2022: The Year in Review

Posted on by Astrid

Hi everyone. It’s the last day of the year, so in keeping with my tradition, I thought I’d do a review of the past year.

I started 2022 by reviewing the forms for my extra care funding application – my extra care had just been re-approved for two years at the end of 2021 – with the behavior specialist. “Extra care” is what I usually refer to as “one-on-one” here, but I’m told by several staff that it’s not technically one-on-one if it’s not full-time one-on-one. Whether that’s true, I don’t know. I made some suggestions for when the application had to be submitted again in two years’ time. With how much has changed over 2022, I doubt any of it will be relevant anymore.

I also started the year with a healthier food plan and by seeing a dietitian. Over the course of the next nine months, I lost about 4-5kg and, like I had hoped, got to a relatively stress-free food plan. I did, towards late summer, start overexercising a little, but I attribute that to the newness of my Apple Watch.

By April, things started to shift a little, as I officially voiced my wish to explore the possibility of my moving to the main institution or another care agency with an institutional setting. The behavior specialist and I created a housing profile with my needs and wants on it and the behavior specialist gave it to the care consultant.

As it turned out, he only got applications sent out to the main institution and to one other agency, an agency in elder care. The reason was the fact that said agency operates an assisted living facility for blind or visually impaired older adults. With the fact that my long-term care funding is blindness-based, it makes some sense, but the place isn’t suitable at all.

I did get to meet the behavior specialist and two support coordinators for the main institution. As it turned out, they did find a place they considered suitable, ie. my current care home. I moved in early October to what from the care agency’s website looked like my dream home. It quickly turned into a nightmare though.

Thankfully, during the timeframe of late November till late December, some things got settled. I’m still finding I feel very easily frustrated with some things in my home and I’m swinging between letting them go (which is very hard for me) and mentioning them (which may come across as me sweating the small stuff).

For one thing, I lost another 6kg during these three months that I’ve now been here. I know I am still overweight by a few kilograms, so in this sense it’s okay, but it does create some difficulties relating to my disordered eating habits. I’d really like to get in touch with the dietitian again.

In other health-related news, I got some med tweaks in 2022. First, I started pregabalin I think in February. Then, in April, I took my first step lowering my antipsychotic dosage.

I also found out during the summer that my kidney function was mildly decreased. I had it retested about two weeks ago and, though it decreased a tiny bit further, this could be because I have a UTI.

Let me also share about my creative endeavors of the year. I did a ton of polymer clay crafting and really loved it. When I moved to my current care home, I for a while had to let go of this hobby, but now I’m trying to slowly reinvent my creative self.

Lastly, faith-wise, I remain a struggling new believer. I am really hoping and praying that God will lead me further on the right path towards Him in 2023.

Joy in August

Posted on by Astrid

Hi all. It’s the end of the month once again and this means I’m reflecting on my word of the year, which is “JOY”. I am linking up with the Word of the Year linky as well as with Lisa’s One Word linky.

The month of July was hard and it ended on an even more difficult note with a health scare. Did I even tell you all about it? Well, I had bloodwork done at the end of July as part of my annual health screening and, while most results came back normal, my EGFR, an indication of kidney function, did not. It’s supposed to be above 90 in healthy adults, had been 81 last year and my nurse practitioner back then had said that anything above 70 was still acceptable. Well, it was 68 this time around. I checked with my GP and he said this could be a one-off lower score, but I do need to be checked again, including a urine test, in a few months.

This health scare, as well as some other worries about my health, did decrease my joy over the month of August. However, I still tried to find moments of joy in the everyday. Like in July, I did sometimes seek joy in material things, for example when I bought a lot of polymer clay supplies a few weeks ago.

However, I also found joy in experiences, such as my and my husband’s trip to Enkhuizen last week and my trip to the town fair yesterday (even though I didn’t buy anything).

