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PREGNANCY, DEPRESSION & EMOTIONAL RELAPSE: HERE’S HOW I’M DEALING WITH IT

Exposure therapy at work? Or, a good friend who coaxed a belly pic and smile out of me? A bit of both... Week 25, 12kg's gained so far, and today was a good day. 

Exposure therapy at work? Or, a good friend who coaxed a belly pic and smile out of me? A bit of both... Week 25, 12kg's gained so far, and today was a good day. 

As I type this, I’m now 25 weeks into marching alongside my scary monster, a once-imagined situation that I’d framed in my mind as “the most frightening thing in the world.” I’m not talking about public speaking or spiders or failure or the dark. I’m referring to a condition that many millions of women welcome and yearn for: pregnancy. Please don’t misread this- I’m elated to become a mom, and I consider my good fortune at conceiving naturally at this point in my life nothing short of a miracle. However, the concept of being pregnant has always terrified me. Whenever my husband and I discussed our options for potentially starting a family, including fertility treatment, I usually came to the somewhat illogical conclusion that I’d been dealt my hand of cards- which included a history of depression and less than fabulous hormonal wiring- for good reason, and one of those reasons was that I simply wasn’t meant to be a parent. As I mentioned in my last blog post, that line of thinking was never a huge deal for me, and I knew that I could be fulfilled as a person with or without children.

Since week 8, my “scary monster of pregnancy” has been all too real, beginning with a solid two months of morning sickness that rekindled some of my worst hangover memories and made me question my own inner strength. Regularly hugging the toilet bowl at 3am was hard; harder still was feeling like I was constantly letting people down because I couldn’t get out of bed some days, or worrying that my own physical and mental state might be causing harm to my baby. While the millions of pregnancy blogs all seem to view the second trimester as a golden and bliss-filled time, around week 14 I slammed into a steel wall of what appears to be antenatal depression, marked by persistent insomnia, obsessive thinking, and extreme irritability. Although an estimated 20 percent of pregnant women contend with antenatal depression, I didn’t even know it was a “thing” until I began investigating what the heck was going on with me- we only seem to talk about the postnatal kind. To compound matters, I became unable to look at myself in the mirror without feeling repulsed, which unfortunately continues to this day- quite an interesting conundrum for someone who regularly preaches self-love and works with women on their own journeys through body dysmorphia.

Yep. All the feels in the world for this. 

Yep. All the feels in the world for this. 

But, it’s not only my own head that’s been doing me in. The public commentary is also surprising.

“You’re pregnant!” some random guy exclaimed to me at the gym last week, as if I hadn’t noticed.  “Shouldn’t you be sitting down? Can’t exercise like that hurt the baby?” He openly and persistently doubted the expertise of both me and my doctor.

“A 10kg weight gain at this point in your pregnancy is a bit high. We’ll monitor it and do a test for diabetes later on,” the nurse said to me during a routine check. This is definitely not something a health fanatic wants to hear.

And, let’s not forget the various folks who decided to take a guess on the baby’s gender, based entirely on an old wives tale that a woman who’s become ugly must be having a boy…. or a girl... depending on your cultural lens. Yes, a few people actually said this to me.

In the parallel pink cloud universe that seems to have a particularly strong presence in Singapore, pregnancy is touted as a lady’s time to magically float and glow from one high tea luncheon to another- in luxurious silk kaftans, of course. “Cherish every moment!” they say. “Enjoy your pregnancy!” I don’t think it serves anyone to pretend that we all blossom beautifully in our ripening when the reality is often anything but. 

Thankfully, I tend to hang around some seriously awesome and refreshingly honest women who, rather than shaming me for expressing this unpopular narrative, were willing to open up about their own conflicted pregnancy experiences, doubts and fears, or at least just listen to mine without judgement.

