#actually hes a chronic everything cracker

[frogmanfae]

David Jacobs is a chronic knuckle cracker thank you for coming to my TED Talk

#actually hes a chronic everything cracker #knuckles #back #neck #ankles #elbows #jaw #knees #his bones are cracky and who is he to deny that #newsies #david jacobs #livesies #davey jacobs #newsies live #92sies #uksies #newsies uk #newsies 1992

[bottlecaprabbitgames]

Weight Loss, Dieting, Medical Shit Goin' On

At the request of @meethisharma , I'm making a big post of like. EVERYTHING I've learned so far since truly trying to lose weight and do better since February of this year. I'm of course going to go into my background as to why I need to lose weight and my life as an obese person, different references I've used to help with my weight loss, dietary changes, THE WHOLE SHEBANG.

So uh. Buckle up, it's a LONG post.

(Also, shout out to Jordan Shrinks over on YouTube, I've followed this woman for years and she is still the biggest inspiration and my favorite fucking person who has helped me shape my routine for weight loss.)

Why did I start trying to lose weight?

I have been obese pretty much my whole life. In high school, I weighed 260-270 lbs. Both of my parents struggled with drug addiction, and that meant that we ate a lot of unhealthy, over processed food as it was the cheapest. I also rarely, if ever, drank water growing up; we mostly had soda in the house, and that's what I drank.

Last year, in May of 2022, I weighed 330 lbs. This was after I had already lost an unknown amount of weight, as I put on a LOT working at McD's given the food was free and I was broke most of the time. This was still not enough for me to start losing weight, but I did start packing my own lunches and at least started eating better. In September, I started my first hotel job, and with the better work and pay, I was finally able to afford insurance for 2023 and start going to doctors like I needed to. I've always had a LOT of chronic issues, but none were ever diagnosed as I really didn't go to the doctor much unless it was an absolute dire emergency.

Timeskip to the first week or two of February, 2023, and I finally get in to see a nurse practioner who will lead me to find my current primary care doctor. I weighed 312 lbs, and she was very... well, blatantly, she didn't even give me the time of day LMAO. She didn't even bother to tell me I was pre-diabetic, I had to find that out from looking at my lab results myself.

Week 3 of February, I get in with the guy who's now my primary care doctor. He's also fat, like I am, and he was also far more direct with me about my situation. As it turned out, I was in like stage 3 hypertension (my blood pressure was 150 smth over 140), I was almost 90% deficient in vitamin D (y'know, the shit that makes your bones HARD), my iron saturation in my blood was in single digits (aka severely anemic, borderline needed a blood transfusion), I was well into my way to being a Type-2 Diabetic (my A1C was 5.8, you need to be 6.4 to be diagnosed), AND... my liver was struggling really, really badly. Side note, he's also a mental health professional, and he's the one who originally diagnosed my severe PTSD and got me in with my therapist.

NEEDLESS TO SAY, I WAS NOT IN THE BEST CONDITION. I was actually well on my way to developing early heart disease, osteoporosis, diabetes, blood clots, like everything I was the MOST afraid of was what I was about to have. Because I wasn't taking care of myself, I was living off of ramen and fast food and processed as shit food all the time, TV dinners... I'd make a meal out of a family-sized bag of chips or a whole roll of crackers and several slices of cheese.

My doctor was very point fucking blank about my outcomes. I could've died if I did nothing. A really horrible way to die, too. He told me that if I wanted to make changes, he'd get me every resource possible he could to help me, but I had to want the changes if they were gonna stick. Keep that in mind, right? YOU have to want the changes needed.

And that's when everything started.

THE GAME PLAN

SO, what did I do to start losing weight? What changes did I make?

Everything. FUCKING everything. My doctor said I needed a low-as-possible sodium diet, so I changed it. I needed to start exercising, so I did. I needed meds and to get into therapy to help deal with my mental health, so I religiously take my meds and I go to therapy as many times as possible each month. He also wanted me to get a daytime job, as my overnights were likely making things worse, and I finally got that done now, too.

A big thing to add here, too: my doctor has not talked to me about BMI. The only thing he has asked me to do is get to 200 lbs. He says so long as I don't drop under 120, he's said it's fine whatever weight I stop on, so long as I get to 200.

But where did I begin? The SIMPLE shit.

I started with ten minute walks. That's it for exercising, I started with TEN MINUTE WALKS. And you know what? It was fucking hard. It still is. It's like pulling teeth sometimes to get me to get up and go take a 30 minute to an hour walk. But don't let these fucking fitness influencers bully you into thinking that if you can't handle pumping iron in the gym for 6 hours straight then you're always gonna be a fat slob or whatever those fuckheads say these days. And, if you don't like walking, if you'd rather lift weights, you can do that too! If you don't want to go to a gym like I don't, order some cheap ones off of Amazon or Walmart. Go cycling or swimming or jumping rope. You don't have to go big and hard into exercise to be healthier. Start small.

Now, diet-wise, I threw myself in it a little too vigorously and I also paid the price of wasting like $50 each payday in shit I didn't eat or still haven't, and I also fucked up my GI tract for a solid month. I was ROUGHING it. Raw-dogged the low sodium diet and it did it back double time, do NOT do what I did. There's gonna be a WHOLE section after this one on dietary shit. Big thing, though? MEAL PLANNING. I don't care if you only meal plan one meal of the day, I only do my damn dinners. Just take time on your day off to batch cook a bunch of shit to be able to eat for one meal throughout the week.

MAKE GOALS. I don't care if the goals you set seem shallow to you or not, make some fucking goals. Keep them on a list you can easily find, especially like on your phone. HELL, keep the list in SEVERAL ways, like a paper on your wall. I have another section planned for like examples and my own goals on down.

EXERCISE

AGAIN, start small. Don't go hog wild and try to do an hour a day at the gym to start; that's gonna burn you out and wear you down before you even get started. Also, you don't need a gym to exercise. If you never wanna step foot in a gym, you NEVER have to.

Start with a five to ten minute walk every other day. You don't like walking? Cool, get some cheap weights (or a kettlebell weight) and lift weights for 5-10 minutes. I just recently got a 5lb kettlebell on Amazon for like $8.55 after tax so I can start doing weighted exercises. (NOTE: don't start with big heavy weights. You'll fuck up your muscles and joints. You'll want to research what weight to start with first.)

I think it wassss two weeks of me walking for ten minutes every other day before I moved to 15 minutes? Now, in May, I can go for an hour at a leisurely pace.

My Routine:

45 minute-hour walk at LEAST 4 days a week.

One day of 30 minute power walking or walking-jogging intervals. I walk along the street I live on, and I do 1/3 of the way jogging, the rest walking.

At LEAST one day using resistance band exercises. Resistance bands are like $10 at Walmart, I recommend using a light one to start WHILE AT YOUR HEAVIEST WEIGHT. Resistance bands work by using your own body weight as the resistance, so it's best to start while you're still at the heaviest.

Hoping to work the kettlebell in on at least three days of the week, doing weighted HIIT exercises (high intensity training).

DIETARY CHANGES

The BIGGEST piece of advice I can give you is to make sustainable changes. The reason diet culture doesn't work is because you can't survive off of diet food for a long period of time, meaning you'll just regain the weight back once you return to a normal diet. Also, carbs are not bad for you. Unless a doctor specifically tells you to lower carb intake, PLEASE do not just suddenly decide to stop eating carbs as you can permanently damage your major internal organs.

Now, I am not on a diet, persay. The changes I've made I plan to keep for the rest of my life. Now, I can only tell you what I do, and not what you should do. I have some formal training in nutrition, and I can give you advice on what not to do, but again, I can mostly tell you what works for me.

NOW THAT THAT'S OUT OF THE WAY, HERE WE GO! I am on a low-sodium diet, meaning I do not add salt to shit. I use Accent, a shit ton of seasoning and spices, and I get my canned food no salt added when I can. I also mainly only eat turkey and chicken (mostly chicken), while beef and pork are like... a treat every once in a while. I also get low sodium canned tuna or like... actually good fish sticks. And, as I live on the Gulf Coast, I get fresh shrimp once or twice a month. I also do NOT add sugar to something unless it's a recipe for like bread to feed the yeast. I get canned fruit in 100% juice, or I get it frozen mostly. If I want to add something to make it sweet, I dump fruit in it. I've also recently been adding like... one packet of splenda ALONG WITH FRUIT to my oatmeal. Tastes p good, do not recommend splenda in coffee. Shit's nasty.

I am also a calorie counter and believer. The easiest way to think of calories is like... energy. One calorie is one unit of energy. I HIGHLY recommend using a couple of calorie calculators to help figure out your daily intake, and I use the My Fitness Pal app to keep track of what I eat, especially as I am prone to boredom eating and binge eating, as I do still struggle with disordered eating. I also keep an eye on my macros (protein, carbs, fats), as well as my cholesterol, sodium, and saturated fat levels.

So, what does Cy do for food? A lot but also... not very much, lol. I am a convenience bitch. I ain't here to cook several times a day and shit, I ain't got time for it. I be makin' shit as easy as possible.

I do often drink protein shakes before or after I walk or have an intense workout. You don't have to, just keep in mind you DO need high protein intake before or after working out, to help your muscles repair themselves. I get the cheap af Purely Inspired brand at Walmart, mix it with frozen fruit and milk in my blender.

PLEASE, GOD, DRINK WATER! Drink plenty of frickin water. Your body has to be hydrated and the more water you drink, the less water your body retains as extra. A bit weird, I know, but take it from me as I carry about 10-12 lbs of water weight a day, and it was a LOT more when I wasn't hydrating properly.

I meal prep one meal a week. It's dinner now, so I take a day I'm off, make a big batch of smth, and separate it into like 5-7 containers, freezing some and fridgerating the others. I post recipes and total costs over on @cylentlycrafting , and I get those cheap ass Mainstays meal prep containers. It's like $5 for 5 of em, and I have like... 3-4 sets.

The main meat I eat now is chicken, as it has the highest amount of protein across all meats. I also pretty much exclusively eat whole grain foods (brown rice, whole wheat bread, whole wheat or brown rice or quinoa pasta), and I keep instant brown rice and instant oats on hand. Listen, I'm an impatient ass mfer, I don't have 45 mins to cook some goddamn rice.

I also luv eggies. And cheese. And dairy. Though I typically get reduced fat dairy products, except milk. Reduced fat sour cream, reduced fat cheese, sometimes reduced fat yogurt, but I take any yogurt I can get my hands on.

I use a LOT of canned beans, peas, chickpeas, and tomatoes. I also get frozen broccoli, cauliflower, sweet potatoes, red potatoes, and carrots as far as veggies go. I also often get chopped romaine lettuce, carrot chips, grape tomatoes, and onions. That is the beginning and the end to the veggies I eat, and best be fucking sure I put red kidney beans and chickpeas in everything almost it. Broccoli, too. Tomatoes.

Fruit wise, I have a LOT of fruit cups and canned fruit in 100% fruit juice, frozen fruit, and I also have a thing for clementines lately. Been eating tf out of them.

Snackies wise, I usually get that big box of baked chips from Lays. Peanut butter and graham crackers. Dark chocolate. Power Crunch protein bars because PROTEIN BARS DON'T HAVE TO BE DISGUSTING!!!!!

I pretty much exclusively use olive oil, but canola oil is also pretty damn good if you're on a budget! Just avoid regular butter, that shit's got so much calories and fat in it.....

Listen, you don't have to go broke buying shit. I tend to allot more money to food than most people because I have a LOT of food issues, and because I commit hard to shit. I have olive oil mayo and butter replacements, I keep low sugar and low sodium ketchup, and I buy expensive ass Lucini tomato sauce. You don't have to. Like I also buy tater tots and off-brand coco puffs and mini wheats.

I have experimented with a LOT of brands in the past few months, which I will probably make another post about eventually? Maybe? Also more budget-friendly shopping hacks and shit given I be trying to save as much money as possible.

GOALS

Listen, like every big project, you need goals. Getting your body healthy is a big project, and you should make goals. Goals on why you want to get healthy, goals on why to keep going even when shit gets hard. I don't care if it's the most vain shit ever, if it's a goal it's a fucking goal.

Here are some of mine:

More clothing options. If I lose more weight, I will be able to fit into smaller sizes and have more choices on what to wear.

SELF CONFIDENCE

Feeling less embarrassed when eating out somewhere.

HEALTH. A large part of me always feeling shitty is my diet and lack of proper vitamins and nutrients.

Prediabetes. I don't want to be like my mom and papaw and have to poke myself multiple times a day nor be reliant on insulin.

FINAL THOUGHTS

The main things I can impress upon y'all:

Build sustainable habits. If you don't think you'd be able to do it for the rest of your life, maybe rethink the habit before it becomes too set in stone.

You're gonna fall off the horse sometimes. You're gonna cheat, you're gonna make slip ups. And that's okay. Don't feel guilty, don't overrestrict or punish yourself for it. You're human, and you're trying, and that's okay. You can only do as much as you're able to right here and right now.

It's a hard and long road. Getting healthy and fit isn't going to be a breeze in the park. This shit is hard, especially if you're building new habits from scratch. But you got this. YOU CAN DO IT.

You HAVE to want this for yourself. No one else can want it for you. It has to be on you and you alone.

You're gonna find people wanting to sabotage you, as horrible as it sounds. Sometimes people feel threatened when others attempt to better themselves, because that person or those persons know they wouldn't put the time or energy into doing so themselves. And, unfortunately, some of those people are your close friends and family :/

TRY NEW THINGS. FAIL AND KEEP GOING. I have tried so much shit in the last few months, and some has stuck, some has not. I have learned I do not like a lot of vegetables, and that's okay. I also make taco salad (from 'scratch') at least two to three times a month. What works, works!

You are going to bloat A LOT when you start amping up workouts. Your body holds extra water and nutrients for up to FOUR WEEKS after you start exercising or start a new exercise routine/build up on your existing one. This is to repair your muscles and joints as they grow.

Scales like to lie, and they won't tell you how much water weight you're holding. And yes, you will be able to tell you're bloated. I never knew of bloating until now and sometimes shit fits weird when I'm majorly bloated. It SUCKS

Measure yourself. Your stomach, chest, waist, hips. All of it. Keep it. It'll be amazing to see how much you've changed eventually.

I actually would LOVE to keep making posts like this. But, here's my current progress:

I am a little under 270 lbs, unsure of how much as I am starting and trying new exercises, as well as my new job being HELLA more active than my old one.

I do have more processed stuff in my diet, but i do try to balance it with healthier food, too. Budgeting is.... hard.

My blood pressure tends to run 110/70 now.

I hope this helps someone out there.

My heart rate has gone down from 100+ bpm, to now it's at 60-75 bpm.

I also drink diet soda now, usually one a day.

#weight loss #weight #nutrition #health #health and wellness #wellness

[gurggggleburgle]

every time i think about the svsss donghau i think about how shitty the geometry and texture is on this is just soooo fucking whack and i laugh. but it also lets me think about how potentially the actual explanation for all of this is that binghe is not actually not that good at cooking. He’s decent and all around talented, but Shen Yuan despite being a rich ass bitch doesn’t know what good food is and has a sad white girl on tik tok energy when it comes to cooking and just eating nice food in general. Man died of food poisoning and you can’t tell me it wasn’t from eating 4 year out of date cup of yogurt he found in the back of the fridge while dipping in goldfish crackers into ranch and angrily typing his comments while having had instant noodle things and cheap ass takeout that’s almost a little sketch but whatever the delivery time was short ASF for 3 weeks in a row.

Chronically ill and weak bodied Shen Yuan is absolute classic but the crack theory and visual that the man just literally doesn’t know what a good bowl of congee is supposed to be despite everything is fucking hilarious to me. It’s like when my mom forgets to buy apple sauce for latkes or when people try to tell me there isn’t a difference between jewish and southern bbq style brisket. I just think it’s funny to imagine this bitch doesn’t know what good food should taste like despite everything, especially considering the world is a shitty novel full of hyperbole.

The concept that binghe’s cooking is just overblown is chef’s kiss mwha to my gremlin loving being who loves chaos in all things. orgasmic cooking my ass. he gets 3.1 stars on yelp from me

#svsss #bingqiu #luo binghe #Shen Yuan #scumbag system #scum villian self saving system #i am a terrible person #i constnatly show this imagine to my friends who are animators and all we can do is laugh #like from a construction point this is so bad and low effort #we laugh every time because what else is there #you can see the seam of the fucking dome they overlayed a plastic bump map on #its comedy gold

[slightlyrebelliouswriter23]

hey so i'm hoping to get some writing advice about creative burnout? like i seem to write in fits and spurts. some months i can churn out a oneshot or chapter everyday and some months i can do one (1) creative thing only. so i'm wondering how to prevent creative burnout and how to just create more smoothly <3 thank you!

Creative Burnout & How To Ward Against It

First, I’d like to preface this all by saying you’re definitely not alone. You probably already know this, but sometimes it’s nice to be reminded.

I know from personal experience that creative burnout can leave you feeling hopeless, detached from yourself—the kind of identity crisis no one needs in 2020. 

So buckle in, folks. It’s a dosy.

I. The Symptoms

Not to be the local WebMD page here, but signs of burnout can include:

Procrastination (more than usual)

Dreading writing and feeling stuck or overly perfectionistic when you try

Physical tiredness and/or irritability

Feeling like everything is monotonous

It’s more than just writer’s block. It’s a physical and emotional exhaustion response to something that goes deeper than a simple lack of inspiration. In my experience, and from a bit of research, I’ve found that what your brain is really looking for is dopamine.

Dopamine is essentially your brain’s chemical reward system for doing something interesting or exciting to you. As someone who is diagnosed with ADHD, I have chronically low levels of dopamine, so this is a constant struggle for me—but it is absolutely made worse by creative burnout.

II. The Problem

Studies have shown that the more we do A Thing the less that thing will give us dopamine (unless a component of the activity changes regularly). This is because eventually our brains desensitise to the stimuli provided by the activity, and subsequently, we become disengaged.

But it’s not necessarily The Thing (i.e. writing) that becomes boring. Actually, more than a few factors could be at play here, and the first step to finding a solution is to identify the problem.

1. ENVIRONMENT LACKS EXCITEMENT/CHANGE—

Sometimes, the monotony of everyday life can feed creative burnout. This becomes especially applicable in quarantine when you’re not leaving your house.

What we don’t realise is that even something as small as the variables of driving to and from work, or interacting with passing coworkers, gives us dopamine. So if you have the same routine every day that does not involve any added variables, your brain will begin staunching that dopamine supply.

2. EITHER TOO EASY OR TOO CHALLENGING—

In 1975, Hungarian-American psychologist, Mihaly Csikszentmihalyi, coined the term “flow”, which refers to a heightened state of creativity and concentration on an activity. Csikszentmihalyi posited that if your skill level is equal to the level of challenge in any given activity, you will experience this state of flow.

The chart below is taken from Csikszentmihalyi’s own study on the subject of flow and motivation. It examines “your skill level” on the x axis in relation to the “challenge level” on the y axis.

Essentially:

Too much challenge + not enough skill = anxiety, worry (which might lead to procrastination and perfectionism)

Too much skill + not enough challenge = boredom, apathy (which might lead to monotony, irritability, and other depression-like symptoms)

Skill level = Challenge level = Flow

3. NOT ENOUGH “ACTIVE” STIMULATION—

When it comes to dopamine seeking, there is a distinct difference between active and passive stimulation in the brain.

Active stimulation is any form of activity that you have to actively engage in. For instance; exercising, doing a crossword puzzle, or reading a book. These kinds of activities not only give you dopamine, they also facilitate critical thinking and problem solving thought processes, which act as catalysts for creativity.

Passive stimulation, on the other hand, comes in the form of television, social media, and YouTube. It’s anything you can consume without having to actively engage. Passive stimulation will indeed give your brain dopamine, however, it won’t activate your creativity.

The problem also lies in the speed at which you receive the dopamine from passive activities. Passive stimulation is so easy to access that the more you consume, the harder it becomes to pick up active stimulation. Your brain expects a hit of dopamine just by picking up a phone or turning on the TV—it becomes addicted to the quick fix of a Netflix binge.

III. The Solutions

Based on the problems mentioned above, I am going to list a few solutions. Keeping in mind that not every solution will work for everyone, these can act as both preventative measures and remedies for someone who is currently burned out.

1. CHANGE UP YOUR ENVIRONMENT/ROUTINE—

Aim to do at least one thing per day that will add “variables” to the monotony. This can be as simple as going on a long walk, dressing up in that bold outfit you always wanted to wear to the office but never did, or sitting at a different workspace in your home.

Anything you can do that’s simple, but might provide an extra variable to your day to spice things up. Note: this shouldn’t be the same thing every day.

2. CHALLENGE YOURSELF MORE—

If you find yourself bored by your work, try challenging yourself more. This could mean setting goals for yourself that go a bit beyond what you’ve been doing. 

For example, if you’ve been writing 500 words per day, see if you can beat your own word count every day for the next week. If you’ve been writing mainly fluff pieces, switch it up and do an angst piece. See if you can write a book in a month, or start a blog where you don’t write fiction at all!

Anything you can do to add a little kick to your workload. Note: Beware of challenging yourself too much! This can lead straight back into burnout.

3. CHALLENGE YOURSELF LESS—

If you’re on the flip side of that coin, and find that you are anxious, procrastinating, and perfectionistic when it comes to writing, fret not. Just because you’re experiencing any of these things, doesn’t mean you’re incapable of doing the job with your skillset.

It just means your perception of the job needs to be shifted.

Procrastination, at its heart, is a fear of failure, which results in actively avoiding the negative emotions associated with the task that causes this fear. Perfectionism is a type of procrastination that is a combination of a fear of failure and a fear of success (or, more accurately, other’s critiques of your success) all at once.

Neither have anything to do with your actual skillset, but they have everything to do with your perception of your skillset. Obviously, this is a harder thing to fix, as it has to do with deeply ingrained levels of self-esteem.

What I can offer you is a tactic to trick your mind into thinking you’re capable.

If you have a task, big or small, and you are feeling overwhelmed by it (like you might go curl up in bed and scroll Tumblr), immediately break that task up into smaller tasks. Keep breaking up the smaller tasks until you have the smallest possible part of the bigger task without doing nothing.

