Mars is a health and wellness blogger at www.krackedkaleidoscope.com. She is a registered nurse, a mother of 6, and a lover of peanut butter and chocolate.
I am sitting in the waiting room at the oral surgeon right now and I feel lucky. Lucky that they will be removing the heinous tumor between my front teeth that now feels like a tiny parasitic twin that’s sucking the life out of me and making it so I have to cut strawberries* with a knife and fork to eat them. I feel grateful because I actually showed up late–like 30 minutes so–when I spaced the true appointment time (and thought I was showing up early). They could’ve sent me packing to wait yet another month in this 7 month saga, but they didn’t and I’m hoping for a hole in the schedule so I can get this done.
The troubling thing is this: it is the THIRD time in the last few months that I have spaced something important. Although I am the kind of person who walks in late to meetings and parties, I am usually fully aware of my tardiness. But this is different. I keep surprising myself with these irresponsible moments of remembering wrong. The first infraction was accidentally skipping out on a day-long mandatory class for work. The second was showing up very late for my nephew’s birthday party, so late that we only made it in time to eat cake before the venue kicked the kids out of the party room and my children cried because they didn’t get to enjoy the bouncy houses with their cousins.
This is not like me. Besides my usual “island time” tardiness I am actually a dependable person, showing up basically when I say I will. I do this despite juggling the schedules of a full time manager, a mother of 6, and an individual who tries to make time for people who matter. Frankly I am worried about my behavior and the impact this spaciness might have on my life. What if I forget something even more important, like leaving my baby in the car or do something dangerous to a patient at work? Fear is making my heart rate go up as I type in this plastic chair, sitting amongst calm people who made it on time today.
I often lose sight of what I really want. It is easy to get caught up in things that don’t really matter, distractions and avoidances that help dilute the sting of failure when trying to reach a goal. Sometimes those coping mechanisms are in direct opposition to my true desires.
I can get depressed or bored thinking about my health problems and it makes me want a Monte Cristo sandwich or something fried dipped in ranch dressing. It is no secret that I have overeating tendencies and I also have what I like to refer to as “blood sugar issues”. Hyperglycemia can lead to so many poor outcomes. I am fully aware of how losing one’s eyesight, kidneys, or legs can be devastating to quality of life. I have personally wrapped the stumps of newly amputated legs of diabetic patients. And then watched the patients call their families and friends to sneak them thick stacks of tortillas or a 2 liter of cola. Even when loss is fresh, and literally painful, old habits die hard.
I have considered tattooing the likeness of my kidney or heart on my arm as a reminder that what I eat might take those things from me someday. It is damn hard to keep motivation going, to keep goals and realities at the forefront of my thoughts, intentions, and actions. Ultimately it is my desire to live a long and healthy life. To spend as much time as possible with people I love doing things I enjoy. In order to do those things I need my organs and my ability to walk, to see. So why can’t I be honest with myself when I binge eat a cake, that I am sorta killing myself in shortened life or functionality? The ideal would be to preserve my health, not squander it foolishly.
There is a tumor in my mouth. It has been there since the end of November, and I have yet to have it biopsied or removed. There are many factors involved, including:
Delay in referral TWICE from my dentist’s office
A referral to a provider that’s not accepting my dental AND medical insurance
A seemingly lengthy medical review process
Limited number of providers who can assist with my problem, creating a scheduling delay
In the meantime my tumor has progressed and what seemed like a simple situation has turned into one where I have tooth bone loss and an uncertain prognosis. Already I have seen multiple providers and not all of them seem to know what they are talking about.
I happen to work in the healthcare field and know a thing or two about what it takes to get access and follow through with both preventative care and treatment for illness. I understand the system, have good insurance, and know how to advocate for myself, but yet I feel the pain of trying to use the healthcare system. There are reasons some people fall through the cracks or don’t do what their providers ask of them. In healthcare we call these patients “non-compliant”, as in, “Jeff is non-compliant—he hasn’t seen the specialist we referred him to for his abnormal labs.” Or, “Susie hasn’t been taking her asthma inhalers as prescribed and has been non-compliant with the treatment plan.” Yes, there is judgement involved.