As a coach and behavioral health professional and with their moral support, I can confidently (albeit very self-consciously) admit that after seven years of feeling mentally rock solid the majority of the time, I am no longer at that place since becoming pregnant, thanks in part to some pretty major hormonal shifts. What was beyond a doubt some of the happiest news of my life has also morphed into an anxiety-riddled roller coaster ride, and I’ve not yet figured out a way to quell the resulting cognitive cacophany. From a recovery perspective, I recognize this as an “emotional relapse.” In other words, I’m not thinking about drinking or restricting food again to deal with an uncomfortable state of being, but some of my emotions and behaviors are in line with what led me into addiction in the first place. No matter how long someone has abstained from their destructive behavior(s) of choice, whether it’s binge eating, pill popping or excessive drinking, most people in recovery will experience emotional relapses at various points in their lives, particularly during high stress situations or periods of great change. The signs of an emotional relapse include:

  • Anxiety
  • Intolerance
  • Rigidity and inflexibility
  • Isolating oneself
  • Insomnia
  • Rejecting intimacy and love
  • Poor eating habits
  • Shame and blame
  • Black and white thinking
  • Mood swings
  • Ruminating and living in the past
  • Refusing to seek help

Whether simply the side effects of a rough pregnancy or something more, I know that for myself and the people I work with, this potent psychological cocktail is nothing to mess around with. So, as I prepare for the third trimester, I’m assessing what I’ve been doing to support myself through this emotional relapse and life challenge. Here’s how I’m getting through my first big emotional relapse in nearly a decade while tackling antenatal depression head on:                                          

And, once in a while radical self-care means sitting on a beach when you're supposed to be at a conference.

And, once in a while radical self-care means sitting on a beach when you're supposed to be at a conference.

  • I’m not hiding. As hard as it’s been to be honest about my own experience of pregnancy in the face of so many myths and expectations, I’ve committed to speaking my truth. When I’m not ok, I say so. When I’m feeling really down, I do my very best to reach out to someone I trust. And, although it’s exceptionally tough for a person who works in the behavioral health sector to admit to their own weaknesses and rough patches, the fact of the matter is that coaches, counsellors, psychologists and other “helping” professionals can be particularly prone to depression, anxiety and addiction-related issues. The related sensitivity and experience is what brings so many of us into the field in the first place. Consider this- nearly 50% of practicing NHS psychologists in the UK currently have depression. We’re all human, bottom line.
     
  • I’m practicing RADICAL self-care. Radical self-care means saying “no” to anything and everything that totally stresses me out. It means making a pampering date with myself at least a few times a week, whether for a manicure, massage, physiotherapy or shopping for new bras. It means journaling and drawing and curling up with a good novel instead of focusing on an achievement-based “to do” list. It means forgiving myself for engaging in harsh self-talk and negative thoughts, instead of identifying with them. And, it means staying away from people who may be toxic for me at this time.
     
  • I’m fighting the urge to isolate by keeping the lines of communication open and asking for help when I need it. I knew the importance of being honest with my obstetric doctor about my personal history, and as a result I’ve been seeing a therapist every few weeks who specializes in pregnancy and fertility-related issues, including anxiety and antenatal depression. I also have a small yet strong support network of friends who I can trust and I’ve been making it a point to reach out to some of them, whether it’s just a text, a brunch, or a tea date at my place.

  • I’m making exercise and good nutrition a top priority. While I actually don’t feel like working out or eating much, I’ve been getting in at least 30 minutes of exercise most days of the week and I also eat between 2,200 and 2,400 calories daily consisting of healthy fats, complex carbohydrates and lean proteins. Despite the urge, I’m not bingeing on junk food because I know that the sugar crash won’t help my mood. When the cravings come, I’ve got some good snacks on hand, like sliced banana drizzled with honey and nut butter. Having a workout buddy I can lean on- usually my husband or Roz- has helped immensely during this time.
     
  • I’m taking a long sabbatical from social media. Uploading this blog will be the first time I’ve logged onto social media in over two weeks, and after it’s been published I’ll unplug again until the end of October. I’ve been using HootSuite to pre-upload posts for Tangram Wellness, and have it set up so that I’m not able to view anyone else’s feeds- it’s a fantastic tool! Social media can easily bring up a slew of negative emotions for people, as well as serving as a crutch or addiction when the going gets tough, which only compounds the problem. I advise many of my clients to curb their social media use, particularly if they find themselves comparing their own experience to that of others, and I’m taking my own advice here.