Then do that smallest possible thing.

If your goal is to write a 2000 word one shot, a small part of that task is writing half of it. An even smaller part of that task is breaking the one shot up into “scenes” and writing one scene. For instance:

Jude wakes up to a sore throat, a runny nose, and a fever.

She tries to go to work, but Cardan, being the mother hen that he is, threatens to never make her another grilled cheese sandwich (her favourite food) ever again if she doesn’t stay home.

Jude agrees begrudgingly, and Cardan sits her down in front of the TV with a bottle of Gatorade. He leaves to go get medicine from the store.

When Cardan comes back, Jude is worse than before. He makes her soup and saltine crackers and spoon feeds her.

She complains the whole time and, in her feverish state, threatens to never buy him another bottle of wine (his favourite food) ever again if he doesn’t let her feed herself.

Each bullet point represents one “scene” of about 200-400 words each. Obviously, there will be more details that you work out as you write. But with these five smaller scenes, your goal is no longer writing the 2000 word one shot. Your goal is writing the first of the five scenes.

If you complete the smallest possible task, you can stop, and you’ll still feel like you’ve accomplished something because you can cross off that task from your list. But chances are, by the time you cross off one task, you may have inspiration enough to keep going.

4. ENGAGE IN ACTIVE STIMULATION—

Since active stimulation has been proven to turn on the creative “tap”, try incorporating more of these activities into your daily routine:

Exercise: As the resident couch potato, I hate to say that exercising is good for creativity, but it is. Even if it’s just going on a short walk, so long as you’re moving.

Reading: Sometimes you have plenty of ideas, but no words to fit those ideas. Fill your well of words by carving out an hour or two each day for reading a good book.

The Creative Process: In the writing world, the creative process is a process of about 20-30 minutes that the writer partakes in every day before they start writing. This process should be creative, but also have nothing to do with writing. You can try colouring in a colouring book, painting, organising a page in your bullet journal. Anything that is creative but does not make you think about everything you have to do that day. Think of it as creative meditation.

Listen to music: Having APD, I personally can’t listen to music while I write. However, studies have shown that if you listen to at least ten songs per day, it will significantly benefit your dopamine levels and overall mood. If you’re like me and prefer to work in silence, maybe stick on a couple songs during your creative process. If you can manage music and writing together, get out those headphones!

5. KEEP A REGULAR SCHEDULE—

I know this is the most cliche point in the book, but it’s valid. This doesn’t mean do the same thing at the same time every day over and over, because ultimately we’re looking to avoid monotony. 

But having pillars of structure to bolster the excitement can definitely work to keep you from slipping into burnout. Going to sleep, waking up, and having your meals at relatively the same time every day are good examples of this. 

Feel free to change up the things you do between breakfast and lunch, but make sure you have those pillars of consistency so your brain knows that a break is on the horizon and doesn’t get tired.

6. PACE YOURSELF—

This is particularly difficult for those of us who are coming out of a creative burnout, but I urge you to pay special attention to this one. If we are suddenly hit by inspiration and the writing is flowing and flowing and flowing, eventually we will hit the point of highest dopamine capacity for writing.

Not putting a check on the flood of inspiration coming out of a creative burnout, I’d argue, is actually a guarantee that many of us will experience burnout all over again. It becomes this vicious cycle in which we are trapped.

While it feels great to write non-stop and receive immediate validation for that work, try to limit yourself to how much you’re writing and how immediately you post your writing (if you plan on posting it).

Whenever I finish a one shot or a chapter of something, I like to allow at least one day for editing before I post. This timeframe is important, because it acts as a buffer of rest between writing marathons. 

