hypoglycemia

At least, I’m going to call it hypoglycemia for convenience. You’ll see why later.

Background

The first time I spontaneously got dizzy I was 12 when I tipped my head sideways to see into my desk. Although I don’t remember circumstances, I do recall having very occasional dizzy spells from that time and into university, at which point they became a little more frequent. I’d usually go home and have a rest, which sometimes helped and sometimes didn’t. Someone suggested it was low blood sugar but it didn’t seem likely because I was sometimes dizzy after a meal.

When I eventually went to the doctor, he diagnosed vertigo, meaning “I spontaneously get dizzy sometimes” and advised me not to move my head around too much. Uh, thanks. He was wrong, but in fairness it took me years of experience and a few other doctors and finally a particularly knowledgeable and helpful school nurse to figure it all out.

A couple of years after this most unhelpful of diagnoses, and after I’d graduated and moved to a different city, I’d been struggling with diet generally. I’d moved away from home with my boyfriend and neither of us were very interested in cooking. I generally ate food cooked from scratch rather than convenience food, so I was having trouble figuring out what the problem was. There had been dizziness, one occasion of an inexplicable sensation of nervousness, feelings of nausea, and no doubt other symptoms I’m forgetting. I went to the doctor, who said it sounded like hypoglycemia, though he didn’t order any tests. Just as well because the test is a glucose tolerance test in which you consume a sickly sweet glucose drink and then have blood tests every half hour for 2, 4 or 6 hours. As a needle-phobic, I was happy to give that a miss. His advice was to eat more meat and drink more milk to increase protein intake, but I found this challenging because I preferred to go more vegetarian and I was off milk at the time. So I attempted to manage my blood sugar through diet, albeit with limited success.

A few years later, when I was teaching English in Japan, I often struggled with low energy, low mood and difficulty focusing. One morning I was having a tough time. I’d made friends with the school nurse and her assistant; both of them had pretty good English but mostly they were nice, and I enjoyed being around them. So feeling unable to focus on work, I retreated to the nurse’s room and as we were chatting I told her I wasn’t feeling all that well, so she asked some questions. The main thing was dizziness and feeling generally blah. What kind of dizziness? This was the first time anyone had asked that question and I wasn’t sure how to explain it. Was it a sensation of going up and down like on an elevator, or was the room spinning horizontally? It was the up-and-down type.

This concerned her because up-and-down signifies high blood sugar, while horizontal spinning is typical of low blood sugar. It was very troubling to her, a nurse whose supervising doctor specialised in diabetes, that I should be having high blood sugar in the morning. Ah, I said. I ate something very sweet for breakfast. But from then on I paid attention to the type of dizziness and it was always pointed to low blood sugar.

I continued to struggle with blood sugar issues in Japan, so when I got back I consulted a nutritionist. Doctors don’t really get any instruction on nutrition, but some nutritionists aren’t much better. When this person encouraged me to eat things like Cheez Whiz and diet soft drinks, I knew I was unlikely to going to get any useful information out of her.

Anyway, since then I’ve just continued to treat it as hypoglycemia and try to figure out what works for me through trial and error.

Reactive hypoglycemia

If you consume sugar and a short while later your blood sugar is actually lower than it was to start with, that’s reactive hypoglycemia. The science is still somewhat unsettled on the precise mechanism, but one theory is that when the sugar is consumed, the body overproduces insulin. Insulin’s function is to lower blood sugar but here it kind of freaks out, and then you crave sugar. If you succumb to that craving, your blood sugar bounces up and down, and generally wreaks havoc.

Because I haven’t had the test, I’m not certain that this applies to me, but my current doctor says they don’t really do the glucose tolerance test for this anymore. And I know from experience that if I were to have a coke or even orange juice without eating some real food at the same time, it would fuck me up, so I probably do have reactive hypoglycemia.

But this isn’t the only issue for me.

Low blood sugar before meals

I also get low blood sugar before a meal, but since this isn’t provoked by consuming sugar, it can’t be reactive hypoglycemia. I suppose it’s just a normal low caused by my body burning off whatever I ate last. In other words (though I hate the term), it includes being ‘hangry’.

There’s another issue at play — I don’t really feel hunger and instead I eventually get low blood sugar symptoms. At first I thought this was an inconvenient coincidence, but now I wonder if I’ve actually learned (or was taught) to ignore hunger and if so this would be part of the cause of my blood sugar woes.

