Hustle Hassle

These days it can feel like you have to juggle everything at once in order to make a success of your life – if you aren’t busy then you aren’t trying.

So many women I know have a “side hustle” – partly because we are all renting tiny flats from people with big bank balances, and partly because we all have a range of interests and ambitions. We treat patients and paint portraits, we analyse accounts and run sports teams, we sell houses and write books. We cook, clean, nanny, host, tutor. All on top of our day jobs. This makes me immensely proud, but it also means we are all operating at maximum capacity all the damn time. A night in still consists of our laptop in front of us, emailing, planning, replying. Is it any wonder we are all bloody exhausted?

For last few weeks I have been pushing myself far too much, which when added to a chronic illness has wound up with me abandoning cooking, food shopping, hoovering, washing my hair…. It also means I have been MIA from social media as I have had very little to say (other than mild screams). There has been no food to photograph because I have mainly eaten bread. Straight out of the cupboard. Occasionally with some spread. Fancy.

Self care has not been a priority but I am hoping that can change from now. Well, from tomorrow after I actually buy some food and sort my monobrow out. Look after yourselves, kids. 

What’s the deal with… “plant-based eating”?

So first things first, let’s talk about me. Am I a vegan? Nope. That’s a good few Instagram followers gone. I am mostly a vegetarian – I don’t tend to eat meat or fish for a variety of reasons - some of which are taste-based, some are ethics-based, some are money-based. It’s a multi-faceted thing. Because I also don’t have dairy and I don’t like eggs I am also a sort of accidental semi-vegan. I phased out honey because of my love for bees (I have one inked on my wrist to make strangers aware of how deep this love is), but I still wear wool, I have a leather bag and I own leather shoes. Next batch of Instagram followers gone. Also, as a full disclaimer, I did eat marshmallows about a month ago because they were right there and I was ravenous… If I am ever forced to label the way I eat (and it happens surprisingly often) I refer to my diet as “plant-based”.

Plant-based eating is often seen as a synonym for veganism, and many use the term interchangeably, but I believe there are some  real differences between the two. I see veganism as falling under the umbrella of plant-based eating, but not the absolute definition of what it is. I remember seeing Laura Thomas (a nutrition-science-crush of mine – yes, that’s a thing) speak at VegFest last year in London. When talking about the variations of scientific studies on the subject she explained that ‘plant-based’ means different things to different people - some researchers include dairy, others some meat. There were audible gasps.

But this attitude to the concept of a plant-based diet is much more my cup of tea. The clue is in the word “based”. The idea that most of the food we eat should be ‘based’ around plants is a good one – fruits, veggies, wholegrains – all good stuff. This is reflected in the advice us dietitians give people, and the basis of the EatWell plate and its equivalents around the world. If you start with plants you have got a solid foundation of good nutrition. But this probably won’t make up your diet alone, it certainly doesn’t make up mine.

It is easy to get bogged-down with labels, especially in a world where a hashtag is everything. We divide the world into clean or dirty, vegan or paleo, high carb or keto, but this is not how most people eat, and neither should it be. Do I try to avoid relying on ready meals and attempt to make most things from scratch? Yes. Last Thursday did I get home and eat a big piece of cake and order takeaway pizza? Also yes. A healthy diet isn’t one without wiggle room, it doesn’t demand you align yourself to a tribe, a healthy diet is the diet that fuels you, nourishes you and makes you feel good. So when I am forced to announce myself as a plant-based eater it means I eat mostly plants, but it also means I eat plenty of not-plants too. 

What’s the deal with… “refined sugar”?

A few years ago the word “refined” was only really heard when people on BBC 4 were discussing rich Victorian ladies, but now it seems to be synonymous with all that is wrong with the food industry… so is it?

The term “refined sugar” is used to describe bog-standard table sugar, the stuff that you are used to spooning into your coffee, pouring into cakes or sprinkling on your cereal. It is also now seen as an enemy of the people. Now this isn’t without warrant; too much sugar can cause weight gain both in places we can see, like around our thighs and tummies, as well as places we can’t, like around our horrible things. This is increasing our risk of getting heart disease, cancers, type 2 diabetes and other nasties. Sugar also ruins your teeth if you aren’t careful. We are only meant to be having 30g a day (assuming we are all over 11) but nearly all of us are eating too much of it.  

Now, it’s a good thing that people have started to shout about sugar, but the issue with the #refinedsugarfree movement is the perceived difference between the cheap, familiar white stuff and the astronomically more expensive, harder to find “substitutes” – honey, agave nectar, brown rice syrup, fruit syrup, date syrup, maple syrup (so many syrups), coconut sugar, palm sugar, brown sugar, I could go on… This holier-than-thou hashtag is plastered across recipes for everything from brownies to cakes to energy balls and porridge, all of which are JAM-PACKED with sugar. Yes, sugar.

The bottom line is, whichever one of these snazzy ‘substitutes’ you choose, you are still choosing sugar. And it’s fine if you know that. The problem comes when you think that any of these are less harmful due to being “less sugary” because that’s when you reach for the second brownie, put a third spoonful in your tea and eat that fourth slice of cake (trust me, I’ve been there). I should also stress that you are absolutely not to blame for believing this myth; everybody from chefs to bloggers to TV doctors have been telling us that in order to eat less sugar we should just eat different sugar. The truth is, however, that our bodies don’t care what packet the sugar came in.  

“Stop!” people will be shouting (very attractive people who store their oats in glass jars and are wearing Lululemon leggings probably), “not all sugars are created equal! Some are low GI! Some have vitamins and minerals! You are in cahoots with the food industry!” So let’s deal with those points.

