Summer ’19

The temperature today will hit a mere seventy degrees*, which I am going to celebrate by walking everywhere. This summer has felt endless, and it feels like a relief to be finally entering FALL.

*= 21.111Ā°C for Celsius friends

 

 

Limbo

It’s been an odd summer. We attended five weddings, of which four required significant travel. We settled into a new apartment, only to make plans to move again shortly. We both left and started new jobs. I planted flowers for the first time and they’ve since shriveled up in the heat. I suppose if I had to put a word to it, I would describe summer as a time of limbo. Endings and beginnings. In-betweens.

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Also, Paris Baguette opened up two new locations in Philadelphia šŸ˜›

Body weirdness

Summer has been slower. It took a while for me not to feel as anxious or panicky about having more free time. Sadly, it feels like I haven’t been able to make the most of this short-lived restfulness, partly due to the fact that I’ve spent a lot of time (and money!) dealing with a string of random health issues — the most vexing and recent of which has been a cracked tooth. No kidding, I have been to four dentists/endodontists this summer. Other fun issues have included a UTI, testing positive for tuberculosis (it was a false positive), knee problems, debilitating jaw pain, etc.

I find it interesting that all these ailments started popping up once I started to sleep more and rest more in general. My inner hypochondriac was freaking out a little all summer. As someone who came of age at the same time as search engines, I have fond memories of googling diseases and feeling utterly convinced that I had all of them.

Seriously, though, bodies are a mystery. On the one hand, they are so prone to disease and decay (and bug bites). But on the other hand, they have such an incredible capacity for healing and renewal.

Sleep quality

I’m truly grateful for what feels like a level-up in my quality of sleep. For the first time in ten years, I am sleeping ‘normally’ — for me, that’s about eight hours of uninterrupted shut-eye. I struggled with insomnia and waking up early (3-4am) for a long time, and to be honest, I can’t pinpoint what exactly has shifted. I suspect that not being in front of a screen for 12-15 hours a day has something to do with it. Having much less day-to-day anxiety is great and not being hungry all the time helps. But I think the final piece of the puzzle for me has been having a consistent bedtime routine. We learn that routine is critical for kids to thrive, but I wonder if adults are that much different.

I don’t know right now and that’s OK

Existential questions stop when you graduate college and/or get married, right? WRONG.

There are so many aspects of life that feel like shifting sand. Questions surrounding vocation, where to live, family, faith, friends, money, identity, etc. abound and can feel exhausting and overwhelming. When those feeling arise, I’m getting in the habit of saying to myself (sometimes out loud), I Don’t Know Right Now And That’s OK. Sounds a bit crazy, but somehow in our Cartesian minds we have an expectation that we ought to have it all figured out by now.

On a lighter note

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At the beginning of the summer, I started swapping out some of our cleaning and personal hygiene products for more “environmentally friendly”, “less toxic” ones (in quotes because it’s hard to believe or trust these claim sometimes). My parents gifted me with a Target gift card for my birthday in May, so I decided to splurgeĀ invest in new shampoo, conditioner, facewash, deodorant, and detergent (laundry + dish). I have mostly enjoyed the new products, though I’ve run into a few issues here and there. The most interesting outcome is that my menstrual cramps have progressively become more and more manageable over the summer — from debilitating to a slight annoyance. If that sounds odd, one of the main reasons people switch from their regular beauty/personal products is that they contain chemicals that mimic our hormones (even the ‘good’ brands like Dove!). Research is still not conclusive, but the according to the theory, being exposed to these chemicals disrupts our hormonal balance. Some people argue that the vast majority of our exposure to environmental toxins is well beyond our control (e.g. toxins in the air), so using a different shampoo isn’t going to move the needle…but again, this is my highly unscientific personal experience & experiment.

Happy Fall!

Right, that was a monster of a post. Happy fall & go enjoy a pumpkin spice latte if that’s your thing!

The ‘p’ word: Why period health matters

Today I’m writing about something that’s a little bit awkward…but I think that’s exactly why we need to talk more about it. Many of us ladies (and perhaps men) have a bunch of negative beliefs about menstrual periods — that they’re gross, dirty, annoying, shameful, unnecessary, inconvenient, etc. — and that 6th grade puberty class probably didn’t help šŸ™‚ I want to share a little bit of my journey here, and hopefully inspire some curiosity about your (or your partner’s) menstrual and hormonal health, because itĀ matters.