Even so, my low blood sugar symptoms seem to be more sudden and intense than what most people experience.

Symptoms of low blood sugar

Low blood sugar can cause a variety of symptoms. These are the ones I’ve experienced:

  • mood: from irritability, through grumpiness and foul temper, to full-on meltdown (crying etc.)
  • cognition: brain fog; my natural indecisiveness gets worse to the point of complete inability to make a decision (including, inconveniently, what I want to eat or where); inattentiveness; sensation of nervousness
  • dizziness
  • stomach: I’ll get a sudden feeling not of hunger but of void, which quickly turns to nausea (though I’ve never thrown up)

How I try to avoid low blood sugar

Avoiding reactive hypoglycemia is pretty straightforward: no sweets outside of mealtime, and especially no sweets as a meal. This includes sweet drinks such as soft drinks or fruit juice.

Avoiding low blood sugar at other times is more complicated because of my largely absent sense of hunger.

In general, I need to eat proportionately less carbs and more protein and fat than other people seem to need. If I eat carbs, I opt for complex carbs (e.g. rolled oats, brown rice, potatoes) instead of refined starches or sugars, but some carb-centric meals are best avoided (e.g. pizza, pasta). (You can get an idea of the effect of a given food on blood sugar by checking its glycemic index, but in general the less processed the better.) I eat meat, and dairy is a big part of my diet (full-fat everything). I eat on a schedule and frequently (breakfast, lunch, afternoon snack, supper, bedtime snack).

All of this becomes more complicated when I’m travelling because I don’t necessarily have access to a fridge, I can’t cook for myself, and I may be stuck with someone else’s schedule (especially on planes!). You can get carbs in any vending machine but protein is much harder to source. New restaurants are mostly a source of worry: will I be able to find something to eat here and will it be served before I have a crash? Do I have the language skills to figure out the menu and advise of my dietary issues? If I’m travelling, I don’t go anywhere without emergency rations.

As a result, travelling (or even going out to a new restaurant, or having a social event that centres food) causes me some low-grade worry. Will I get what I need when I need it? Dipping into my emergency rations around people is awkward because sometimes I sense they think I should share.

How I deal with low blood sugar when it happens

If I sense that my blood sugar is just a bit low and I can’t eat real food immediately, I’ll go for protein and fat (e.g. nuts). If it’s a little lower, then I’ll add something sweet (e.g. nuts plus chocolate, chocolate almonds). If it’s more of an emergency situation and my blood sugar has fully crashed, then I go for something sweet, preferably liquid because the sugar starts being absorbed into the bloodstream directly from the mouth (e.g. soft drink, fruit juice).

If my blood sugar is low enough that I feel I need some sugar right now, then sugar is the first step and real food is the next step. Real food doesn’t work as a first step in an emergency because it takes too long to be digested — I’ll end up having a full on blood sugar crash while I wait for the food to kick in. Not fun.

Conclusion

Blood sugar issues are inconvenient and become more of a hassle the farther away from home I get. I get anxious about it when I travel but I’m more relaxed if I have a travelling companion who understands my issues and can problem solve when I’m not able to. It’s not all negative though: it forces me to eat healthy food on a regular schedule, which is not the worst outcome. Uncontrolled hypoglycemia can encourage development of diabetes, so managing the issue through good diet is long-term self-care.

 

Notes on dizziness

The nature of the dizziness can be diagnostic (too bad my doctors didn’t know that). I’ve experienced the following:

  • low blood sugar: feels like the room is spinning, a horizontal feeling
  • high blood sugar: feels like you’re on an elevator, a vertical feeling
  • benign paroxysmal positional vertigo (BPPV): sudden and rather violent dizziness, provoked by changing the position of your head, can be calmed by moving your head back; results from crystals spontaneously forming in the semicircular canals of your ears and then interfering with the messages that the liquid and cilia in the canal send to the brain about position and movement (I’m certain that this is the first dizziness I experienced at age 12, and as of fairly recently it has become chronic)
  • extreme tiredness: to me feels like non-directional wobbliness; confusingly, the dizziness can happen even after I’ve slept, if the tiredness was bad enough (in university, I think I had both this and low blood sugar dizziness – the doctor’s mistake was thinking that there was only one kind of dizziness and thus one cause)

Notes on fatigue

In Japan I struggled with fatigue, at any time of day. At the time I assumed that my fatigue was all blood-sugar related, but I underestimated how exhausting it was for me to be surrounded by a different language and culture all day. I should have been eating a different balance of food, more of it, and having more naps. Fatigue is a difficult symptom to work with because a huge number of issues can cause it.