    I share this blog post in part for every woman who has experienced a less than stellar pregnancy, and for the millions in recovery who will go through an emotional relapse at some point in their lives. As the saying goes, "we are only as sick as our secrets." We free ourselves and others when we each speak our truth as women, as parents, as individuals in recovery, and as helping professionals. 

Thanks for reading! If you feel like this post would help someone you know, please share it. If you have a question or comment, leave it below or email me directly at aimee@tangramwellness.com

- Aimee

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You Are Worth the Work!

This morning I was reading about the work actor Matthew Perry is doing to help fellow addicts seek sobriety. One of the greatest gifts about the journey of recovery is having the opportunity to be a light for others who are new to the path of deeper living.

Many struggling with addiction- be it food, booze, sex, drugs, or anything else- believe that if they are "good" for a month or that if they go to enough meetings or abstain for a certain period of time, they'll be "cured,"- "all better" or that there was no issue to begin with. I certainly thought that way in the beginning, and then I ended up continuously falling into destructive patterns for nearly half my life!

It's not just about the BEHAVIOR, it's about the THINKING behind the behavior. If you've physically and mentally been operating a certain way for 10, 20, 30 years, why would you think that you can turn it around in a week or a month? Don't be so hard on yourself!

Recovery means learning a new way of living and being, AND doing the work to carry out that new way each and every day. You step into a daily ritual of gratefully rebuilding yourself until eventually, it becomes you, and even so, THE RITUAL CONTINUES BECAUSE IT HONORS THE BEAUTY AND THE PURPOSE OF YOUR LIFE.

Today, I'm thinking of all those who are new to the path. Yes, it is really tough stuff, but you are tougher, more resilient and YOU ARE WORTH THE WORK.

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Beauty and the Booze: What Alcohol Does to Your Looks

Like so many women, I’m a sucker for the cosmetics superstore Sephora, that glittering rainbow of color and light with all its tantalizing promises of MORE: more youthful, more vibrant, more glowing, more visually appealing and aromatically pleasing.  So, when a jumbo Sephora outlet opened up just a few blocks away from my studio apartment in Hell’s Kitchen at a time of particular weakness, it quickly became a regular pit stop in my weekend circuit of bars, bookstores and restaurants.  As a heavy drinker in my late twenties, Sephora was my haven of hope. I regularly charged up hundreds of dollars on anti-aging creams, anti-acne washes and most notably, concealers- ones to dab on my persistent under eye circles and bags, ones to dot across the volcanic cystic acne that erupted across my chin, and ones to cover the squiggly red spider legs on my nose that appeared like firecrackers.

While I lacked the patience or self-care to seek out a qualified dermatologist at the time, my gut told me that this crisis on my skin was likely due to the fact that I drank far too much wine- about a bottle a night, on average, and twice that on the weekends. My face, after so many years of relying on booze and pills, was beginning to change- and not in a good way. The conclusion wasn't, however, “I should quit drinking now.” Instead, my circular reasoning looked like this:

"I look like crap." -> "Mmm, wine!" -> "I Still look like crap."-> "I need to go to Sephora and pick something up to fix this situation."

Ad nauseam. 
 

A rather sexist binge drinking awareness campaign. Point taken, however. 



A rather sexist binge drinking awareness campaign. Point taken, however. 

An intense relationship with alcohol, it turns out, is just like any other sordid affair and thus I became clinging and blind, hoping no one else would find out about these cycles of madness- least of all myself. I became at once careless and perfectionistic, wearing the same drab beige H&M wrap day in and day out while sparkling up my face with myriad concoctions that I somehow believed would scrub away whatever happened the night before. When I look back on it, it all just seems insane, but then again, we’re dealing with alcohol- baffling, cunning, and powerful.

