get some feedback from you all in the comments section regarding ideas not listed here!
- Take yourself out/treat yoself
It's fun to do things by yourself sometimes, and I highly recommend doing so. This past year I've spent a lot of time by myself in coffee shops, cafes, movie theaters, the library, concerts, and so on. With each experience I have gotten in touch with myself better and was able to enjoy my time as well. Let's face it, sometimes we want to go do something and no one will come with us, so why should that hold us back? Plus, no one I care about has to see me bawl through an entire movie...
- Do what makes YOU happy
This relates to the previous piece of advice, and may seem simplistic, but make sure to do one thing a day that makes you happy whether it's watching Netflix, having a dance party in your room, catching up with an old friend, or whatever works for you. Prioritizing your happiness is a surefire way to work on loving yourself :-)
- Make sure to surround yourself with positive people who love you for you
Another self-explanatory point, but this is something that I used to pay no attention to. How can you expect to grow and feel good about yourself if you have jabronis putting you down left and right? Get rid of those people, if possible, and keep an entourage of encouraging, supportive peeps instead. #byebyebye
- Do not look to others to validate your self-worth
If there is one piece of advice I need to follow, it's this one. Growing up I always wanted praise and validation, as most kids do, but when you're a sensitive Sally like myself, that need is stronger. I wanted people to compliment me on sports accolades, musical endeavors, grades, a new haircut, a nice outfit, etc., but I would NEVER congratulate myself inwardly. Of course there is a fine line between being confident and cocky, but I think I'm finally able to give myself props if need be. I still look to others sometime to validate how awesome I am, so this one's a work in progress ;)
- Learn to say "no"
I am a people-pleaser at heart, but I have found that saying "no" and avoiding situations that make me anxious or drained has served me well. For instance, saying no to partying = a happy liver = a healthier Yoolie = self-love. Your situation might be completely different, but if you truly do not want to do something, try saying no and feel empowered. It is okay to not hang out with your friends every second of the day or do something for a significant other. It is okay to put yourself first sometimes :-) This is ESPECIALLY important if you have a chronic illness because there are moments in time where you need to get some rest a relaxation, or truly cannot just have a slice of bread or a piece of cheese, so learning to say no is a huge part of recovery.
- Be more forgiving and accepting of your flaws
So this doesn't turn into a novel, I'm going to list off some other suggestions that I pulled from the web while researching this topic and/or tactics that have worked for me.
- Don't beat yourself up over the past - move forward from your past mistakes and learn from them to help you overcome obstacles in the future.
- Don't sweat the small stuff - cliche, but seriously, life goes on and trivial drama and mishaps are not worth your time and energy.
- Spend time journaling and getting in touch with your emotions - this is an area that I really need to work at, but whenever I do mentally check in during the day I am better for it.
- Practice yoga - doing yoga teaches you patience, helps you get in touch with your body, and ultimately is a great way to treat yourself kindly. I highly suggest doing yoga at least once a week! Either way, you'll get a good stretch in :-)
- Write a positive letter to yourself and/or a list of your favorite qualities about yourself - it doesn't have to be cheesy, it can even be one thing on a sticky note. Either way, praise yourself for how awesome you are!
- If you catch yourself in the midst of a negative feedback loop, stop the inner-demons and think positive - this is something I've been trying to be better at lately. Once my mind picks up on a negative thought its off to the races and I'm left drained and miserable after a downward spiral of negative, belittling thoughts. I've found that distractions help to cut off this supply, and for me, they include working out, reading, watching a documentary, talking to someone on the phone, playing the ukulele, etc.
Okay, hopefully one of these tips resonated with you or there was a novel idea that you hadn't heard of before. I hope that you all have a lovely Valentine's Day whether you are single, taken, in a gray area of a relationship (if so, I feel for you, because gray area relationships are my forte), etc. While I think it's awesome to be able to show love and affection toward another human being, it's very important to give ourselves that same support too.
What are some tactics of self-love that you have used in the past that have worked? What strategies do you implement on a daily basis to show yourself love? What benefits do you think self-love provides?
I'd love to hear any feedback from you all, so feel free to leave a comment and make sure to treat yourself to something delicious and special this Valentine's Day! I'll be making some AIP-approved truffles for Valentine's Day, and I can't wait to try them.
Until next time!
Moffe, E. (n.d.). The Secret of Surviving Criticism. Retrieved February 11, 2015, from http://www.beliefnet.com/Wellness/Galleries/The-Secret-of-Surviving-Criticism.aspx
Scade, P. (2014, May 6). Why Self-Love Is The Key To Finding True Love. Retrieved February 11, 2015, from http://tinybuddha.com/blog/why-self-love-is-the-key-to-finding-true-love/
Sekendur, B. (2014, July 17). What Self-Love Means: 20 Ways to Be Good to Yourself. Retrieved February 11, 2015, from http://tinybuddha.com/blog/what-self-love-means-20-ways-be-good-to-yourself/