Food Matters

reflecting and looking forward

“No peeking”, a Sinful Sunday photo from May 2016.

Well, 2019 was a year. Fortunately there was more positive than negative.

IBS-friendly diet and improved energy

In late 2018, I started managing my IBS using a FODMAP-based diet and by January 2019 I could tell that it was having a positive effect, and not only on my digestive symptoms.

The most unexpected — and utterly delightful — effect was that it largely resolved the fatigue that I’d struggled with for over seven years at that point, despite having undergone every relevant test my doctor could think of. As a result, instead of being constantly dragged down and only randomly experiencing the occasional unpredictable ‘on’ day, most days are now good days and if I get blindsided by some surprise fatigue, reverting to a conservative diet and waiting out my digestive process for a maximum of three days almost always resolves the issue.

For an accidental discovery, it’s had a huge effect on my day-to-day life. A few years ago, the combination of fatigue, poor sleep, depression and then antidepressants meant that I never knew for sure if I’d have the energy, cognition or focus to a given thing at a given time. (A few weeks after I tapered off the antidepressants in April 2018, the cognition and focus came back, but fatigue remained.) Eventually I got tired of disappointing myself so I just stopped planning anything and instead would decide on the day whether I was up for doing the thing. Which was me doing my best to cope, but it wasn’t very effective and it had exacerbated my inherent tendency not to make plans or have goals.

I now have the energy to plan and set goals, though I’m not actually very good at either of those things. So I’ll be working on that in all areas of my life, especially food (shopping, prepping, cooking), and sexuality (specifically exploring the factors that may be contribute to my low libido).

meditation

At the beginning of 2019 I started going to a weekly meditation class with a Buddhist group that meets conveniently near my place. I’d been thinking for some time that meditation would probably be good for my buzzy brain. And during my most recent meditation, I became aware that even though my brain is still far from quiet, it’s perceptibly quieter than it was when I started a year ago. It’s nice to feel that sense of progress.

I’m not practicing regularly at the moment but I’m working on making it part of my routine. And I’ll continue going to the classes because I find them helpful and I like the people: folks who are actively working on themselves to to decrease criticism and increase compassion are people I want to be around.

Wolf’s new job

Another significant change was that at the beginning of 2019 Wolf got a good contract job in a nearby city. For a change, we’re now both working at the same time, so things have suddenly gotten much easier financially, although he now has the expense of his own apartment and utilities. I’m in the process of paying out our mortgage early (we’re currently in payout limbo as the request has been made but the bank hasn’t withdrawn the money yet), so there’s a financial freedom on the horizon for us.

It’s not a secure enough job for me to consider upping stakes yet. But we’re making efforts to remain connected despite the distance, and he’s going to look for enjoyable things we can do when I come to visit to help with my project to have more pleasure in my life.

solitude

But with Wolf away, I’m once again alone here. It’s less than ideal but nowhere near as difficult as when he was overseas doing his doctorate: I tend not to get especially lonely; we talk on the phone every day and see each other every few weeks; neither of us are dealing with depression and/or anxiety the way we were before; and I still have support from Jaime.

Some time ago, I discovered that I couldn’t answer the questions “what do I like? what do I want?” in relation to sex. I now see that I struggle to answer these questions at all, for anything. I think this is largely because other people’s needs and wants seem much louder to me than my own. (It’s no coincidence that my epiphany occurred only after Wolf had been away for the better part of two years.)

But there is a mental quietness that comes from being by myself virtually all the time, enhanced by the fact that I keep the house literally quiet most of the time too. That literal and figurative quiet allows me to listen for my inner voice.

I’m going to make the most of my quiet time, keep trying to figure out my answers to those questions, and see what I can do to remain tuned in to my gut even when I’m not alone. I currently subject myself to a certain amount of mental chatter via social media, but I’m considering cutting down in order to be more deliberate with my energy; no decisions made yet on this point.

car theft

Our summer was marred by the theft and subsequent destruction of our car. Someone came in the back door of our house in the early evening and stole a handful of keys that were right there, including the car keys. I experienced a bunch of difficult emotions, chiefly anger, but in the end it didn’t hit me as hard as I (and others) expected. It was too much to process at once (similar to grief in that way) and I was concerned that perhaps I was at risk of burying the emotions rather than processing them. But I’m able to think about it now and while it’s still a bit sensitive, I don’t feel the need to avoid it, so I guess I’m OK.