As a nurse it is hard to always objectively see the obstacles to a perfect treatment trajectory. Once we recommend something to a patient we like to sit and wait for them to do their part, to see the next specialist, take the next medicine, get the next test done. We like to think we can only lead the horse to water, and can only reasonably convince so many horses under our care at once to drink with the resources we have.
But when I am on the other side of the exam table I get it—I really do know from experience—as a mother and a patient what those obstacles to healthcare are. In order to improve health we have to have access to people and tools to help us, follow through on testing and interventions, and maintain new habits and routines. The stars must align in the following ways:
Access
Provider Availability
Proper providers accepting new patients
Specialist referrals happen when needed
Affordability
Able to pay insurance premiums, deductibles, copays, coinsurance
Straightforward billing and payment options
Convenience
Location
Reasonable waiting periods for appointments
Appointment time slots available (minimizing lost time at work or school)
Follow Through
Open communication between provider and patient
Thorough education provided on what is happening and what to do next
Continuity in providers
Trust and rapport in the care relationship
Motivation of the individual—seeing value in therapies
Maintenance
Incorporating new habits and routines
Long term monitoring for chronic or high-risk problems
Appointment reminders
Care coordination between providers, specialists, and therapists
When things go right there is a balance of “providing” (done by practitioners) and personal responsibility (of the patient and their caregivers). There is a dance of expectations by both parties, and many times those expectations are not met. Sometimes it is the nature of the system that creates trouble, especially when it comes to access, but there are ways to help ensure you are getting what you need.
See the best providers available
Get recommendations from friends or screen online reviews. Don’t be afraid to ask for special permission if you are told that a provider isn’t taking new patients. They may make an exception if you are related to or know a current patient. Find a different provider if you aren’t meshing well with the current one. If you have a rare or hard-to-manage issue try to find someone who has experience with it. Use your insurance company as a starting point to find providers in your area who fit your needs.
Understand the workings of your health insurance
What is covered and at what rate? Who do you call if you have questions? Insurance companies can actually be very helpful in preventing costly mistakes—mine once helped me clear a $1400 charge that a hospital was wrongly trying to collect from me. Sometimes insurance companies make mistakes too, and if you know your coverage specifics you can argue or appeal items not paid.
Contact billing if you are having trouble paying
Payment plans can keep you out of collections. Providers can end their relationship with you for non-payment, and if you aren’t hiding from your bills you will be more likely to follow through with appointments and tests. Don’t forget to ask for itemized bills to ensure accuracy.
Maintain the care conversation
Call and call again if you have to. Ask for what you want and be open to negotiating. Let someone know if you don’t understand or need more information. Be honest with your providers and expect the same from them.
Keep your promises
To yourself and to others. Do your best to attend recommended appointments and tests. Take responsibility for your health and the things you can directly control.
Don’t give up even if it seems near impossible to have health care without obstacles and glitches. I anxiously await my appointment with the oral surgeon for my tumor. And I’m sure this won’t be the last point in a chain of custody for my health that will bounce back and forth between the sides of the medical court, me on one side and “the system” on the other. (But wait…I’m part of the system. Does this mean I am playing against myself? Too deep for me today.)
We just had a storm roll through, which prompted my neighbor, Shirtless Guy, to ring my doorbell. He wanted to return a bungee cord that flew off my travel trailer from the wind and into his back yard. Shirtless Guy usually likes to wear his chenille bathrobe outside year round, smoking cigarettes in front of his garage while gazing at his old black pick-up truck. He is not the kind of guy to be judgmental, not the person you wouldn’t want seeing the inside of your messy house on any given afternoon. But because I am a failed perfectionist I cared that he caught a glimpse inside. There was utter chaos in my living room, and I wanted to say “It doesn’t always look like this!” which is true. The more accurate statement is to say that it doesn’t always look like this, but it usually does.
I delude myself when I pretend that order and cleanliness are the norms from which my family occasionally strays. It’s not that we don’t clean—in fact we spend way too much time “cleaning” (me nagging my kids while they go Krav Maga on each other on the carpet and are asked to get back on task over a dozen times). The house gets sort-of presentable at least once a week for Sunday dinner and we pick up every day, but it is only an interval of seconds to minutes before there are sweatshirts in the hallway and crumbs under the chairs. The Hubs’ favorite thing to do is to eat out for the rest of the day after the kitchen gets detailed just so we can look at it again before it’s destroyed.