1.     I am bitter about the oats and the expensive activewear, sorry

2.     It is true that not all sugars are created equal, but I promise you they aren’t really that different, and more importantly, they all count towards your daily allowance of ‘free sugar’ (that pesky 30g I talked about earlier)

3.     When we talk about GI we are talking about ‘glycaemic index’ which essentially describes the impact of a food on your blood sugar. It is a scale from 1 to 100, with 100 being the effect of pure glucose. For reference, table sugar sits at around 65 on this scale. Now, it is true that some ‘sugars’ do have a lower GI than others, but GI alone is not a good indicator of how ‘good for you’ something is. And, unless you are eating any of these sugars off a spoon (and please, don’t do that) then there are other factors effecting the GI of your food too; things like the protein content, how much fat it contains, whether it is high in fibre, and so on. Within this context, the GI of the sugar you use probably isn’t that important.

4.     Some of these ‘alternatives’ do have vitamins and minerals that run-of-the-mill sugar doesn’t have, but you know what? If you are eating so much honey that it is providing any discernable percentage of your daily vitamin and mineral intake, then you need to chill out on the honey. There is no nutrient in any of these sugars that you can’t get from everything else you are already eating.  

5.     If I really was in the pocket of the food industry, then I would not be waiting for payday to buy this super-cool David Bowie pin badge I have seen for £2.50 on Etsy. True story.

So what the hell do I do when I want a sweet treat? Well, I hate to rain on your parade but all those #refinedsugarfree recipes are still loaded up with sugar. The sad fact is that there aren’t really too many recipes for genuinely low-sugar goodies that actually taste super sugary. The real trick is to retrain our brains into accepting food that just isn’t that sweet, and at the same time viewing sweetness as a little something extra every now and again, as oppose to an integral part of our day. Get in the habit of feeding your sweet tooth with a piece of fruit or natural, unsweetened yoghurt and before long these will mostly do the job.

Of course there will no doubt be those days where anything but a sugar hit just won’t do, and in a healthy, balanced diet there is absolutely room for a cheeky biscuit here and there, or that chocolate bar you have been dreaming about since last Tuesday. The trouble comes when you are reaching for the sugar every day, without thinking. And that means all sugar. So if you like agave syrup and it’s the only thing motivating you to cook porridge at 6:30am, then by all means whack on a couple of teaspoons. But please note - it is still sugar.

Body Language

I remember walking into a room when I was about 18 wearing a dress I didn’t really like, one that I had thrown on at the last minute, and somebody told me I looked beautiful.  I remember it so clearly because it was such an unexpected remark. But although it was unexpected I don’t remember assuming it was undeserved, in fact I remember it washing over me and I remember accepting it – I just smiled and thought it was a nice thing to hear.

I think that is probably the last compliment I have honestly accepted for 9 years.

A few months later I was at one of my lowest points with my chronic illness and my body changed in a multitude of ways. It became a place I resented having to live in, and its outward appearance began to morph in front of my eyes and out of my control. Weight gain and bloating and being forced to stay in bed meant that my clothes became somewhere to hide – a safety blanket, a retreat. (I wrote a blog post on this a while ago).

Those of you who know me will know that most of my wardrobe is about 5 sizes too big for me. One of my most frequently worn items is a vintage Ralph Lauren men’s denim shirt. It is a size XL and it comes down to my knees. ASOS has a new feature that means it can suggest the size you need based on past purchases - in the last week I have taken my actual measurements and discovered that my recommended size is 1-2 bigger than I need.

I loved training as a dietitian and I am obsessed with nutrition science, but I have always felt defensive about not being as slim as my peers because of my career choice. Throughout my placements I was always terrified of being asked about my weight. What if my supervisors questioned me about my diet? What if patients refused to take my weight loss advice because they thought I was not practicing what I preached? The truth, of course, is that this never happened. This curious mix of vanity and self-loathing meant I felt simultaneously unworthy of any attention and also under constant scrutiny by everyone around me.

This week there has been a lot of talk about mental health recently thanks to a high profile campaign over here in England, and that is why I have decided to publish this post. There is no doubt that I have experienced depression and a distorted body image throughout the last 12 years from battling daily against symptoms like fatigue and chronic pain. I have realised that all the issues I have had with my appearance are actually rooted in the disappointment and betrayal I have felt by my body letting me down and limiting my life. I have been angry at it for its reluctance to cooperate with my plans, with its consistent insistence that I fail to reach my goals. I think I have been punishing it by hiding it away and wrapping it in a cocoon of baggy jumpers and oversized t shirts.

So this week I did something new. I bought some tight t shirts and I tucked them into my jeans. And you know what? Nobody cared. I left the house, I went the shops, I got on the tube and not one person stopped me to tell me how awful I looked.

A large factor in my change of heart was actually Instagram accounts like @theeverybodystandard and @any.body_co as well as models like Iskra Lawrence, Kate Wasley and Sophie Dahl. I hadn’t thought that seeking out and seeing images like these were important, but finding women who don’t conform to a typical marketable body type has actually really put in perspective the narrow range of bodies deemed attractive enough to advertise anything from handbags to razorblades. Their punctuation of my feed has become a very welcome change. If you are struggling to face the constant barrage of images of women that look nothing like you then curate the space you can control to be full of people who instead make you feel good about yourself. Unfollow that underwear model, hide the newsfeed from that friend who is a professional dancer and ignore the videos of that lifestyle blogger. We can control so few of the images we see day in, day out, that taking the time to create an online space where you feel empowered and not inadequate can be a small but powerful change. 