You can take however long you need for the editing process, but definitely make sure you have a set amount of time in place. Otherwise, your brain might not have enough time to come down from what is essentially a writing high, and you will always need to reach greater heights in order to achieve that same level of dopamine.

~~~~

Overall, the most important things to take away from all of this are: 

Change up your environment

Keep your brain actively stimulated 

Have pillars of structure between which you can run about chaotically to your heart’s content

PACE YOURSELF!

Hope this helped. Happy writing!

-Em 🖤🗡

Writing Tip Masterlist

Fic Masterlist

Celebrate 2K with me!

#this one was a spiritual one y'all #thanks for the ask babes! #writing #writing tips #writing advice #writeblr #writing tip masterlist #writer #writer's desk #writer's life #writer's problems #writer's block #ao3 #fanfiction #creative burnout #asked and answered #em answers #danaanruhn #thank you for 2k!! 🥳💜

[heyitssmiller]

Clandestine: Chapter Fourteen

We’re here. The final chapter. Y’all. I’m gonna cry.

@lumosinlove thanks for these characters!!

@donttouchmycarrots thanks for being my partner in crime during this whole mess of a story <3

And thank you, lovely readers!! For sticking with me for this crazy rollercoaster of a story, for encouraging me when I felt like quitting, and for always being so, so wonderful. I appreciate y’all more than I can say.

CW: prison, food, anxiety

Clandestine Masterlist

.

The drive back was silent, punctuated sharply by the two empty seats in the van. It was something they should’ve seen coming, but yet were completely blindsided by. Sirius had been on their side for so long now, it seemed odd to picture him anywhere else. It was like he’d been there for years already, fitting in seamlessly and making friends fast, filling a gap that hadn’t been obvious before but felt like a chasm now. He belonged in Gryffindor with them. And Regulus, while more reserved and distant than his brother, didn’t seem to deserve the fate he’d found. The main motive that kickstarted this whole mission had been him – all for him – and he still couldn’t avoid being dragged down with the Snakes.

Remus was on the phone with a contact from the FBI – he had been since they’d taken Sirius away – trying his hardest to find any loopholes he could. He was… actually strangely calm. Methodically tackling one idea after the next, his analytic brain working overtime. Logan could understand, though. Being productive was helpful. It was when things settled down and got quiet, when all you could do was sit there and wait…

That was when things got tough.

His leg bounced up and down in anticipation the closer they got to the cabin, his one-track mind stuck on one thing and one thing only – getting a blond safe-cracker into his arms again. Not having Leo with them had been like missing a limb, making everything feel out of balance. And even thought he was safe, he was still too far away. Logan couldn’t stand it.

Finn reached over and placed a hand on Logan’s with a knowing smile. He was ready to be home, too.

Gravel crunching under their tires only fueled the eagerness. There were lights still on in the cabin, a warm, inviting pull. The front door was open before the cars had pulled to a complete stop, revealing Leo and Hope and Lyall. Julian was presumably asleep, given the hour. Logan’s seatbelt was thrown off and the door closest to him was yanked open, Finn hot on his heels.

Leo bounded down the steps of the porch and flung himself at the two of them, finding every inch of space between them and filling it, a soft sound escaping from his lips as he held on tight in a one-armed grip. Logan and Finn both stumbled back a few steps at the impact but quickly returned the embrace, Logan’s face buried in the junction between neck and shoulder and Finn’s forehead pressed against the blond’s. They seemed to take their next breaths in tandem, slow and steady, as they leaned into each other. Time slowed, everything in the periphery faded, and the world, previously off-kilter, evened out in equilibrium.

Finn suddenly realized he felt the coarse, scratchy texture of Leo’s sling pressed up against him and pulled back a little. “Careful, baby.”

That made Leo pull back. “Why?” He glanced over them nervously. “Are you hurt?”

Logan sighed long-sufferingly and cupped Leo’s face in his hands, looking him in the eyes with a fond expression that belied his exasperation. “No, but you are,” he moved his hands to smush Leo’s cheeks, causing Finn to laugh, “so take it easy.”

Leo smiled – a real one this time, not one of the fake ones he’d given them before they left – and relaxed. After a quick kiss from Logan he asked, “So it went well? Mission’s done?”

Logan and Finn both froze at that. Finn looked over to Remus, who was still on the phone (like he had been for the past hour at least) and frowned.

“Not quite.”

“We can talk inside,” Leo said, looking worried again. “there’s lots of food for y’all.”

He wasn’t wrong. Food covered pretty much every open surface of the countertops, ranging from pancakes to grilled cheese to the cinnamon swirl muffins Leo brought to their first briefing all those months ago. Finn smiled at the memories and instantly snagged one on their way to the kitchen table. His eyes landed on Talker, who was explaining something to Hope as she took a look at his leg. Nat, Kasey, and Alex were piled onto one couch, looking tired and each with a grilled cheese sandwich in hand. He could see Remus on the porch every once in a while when he passed by a window as he paced, phone pressed to his ear.

It didn’t bode well.

Logan sat down with a plate of pancakes drenched in syrup and started telling the story, voice a quiet murmur and only interrupted when he shoveled food into his mouth. Finn wondered how none of them had really seen this coming. In hindsight, it made sense that there would need to be a trial – after all, Sirius and his brother weren’t innocent. Finn wasn’t sure what happened next, though. Criminal trials and sentencing weren’t part of the job for them. He hoped they could get the brothers out of this mess, though. If anyone could find a way to do it, it would be Remus.

At least the Snakes were done for. The information on the flash drives was enough to lock them away for a very, very long time.

He took a bite of his muffin, no longer really hungry, and listened to Logan talk.

***

Remus sat down on the porch swing, tired and stressed and not at all ready to quit. He listened to Alice, his only contact in the FBI, rattle off some statistics that he couldn’t even begin to understand. And he wasn’t trying to be rude – that really wasn’t his intent – but he needed to act quickly about this. So he grimaced and cut her off. “Can we get them placed in another prison? Or even in solitary until we can figure something out? If the Snakes can get to them…”

Well. Remus didn’t think they’d show much mercy to the two people mainly responsible for putting them in jail.

Alice sighed, the sound of her rummaging around in her desk filtering through the phone. “We can try. Since they did help you guys, we should be able to swing it. If something jeopardizes their lives, it shouldn’t be too difficult.”

Remus’ heart twisted – a deep, chronic ache under his ribcage that refused to let up. “Do it fast. I’m going to start reaching out to lawyers.”

“Lupin, it’s four in the morning.”

“I know.” He ran a hand through his hair with a frustrated huff. “Thanks for all the help, Alice.”

He hung up, then braced his forearms on his knees, hands gripping his hair, and breathed.

If there was one thing Remus Lupin was good at, it was planning. It was his job, and a big part of the reason he’d switched from field work in the first place. He relied on structure to get through his days, needed the stability in order to function.

There was none of that.

This was being adrift at sea, constantly assaulted by the waves and the current without rescue in sight.

And Remus had no idea what to do.

His phone pinged, catching his attention. A text from Alice flashed across the screen.

I’ve got a friend who’s a lawyer, and she’s a damn good one. I know you’ll want to do your research on her yourself, but I can vouch for her too. Here’s her contact if you want to reach out.

The contact number and email were listed under the name Dorcas Meadowes.

***

Dorcas Meadowes was, to put it simply, awe-inspiring.

Black curls, a dark complexion, and a serious, no-funny-business expression on her face. Her office was neat and organized, a few pictures around the place of her and a blonde girl with a wide grin and freckles. There was a small pride flag on her desk. Without a word, she motioned for Remus to sit, cool and composed and ready to get to work.

That was all it took for Remus to instantly respect her.

“So I’ve heard some of the story from Alice, but I’ll need you to start at the very beginning. Don’t leave out any details, tell me everything.”

Remus did, settling into the chair and getting comfy. It was a long story, after all. When he was done he looked back up at Dorcas, whose face was expressionless except for a single, raised eyebrow.

“That’s…” she trailed off with a low whistle.

“Yeah.”

“Well, the good news is that, if we’ve got enough evidence to back your story up, we can reduce his sentence by a lot, maybe even get him released.”

Remus sagged back into the chair, relief taking over and wiping out the tension radiating through his muscles. “Great.”

He’d known, logically, that they’d be able to reduce his sentence. With all the work he put into taking the Snakes down, there was no way they’d give him a full sentence. But getting him out of there for good…

Remus had never wanted anything so much in his life.

Dorcas leaned forward, powering her laptop on. “We’ll go visit him in the next few days and tell him what’s going on, but first we need a plan. Here’s what I’m thinking…”

***

Sirius hated this.

He was bored, he was tired, and – more than anything – he was lonely.

In Gryffindor, he’d become so accustomed to always having at least someone with him at all times. It was usually Remus, but he’d also grown close to most of the team. And it was nice at the time – god, did he miss it. But it was painful now. He’d witnessed what his life could be like, happy and surrounded by friends and possibly in love, and now he was back to the way his life used to be. Alone and on the wrong side of the law.

He hadn’t seen Reg since they’d been escorted into isolation for their own safety. Which don’t get him wrong – he was grateful for it. Knowing Riddle, they wouldn’t have survived the night if they were all being held together. But it was too quiet now.

The door to his cell rattled and Sirius looked up sharply. A guard was standing there, unlocking his door and opening it.

“Come with me,” the guard said, sounding bored as he opened the door further and held out a pair of handcuffs. Sirius looked at him hesitantly, not moving an inch. The guard rolled his eyes. “You have visitors.”

Sirius perked up at that, the only thought running through his head being Remus. He knew him well enough to know that he wasn’t going to take this sitting down. He’d be fighting to get Sirius free, no doubt about it. He wasn’t sure who else would be visiting him, anyways – if someone was here, it was sure to be Remus.

So Sirius got up and held his wrists out to be cuffed, then watched as the officer pointed down the hall.

“This way.”

It took all the self-control Sirius had to not run, to slowly put one foot in front of the other until he finally reached his destination. The guard moved around him to open the door and then Sirius was moving again.

He spotted caramel curls as soon as the door opened to the visitation room and felt his shoulders sag with relief. “Remus.”

Worried brown eyes followed him as he crossed the room quickly to sit in front of him, separated by a thick wall of glass. The movies weren’t lying, apparently. But it was so good to see him that Sirius didn’t care.

Remus looked tired. Unfortunately, that didn’t surprise Sirius at all. He knew the tendency to overwork all too well at this point. More than anything, it made Sirius want to get out of there, to wrap him up in his arms and let him take a nap there, to make sure he was taking care of himself. He settled for giving him a stern look instead.

“You need to get some sleep.”

Sirius expected a sharp, witty retort. Some sass, a comeback of some kind. Instead, Remus did the unthinkable and just smiled. “I missed you.”

Sirius sighed, softening at the gentle admission. He’d missed Remus too, of course. More than he could really put into words, and it had barely been a day. The smell of his shampoo, the quiet, reassuring presence of him by Sirius’ side, those eyes that just seemed to see right through him and know even the things Sirius tried to keep hidden. He found he didn’t mind it too much - not when it was Remus.

“I missed you,” he echoed in agreement, refusing to look away until someone cleared their throat loudly. Sirius looked over to a woman sitting next to Remus, looking unimpressed. Sirius hadn’t even known she was there, as wrapped up in Remus as he was.

Remus, to Sirius’ endless delight, blushed. He wasn’t sure he’d ever seen Remus blush before. It was cuter than it had any right to be. “Um, Sirius this is Dorcas. She’ll be representing you in court.”

Right.

He had to go on trial.

Dorcas took over from there. “We think, with the evidence we have, that we can get the charges reduced, maybe dropped if we’re lucky. If you can think of any evidence we don’t know about, we can use that to strengthen your case, too.”

Sirius nodded, relieved. That sounded better than he thought he’d get, to be honest. “What about Reg?” he asked, looking between the two.

Dorcas was very hard to read, Sirius realized. And Remus looked confident… until he looked over at the lawyer. Then his expression flickered.

And Sirius’ heart sank.

“That’s a bit trickier,” Dorcas stated slowly, treading carefully. “The thing is, he never tried to get out. He stayed with the Snakes. And I know it’s not easy to get out of situations like that,” she rushed to continue when she saw the look on Sirius’ face, “but the fact still stands. And he didn’t do as much to help take the Snakes down, not like you did. We can probably reduce his sentence, but he’ll be in prison longer than you. I don’t think we can fix that.”

Sirius felt himself being torn in two different directions. He wanted to be free, to be able to live his life again. Maybe make a home in Gryffindor (or maybe move in permanently with a certain spy), get a job as a consultant. He’d make sure the poor houseplant in Remus’ apartment survived, the poor thing, and he’d keep Remus’ favorite tea stocked in the cupboard. He’d be able to relax for – well, the first time in a very long time.

But his brother.

He was the main reason Sirius got out in the first place. The reason he ended up in Gryffindor, this entire mission was for him. To get him out, to make sure he was safe.

What was the point, if he was stuck in jail while Sirius got to walk free?

He could practically hear his brother telling him how stupid he was being in that dry voice of his, but he pushed the thought away. He’d made up his mind, and it was practically impossible to sway him when that happened.

Sweet, caramel eyes might test him, though.

Sirius looked up at Remus guiltily, dreading the response he was going to get. But yet again, Remus took him by surprise and smiled sadly.

“I understand.”

Those words hit Sirius like a freight train. He sucked in a deep breath, eyes stinging and throat getting tight. “I’m sorry.”

Remus just shook his head. “Don’t be.”

Sirius loved him.

Remus glanced over at a confused Dorcas. “He can’t leave his brother. Whatever sentence Reg gets, Sirius wants to do the same.”

She was silent for a long time, looking back and forth between the two of them. Then she sighed, seeming resolute. “Well then we’d better get those charges as low as we can.”

***

Four Weeks Later

.

Leo found Remus in the courthouse hallway during the trial recess before they were supposed to reconvene for the sentencing, looking seconds away from pacing from one side of the building to the other. The past few weeks had been hard on all of them. Between coming to terms with everything that had happened in the recent months, to trying to figure out the evidence they needed to bring forward to try and get the charges dropped against both Sirius and Regulus, to the strange feeling in the Agency brought forth by Sirius’ absence, it had been weird for all of them. Remus had been hit the hardest by all of it, though – and understandably so. That didn’t make it any easier to watch, though.

He’d been running himself to the bone the past four weeks, going above and beyond to make sure everything was in order for the trial. He looked ready to drop, if Leo was being honest.

But he understood. If it were Logan or Finn in Sirius’ place… well. He’d already figured out just how far he’d go for them.

He put a hand on Remus’ arm, trying to be as calming as possible. “You’re going to be ok,” he said carefully, choosing his words meticulously. He didn’t want to be cold, but he didn’t want to get Remus’ hopes up only for them to be dashed.

Carmel eyes met his own, and Leo sighed at the stress he saw there. He looked tired – so tired.

“What do you need?” Leo asked quietly, hoping for some sort of guidance on how to help him, how to get that look off of his face.

Remus just laughed under his breath, a sad sound. “There’s a lot of things I need.” He shuffled on his feet, gathering his sleeves in his hands. “But a hug would be a good start.”

Not hesitating, Leo gathered him into a hug, the stretch pulling at the scar tissue in his shoulder that was finally free of a sling. Remus was tense and still for a while, then relaxed into it. Leo wished he could do more, wished he could make any sort of difference in this situation. But everything was so far out of their control now; the only thing left to do was wait.

“Whatever happens, we’re here for both of you. You’re not alone in this.”

Remus stepped away with a fake attempt at a smile. “Yeah.”

There was a visual cue that neither of them seemed to catch and people started filtering back into the courtroom, making Remus’ face grow paler and more pinched. Leo stuck by his side as they walked back inside, trying to ignore the soft sound Remus made when he saw Sirius again – all the way in the front, in a jumpsuit that looked too big for him, hair longer and eyes a little duller than they remembered, fidgeting with something in his cuffed hands. Regulus was next to him, head down and avoiding everyone’s eyes. Leo just stuck to Remus’ side as they squeezed into the row of chairs with the rest of the Agency, making sure Remus was right in the middle, surrounded by so many of the people who cared about him most. Finn and Logan sat down next to him with grim smiles.

Leo reached over to tangle his fingers with Finn’s, feeling him squeeze back gently. The bruises were completely gone from his face, and he was walking limp-free now. He dropped his head onto Logan’s shoulder, having to angle his shoulders down to rest somewhat comfortably against the shorter man.

Leo would never get over the height difference.

“I’m taking a nap when we get home. This is so stressful, oh my god.” Finn sighed, making Leo smile.

Home.

That was still somewhat new for the three of them. After a few days back in their separate apartments in Gryffindor, they’d realized how incredibly codependent they’d become during their mission. Leo would find himself staring up at the ceiling most nights, worrying about the other two, until he’d get a phone call from one of them and they’d end up driving to each other and collapsing in bed together, squished together just like those hotel rooms they’d shared. And it had gotten to the point where there wasn’t any point living in different apartments when they ended up together most nights anyways, so Leo and Logan had packed up their things and moved in with Finn. He had the largest bed, anyways.

So yeah. They lived together now. And Leo was ridiculously pleased about it.

They were taking that vacation in a few weeks, too – the one Finn had first brought up in the back of a getaway car, tears in his eyes and blood on his hands. Somewhere warm, just like he’d promised. He’d get to watch Logan tan and Finn turn red like a lobster, only to go straight back to pale. They’d get some time to relax and not stress about work – just themselves and the vast expanse of beach and water in front of them.

Leo couldn’t wait.

“We’ll take that nap together.” Logan answered Finn quietly, turning his head to meet Leo’s eyes as he pressed an affectionate kiss to Finn’s head. Leo smiled at him, the sense of one chapter ending and the next beginning washing over him.

Whatever came their way, they’d be ok. They’d proven that already.

The crowd hushed as the judge sat back down, face impassive.

“We have reviewed the evidence and testaments brought forward in defense of Sirius and Regulus Black.” He started, looking down at the two in question critically as everyone in the courtroom seemed to hold their breath.

“It still doesn’t change the fact that they committed crimes while with the organization,” the judge stated firmly, then continued, “Regulus and Sirius Black are hereby sentenced to one year in prison.”

The gavel slammed.

Remus sat there in quiet disbelief.

They’d done… everything. They’d worked so hard for the past month in attempts to let Sirius and Regulus’ sentences reduced – and that was technically a reduced sentence – but it was still more than any of them had been expecting.

A year.

They hadn’t done enough.

Remus almost missed all the movement around him, too busy staring at the back of the seat directly in his line of vision, but his gaze snapped up when an achingly familiar voice called his name.

Sirius slowed to a stop as he passed Remus on his way out, eyes wide and frantic. Desperate. It broke Remus’ heart, more than it already was. “Wait for me?” He asked intently, like his sole focus was on Remus and his answer. He shoved his open palms out, revealing what he’d been fidgeting with during the entire trial. Remus looked down to find an origami flower, conveying all of Sirius’ hopes for the future within the delicate folds.

Remus wished more than anything that he could reach for him; to pull him in tight, hold him close, and refuse to let the guards take him away. He also had the half-formed plans of a jail break already in mind, even though he knew Sirius would never agree to it. It was then that his eyes locked with the gray ones he’d come to know better than his own and he knew – he knew that he’d wait, however long it took.

Remus loved him.

It wasn’t a grand revelation, it wasn’t sudden. In all honesty Remus had probably felt that way for a long time now, the truth prodding at the back of his head, nagging at his subconscious. He loved Sirius, plain and simple. Simple except for the fact that one of them was going to jail for a year. And yet, no matter how complicated it got, no matter how much time went by, it was the easiest decision Remus had ever made.

Well. If love made people crazy, Remus was certifiably insane.

He smiled a little tearfully at Sirius and nodded fiercely, picking up the paper flower delicately.

 “You know I will.”

#lumosinlove #sweater weather #coast to coast #coops #sirius black #remus lupin #o'knutzy #finn o'hara #logan tremblay #leo knut #clandestine #cw: food #cw: prison #cw: anxiety

[ashintheairlikesnow]

Christmas Specials: Silver

CW: Chronic pain, references to attempted murder and past torture

The lights dance over Mina’s hair, edging black with red, yellow, green, and blue as she moves on little legs to touch the wrapped boxes piled underneath the tree. 

Danny sits on the couch with Toto curled into a ball next to him, watching Nate and four-year-old Mina get everything ready for Santa’s arrival. 

His back is a constant low throbbing ache, with occasional sharp spikes, but he’d been determined to make it downstairs to see this. He’d spent the whole day in bed, timing his pain meds just right to ensure they’d be at full strength after dinner. 

Abraham doesn’t get to take Christmas away from him any longer, even just in his body refusing to forget the blade that had been buried in his back.

Making it to the couch still counts.

Mina has an expression of pure and earnest seriousness on her round face as she carefully places a cookie on the special Santa plate that Danny had braved the crush and the stares at the store to buy. Next to the cookie - which Mina had informed them could be anything BUT oatmeal raisin - there were five small squares of cheese, a smattering of crackers, and a few slices of cured meat.

“Santa’s ch-ch-cheese plate is done,” Nate says, looking up, his eyes warm when they meet Danny’s. Danny gives him a smile in return, shifting with his discomfort but refusing to let it show on his face. 

He has so much experience, after all, in forcing himself to power through pain.

“Great. What comes next, Mina-bean?”

“Santa needs a drink!” Mina says cheerfully and claps her hands.

“Don’t we all,” Danny murmurs, and finds it in him to laugh when Nate shoots him a look. “Oh, what. She already learned to swear from me, might as well teach her this, too, right?” His back twinges, which is a fun way to describe the spike of sudden sharp agony that shoots up his back and he stiffens, closing his eyes. 

Toto seems to sense the way he tenses and the little dog raises his head, watching Danny with large soulful eyes. 

Ride it out, ride it out, ride it out, you can do this, just a second, just-

“D-Danny?” Nate is back to him without more than a breath of time passing, and Danny opens his eyes to look into the deep mossy green of Nate’s. “Are you okay? N-need to go back upstairs?”

“Oh… I th-think I’m sleeping down here t-t-tonight, thanks,” Danny hisses, but he lets Nate push Toto off the couch and slowly lay Danny down, and once his stomach is flat against the cushions, the pain starts to fade back into the low-level throb that he’s learned to push past, to live with. “M-might have to take… pull out the big guns later on, Nate.”

“That’s okay. You c-c-can have another dose in a few hours, we’ll switch paink-killers then.”

“Oh, no,” Mina says, looking at them with wide brown eyes utterly heartbroken. “Daddy, no.”

“What’s-... what’s wrong, Mina?” Danny’s voice is airier than he wants it to be, but his back is starting to settle again, muscles gradually relaxing as the nerve pain fades. He turns to look at her as Nate carefully drapes a blanket over him, then moves back to the kitchen. A cabinet door opens and closes. The microwave kicks on. Guilt is ever-present, that his pain will ruin the moment for his daughter, that he won’t be able to be enough when it counts.

Her eyes are wide as saucers. “Will you sleep through Santa presents?” 

Danny isn’t sure at first how to answer. It hurts, it always hurts, to know that his daughter is already used to what Abraham’s final gift has taken from him, that she has adapted so well to Danny’s limitations that they are the framework of her world. And yet he’s so proud of her, at the same time, for her compassion, for her small serious expression, for the fact that she worries he’ll take the meds and sleep through Christmas.

He won’t.

He won’t.

He swore to himself Abraham couldn’t steal any more Christmases, that he couldn’t twist them any longer into terror after he was dead. He promised himself, that first Christmas back home watching Nate decorate a fake tree they got at the store, that he would get to decide, from here on out, what Christmas looked like.

The lights dance over Mina’s eyes and hair and skin, and Danny smiles a little, thinking of a blurred sense of lights, of Nate’s hands over his body. The weight of eyes that he had thrown off, however briefly, to hold Nate as close as he could get without the other man sliding under his skin. 

Nate won’t talk about that night, but Danny thinks about it, sometimes, about how happy he’d been, for just a while, with someone he actually - already - wanted.

“I won’t, sweetie, I promise.” Danny forces his voice to be firm, and strong. Nate returns and lays the heating pad, freshly hot from the microwave, over the blanket. Heat spreads, and tensed muscles around damaged nerves relax even more. The hurt fades, never gone but barely noticeable, no longer enough to stop him.

He closes his eyes, relishing the simple joy of feeling only a minimum amount of pain. “I won’t sleep through Christmas,” He murmurs, “Because your Dad will wake me right up. Right, Dad?”

Toto hops back up and curls right back into his ball, settling into a hollow in the blanket between Danny’s knees.

Nate’s hand runs through his hair, briefly over one shoulder, and Danny opens his eyes again to watch Nate move back over and set the small red-and-clear-glass tumblr on the tray next to the cookie and cheese plate. Danny knows the drink because he was the one to insist on it when they did their first Christmas with baby Mina - rum, spicy ginger beer, squeeze of lime, a cherry to soak it all up, a slice of lime on the rim of the glass. 

Nate smiles back at him, and Danny is warmed as much by the love in that smile as he is by the heat spread through his back. “Absolutely. I’d n-never let Daddy miss Christmas.”

Not another one, anyway.

“I’ll sl-sleep down here, too,” Nate says, gently. 

Mina’s eyes light up. “Me, too! Christmas sleepover! We all sleep down here!” She looks so fucking delighted, and Danny can’t quite stop his smile. 

Somewhere, in the world, Abraham is a moldering pile of ashes. He took five years of Danny’s life, all told, and left him with pain he’ll carry for the rest of his life. He took five Christmases, five birthdays, he stole a year that Danny could have spent with Nate. 

Abraham stole so much.

But here, right here and now, Daniel Michaelson is determined that that monster will never take from him a single fucking second with his daughter.

“That sounds great,” He says, to Mina’s resounding cheer. Nate settles on the floor so he can lean back against the couch, and Danny chances sliding an arm around his chest, resting his chin on Nate’s shoulder. “Hey, you.”

“Hey, y-you,” Nate replies, his own eyes closing, slowly. He leans back until his hair brushes into Danny’s. Both of them are graying, now, just a little, although Danny’s had silver threading through his red hair like tinsel since he was 24. He turns just enough to press a kiss to the hint of gray at Nate’s temple, down to his eternal five o’clock shadow. 