Despite various anxieties I experienced that made it difficult to buy a new car, I did buy one, and I like it. Rather than getting a colour that would blend in, I got red because it’s my favourite colour, and despite the fact that some people judge drivers of red cars. Rather than getting a standard licence plate I got a personalised plate because it makes me happy to see it. It was an exercise in determining what I like and want, and prioritising my own pleasure.

I still have some anger, sadness and frustration about this episode, but I trust that it will ease over time and that giving it some attention today will help that process. We’ve taken some steps already for increased security and I’ll give some thought to some others, all with the goal of keeping my response reasonable and proportionate and not turning into an angry misanthropist in a walled compound.

looking forward

I’ve spent a lot of time over the holidays planning, which is unlike me. But I think I’m ready for planning and strategizing now in a way that I wasn’t before, thanks partly to the meditation I’ve been doing. (One of my common intrusive thoughts while meditating is my to-do list, so it would be helpful if I gave it its own dedicated time.)

This process of listening to my gut and planning has given me a clearer idea of what I want to do with this blog going forward. Having realised and accepted that I still have unresolved issues around sexuality, I want to work on those and I’m going to try harnessing the power of memes to give me a kick in the pants to get that stuff done 🙂

 

F4Thought

at the turning of the year

looking back

I launched this blog at Christmastime 2014, so this isn’t just the turning of the year, it’s also my fourth blogging anniversary!

In January, Wolf successfully defended his doctoral thesis and shall henceforth be known as Dr. Wolf. It represented the end of a long slog, and while his getting accepted into the university in the first place was a very big deal, we had no idea how emotionally difficult it would be on both of us. We are each other’s primary support systems and without that support, we both ended up in depression (though that wasn’t the sole reason for either of us). Completion for him was thus bittersweet as it had come at a much higher cost than expected and it left him wondering whether it would ever feel like it had been worth it.

March saw me take two very different trips back to back without stopping off at home on the way, which made packing a challenge! I was at a business meeting on a Thursday morning, in a succession of airports and airplanes from afternoon to night (my sleep time completely disappearing while I was in the air), arrived at Heathrow on Friday morning, then put in an appearance at the Eroticon 2018 Friday Night Meet and Greet that evening. I was, of course, exhausted.

My time at Eroticon (my second) was excellent, as expected. Although I’m now aware of one sex blogger and one romance/erotica writer who reside in my neck of the woods, it’s such a treat to just be in a room with more sex writers than you can shake a stick (or cane, or flogger) at. And everyone I’ve met has been my kind of people – intelligent, sexy and kind. Just wonderful. But it’s still a big trip for me. Would I have gone just for Eroticon? It’s hard to say, but I didn’t have to make that decision because Jaime and I had planned to meet up there and then travel together for a few weeks.

I made arrangements with the same photographer as in 2017 to do another shoot while I was in London. I must admit, both the shoot and follow-up were a bit disappointing, and I’ve spent the subsequent months forgetting it rather than remembering it.

Just before I returned home in April, I did my first shoot with Molly, which was also my first outdoor shoot. At about 10°, it was chilly to be naked outside, though better than I’d expected – and vastly better than it would have been if I’d been doing the same project at home! (Molly has given me some edited photos but I haven’t posted any yet; I’m experiencing some kind of block that is making it difficult, for reasons I don’t understand. With any luck, I’ll publish them soon.)

Just before I returned home from Europe, I finished weaning myself off of the anti-depressant I’d been on. By early May, my brain suddenly began functioning better; my cognition, focus and motivation improved substantially, which was such a relief! Since then, I’ve been working harder at the day job than I have in a couple of years, leaving me brain-tired and eye-strained at the end of the workday.

In November, I had a solo adventure in Japan; once upon a time I taught English there fairly briefly and went back this year for a visit. It was fun and stressful and tiring and delightful. I had a strong sense of filling my eyes with wonderful things, which I need to remember so I make a point of doing more of that. I’ve already posted a couple of photos (just before my flight out, and just after I arrived on the other side) and you’ll be seeing more from that trip in future.