While improving my personal appearance was not one of the major factors that finally brought me to quit drinking, seeing the positive changes once I put down the bottle definitely encouraged my sobriety. I began to notice that I wasn’t so preoccupied with hiding all the clues on my body pointing to a not-so-healthy life. Over time, those clues gently faded away with each alcohol-free day, each run, each meal of eating better. The red splotches on my nose disappeared within a year, while facial bloating subsided within a few months. The cellulite across the backs of my thighs gradually eased and the dark circles under my eyes gently faded. My weight, which had slowly been creeping up, began to come back down again. Unfortunately, the zits decided to stick around, although they're not half as aggressive as they once were. And, while I still probably spend too much money at Sephora, it’s certainly a lot more under control than what it used to be.

So, what does booze actually do to your appearance, scientifically speaking? A lot, it turns out.


The second photo is what I would apparently look like over time if I were to regularly drink 6-10 glasses of wine per week, according to the app, Drink Mirror: http://www.drinksmarter.org/  I can confirm that the facial bloating is real! 

The second photo is what I would apparently look like over time if I were to regularly drink 6-10 glasses of wine per week, according to the app, Drink Mirror: http://www.drinksmarter.org/  I can confirm that the facial bloating is real! 

Alcohol Accelerates Aging 

When you consume alcohol, the body treats it as a poison and immediately goes to work trying to remove the booze you've just ingested from your system. As alcohol enters your bloodstream, it also suppresses the creation and release of vasopressin, a hormone in your body that regulates water retention and keeps you hydrated. These shifts set your kidneys into high gear, forcing them to generate increased urine due to the reduction of vasopressin, which then results in dehydration. This dehydration, over time, promotes wrinkles while swapping out your natural glow for a dull, fatigued hue.

You might be thinking, “ok, so I’ll just drink more water with my booze.” While that may sound like the logical thing to do, your body won’t be able to hang onto this extra boost of H20 due to the chain reaction that’s occurred. In other words, you’ll just end up running to the bathroom more often.

Recent research has also found that alcohol damages a part of our cells that regulate aging, called telomeres. As time passes, these telomeres shorten until eventually, the cell dies and alcohol, it turns out, accelerates this process. According to the results of a study, telomere length was nearly half as long in people who consumed alcohol heavily as those that didn’t. Even minor alcohol consumption in midlife was associated with shorter telomere length in old age. 

Finally, alcohol interferes with both the sleep cycle and absorption of vitamins and minerals, which detrimentally impacts skin renewal and repair cycles. And, since women have thinner skin and less collagen than men, the negative consequences of alcohol on facial appearance are generally more profound (lucky us!)


Booze Packs on the Weight 

When a person monitors their caloric intake and chooses lower calorie alcoholic beverages, they'll still be able to lose weight while enjoying moderate drinking, right? That's the common assumption, however, there are a few significant factors to take into account. Alcohol in its pure form contains seven calories per gram- nearly twice as much as protein and carbohydrates- and has no nutritional value. The liver responds to alcohol as a poison and the metabolism redirects all of its energy to breaking it down and getting it out of your system as quickly as possible. When this process occurs, the body stops burning fat and instead uses the alcohol you've consumed for energy rather than utilizing any nutrient-rich foods you've ingested. Any excess calories consumed will then be stored as fat. 

In addition, when we drink alcohol, our logic and willpower both tend to decrease- a bad combo for anyone on a weight loss journey who already has a tough time turning down tempting foods and monitoring their overall intake. Research confirms appetite increases following alcohol consumption and that people eat more even after drinking small amounts of booze, although whether that's actually due to disinhibition or not is up for debate. Considering the impact that alcohol has on metabolism and appetite, as well as the high number of empty calories most drinks contain, it's not too difficult to gain weight as a moderate to heavy drinker, but it's quite tough to lose it. 

You may be surprised to read this here, but there is evidence that drinking a small amount of alcohol each day may actually be better than having none at all. Here's the rub, though- most people only count one half to one quarter of what they're actually chugging, be it wine, beer, or margaritas. So, if you're only having a 6 oz. glass of wine a day, you'll probably be able to manage your weight while still being able to enjoy it. Just make sure that that's really all you're drinking (for many, it's not). Consider that a bottle of merlot is the caloric equivalent of a McDonald's double cheeseburger and a large chocolate fudge brownie- with less nutritive value! 