It’s All TheirMy My Parents’ Fault
I want to blame someone for the lack of order in my house. My instinct is to lash out at my kids, but then I realize that I suck almost as bad at cleaning and don’t set the best example. I am just as easily distracted as they are. If I find an interesting book while picking up a room I might stop to read it. If I’m supposed to put away laundry it might end up poured at the end of my bed for a couple of nights while I sleep above in the fetal position.
The truth is that I loathe household chores for the most part. My idea of a good day does not include any scrubbing, folding, vacuuming, and especially not dusting. I like to fancy myself as more of a “manager” than a “hands-on worker”, and my house is no exception. That hate of chores comes across to my kids, who also have also realized that cleaning is a waste of time and should be delegated to these new house robots I keep hearing about.
So who are the kids supposed to learn from? I certainly didn’t learn good habits from my parents. My dad’s idea of cleaning is to put items into boxes and pile them in front of every mode of egress in the house. Or taking a spare room and throwing everything in it and shutting the door—like the room version of a junk drawer.
I once told a very stressed out friend that I could no longer hang out with her if she didn’t like eating anymore. I was joking to cheer her up (sort of) but hoped that she would feel better quickly and join me at the fro-yo buffet. Usually I feel uncomfortable around people who don’t enjoy food–there is something so human and social about meal sharing that can’t be separated from who I am, and this leads to problems for me when it comes to mindful eating. How we relate to food affects how we relate to people and vice versa since it is so omnipresent in our lives. It is usually easier to overindulge when I am not eating alone. Making the right choices for myself as an individual gets fuzzy when made in the context of a group, a relationship, or at a social event.
Food gifting
At the hospital where I work we are constantly receiving food in the form of gifts from bosses, coworkers, vendors, and even families of the patients we serve. At home I tend to receive presents in the form of treats on holidays, as well as the random donation from a well-meaning family member who wants to share their bounty. I never want to appear rude, and usually the food is well received and tasty. There is however a sense of obligation to finish it off, and an increased aversion to wastefulness when the food isn’t just food, but also represents a relationship in my life.
Special Events
Similar to food gifts, parties and holidays bring chances to bond over gorgeous cheese platters and alluring colorful confections. I look forward to times of celebration with loved ones—and the uninhibited behavior that comes along with them. It is so easy to graze, sip, and sample my way into a bloated coma and find myself waking from a party nap feeling greasy. I let peer pressure sway me:
“Just try one…these are the best. I made them myself!”
“Have you eaten? Yes? Well at least have a small plate or take some to go.”
“It’s my birthday and I want everyone to have a lamb shank.”
When hosting I try to provide the most delicious things I can think of to serve my guests, and sometimes this is a cake covered in toffee (a baby shower MUST!) or mushrooms stuffed with cream cheese.
Let’s Do Lunch
Going to lunch is like my favorite thing, and I’m usually the one to suggest it. This is an excuse to eat whatever I want while catching up with friends. I don’t have a personal Facebook account for multiple reasons, and having to meet over pork so my friends can remember what I look like is one of them. It’s like a conspiratory meeting where calories don’t count but hugs do, and everyone is in collusion.
Happy fat
This is the idea that when life is going well for you indulgent behavior sets in, such as when you find love and settle into the domestic bliss of eating nachos in bed next to the best thing that ever happened to you. The Hubs and I are sooo bad for each other in this way, and have been for most of the last 25 years. If he gets himself a pudding cup (or a street taco, or a foot long sub) I get one too. I ask him every night what he wants to eat for dinner rather than just making what I know I should eat. We love canoodling over noodles. What can I say? He completes me. And he was there giving me googly eyes (is it supposed to be goo-goo eyes?) while I completed the extra 40lbs I have gained since we met.
I only have googly eyes for you. And for street tacos.
The truth is that he will love me even if I eat iceberg lettuce and rye crisps for the rest of my life, and I him. My friends wouldn’t be friends if our relationship was based on waffles alone. Family gatherings CAN be done with slightly less butter involved.