Another important moment for me was the realisation that I was putting my life on hold until the day when I fitted my ‘ideal’ body shape started to scare me. A few things lately have made me realise that life is ridiculously short and it dawned on me just how miserable it would be to look back and realise I had spent a single minute of it worrying about how I looked.

If you aren’t there yet then I feel your pain, and I know that reading this might not make any difference. I know that I read and heard things like this all the time, and none of it ever sunk in because my mind wasn't in the right place. But I also promise you that you can get through this and learn to feel comfortable in your own skin without changing it. Trust me, you've got this. 

Ditching the 'Glow' Guilt

There are many Instagram stars and health bloggers who have taken an interest in nutrition following their own battles against ill-health, and it’s not surprising when you consider the uphill struggle that can be living with an illness that doesn’t get better. I have been there. Good nutrition can seem like the cure-all that nobody is telling you about, and for some people it works fantastically well. But for those of us left behind, who eat all our veggies and exercise ourselves sore and yet still have to down those pills, trudge to those hospital appointments and spend countless days in darkened rooms with cold flannels or hot water bottles. For us it hasn’t solved everything.

Let’s get one thing straight, nutrition is the foundation of good health, and I wouldn’t have trained as a dietitian if I didn’t find its transformative power on the body absolutely fascinating. But this doesn’t mean that improving your diet will necessarily rid you of all of your symptoms all of the time. I think this is important to highlight because I know many people, myself included, who at times feel they have ‘failed’ by still needing to rely on medication. It is easy to feel like a failure when bloggers boast of being able to “come off of all my medication”, suddenly having symptoms “disappear” and their lives being “changed forever”. It is easy to think that the reason you are still sick is because you are not quite doing it right, not cutting out enough foods, not exercising hard enough, not eating enough kale. But this is damaging to your health in itself. Anxiety is not healthy. Panicking about food is not healthy.

Taking medication is not a weakness, it is not a sign that you are doing anything wrong, it has been deemed as safe and is there to help you feel better. It can change your life from barely bearable to fulfilled and enjoyable. So eat your veggies and exercise when you can. But on those days when you can’t get out of bed, when everything hurts and all you want is a cup of tea and a biscuit, remember you are doing all you can. And have the damn biscuit.

#newyearnewme

Ok, be honest, how many of you have already broken your new year’s resolutions? Whether it was to drink less, eat less, sit around less, the weekend has come and most likely scuppered one if not all of those ideas. So should we all just give up? Resolutions are a controversial thing – many people don’t like them as they don’t find them helpful, but I personally find them useful at focussing me after a sofa-centred mince-pie fest!

This year, as you may have seen, I decided to set my resolutions in a different way. Tired of using January to beat myself up about December’s festivities I sent out a message to lots of my friends and family asking them what they thought I should focus on. I did this because I knew I didn’t have the objectivity to set my own goals, plus I am sick of people nagging me to stop being so mean to myself…

The responses I got varied hugely; from teaching cookery classes to going on more dates to visiting friends who live further away. However, all the resolutions set by other people did have some important things in common; none of them focussed on the way I look, none of them told me to stop doing anything, all of them were focussed on positive changes.

So if your resolutions have already caved, why not get your friends and family to reset them?

 

A love letter (part 2)

I have cried at least once every day for the last 16 days. No, I am not going mad (I promise), it is Olympic fever. So this month I thought I would write a follow-up ode to exercise to follow-up my love letter to gym days gone by from September 2015. 

As I said before, exercise was a HUGE migraine trigger for me and I also suffered exercise intolerance. When I was finally diagnosed my consultant advised me to stay away from physical exertion until I felt much improved - which is now, hurrah! 

It was very daunting to pull on a pair of shorts, dust off the trainers and commit myself to an exercise regime; up until one month ago, I had not exercised in any real way for over a year, and I am not going to lie, it was hard. But it wasn't limb-drainingly hard. I didn't want to throw up, I didn't want to sleep for 6 hours, and i didn't feel cold and shake.

Those endorphins people talked about do actually exist. Who'd have thought it?! 

In all seriousness, this realisation led me to want to write this post. I want to tell the friends and family, the co-workers, the school friends, the gym instructors and, whilst we are at it, dietitians of people with a chronic illness - be it diagnosed or undiagnosed, in their heads or in their legs - that sometimes exercise is not good for you.

I spent a lot of my life pushing through pain and fatigue to last as long in the gym as those around me. Even when writing the previous post almost a year ago, I always had the sneaking suspicion I was just weak and making excuses. But I realise now that is not true. I am lucky enough to have my symptoms relatively controlled a lot of the time now and so I can see this from both sides. I have felt 'the burn' whilst well and ill and I can assure you it is not the same. If it means you go home and cry, if you cannot move for days afterwards or if it simply makes whatever symptoms you have worse, then stop. 

So if somebody in your life is unwell and you hurry to tell them that the gym will cure all their problems, please bear this in mind. If they say they are in pain or they are tired then consider the very real possibility that they don't mean 'a bit' they might mean 'a lot'. I have sat and heard medical professionals debate the amount of pain a person is in because they appear to be coping, doubt their fatigue because they appear 'normal' in a 15 minute appointment. People who have illnesses far worse then mine are far better at pretending they are fine. And I am pretty damn good.

I am thankful now that I can start improving my fitness, but I wish I had listened to my body when is was telling me quietly to stop, instead of listening to those around me telling me loudly to go. 

Tokyo 2020, watch out....

 

Good News from Glastonbury

This last month has been pretty hectic with end of exams, a holiday, a festival, degree result sea starting my new job. It has been lovely to have a busy break away for normality but part of me is now looking forward to a bit more routine and in particular, having the time and space to cook up some culinary delights after weeks of barely entering a kitchen! For this post though I want to talk about something that happened exactly a month ago when I went to Glastonbury. 