On Christmas Day I set a boundary with my dad, which provoked a bit of a confrontation, so that was fun. But it means that I’m prioritising my needs over his wants, and that’s good for me. Five bucks says the next time we talk, he’ll pretend it never happened.

Top 100 Sex Bloggers 2018

I’m delighted that Molly (and Michael) included me in her list of the Top 100 Sex Blogs of 2018, which was announced in early December. I’ve fallen in the ranking since last year, which comes as no surprise since blogging regularly continues to be difficult for me, but I’m very pleased to have made the list at all. (Trying to remind myself that it’s OK if I’m less productive, and that I don’t have to blog if I’m not enjoying it.) Warm congratulations to this year’s winner, Rebel’s Notes!

I did find inspiration now and then through the year and there are some posts that I’m proud of, such as:

I’m also very happy to be included in Exposing 40’s round up of 40 [sex bloggers] over 40.

After my first adventure with Jaime in November 2015, I developed irritable bowel syndrome (IBS), which may have been caused by the gastrointestinal issues I had while travelling in a country where you need to be careful about drinking the water. In three years, following basic IBS guidelines has failed to control it and the constant bloating – as well as the resultant dip in body image, slight weight gain, and poorly fitting clothes – have really been getting on my tits, so this month I’ve started on a program to test whether certain categories of fermentable carbohydrates (collectively, FODMAPs) might be to blame, and if so, which one(s).

After the elimination phase, my bloating mostly went away. Around the same time, I was suddenly sleeping less and feeling more alert after struggling with fatigue for a number of years. The increase in energy hasn’t been consistent but this unexpected result provides a new lead for an issue where I’d mostly given up hope of finding a specific cause. There are five categories of FODMAPs and I’m currently challenging the third, so I’m about halfway done this process and I think I’ve identified two triggers. I’ll complete this project sometime in January and then follow up with my doctor.

My libido, which was variable at best and was convincingly sent packing by the anti-depressants in early 2017, is still AWOL. I originally started this blog as a place to record my new sexy adventures, but… I’m not having any. Forgive me Daddy, for I have failed to sin: it’s been almost 9 months since my last partnered sex. I don’t see that changing any time soon. And after giving me 4 orgasms on Christmas morning, my beloved We-Vibe Touch has died *cries*

looking forward

After over a year of looking for work, Dr. Wolf has been hired (last minute) for a lecturer position that starts right away. The catch is that it’s in another city – not too far from here but far enough to be inconvenient, especially given the lack of public transit and the fact that we only have the one car. We drive there tomorrow, I’ll get him settled and stay the night, and then I go back to an empty house. It’s a term position running until the end of June so he’ll be there and I’ll be here for the duration, except for the odd time when he can escape. He’ll be staying in a spartan place so it’s not especially practical for me to go visit him there. After that, we have to wait and see.

I have business trips in January and March, and the latter one (as well as the work to be done before and after) makes it ridiculously impractical for me to go to Eroticon 2019, alas. So my plan is to be dutiful, and then fuck off to Jaime’s house for a couple of weeks in April.

That’s my year in a nutshell. I hope you’re having/have had a great New Year’s Eve, whatever that looks like for you, and best wishes for 2019!

thoughts on fatigue

There’s another post that I’ve been trying to write for, oh, a couple of months now, and it’s not an emotionally difficult topic or anything, so I was struggling to write, struggling to understand why I couldn’t, and frustrated with the (total lack of) result. Blogging was starting to feel like work, and I wondered what the hell my problem was. I think I might have figured it out…

I organize my life around the fatigue that has dogged me for over five years now. I’ve always had fairly low energy, but it now interferes with all aspects of my life. It feels, I think, like how you might feel if you had a had a shit sleep or had to get up hours before your usual wake time, except that I feel like this every day.

I usually sleep for about 9 to 10 hours a night, sometimes even more. If I’m feeling (relatively) alert when I wake up, I can get out of bed within 20 minutes. (I say “relatively” to mean alert according to my personal scale.) If not, I might feel groggy for up to an hour (this is “sleep inertia”) or very occasionally for the rest of the day. I like to catch up on social media for a while because it engages my brain and helps me to wake up.

I eat shortly after I get up: breakfast before 11:00 feels almost “early”. I start my day doing things that I like (reading, looking at coffee table books, drinking a mocha while looking out the window, etc.) and/or things I don’t mind (laundry, folding and putting away clothes). My energy level at this time of day tends to be (relatively) good.