Danny takes a deep breath - the smell of the pine tree and the fireplace, of the man he loves. Toto huffs a sigh and curls up again. “Merry Christmas, yeah?”

Nate chuckles, watching Mina lean forward to examine a large box wrapped in dinosaur-themed paper. “Yes. M-Merry Christmas, Danny. We m-m-made it.”

“We did.” Danny closes his eyes. “We made it.”

We’re here, and he’s not.

Merry Christmas.

---

@slytherynjolras, @whump-it, @bleeding-demon-teeth, @finder-of-rings, @burtlederp, @whumpywhumper, @18-toe-beans, @pumpkinthefangirl, @special-spicy-chicken, @swordkallya, @astrobly, @slaintetowhump, @moose-teeth, @untilthepainstarts, @whumpiary,  @lave-whump @raigash @cupcakes-and-pain, @whump-tr0pes| @wildfaewhump

#christmas specials #daniel michaelson's story #dad fluff #epilogue #hurt/comfort #chronic pain tw #past torture

[suckmysupernatural]

Excedrin and Crackers

Word Count: ~1200, Oneshot

Pairing: Dean x Reader

Warnings: migraine pain, nausea

Summary: Reader is a migraine sufferer and has been since before Dean and her met. Dean helps make her comfortable after finding her in bed, laid up with yet another migraine. 

A/N: Hope you enjoy! I actually wrote the first draft it while having a migraine myself.  -----------------------------------------------------

After working on the impala all day, Dean was ready to eat dinner with his sweetheart. He expected to find Y/N in the library, curled up with one of the Y/A novels that she liked to read on days off. Yet, when he walked into the room there was no sign of her. Before becoming worried Dean decided to check the room that the two of you shared. Walking into the bedroom, he switched on the lights only to be met with a low groan. 

“Migraine. The light, make it stop” Y/N plead as the light burned her sensitive eyes. 

“Oh shit,” Dean whispered, quickly shutting off the light, “I’m sorry baby.” He gave a few seconds for his eyes to adjust to the darkness before making his way over to the curled up figure on the mattress. Dean had become well accustomed to Y/N’s migraines. This was one in the long line of migraines that she had dealt with, as she had been suffering from them since childhood. 

It made hunting 10 times harder. Before teaming up with the brothers, Y/N had worked solo - or at least tried to. Most of the hunts she attempted to go on during that time were interrupted by migraines, requiring Y/N to call in another hunter to take over while she was holed up in a ratty motel. 

Luckily, with Sam and Dean she didn’t need to worry about it. If a migraine took Y/N out for a day or two she could hop back into the hunt once she felt better. The brothers never pushed her to stop hunting, which she was grateful for. Having a chronic condition already made Y/N feel useless enough, she didn’t need anyone to remind her of that. 

It didn’t take long for Dean and her to become a couple once she started hunting with them. They had been together for a few years now, with Dean becoming a pro at making Y/N feel as comfortable as possible during a migraine. 

Sitting on the bed, Dean slowly moved his hand to start caressing Y/N’s hair, using slow and light strokes that instantly calmed your body. Dean always had that effect on her, but especially when she was in pain. Inhaling, Y/N quickly grabbed at her head.

“I’m sorry… you smell like car grease. It’s making it worse,” she whined in pain.

“I’m so sorry! Damn, I’m not helping too much right now am I?” Dean frowned, “I’ll be right back. I’m gonna shower.”

Y/N nodded and rolled over so she could squish her face into the pillow, letting out a small whine. Dean made his way to the bathroom, stripping off his dirty clothes and tossing them into the hamper that sat in the bathroom. Looking under the sink, he found a bar of unscented soap tucked in the back. He didn’t want to use a scented body wash and make Y/N’s migraine worse. He scrubbed off the grease as fast as possible so he could get back and take care of her. Leaving the shower, he wrapped a towel around his waist and made his way back to the bedroom.

He walked in the door, tip-toeing to the dresser and pulling out a pair of grey sweatpants. He slipped them on before making his way back over to Y/N. 

“Is there anything you need me to get before joining you, sweetheart?” Dean asked, making sure to keep his voice as low as possible. 

“Excedrin… please, and… um...something bland… help the nausea.” Y/N responded with difficulty. Her mind was foggy, requiring more focus to speak than normal. Dean quickly hurried to the kitchen, grabbing a sleeve of crackers and the medicine. He came back to the room, placing the items on the nightstand next to the half-empty glass of water Y/N seemed to be nursing. 

Dean leaned over, placing a hand behind Y/N’s shoulder, guiding her to sit up. She did so, nausea hitting her as soon as she was fully up. Dean handed her two Excedrin and the glass of water. With shaky hands, Y/N slowly opened her mouth and placed the pills on her tongue. Taking a small sip of water, she handed the glass back to Dean. He pulled out a cracker and gave it to her. Chewing, Y/N’s eyes began to tear up from the pain that shoots into her jaw. 

“Baby, what's wrong?” Dean asked. Y/N lifted one hand, tapping a finger to her jaw. Knowingly, Dean nodded and climbed into the bed. He wrapped his arm around her, pulling her in close. He used his hand to draw circles on her bicep. Dean breathed a small sigh of relief as Y/N relaxed into his arms. Crying only made the pain worse and he didn’t want her to suffer any more than she had to. 

His phone buzzed, being met with a small groan from Y/N. Dean quickly pulled it from his pocket seeing that it was a text from Sam.

Found a case. Cali. You down to head out tonight?

Y/N has a migraine. Can it wait till morning? Dean replied, turning down the brightness on his phone.

Yeah, sounds good. Let me know if she needs anything. 

Dean responded with a thumbs up and put his phone on Do Not Disturb. Turning back to her, he laid down and pulled Y/N in close. Letting her head burrow into the crook of his neck, she whimpered softly. 

In Dean’s head, he cursed Chuck at the fact that this was one monster he couldn’t kill. Keeping her safe and happy was his top priority, but right now he couldn’t do it. He couldn’t fix it or make her pain go away. Listening to her noises of pain, Dean’s eyes began to water. He would make a crossroad deal to help her feel better but he knew that she would kick his ass.

Little did he know what Y/N was thinking. After handling migraines alone for so long, nothing felt better than being in Dean’s arms. She was so grateful for the man who did everything in his power to help when needed the most. 

Quickly Y/N’s breathing became in sync with Dean’s, calm and slow. His soothing energy flowed over her, her eyelids beginning to lull. 

“Love you” she mumbled into Dean’s chest. He smiled to himself before responding.

“Love you too. Sleep darling.”

Within a few minutes, she was asleep, Y/N’s body fully relaxing for the first time all day. Dean was incredibly relieved. He knew that if she were asleep, the pain couldn’t get to her. Dean ran his fingers through Y/N’s hair, staring at her peaceful face. He felt a small sense of pride, knowing that he had helped her fall asleep. Once he was sure that Y/N wasn't’ going to wake up anytime soon, Dean let his own eyes shut, drifting off into a deep sleep. Y/N dreamed of nothing but woke up to what felt like a dream itself. 

Feeling her head rise and fall, she remembered falling asleep cuddled on Dean’s chest. His even breathing indicated that he was still out and she slowly turned her head up to see his face. 

Looking at him, Y/N smiled. She was the luckiest girl ever. Not only did she wake up without any pain, but she had an amazing man to enjoy it with.

#spn #spn fic #spn fanfic #spn one shot #spn oneshot #dean winchester #dean x reader #dean winchester x reader #dean oneshot #dean one shot #migraine fanfic #migraine fic #spn family #spnfamily #supernatural #supernatural fic #supernatural fanfiction #supernatural oneshot #supernatural one shot #fanfiction #fluff #spn fluff #supernatural fluff

[swaps55]

Writing prompt: Staying up half the night to finish a game with them.

Wordless Ways to Say “I Love You”

47. Staying up half the night to finish a game with them.

At first, Miranda think that Shepard’s relentless insomnia is her fault. Something she overlooked. A miscalculation somewhere that has created a serotonin imbalance, or maybe something has gone wrong with his cortisol or adrenal levels.

She first notices the problem after leaving Omega. She’d emerged from her cabin for a cup of tea to find Shepard sitting at a table in the silent mess, toying with a few crackers and scrolling through a datapad.

Concerning.

Since then it’s followed a pattern. He spends some nights in Mordin’s lab. The salarian needs so little sleep he’s almost always awake, and the two seem to get on rather well. Either that or his endless prattle leaves fewer silences to fill.

Other nights he stays in his quarters. She doesn’t have cameras in there, but EDI confirms he spends hours at his desk, sleeping in his chair – if he sleeps at all – as often as he does the bed.

She asks his permission to run tests. He denies it, growing more and more defensive each time she brings it up. So she stops asking. Once she goes to Mordin for his professional opinion, to which he good-naturedly replies, “Don’t discuss patient matters without consent.”

That at least suggests Mordin has discussed it. But judging from Shepard’s continued insomnia, he does not have a solution.

“Has he always slept poorly?” she asks Moreau. If it’s a chronic issue, that is at least new information she doesn’t have. She’s gleaned much from his service record and the intel the Illusive Man had provided her with, but behavioral patterns leave a large hole.

“I’m not his nanny,” Joker had replied, annoyed. Miranda knows better than to ask Dr. Chakwas. If the salarian won’t discuss it, Shepard’s physician certainly won’t. But she also isn’t helping him sleep.  

They treat Miranda like the enemy when she just wants to help. This was so much easier when she had full control. But he is not her project anymore. He is a fully functioning, stubborn and vexing individual.

And he’s not sleeping.

She’d been so thorough. Why is this one thing so out of place?

The deck of cards appears after Horizon. Miranda strategically gets a cup of tea right around the time Shepard usually wanders into the mess, and tonight he’s right on schedule. But Vakarian and Moreau are already sitting there, playing a game of War almost like they’ve been waiting for him.

“This is a stupid game,” Garrus tells Joker. “It’s pure chance if I can’t look at my cards. There’s no strategy. It’s mindless.”

“That’s the point,” Joker replies. “Play your card, coward.”

Miranda is baffled as to why either of them are still awake. After everything they dealt with on Horizon her body feels like lead, she had been in the lift when the turian fantasized in great detail about the sleep he planned to enjoy that night.

Shepard turns the coffee pot on and leans against the counter to watch them. His eyes are bleary and there’s a tremble in his hands that suggests a dose of stims.

Wait. Is he keeping himself awake?

Garrus’s glance shifts Shepard’s way. His mandibles quiver. “This is only a two-person game, right?”

“Yeah,” Joker says.

“Perfect, Shepard, care to join us?” Garrus gestures to the open seat beside him.

Shepard sits – more like oozes – into the seat, posture slouched with weariness. He blinks, listening but unfocused, as if keeping his attention in the room or even on the Normandy is too great a task. “What do we play?”

Joker eyes Miranda warily. “If Lawson joins in, we can play Horse.”

“What?” Garrus asks.

“Never heard of it,” Shepard says.

“I’ll teach you.”

Garrus flicks a mandible. “What’s a horse?”

“Kind of like those shifty cows we saw on Ontarom,” Shepard replies. “Only less likely to steal your credits.”

“Why not poker?” Miranda asks, cautiously taking a seat. Not because she wants to play, but because the chance to observe is not something she’s willing to turn down. Poker is at least a game she knows, and poses less risk she’ll make a fool out of herself.

“No,” Joker and Garrus say in unison. Joker shoots her a dirty look. Shepard stares at the table and scratches the back of his neck. Miranda shifts in her seat. She doesn’t know why the suggestion was offensive, but doesn’t argue. She’ll investigate it later.

“Teach me Horse,” Shepard says.

It’s a stupid game with too many nonsensical rules. Even though no one but Joker understands how Jacks work in this context, Shepard quickly proves his luck isn’t just confined to the battlefield.

“There’s no way Garrus had both rights,” Joker laments when Shepard successfully “horses” and takes every trick. She is still lost as to which Jacks are lefts and which ones are rights – she swears they change – or why Garrus gets to pass Shepard cards. But Shepard has something that might pass for a smile on his face, which is at least an improvement even if it doesn’t solve the sleep problem.  

When she finally bids them goodnight it’s 03:00 and she still can’t figure out why a Jack of clubs is sometimes considered a spade.

She’s exhausted, sore, still hasn’t completely evened out her electrolyte levels after her output on Horizon, and after that unpleasant confrontation with Shepard’s former crewmate, now has to do some digging into the significance of Commander Alenko before she can finish up her mission report for the Illusive Man.    

Shepard looks exhausted too, and this time she thinks he might actually go to his quarters and finally rest. But when Joker makes the suggestion he waves them off.

“You need sleep, friend,” Garrus says. There’s a gentle thrum in his subvocals that even Miranda finds soothing.

“There are so many stars,” Shepard murmurs, digging at his neck with stiff fingers, right where the seal of his helmet would be. His nails leave red streaks against his skin.

Miranda’s heart lurches as she finally understands. His cabin. The open shutters. Alchera. Shepard had died alone in the stars, the same stars that gleam down upon him while he tries to sleep.

So many pieces she had put back together, recreated with near flawless perfection, but she’d never once given thought to perhaps the most important ones. Ones she can’t touch and can’t repair.  

But his friends have.

She’s tolerated Vakarian with a vague sense of wariness and even disdain, mistrustful of his intentions, afraid of the influence he might have. But as the turian gingerly rubs Shepard’s back with his talons and some of the tension leaves the commander’s shoulders, she realizes just how greatly she has undervalued his presence.  

Likewise, she’s made the foolish miscalculation that Joker is only here for the ship.    

The pilot’s eyes are bloodshot, he can’t stop yawning and he needs a shave as much as he needs a good night’s sleep. But instead of calling it a night, Joker picks up the deck and starts to shuffle.

“My deal.”

#theoriginalladya #garrus vakarian #jeff 'joker' moreau #mass effect #miranda lawson #my fic #ok so this is a slightly different take in 'i love you' #but man the platonic love from this crew #especially where shep/joker/garrus are concerned #is the stuff of life #also i don't get to write about me2 shep nearly enough #yes this is sonata!verse #just consider it concept art

[kaiunkaiku]

Sickdays 6, May 20th: “Oh god”

Fandom: Hamatora

Summary: "Birthday’s knees buckle under him. He catches himself almost immediately, far before he can go down, but he goes stark white with the motion."

Warnings: blood, relapse of a chronic illness

Ao3

Nice is on his way from the bar to the table where Art is sitting, a glass of water in his hand, when Birthday’s movement catches his eye. Birthday is at the bar talking with Murasaki, and there’s something about the way he stands up that steals Nice’s attention for long enough to actually see instead of just glance.

Birthday’s knees buckle under him. He catches himself almost immediately, far before he can go down, but he goes stark white with the motion. Nice has one hand reaching for his headphones before he even fully realizes what’s happening, but speed of sound doesn’t matter if it’s not activated. Murasaki jumps up from his seat, reaches for Birthday’s arms to steady him even as Birthday is already trying to lower himself back to his seat. Nice stands still for a moment, not entirely sure what he’s supposed to do here, until he gets his feet moving and leaves the glass in his hand on the nearest table. Art is moving towards Birthday and Murasaki, too.

Birthday has one hand clutching at his head and the other still holding on to the bar counter. Murasaki is trying to talk to him, but the closer Nice gets the worse Birthday looks. His eyes are glassy, unseeing, and his breathing is erratic at best; it keeps hitching and then trying to catch up. Nice reaches for his phone and notices Art is doing the same.

“Am I calling Ratio or am I calling an ambulance?” Art asks no one in particular, voice steady. Nice shares a look with Murasaki. Neither of them has an answer.

That gets Birthday moving, however. He detaches his hand from his hairline and holds it up, takes a gulp of air like a drowning man, and hoarsely says, “No.” Nice doesn’t bother to suppress the urge to roll his eyes.

“Birthday, that’s either or,” Murasaki says, one hand at Birthday’s throat. “ Or does your heart always sound like this?” he asks, frowning. He continues frowning as he turns to Nice and Art to say, “It’s like a hummingbird.”

“It’s nothing, really,” Birthday insists, trying to take a deep breath and failing. “It’ll pass. It’s just something that, something that, happens, it’ll pass…”

“Ratio or ambulance?” Art asks again, all business, and a vague voice in Nice’s head whispers jump his bones at that tone, mutters god that’s hot and yeah, it is and yeah, it’s been a while since Nice has heard it because Art isn’t a cop anymore, but he would also really appreciate if his brain could stop acting like a hormonal teenager about his boyfriend now that he’s twenty and not, like, fifteen.

Anyway. Birthday is breathing like shit.

“It’ll pass,” Birthday forces out, feeble, teeth grinding. Very unconvincing, overall. “No need to bother Ratio about it–” another attempt at a deeper breath, this time with an underlying wheeze to it, and this one ends with an abrupt cough that has Birthday reaching for his chest. He looks genuinely surprised by it, but his face quickly falls into concern.

“Okay,” he whispers, swallowing convulsively, and Nice could swear Birthday pales another shade. “Okay. Ratio, then,” he concedes. Art wastes no time.

It’s always seemed so very wrong to see Birthday anything that’s not happy, upbeat, energetic, Nice thinks, but this is just a whole another level of it altogether. Yeah, he’s seen Birthday sick, but that was a couple of years ago, and from everything he’s gathered and been told he’s been under the impression that Birthday’s been cured since they put an end to Freemum and got Art back. But Birthday just said this is something that happens, apparently on the regular, so Nice has obviously been under a very incorrect impression – though he’s obviously not the only one, if Murasaki and Art’s reactions are anything to go by.

Master chooses that moment to place his hand on Birthday’s shoulder. “How about we get you lying down, would that help?” he asks, ignoring the way Birthday flinches at the touch.

“Wouldn’t half-sitting be better?” Nice quips. Birthday’s hand is fluttering above his chest, and he’s starting to shake. He keeps listing to the side, and Murasaki keeps trying to keep him upright. Nice moves to put a hand to his back, to provide some more support.

So his hand is directly behind Birthday’s lungs and he gets to feel how they seize up just before Birthday whispers, “Oh god,” pitches forward, and coughs up a mouthful of blood. Nice is inclined to echo the sentiment, because oh god, oh god, oh god, that just happened, what the hell. Murasaki tries to steady him, but the bar stool is a really shitty choice for a seat right now so he ends up helping Birthday onto the floor instead.

Birthday slumps sideways and starts coughing again, and he’s beginning to look genuinely panicked. Art’s voice picks up an urgent edge that Nice catches, even if he’s not paying attention to what he’s saying. Birthday brings one hand to cover his mouth, and grips the fabric of his shirt with the other. Murasaki looks just about as helpless as Nice feels, trying to hold him at least semi-upright as coughs wreck his body one after another.

“Birthday,” comes Art’s voice, sharp and commanding. Nice’s attention snaps at him immediately. “I’m putting Ratio on speaker for you,” he says and promptly does exactly that, holding his phone forward.

“Birthday? Talk to me.” Ratio’s voice retains an air of professionalism through the line, but Nice can easily pick up on the slightly frantic undertone. Birthday huffs a breathless laugh and extends a shaky hand towards Art, who hands him the phone.

“Ratio, hi,” Birthday says, and his strained grin is stained with blood. “Sorry to… bother you, really,” he stops to try and breathe. It doesn’t do much. “They’re being dramatic... about it, it’s jus… just a little episode…”

“He’s coughing up blood,” Nice announces when Birthday stops to catch his breath. Birthday gives him a look of betrayal, which lets Nice know just how much he’s lying about the severity of… whatever this actually is. Ratio swears.

“I’m on my way,” Ratio says, tense even through the phone. “Birthday, give me a number on your pain.”

Birthday grimaces and muffles a cough. This one doesn’t bring up more blood. He leans his head back and closes his eyes, and mutters, “Eight.” Nice is fairly sure that’s bullshit.

Ratio seems to agree, if the stern, suspicious tone he calls Birthday’s name with is any indication. Birthday sighs and quiets down.

“And a half,” he eventually concedes.

Now, Nice knows a thing or two about pain. He’s been both shot and stabbed in his life, and even before that Facultas ran their students ragged until they couldn’t walk or breathe or stand. He’s learned the scale. He’s got a scar on his shoulder, fairly new, that twinges at the way Birthday says “and a half”.

“Is there anything we can do while we wait for you?” Murasaki asks, hands still supporting Birthday.

“He’s supposed to have his own painkillers.”

“Nope,” Birthday says immediately. “They’re in your car.” His breathing is starting to even out, little by little, though he’s still wheezing – it’s no longer the hitching mess trying to play catch-up and stumbling at every turn. He doesn’t have to pause after every other word, now.

“Of course they are,” Ratio sighs. Nice can imagine him pinching the bridge of his nose. “Fine, then. Have him drink something, eat something easy if he feels up to it. I’m about ten minutes out. He can have some paracetamol for the pain.” And with that, he hangs up.

Master brings them a glass of water and two pills that Birthday downs quickly. He’s still shaky, barely managing to hold the glass, but he’s starting to look more like he’s about to crash than like he’s going to suffocate and die, which Nice supposes is a good thing.

“Do you want something to eat? We have some crackers and stuff that should be easy on the stomach,” Koneko speaks up, having stayed quiet until now. Birthday shakes his head.

“Nah, I’d just puke them up,” he says, cracking one eye open and offering her a tired smile. “Thanks anyway.”

There’s not much to do while they wait for Ratio. It feels wrong to just leave Birthday where he is and go do something else, so Nice and Art settle on the chairs of the nearest table. Murasaki stays on the floor with him, still preventing him from toppling over. Birthday’s breathing is barely labored anymore when Nice decides to ask what he’s fairly sure is on everyone’s minds.

“Weren’t you supposed to be cured?” Art kicks him under the table. Nice glares at him.

“Yeah,” is all that Birthday says. He doesn’t offer anything else, but Nice is curious, and more than a little concerned.

“So what the hell was that? Was it unsuccessful or something?”

“We don’t know yet,” comes Ratio’s voice from the door. He spots Birthday quickly and hurries to him. The way he says Birthday’s name, a rushed whisper, seems unconscious. Murasaki moves out of the way.

“It started a few months ago and has happened only a couple of times,” Birthday says, the words directed at Nice but his attention fully focused on Ratio, who crouches down and immediately sticks a stethoscope under his shirt, frowning. Birthday makes a choked noise that would probably be a yelp on another day. Ratio hands him a pill bottle and continues doctoring.

“You haven’t coughed blood before. How’s the pain?” Ratio asks once he retreats the stethoscope. He moves his hands to examine Birthday’s face, glove-clad fingers barely touching his pale skin.

“I've coughed plenty of blood before. Six-ish, flows between high five and low seven,” Birthday replies, making a vague, flowy gesture with his hand. “Koneko-chan, could I have some water?” he then asks, turning to look at Koneko instead of staring straight into Ratio’s eye.

“Can’t you just use your Minimum?” Nice continues. Art kicks him again.

“Not from this you haven't," Ratio tells Birthday, and then turns to Nice. "I can and I have,” he replies, and takes the glass Koneko is offering to Birthday whose hands are still unsteady. There’s something off about his tone, frustration bubbling to the surface from under a layer of composure, and Art gives Nice such a nasty look that Nice decides to drop the subject. Ratio shoves a pill into Birthday’s mouth and holds the glass for him.

“I’d like to take you to the hospital,” Ratio says, hand coming up to cradle Birthday’s face. “Have your old doctor take a look at you.” Birthday leans into the touch, Ratio’s black gloves contrasting his still-pale face starkly.

“And I’d like to go home, Ratio.”

Ratio looks like he wants to argue, but Birthday both looks and sounds so spent, so exhausted, that he doesn’t. Nice knows Ratio has always had a hard time saying no to Birthday, but witnessing it is always interesting.

“Fine,” he sighs in defeat, and Birthday grins at him. “We’ll go home. But if you’re still in pain in the morning I will personally carry you to an appointment.”

“You say that like it’s a threat,” Birthday teases, sounding more like himself than he has since this whole thing started. That gets a smile out of Ratio.

Ratio scrapes a bit of dried blood off from the corner of Birthday’s mouth and stands up in one fluid motion. “Can you stand?” he asks, even though it’s fairly clear to everyone that the answer is no. Birthday looks slightly amused.

“I can barely sit.”

“I’ll help,” says Murasaki, stepping forward. He moves to stand next to Birthday as Ratio nods in appreciation and steps to Birthday’s other side.

Birthday blanches as they get him upright, already pale complexion draining to sickly gray, and his eyes almost roll back. He stumbles into Ratio, legs shaking, and both Ratio and Murasaki drape his arms around their shoulders while he tries to regain his balance. It looks kind of awkward, with how much taller Murasaki is.

It takes a couple of moments of dangerous-looking swaying that has Nice and Art getting up from their seats as well for Birthday to steady himself somewhat. Once he does, he closes his eyes and leans his head on Ratio’s shoulder.

“Oh god, yeah, that didn’t feel good,” he mutters.

“You can sit back down in the car,” Ratio promises, wrapping an arm around Birthday's waist. “Let’s go.”

Ratio and Murasaki basically carry Birthday out, in the end. At the door Ratio turns to thank the rest of them, Art especially for calling, and then they’re gone. Murasaki returns after a couple of minutes, reports that they got Birthday to the car safely and without passing out, and orders a shot of “whatever’s strong”.

Nobody has much to say for the rest of the evening.

#my writing #sickdays 6 #hamatora #reshidei #whump #sickfic

[btamamura]

Sorry, this is a long post so you can feel free to just scroll past. I wrote this on the app since the web page hates my devices, so there is no Read More cut.

Time to open up to my followers.

If you’ve known me for a while, you’d know my battles over the last few years. For the new folks, here it is - I have been living with a chronic illness since November 1, 2014, and it has been awful.

It started out as just chronic nausea. We thought it might’ve been something I ate or a lingering case of gastro. But, that changed February the next year when the pain started.

I woke up one morning to find I was in extreme pain in my feet. I hadn’t injured myself but my feet felt like the bones had been shattered. The lightest touch made the pain even worse, so I was just lying on my back, feet in the air, crying and crying, trying not to scream and wishing it would just go away. The pain faded over the next couple of weeks, but never left completely. It was just an annoyance or painful but not excruciating. My grandfather offered for me to see a podiatrist, he would pay if not bulk-billed, because he thought maybe it was from the many years of walking on my toes.

The next day, right before my cousin’s birthday party, which I had planned on attending for at least an hour just to say hello to the family, the same horrible pains started in my hands. Dad just had to take one look at me to know I would not be going. I asked him, through my tears, in half-seriousness if he could find his axe and chop my hands off so I never had to feel that pain again.

I found a clinic to attend with my grandfather’s help. I saw a doctor about my symptoms. She focused on the nausea, even if I kept saying “I’m in worse pain today!”, so I tried seeing a different doctor in the clinic. The first doctor had ordered a gastroscopy to be done to see if there was something going on in my stomach.

The second doctor kept ordering the same blood tests - iron, b12, vitamin d. And even once those levels had been corrected, I was still sick and sore. I had since had my gastroscopy, which came up clear. The second doctor looked me in the eye and said outright that she believed I had to be faking in order to get out of looking for work. I was already upset that the gastroscopy had no answers (I’d already said I would cry if it came up clear, just as I would’ve if it found a tumour developing in my stomach), but then to hear that from someone who was meant to help?! I broke down crying and told her if everything I had missed in the time I had been sick. By this time, it was early 2016.