There is nothing inherently wrong with sharing delicious food with great company. It is one of the cornerstones of human social interaction. The role we play when giving, receiving, or sharing food likely has something to do with what our ancestors were doing when they gathered berries together or shared a big hunting kill. Modern American life has become so much less communal, which leads to some confusion over the way social pleasure factors into what and when we eat. There are probably more hierarchical nuances going on than most of us want to think about when splitting the happy hour check. Maybe instead of getting together for the sake of eating it is the other way around—we are making the excuse to be together under the guise of special food. Am I secretly afraid no one will love me if I don’t pay them off with snacks? Will no one hang out unless tater tots are around?
No matter how much I love food, I love the people in my life even more. Sometimes we will gather together over rich food, and sometimes it can be done with more sensible fare, or during a long walk instead. If they’re cool they’ll understand they won’t always be offered dessert.
This past weekend I celebrated my birthday and I ate like a fool. It wasn’t just one meal out with loved ones. It was a parade of indulgence, including 4 restaurant meals, 3 chocolate desserts, 2 different kinds of creamed spinach and a host of forgettable things in between. Some of it was good, like the lobster dinner, the flank steak pho, and homemade black forest cake with whipped cream–totally worth the calories in my opinion. But not everything was worth the intended hedonism, including plain dinner rolls slathered in butter and this mayonnaise-y coleslaw thingy.
Intermittently this year I have been journaling which foods have seemed “worth it” vs “not worth it”, including reasons why and sometimes feelings about choices I made. The intent is to create awareness about the emotional aspect of food and cut down on eating things that add little pleasure value but take up prime space in my belly. Some of the foods I have enjoyed the most aren’t traditional indulgences, but feel like a treat for their flavor, experience, or the company with which they are savored.
One of the reasons I have trouble with overeating is there was a time where I did not have enough to eat, and there wasn’t much of a choice of what to put in my face. It was more like I had to beg, scavenge, or sometimes even steal what I could. And that feeling has not left me although it has been almost 20 years since I have really been hungry like that. I always think of food as scarce no matter how abundant my life has become or how well stocked the pizza section at the buffet is. Thankfully, I have hit the point in my life where I can buy food every day if I want to and don’t have to worry about going hungry. I know this, but I want to feel it and live with the reality that I can be choosy.
The hardest decisions are when there are too many choices or too few. I get so delusional when I am hungry that everything looks good. When confronted with an array of foods, like at Costco with the aisles of samples, I usually feel compelled to try them all. If someone has brought shitty donuts or cookies to work I will sometimes eat one (or more) just because they are easy and right there, they are free, and they were a gift of sorts. When I am stuck somewhere or am super busy I might cave and eat what’s available rather than holding out for something decent. I really don’t need to eat another piece of disgusting neon-colored grocery store bakery birthday cake at the next kiddie party–I have already had that adventure.
This is the lone, stale, broken cookie from the break room table that I almost ate but didn’t in a moment of clarity–definitely Not Worth It.
I stay away from “diets” per se, but I’ve been working on changing my eating habits for the better. My hope is that journaling the Worth its and Not Worth its will be helpful for me to mindfully eat the things that sustain my body and that I like. Eating should be joyful. Feelings of shame, guilt, or loss of control should have no place at my table. Just because eating should feel good doesn’t mean that I should let my feelings alone tell me what to eat. I need to let some logic into my choices so that impulse and conditioning do not dictate everything I consume. A balanced diet is not only about what types of food you eat, but negotiating pleasure with healthy sustenance too.
I started drinking this smoothie because I wanted something quick with some protein and no added sugar for breakfast. It works really well with my Ninja using the 16 oz single serving blender jar. Some people will think this is not sweet enough, so I say put in a whole banana if you don’t care how much sugar you are drinking. Bananas are rad as a natural sweetener, but they have so much natural sugar that I only use 1/2 of a medium banana or 1/3 of a large banana in my smoothies. It is a great way to use up all the frozen bananas I store when we don’t eat up every one in the bunch. I also store leftover greens in the freezer and use those in this recipe too, only the volume will be a little off since the leaves compact when frozen.
Print Recipe
Green Peanut Butter Banana Smoothie
Simple green smoothie with a mellow, not-too-sweet taste. Packet with peanut protein but without the full calories of peanut butter. Perfect for breakfast, a snack, or post-work out.
Add ingredients in order to blender (this allows items to fit if using a single-serve blender jar). Blend or pulse until no pieces of green leaves can be seen.