For years I have wanted tickets to Glastonbury and have not succeeded before this year - needless to say I was unbelievably excited but I was also nervous. Previous camping trips and festivals have always ended in me being very unwell. Between interrupted sleep, loud music, flashing lights and eating strange food at a variety of times, I have always come home needing some recovery time, and not having enjoyed myself as much as I could have, and certainly not as much as I have pretended. 

A few years ago a group of us went to Cornwall for a week-long beach break. Soon into our stay I was in agony with stomach pains, my face, hands, feet and abdomen were swollen and I was fatigued and tearful. After passing out in the shower on the third morning, I had to leave my friends and catch the long train back home feeling frustrated, upset and like a complete failure. When I got to my stop a man helped me with my bag and asked me "how far along I was", I wasn't offended because I was aware of how I looked so I just told him "about 7 months" and made my way outside. When I arrived in the car park my mum didn't even recognise me until I was standing right in front of her. It took me over a week to recover. 

For this reason, I approached Glastonbury with caution. I bought a new tent which was standing height so I could stretch out - sitting for long periods really exacerbates my abdominal symptoms. I also made sure that the tent was warm and waterproof and got myself an arctic-grade sleeping bag to help me if I had an attack, as they leave me feeling frozen and unable to get warm. I also had a camping bed to raise me off the ground and a decent pillow, both of which I wanted to avoid any extra neck pain or stiffness that can occur with an attack. Needless to say, I was prepared. 

I was unbelievably happy to get to day 5 and still feel well. I had a slightly swollen tummy and I did pass out breifly once, but this was a short lived episode and other than that I was fine. I phoned home a few days in and nobody could believe how well I was feeling. There were tears.  The whole experience was such a breakthrough for me that I felt absolutely ecstatic to make it through, and not just survive but have an amazing time. 

Day 5, still smiling!

The experience has undoubtedly changed my outlook. So often I make plans and I have to cancel, and if I don't cancel then I leave early, and if I don't leave early I regret it when the symptoms of migraine creep in during the following days. This was honestly the first time that I have made a plan (a risky plan that was 5 days long and certainly not migraine-friendly) and been able to see it through to the end, feeling so well that I didn't have to worry about the 'hangover' to follow. 

On the Saturday night, having not had any dinner, lights flashing, music blaring, I looked around me and realised how far I had come. Finally I wasn't just amongst people enjoying themselves, I was enjoying myself. The emotion caught in the back of my throat. There was a sudden flood of memories of all the nights out, the holidays, the festivals and the realisation I had never been able to surrender myself completely to simply having a good time. And now the nagging voice in the back of my head reminding me that I would pay for this later was silent.

All at once I realised that this is how everybody else feels and how I had never felt, until now. 

"Learn to manage your stress" and other vague suggestions

It has been a long two and a half months that I have been away from this little blog, full of exams and placement and dissertations and hysterical all-night library sessions. Not entirely enjoyable I must say. Due to all this stress and upheaval I have been neglecting my diet and sleep patterns and general wellbeing and have found myself in quite a migraine-addled predicament. However, I though I would take the opportunity to write about how I have coped (or not coped) with getting through 5 years of university with a chronic illness. It is a topic a lot of people have asked me about so here goes:

1st year (1): My first year wasn't my proper first year. Having had my heart set on being an artist, my A-Levels were English Lit, Sociology and Art. I then went to art college, hated it and had a life crisis. For this reason, my first year of university was a 'foundation year' - a crash course in biology, chemistry and maths.

I went into the beginning of the degree process aware of my PCOS and having been diagnosed insulin resistant. I was following a healthy, low GI meal plan, taking exercise and trying desperately to lose some weight. I still had unexplained and somewhat terrifying bouts of ill health, often with tenuous or absent links to my blood sugar level, but I had no real idea about what that was or why. Anyhow, I managed to meet the entry requirements for King's and so progressed onto my actual first year.

1st year (2): My first year at King's started with a messy break-up which resulted in me losing a stone in about a month (not a good thing, contrary to my views at the time) and, for at least a week, if not two, I survived on a single KitKat each day (definitely not a good thing). At this point the (still undiagnosed) migraine reared its ugly head, as expected, but thankfully did not stick around all that long once life was back on track. Once the course began, I met the bunch of mad individuals I now call my friends (in fact I call them 'the pigs', but that is another story). After the initial grip of symptoms, I felt relatively well for a lot of the first year. 

At this time, I also had a great GP who quashed some of the earlier myths I had been told about my condition. He checked my long-term blood glucose control as well as some other markers, in order to see if I was, in fact, insulin resistant. I was not. However, whilst it was nice to know I wasn't insulin resistant, it did leave me in a complete wilderness with regards to this mystery illness. Usually, when people would say "Why have you gone a funny green colour?", You look like you might fall over!" "Why aren't you drinking?" I could reply with certainty, "I am insulin resistant". But now I had no answer. And whilst it had never been an answer to everything, it was a comfort blanket of sorts.

Now I was back to square one. 

2nd year: Oh second year. The worst of all the years. There is no doubt about it, my second year was absolutely horrendous, to the point where I nearly left university more than once. 

Firstly, I found the academic schedule was particularly tough. At risk of sounding like a spoilt brat, I failed my first ever exam in the November and did not know how to handle that at all. Things had got a lot more 'sciencey', and my extensive knowledge of Thomas Hardy novels and the fact that I use words like 'sciencey' were not proving particularly helpful. 