I told her of missing visiting my niece as a newborn. Of how I couldn’t attend my cousin’s engagement, Hen’s night and wedding. Of how I couldn’t attend my pop’s funeral. Or the missed annual dinners with Nan and Pop before his passing. (Pop is my dad’s stepfather and was a big part of my life growing up despite living far away.) How I had planned a holiday to the Gold Coast for my 30th birthday but instead spent that day in bed, struggling to down my food and avoiding the family as they ate theirs because the smell made my nausea worse. Of the Christmases I spent sick in bed and unable to visit my mother’s grave. Of not being able to hang out with my sister and spend time with my young nephew and much younger niece. I refused to see that doctor again and left feeling terrible.

New doctor at a clinic my great-uncle visited. He decided to do the usual blood test but also tested to see if I was autoimmune. Yep, so he then tested to see if I had lupus. Nope. But, he still seemed to be doing more for me than the last two doctors. A week after the autoimmune result came in, I wound up in hospital. I hadn’t been able to eat or drink for a week because I was having difficulty swallowing. I wasn’t in a dangerous condition, so I was only admitted overnight for observation, having some fluids by IV and to speak with a speech therapist the next morning as I was put on a purée diet. While being observed, the doctor in hospital noticed something - a goitre.

Eating troubles started becoming more frequent at that time. By the end of 2016, I was struggling with abdominal pains and low appetite. There were sporadic days I couldn’t eat a thing. I attended another appointment where the doctor forced me to have two jelly babies because my blood sugar was low - no, I’m not diabetic. They came to a head in late-March of 2017.

I hadn’t eaten more than a nibble here and there and only barely sipped at a drink for a week. I was very unwell and after the third time of being sick, I decided I had to go up to the emergency department because something was very wrong. I was right - they saw me right away. I was in the early stages of Refeeding Syndrome due to starvation, my blood sugar was low, my ketones had gone up and my organs were slowly starting to shut down. My blood was acidic. I was told to try sipping at apple juice, but it was no good, I couldn’t even muster that.

I was moved to short stay while waiting to transfer to a ward. My time in hospital was scary, and not in the usual “I’m afraid of hospitals” way. I was in danger. I was diagnosed with starvation ketoacidosis (similar to diabetic but I’m not diabetic), as anorexic (no appetite version, not anorexia nervosa) and even if they tried to get me to eat, I struggled even with crackers. They put me on Ondansetron (usually for chemo and radiotherapy patients) to ensure anything I did try to eat would stay down. I was put on different infusions - saline, glucose, potassium (THAT HURT SO MUCH, I THOUGHT SOMEONE WAS TRYING TO SNAP MY ARM IN HALF AND I ACTUALLY PASSED OUT FROM THE PAIN!!) and others. I had blood tests at least twice a day and tests for my blood sugar and ketones every time I was about to eat or if I looked a bit more unwell. I had to be hooked up to a portable heart monitor, but the first night of that, my heart rate reached 150bpm just slowly walking to the toilet, and a Med Call was made to make sure I did not go into cardiac arrest. The doctor who made his rounds had to outright tell me that if I failed to eat, I would need to be put on a feeding tube or else I would die. That’s how bad it was. I was in for a week before I was deemed well enough and safe enough to go home.

The third doctor started to let me down, ordering the same blood tests to make it look like he knew what might be going on. No good. Wound up feeling too ill later in the year so I missed my uncle’s funeral.

In 2018, I started going downhill. Wound up hospitalised with starvation ketoacidosis again following a bout of gastro the day before. Falls also started occurring. But, it was no good, I couldn’t find a good doctor who could help instead of just playing around with the same old blood tests. I missed more events including my other niece’s first birthday and my great-uncle’s funeral.

2019, still struggling. I’m seeing a new doctor, but she very quickly lets me down by saying EVERYTHING is just tied to my anxiety. At least she took the lump in my breast seriously - thankfully not cancer. But, as the year progresses, a good doctor is finally found. My cousin helped me find a clinic that bulk-bills and is taking on patients.

My current GP listens every time I see her. Every. Time. I go in with a new symptom or concern, she orders the right tests or refers me to someone who can help. Through her help, I’ve been able to see a speech therapist about the ongoing swallowing issues, a physiotherapist about my falls, a dietician about my dietary issues which contribute to deficiencies, a surgeon about my goitre (he put me on medicine because my thyroid was a bit overactive - suspecting hyperthyroidism or any other forms of it - in the most recent blood test through the hospital when I went up by ambulance with chest pains, ordered a CT scan and believes the best course of action may be to perform a complete thyroidectomy, meaning removal of my thyroid), had me undergo full blood tests (not just the usual), had me undergo an ECG and TTE (trans-thoracic echo, an ultrasound of the heart) just to make sure all is well there since I keep having chest pains and most recently referred me to a neurologist because she believes my symptoms line up with a rare genetic condition. She’s also looking into finding a neuropsychologist who can help with an autism assessment.

Because of the help I’ve been receiving, I’ve been a bit more hopeful of a diagnosis finally coming in the near future. Because I’ve been seeing a physio who helped me with strengthening exercises for my legs, I have been able to go out walking for a little while - never out on the streets but yes in shopping centres, that way if something goes wrong, someone is nearby to get help.

I still feel nauseous (still on Ondansetron for that). I’m still in pain every second of every day. I still feel that weakness. But, I’m starting to have those okay moments where I can go shopping or play with my niece and nephew - both occurred over the last couple of days, a water fight two nights ago where I just stood there shooting a water pistol at them as they ran around me, and an hour out shopping with my niece. Yes, those hit hard the next day and up through the next week. I do not intend to push myself so hard I’m at risk of hospitalisation. But, I also need to work at rebuilding my stamina. My father and grandfather have special birthdays next year and I want to be able to attend the dinner organised...even if I can’t eat while there, as long as I’m there is what matters.

But, for now, it’s baby steps. Sitting up and watching a movie. Washing some dishes. Carefully playing with the kids. Try to keep the shopping trips short. Eat what is possible, not what is a must.

#life #chronic illness #long post

[lyesera-thoughts]

Therapy - admitting mistakes and marijuana talk

For as long as I can remember, I have only ever eaten junk. Mom worked 2-3 jobs, had to get kids to school, and dad was sleeping all the time or just didn’t help.

Breakfast consisted of BK breakfast, Debbie Snacks, Donuts, or whatever quick CHEAP thing mom could grab on the way into school.

Lunch happened to be whatever the school gave me. I honestly don’t remember much, not very fancy (we were so poor my brother and I had free lunches), but I remember a lot of Friday pizza.

Dinner was whatever mom could get on the way home, or whatever was cheapest to stock in the house. Lots of pasta, pizza, BK meals, deli meats and white bread, steak and potatoes. Not a whole lot of green.

Snacks, because always snacks, whatever we could buy in bulk. Chips, crackers, ice cream, popcorn (slathered in butter), etc.

Then it was also an escape. Dad having an absolute fit and mom was done? Grab the kids, get in the car, and go to the store where she could get cigarettes, lotto tickets (to get free from her terrible, penniless life) and candy bars for the kids.

Food has always been bad/junky and always a quick and/or escape thing I always did. 

It’s made NOT eating junk food an absolute nightmare to achieve. I seem to get better (read: eat maybe a couple donuts at breakfast AND have a bag of candy in the afternoon) and swing back to the worst (read: only eat whole cakes for breakfast lunch and dinner and also have candy if I can stomach it).

I also hide it. My fiance hates that I do it and I hate how ashamed I feel when he catches me. So I hide it as much as I can.

So it’s really hard to admit that I’m slipping back to the worst. 

For the last few days, I have been making it a point to behave. I mean only the breakfasts my dietitian recommended. Only chicken and salad and a yogurt based ranch dressing for lunch. Only a lean (non red meat) protein and veggie for dinner. Healthy snacks (proteins and fruits) every afternoon. Sugar snacks MAYBE once in a while (and I had mine this weekend)

It’s been hard. I had been doing weeks of eating almost exclusively sugar prior to this change, which was Thursday. So right now, I get headaches and feel generally fucking terrible not having large amounts of sugar in the morning and afternoon. Been trying to push through by just making it harder to give myself the chance to have sugar, but it’s very very hard.

I really hope I start to feel better soon. I know that it usually is said I have to be generally sugar free for about 2-3 weeks before it’s more natural, but I really need it to be a lot faster.... 

On an unrelated note, marijuana. So I live in a state where it is legal to own up to an ounce of bud and can consume within the privacy of my own home. Also grow it, but I’m not much of a green thumb and there’s still laws about making sure its secure and such. 

Recently, my landlord adjusted the rental notice to make it a violation of our agreement if we were to grow or consume marijuana in the apartment. Fortunately or unfortunately, I’m not a smoker. I have asthma, always have. I just don’t want smoke of any kind in my lungs, I barely breath when it’s humid outside because the air is denser. Thank you, but no thank you.

But it means that in order for me to consume it, I have had to bake it, in a coconut oil infusion I made. Which makes the house reek. Until recently. We discovered melting the oil into a pot and making rice krispies doesn’t end in an apartment full of marijuana scent.

The other big problem is, while it is legal to own and consume privately, it is still very much illegal to purchase marijuana in my state. Which means, apart from “gifting” I can’t get marijuana legally. I can only obtain CBD (hemp based) products legally.

Here’s my issue. I have a condition called fibromyalgia. It’s a stupid condition where my body produces large amounts of inflammation out of food sensitivities and even my own stupid fucking emotions (thank you anxiety and depression), then turns my pain receptors up to 11 for no (currently) discernible reason. 

Now, my doctors offered me some medications in which I didn’t like the side effects. I’m one of those people who does a lot of research, asks my doctors a lot of questions, and tries to take everything in as neutrally as I can. I trust my doctors. If I find something online I want to hear their opinion on that and I listen.

They’re trained professionals, go figure!

But we both concluded that we didn’t like the side effects and that I wasn’t in a place that I HAD to take it. She wanted me to lose weight anyways and, in her words, it would probably fix everything. (I’m skeptical on that, but we’ll circle back when I actually lose weight).

But it means that I can only have over the counter pills for the pain management...which I’m getting conflicting answers on. My Rheumatologist says if the pains really bad, alternate high doses of Ibuprofen and Tylenol as needed. My primary, however, doesn’t like that in the least bit. Would rather I use cold/hot packs and suck it up. To be honest, neither really help, and I resent that these are my only options.

I tried CBD for a while. A lot of people were raving about it. I even went and saw a cannabis/hemp specialist in the area. (His only job is to talk to people about these choices and how to use them in their daily lives). But topically, nothing helped and orally, I was using so much to achieve results, that I was spending at least 50% more in a month on CBD oils than it cost for an ounce of bud.

Well...I have friends...friends who have been recreational users for a long time, who have been wanting me to try with them for a while (I wasn’t joking about not doing stuff if it wasn’t legal thing). 

They were thrilled at the opportunity to help me out. I really appreciate that, I’m not sure that I expressed it properly to them, but I do appreciate it. Because within a week of reaching out to them I had my very own bud of flower.

No idea the strain I had, but it was at least a hybrid, if not a majority indica strain. And it did exactly what I wanted...

I followed their directions for decarboxlation and then into coconut oil infusion (thankfully before the rental agreement change and thankfully no one asked, because the house smelled like marijuana for weeks!). Then came the baking.

Barring a rookie’s mistake dosing the very first time (we fucked up bad, a story for another time perhaps), it’s been wonderful. I’m a dummy who doesn’t use it every night, but when I use it, it’s great.

I can only describe it as making things feel normal, or right. The pain dials down. I have some pain still, but I’m a big girl who’s out of shape. It doesn’t consume my thoughts, though, which is a huge change!

Things become happier and calmer around me. I’m quicker to smile, easier to cuddle with. I want to do things and have fun and then I sleep through the WHOLE night.

It’s fantastic. 

I eat such small doses (a fraction of the recommended dose), only in the evenings, that my ounce of bud wound up lasting over a year! Even with my fiance eating a dose most nights (he just liked the good feels, I’d rather he do that than anything else).

A year! For less than a month of CBD! And it did what I wanted!

I want a medical marijuana license so I can legally obtain some more, but I’m finding a few issues. The laws in my state have a very, VERY short list of things someone on the registry must have to be approved. Chronic pain is on there, but listed as debilitating chronic pain. AND that a reasonable effort has been made to treat it in other ways.

I haven’t done those. I haven’t taken other meds because I don’t want to deal with the side effects. I haven’t lost weight yet, I’m struggling with old bad habits.

But all I can think of is that it’s so unfair that I have to just deal with my pain and frustration and bad emotions and not have easier access to a drug that could, just as easily, be controlled by the government like they do tobacco and alcohol. 

A drug that has given me relief and good night sleeps, and biggest side effect is that I smile more!

Just saying... 

#therapy #random thoughts #mistakes #over eating #fat #weight not coming off #marijuana #medical #medical marijuana #cannabis #pain relief

[inexchangeforyoursoul]

Aaand... here. [ffnet] [ao3]

Me notes: I’m living dangerously and haven’t actually looked up the possible lingering symptoms of lead poisoning up till a week ago. And yet, it’s disturbing how legit my guesses were, even past the chronic pain lmao??? Shit’s wild, yo.(Won’t come up, but among other things, it can fuck up your cognitive abilities, that is to say, make you stupid(er)... our genius Law’s IQ was probably so broken that it needed to be nerfed to hell, yet he’s still one of the smartest jackasses in the series. somehow, this info delights me… what a force of nature.) (I’m definitely winging the shit as to why those things happen tho, this is just a shitty fic project, I don’t need nor really want a PhD in neurosurgery and whatnot. … for now, at least. I’d be happy with a teacher’s degree. And something to prove that I’m by no stretch bad at translating stuff.)

26. Shenanigans

As soon as Kat reaches her destination, Nami poses a question immediately; “What was that about?” All she could see was that Law was both mad and… well, confused, while trying his darnest to be civil. Which in itself is a point of interest, just like the fact that her new friend here also seems kind of lost.

Kat sighs. “I’ve been too,” Honestly, how should she summarize this? Uh... “well... nice?”

“Too… nice.” On second thought… the navigator feels she shouldn’t be surprised that the Heart captain would find that unwelcome. He’s not exactly the buddy-buddy type, hell, probably even paranoid.

“Like... I felt kind of guilty for skipping all that practice and being a general nuisance,” among other things she cannot talk about... “... so I brought down some rice crackers and tea after breakfast and washed his dusty mug that must have been lying around for months for him,” she looks up, slowing down a bit to get her thoughts in order; “We had, like, a tea party. Which was still okay, I guess. After having managed to sit out the new training shit proper, probably looking like a maniac during it all… I definitely overdid it by buying a teddy at the fair for his suspiciously big bear themed collection.” It really seems excessive and random in hindsight. “Man, can you imagine I even considered to buy a gigantic one? I couldn’t bring myself to pay up the twelve grand, but… pfff.” she mumbles mostly to herself, putting on a faint smile over the mental image of chucking that monstrosity at him again, then places a hand on her cheek while contemplating the general idea over in vague confusion. She settled for the small one, but... sheesh. On the other hand, she likes being charitable, and it’s been too damn long since she had both the financial background and an excuse to buy a gift for someone apart from the obligatory job stuff. Thinking about this makes her want to give a little ‘thank you’ gift of sorts to both crews… except, well, she ain’t got jack as far as ideas are concerned. They already have everything they could need, too.

Nami rolls her eyes upon hearing that. “Geez… it’s like you’re wishing him a belated happy birthday and he’s complaining over the attention. Which… is not all that surprising, I guess,” she concludes then with a shrug. “He did the same when we threw him a party before arriving in the country,” His main complaint was that he had his private party with his crew a few days back… none can do for Luffy if he wants to party, however. “On the other hand… you do realize that you sound like an overly apologetic boyfriend, right?” Nami muses while returning her attention to her, finding sudden enjoyment over the image of Knight Kat and her grumpy liege.

“Well… he is a princess as far as I’m concerned,” Kat nods in agreement. “While I’m not sure his highness would agree, I can see where you’re coming from, though,” she adds, scratching the sideburns in embarrassment. “I’m… not really good at taking care of anyone or anything in general, no lie. The moons must have aligned, or something.”

“You must be underestimating yourself,” the other woman states, leading her towards the table with the still steaming drink on it. Sanji must have been here a mere minute ago. “People who have no sense of nurture would never be able to do your job, you know?”

“Work is different,” she protests, crossing her forearms in an X, and squints at the back of Nami’s head where some small creature seems to be very, very lost in the orange sea; “Because… I know I have to do that stuff, and I must pay attention at least some of the time, you know? If I didn’t, I’d get fired. When just home, or hanging out… I get way too comfortable, and next thing I notice after spacing out is that the day is already over. Flowers unwatered and still full of lice or whatever, dog unwalked and unpooped, cat unfed and has knocked everything off the table, and then there’s me, also hungry and dirty... Can’t just do all of that quick before going to bed, can you?” She sighs. “I’m happy I’ve gotten far enough to be able to take care of myself, you know.” Sometimes she still forgets to eat, or keeps going just one or two more days without the designated bath. It’s so… it’s beyond embarrassing. And infuriating. Occasionally… even humiliating.

She picks up her cup and stirs the beverage, then downs half of it immediately. A sugar chunk in her mouth and the barely comfortable temperature remind her that she probably should slow the fuck down. Oh well… if she already has half the cube, might as well lick it away.

“... I still think you are selling yourself short, but… can’t say I haven’t met the problem.” Getting started after Bellemere was… overwhelming. Although they helped out a lot since they were little, and there wasn’t a lot more extra work to do, neither her nor Nojiko had an idea where to start with the household, even though the villagers cleaned up the mess in the house that Hachi had left behind. The laundry seemed to be more when it was less, the cooking more challenging... even the tangerine grove felt bigger and more intimidating than before. Everything appeared to be more than what it was in reality. When she noticed some work waiting to be done, she handled it on autopilot, but there really was a lot of spacing out while doing stuff. From what she just said, Kat seems to be in a similar state of mind, albeit near permanently. “Either way, that already is something. You talk as if you were worse about it, so there’s nothing to be worried about. That forestside cottage won’t tend itself once you get there.”

Kat lets a smile creep on her face, being reminded of her silly life goals. Nami was listening in on her and Robin’s conversation, huh? “I guess… but I’m still eons away from even attempting that.” Finishing the sentence, she also finishes her coffee and puts the cup down. Now, let’s address that minor annoyance that’s been bugging her quite literally for a minute… “By the way, turn around a bit?”

“Turn…? Why should I?” the redhead asks, complying with the request regardless.

Kat reaches into her hair and picks out one tiny black dot after short looking around the neck area. “You had one of these really small spiders in your hair,” she says, lifting the little goober for her to see. The wind carries these all over the place.

“Eeeh,” Nami gets shivers turning back to her while holding her locks, zeroing in on the barely visible animal. “Oh, god, get it away….!”

A mischievous smile appears on Kat’s face; Nami knows her just enough to step back and eye her with suspicion.

“Away?”

“Don’t…”

“Don’t what?”

Another step back is followed by a step forward by Kat, and they start waltzing faster and faster, until Nami starts sprinting and runs into Sanji, who is bringing out drinks for her and probably Carrot, as Robin should be having her coffee now.

“Shield!!” she shouts, flinging him in between. The man keeps enough balance for the layered cocktails to barely sway; quite impressive. He’s also visibly pleased with the development.

“Oh, Nami, dear~ you are so passionate today. What brings you to me~?”

“An itsy bitsy spider,” says Kat, bringing it up to his nose, almost.

“Oh, a spi---” the smile freezes onto Sanji’s face upon turning towards her, then he emits a sound alike a deflating balloon before arching back all of a sudden over Nami in panic. The utensils in his hand can’t compete with the sudden movement, and are wobbling precariously, until the tray itself starts to tilt; noticing that, Kat snaps her hand towards said objects to stop them from falling, and the spider, having had enough of these shenanigans, uses the momentum to make an exit with a jump into the greenery.

The drinks, along with every layer, practically stop in time; Sanji looks over to them, still in shock.

“Sweet catch,” says a bubbly Carrot who has likely seen everything as she's sliding down the mast.

“... thanks…” Kat squeaks. Something about this feels… weird, though. “And, uh, sorry,” she adds, looking over to the cook. “Didn’t know you felt this strongly about creepy crawlies.” She almost ruined those drinks and potentially could have broken the glasses, too...

“I-it’s fine,” he croaks with the frozen smile still on his face, shaking a little both from the position and scare.

“That was mean, Kat,” Nami grumbles, pushing the man back onto his feet, checking the grass for the small stowaway. “Don’t bring bugs near me… or Sanji, -sorry, Sanji,- they are gross!”

“After this, I really won’t,” she mumbles, slowly setting the glasses back into position on the tray now that Sanji’s calming down and is not shaking things all over the place. The contents, however… need extra care? They are levitating by themselves, so she needs to move them along with the glass. What is she doing differently, here?

“Thank you,” the man mumbles with the last item returning to its place and having recollected himself.

“No need to, I was the one brewing trouble in the first place.” Being done with the extra task, she feels relieved. “The falling things save is an aspect that I’ll definitely miss, no lie,” she breathes then; the odd feeling from before has not left her. There’s a notion that she can pinpoint every last detail around the ship, to the last strand of hair… she can even feel the little tiptoes of that tiny arachnid under them; taking a look to the side, she can spot a dot exactly where she thinks it is, too. And two butterflies flapping around the garden, flies all over the place, and just in general a lot of all kinds of small creatures all over. Even the positions of people moving around on board, whom she can kind of identify by size, position, what they might be doing or the way they walk… as well as the different layers in the drinks, which appear to be the most detailed ‘feeling’ thing. There’s just a lot of stuff not belonging to places, and it’s a little overwhelming.

Her perception being off is apparently noticeable, as Nami picks up on it as well. “You alright?” Kat has a tendency to space out or look out of it, so she’s always a little worried that there’s something like a pulled neck muscle going on. Most of the time, though, she’s just daydreaming.

“No, I’m alright, it’s…” Suddenly, she feels enlightened. “Oh, I think I know what this is…”

“What would that something be?” Nami asks, blinking in confusion.

“I think I just activated this scanning stuff by accident,” she informs her, looking down at her hands. The trigger must have been reaching for the glasses, but… how does one turn it off?

“Scanning…?” the woman mumbles. This must be something Ope Ope related.

“Like… I just know where a lot of stuff is, all of a sudden…” Thinking about it, she knows specifically where living things are, and the overall shapes of objects. And… possibly the density of things, because, those drinks...

Sanji notes her sudden interest in said beverages. “Would the resident changeling fairy like a glass of her own?”

Oh god, he’s already back to cheesy descriptions level… ANYWAY.

“No, thanks, I don't drink... I do like looking at pretty cocktails, though.” Honestly, sometimes they smell really nice, so it's hard to resist.... like these. There’s some chocolate and raspberries in there… but all she has to think of is the bitter aftertaste and the temptation is no more.

“Actually,” she continues as Nami gets her cocktail to sip on and Carrot walks up to them, asking whether she can have the other one, to which Sanji informs the mink that it was meant to be hers anyway; “mind if I try something with one of these…?”

“Oh, are you going to do some cool tricks?” Carrot asks with excitement; “I’ve been wanting to see the stuff Bropper has been talking about, too!”

“Ah, right!! I wanted to show you some stuff, anyway!” she says while sucking up some of the radiating fuzz buzz up, too.

Sanji raises a brow and puts on half a sulk. It takes a second to let the notion of food being tampered with slide, but if it’s for the greater good and less frustrating body statuses… Indeed, the thought of everything in the universe being in its rightful place puts his head back in the clouds. “I’ll be on my way, my lovelies, call if you need anything~” he swoons while disappearing back in the kitchen in a whirlwind.

Nami also gets going direction library and waves goodbye while drinking, which gesture the remaining two return.

“So, so,” the mink starts again, lifting up the glass to Kat; “what do you want to do with this?”

“What I want to do with the drink specifically is probably not that interesting, but even if it’s a total failure, I’ll make it up to you right after,” she notes. She has about one shot at this, anyway.

“Tee-hee~ Show me watcha got,” the rabbit girl says with a smug face to challenge the cocktail’s opponent.

“As you wish,” Kat responds with a smile of the same smugness level; Carrot snorts at this.

“You legit sound and look like Bepo’s captain right now,” she giggles.

“Hey, hey, careful,” Kat half-laughs while trying to keep the glass upright; “I need this thing as it is right now.”

“Alright, even if you will suck at this, you’ve already redeemed yourself,” the mink states as they waddle with combined efforts towards the table to put the beverage on. “Purely on a basis of a spot-on impression that you ruined immediately after.” She wasn’t there for the first performance anyway. “Bonus points for not even trying, tho.”

“Well, Carrot, to catch the pray…” she looks around with shifty eyes as the glass clinks on the polished surface; “you need to become the prey.”

“Well, well, well, Kat… I literally am prey,” she nods, releasing the object at last. “Also… are you saying you are out on a hunt? Hmm?” The smug smile returns, and this time it’s accompanied by a knowing look and crossed arms.

The girl needs to consider this for a moment, and she also puts on a comically exaggerated thinking face. Is she trying to go for Law's jugular in any way or form? She's had worse company, but... "Not really. Or deliberately. Unless hunting for funny situations for either person counts as such." With that she also lets go of the poor liquid that still retains most of its original form.

