The Fix.

Are you an addict?  Do you need a fix?

Addiction is essentially a compulsive dependence on a behavior (e.g., gambling) or substance (e.g., caffeine) that persists despite negative consequences. A hallmark of addiction is denial (‘I can stop anytime’); thus you must recognize that there is a problem before you can begin to address it.  Battling that addiction is tough. The habit is merely a symptom of the psychological condition. By definition, an addict is vulnerable, so it is easy to see why it is common for a recovering addict to transfer his addictive behavior to other parts of his life, sometimes without even realizing it.  This is ‘replacement’ or ‘substitute’ addiction, also called “switching.”

A dear friend of mine is a recovering drug and alcohol addict. She said that in rehab, they told her that the most common substitute addictions are sugar and sex, but they may also be exercise, work, smoking, dieting, overeating, drugs, shopping, cleaning, or a host of other activities. It’s still addiction. Even if the substitute is not in itself a bad thing, like work or exercise, it is clear that spending an excessive amount of time working or exercising can be harmful. You’ve changed the outward manifestation of your addiction, but you’re still addicted. You may not know it, but the people around you probably do.

I’ve known people who choose not to drink because their parents were alcoholics; their drug of choice is food, specifically sugar. One of my acquaintances quit drinking hard liquor and now only drinks beer. And we all know ex-smokers who gain weight because they eat candy instead of smoking. They simply replaced one habit with another – and that is not recovery. Your brain still craves the reward, the ‘high’ of whatever you did to satisfy the craving; it’s just finding another way to get the fix.

So let’s bring this closer to home. After a lifetime of obesity/food addiction and unsuccessful, yo-yo dieting, you have weight loss surgery. You have changed your eating habits; you are losing weight and getting healthier. However, you now smoke twice as many cigarettes as you used to. Or now, under the guise of ‘celebrating’ your weight loss, you max out your credit card at the mall. Or maybe you have become obsessive about working out. Or you become overly flirty and promiscuous in an effort to demonstrate your attractiveness. Or you become preoccupied with proving something at work, becoming an overachiever or workaholic. Or you spend countless hours online.

Whatever your replacement addiction may be, legal or not, it is like a rebound after a romantic breakup – it is a short-term, feel-better coping mechanism. It helps you escape the downside or negative consequences of your behavior. At best, it may not be harmful, but at worst, it certainly can be.

The problem is not the activity itself – it’s the obsession.

The need.
The craving.
The dependence.
The preoccupation.

So what can you do about it? Well, recognizing that you’re switching is a good start. Then you must realize that you need help dealing with it. Help might mean behavioral therapy with a professional. It might be a 12-step program, counseling, or a support group. It might be developing other ways to deal with the stresses in your life or adopting new pastimes. It might be as simple as enlisting friends and family to hold you accountable or to help keep you away from challenging situations.

To me, it proves that I can’t do this alone. Left to my own devices, I would substitute one thing after another after another. For years, when I dieted, I would smoke more; when I tried to quit smoking, I’d eat more. When I finally quit smoking for good, I gained a lot of weight. Now that I’m not overeating, I find that I’m shopping more and spending more idle time online. (I’m also writing more, but I think that’s a good thing.) I have to be very careful not to let the habit gain the upper hand because I know it can easily happen.  My brain still wants that fix.

I’ve come to the understanding that my obesity was not just about food. Facing myself and overcoming my compulsive behavior takes a lot of work and a lot of time. The key is in finding the balance in your life. You want to cultivate productive, healthy habits and behavior but not form detrimental attachments to them. It’s tough. I’m glad that Mr. Stuck and I are working on this together. I’m grateful to every one of the people who come to the same WLS support group we attend, because their insight and encouragement is what keeps us coming back.

I’m not a psychologist or counselor. I offer neither authority nor expert opinion on addiction. I know there are people out there in much worse situations than I, and I do not mean to downplay their struggles toward recovery. I just want to acknowledge that an addict doesn’t have to have a needle in his arm or a bottle of vodka hidden in the bathroom cabinet. It could be the guy on the treadmill, the boss who stays late every night, or the woman next to you with the Diet Coke.  It could be me.

Or it could be you.

 

For further reading on this subject, check out the book Eat It Up! The Complete Mind/Body/Spirit Guide to a Full Life After Weight Loss Surgery by Dr. Connie Stapleton, a licensed psychologist and certified addiction counselor.  Eat It Up! shows you how to create and maintain balance in your life and helps you on the journey to your well-being.  In addition, Dr. Stapleton is the ‘Doc’ to Cari De La Cruz’s ‘Post-Op’ on their Facebook page, A Post-Op & a Doc, where you can find wit and wisdom and lots of support.  Check them out!