Getting my first period

The first thing I remember about my menstrual journey is that I was incredibly anxious to get my first period. I was an active fourteen-year-old gymnast and was dreadfully conscious of the fact that every girl around me had started their period, except for me (or so it seemed). I read every Judy Blume book I could get my hands on and worried constantly that there was something wrong with me. I thought that maybe I had a rare, undiscovered disease where I bled out of my nose instead of my vagina, since I had a lot of nosebleeds back then (I wish I were making this up, but I’m not). Finally, while struggling over an assignment on war poetry, I started bleeding for the very first time. The relief!!! I was fourteen, which is a little later than average, but not anything to be worried about.

Unpredictable, painful, inconvenient

Of course, once I started my period, I wished I had never gotten it. I worried about whether I was going to bleed during gymnastics competitions. They weren’t regular at all, which made them hard to plan for. And they wereĀ so painful. I remember being in agonizing pain before a French final exam one time. My sweet friends bought me some french fries from McDonalds and prayed for me. I think it’s important to note that at this point, irregularities in the menstrual cycle are totally normal, and everybody’s process is going to be a little different — your body is cranking out a lot of hormones, and it takes a while (several years, actually) to get into a predictable rhythm.

Hypothalamic amenorrhea – losing my period over and over again

In my late teens, I started to under-fuel and over-exercise my body in response to some stressors in my life. I had no idea that I was developing an eating disorder and remained in denial about this for several years, but my body immediately sensed what was going on. I stopped getting my period almost instantly. I think ‘hypothalamic amenorrhea‘ (HA) is kind of an obnoxious term, but essentially it means your brain tells your body, “Stop! We don’t have the resources to sustain a pregnancy, so shut off the periods for now.”

My period came back in fits and starts throughout college and into my early twenties, but whenever I resumed the disordered eating and exercise behaviors, my period would stop like clockwork. I did get worried about this — not necessarily because I wanted to get pregnant right away, but because I am a worry-wart, and possibly because I knew instinctively that something else was going on with my health. However, whenever I raised my concerns with doctors and OBGYNs, they told me that it was no big deal. IĀ wish someone had asked me a follow-up question about my eating habits or my lifestyle. IĀ wish someone had told me that not getting your period was dangerous for your bone health, because making progesterone during your cycle is how your body retains its bone density. Instead, they told me that once I was ready to get pregnant, we could talk about some pharmaceutical interventions.

Charting, the pill

I remained dissatisfied with their answers, but also felt a little crazy and overdramatic for making such a big deal out of what didn’t seem too worrisome in the eyes of medical professionals. At this point in time, I was also starting to get interested in a form of birth control known as theĀ Symptothermal MethodĀ (STM). At this point, I actually had been prescribed hormonal birth control (the pill) by my OB/GYN — the box of pills had been sitting in a corner of my bedroom for a long time — but for some reason or another couldn’t bring myself to take them. I read the classic resource, Taking Charge of Your Fertility by Toni Weschler, and had started to give charting a go on my own.

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Wait…what’s charting? Charting simply means tracking your temperature and other fertility signs such as cervical mucus and position on a chart; here’s a recent incomplete example of one of mine. By tracking these patterns, you get a sense of when you ovulated: after you ovulate, your body’s temperatures shift higher. In this cycle, my temperature shift occurred between day 17 and 18, so I likely ovulated on day 17. Side note: it’s aĀ myth that every woman ovulates on day 14! It’s simply not true. It’s like saying, every woman is 5’5″ šŸ¤¦.

Anyway, I remember feeling kind of lonely and crazy at the time, because no one I knew was doing this stuff. It seemed a little neurotic. And besides, my charting efforts at the time felt fruitless because my periods were coming once every three months or so, and my temperatures had no clearly-defined pattern. My chart was literally all over the place. However, charting is what first tipped me off to the fact that my body clearly wasn’t functioning at its optimal level — in fact, it wasn’t even close. Other than the fact that my cycle lengths were irregular as an adult, there were two other characteristics of my menstrual health that helped me to grasp that something about my lifestyle – particularly my nutrition – needed to change.

Luteal phase length & anovulatory cycles

I don’t want to get overly technical here, because there is such a wealth of science information and research behind all this stuff, but I do want to share some specifics of what I learned in my charting journey. So first off, a couple of definitions:

Luteal phase: This is the phase within your cycle that starts from ovulation and ends when your next period comes. Counting the start of your period as day 1, this meansĀ on averageĀ that the luteal phase is between day 15 and day 28, lasting a total of 14 days. Having a luteal phase <10 days is known as luteal phase defect, and can indicate low progesterone and predict infertility and miscarriages.