Health wise, I know that I must have been feeling unwell because I ended up seeing an endocrinologist (hormone specialist) in the New Year. Results of various blood tests and scans showed that my food wasn't getting where it was meant to, hence why I was getting severe abdominal cramps and swelling. It also meant that my insulin release was out of sync with my blood sugar; basically my body was ready for food but no food was arriving. This, at least explained the gastrointestinal and blood sugar side of things. 

I was given a course of medication which helped initially but then my body became used to it. There were no other options. On top of this, the overwhelming dizziness was still with me almost every day, I was exhausted, my hair was falling out and I missed countless lectures, completely unable to get out of bed. I was so cold I would often be in two pairs of pyjamas, 2 jumpers and in bed with an electric blanket on full, yet still unable to stop shivering. I also had to quit my job and start relying heavily on my parents, which I hated. 

I am aware that this supposed to be a post about coping with university, but I honestly didn't cope at all in my second year. I was completely miserable and did far from my best in most modules. I think if I had been younger I would have taken a year out, but having gone back to university at 21, with still no real money to call my own, I was just desperate to make it through. 

3rd year: Things stayed the same moving into third year, although the course began favouring my essay-writing preferences, with less focus on metabolic pathways and mathematics. I still regularly needed to nap on a regular basis and I was on a liquid diet (not the fun kind) a lot of the time to try and manage the gastroparesis. It was May of my third year that I finally received my correct diagnosis - right before clinical placement. Needless to say that said clinical placement was a bit of a struggle, and it led, without a break, straight into my fourth and final year

4th year: Hurrah! I have made it to fourth year. Hopefully my last (unless I catastrophically fail and have to repeat). Yet another clinical placement, and a dissertation to write means that stress has been continuing to mount, but has been slightly tempered by the knowledge that the course is almost finished.

The good bits: Despite all the health hassles I have enjoyed my university experience. I also think that the course I chose was particularly full-on in terms of its content and contact hours. It was potentially that little bit more difficult for me because I am not somebody who finds the sciences easy. The sense of achievement I felt when I progressed to each year was immense, and I feel proud that I have managed to do reasonably well despite my setbacks. Studying a healthcare focussed degree also meant a lot of my classmates and lecturers were very supportive and understanding. There were also many people in my class who had some form of illness, many far worse than my own. And we have all made it to the end. Also it is worth remembering that it doesn't matter if it takes you 3 years, 5 years or 10 years - a degree is a degree and it is a magnificent achievement regardless. 

Things to think about: I have had a minimal social life throughout uni and this is something I have just had to get used to. I have a very supportive group of friends both at uni and from home who accept this, which makes it easier.  I have always prioritised eating well and exercised where possible. I think this helped to keep symptoms at bay but it wasn't always enough. With the benefit of hindsight I wish I had taken more time to look after myself, even if my marks did suffer. Taking up yoga, taking time off and not striving for such perfection would have all helped.

So really, in terms of coping, I am not sure I am a shining example of how to. I am incredibly stubborn and determined but that is not always enough. You only have to turn to Instagram or Tumblr to find a plethora of slogans claiming that strength is about fighting and hurting and carrying on. But this is not a fight. Sometimes you need to stop coping, stop smiling and just breathe. It is futile to cope if you make yourself more unwell in the process. 

If you are starting university soon and you are living with a chronic illness please feel free to contact me if you have any questions - it can be really scary and I will do my best to be helpful! 

 

As an aside, without my NHS bursary I would not have been able to survive without working a part-time job for 3/4 years. This means I would have had to have tried to work in my 2nd year. You have just read about my 2nd year. You can probably work out my views on the bursary cuts. 

"...rewarding experiences from which one is absent".

The Indian meal at my favourite restaurant last week, the afternoon tea the week before, Christmas 2014, New Year's Eve 2015. Things like these have filled my newsfeed and my inbox countless times whilst I sat somewhere else, usually feeling sorry for myself. 

FOMO. Some days it is just inconvenient. Some days it makes me angry. Some days it makes me sad. I have got used to the 'flake' jokes, the assumption I won't attend and the eye-rolling. I can ignore the snappiness of friends when I cancel for a second (third, fourth, fifth) time, the "can't you just come for a bit?", the passive-aggressive texts that remind me that I've let someone down.

There is also a special type of FOMO - the loneliness you can feel in a packed room or at a full table - the feeling you get whilst looking around you that you are just not enjoying yourself like you should be. You want to go home. Everything hurts. Smile and get on with it. A particular night out last summer was a prime example of exactly this for me; constantly on the brink of tears, utterly exhausted and acutely aware that I was meant to be having fun. So essentially, sometimes it boils down to: FOMO if you're there, FOMO if you're not. Ideal. 

And sitting at home on a Saturday night can be a lonely experience. Sat in a new dress, make-up done, with your shoes on texting the words "sorry to be rubbish, catch up soon". Let's face it, social media has only exacerbated this nagging feeling that everybody is having more fun somewhere better with more entertaining people. So for this reason, I have decided to create an online space where all of us who are stuck at home can chat and support each other from the comfort of our beds and sofas. It will hopefully get going the weekend after Easter (the first weekend of April). So if you are unable to dance or drink or even get dressed, consider this your Saturday Night Invite.

Be a part of our gang when you have to apart from yours.

The phantom-osia is here, inside my mind

I am currently very nearly halfway through my final clinical dietetic placement, working in a hospital and helping patients get the right amount and type of nutrition to get them better.  However, I have also spent a large portion of the last week smelling the nostalgic aroma of a campfire. No, it isn't the NHS resorting to burning hospital furniture to save money on the heating, it's just yet another neurological quirk: Welcome to the bizarre world of olfactory hallucination . 