Earlier this week, I of course tried to find joy in another material thing by buying an Apple Watch. It’s pure delight seeing how I reach and even exceed my goals. That being said, I did have another health scare today, when the stupid thing told me my cardio fitness level is low. “Low” is the lowest score your Apple Watch will give you. My husband joked: “except for ‘dead’, but that’s not far off.” Great, huh? Thankfully, I do know I can to a degree increase my cardio fitness level by exercising. It is good to feel some sense of control.

July 2021 Health and Wellness Update

Posted on by Astrid

Today, I’m not feeling too inspired to write. However, I said last month that I wanted to make health and wellness updates a monthly occurrence. Here goes.

Last month, I was worried about my kidney function. My nurse practitioner was since able to reassure me it was within the acceptable range. I since have stopped using the Water Reminder app, as it was being a bit of a nuisance having to fill out my fluid intake each time. However, I still make sure to drink plenty of water.

The fact that my kidney function is acceptable means I have been able to start the topiramate too. Thankfully, like I’ve said, I don’t experience any side effects.

I also found out last month that I don’t have a UTI. The doctor still isn’t sure what is causing my bladder pain. I for a while took the max dose of paracetamol plus naproxen twice daily. Thankfully, I have since been able to get the naproxen back to an as-needed prescription.

As of last Tuesday, my magnesium, which I’ve been taking for constipation for a few months now, has been upped. I myself thought I suffered with diarrhea, but my GP was able to see that it was a result of constipation really. I am really hoping this will work.

To be honest, with respect to lifestyle, I’m not too satisfied with how I’ve been doing over the past month. I am still struggling to make healthier breakfast and lunch choices. This week, I started having crackers for lunch, which I like far better than slices of bread. However, we didn’t have those until Wednesday and yesterday, we already had a special grill lunch.

I did make sure to eat some fruit at lunchtime each day as well as some slices of cucumber. Overall, combined with my relatively healthy choices from the meal delivery service menu, I did meet my five servings of fruit and veg each day.

I got weighed in again yesterday and, sadly, had gained 400 grams compared to last month. I am still within the acceptable to me weight range, but I do need to make sure I really watch my diet more carefully over the next month.

Exercise-wise, I’m not doing as well as I’d like to. I would really like to make it to 10K steps more regularly again. I do know the weather hasn’t been great, but I still have the elliptical and can dance in my room. I would also really like to make weight training a part of my routine again. That might take some more time though, as, well, I want so many things.

Overall, I feel okay about the things I can’t control, like the fact that my kidney function is within the acceptable range after all. However, I could really do better on things I can control, such as eating a healthier diet and exercising more.

Nurse Practitioner’s Appt This Afternoon

Posted on by Astrid

I had a brief meeting with my nurse practitioner this afternoon. Even though it was only half an hour, we discussed a lot of things. First we made concrete plans for me to start the topiramate. Like I said before, I would need to be on the injectible birth control for two weeks before I could start it. That would be next Thursday, but I proposed I won’t start with the topiramate until the Sunday after that, July 4. That way, I won’t be just starting out when I go to Lobith on July 3. This was okay with my nurse practitioner and he’d make sure the pharmacy would get it ready on time.

Next, we discussed my bloodwork results. In the part that measures metabolic health, nothing worrisome was found. I asked about my kidney function and first my nurse practitioner said that unless your estimated GFR is below 60, it’s no reason to worry yet. Mine was 81. He checked my previous lab results. My estimated GFR was 71 in 2019 and 82 in 2020, so there’s not a clear decrease either.

He also complimented me on my cholesterol level, which was completely normal. Of course, there is only so much you can do about high cholesterol, but apparently I’m doing what I need to. It probably helps that I don’t drink and try to eat a relatively healthy diet.

Then the other page showed my blood level for my antipsychotic aripiprazole and its active metabolite. These were quite high. This means that side effects may outweigh the effectivness of the medication. While I don’t experience any major side effects, we will try to lower my aripiprazole dose in the not-too-distant future. That’s been a long-time wish for me anyway.