Anovulatory cycle: This is when you have a cycle in which an egg is not released. It is perfectly normal to have this once in a while, if you’ve just started getting periods (menarche), or if you’re approaching menopause, but can be a cause for concern if you’re not ovulating at least most of the time otherwise.

In summary, charting – even through my wacky cycles – helped me to realize that (1) I had a very short luteal phase, lasting 6-9 days and (2) I often had cycles where I didn’t ovulate at all.

Recovery, progress, and the amazing human body!

Whew. This is a long post. But we’re finally getting to the turning point in the story.

Having the tools and the resources to observe and learn about my menstrual health was critical in helping me realize that my poor eating and self-care habits were sabotaging my overall health and making me miserable. I was cold all the time, grumpy, always in pain… and no wonder, since my hormones were out of whack. Learning about how my choices were affecting my fertility also made me realize that I was impairing my dream of carrying a pregnancy to term some day. I got some much-needed help from a team of professionals – a registered dietitian, a specialized doctor, and a specialized therapist. Learning to fuel myself properly and stop compulsive exercise was excruciatingly difficult after so many years, but that’s a whole other story for another time šŸ™‚

Two months or so into treatment for my ED, my period returned. Just as charting my wacky periods helped me to know that something was going wrong,Ā observing my menstrual health restore itself over the next several months and become regular again has been one of the most amazing signs of recovery and progress. I am in awe of the human body (and in particular, of the female reproductive system!) and sad that this is still such a taboo subject in our culture and in many other parts of the world. My luteal phase lasts for 14 days like clockwork, and I can clearly identify ovulation. A little geeky, but honestly, it’s so cool when you learn how to figure this out for your own body.

All the things I didn’t get to talk about

I’m going to stop here… but I want to acknowledge that there are ton of important topics that I didn’t even begin to address, since this is just my own personal story. Some of these topics are:

  • Charting with PCOS;
  • Charting when coming off hormonal birth control;
  • Endometriosis;
  • Using charting as a tool to either avoidĀ or achieve pregnancy;
  • Involving your partner in this process;
  • The importance of progesterone and your period even when you’re not trying to get pregnant;
  • Specifics on how to track fertility signs (body basal temp, cervical mucus & position, etc)

I’m hoping that if you’re interested, you’ll check out the following resources that have been incredibly helpful for me:

Taking Charge of Your Fertility by Toni Weschler (book)

Kindara (free app I use for charting; their website has a lot of great info too!)

The Real Life RD (blog that talks extensively about hypothalamic amenorrhea)

Fertility Friday (podcast)

And as always, if you want to talk, please reach out!

 

National Eating Disorders Awareness Week

Today marks the last day of National Eating Disorders Awareness week. This is close to my heart — I’ve walked through recovery with a team of professionals, and am acutely aware of how much chaos and disruption an eating disorder can bring. A general lack of education among both sufferers and their communities makes the recovery journey even harder. Here are some myths about eating disorders that I encourage you to challenge:

MYTH 1. Eating disorders only affect a certain type of person – typically white, female, young, thin, upper-middle class. Media representations have perpetuated this stereotype and even glamorized the illness. Eating disorders affect people from all sorts of backgrounds and with all kinds of body shapes. Never feel like you cannot seek help because you aren’t thin enough, or don’t fit into a certain profile. Check out this article.

MYTH 2. Eating disorders are a choice, or a type of attention-seeking behavior. Research shows that eating disorders arise when someone genetically predisposed to certain physiological behaviors experiences a situational trigger. This has to do with a different set-up of the brain’s reward system in conjunction with certain personality traits such as perfectionism. Don’t take my word for it — look at the research.

MYTH 3. Eating disorders are just diets and are not that serious. Extreme dieting is an ED behavior, but they are NOT the same thing. An eating disorder is a psychological illness. Often, the sufferer has lost the capacity to stop restrictive or compensatory behaviors well beyond the point of reason or health. They can’t “break the circuit”, even though they very often want to. This is because their brain is rewarding them for behaviors that are harmful and compulsive. As a side note, diets are terrible too…but they’re not necessarily EDs. More informationĀ here.

MYTH 4. Eating disorder sufferers can never fully recover. Untrue! The brain is amazing and has the capacity to re-wire itself. However, this almost always requires professional help from dietitians, therapists, and medical professionals. A big component of an eating disorder is deception, both of others and of self — it’s hard to be objective when you have gotten so good at denying what is happening in your body/mind. Read more in this article.

Finally, I want to link to some resources that I find very helpful: here, here, here, here. Nothing beats having a treatment team and getting the proper care that you need, but hopefully these resources can be a good stepping stone to full recovery.