Right around the time I feel like I can face doing some work, my energy and motivation drops. In order to do any work, I need my brain to be functioning well and if it isn’t, there’s not much point in pushing myself because I can’t accomplish much, and I lack the motivation to force myself to do it anyway.

The fact that I work with family members and that I can work from home gives me a tremendous amount of flexibility (including the ability to take a nap if needed), which is great. (If I had a regular job, I’d struggle miserably.) On the other hand, these same family members are also workaholics, and it’s really difficult for me not to compare myself to them and get frustrated with myself and my low output. Also, since my family tends not to talk about difficult things at all, just because I haven’t heard any complaints about my low productivity doesn’t necessarily mean that everything is fine.

Months ago, I used to have one- to two-hour naps almost daily. I always benefit from a nap: I wake up feeling better, and it doesn’t seem to keep me up at night. If I can’t shake the morning groggy feeling, I usually end up having a nap. I’ve been napping less lately though, maybe once or twice a month.

Most days I feel guilty because I didn’t work more. Getting started on work feels difficult at best and excruciating at worst, depending on the day. With the right work and highest energy, checking my email or writing a list can be all I need to get rolling. An average day (if there is such a thing for me) might involve me sitting at the computer doing nothing and allowing myself to get bored enough to start. If my motivation and energy are low and the work to be done requires problem solving, I might not be able to force myself to do anything. Sometimes the amount of work I get done in a day is embarrassingly little. Or none at all. I hate that.

In this culture, busyness is a virtue. If I run into an acquaintance, they almost always say something like, “Keeping busy?” and everyone knows that the correct answer is “yes”. Not being busy is an anomaly, and choosing to relax is a radical act. I used to grit my teeth to give the correct and yet wrong answer, but now I say I make an effort not to fill my schedule. Though I suppose I could in all honesty say that I’m busy, as long as I know that this means I’m doing as much as I can, and not that I’m doing as much as the next person, measured in hours and sweat.

I rarely feel really alert. Maybe that’s why it’s hard to distinguish between “My energy is too low for my willpower to function” and “I don’t really like this job and I suck at making myself do it”. It frequently feels like laziness.

After supper I usually feel pretty good, though I can’t face working in the evening, and besides, that’s when I do my important fun stuff, like my bi-weekly two-hour Skype appointment with Gawan.

Then there’s the exercise issue. During the school year I’ve been teaching two dance classes a week, and over the summer I’ve taught one and been a student in another. It’s important to me to stay active, but I don’t recover quickly and I may still feel wrecked the day after a particularly vigorous class. I also have a daily exercise routine of an hour or so (maybe 1h20 if I do every single exercise) to manage my various aches and pains. My health is top priority.

Although I aim to go to bed around 11:30, I sometimes don’t turn out the light until 12:20. I don’t tend to feel sleepy until fairly late unless it’s a dance class night, in which case blood flow, reflexive analysis of the class, and earworms conspire against me. I take a sleep aid to help me with falling and staying asleep, so those issues don’t currently vex me.

Up until my trip to Europe this past spring, my leisure time was spent mostly on the blog. After I got home (and recovered), my writing and photography slowed down, and then pretty much stopped. I thought the issue was that I just didn’t feel like blogging for a while — I had picked up a couple of old hobbies that I’d dropped some time ago, and it seemed that I was just choosing to spend my time differently — but now I’m not so sure.

Over the last couple of months, I had gotten seriously bummed about the fatigue; it’s deeply frustrating when my body can’t keep up with my mind, but my mind has slowed down too, and I mostly don’t feel like doing anything. Also, because I can’t predict when I’ll have a good day versus a bad day, I avoid making plans in order to avoid the sense of failure and frustration when I don’t have the energy or motivation to do what I intended to do. If I have a good day — that is, a day during which I feel almost normal and I do an ordinary number of ordinary things — there’s a fair chance that I’ll be exhausted the next day. I had started to resign myself to the fact that I may be suffering from chronic fatigue syndrome, a diagnosis that my doctor has been hesitant to make since there’s no test and no treatment and thus potentially no benefit to me to be labelled in this way.

However, since I started looking at the details more analytically in the process of working on this post (which has, unsurprisingly, taken much too long to write), I realised that the nature of the fatigue has changed. It was bad last year but then I did actually see some improvement. I discovered that the timing of when the fatigue started being especially problematic again roughly corresponds to adjustments to the dosage of my anti-depressants.