This week I have started running again after an 8 month hiatus. Before that hiatus I had been struggling to get my mojo back while recovering from a herniated disc that left me with a dragging leg. I was slowly adjusting to bearing more and more of my (unfortunately increased) body weight using an antigravity treadmill and twice a week physical therapy. After I had finally started pounding pavement I was blessed with pregnancy and my best laid plans sunk like a massive stone. I went from running a 10k every week to rolling around on a chaise lounge like a narwhal. A narwhal that likes to eat peanut butter with a spoon out of the jar.
Now I am at it again adjusting to running, and I feel the pain of an untrained body, the burn of lactic acid in my quads. Today I didn’t really want to go on a run since I was up half the night with Baby Boy and my running pants feel like sausage casings. But my sister (and usual running partner) wanted to go. She is running a year-long virtual race and I didn’t want to let her down, so I went despite all of the excuses I wanted to come up with. I was slow and I had to keep stopping to help my 5 year old with his monster scooter. Altogether I made it a painful mile and I was glad I went—it wasn’t nearly as bad as I thought it would be.
I remember when I first started almost 6 years ago, and how I could barely run around the corner without hyperventilating and stopping tripod style, hands on knees, wishing that I had never left the house. It took a lot of mental self-prodding and progressive commitment to get to the point where I felt like a “runner” and craved the feeling of hitting the streets, wind in my armpits and endorphins in my veins.
It is hard to get over “the hump” of making an exercise habit. There is a part of your mind and body that wants to stop the demand of training and take you back to somewhere safe, where yoga pants are comfy for binge-watching Netflix and the only sweat you see is on the outside of your glass of Diet Coke (or the inside of the wrapper of your hot burrito). You must defy that part of you and keep trying until it becomes who you are and what you do.
Things that have helped me defeat exercise procrastination:
Schedule it in every week. Hit the frequency and duration you desire by clearing your calendar, booking a class, arranging childcare or a meetup, etc. Making an external commitment helps keep you from cancelling your date with fitness.
Find secondary wins. The more you get out of your experience the more likely you are to stick with it and look forward to it. Positive feelings snowball and accumulate. When I bike to work I save money on gas, improve my mood with sunlight, and save time by combining workout time with commute time. And when I meet a friend to bike on the way I also get social time!
Keep setting goals. Give yourself a milestone to reach. And once you’ve reached it set another.
Sabotage the saboteur. Cut your excuses off before you can make them. Write down all the reasons you might give yourself not to exercise and the workaround you can use when they present. Here is one of my examples:
Saboteur Me: “It’s too rainy outside. Might skip the run today.”
Smart Me: “Oh-no-ya-don’t. You can get out the rain cover for the jogging stroller and wear a hoodie. Or you can pay the small fee to run indoors on the treadmill at the public pool.”
Set yourself up for success. Give your body and mind a chance to be good at being active. Get plenty of sleep, eat right, save energy for workout time, and be safe to prevent injury.
Give yourself credit for activity, not just “workouts”. Everyday things like yard work, grocery shopping, and cleaning are exercise. Get some chores done while you get fit.
Change it up. Cross training is good for your body. Find different ways to move and different places to do it to keep from workout burnout.
Track it. Keep an exercise journal, spreadsheet, or use an app to see how far you’ve come in your journey.
Share your struggles and successes with others. Talk about it and surround yourself with people who are supportive.
Celebrate your milestones. You deserve to feel good about working hard.
Integrate activity into your identity. If you dance call yourself a dancer. And if you aren’t quite ready for that yet be okay with telling everyone “I do Zumba.” Proudly wear your freebie T-shirts and use your water bottles from the events you attend and places you’ve exercised.
Be okay with making mistakes. Don’t let a setback derail your efforts. Instead use your experience to avoid failure in the future (see #4).
Give yourself permission to give up. Sometimes one type of activity just doesn’t float your boat anymore. Competitive body building or curling or trick water skiing can’t be for everyone. It’s okay to break up with your workout routine, although you shouldn’t stay single. Find another exciting rebound exercise right away! There are other fish in the sea.
I am trying to take my own advice. I will be revisiting these mantras over the next few months as I try and reach a goal of running a race by the end of summer.
