Taking Charge

I read and write about these things frequently:

• Be mindful
• Meditate
• Eat wisely
• Move your body

I even nag, cajole, and encourage others, like you, to adopt them into your lifestyle because of the all-around good they can do. And yet, with the exception of mindfulness, I don’t do any of them consistently myself.

Why? What in the world is wrong with me? I have rheumatoid disease! I’m on four--count ‘em!--four DMARDs, three supplements, and two pain medications because of it. I’m in frequent pain that limits my activities and affects my physical and mental health. And yet I have trouble making those four, simple exhortations a real part of my life.

And they’re vital. Really.

Recently I went to an oncology/hematology clinic to take the second, six-hour infusion of a biologic med prescribed by my new rheumatologist. Since two other biologics have failed to have any effect on my disease over the last 12 months, she felt that this one, which was originally a cancer drug, might do the trick. I was a little nervous, but I was willing to try it because during this long year, my pain has grown exponentially worse, affecting every other part of my life more and more profoundly.

When I arrived at the clinic this time, the nurse marched me to the scale, first thing. Like most people, I hate being weighed--it’s almost always bad news. Well, this time it wasn’t all bad: I was three whole pounds lighter than I’d been two weeks before! But my weight still appalled me. I’ll be honest here: I’m obese. I weigh 60 pounds more than I should for my height and frame. I could, in my defense, argue that it’s taken me more than 25 years to become a heavyweight, and it’s not like I’ve never tried to lose it. I have; I’ve lost at least 50 pounds of it in dribs and drabs: 10 pounds here, five there, 25 here. But each time I’ve always gained them back, plus a few more. As we do.

Once settled into the recliner with the medicine slowly dripping into my bloodstream, I thought about what I hoped it would do for me. First, of course, I hoped it would make my pain lower--or even better, go away. But to do that, it would have to slow down or stop my body’s crazy, autoimmune attack on its own tissues. Once it did--if it did--what then? Frankly, I would still be obese, the many extra pounds I’m hefting around stressing and straining my already damaged joints. My RD might be under control with the help of this drug, but I also have osteoarthritis--the wear-and-tear type most people over the age of 30 eventually get. And I have osteoporosis, the bone-thinning disease so many post-menopausal women of small frame have. Both diseases wreak havoc in the joints and bones, and extra weight makes increased damage far more likely, particularly in the lower body: the lower spine, hips, knees, ankles, and feet.

So, I thought glumly, I might actually find myself free of RD symptoms only to succumb to new problems caused, in large part, by my own hefty self. It was a depressing thought. So, with the Thanksgiving feast just a few days distant, I focused my attention on something less depressing: a rousing game of Mah Jong on my Kindle.

Fast-forward to several days later. It was lunchtime and I was feeling peckish. But when I opened the refrigerator and found myself faced with Thanksgiving leftovers yet again, I decided to dig out the microwaveable brown rice and a can of beans from the pantry cabinet. A little seasoning to flavor it up a bit, and it would be a lighter lunch than I’d had in days. In our apartment the pantry is an elegant, old, oak credenza. Where it once stored neatly ironed tablecloths, placemats, and linen napkins; napkin rings; and candlesticks, today boxed and canned foods that have no other place to live in our tiny kitchen fill it up.

To see into the credenza, one must drop to one knee, bend, and peer in. I did this and found the ingredients I was looking for, then went to stand up.

To my dismay, the muscles in my legs, hips, and back didn’t have enough strength in them to lift me to my feet. I ended up pulling a chair from the table over, one that I could use as a stable anchor, and with a great deal of effort, I stood.

Puffing with exertion, I flashed on that day way back when, as a 22-year-old, I lifted a sixty-pound weight off the ground and over my head to qualify for duty in the Air Force. I was young and strong, and although the weight had been heavy, I’d lifted it without much trouble. Now, I thought, I can barely lift my own bottom off the ground.

As I made my meal, I thought about those four vitals, no matter who you are or what you may be struggling with: mindfulness, meditation, eating wisely, and moving your body. Each one weaves into the weft of all the others to promote physical and mental health. And it hit me: I really, really, must do this. No more lip service. No more passing it along to others without committing to it yourself.

Because, Wren, you know the truth: if you don’t take charge of yourself, you will only get heavier. It will happen slowly, but it will happen. And as it does, you’ll get sicker. Maybe you’ll get lucky and the RD, osteoarthritis, and osteoporosis won’t worsen. But that’s unlikely. And chances are you’ll become diabetic, too. You already have high blood pressure (treated with medication); if you don’t take charge, you may have a heart attack, or a stroke. There are so many dangerous conditions connected to the double whammy of increasing age and obesity.

So, I’m taking charge. Today, I ate wisely, falling back on the old low carbohydrate, vegetable-rich, high protein diet that has given me successful weight loss and much better nutrition in the past. Today, I practiced mindfulness as much as I could. Today, I went outside and took a walk. It wasn’t a very long one, but it was a start. And today, I spent 10 minutes doing nothing but focusing on my breath. Every time my monkey-mind started clamoring, I gently shifted my attention back to breathing in and out, slowly and steadily. The minutes passed far more quickly than I expected them to--and I enjoyed the small discipline and surprisingly renewed energy.

It will take me a long time to drop those sticky, long-cultivated 60 pounds. But that’s OK. I want to be able to pick myself up easily off the ground, should I need to get down there. I’d like to find out how it feels to walk fast, or maybe (do I dare hope?) jog a little and feel the wind of my own movement caress my face like it did when I was a child. I want to eat things that are good for me, and I want to give myself permission to stop thinking for a while each day, to just rest my mind and find the real Wren, the one I know lives in there. I want to take charge of myself, gang.

I’m doing it.