Depression!

Yes, I know I write a lot about depression. Strange really, but it does consume quite a large chunk of my life in fairness. But this time it is a different perspective.
In the past I have recorded the lows of my days, expressing the loss of control, the uncontrollable feeling of nothingness, and the pointless battle of trying to get out from the slump. Then there have been the fight backs, the recovery, and the jubilation of once again rising from the pit of despair.
Not forgetting my attempts to explain the inexplicable to those who want to, or think they do understand the true depth of depression.

But like I say, this is different. A recent consultation offered me a unique new perspective on the whole matter, and made me realise there is more I could do, should the opportunities arise. To date, I have not sought such a thing. Although have recently set out on a vlogging mission, thanks to another chance encounter with another medical professional.

Back when I did my CBT course, I became aware that I grew in strength and self understanding, while talking to others about my journey. Not counsellors, but a group who were too suffering from anxiety and depression. As the course went on, so I realised that telling your stories, as you understand them, to others, helps them see patterns, and routines in their own lives. Once aware, you are slightly more able to take control. Spurred on by the confidence gained from realising you are not alone, and you are indeed understood by someone at least.
By the end of the course, I was overwhelmed by the number of people from the group who felt I had played a positive part in their improvements, and that my openness was key to that.

On speaking to my GP yesterday, I was very surprised when she expressed an interest in me helping educate a group of medical students. As we discussed it, the idea grew. On agreeing to the the seminar , I realised it is something that really interests me. When my mind is clear, I love trying to put things together and help others understand depression, from my perspective at least. Both medical professionals, and sufferers have something to gain from such discussions.
I am not saying I am the Messiah, and the key to depression. I am not for one second suggesting I understand depression in all its guises, I really don't. However I do believe I have built an understanding of what you might call standard depression and anxiety can drive you to.

Seeing others speaking out on a larger platform about how they have battled with mental health makes me almost feel like I could do more. Be it making myself available to speak to others, getting going on the vlogging, or writing more, I'm not sure. But I do know one thing without a modicum of doubt, I feel compelled to make a difference, and I am truly passionate about helping with depression and anxiety. Maybe sharing my stories with medical students is just the beginning. Maybe I can do this more often?Who knows, but I will be sure to speak to the GP about this.

When I am low, I don't look for help, but occasionally will reach out to someone I know I can trust. I am truly blessed to have a small group of friends who understand this, and are amazing at what they offer at these times. However I am so very aware of how long it takes to build the trust to speak to someone you know about it, or even find someone in your circles who you can talk to. Believe me when I say, that alone is one of the toughest parts of recovery.
For some people, they will either never gain such confidence in their friends, or simply not have the network there to embrace them. This is where it becomes problematic.

When you finally reach out for help, you speak to a GP. The standard assessment will be made, the score will be taken, and if necessary, medication will be prescribed. Sadly for some this is the start of the end. With a health service under pressure, and quite frankly such little understanding of depression from the majority of GP's , you take the pills, feel a bit more balanced, and on you continue. No big attempt to solve the cause of the issue. Being such a vast condition, to a degree I totally understand why this happens.

However, if you fall and bend your leg awkwardly, you are not given painkillers and crutches and sent on your way. Investigations are possible to see the cause of the pain, and treatment given accordingly. Unfortunately the physical body is far easier to make sense of than the brain. And we are full circle on why most cases of depression or anxiety are left unexplained.

If you are lucky like me, and you get an amazing and passionate GP, like Dr Paul, your hopes are better. Along with Dr Mason (my work doctor) they supported me to the point where I could carry on without support. Like the leg injury, they were my crutches which carried me until I could manage alone. From simple sit downs to express where I was mentally, to dosing changes. And of course shoving me in the right direction to get CBT, and stick at it.

Of the tens of thousands of people in the UK on Citalopram and other such medications, I would be curious to know what percentage have ever had any further interventions than being medicated.
I am not saying medication is a bad thing, or evil and addictive. Far from it in fact. But as in my early blog, for me the medication is only there for me to rise back up from the depths of depression, and regain control over the matters which influence my mental state.