A few people who have migraine aura, including myself, occasionally get these phantom scents trapped up their nose for anything from minutes to days. As I am writing this now I can smell the distinctive fragrance of burning wood; a campfire, fireworks night, my parent's lounge in winter. I am, however, typing in my bedroom and nothing (as far as I am aware) is on fire. This is just my brain playing tricks on my nose. For me, it's one of my less unpleasant migraine symptoms, and it's thankfully so familiar now that I know longer spend ages trying to find "what is burning". Instead I see it as a welcome heads-up that a migraine is either on its way in, or (hopefully this week) on its way out. 

Some people are unlucky enough to have these "nasal hallucinations" with sour smells or other nasties like sewage or chemicals. I am fairly ambivalent about mine. The only problem is the effect it has on the taste of my foods. As I haven't been eating much this week thanks to my gastroparesis anyway, it really hasn't effected me that much. In fact I imagine it could greatly improve a spare rib or some pulled pork...

If you do have these symptoms and your GP doesn't know, you should go and speak to them - it can be a symptom of some quite serious illnesses. There is also more information from the NHS here

Not disabled, not pregnant, but less able to stand

Since yesterday there has been a photo on my phone which I have nearly posted about 6 times before bottling out. So instead of ignoring it I decided to give myself a stern talking to. Essentially it all boiled down to a good old dose of shame. The photo is of my tummy during a flare up of gastroparesis – something that happens before or during a migraine, and bizarrely sometimes randomly and without warning. This week was the first week of my final clinical placement and needless to say that can be quite stressful at the best of times. Getting tired, getting nervous and disordered eating times, plus a good dose of florescent lighting and a tight skirt are a recipe for disaster. Said disaster began on Wednesday, and by yesterday afternoon I looked like a barrage balloon. The condition also causes my feet, hands and face to swell up a bit as well, so yeah, I am looking super attractive right now.  

When I look like this I am not proud of what I look like, I spend my day trying to hold it in (painful), trying to cover it up (impossible) and trying to hold folders/books/notepads in front of myself (ridiculous). The real question is why all the embarrassment? I have lived with this for years and it’s not going anywhere anytime soon. The worst that can happen is that somebody sees me and thinks I have gained lots of weight or that I’m pregnant, neither of which is abnormal or something to be ashamed of.

So as of yesterday I have made the executive decision to embrace the bump, and the oedema, and style it out. If people do think I am pregnant I can only really see benefits from this: Firstly, a seat on the tube, which I 100% deserve after stabbing abdominal pain all day. Secondly, the acceptable wearing of comfortable, stretchy clothing as opposed to cinching waistbands that only make things worse. Thirdly, people looking lovingly at my tummy when I am, in fact, very angry at it, reminding me that least I have one and at least it works most of the time.

Call me Pollyanna but the most sensible thing to do in a situation like this is play the “glad game” – and this evening I am glad that I know this will end, I am glad I am healthier than many other people and most of all I am glad that I didn’t delete this photo


A dietitian walks into a nail bar...

Yesterday I enjoyed a wonderful evening listening to five, fifteen minute speeches all about food and the future. Well, I mostly enjoyed it, apart from a few select moments; Michael Mosley showing us a picture of a diabetes-ravaged foot, George Monbiot telling us all about his habit of eating grasshoppers, but particularly Adrian Anthony Gill informing all dietitians in the audience they should "get a proper job", because apparently, we are just "people who couldn't get a job in a nail-bar". So Mr. Gill, please find below a summary of why you are wrong; a testament as to why, in fact, dietitians would be perfect working at a nail-bar:

  1. Both jobs require people people: Unlike some other areas of health, nutrition cannot be prescriptive and 'one size fits all'. Dietitians have to be able to talk to people, gain their trust and empathise with the barriers they have to overcome in order to make a lifestyle change. Food, as you said yourself Adrian, is highly emotive. It is not medicine, and we cannot treat it as such. That is why a dietitian has to be able to communicate effectively in order to tailor the advice they give. 

  2. Both jobs help people feel better about themselves: Hopefully, when doing the job properly, people come to dietitians with a problem and they go away feeling better about it. If they have an allergy they equip them with the knowledge to eat at restaurants without feeling scared, if they have part of their gut missing they help them know what to eat without being sick and missing out on vital nutrients; dietitians take facts and translate them into the knowledge that allows people to make an informed choice about what they eat.

  3.  Both jobs need to keep up with trends: There is always some nonsense circulating the papers and telling people what they should and shouldn't eat. Current crazes include "eat as much fat as you like", "honey isn't sugar" and "gluten is the devil". Dietetics has to adapt with the times, and separate the facts and the fiction. 

  4. Both jobs get belittled by Sunday Times food columnists: And I am not sure why you are so grouchy about them both, but I do hope you swing by for a consultation/file and polish if you ever need it...

Take life by the bow and arrow

Happy New Year! I sadly spent my new year's eve in bed with a horrendous cold that seems to be sweeping its way through our local area, however this does mean I get a true taste of the new year's day headache, nausea and self-pity that I usually miss out on as a non-drinker. Every cloud. 

So anyway, New Year: this weekend will be the time that thousands of resolutions will be made, only to be discarded once we all realise how cold and miserable it is, and how inviting the sofa and a pack of biscuits look. When it comes to nutrition, the best of healthy eating intentions can fall by the wayside quickly after the inspiration of January 1st wears off. But why bother with healthy eating at all?