Carrot nods wisely after a few seconds, eyes entranced in the cloudy horizon. “... that’s fair, can’t blame you for that.”

Kat needs to hold back a smile, then decides to put an end to this banter. “Okay, alright, I may have finished off my coffee in like three shots, but I’ll have to hurry regardless,” she waves her hands around. “Let’s see this bad boy,” she groans while dropping on a chair; Carrot follows her lead and watches intently.

Okay, so… she still has that feeling going, that’s good; she also tried to keep the drink stable while holding it, which seems to have been a success. Now, how to do the thing she has in mind… She touches the glass again, which seems to power up the sensation somewhat; even if it’s a placebo effect, being in contact seems to make things much easier. There is definitely a difference between the glass and its content... what she’s really interested in, however, are the individual layers, which also seem different… they feel different. Especially the lightest and heaviest ones.

What if she just tried, took the lowest, dark layer, and...

“... Kat, what part of reality are you breaking again?” asks Usopp in a vaguely wary manner while passing with his tool box, his eyes catching the liquid blob pass a rather opaque layer following her finger before settling on top. Carrot breathes a ‘cool’ as she watches on with her head on the table.

“... density or gravity, I guess.” If not both. Those are kinda correlated, aren't they...? Eh, fuck physics. She can break all the rules, anyway.

As the layer settles in, she takes a look at the one now below it; a motion of another finger lowers it to the middle, then she raises it up again through the static ones. After that, she puts the reddish, heavy goop back to its place, with the lightest layer over it. Releasing it all makes the whitish liquid phase through multiple other ones, stirring the entire cocktail up. Looks rather nifty, with all those vertical stripes in it. Last part notwithstanding... if souls or whatever feel just as different, and she can make them slide through another... after some refinement, this just might be the thing she needs.

#Kate writes #KMKY #opfanfic #been a while since I tagged it like that so

[paleorecipecookbook]

RHR: A Three-Step Plan to Fix Conventional Healthcare

In this episode we discuss:

The patient case that inspired the book

Who is this book for?

The mismatch between our medical paradigm and chronic disease

Drug companies and conflicts of interest

How clinicians can help create a new paradigm

The three core problems and how to solve them

What this new paradigm looks like

How do we pay for this? Is it scalable?

How allied providers are the key

Show notes:

Unconventional Medicine by Chris Kresser

Special offer for RHR podcast listeners - get the audiobook free if you buy the book by November 12th.

NaturalForce.com - use coupon “unconventional” and get $10 plus free shipping

[smart_track_player url="http://ift.tt/2yiM0Yd" title="A Three-Step Plan to Fix Conventional Healthcare" artist="Chris Kresser" ]

Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today we’re going to do something a little different. I am bringing on a guest host, Tony Federico, he’s the VP of marketing for Natural Force Nutrition, a physiology editor for the Journal of Evolution and Health, and a longtime contributor to Paleo Magazine, and also at Paleo f(x), which is where I met Tony, I think, originally, and I have interacted with him the most. And he’s moderated several panels that I’ve been on and I’ve always been impressed with the way he’s done that, the intelligent questions that he asks and just his balanced perspective on ancestral health and Functional Medicine, and this movement overall. Today is the day that my new book, Unconventional Medicine, comes out. It’s now available on Amazon, and I wanted to ask Tony to come take over the podcast and talk with me about the book because I know he’s really interested in all these topics and he’s read quite a bit of the book himself, and I thought it would be more interesting to have a conversation about it than for me to just sit here and do a monologue. So Tony welcome to the show and thanks for being here. Tony Federico:  Yeah, thanks for inviting me on, Chris. It’s always fun, when we’ve had the chance to chat, as you said. Whether in person or on podcast, I’m always happy to jump in and dish on health with you. Chris:  Fantastic. So, you have read a little bit of the book and we chatted a little bit about it via email, so let’s dive in. Let’s talk a little bit about this book. And for me it was really, it felt like the most important next step that I could take in order to get this message out about ending chronic disease. Tony:  Yeah, I got my copy of Unconventional Medicine a couple days ago. I just so happened to have some time off yesterday, and the next thing I knew I was 80 pages in. Chris:  Nice. Tony:  So, I have to say that, as somebody who’s been in the trenches, I worked as a personal trainer for 10 years, I could really relate to a lot of the things that you were saying in the book, and we’ll get into why a little bit later on in the interview. But you know I just am really impressed with what you put together here, Chris. So let's just, let's get into it, and the first thing that I actually wanted you to maybe tell me a little bit about was how you open the book, which I think is a really great story about a patient named Leo. So I wanted to talk a little bit about Leo and his story and kind of how that inspired you to go down this particular path of unconventional medicine.

The patient case that inspired the book

Chris:  Sure, yeah. So, Leo was an eight-year-old boy that I treated in my clinic a few years back, and I wanted to start with his story because it's, unfortunately, a typical story, much more common than, of course, we would like. And it was powerful for me, it was a powerful experience. It's what actually led to me writing this book. So, like way too many other kids of his age, he was suffering from a number of behavioral issues. He was initially diagnosed on the autism spectrum. Eventually they settled on OCD and sensory processing disorder. He would throw these just crazy tantrums where he'd end up crying or screaming inconsolably, writhing on the floor, and this would happen for seemingly the simplest of reasons. Like trying to get his shoes tied as they were going out the door, not cutting the crust off his sandwich in just the right way or getting a stain on his favorite T-shirt. And he was really rigid around his behavior and its environment, everything had to be just right, just the way he wanted it to be, or else he would fly off the handle.

Is a new healthcare paradigm affordable? Scalable? You bet.

His diet was extremely limited, he only ate a handful of foods, pretty much all of which were processed and refined. So crackers, bread, toaster waffles, that sort of thing, and this is part of the kind of OCD-like tendencies. And any time his parents would try to introduce new food, he would go totally ballistic. And they were worried about nutrient deficiency, but they didn't feel like they ... they were just worn down. Any parent who has a kid like this will understand that. It's just they didn’t feel like they had the resources to battle him at every meal. And they took him to a bunch of doctors locally, and that’s where they got those diagnoses. Initially they were kind of relieved to have those, but then after a while they realized that they were just simply labels for symptoms. And when they asked what the treatment was, you can probably guess the answer: medication. Tony:  Something to do with drugs. Chris:  Something to do with drugs. Yeah. And when they asked how long he would be on that treatment, you can probably also guess the answer. Tony:  The rest of your life. Chris:  Yeah. Shrug of the shoulders, indefinitely, maybe he'll grow out of it, that sort of thing. And they weren't excited about the idea of of medicating their son, but they were also aware of how much he was suffering, and they were suffering, frankly, too. They decided to give them a try, starting with Adderall, and then they progressed to Ritalin and then antidepressants. And certainly the drugs did seem to help with at least some of the symptoms, but there were a couple issues. Number one, they also caused some very intractable side effects like headache, abdominal pain, irritability, and most significantly, severe sleep disruption. And they had a couple of other kids that were younger than Leo. So they were not happy about the sleep disruption. Nobody was because it was brutal for them and also brutal for Leo. Kids need a lot of sleep, and if they’re waking up throughout the night, that’s going to make ... So that was in some ways worse than the original symptoms they were trying to treat. And then Leo's mom had done quite a bit of research on the effects of these medications and she was scared. Particularly for children and adolescents, some of these drugs have some pretty scary side effects and long-term risks. So what really stood out to me, and I mentioned this in the book, is that not once during this entire process of seeing all these different doctors, primary care provider, psychiatrist, eventually behavioral disorder specialists, did anybody even hint at the possibility that something in Leo's diet or some other underlying issue like a gut problem or nutrient deficiency or heavy metal toxicity or something like that could be contributing to his symptoms. It wasn't even broached as a possibility at any time. Fortunately, Leo's mom, one of her friends followed my work and sent her a couple of articles from my blog. One was on the gut–brain–axis, and I think the other one was on the underlying root causes of behavioral disorders. And so that's what led them to bring Leo to see me, and long story short, we were able to ... we did a bunch of testing, found issues that you might guess at. So, disrupted gut microbiome, SIBO, fungal overgrowth, gluten intolerance, but also intolerance of soy and corn and rice and buckwheat, which were major ingredients in a lot of the processed and refined food products that he ate, and arsenic toxicity because rice milk was the only other beverage he would drink aside from water. And we know that rice products can be high in arsenic. So, we, over several months, it definitely wasn't easy to address these problems because of his OCD-like tendencies and his picky eating habits. But after several months he was like a different kid. His teacher even called home and was like, “What have you done with Leo and who’s this kid that you’re sending in?” Because it was a big issue for her. They often had to come to school and pick him up early because of the behavioral problems. And his diet expanded; he was eating foods he would've thrown against the wall just months before, he was more tolerant of disorder, more relaxed in his environment. They were able to travel for the first time in a long time because he wasn't so anxious in unfamiliar environments. His physical symptoms had improved significantly. So they were just over the moon. They couldn't believe it, and toward the end of our treatment together, she said something that really struck me, which was there’s so many kids out there that are like Leo and they’re suffering, they’re not finding help in the conventional system. Tony:  Sure. Chris:  And their doctors and parents are not even thinking about this stuff. Like it’s not even in most people’s consciousness that if a kid has a behavioral disorder that you should look at these physiological issues. It’s not, for 99 percent of people they don't even go there because they don't know. Tony:  Yeah, I mean I think that that was—reading about Leo and reading about a story and certainly there's people that I've known, myself included, who have had very similar experiences—I think it's great to have a narrative like this that you can really connect to because then when you tease it apart, all the pieces really make sense. It makes sense why having doctors treat symptoms has failed, it makes sense why a lack of communication between the health provider network that was supposed to be serving Leo failed. It makes sense why it didn't work when you actually start to tease it out. But then we’re still all, well not all, but most of us are still going down this path and it's an exercise in futility, really. You have an eight-year-old kid who's on powerful stimulant medications, he’s on antidepressants, and it was bad enough for his parents to reach out and to seek those interventions as solutions, and then the side effects are even worse. And that’s just something that just gets you right in the heart. And like you said, he’s not the only one, he’s not the only kid. His parents are not the only parents. And frankly, his doctors are not the only doctors because I can guarantee you that that probably doesn’t really feel good for the practitioner, for the healthcare provider to not get results as well. And they’re working with what they’ve got. Chris:  Absolutely. Tony:  And trying to use the tools they have. Chris:  Yeah, I mean, let’s be clear about this. Everybody is doing the best they can in this situation. The parents are doing the best they can, in the vast majority of situations, parents just love their kids and do everything possible that they can to help their kids thrive. I’m a parent, I know that that’s how I relate to my kid. I know that every parent I know, that’s how they relate to their kids. And I would even, I would say that’s true for doctors too. The vast majority of them are trying to do the best they can with the tools that they have and in the system that they’re working within. And that’s the rub. Tony:  Right. Chris:   It’s like most doctors I’ve seen have been caring and they’ve wanted to do the right thing, but the question is, can they do the right thing in the conventional medical system as it exists today? And, of course, that’s largely what the book is about.

Who is this book for?

Tony:  Yeah, so let’s kind of speak to that specifically. And we’re talking about doctors, we’re talking about medical professionals, we’re talking about patients, and then we didn’t mention it, but where I fit into this formula or potential formula as an allied healthcare provider, as a personal trainer/health coach, is that your audience for this book, do you really see that kind of triad is who you're speaking to here? Chris:  Yeah, definitely. I think if you look at the cover of the book, the subtitle is “join the revolution to reverse chronic disease, reinvent healthcare, and create a practice you love.” So that last bit would suggest that it's mostly for practitioners, but that's not true. It is really for anybody that is interested in the ideas of reinventing healthcare and reversing chronic disease. And, in fact, I would argue that that change is going to be initiated by people, primarily by people that are not practitioners. So it's like a grassroots, bottom-up approach, where a good example is with my training program, my ADAPT training program, now that we've been training practitioners in this approach for the last couple years, we always ask people how they learned about my work or how they learned about the training program. And in a surprising number of cases, the answer is from their patients. So these doctors or other practitioners, their patient brings an article in that I wrote or brings something in, tells them about me, and to their credit they’re open-minded enough to go and check it out. And then they like what they see and they end up taking the next step. So people even who have no intention of ever becoming a healthcare practitioner, I think would really benefit from this book if they're interested in these ideas. And then certainly, as you mentioned, licensed healthcare providers like medical doctors or nurse practitioners or physician assistants that are currently working within the conventional paradigm but have already seen its limitations and want to do something different but don't yet know what that might look like. And then people who are outside of the conventional paradigm but are already practitioners, so acupuncturists, chiropractors, naturopathic physicians, etc., in many cases they’re already well aware of the limitations of conventional medicine, which is why they chose to go down a different path. But speaking personally as an acupuncturist myself, I also saw some limitations in the traditional Chinese medicine approach, or at least some differences in the way that I wanted to practice it. I was looking for something that could incorporate modern diagnostic testing and create a more systematic approach that included ancestral diet and lifestyle and some of the other things we talk about in the book. So, I think many of those practitioners can benefit from the book from that perspective. And then you have the growing and already large number of people like yourself who are personal trainers, health coaches, nutritionists, etc., who I really think are going to play an increasingly important role in this revolution to reinvent healthcare. Tony:  Yeah, it so important now for people to really, for patients to be their own advocate, and I don't think we’re living in a time where I remember with my grandparents—if your doctor said something, it was basically gospel and you didn’t question it and you didn't think about it. Now, the first thing people do when they experience a symptom, it's Dr. Google first. So it's super important to equip and arm patients with good information, which I think this book does. Here's a path, here's a path forward for you as a patient. But then it's respectful of the role of doctors, and you highlight many situations where conventional medicine is great. If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But it's really in this kind of gray area, it’s really not gray, it’s actually quite clear. And we could probably specify a little bit more, but there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach. And that’s where that whole middle ground and acupuncturists and massage therapists and everybody who's in that middle zone. I had clients constantly when I was actively training, constantly asking me questions where I was like, you know what? This is really something they maybe should be taking to their doctor. But guess what? The doctor only has 15 minutes under pressure to see as many patients as they can. I had a friend who was a physician in France. And he was telling me about their medical model, and he would spend tons of time with his patients. And it was actually incentivized for prevention. And here we see some maybe misplaced incentives, and perhaps you can speak a little bit more about that.

The mismatch between our medical paradigm and chronic disease

Chris:  Yeah, so, going back to your original comments, I think that the most important thing for people to understand is that our medical model, when it comes to our medical paradigm, is that it evolved during a time when acute problems were the biggest issues. So in 1900, the top three causes of death were all infectious diseases, tuberculosis, typhoid, and pneumonia. And the other reasons people would see the doctor were among those you mentioned, like a broken bone or a gallbladder attack or appendicitis. Tony:  War. Chris:  Right, injuries, trauma, etc. And so the treatment for that's pretty straightforward. It wasn't always successful, of course, but it was straightforward. You know, if the bone was broken, you set it in a cast. If the gallbladder was swelling, you would take it out. If someone was having appendicitis, you’d remove the appendix. So that's pretty ... it's one problem, one doctor, one treatment. Pretty straightforward. But you fast-forward to today, it's a totally different healthcare landscape. Seven of the top 10 causes of death are chronic disease rather than acute problems now, and 86 percent of the healthcare dollars we spend go toward treating chronic disease. And unlike acute problems, chronic diseases are expensive, difficult to manage and usually last for a lifetime. They don't lend themselves to that one doctor, one problem, one treatment kind of approach. The average chronic disease patient requires multiple doctors, usually one for every different part of the body in our system, and is taking ... Tony:  Specialists. Chris:  Right, specialists, they’re taking multiple medications in many cases, and they're going to be taking those medications for the rest of their life. So far, it's really, our conventional medical system is amazing for these acute problems. But it's the wrong tool for the job for chronic problems. So that's one issue, and it’s really important to point that out, because we just went through the whole healthcare debate again with the Affordable Care Act and the current administration’s proposal for a replacement, which has not come to fruition. But throughout that entire discussion, it really bothered me that there was an elephant in the room. All the discussion was around insurance. Like, who gets insurance and who doesn’t. And that’s important, it’s important to talk about that. But we have to recognize that health insurance is not the same thing as healthcare. Tony:  Yeah. Chris:  Health insurance is a method of paying for healthcare. And that’s really crucial to get that difference. Because my argument in the book is that there is no method of paying for healthcare, whether it’s the government, corporations, or individuals, that will be adequate and will be sustainable under the pressure of growing prevalence of chronic disease. It will bankrupt all of us. Government, the corporations, individuals, whoever is responsible for paying for the care will not be able to do it unless we can actually prevent and reverse chronic disease instead of just slapping Band-Aids on it. Tony:  I think the analogy you gave in the book was rearranging the deck chairs on the Titanic. “Making a few small tweaks to our current system and expecting that to work is like rearranging the deck furniture on the Titanic as it inexorably sinks into the ocean. Too little, too late.”  Chris:  Yeah, exactly. That’s the argument about insurance. As the whole ship goes under, sinks under. The other problems you mentioned are very real also. So we have a misalignment of incentives, like the insurance industry, for example, doesn't benefit when the cost of care shrinks because they only make more money when the overall expenditures rise. So it's actually not in their best interest necessarily to seek out the most cost-effective solutions.

Drug companies and conflicts of interest

Chris: And then of course, we have drug companies. People are pretty well aware of the conflicts of interest there. It’s in their interest to sell drugs, and even when that’s not in the interests of the general public or the patients or the doctors. In many cases, it’s not in their interest either. So the best example of this is a recent one. We’re in the midst of an opioid crisis, the worst we’ve ever seen by far, and the DEA has been wanting to create new regulations that restrict a pharmacy’s ability to sell opioids in ways that will protect people. So, for example, there was a pharmacy in West Virginia in a town that was tiny. It had like 30,000 people in this town, and they had ordered something like nine million opioid pills in the last year. It was clearly a front, like there’s clearly something shady going on there. There's no way that 30,000 people in that town needed nine million opioid pills, and yet there are no regulations to actually prevent that from happening. And so, the DEA had proposed some regulations to just safely protect people from that kind of thing. And the Big Pharma lobby basically shut that down and they played a big role in writing a law that limits the DEA's ability to do that kind of regulation in the midst of the worse opioid crisis ever. And to put this in perspective, we hear a lot about the gun lobbies and their control. They spend about $10.5 million lobbying Congress, I think, per year. And Big Pharma, they spent $250 million. Tony:  Wow. Chris:  Twenty-five-fold higher. Tony:  It's really tragic. I actually, I don’t think we’ve ever talked about this, but I grew up in South Florida, which was kind of ground zero for the opioid epidemic. And I remember in high school down in Miami and West Palm Beach, and kids would get a hold of a contact or whatever, somebody that had a prescription and basically would end up being a de facto drug dealer vis-à-vis a pill mill, etc. The kid across the street from me died, multiple kids in my high school died, multiple kids went into in-treatment programs, some of them battled addictions for decades. Some of them got out of it. Very few got out of it. Some of them didn't and have continued to be plagued with either switching from pharmaceuticals to street drugs like heroin, etc., and then we can see what's happening there. And that's just one example. If we look at drug consumption in the United States, is it that Americans are just that much sicker and we’re in that much more pain than people in other countries? Because we’re consuming far and away more painkillers than any other country on the planet. And I would venture to guess that you could say the same about antidepressants or ADD medication. It's very much a case of misaligned incentives. And incentives are working in the sense of the pharmaceutical companies are doing very well. Chris:  Yeah. Who are they working for is the question. Tony:  Exactly. Chris:  We’re the only country aside from New Zealand that allows direct-to-consumer drug advertising, and I think that's a big part of the problem. But it's not just Big Pharma. We also have conflicts in medical research that, of course, are related to Big Pharma because they pay for two-thirds of all medical research. We have broken payment models, where there's no real incentive or reward for good performance, and in fact, you could argue it's the other way around because doctors are compensated for, usually based on the number of procedures they order and the number of patients they see. So to your point about the doctor in France who is actually incentivized to prevent, rather than just treat disease, we don't have that at all, it's the opposite. And so there are a lot of deeply entrenched issues that we certainly need to address, and that's not essentially what this book is about. There are other books that cover that material really well, and frankly many of those issues are outside of our individual control as clinicians or practitioners.

How clinicians can help create a new paradigm

Chris: We can work toward addressing them, and I think we should, but the good news is that I think that the bigger changes that we need to focus on individually and collectively are addressing the medical paradigm which we’ve talked about, creating a medical paradigm that’s better suited to tackle chronic disease. Addressing the mismatch between our modern diet and lifestyle, and our genes and our biology, which we've, of course, talked a lot about on the show before. And then creating a new way of delivering healthcare that actually supports this new medical paradigm and this more preventative approach. Because those things are all within our control as clinicians. Tony:  Yeah. I like how you posed the question, and it was kind of a cool little, I think it was, not Hiroshi, but the person who is in charge of cooking at a Buddhist monastery. And basically a young monk comes up to this older man. He’s like, why are you doing the grunt work, basically washing rice out in the courtyard? And he says, it was like, what was it? “If not me, who? And if not now, when?” And I think that that’s really kind of the core of setting all this stuff up. Talking about the problem is really in the service of pivoting to the solution, and I’m a big believer in thinking globally, thinking big, but acting locally, hyper-locally, like yourself. Chris:  Yeah. Tony:  And then the people around you and who you can touch and impact. That’s ultimately where the power comes from. So let’s talk about that. What is in people’s power. And you started to describe some of those pillars of a new model. And you describe it as the ADAPT framework. And I don’t know how much you get into this on your regular podcast episodes, but to just kind of lay it out, ADAPT from a big-picture perspective. How does that actually address some of these systemic issues from an individually empowered stance? Chris:  Yeah, great question, and before I even go into that, I just want to say I agree that I think the change is going to happen on different levels. So, because a lot ... we’ve talked about this stuff at conferences or even some people who’ve already read the book. They say, oh, this is fantastic. I’m so excited. But how are we going to deal with Big Pharma and the insurance industry and these misaligned incentives and all of that? And can we ever deal with that? The answer is we’re not going to deal with that overnight and it’s going to take a while to unwind those things. Tony:  It’s the chronic disease, is what you call... Chris:  Exactly, exactly. And I use that analogy in the book. But the good news is that changes can happen very quickly on an individual and local level. And there’s already a lot of evidence of that happening. So my own clinic, CCFM, tripled in size in the last three years alone. We have Cleveland Clinic Center for Functional Medicine, launched by Dr. Mark Hyman, has just blown up like crazy. I mean they started in this tiny space. Now their 17,000-square-foot space, it takes up the whole second floor of the Glickman Tower at Cleveland Clinic. They've got a waitlist of 2,500 patients from nine countries around the world. This is really exciting! The Cleveland Clinic is always on the forefront of the newest trends in medicine, and the fact that they've invested that much money in this speaks volumes. Then we have groups like Iora Health, an organization based in the Rocky Mountain area that’s reversing diabetes using health coaches. So there are lots of really interesting produced concepts, and there's going to be more and more of these. Like we’re doing a pilot program with the Berkeley Fire Department where we’re working with their new recruits to help, we’re implementing a wellness program. Tony:  That’s awesome. Chris:  To reduce injuries and help with recovery and optimize their performance. And if that goes well, there’s been interest from the wider fire department and in the city of Berkeley as a whole. Robb Wolf’s done some incredible work with Reno that we’ve talked about before. So I think the change is going to happen more quickly on this local grassroots level, and then that's going to start to get the attention of people on a state and federal level. And then it will start to get really interesting.