Alcohol Dulls Hair and Eyes 

Remember how alcohol sets your kidneys into high gear and dehydrates your body? This impacts the hair as well, robbing the mane of its shine and replacing it instead with brittle, easily breakable strands due to lack of moisture and vitamin deficiencies. And, alcohol can radically impact the way your eyes look as well, enlarging the blood vessels and promoting a tired, bloodshot look. 

If your relationship with alcohol is a healthy one and you enjoy a drink once in a while or even a glass of wine at night, alcohol probably won't impact your appearance or weight loss efforts too much. However, if you're one of the (rapidly increasing) millions who regularly have three or more drinks most nights of the week, I can almost guarantee that it will catch up to you over time, especially if you're struggling to maintain a healthy weight. Charging up hundreds of dollars at Sephora or on "get slim quick" schemes won't help you here. Decreasing your intake or abstaining from drinking will, and the good news is that a lot of the effects are reversible. 

Thank you for reading! Have a bit of fun- check out the Drink Mirror app here and see what you think. If you missed the previous posts in "The Conversation," a series on drinking and women, head on over to the main blog page. What would you like to read about? Do you have any questions for me, or topics you'd like me to cover? Leave your thoughts in the comments section! I'd love to hear from you. 

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The Conversation: What Does An Addict Look Like?

“I don’t think you are really an alcoholic,” someone close to me remarked quite unexpectedly as we shuffled past a neighborhood bar, making our way through the cool dark to a restaurant by the sea. It wasn’t a conversation I welcomed chewing into at that time. I was hungry and I didn’t have the patience to get into how the term “alcoholic” is both dated and inaccurate, or what “alcoholic” even means anymore.

“Why do you say that?” I asked. My throat tightened.

“Because you’re not that weak,” he replied. The weight of those five words sunk to the pit of my gut and anchored there as carelessness and ignorance. This, from someone so intelligent, someone who knew me so well. “Well, that’s your opinion,” I said, having nothing more to offer on the matter and sensing that any further explanation would just be wood chips for the fire. I have since realized that those many cutting statements delivered to people in recovery are not only sprung from 
naiveté, but also from a desire for control. It is “Human Nature 3.0”- we like things to be predictable and we want to have the upper hand (more on this in a future “Conversation”).

"Because you're not that weak." 

Stereotypes imprison the addicted and block our collective consciousness from seeing that this crisis is perhaps the largest societal challenge we face today. After all, the vast majority of us are addicts in action; our poisons are the differentiator. Food. Sex. Gambling. Money. Shopping. Booze. Drugs. Pills. Work. “Perfection.” Love. Prestige. Exercise. Religion. Facebook. Beauty. Power. And yet, when people conceptualize the image of an “addict” in their minds, their own reflection is rarely conjured.

"Getting sober just exploded my life. Now I have a much clearer sense of myself and what I can and can't do. I am more successful than I have ever been. I feel positive where I never did before, and I think that's all a direct result of getting sober." - Jamie Lee Curtis

"Getting sober just exploded my life. Now I have a much clearer sense of myself and what I can and can't do. I am more successful than I have ever been. I feel positive where I never did before, and I think that's all a direct result of getting sober." - Jamie Lee Curtis

Imagined instead are: 

  • A drink upon waking
  • Homelessness and squalor 
  • Trembling hands, “the shakes”
  • Messy hair, body odor, bad teeth
  • Joblessness & living on the dole
  • School dropouts, lack of education
  • Marital and financial trouble
  • Piercings & tattoos
  • Drink or use every day 
  • Foolishness, weak-willed  

Maybe so many people have chosen to frame addicts this way because it’s easier, because the reality is far too close and unearths unacceptably discomforting levels of fear. Consider that over 7% of the US population and just under 4% of Singapore’s population fit the criteria for having an alcohol use disorder, according to population-based surveys (estimates should be considered extremely conservative, given self-reporting methods and the shame associated with admission). Millions of these people are educated, hold down jobs, and have family and friends to answer to. In fact, around 20 percent of individuals with an alcohol use disorder are considered “high functioning”- in other words, highly intelligent achievers who are able to maintain the façade of an accomplished and even enviable life despite their dependence on alcohol. Gabrielle Glaser, author of “Her Best Kept Secret: Why Women Drink,” writes that the more educated and well off a woman is, the more likely she is to consume booze, and that white women are more likely to drink than women of other ethnicities. And, according to a new survey by Protecting.co.uk, a third of workers in the UK have admitted to using drugs at work while nearly every respondent said they had gone to work drunk at least once.