Debts, relationships, work and so much more can influence our state of mind.We can get down about it for a while, or we can fall further, lose control and begin to curl up to hide away from it all. That is the point where intervention is needed, and not always just in the medication way. Meds are not the solution for all. In fact I would bet most could be back off them, and balanced of their own accord within a year or so. Depending of course on the changes in their lives, and the root causes of their initial downward spiral.

Sitting here tapping away, I would love to learn more about the subject, and write something meaningful about it, something helpful. A first hand account of what some are going through, and a look through window into the future of hope. I am not the solution, I am not the cure, but I am experienced, and open enough to discuss it with others. Knowing my blog has been read by strangers and impacted them positively just increases my drive to help more.
Speaking to the students could just be the beginning. For the rest of the journey, I need to find my way.

Me and my health.

The good news is, mentally I am fine. Phew, that's a relief.

However physically, things are a little more grim for me.
The first couple of months of the year I have struggled with foot pain. To the point where shoes and walking were a no no. Occasionally venturing out on the bike, desperate to keep my legs spinning, only to be rewarded with even worse foot pain.

With that now somewhat under control, my body thought long and hard, before giving me the next challenge. Delivered in a gold envelope by a smug looking twat in a lab coat, no wait, that's Top Gear...
Over the past few weeks, both at work and at home, people have commented on me breathing heavily. At the same time I have noticed that I labour a little with certain tasks. Usually walking or climbing stairs. Up until this time, I have been fine, walked at a good pace, climbed stairs with no issue. (Remember taking the stairs to the 22nd floor at Guys Hospital?). So obviously this has caused some concern for me.

This time of year, a lot of people with asthma (like me) struggle a little more with hayfever and other allergies causing complications. But for me that usually appears along with a chesty cough getting me all blocked up. This time, nothing. Antihistamines don't seem to help either, again they usually would. And finally my inhaler has little if no effect whatsoever.

To just spice things up a little more, my body decided to throw heart palpitations in the mix too. It's all the chest, right! Now as an avid cyclist, who strangely during all this, can actually still cycle like a nutter (confusing right!) I see my heart rate quite a lot, and push my body quite hard. Nothing abnormal shows on my HR, and there are no unexpected weaknesses or shortness of breath etc.

On speaking to my GP, he has arranged for a set of tests to be run. Bloods, heart trace, and a breathing function test. First two are done, 12 lead ECG appears fine, bloods we will see, and breathing function is being tested at the weekend. Hopefully they will point at something, as it would be a lie to say it doesn't concern me slightly. If not, the tests go on, to see what is going on in there.

I reminded myself to write this on the way back from the shops just now. Slow steady pace walking, warm but not uncomfortable day, 1 mile or so round trip. Being overtaken by people with walking trolleys, and feeling like I am labouring to carry on. Taking my heart rate on the way around, nothing shocking to see. 80-85 bpm, which is pretty good going for the conditions. Made the trip fine, but this is just one of many journeys on foot which I have made and struggled with.

The confusing part is, it can be walking or getting up that temporarily knocks me for six. But cycling, I can go on forever. The GP suggested, as expected, that weight may be a contributing factor, which I completely accept. I am indeed overweight, but should add I have not gained weight in months, so why suddenly now feel this way. And why do some less intense activities affect me worse than being bent over cycling?

Right now, it's all a mystery to me, and everyone else, but hopefully there will be some answers soon.

So that is my little update. Thanks for reading.

Learning to walk again

For once, not a metaphor.
Following years of pain in my feet, mainly in my Achilles tendons, I finally decided to go to see the doctor about it. Coinciding with a flare up of gout, and with pain in the same region being hard to differentiate, I needed to know what was what. So as the gout subsided and the pain remained in my Achillies, I got the doctor to check them out. The diagnosis, Achillies Tendinopathy, aka a swelling and stiffness in the tendon, causing pain and difficulty walking. Anyone who reads this blog a lot will know, I LOVE walking! It is a huge part of my daily routine, and of course needs to be with the dogs.

One referral to the physios at Lewisham Hospital later, and I was examined, and given a series of exercises and stretches to do daily.
We went through a series of tests do check the distances the tendons moved. Measurements taken on day one showed quite a large difference between my left and right tendons. The right has always caused me the most pain, but the left plays up too.
After the first appointment I came away with a positive mindset that something could be done about the situation, and got stuck into the routine of following the program I had been given. Much to my surprise I started to notice a bit of a difference, and by the next appointment I felt like I was getting somewhere with it.