I work with children, which means I get asked all sorts of questions ranging from "did bendy rulers exist when your were younger?" to "why are you wearing your placement costume?" (a testament to my usual scruffiness) and my personal favourite "if you didn't have the internet when you were younger, how did you get on Instagram?". But children are especially good at asking questions that are actually really important and are often things that grown-ups think but don't say. 

One such question was this; "I know that eating unhealthily, not exercising and  smoking cigarettes are bad for you, but there are lots of people who do all of them and live for ages - so how can they really be that bad?". This is a tough one, especially as the answer essentially hinges on the seemingly abstract concept of "risk". Anybody who knows me will testify that I am appalling at statistics - I have always found them hard to get my head around and I don't think I am alone in that. Statistics like "risk ratios" are really useful in the right context, but for many people (me included, prior to many a stats textbook)  they often don't seem as real as the story of your great uncle who did nothing but chain smoke and eat bacon sandwiches until he finally popped his clogs peacefully in his sleep at 104. So what is the answer?

The answer I came up with was this. Let's imagine that life is a game of archery. Bear with. In this game of "Life Archery", living healthily to ripe old age is the gold - the middle of the target we are all aiming for. We all start standing quite close to each other in a line. Maybe girls are a bit closer (we know that females tend to live longer), but we are generally equal. Each decision we make about our health means we get to take a step forward or backward. I really must clarify at this point that a decision about your health is not having a doughnut one Tuesday night, it is having lots and lots of unhealthy foods over a significant period of time. If we choose to smoke we take steps backwards, if we choose to eat unhealthily most of the time we take steps backwards as well.

There will always be a few people miles away from the target, barely able to see it sometimes, who somehow still manage to get their arrow straight in the centre. These people are your cigarette-puffing, bacon-eating uncle. There will also always be those unlucky few who stand close to the target and still miss it. However, to give ourselves the best chance of living a long and healthy life, doesn't it make sense to try and stand as close as we can to the target? So if your resolution quickly falls apart don't abandon all hope, even a little shuffle in the right direction can make a big difference!

Silent migraine - it's not all quiet

I haven't done a blog post for the whole of November, and I am not really going to start now. I have had to cancel a trip to Belgium tomorrow in order to get a tonne of work done all whilst battling the dreaded gastric stasis that has decided to rear its ugly head.

However, I stumbled across this on the interweb and had to share - couldn't have put it better myself. This video was made to describe sensory overload in autism but it represents exactly some of the feelings I get when I have an attack. This used to be what I lived with everyday - (it's no wonder my cortisol was through the roof really!). Thankfully now it's less often but if you bump into me running late for uni or having not had any sleep or in any Marks & Spencer's (Always. Every time. Lord knows why) then this is what I am hearing whilst you talk to me. So sorry if I don't really listen or I look super confused. 80% of the time it's because of sensory overload. 20% of the time I have no excuse.  

I originally found this at: The Daily Headache

Hidden testing, leaping bunny

This week a petition is doing the rounds pressuring Maybelline to stop animal testing. This is something that is close to my heart so I thought I would dedicate a blog post to it. 

A few years back I made a new year's resolution to stop buying cosmetic products that had been tested on animals, and unlike biting my nails or training myself to do the splits, this is one I have actually kept to ever since. So why bother? Well, I am not here to flood your newsfeed with pictures of diseased animals because people get very upset about that (personally I think if you don't like it then you should try and stop it happening, but anyway....) but I will say that this side of the beauty industry is not pretty. 

The testing of make-up is not the application of finished make-up onto bunnies, it is the systematic torture of animals, including dogs, rabbits and mice, by applying concentrated chemicals into their eyes and onto their skin. Personally I don't see why the dog thing upsets people more than the bunnies but it seems to tug at the heart-strings more. 

I don't even know where I stand in the pharmaceuticals debate so I am not talking about that here. I am not educated enough to understand whether or not drug testing could be done solely on humans but I know for a fact that cosmetic products can be, so that is why I made this resolution. And stuck to it. If you don't think it can be done, then I invite you to look in my make -up bag and bathroom cabinet and think again. There is not a single product that I haven't found in a cruelty-free form. So how do you get started?

Get yourself down to your local shop, then start looking at those labels...

Leaping bunny: The simplest way to ensure all your make-up is guilt-free is to look for the 'leaping bunny' on the back of the packet. 

Company/product name does not test any of its products or ingredients on animals, nor do we commission others to do so: Perfect! This is also a green light, and it may feature on products without a leaping bunny if the company hasn't applied for one yet etc. 

Company/product name does not test any of its products or ingredients on animals: The company doesn't carry out testing themselves, but they may well pay other companies to test itsfinal products or ingredients

This product not tested on animals: the final product (e.g. eyeliner) has not been tested, but the chemicals used to make it may well have been. 

Nothing written: Assume the worst...

So what are the rules? Well that all depends on what approach you take, and this part comes down to personal choice. I personally take a company-down approach to what I buy. This means that not only do I exclude products and ingredients that have been tested on animals, I also exclude products made by companies that commission testing, and if a range of products is produced or owned by an animal-testing company, I will not buy those products, regardless of whether or not those products or their ingredients have been tested on animals. Most companies are quite shady about disclosing their policies, as they are aware it puts off consumers, and for that reason I err on the side of caution and do not buy from companies with ambiguous statements either. 

"Great! I will just go to the Body Shop!" I hear you cry... Ah the Body Shop. They get their own section and everything. For years they were the pioneers of cruelty-free cosmetics. They even gave out little brown "against animal testing" bags and we all rejoiced. Then they were bought by L'Oreal. And nobody lived happily ever after. I stopped buying from them and so did many others. 