                                                                                    "What made me stop [drinking]? I realized it was not going to end well." - Kristin Davis 

                                                                                    "What made me stop [drinking]? I realized it was not going to end well." - Kristin Davis 

In an age where nearly everything seems to revolve around cocktails- from bonding with friends to making important business decisions and even having sex (yes, many people admit that drinking is often a prerequisite requirement to doing the deed), what does addiction actually mean and how can someone tell whether or not they’ve crossed the line? Perhaps it is first crucial to accept that no one definition of addiction exists, as it is viewed from diverse perspectives.

Many scholars and doctors define addiction as a “brain disease,” which in my view is a simplistic and even dangerous way to categorize a many-tentacled beast that sucks its existence from complex social, cultural, biological, psychological and spiritual forces. Other addiction experts say that addiction is a chronic neurobiological disease characterized by impaired control, compulsion, continued use or behavior despite harm, and craving. This perspective to some extent minimizes the outcomes while focusing on the actions. Is an addict still an addict if she is no longer engaged in her addiction? SMART Recovery describes “addiction as an impulse disorder, favoring momentary satisfaction over the long term view,” while other programs consider addiction a “spiritual bankruptcy.” The origin of the word “addiction” perhaps gives us a clearer meaning; it is derived from a Latin term that means “bound to,” or “enslaved by.” This notion, “an enslavement,” resonates most with me; when you have an alcohol use disorder- or any kind of addiction- you must tie yourself to some external actor in order to feel ok; that desired sense of belonging or normalcy exists at the other end of the craving. Addicts without their fix- be it cocktails, cakes or cocaine- find it impossible to inhabit themselves.

So, when does drinking become a problem; how do you know if you have an alcohol use disorder? Well, you can take a handy "Almost is Too Close to Always" quiz from Harvard, although I’m not sure its results are definitive, particularly since, again, the criteria varies. Or, you can go with a more traditional screening method like CAGE:
C
 Have you ever felt you should cut down on your drinking?
A Have people annoyed you by criticizing your drinking?
G Have you ever felt bad or guilty about your drinking?
E Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? 
According to a CAGE screening, two positive answers warrant further assessment. 

Be warned however, that most people severely underestimate how much they drink and count, on average, only one quarter to one half of the drinks they actually consume. I think, with many of these types of issues, we already hold the answers within. I knew years before I quit drinking that it was hollowing me out and stealing my spirit. But, if someone asked me about it, I wouldn't hesitate denying that knowledge.  

It is alcohol after all... cunning, baffling, powerful. 

So, if you suspect that your drinking may not be serving you well anymore, why not begin your exploration of that relationship by reflecting on these questions?

  • Is my alcohol use holding me back from my dreams?
  • Is my drinking negatively impacting my relationships or my health?
  • Do I actually enjoy drinking or has it just become something to do?
  • Am I drinking away boredom?
  • Would my life be better if I quit drinking? In what ways?

I quit booze when I realized that it was beginning to steal the life I was meant to lead- one with a sense of peace and confidence, a creative existence, a good marriage, a rewarding career, a spiritual belonging, the ability to accept myself as is. A few people might argue that I hit the bottom several times, while most others standing on the outside looking in could only see a woman who had it mostly together- top student, secure job at a great company, solid friends and marriage, and a rather exciting life in a "city so nice they named it twice." What I knew for sure was that I was deeply unhappy with who I’d become, and that if I chose sobriety, I’d at least have a chance to turn it around.