The three core problems and how to solve them

To answer your question, in my book I basically lay out three core fundamental problems with the healthcare system in the US. And these, I argue, go even deeper than the misaligned incentives and Big Pharma and all of that stuff, although they’re, of course, connected. The first is that there is a profound mismatch between our genes and our biology and our modern diet and lifestyle. And I'm not going to say more about that now because almost everyone listening to this podcast knows exactly what I mean. The second problem is the mismatch between our medical paradigm and chronic disease, which we just talked about. We need a new medical paradigm that is better suited for chronic disease. And then the third is that the way we deliver care in this country is also, it's not set up to support the most important interventions. And we’ve touched on that too, where the average visit with the primary care provider is just actually eight to 12 minutes. Tony, you were talking about 15 minutes. That’s luxurious in our current model. The average amount of time a patient gets to speak before they’re interrupted by the doctor is 12 seconds. Tony:  Wow. Chris:  So I think it’s pretty clear that if a patient has multiple chronic diseases, which one in four Americans now do, one in two has one chronic disease, and they show up to the doctor’s office and they're on multiple medications, and they had been presenting with a whole set of new symptoms, there’s absolutely no way to provide high-quality care in a 10-minute visit. So we have to change our, not only the paradigm, but also the way that care is delivered. So that was my premise. So it follows then that my solution would address, I would hope at least those three points, right? Each of those three deficiencies. So the ADAPT framework combines an ancestral diet and lifestyle, which addresses that mismatch between our genes and biology in our modern diet and lifestyle. And then Functional Medicine is the new paradigm of medicine that is based on addressing the root cause of health problems, so we can prevent and reverse them instead of just suppressing symptoms. And then the third component is what I call a collaborative practice model, which links licensed providers like medical doctors, nurse practitioners, with what I call allied providers, which include folks like yourself, Tony, health coaches, nutritionists, personal trainers, etc., to provide a much, much higher level of care than what doctors are able to provide on their own. So, again, we're not trying to replace doctors in any, or even conventional medicine. We need people to do colonoscopies and remove cancerous tumors and use all of the incredible amount of training and expertise and skill that they’ve acquired over a lifetime of practice and study. We absolutely want that, but we need to add stuff to that that's not available now. Tony:  What that really says to me is, emphasize the importance of community, of connection, of collaboration. We’re social creatures, we’re tribal by nature. That’s another kind of Paleo/ancestral health part of the puzzle. And it would be foolish to think that we can dissect out and silo out all these different aspects of our lives without consequence. I really like this idea of bringing everybody into the fold, and it’s not saying that you can go to just the naturopath, or you can go to just the health coach. Because like I mentioned already, I certainly would’ve been ill-equipped to handle plenty of issues that a client would’ve brought to mind or brought up in conversation during a training session. But it would’ve been really great to say, ah, here's the Functional Medicine practitioner that I recommend you speak with, and to have a good relationship with that person and to be able to, as a health coach, help my clients better by getting them in touch with the right person. And that’s having this network that can really support people throughout their health journey whether it’s just feeling better and more energy, or addressing something like diabetes or hypertension. Which certainly there’s a place for all the players in that kind of scenario.

What this new paradigm looks like

Chris:  Absolutely. And let’s use an example just to bring this to life for people. So, imagine you go to the doctor and they do some blood testing for your annual physical. And they find that your fasting blood sugar is 96 or 97. Your hemoglobin A1c is 5.5, and you’ve got triglycerides that are 110, 120, maybe 130. Currently, what would happen is nothing, usually. Tony:  You’re not sick enough yet. Chris:  Yeah, all of your markers are within the lab range, they say, and that means you’re normal, and so you might get some vague advice about make sure to exercise and follow a good diet. And thank you very much, that’s it. Certainly there are exceptions to the rule, of course. There’s some practitioners who can get a lot more proactive about that. But I can’t tell you how many people, patients I’ve had that have been given that basic line with those kinds of lab results. What could happen is this. The doctor says, “Well, you know, if we think of blood sugar disorders on a spectrum, on the left you’ve got perfect blood sugar. On the right you’ve got full-fledged type 2 diabetes. You’re not on the right yet, you don’t have type 2 diabetes or even technically prediabetes, but you’re progressing along that spectrum. And what we know from a lot of research is that if we don’t intervene now, that you’re going to continue progressing. And in fact, we have studies that show that the average patient who has prediabetes, will progress to full-fledged type 2 diabetes in just five years if it’s not addressed.” So what we want to do is be proactive here. We want to intervene now because it’s much easier to prevent a disease before it occurs than it is to treat it after it’s already occurred. So here’s what we’re going to do. We’re going to set you up with our staff health coach, and they’re going to give you all the support you need to adopt a better diet. They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they're going to give you recipes and meal plans and give you ... totally hold your hand and do everything that they need to to get you on this diet. Because we know that information is not enough. We’ve got lots of studies. I can tell you as a doctor, go eat a healthy diet, and hey, we know that that’s probably not going to happen. Most people know what they should be doing, but they’re not doing it, and it’s not because of lack of information. It’s because they need support, and we’re here to support you. We’ve got this health coach. Furthermore, we've got this great personal trainer named Tony. We’re going to set you up with him and we’re also going to set you up with a gym membership. And the good news is, your insurance is going to pay for all this. They’re going to pay for the health coach, they’re going to pay for the gym membership, they’re going to pay for your sessions with Tony. And in six months’ time, you’re going to come back here and we’re going to retest your blood markers and I can almost guarantee that if you stick with the program, you’re going to have normal blood sugar by that time. And throughout that period you’re going to have weekly check-ins with a health coach, you’re going to have training sessions. And not only will your blood sugar be normal, you’re going to lose weight, your energy levels are going to go up, your sleep’s going to get better, you’re going to feel more confident and empowered because you’re making these changes, and you’re going to feel like a different person. Now that’s totally possible.

How do we pay for this? Is it scalable?

Chris: I can hear some people saying, “Oh, how are we going to pay for that? That’s ridiculous.” Tony:  Is it scalable? Chris:  The question we should be asking is, is treating type 2 diabetes scalable? Because I mentioned this in the book, it costs $14,000 a year to treat a single patient with type 2 diabetes. So let’s imagine that this patient progresses. We don’t intervene, five years later they have type 2 diabetes. All of a sudden the healthcare system is spending $14,000 a year paying for that person’s care. And let’s say that that person gets diagnosed at age 40, which is still reasonable these days. The age of diagnosis is dropping more and more, and then let’s say that they live until they’re 85 years old, which is also possible because of our heroic medical interventions that keep people alive a lot longer than they might have been otherwise. So 45 years living with type 2 diabetes, that’s a cost of almost $650,000 for one patient to the healthcare system. Tony:  And that doesn’t even touch on the lost wages, cost to employers, when someone’s on leave, loss of productivity. And then the cost to the family members. Chris:  Absolutely. Tony:  People that are actually, are helping the patient, their health is going to be going down too. Chris:  Yeah. Nor does it touch on the qualitative aspects. Being immobilized, not being able to play with your grandkids, all of that stuff. But let’s just even forget about that for a second—$650,000, okay? And then the CDC recently came out with statistics saying that 100 million Americans have either prediabetes or diabetes, and 88 percent of people with prediabetes don’t even know that they have it. Which means they're almost certainly going to progress, right? If you do the math and you multiply 100 million people times even $14,000 for one year, you get a number that’s so large, I don’t even know what it is. It’s like a google something. It’s like, it has so many zeros after it, I don’t even know how to characterize it. But then if you multiply 100 million times like 20 or 30 years, it’s more money than there is in the world. It's like it's not going to happen. Tony:  Not sustainable, not scalable. Chris:  Not sustainable, not scalable. So let’s say in our example that we ... the healthcare system spends $10,000, which is way more than would be necessary, but let’s even say we buy the person’s groceries for three months. And their gym membership and their trainer, and their health coach, and those weekly, let’s say we spend $10,000. We’re just super generous and we spend $10,000 for that six-month period. Again, the research and my clinical experience indicates with near certainty that if the person is at that stage of not even prediabetic and we intervene, there’s like almost no chance that it’s not going to, we’re not going to be able to normalize that person’s blood sugar. And if they do that and they stick with it and they are able to do that because they now have support rather than just information, we’ve just saved the healthcare system $640,000 over the course of that patient’s lifetime. And that’s a conservative estimate, as you say. We're not including even the indirect costs. Tony:  Right, right. Chris:  I think that this is not only possible, it's going to become necessary. And whether we get there with a proactive approach where we decide to move in this direction and we make these changes or whether we get there because we absolutely have no choice, we’re going to get there. Tony:  Yeah. I mean it really sounds like we can’t afford to not do this. Chris:  Exactly. Tony:  And if we get to that point where we continue down the reactive path and we wait until there’s a total collapse, it might be too late, just to put it frankly. And it’s going to come out at a huge, not just financial cost, a huge human cost. Chris:  Yeah, it’s going to be, we can use the chronic disease metaphor again, it’s a lot easier to prevent a problem or reverse it at an earlier stage than it is to wait until the patient is essentially on life support or the healthcare system is on life support. It’s harder to reverse it at that time. And that’s of course why I’m writing the book now because I want to get this message out as far and wide as I can. Tony:  Yeah. If not now, when? If not you, who? Go right back to there.

How allied providers are the key

Chris:  Exactly. And one more thing about that is the amazing thing, the beauty of this is that it takes about eight years and hundreds of thousands of dollars to train a doctor. And it takes a certain kind of personality and a certain kind of comfort level with science, and a lot of prerequisites. It’s not for everybody. And there’s a ... already we have a shortage of doctors, and that’s predicted to get worse. I’ve seen estimates that suggest by 2025 we’ll have a shortage of 52,000 primary care physicians. So that’s a big deal. [insert image] So we already don’t have enough doctors, it’s already going to get worse, but if you think of healthcare as like a ... I have something in the book called the healthcare population pyramid. And you were referring to it earlier, Tony, where at the very top of that pyramid you’ve got 5 percent of people who are in really acute situations. So they’re in the hospital or they’re in an intensive outpatient care setting. They need the conventional medicine paradigm as it exists, and it’s fantastic for those situations. Then you’ve got another 25 percent of people in that kind of high middle of the pyramid who are dealing with some pretty serious chronic health challenges. So they require more regular care, but they’re not sick enough to be in the hospital or in any kind of ... they’re living their lives, but they’re struggling a lot. A Functional Medicine practitioner/clinician usually working in concert possibly with the conventional specialist of some kind is a really great option for that 25 percent of the pyramid. But then you’ve got the 70 percent at the bottom. So these are people who do, may have health issues, but they’re more minor, so they might have skin problems, or a little bit of brain fog, some difficulties sleeping, some GI issues. And these can be definitely debilitating and total pain, but they’re not at the level of that 25 percent. My argument is that in many cases these people could be very well served by a health coach or nutritionist with good training. And possibly seeing a Functional Medicine provider once or twice a year, or something like that. And the thing is, we can train people in a year or two without an extensive science background to be very, very objective in this role. Because they’re mostly working with patients on changing their behavior. If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making. And so if a skilled health coach who’s trained in things like motivational interviewing and coaching to strengths and other evidence-based principles of facilitating behavior change which we have a ton of research on, they can be incredibly effective for that 70 percent of the population. That's the majority of the population. So we’re totally underutilizing these practitioners, and my argument is that they’re going to play a huge role in this future of medicine. And that's of course one reason why we're launching an ADAPT Health Coach Training Program next year to complement the practitioner training program that we've been doing. Because I want to create this ecosystem we've been talking about where you have all of these different types of practitioners working to the maximum of their training and ability and scope of practice and supporting each other and therefore providing the highest level of care to patients. Tony:  That certainly kind of perks my ears up hearing about the ADAPT health coach option and something that I’m personally interested in. So who knows? Maybe I can get in on that. We can talk about it again in the future. Chris:  Yeah, for sure. For sure. Tony:  So, for this particular book, for Unconventional Medicine, people are fired up, they’re hearing about it, they’re like, “Okay, this resonates with me. I’m a practitioner, I’m an allied health provider, I’m a patient, I’m ready. Now’s the time. This is it. We’re going to do this.” What’s the best way for people to get their hands on this thing? Chris:  Well not surprisingly, Amazon. They have the best way to get your hands on anything. So it’s available in paperback, Kindle, and audiobook. We’re hoping [the audiobook] is going to be out today, the day this podcast is released. But it might be another two or three days. They’re just taking their sweet time to approve it. I narrated the audiobook myself. So you podcast listeners, I figured you might be into that, since you like to listen. Tony:  They know your voice. Chris:  Yeah, and just listening to something instead of reading it perhaps. So to that end, we have a special offer for podcast listeners, because I appreciate your support and I know many of you are already part of this movement, and some are wanting to get involved. So if you buy that paperback or Kindle version between now and Sunday night, you’ll get some really cool bonuses. The first is a free copy of the audiobook. So again, we wanted to include that for podcast listeners, since we figured you guys and gals are probably interested in audio. But there are two other things that are really, I think, fantastic. And one, they’re both tools to help you be more confident and persuasive and factual when you share your passion for Functional Medicine and an ancestral diet and lifestyle. Because we’ve had a lot of questions from people, both practitioners and non-practitioners alike. They say, “Oh, how do I talk about this stuff to my sister at Thanksgiving?” Tony:  “Isn’t that that caveman diet?” Chris:  Yeah, exactly. All of our ancestors died when they were 30, so why should we even care? How do you respond to those arguments? Or if you start talking about Functional Medicine and maybe one of your conventional medicine colleagues says, “Oh, that’s just, I saw something on Science-based Medicine that said that was all just hooey. There’s nothing to it. How do you respond to that?” So what we wanted to do is give people the ammunition they needed in a respectful way. You know, this isn’t about getting the better of somebody. It’s about responding in a factual and convincing but respectful way. So we’ve got two different, we’re calling these the Power Packs. And one is for practitioners, so clinicians, health coaches, nutritionists, trainers, etc., and these are facts, research that you can reference and persuasive reasons for your clients or patients or colleagues to consider this Functional Medicine and ancestral diet and lifestyle approach. And then we have one for non-practitioners called the Supporter Power Pack. And these are smart answers and compelling comebacks, again respectful, for those common objections that you hear when you start talking about this stuff with your friends and family. So these bonuses are available until Sunday night [November 12, 2017] at 11:59 p.m. Pacific Time. So you’ve got a few days to act on that, and you can go to ... we set up a special link for you to get these and that’s Kresser.co/bonus. That’s Kresser.co/bonus. So head over there to get your Power Packs and your free audiobook, and that’s after you purchase either the paperback or Kindle. There’ll be a place where you enter your order number and we ask for some information just to verify, and I hope you enjoy those and get a lot out of them. Because they were actually really fun to put together. Tony:  Yeah, I think the audiobook is huge. I like to listen to audiobooks when I’m driving around town or outside getting some exercise. Chris:  Yeah. Tony:  So, no excuses when you make it that easy. Chris:  Yeah, yeah. So, Tony, thanks so much for doing this. This has been really fun to talk to you, as it always is. And I appreciate it. Tony:  Actually, I wanted to throw in one extra little special thing, as we mentioned, at the top of the show. I spent 10 years as a personal trainer in the trenches, I was involved with Paleo Magazine for many, many years, going to all the events, and for me kind of an evolution in my professional life was, how do I impact more people? How do I help more people? And at first I was working one on one, and then it was as a facility manager helping other trainers and coaches get better. And then I was able to scale it up that way. And last year I had an opportunity to join the team over at Natural Force, which is all-natural, nutritional products, and I basically said, “You know what? I’m going to go all in on this because if I can touch a million people through really good, high-quality nutrition, that’s me maximizing my impact and really kind of living my purpose.” So one of the things I wanted to do today is put it out there for anyone listening who maybe uses collagen or MCT oil or whey protein. We really bend over backwards to source the best ingredients in the world, no additives, all that stuff. Everything is as clean as we can possibly make it. It takes a lot of work, working with manufacturers. Kind of like what you were saying, how patients have to know how to talk to their doctor. I don’t think people really realize, and I didn’t realize until I got on the inside, how much work it is for a brand to work with their manufacturers to convince them to get outside of the conventional mold. So it’s the kind of unconventional nutrition is really what we’re pushing here. So I set up a discount code for any Revolution Health listeners. Go to NaturalForce.com, use coupon code “unconventional” and get $10 off plus free shipping on your order. So I just want to put that out there as just a little extra bonus for anybody, and I would certainly love to help in that way and really get some good, high-quality nutrition into people’s hands. Chris:  Awesome. Yeah, and there’s so many ways people can help, and I ... at Paleo f(x) we’ve see the growth of companies that are serving this space, and it's amazing. Like the products that are available now. I had breakfast this morning, I had some eggs and kale and parsley and a little bit of bacon in a couple of cassava flour tortillas. Breakfast burritos. Whoever thought I’d be having a breakfast burrito again? Tortillas are made from completely cassava flour. They’re autoimmune friendly and they’re grain-free tortillas. It’s incredible. Tony:  I think I might have some of those in my fridge as well. Chris:  Yeah. I mean there’s so many things. And these people, they’re serving this movement with that kind of work. So it’s great to see. Tony:  It takes a village, man. Chris:  It does. Thanks again, Tony. I really appreciate it. Thank you, everybody. So again, Kresser.co/bonus to pick up your free audiobook and the other bonuses, and I hope you can all join me in this revolution to reinvent healthcare. We need you, whatever your background and goals. Take care, everybody.

Source: http://chriskresser.com November 08, 2017 at 04:12PM

#paleo #recipe #food #delicious #healthy #yum #diet

[thedancemostofall]

notes on eating

Ruby Tandoh on Sugar

The idea of a monolithic, wondrous, dreadful sugar would hardly have made sense to medieval cooks. Sweetness was not a category, but a seasoning

In many cultures, this sugar-salt symphony is still foundational. “The food I grew up eating every night — that is to say, Persian home cooking — is all about balancing the plate with sweet and sour, salty and rich, crisp and soft,” says Nosrat. “Fresh and dried fruits — pomegranates, sour cherries, dates, raisins — all regularly found their way onto our dinner plates. So I have always been drawn to a little sweetness in my food.”

How has sweetness — something we are evolutionarily programmed to like, for survival — come to stand in for sex and escapism and hedonism? Humans are metaphor machines, and our mouths are liminal places where food and words mingle, where hot dogs, tagliatelle, and Nigerian puff puff meet “my name is,” memory, and “I.” True synesthesia — the blurring between one sense and another — is relatively rare, but its logic pervades our language, so that trumpets might sound hot, or sadness taste sour. One study found that honeycomb toffee tastes less sweet when eaten whilst listening to a “bitter” soundtrack than when eaten whilst listening to a “sweet” soundtrack. And our senses don’t just crisscross randomly — “How come silence is sweet but sweetness isn’t silent?” one paper asked.

https://www.eater.com/2018/8/6/17631452/ruby-tandoh-sugar-history-kara-walker-will-cotton

Taffy Brodesser-Aknery on Losing it in the Anti-Dieting Age

About two years ago, I decided to yield to what every statistic I knew was telling me and stop trying to lose weight at all. I decided to stop dieting, but when I did, I realized I couldn’t. I didn’t know what or how to eat. I couldn’t fathom planning my food without thinking first about its ability to help or hinder a weight-loss effort. I went to a nutritional therapist to help figure this out (dieting, I have found, is its own chronic condition), and I paid her every week so I could tell her that there still had to be a way for me to lose weight. When she reminded me that I was there because I had realized on my own that there was no way to achieve this goal, I reminded this wonderful, patient person that she couldn’t possibly understand my desperation because she was skinny. I had arthritis in my knees, I said. Morality and society aside, they hurt. I have a sister with arthritis in her knees, too, but she’s skinny and her knees don’t hurt.

I went to an intuitive-eating class — intuitive eating is where you learn to feed yourself based only on internal signals and not external ones like mealtimes or diet plans. Meaning it’s just eating what you want when you’re hungry and stopping when you’re full. There were six of us in there, educated, desperate fat women, doing mindful-eating exercises and discussing their pitfalls and challenges. We were given food. We would smell the food, put the food on our lips, think about the food, taste the food, roll the food around in our mouths, swallow the food. Are you still hungry? Are you sure? The first week it was a raisin. It progressed to cheese and crackers, then to cake, then to Easter candy. We sat there silently, as if we were aliens who had just arrived on Earth and were learning what this thing called food was and why and how you would eat it. Each time we did the eating exercise, I would cry. ‘‘What is going on for you?’’ the leader would ask. But it was the same answer every time: I am 41, I would say. I am 41 and accomplished and a beloved wife and a good mother and a hard worker and a contributor to society and I am learning how to eat a goddamned raisin. How did this all go so wrong for me?

https://www.nytimes.com/2017/08/02/magazine/weight-watchers-oprah-losing-it-in-the-anti-dieting-age.amp.html

Oprah- how did i let this happen again?