Part of the difficulty I had in pinpointing the problem up to now is that I experience a lack of motivation as one of my more significant symptoms of depression. Now I suspect the lack of motivation is being caused (at least in part) by the lack of energy. In other words, lack of motivation may be cause by the anti-depressant dosage being too low or too high. This is… not helpful.

So now I’m cautiously optimistic that my recent lack of interest in blogging is due, not to an authentic desire to stop, but rather to a sense that I just didn’t have the energy or brainpower to put into it. And if lack of energy and brainpower can undermine my interest in a hobby that I know I have enjoyed, then it’s possible that my disinterest in work is also primarily an issue of energy and not that I hate my job. I have a doctor’s appointment this coming week and will see about adjusting my meds.

With any luck, I’ll be blogging more regularly again in the not too distant future.

an affair of the heart

That is to say, a matter concerning a literal, beating heart. To wit: my partner’s.

Soon after we got back from the UK, he went to the doctor for a routine checkup. The doctor didn’t like what he heard and sent him to the cardiologist two days later. He had a second cardiologist appointment less than a week after that and was told he’d need open heart surgery. That was five days ago. My head is still spinning a bit.

The underlying condition is a congenital defect in one of the valves, which is now effectively worn out. My partner and I are quite close in age: he’s not “young” but I feel like he’s young for a heart problem. I guess that’s because I’m thinking of heart disease, but this is a defect and thus a different beast. So the fact that he has done the things that help you avoid heart disease — eating well, being reasonably fit, not smoking, not drinking much — doesn’t score him any points in this particular game.

Having had his attention drawn to the symptoms, he began looking back to see if he could remember when they started. There’s the heart murmur that he has been aware of for a long time. About two years ago, he noticed a minor change. He figures the odd pounding-heart feeling has been about 6 months, worsening a bit about 3-4 months ago, and a bit more about a month ago.

Three months ago is when I arrived in the UK, and thus when we resumed fucking — a lot, and hard. It was enough to affect his fitness: he has lost weight as a result. So, perhaps we wore out that valve a little faster than absolutely necessary.

Now of course he’s paying a lot of attention to odd sensations, looking for symptoms and danger signs. He’s been told not to do any heavy lifting or exercise, and just to take it easy.

We had sex the other day, for the first time since getting this little bombshell. I did a lot more of the work than I usually do — oral, and a few positions where I was on top and/or more active, but we were at it for rather a while. His heart rate got up a bit high and felt weird to him. Afterwards I could hear his heart beating from over 12 inches (30 cm) away. That ain’t right.

We had another go today, similar to last time but with him making more of an effort to be less physical. Still, his heart rate was uncomfortably elevated. Even if it’s not so high as to be a problem, a fuck is not worth the resultant worry.

He has an appointment for an angiogram in two weeks to make sure there isn’t anything else going on that they need to know about. Surgery will follow soon after, probably within a few days. And then there’s recovery time.

In the meantime, he’s trying not to worry about having his traitorous heart ambush him before the surgery, or feel guilty about depriving me of the regular fucks that he feels I deserve. (If this had come up two years ago, it would have had absolutely no effect on our sex life.) As for me, I’m trying not to worry about the day of, success rates, and the details of the procedure. (I could never work in health care at any level: I’m much too squeamish. It’s not about blood per se — it’s about damaged flesh and pain, and empathy to the point where I can almost feel it myself. And needles, ugh.)

So I guess playtime is going to look rather different for a while.

You learn about yourself when confronted with difficult situations: “building character” and all that. I’m not angry about this because I don’t consider this to be a breach of a promise of good health, or a punishment for some moral infraction, known or unknown. We’re just in a holding pattern; nothing substantial has happened yet, and I’m pretty good with wait and see. I’m optimistic because, aside from this valve issue, my partner is in good health, which will stand him in good stead.

I’m a bit worried because I know that medical science is not perfect, sometimes the unexpected happens, and there is always some risk with anesthetic and surgery. But I’m not fretful because in the grand scheme of things the risk is small, and worrying (especially ruminating) has no effect on the outcome.

Also, there’s a good thing going on in my life right now, so when my mind wanders I tend to think of that rather than this health thing, which helps to keep me sane.

So. We shall see.