Best. Decision. Ever.

 Perhaps it will be the same for a few of you reading this today.

If you missed the first two installments of The Conversation, you can check them out here and here. Blogger EJ Austin-Jones also had some thought provoking things to write about this series, so check out her take here. I'd love to hear your thoughts, so please share them in the comments section. If you liked this post or think it might be interesting to someone else, please share! Stay tuned for next week's installment and if you have a question on addiction or would like me to cover a particular aspect, just send me a message. 

 

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On the Bench: Staying Focused When You’re Out of the Game



When I launched Tangram Fitness only a few short months ago, I had a mission to build an empowering personal training and health coaching business that also raised awareness on important women’s issues – topics like mental health, eating disorders, self-esteem, body image, hygiene, and chronic illness. My reason behind creating a company like this was quite simple- I had turned my own life around through fitness and nutrition, and I know just how powerful a regular exercise routine can be, both anecdotally and scientifically. Exercise is my drug, the most powerful form of medicine I’ve found, and I wanted nothing more than to share it with others.

Feeling invincible.

Feeling invincible.

What I did not expect, however, was to have to face yet another serious challenge at a time when everything seemed to be coming together perfectly. I had a new business that I loved with some incredibly awesome clients, I was training to compete in a figure competition and feeling physically stronger than ever, and my life had been pretty excellent for quite a while. Everything was moving in the right direction…with one exception. The pelvic pain I’d first experienced five years ago (which was diagnosed as interstitial cystitis, or IC) had returned with a vengeance, despite following an IC-friendly diet and religiously caring for my physical health and stress levels. Each month, the pain became worse, and even as I gave my all to push through it at every workout and training session, I began struggling to accomplish simple daily tasks. I felt like I was sleepwalking with a sixty kilogram kettle bell attached to my pelvis, and I was urinating more than forty times per day, unable to sleep for more than an hour at a time at night.

Eventually, in September, I decided that it might be time to see a doctor. He referred me to a specialist, which led me to another specialist, who diagnosed me with endometriosis. Endometriosis is a common women’s health condition that occurs when the cells from the lining of the uterus grow on other organs of the body, like the bladder, kidneys and bowel. Approximately 7% of women will have endometriosis in their lifetime, with an average diagnosis at between 25-35 years old. While many don’t exhibit any symptoms, for others, the pain can be excruciating. The exact cause of endometriosis is unknown, although recent studies indicate that exposure to pesticides greatly increases a woman’s risk of developing it. Up to 50% of infertile women have endometriosis, and it often coexists with other autoimmune and inflammatory conditions, like lupus and interstitial cystitis. Aside from impacting tens of millions around the world, there are many well-known women who have endometriosis, (most notably, Padma Lakshmi, who founded the Endometriosis Foundation in the US) and yet, you hardly hear about this common disease, especially in Singapore. Unfortunately, lack of awareness has dire consequences. According to my specialist, many local women do not seek help until the endometriosis has reached a severe stage, which can be very difficult to treat.

This Wednesday, just a few hours after boot camp, I underwent laparoscopic and cystoscopy surgery- otherwise known as “keyhole surgery,” which removed nine areas of endometriosis on my organs. Reduction in pain is experienced by 80% of women who undergo this surgery, but there is a 30-40% chance that the endometriosis will return and surgery will be necessary again. For now, I am solely focused on healing quickly and being able to resume my active life again, but I have to admit, being sidelined like this is not my forte. I don’t “do sick” gracefully and one aspect of myself that I could stand to work on is patience, the ability to sit still and let life roll on as it is beyond the fifteen minutes I spend meditating in the morning.

As an athlete and fitness professional, accepting the trials of my body over the past five years has been difficult, but at the same time, it's also one of the factors that drove me to change my life and become an athlete in the first place. Because of the pain, I’ve missed more than a few of my workouts in the past four months, and for many other workouts, I was unable to give 100%. When I confided to a bodybuilder my concerns about surgery, I was told that I may not be able to compete after all because of the scars on stomach (total rubbish, by the way). More than a few people have said, “but you look fine!” Today, I’m finding it difficult to walk to the kitchen, which makes me wonder when I’ll actually be able to run again… two weeks, three weeks, a month?