"How Did I Let This Happen Again?"   Photo: Matthew RolstonFour years ago, when Oprah managed to get down to a trim and fit 160 pounds, she thought she'd hit on a foolproof formula for permanent weight loss. Then life—in the form of a thyroid problem and a killer schedule—intervened. Last year she was back up to the 200-pound mark and knew something had to change. After a desperately needed time-out to reflect and recharge, here's what she's learned, what she's doing differently, and what's next.You know how bad you feel when you have a special event, a reunion, a wedding, a bar mitzvah, and you wanted to lose that extra 10 to 40 pounds, and you didn't do it? So the day comes and now you've got to try to find something to wear that makes you feel halfway decent, and you have to figure out how to hold in your stomach all night and walk backward out of the room so no one sees that your butt keeps moving even when you stop. Multiply that feeling by a million—make that more than 2.4 million for every Oreader—and you'll know how I've felt over the past year every time I had to shoot a cover for O. If you're a regular subscriber, you'll notice you've not seen a head-to-toe shot all year. Why? Because I didn't want to be seen. " In 1992 I reached my heaviest, 237 pounds. I was 38. Then, four years ago, I made it a goal to lose weight, and I appeared on the January 2005 cover (left) at a toned 160 pounds. I thought I was finished with the weight battle. I was done. I'd conquered it. I was so sure, I was even cocky. I had the nerve to say to friends who were struggling, "All you have to do is work out harder and eat less! Get your 10,000 steps in! None of that starchy stuff!" Bam! Karma is a bear of a thing. So here I stand, 40 pounds heavier than I was in 2006. (Yes, you're adding correctly; that means the dreaded 2-0-0.) I'm mad at myself. I'm embarrassed. I can't believe that after all these years, all the things I know how to do, I'm still talking about my weight. I look at my thinner self and think, "How did I let this happen again?" It happened slowly. In February 2007, at 53, I started to have some health issues. At first I was unable to sleep for days. My legs started swelling. My weight started creeping up, first 5 pounds, then 10 pounds. I was lethargic and irritable. My internal clock seemed totally out of whack. I began having rushing heart palpitations every time I worked out. Okay, I've never loved daily exercise, but this was different. I actually developed a fear of working out. I was scared that I would pass out. Or worse. I felt as if I didn't know my own body anymore. After many trips to various doctors, I received a diagnosis. I had hyperthyroidism (an overactive thyroid that can speed up metabolism and cause weight loss—but of course didn't make me lose a single pound) and then gradually started moving into hypothyroidism (a sluggish metabolism that can cause fatigue and weight gain). My doctor prescribed medication and warned me that I must "learn to embrace hunger" or I would immediately gain weight. Believe me, no part of me was prepared to embrace hunger. It seemed as if the struggle I'd had with weight my entire adult life was now officially over. I felt completely defeated. I thought, "I give up. I give up. Fat wins." All these years I'd had only myself to blame for lack of willpower. Now I had an official, documented excuse. The thyroid diagnosis felt like some kind of prison sentence. I was so frustrated that I started eating whatever I wanted—and that's never good. My drug of choice is food. I use food for the same reasons an addict uses drugs: to comfort, to soothe, to ease stress. I switched doctors and still gained weight. At one point I was on three medications: one for heart palpitations, another for high blood pressure, another to moderate my thyroid. Who knew this tiny butterfly gland at the base of the throat had so much power? When it's off, your whole body feels the effects. [For more information about thyroid disorders, see The Truth About the Thyroid.] I followed my doctor's orders to the letter (except for the part about working out). I took the prescribed medication religiously at the same time each day. Being medicated, though necessary, made me feel as if I were viewing life through a veil. I felt like an invalid. Everything was duller. I felt like the volume on life got turned down. I realized this to some extent, but I wasn't fully aware of the effect of the medication until I had a conversation with my friend Bob Greene. He'd given up lecturing me about working out and eating well, but we were walking together one day and he said, "I think something's wrong. You're listless. Your movements are slower, even when you're just doing normal stuff. Twice I've told you something and you don't remember it. There's no sparkle in your eyes. I think you're in some sort of depression." Me—depressed? I hadn't thought I was, but definitely something was off. I felt like the life force was being sucked out of me. I always had an excuse for being tired. It took extra effort to do everything. I didn't want to go anywhere, and I didn't want to be seen any more than I had to. I could oversee a show and a magazine that tell people how to live their best lives, but I definitely wasn't setting an example. I was talking the talk, but I wasn't walking the walk. And that was very disappointing to me. Immediately after that conversation with Bob, I called my doctor. "All this medicine is making my life feel like a flat line," I said. So my doctor slowly weaned me off it, except for one aspirin a day. (By the way, never suddenly stop taking prescribed medication, especially heart and blood pressure medication, without checking with your physician.) That choice was the beginning of my road back to health—and back to myself. Regaining my footing hasn't been easy. What is true for every one of you is also true for me: Life's responsibilities don't lessen just because you aren't feeling your best. In my case, the show literally must go on. Many days I didn't feel like going to work, but sick days aren't an option when more than 300 audience members have bought plane tickets and arranged babysitters so they could come to a taping. I think I hit bottom when I wanted to stay home even from a show as fun as the one we did with Tina Turner and Cher in Las Vegas. I was supposed to stand between them onstage, and I felt like a fat cow. I wanted to disappear. "God help me now," I thought. "How can I hide myself?" Later, as I was interviewing both of them about their ages (at the time, Tina was 68 and loved being older; Cher was 61 and didn't), I asked myself, "Who's the real older woman here? I am." They both had more energy than I did. They didn't just sparkle; they glittered. At the close of our 2007–2008 season and the beginning of my summer hiatus, I still had other commitments. I make at least four trips each year to check on my girls in South Africa. No matter what continent they're on, a group of 150 schoolgirls is a lot to manage. By the time I left South Africa, I knew I needed some time to do absolutely nothing. In July I was able to take a break. I went to sleep and woke up whenever I pleased. I sipped soy milk, downed vitamins, snacked on flaxseed, and allowed my body to restore itself. Some days I exercised by walking with my dogs in the hills of Maui; gradually I started working out on the treadmill, at first with a heart monitor to make sure there were no palpitations (it was a black box smaller than a BlackBerry, which I wore on my belt). By the end of the summer, I felt I could do a full hour of cardio without dropping dead. Next I tackled the food addiction, which is ongoing. As far as my daily food choices go, I'm not on any particular program. I've gone back to the commonsense basics we all know: eating less sugar and fewer refined carbs and more fresh, whole foods like fish, spinach, and fruit. But in order not to abuse food, I have to stay fully conscious and aware of every bite, of taking time and chewing slowly. I have to focus on being fully alive, awake, present, and engaged, connected in every area of my life. Right now. What I've learned this year is that my weight issue isn't about eating less or working out harder, or even about a malfunctioning thyroid. It's about my life being out of balance, with too much work and not enough play, not enough time to calm down. I let the well run dry. Here's another thing this past year has been trying to teach me: I don't have a weight problem—I have a self-care problem that manifests through weight. As my friend Marianne Williamson shared with me, "Your overweight self doesn't stand before you craving food. She's craving love." Falling off the wagon isn't a weight issue; it's a love issue. When I stop and ask myself, "What am I really hungry for?" the answer is always "I'm hungry for balance, I'm hungry to do something other than work." If you look at your overscheduled routine and realize, like I did, that you're just going and going and that your work and obligations have become a substitute for life, then you have no one else to blame. Only you can take the reins back. That's what I'm doing. These days I've put myself back on my own priority list; I try to do at least one hour of exercise five or six days a week. As I work out, eat healthfully, and reorder my life so there's time to replenish my energy, I continue to do the spiritual and emotional work to conquer this battle once and for all. My goal isn't to be thin. My goal is for my body to be the weight it can hold—to be strong and healthy and fit, to be itself. My goal is to learn to embrace this body and to be grateful every day for what it has given me. In 2009, dare I, dare all of us give ourselves all the love and care we need to be healthy, to be well, and to be whole? I know for sure that for each moment of this brand new year, I'm gonna try.

https://www.oprah.com/spirit/oprahs-battle-with-weight-gain-o-january-2009-cover/all

The unhealthy truth behind “wellness” and “clean eating”

I spoke about this purity fetish to Nigella Lawson, whose guilt-free approach to eating helped to reconfigure my attitude to food when I was at my most vulnerable. "I despair of the term 'clean eating,'" she said, "though I actually like the food that comes under that banner. ['Clean eating'] necessarily implies that any other form of eating—and consequently the eater of it—is dirty or impure and thus bad, and it's not simply a way of shaming and persecuting others, but leads to that self-shaming and self-persecution that is forcibly detrimental to true healthy eating."

Our diets become a moral issue when this is the food culture we foster, and gluten is just the start of it. "I wish people would recognize [this] before saying, 'Hey, try this cool elimination diet—you've got nothing to lose,'" lamented Alan Levinovitz when I asked him about this modern cult of elimination dieting. "Nothing to lose? No, there's a lot to lose."

https://www.vice.com/en_us/article/jm5nvp/ruby-tandoh-eat-clean-wellness

Why we fell for clean eating

https://www.theguardian.com/lifeandstyle/2017/aug/11/why-we-fell-for-clean-eating

[therunningpa]

New job & night shift novella

So I’ve been at a new job the past 6 weeks. I’m still a hospitalist, but I’ve moved to night shift. It’s a long story for another time, but basically I was getting burned out and it was either change shifts or move to a different department altogether. Because I love IM so much I am desperately clinging to it for the time being. In my current role, I only do new admissions and consults.

Since I only post now, like, once a year I figured I might as well write a nice long story for you guys! Because also, when have I kept things short, ever?

So, here you go, a narrative of my day (night?).

I leave my house, clutching my tote of Campbell’s Double Noodle soup cans, rice crackers, and Gatorade. I kiss my husband, tell him I love him, and remind him to please finish cleaning the kitchen for me. He needs a lot of reminding. I need a lot of therapy. We’ve had a lot of therapy. It’s been a year sober for him and the anniversary has been hard, bringing back the guilt big time. It’s been more down days than usual the past month and as I leave the house I can only hope I won’t get any liver patients or alcoholics tonight.

I pull in to the hospital, badge in through various doors, end up in the office. The day shift is coming to a close. “Hey!” my coworkers greet me, “Feeling better?”

“Tons! Not a hundred percent but good enough for active duty.”

My terrible med seeking external ED dump patient from earlier this week had given me her norovirus. I’d spent the previous night out sick, puking and near-syncopizing. (FYI- use the bleach wipes next time!!)

I check in with the three physicians I’m working with that night. One, a seasoned night shifter, a quiet man I dub “The Machine” because of his deftness and ease at admitting patients. One, a seasoned nocturnist, another quiet and confident man who could run a thousand codes without screaming “fuck!” not even once. The third, an exceedingly nice new residency graduate who recently started with us and is probably reconsidering the job after his first week on nights. They have a lot of patients coming from outlying facilities, but no one arrived yet.

I sit around for an hour and a half, check emails, clear my inbox of the previous day’s results and check up on a few of those patients, eat a cup of noodles, rub my belly, think about how I shouldn’t have had coffee, then, all at once, I have 3 admissions I’m called to see. Yes, it’s true, they really all do come at once.

I triage them, and go see first an unfortunate lady who is bleeding and clotting. Or rather, likely to bleed. She has a genetic disorder predisposing her to clots and bleeding, and has come in with chest pain. The chest CT showed a pulmonary embolism, one in each lung. I’d hoped they’d be subsegmental, but they weren’t. I meet with her, spend a long time talking. I tell her I’ll call the hematologist and get back to her. I put out a page.

I jump up to the orthopedics floor to see my next patient, a 73 year old lady with COPD and osteoporosis who fell down the stairs at home and probably broke her sacrum. She’s straightforward enough, other than saying she’s intolerant to everything IV opioid except fentanyl. Which she’s not going to get outside of the ED. I write for oxycodone and IV ketorolac and pray her pending labs show normal renal function.

The hematologist pages me while I’m writing patient 2′s note. He recommends a heparin drip, so it can be turned off quickly if patient 1 starts to bleed. He also says he has no idea what to do with her after that, as far as a long term plan. I text my attending and let him know the plan for tonight. While I’m finishing my note, he texts me back an SOS that patient 1 is refusing heparin because she’s afraid of bleeding.

I go back to the ED, I print out UpToDate, visit the poor lady with the PEs again. I talk about risks and benefits, types of heparin. She has some cognitive impairments from a stroke, but she gets it enough that she has capacity. She still declines the heparin, wants us to “watch her” overnight in the hospital though. I check in with bed control, ask for an IMCU bed since she’s refusing blood thinners, and am told there are no ICU beds left. She’ll have to go to the regular floor.

My third patient is a prisoner with history of peptic ulcers and GI bleed coming in with worsening anemia. Actually, he never shows up from the outside hospital because of some officer conflict. His name gets handed off to the next shift.

Fourth patient shows up in the IMCU, from an outside hospital. The notes he comes with are scanty. Acute on chronic hyponatremia, ?dementia. Hypotensive. Weak. I hope he can give me some history. When I walk in he tells me he’s in a hotel in a different state and doesn’t remember how he got here. He denies any symptoms or concerns. It’s 11 pm, but I dial his elderly wife and bless her, she’s up, and gives me the full scoop. He ends up with a slew of labs, head CT, cardiac echocardiogram.

Fifth patient was not supposed to be admitted. Just discharged 2 days ago with COPD flare, end stage COPD on home oxygen. I read the ED notes in the chart, indicating the family demanded the patient be admitted because they are unhappy and that we are being investigated for discharging her too soon, or was it the nursing home was being investigated for not taking care of her the past 2 days? Or both? The discharge summary from my PA colleague indicates the patient refused hospice the last stay. Awww nawwww. I go and see her. It’s late and at least that means the angry family has gone away. I sit with the patient, she’s very anxious, I’ve taken care of her before. I listen for a long time, answer questions, sometimes the same question over and over. She eventually admits her memory ain’t so good anymore. She then marvels “you’ve asked me more questions than anyone else has today”. I hope that’s a good thing. I go through her extensive workup and again conclude that “I am so sorry, but what you have is not fixable. I think we need to focus on trying to get your symptoms better, but we can’t cure you”. She agrees to at least have a palliative care consult. She grumbles about her bad nursing home experience and says her family called to have the bed held for the following day. I waggle my eyebrows at her “You know, if you don’t hold the bed they’ll give it up and then you’ll have to be here through the weekend and then we can see if your preferred nursing home has a spot now, But, you didn’t hear that from me!” She beams. Somewhere, a social worker has rolled over in their grave and pledges to haunt me in my dreams tonight.

I run up to my office again and eat some more noodles, drink Gatorade, rub my gastroparetic-feeling tummy, and finish up my notes just as one of the physicians strides in with a cardiology consult for a patient who just had a STEMI, now in the coronary ICU. They were found to have multivessel coronary artery disease, received a stent. “Should be easy” he says, “Cardiology has done everything!”.

Except, they haven’t. Patient is from outside our system. Needs an entire medical record update. I also notice his blood sugar is > 300 and there’s no insulin ordered. I add “Type 2 Diabetes” to his problem list. I go in and see him, expecting him to be asleep at 1:30 in the morning, but he is wide awake and surrounded by family. He’s a good soul, we have a long talk about diabetes. His wife has a lot of cardiac questions and try to answer as able. His nurse pops in. “His blood pressure is greater than 150 and they want him under that post cath. There’s no medications ordered”. I step out, sigh. Honestly, I have no idea what cardiology does or does not want for an antihypertensive in their post cath patient. I have a sneaking suspicion it also varies widely by the cardiologist. I wish they would order this shit on their people already. I’m just here for the diabeet-us. Gah! 

“What do they usually do for the post cath protocol?” I wonder out loud.

“How about some PO metropolol?” a nurse asks.

I make a face “Really? They do that?”

The nurse looks horrified “Um, yeah, all MIs should be getting that!”

I shake my head “No, I know that, that’s not what I meant, I just mean it’s not going to act rapidly and it’s not going to do much, I mean maybe IV metoprolol but-”

She looks further horrified “No, they never do IV!”

I wanted to say “but I would never give that”, finishing my thought, but instead I shrug and give up. “I’ll ask the attending.” 

I don’t work in the ICUs that often, and I especially don’t know the night crew being new at this job. It’s true what they say, sometimes you need to earn your stripes with some ICU staff, especially if you’re a PA. Also, goddammit cardiology, order your antihypertensives! And beta blockers! And statins! (Also, I love you my cardiology people out there, please don’t take my 2 AM thoughts too seriously to heart, ok?)

I trudge back to my office, finish writing notes and checking labs and imaging that have come back. The demented hyponatremic guy does not have a brain bleed. The COPD flare bounce back has a normal procalcitonin. The untreated PE has normal blood pressures. Broken sacrum indeed does have normal renal function. I order new labs for the day crew. I report out to my docs. Around 3:30 AM I hang up my coat, collect my soup and Gatorade cans to recycle, and stumble out the cold wintry parking garage. I cast a few glances, good, no creepers trolling about, get in my car, and drive home.

I drive through the industrial part of the city and through spotlights and fog I see that the operations are already going at this ungodly hour. Backstreet Boys is playing on the radio. I pull into the back alley outside my house. I tentatively feel my way through the backyard, trying not to fall on my ass on the ice over our sidewalk, like I did the other night. I slip inside, and am completely delighted to see that not only has the kitchen been cleaned but there’s a loaf of homemade banana bread sitting out, steaming a little still. I hear a soft pitter-patter and my puppy steals down the stairwell to greet me. She wiggles from head to toe and jumps on me, playfully stealing my lanyard of keys and running away, shaking them. I took her home one day from a rescue this past summer, pretty much against my husband’s will, and I secretly believe she at least 75% the reason his depression lifted. He now agrees. I let her out to pee, then tread upstairs and wash my face and put on my pajamas, kiss my sleeping husband. I’m too wired to sleep though, maybe because I spent the last day and a half sleeping off the norovirus, so I go back downstairs, eat some banana bread, and start to write.

#dayinthelife #hospitalist pa #hospital medicine

[rachelvalente]

Quarantine Life Lately

I think I’ve officially lost track of how long we’ve been self-isolating…and for those of us in NY, there seems to be no end in sight.  I’m so grateful to have a job that I can do from home, but I’d be lying if I said that this virus outbreak hasn’t altered the scope of my work.  While some of you have mentioned that you welcome the distraction of personal style posts & pretty spring fashion, I also realize that we are living in a very different world right now & I want to share content that is both practical & helpful for navigating these circumstances.

So, today’s post is more lifestyle-related & I’m sharing what I’ve been up to lately – including the tastiest meals I’ve made, the workouts I’ve been doing & the best things I’ve purchased since quarantine began.  Hopefully this gives you some new recipes to try, fun activities to do & simple ways to make this time of staying at home a little more enjoyable!

THINGS I’VE BEEN BUYING

All these are exclusively from Target & Amazon because they have the quickest delivery available (so many other retailers have delayed shipping right now).  I love utilizing the order pick-up option at Target & I’ve discovered that many of their items actually have special deals/lower prices when you do it this way – for example, I can get my favorite coffee for $2.00 less!  Here’s the best of what I’ve bought over the last month:

Ribbed Crewneck Tees My t-shirt drawer has been needing a little update, so I was happy to discover these cotton/modal blend tees.  They are so soft & stretchy and the ribbed detail gives them a more refined look (perfect for dressing up or down).  These come in 11 different colors & they’re on sale now – I bought two in blush brown & white (not see-through at all!).  These are a little more fitted than your average tee, so I’d size up if you prefer a looser fit.

Acrylic Stackable Organizer Drawers Quarantine provides the perfect opportunity for organizing…and since we have the added benefit of packing for our upcoming move, we’ve been purging a lot and working to identify what we need to maximize storage space once we’re settled with my parents.  I bought some of these clear drawers, which are ideal holding vitamins, first aid items, toiletries or makeup – you can set them side by side or stack tall & they come in two different size options.

Healthy Snacks Who else feels like they are snacking constantly while stuck at home?  I’ve learned that if we don’t have healthy options on hand, I will end up eating my kids treats (hello, leftover Easter candy).  So I am trying to keep a constant stock of my favorites like this grain-free granola (so good with fresh fruit & yogurt), these roasted pistachios (no shells to hassle with) & these cheddar cheese crisps (pairs very well with red wine!).

Posture Corrector File this under things I should have bought years ago.  I cannot tell you what a difference this has made & how much it’s helped me to stop slouching & hunching over my desk all day long.  It’s comfortable and you can wear it under or over your clothes – I put mine on around 9am & take it off at 3pm.

Reusable Silicone Straws I love that these are color-coded & come with their own carrying case so everyone in the family gets one.  These come with a little cleaning tool, but I usually just throw ours in the dishwasher.  We typically keep these in the car for easy access on-the-go – although we haven’t been going out much lately, I know these will come in handy on our cross-country trip in a few weeks.

Wireless Charger As soon as the kids started doing school from home, we realized that we didn’t have enough chargers for all the devices in the house during the day – and, let’s be honest, we were getting a little tired of hearing them argue over who had a lower battery life and needed it more.  So we bought two of these wireless chargers and put one on the main floor & one upstairs near their bedrooms.  It’s such a great price & is compatible with most devices (works for AirPods too!).

Geometric Earrings + Straw Headband I used to love walking through Target to just browse their new arrivals & try things on…but those days are gone, so now we have to do it all online.  When I was buying the tees mentioned above, I needed a little more to add to my order, so I threw in these fun accessories at the last minute and I couldn’t love them more!  Both of them are 5% off right now when you use Target Circle (sign up for free here).

Adult Coloring Book + Colored Pencils We’ve been trying to get creative with family activities since quarantine started – challenges be an ordeal or an adventure…so we are doing our best to focus on the latter & make fun memories for the kids.  We’ve done outdoor scavenger hunts, game olympics, fitness challenges, and our new favorite: art night.  I ordered coloring books on Amazon for everyone – my son got this Harry Potter coloring book, my daughter got this summer scene coloring book, my husband got this muscle cars coloring book & I chose this street style coloring book for myself.  We turn on some music & sit around the table while we talk, laugh & color together – it’s the perfect activity for those rainy evenings when we can’t go for a family walk.

Core Sliding Discs I’ve definitely been buying more workout equipment over the last month & these are the latest addition – try them for an effective core workout like none other!  These are double-sided so you can use them on hard floors or carpet.  If you don’t already own resistance bands, there’s a great combo pack with sliders here.  This is a great reference sheet for different moves to try with them.

Elastic No-Tie Shoe Laces These are a game changer if you’re like me & have been wearing sneakers more lately.  Just take out your regular laces & replace with these and you’ll have shoes that you can easily slip on & off!  After I bought mine, I ordered some for my mom & dad since they have a harder time bending over now that they’re older.  These come in 22 different colors & would also be great for little kids!

Silicone Stainless Steel Tumbler We’ve been trying to do a family walk after dinner each night when the weather is nice – it’s such a great bonding time and the dog loves it when we’re all walking him together.  Since it’s usually a leisurely stroll around the neighborhood, I’ve started bringing my wine along with me in this sleek tumbler.  It’s vacuum insulated so it’s great for hot or cold drinks + the lid keeps your drink safe from splashing out.

Expressie Nail Polish So many of you have messaged me asking about at-home manicure tips and I think this video is the best tutorial I’ve seen (I use the same techniques when I paint my nails).  I recently picked up these new polishes to try & was amazed by how fast-drying they were!  They have a slightly angled brush, which I think is so much easier to use.  I got the shades Second Hand, First Love and In A Flash Sale (perfect for spring!).  Right now, Target has a promo where you can get a free bottle of nail polish remover when you buy two of these.

Pixi Eye Patches I’ve mentioned these before but I just ordered more on my latest Target order pick-up because I’ve been using them so much.  They really are the best eye patches I’ve ever tried for depuffing and hydrating.  Highly recommend!!

Olly Energy Gummies I don’t know about you, but I’ve had the hardest time with my energy levels lately (probably doesn’t help that we’ve been staying up much later than usual since quarantine began).  I’ve sung the praises of this brand for years so I decided to try these gummies to see if they would help.  I’m chronically low in B12, so it’s a supplement I need anyway + this flavor is so good.  I definitely feel like I’m more motivated to get going & able to focus better throughout the day.

MEALS I’VE BEEN COOKING

If there’s one thing that quarantine has forced us to do, it’s to have more meals at home.  If you’re like me, you’re probably running low on ideas. I’ve been trying out tons of new recipes and, to be honest, there have been some hits & misses.  So I thought I’d share with you the ones that my family has loved & that we’ve now added into regular meal rotation at our house.  These are all gluten-free and most are Whole30 compliant too!

Vegan Creamy Cauliflower Wild Rice Soup Comfort food at its finest – this is so creamy, you won’t believe it’s dairy-free! I serve this with a side salad & these almond flour crackers.

One-Skillet Spinach Artichoke Chicken I made this for the first time when I was in Oregon for Christmas with my family & it was a huge hit!  You can serve it over mashed potatoes or mashed cauliflower.

Paleo Fish Tacos This is my Dad’s favorite recipe of all time – he asks for it weekly!  I buy the Siete Almond Flour Tortillas and heat them up in a small pan until they get a little crispy (if you’re not GF, you can use whatever brand you prefer).  I recommend using slightly less sparkling water than is called for, so the batter is thicker.  I serve with homemade guacamole & these chips (also love these for a grain-free option).

Slow Cooker Honey Garlic Chicken There’s nothing easier than a good crockpot meal – just throw everything in, set the timer & forget about it!  This is so easy & delicious – I recommend doubling the sauce ingredients so you have extra.  I also modify this a bit and use Coconut Aminos instead of soy sauce & this unsweetened ketchup (you can add more honey if you prefer it a bit sweeter).  I serve with jasmine and/or cauliflower rice & French green beans.

Crispy Zucchini Fries This obviously isn’t a meal in & of itself, but these are such a tasty side dish!  I make them when we have burgers & they get devoured.  I use this ranch dressing (if you’re dairy-free, this is a good alternative).

Mexican Pizza This tastes so similar to the Taco Bell version I grew up eating – definitely a more indulgent (and filling!) meal, but so worth it if you have a craving for Mexican food.  Her sauce recipe is amazing & I’ve ended up using it for homemade enchiladas too!  I double the recipe for our family & use Siete Almond Flour Tortillas for myself and these white corn tortillas for everyone else.

Maple Walnut Crusted Salmon This sounds & looks so fancy, but it couldn’t be more simple.  My kids aren’t huge fans of salmon, but they gobble this up.  If you don’t have walnuts, you can substitute pecans (I did this last week & it was just as delicious).  I serve alongside Japanese sweet potatoes & roasted broccoli.

Black Pepper Chicken This tastes just like Chinese take-out…without the guilt (or MSG)!  And don’t worry if you don’t have fish sauce on hand, it’s just as good without it.  I serve this with jasmine rice and/or cauliflower rice.

Honey Mustard Sheet Pan Chicken & Brussels Sprouts I love this meal because it’s quick & easy and you only have one pan to wash when you’re done!  I recommend cooking the chicken for about 15 minutes before adding the Brussels sprouts (unless yours are very large) – mine were smaller & ended up a little overcooked when I made this the first time.  I also double the sauce to have some extra leftover (trust me, it’s so good!).

WORKOUTS I’VE BEEN TRYING

Active by PopSugar This site has over 500+ workouts & you can join for free!  They have pretty much everything you could want – yoga & pilates, dance, high intensity cardio, low-impact exercises, boxing & barre.  There’s a good range of 20-60 minute workouts & most don’t require any equipment (the 60-minute cardio boxing is my current favorite).

Modern Savvy Run Club My blogging BFF just launched a running club challenge that starts May 1st & I’d love for you to join us!  Just download the Nike Run Club app (it’s free) and request to add Alyson Seligman as a friend.  Once accepted, she will send you the invite to the challenge, which is to complete 30 miles by May 31st.  Even if you’re not a runner, you can jog or walk the miles – it’s a great way to stay motivated to move a little each day & get that accountability that we all need right now!

Madeline Moves I just discovered this sweet girl a couple months ago and, once quarantine began, she started sharing at-home strength training workouts on her Instagram.  I’ve created a workout folder & saved all of them so I can reference them easily – you can choose whatever weight works best for you & I like that she offers modifications for certain moves.  Other Instagram accounts that I like to follow for workouts: Alexia Clark, Cara Loren & Megan Roup.

The post Quarantine Life Lately appeared first on Penny Pincher Fashion.

Quarantine Life Lately published first on https://skinalleyupdates.tumblr.com/