 

photo credit Alan Cleaver

 

 

Shapeshifting.

When I first sat down at my dining room table last night, preparing to crack crab for dinner, I felt like a kid. The table seemed higher to me, somehow. I commented to Mr. Stuck that I needed a booster seat, and he said, “Me, too!” And we laughed, having found yet another unforeseen effect of our weight loss. Our derrieres are smaller and flatter and provide far less cushion these days. I ended up fetching a pillow to sit on, which brought me up to a more comfortable working level, and I felt like a grownup once more.

But that is just the latest in my constantly adjusting frame of reference. This new old body of mine is taking some getting used to. When I crawl into bed at the end of the day, I must fold my body with origami precision so my knees (or elbows, or ankles) aren’t knocking painfully together. The sleeping positions in which I have historically arranged myself aren’t as effective without padding, so extra pillows are a must. I find myself tossing and turning even more now than before, as my bonier frame has less tolerance for pressure. Now, when I lie on my side, I can feel my hip implants, and while they’re not exactly painful, they’re certainly not very comfortable

I remember Mother teaching me how to stand up straight and carry a book on my head.  I was pretty good at it.  As I got older and heavier, my posture changed to support the weight I carried around. I slouched more, hunching myself over.  With the development of my inner-ear disorder, I realized that my sense of balance was capricious, and I began reaching out and holding on to walls and furniture for stability.  I lost my normal stride as the pain took over and replaced it with a waddling, unnatural gait. You’ve seen it – or maybe you have that same walk: you swing your legs out and rock from one side to the other instead of using your hips and knees.  It’s the Weeble Wobble.  Mine got so much worse when my hips were bad that my physical therapist actually had to teach me to walk the right way.

It was easy to slump, shuffle, and waddle when I was heavy; that’s all my body wanted to do. My balance issues made me worry about stairs and inclines and uneven surfaces. My activity level slowed to a near halt. So now that my range of movement and my flexibility have improved, it’s time to work on my posture. I’m constantly reminding myself to sit up straight at my desk. Even when my back aches, I know I have to pull my shoulders back and straighten my spine.  I’ve got some work to do so my default position isn’t ‘Slouch.’

Living in this new old body is wonderful, but not without its challenges. Bruises appear all the time, inexplicably. When I bump into things, it hurts. (But still, I marvel at the bones appearing under my skin. Cheekbones?  Clavicle?  Yes, please!)  Even my feet are different – after many years of wearing size 10 shoes, I now must wear size 11. My feet seem thinner, but longer: when I put on my old sneakers, my toes hit the end. What’s up with that?

I’ve always been somewhat clumsy and uncoordinated.  Being fat didn’t help; it made me feel like I took up too much space, and I often felt that I just needed to get out of the way.  That’s changing.  I sometimes visualize myself unzipping and stepping out of my fat suit. In some ways, I feel like a gangly teenager who’s going through a growth spurt and hasn’t quite gotten used to his body. But I suppose, like that teenager, I will grow into it.

 

image credit libertygrace0

 

Part II – You Spin Me Round.

This is what vertigo feels like.
This is what vertigo feels like. Only worse.

(reposted due to problem with first post)

I suffered many bouts of vertigo over the next couple of years, events so sudden and violent that they would cause me to fall to the floor.  Some of these ‘drop attacks’ were quite scary.  Following an episode, I would sleep for 12 or more hours, waking up exhausted and foggy the next day.  I tried medication, but the Meclizine made me groggy, the diuretics had no noticeable effect, and the Valium only seemed to take the edge off of the anxiety I experienced with an attack.  It was miserable and frightening and hard to explain.  One MD patient described vertigo like getting really drunk and then getting on a carnival ride.  Sounds fun, huh?

My equilibrium was in constant flux; some days I would walk holding the wall to keep me from tipping over, and some days my horizon would shift and I had to tilt my head to the side to compensate.  Even on days with no vertigo, I never felt ‘right’ – it’s hard to explain, but it was almost like I was always in suspense, waiting for my next round of extreme spinning and nausea.  My drop attacks had been coming around once a month for quite a while, but it was unnerving when I didn’t know what to expect, or when.