Here’s the reality: the vast majority of us, at one time or another, will face a major health challenge that will either derail us from our goals or push us to emerge both stronger and wiser. You’re training for a marathon and you twist an ankle. You’re putting forth a serious effort to lose weight and you rupture a disc in your back. You’ve been preparing for a triathlon and you sustain a serious injury. These are all true stories from people I personally know, and they’ve all faced the same decision- keep moving forward, however slow, or stop. Unfortunately, many people do decide to give up, to use their illness or condition as an excuse to avoid anything that may be uncomfortable.

I’ve spent some time contemplating how I can still reach my big goals for 2014- building an impactful wellness business, changing people’s lives for the better, and competing successfully in figure- while healing fully.  Here are my steps to stay on track, as I work toward moving off the bench:

1. Create a recovery plan of action. Don’t just wait around until you feel 100% again- if that’s your mindset, then you might be waiting forever! Type out a road map that will get you back to where you need to be. Schedule walks and mini-workouts, as well as appointments with physiotherapists, naturopaths, and massage therapists who will assist you on your path to wellness. Put all of your exercise sessions on your calendar, and keep a notebook on your progress. Take things slowly, and aim to increase your speed or intensity by no more than 5-10% each week.

2. Express your frustrations constructively. Bottling up any negative feelings you may be experiencing can hinder your recovery and put you in a sour mood. Talk things out with a trusted friend, keep a journal, draw cartoons or blog about your journey.  If needed, don’t be afraid to chat with a therapist or psychologist. For those of you living with chronic conditions, it’s important to have a regular outlet to express what you’re going through. Painting and creative writing can also be beneficial.

3. Invite inspiration into your life. Identify people and sources of information that remind you of what you’re working on and why. I’ve been following IFBB Figure Pro Ava Cowan’s blog “The Journey Back to Strength," which documents her recovery from a serious injury as she works her way back to the stage. I also read Bodybuilding.com’s Transformation stories every single week for a feel good boost.

4. Recognize that there’s always another event down the road. So what if you miss the triathlon, marathon, or bodybuilding competition you were preparing for? Events are a dime a dozen now, and you can always register for one at a later date. On the plus side, it gives you more time to prepare! Don’t get so hung up on a deadline. If you want to get there, you’ll get there.

5. Take time to meditate. If your body is fighting an illness or injury, it’s more important than ever to reduce your stress levels and gain perspective. Mindfulness meditation can also assist with pain management, reducing chronic pain by up to 57% in clinical trials.

6. Buy yourself a motivational gift. Find a special treat that you’ll look forward to using when you’re back on your feet. A few days before my surgery, I went out and bought some fancy “Run NYC” kicks from New Balance. They’re waiting patiently for me.

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7. Eat for your health. Now is definitely not the time to pig out on junk or rely on processed food. Indulge in lots of whole fruits and veggies, and read up on diets that may help you in your healing. I’ve been following the Paleo Autoimmune Protocol (with a few exceptions- I still include lots of eggs in my diet and I avoid tomatoes and citrus). There are other types of elimination and immunity-building nutrition plans you may wish to try, depending on what you're dealing with.

8. Use this downtime to learn and grow. Make a list of books you want to read and topics you want to learn about, and then dig in! If you’ve ever wanted to build a website, get a certification, learn how to use Photoshop or Excel, or take an online course through a portal like Coursera, now is the time.

9. Practice self-love. Being sick or injured is not your fault; don’t take this stumbling block personally. Honor your needs with compassion, and listen to your body. Write a personal mantra or statement of healing, hang it up in your bedroom or bathroom, and recite it aloud as often as you can.

I’ll keep you posted with my learnings as I move forward, and explore writing more about fitness and nutrition for those of you who have chronic conditions or injuries. We all experience setbacks, but we should never let these barriers get in the way of living a full and fit life!

As always, leave your comments and questions below. I'd love to hear from you!

Take care,

Aimee 
 

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