Then we got to discuss my crisis last week and my conversations with my husband. My husband had suggested I might have dependent personality disorder and I eventually thought he was right. Of course, in my mind, this led to all kinds of additional conclusions that my husband hadn’t mentioned, like my not having trauma-related issues and my not even being autistic and my being one giant manipulator.

My nurse practitioner said that DPD rarely if ever goes alone and that he wonders whether it even is a valid diagnosis. It is according to DSM-5, of course. He added that this is one of the most negative diagnoses to give someone. My nurse practitioner obviously didn’t mean my husband, as he didn’t really try to diagnose me at all, just wanted to give me food for thought. We will further discuss my issues with dependency in the future.

Overall, it was a good appt. As my nurse practitioner hadn’t read the E-mails we (meaning my inner people) had sent him over the weekend, we didn’t go into those specifically. Those E-mails had included a lot of self-loathing and self-doubt, including about our possible DID. I did explain about the dependency issue, like I said above. He also made sure I’m no longer in actual crisis. I confirmed this. This means I no longer need more frequent contact with the mental health team than I normally have.

June 2021 Health and Wellness Update

Posted on by Astrid

I am feeling kind of worried about my health lately. To get myself a more realistic picture of how I’m doing, I thought I’d do a health and wellness check-in. I am hoping I can make this a monthly habit.

Firstly, the reason I am worried is one abnormal result on the annual bloodwork I had done last week. I get an annual blood test for fasting glucose, cholesterol and other indicators of metabolic syndrome. This is because I take psychiatric medications that can influence this. Last year, my mental health agency ordered it, but this year, my care facility’s physician did. This means I could see my results in the patient portal for my GP surgery that same evening.

The good news is my fasting glucose, cholesterol and triglycerides were all within the normal range. The one thing that wasn’t, is an estimate of kidney function. It should be above 90 and was 81. Because it is an estimate, one abnormal blood test doesn’t say anything. I may need to be retested in a few months.

I looked up what to do about decreased kidney function, hoping to find that if I drank plenty of water, I could get it back to normal. I’m still not sure that’s the case. I mean, I try to drink at least two liters of fluid each day, but can’t figure out whether that should be enough. Other than that, I do try to watch my salt intake more closely. That’s pretty hard, of course – harder than drinking more water.

I do worry that I might not be able to tolerate the topiramate though, because if I remember correctly, that medication is eliminated through the kidneys. I’m not sure though and will leave this to the doctors to decide.

Like I said though, all my other results were within the normal range. My fasting blood glucose was 4.3. It should be between 4 and 6 and was 4.2 the last time, but I’m not drawing conclusions about it increasing as of yet.

Today, I did send off a urine sample for checking for a UTI, because I’ve been having lower abdominal pain. It came back alright. My staff will likely call for an appointment for me to see the doctor, as the pain is still pretty intense.

As for some good news though, I stepped onto the scale this morning and am back at my average weight for the past six months or so. My weight usually goes up or down a few pounds. I’m now 72.1kg, which means 2kg to lose for a BMI under 30. I am unlikely to reach that goal, but it’s okay.

As my husband reminded me when I told him about the abnormal blood result, small steps go a long way. I am already trying to cut back on my snacking on the weekend. I also make sure to eat enough veg and fruit. I mean, the meal delivery company isn’t great on putting veg in its pasta and rice dishes, which I eat most days. However, I make sure to eat some cucumber, tomatoes or raw bell pepper with each lunch. For the upcoming month, I’ve also selected some potato dishes from the meal menu, since they usually are richer in veg.

My husband also pointed out that I get enough physical activity. I could go on the elliptical more often, but my walking is pretty good already.

I did feel a little depressed when my husband told me that it’s obvious that I’m not as healthy as the average woman in her thirties. Then again, he reminded me that I turned the tide on my weight gain in 2018 and am healthier in some ways than I was before. Besides, a century ago I wouldn’t have lived past infancy. That put things into perspective.