Meniere’s disease can go into remission for weeks, months, or even years; unpredictability is its nature.  Finally, just as suddenly as they had begun, the vertigo episodes stopped.  It is an uneasy pause, though, because I don’t know if or when it will return.  I still have what I call ‘the woozies,’ where I get what feels like the precursor to a vertigo attack, but the vertigo never comes.  My eyes stop focusing, my balance seems to leap, and mentally, I fade.  Sometimes my ears feel full, like I need to yawn to make them pop, but they won’t clear.   These symptoms are very common with Meniere’s sufferers.

Hearing loss associated with this disorder is generally at low frequencies, or sometimes at both low and high frequencies.  Couple that with my existing mid-range loss, and I knew I was in trouble.  I began to worry about total deafness.

I found myself struggling more and more to hear people talking to me.  I hated to use the phone, I tried to avoid crowds, and I relied on the closed-captioning option on my television.  I complained to no one in particular that people were mumbling; and I started to rely on the ‘smile and nod’ to get me through conversations I couldn’t hear, rather than continually asking the speaker to repeat himself.  I’m sure that sometimes I appeared uninterested in a group conversation; people who didn’t know about my hearing might have thought I was rude or not paying attention to them. 

I knew I was missing a lot of things: my husband and sons would summon me to the porch to hear the frogs, or crickets, or owls, or coyotes in the night.  Rarely did I hear them.  The rain would have to be coming down in buckets before I could hear it from indoors.  I missed a lot of jokes and conversation because I could not keep up, and I didn’t want to ask and expose my disability.

Sometimes, I just wanted to be by myself with my silence; it was so much easier than straining to hear, and mis-hearing anyway.  Often my mistakes in hearing were pretty funny; the difference between what I thought I heard and what was actually said could be quite amusing.  I remembered Pa doing the same thing, and suddenly, it wasn’t as funny as I thought.  We would all laugh, but he was doing the best he could, and now, so was I.

Continued in Part III

Part I – Listen Up!

The phenomenal Helen Keller in 1948.

Blindness separates us from things, but deafness separates us from people.
Helen Keller

My life changed last week, in a big way.   I’ll tell you how, shortly.

First off, some background: as a child, I suffered from frequent ear infections.  It seemed that every cough, wheeze, or sneeze heralded a virus that ended up lodged deeply and aching in my middle ear, where my only relief was couch time with glycerin drops and a heating pad.  I spent a lot of time on that couch.  During that time, I realized that I always had a ringing or buzzing in my ears that nobody could hear but me.  My father had it, too, and he taught me the name for it: tinnitus.  When my elementary school administered hearing tests to the students, I was sent home with a note to my parents, encouraging them to take me to a doctor for further examination.

I remember having the hearing test with the booth and the headphones and the tones of varying range and volume.  When I came out, the doctor showed me what he called my ‘cookie-bite’ hearing loss: normal hearing at the low and high ends of the spectrum, but a deep U-shape curve in the middle, demonstrating mid-range hearing problems.  The mid-range is where conversation takes place.  He explained to me and my parents that I had ‘nerve damage’ hearing loss, and he said there was nothing that could be done about it.

Over time, I got used to not hearing what others heard, and I tried to become a better listener to compensate.  I would sit at the front of class in school and take copious notes.  I tried to focus closely on what people said, and it helped a lot if I could see their faces.  I often asked people to repeat what they had said, or I would ask a person beside me to relay the information.  Before long, it was second nature to me to compensate for my bad ears.

Fast forward to a little more than ten years ago.  I was sitting at my desk at home when suddenly it felt like someone had come up behind me and tipped my chair backward.  I called out to my husband and clung to my desk for dear life before realizing I wasn’t tipping over and there wasn’t anyone behind me. 

Mr. Stuck came to help me out of my chair, and I soon realized that my balance was gone, my vision was distorted, and the room felt like it had gone sideways.  Any movement of my head caused a swell of nausea; I told him to take me to the bathroom in case I had to throw up.  Fortunately, that didn’t happen, but I sat on the bathroom floor against the wall for half an hour, trying to figure out what had just happened to me.  Mr. Stuck put me to bed, where the vertigo eventually calmed down. 

I went to the doctor and after several different tests was diagnosed with Meniere’s Disease (MD).  Meniere’s is a disorder of the inner ear, characterized by vertigo, ringing in the ears, a feeling of ‘fullness’ in the ear, and progressive, intermittent hearing loss.  It can be treatable, but is not curable.  I noticed that when I had a vertigo episode, it seemed as though my ears were stuffed with cotton.  I read everything about MD that I could get my hands on; all of it said the same thing: most sufferers will experience intermittent temporary hearing loss, but for some, the loss would be permanent.  Great — just great.

To be continued in Part II

photo credit uppityrib