Unfortunately I was starting to get pain in my lower back and glutes now. Transference of the issue to another point. By the time of the second appointment I had a new physio with a new idea and checks. On mentioning my pain she checked the strength in my glutes by doing a side leg raise, then pushing the leg back down. Now she is only a little lady, so on the good leg she probably could have hung off it without it moving. But when we got to the right side, I was shocked, I lifted my leg fine, but it just collapsed as soon as she put any pressure on it at all. Truly shocking as I have never felt  had any weakness in there at all.

By all accounts, while I have been subconsciously managing the pain in my right achillies, I have in fact avoided using my right leg a lot, and because of this the muscle strength in that side has deteriorated quite badly. Cue the addition of more exercises to bolster strength in the right side. Side leg raises, and one leg stand to squats.

By the third appointment a few days ago, things have improved remarkably, and the balance between left and right is slowly equalising. The strength returning to my right glute and quads, and the pain when walking disappearing by the day.

And finally I reach the reason for the title of the entry. Learning to walk again.
Since realising there was hope, and taking health seriously again, I have decided to make my own contribution towards the fight for recovery, and made some changes of my own.
The main one being, teaching myself to walk in a different way to how I have done so for 40+ years.
I have always been a powerful walker, able to average 4.2mph a few years back (GPS measured) long strides, good endurance, and able to chalk up 10-20 miles in a day without worrying too much about it. In recent years my goal has been 10 miles a day, but the flare up of the tendinopathy has really dented that goal, with some days me not even wanting to walk the dogs.
However it was time for change.

Just a quick note, so powerful are my downward thrusts with my feet when walking, that I am prone to slipping, so as I push off with the leading foot, the foot will slip on the surface as I roll onto my toes. I also wear through trainers at an alarming rate!
So, with all the progress being made with the physio, I decided to give my feet a second chance. Consciously walking with less vigour, taking the pressure out of the strides, smaller steps, a more upright stance, and trying to block out the goal of time or distance, and instead concentrate on my strides and keeping them smooth.

Amazingly it seems to be working, I can do a full 5 mile walk in the mornings now with no ill effect on my achillies or any other part of my feet really. Maybe a little tightness in the toes, but I guess that is all down to a transference of impact from one part to the next.

The last time my tendons were measured, and the test done on my glutes, the improvement was huge. Greater range and motion in the side leg raises, surprising the physio somewhat as the leg carried on rising into the air almost out of reach for her. As well as an improvement in the strength too, able to resist the downward pushing much more. As for the elasticity of the tendons, the lunges I can do now are massive compared to when I started, even causing the physio to suggest easing off on stretches for the stronger left side, as otherwise I will be doing the splits next time I'm in.

I am really grateful to the NHS for providing me this physio, they take a lot of stick, but at times like this, they are a god send, and very competent at what they do. I can feel the changes happening as I do my stretch routine daily, so know it is playing its part.

The tough part for me now is to stay focused enough to continue with both aspects of the program, and maintain my determination to learn to walk again, but in a way which is beneficial to my body and health, and caring less about getting somewhere quickly, and being the fastest person on the pavement.  Changing the way you walk at this time in life really isn't easy. I realise there are other people out there overcoming much greater challenges with their walking, but from this small experience I have learned to respect them even more.

Just to add, I am familiar with changing how I walk regularly in the past, with flare ups of gout causing me to improvise, it be immobile. From those short spells alone, you soon learn about weight and pressure transference, and how it impacts other parts of the body.

Anyway, after a long  morning of walking, training and physio stretches (3 hours to be precise) its time for me to have breakfast.... Or is that lunch now?

Get a grip !

That is what I am repeating to myself over and over recently. It is becoming very frustrating seeing myself gaining weight, knowing what I need to do to control it. Then promising myself that I will take control back............... And failing, badly!

As pointed out by a friend last week, my weight and body shape is something that has changed for better and worse numerous times over the past decade for example. It isn't a conscious decision to do so, but more dictated by my varying levels of health and self control. Not to mention my mental state at any given time.
Determined and dedicated, I can make huge changes in short periods of time, with seemingly very little effort. But when doom and gloom strike, it all goes to shit. I can't say I am particularly filled with doom right now, but I am certainly lacking willpower or even just plain old will!

T-shirts are getting tighter around the tummy again, yet arms and legs are looking good. Strange old body I have here, but one I need to get under control and fast.
Each week I say the old famous "next week". Then I binge all weekend as a final blowout, then fail to start. Each time it happens I beat myself up about it, and promise myself, next week.... See the cycle here?

There is no real excuse. I have a little man cave full of equipment to use, I have a bit of knowledge in training. Certainly enough to make a difference in my appearance. I can eat clean when I want to and am determined enough. But right now, none of that seems to matter, and I am doing nothing about the situation.

I should point out at this point that, having failed to motivate myself, I am  now trying to borderline embarrass myself into getting my shit together. Publicly announcing that I am failing myself, and trying to make a declaration of commitment to getting healthy again. This isn't a public cry for help as such. But please feel free to abuse me, or cheer me on, whichever you decide would be most effective.

My average weight varies +/- 30 or sol pounds. I have gone further both ways in the past, but most still maintain that at my lightest in years I looked borderline ill. My average weight surprises some people still, but it's a number I have become accustomed to these days.

For years my training ethos has been heavy and hard. Building muscle mass at quite a rate, making fitting into some clothes a challenge. That said, my physio pointed out a month ago that I have lost a large amount of muscle mass around my back, which surprisingly is a good thing for me. My words, not hers. Very noticeable for me when putting on wetsuits and scuba gear for sure.  The only downside to this is the loss has coincided with my loss of willpower, and the gaining around the waist.

In fairness to me (yes, excuse time) with recent issues with my achillies and glutes all coming to a head, and now seeing a second physio about the issues, I am mentally off my game in the name of self preservation, and physically off my game due to training limitations. That said, it's no excuse.

As I was saying, my training ethos, for years has been heavy, but I am slowly coming around to the fact that I am needing to tone more than build these days. Burn fat, and lose size, rather than build muscle and gain size. Contrary to my own beliefs, I'm apparently already quite large as muscle goes. With a GP exclaiming "oh my, you have huge arms, I mean HUGE arms" last year, I guess if someone who examines people daily says it, he must have a point.

I think this might actually be my folding point right now. I know how to train heavy, and obviously training lighter isn't so different. But the feeling between the two is worlds apart. The failure point feels different, fatigue is a whole different game, and the sensation of making changes feels confusing. But I NEED to do it.  I also NEED to get more active again. I am still up silly o'clock daily and out with the dogs, but with the weather changing the dogs are getting out less with me. Trying to pace myself so not to aggravate my achillies or glutes is a chore too. I am a power walker, not a stroller. Walking slowly makes me feel like I am getting old, and I hate it. Being overtaken is NOT cool!

So here I sit, gym equipment behind me, cloud over my head. Thinking to myself "next week", and really hoping that I am right this time. I need my mojo, I need that motivation and self discipline. I respect myself enough to care for myself. Now I just need to show it. Cut the crap eating, reduce intake, strip it all down, and for goodness sakes, WORK HARD !

I have a busy weekend ahead, but hopefully I will find the time to sit down with myself and get a training plan drawn up again. Not to high impact on my feet, allowing for morning stretches and physio too. Targeting my "soft" spots, and really taking things seriously again. I love feeling fitter than this, and heavens knows I like looking better than this. So now is the time.... Isn't it?

Wish me luck, scoff, or just close this blog and wonder why you just read all of this. Whatever you do, hopefully I will be busy getting my shit together and sorting myself out once and for all. Or at least once again! I know a lot of the above is just convenient as an excuse, I don't need telling to stop making them. I know as well as you that I am better than that. What I do know is that as much as an excuse as they are, they are also legitimate issues, but ones I can work around.... And I will !

Thanks for reading, and here's to next week. Oh and me not having to write another one of these "HELP MEEEEE!" style entries for a while.


PS, I know a few highly critical friends of mine will be reading this. I value your opinions truly, admire you commitment to yourselves, and your ongoing ability to maintain. In fact I envy that.

"One day I will be great, until then, I will be determined."