China is another sticking point. China is an exciting and growing market for companies and this means they are all rushing to sell their products in Chinese shops. Unfortunately, China has this bizarre rule that all cosmetic products have to be tested on animals before they are able to be sold. Yes really. So now I have had to add to my list of excluded brands any that sell in China. This means I have said a teary farewell to my Estee Lauder blusher and my Origins tinted moisturiser for good. Worth an honourable mention is Dermalogica, who ended up retracting their products from China due to its policies. 

All in all it can be a bit of a minefield, so I have made you all a handy flowchart to cut out and keep:


If you are really stuck for where to shop, then these are my fail-safe options:

1. Superdrug own brand, including GOSH make-up

2. Barry M

3. Marks and Spencer own brand - including their perfume (perfume can be very hard to find)

4. Sainsbury's own brand products, especially their shampoos and soap - includes cleaning products. (Their pet foods are tested for taste, but only by happy cats and dogs who are getting a free meal out of it)

5. Phil Smith hair-care

6. Liz Earle 

7. Waitrose own brand - also includes cleaning products

8. Boots No7 - this is a difficult one, because Boots do have a pharmaceutical business in China, however, I have researched into it, and it doesn't seem that they are selling any cosmetics in China. I could well be wrong and will update accordingly.  

9. Dermologica - Handy if you have adult acne like me

10. Topshop (and all Arcadia group) cosmetics

http://www.leapingbunny.org/

I suppose I should put something here about this being my own opinion and other disclaimers. All I would ask is that you think about what is written above and if you have the ability to make a change, then consider making it. Be the change you wish to see in the world. 




Mirror, mirror on the wall....

Trawling through the chaos that is my desk this morning I found a blog post I wrote over a year ago, which I thought deserved another airing. It has been tweaked and reposted for your enjoyment…

At 18 had a wardrobe of (somewhat dubious) tightly fitting, short, ripped clothing, all of which I had bought from regular shops, on normal shopping trips with my friends, who all looked exactly like I did. And then I became ill with crippling chronic migraines.

My stomach was hugely distended, my face and feet were swollen and I was essentially bed-bound for days at a time due to the sheer exhaustion of whatever was wrong with me. I spent days under the covers, avoiding college, avoiding socialising and avoiding the mirror. I had to replace my wardrobe with elasticated clothing that allowed my stomach to swell without it being cut in half, I bought them on shopping trips that left me feeling humiliated and distraught, desperately praying not to bump into people I knew, with only my mum allowed to come with me because she was the only person who would understand. Does this mean that if you gain weight you should feel this way? Absolutely not. But I did, and it wasn’t because I felt ashamed of my body, it was that suddenly my body became everybody else’s problem. I was suddenly on the receiving end of this form of accepted prejudice and left with no self-esteem, no self-belief and a horribly distorted body image.

As my illness rapidly worsened my body changed in a way it never had before. I went from never giving it a second-glance to being preoccupied with it every time I caught a glimpse of it in a shop window. It didn’t matter how much I was reassured by my family or closest friends that the change was unimportant, because the world had decided it was important, and that it was important to let me know. For every person who told me I looked fine, there was somebody waiting to undermine them. I have included just a few of the countless examples:

  • When taking a size 8 dress into a Topshop changing room for a friend, the assistant made a point of showing me the label size in case I hadn’t noticed. When I assured her I knew the size and continued to walk in, she smirked and turned away saying “Alright then…”
  • When I cried at the sight of myself on holiday in a bikini I had owned years previously, I was helpfully told (by a now ex-boyfriend) “it’s not your fault you are fat, but maybe things would be better if you went to the gym”
  • When I asked for something extra to eat at a friend’s house, I was asked “if I was sure”. They then proceeded to get themselves a bowl of cereal. I didn’t eat anything else and went to bed hungry.
  • When I put on more weight (a mere 0.5lb for that matter) I was told to “stop reaching for the biscuits”.
  • When serving a customer at a shop I worked in “You look a bit like Lily Cole, except obviously she is thin”
  • When pointing out that weight is not the sole determinant of a person’s health to a Nutrition student at university I was told that the overweight woman in question had made “too many mistakes”. I was then subsequently labelled “a fat dietitian defending another fat dietitian”.

Suddenly the world had a right to comment on my appearance and offer me endless advice about how I could “improve myself”. Some of these people had no idea the amount of physical pain I was often in, how sick my medication was making me, how often I was fainting, how desperate I was to change my appearance and how impossible it was for me to do that. What’s even worse, is that most of them did.  

In reality, it was not my weight that left me emotionally hurt, but everybody else’s reaction to it. You have no right to comment on my body, it does not belong to you. People’s reaction to my appearance did untold damage to the way I view myself to this day. Personally, I have learnt that recovery has to take priority over weight loss. I am only just beginning to improve my health with the help of more medication and generally being easier on myself in the meantime. This doesn’t mean I have come to terms with what happened to my body, but it does mean I am learning to make my health and not my thigh-gap the priority.

This isn’t easy in a culture that stigmatises every variant of the female form, a society that insists that women take up as little physical space as possible, a world that demands us to shrink until we cannot be seen. If we measure every woman by the width of her abdomen and not the depth of her character then Fitzgerald was right; “The best thing a girl can be in this world is a beautiful little fool”

 

Everybody is fighting a battle you know nothing about. Be Kind. Always. 


On being a difficult dinner guest

I was lucky enough to spend this weekend in Verbier celebrating the marriage of two fabulous people amongst mountains, cows and alpine horns. As with all great parties, we also got to enjoy some great food. Having identified some dietary triggers long before my diagnosis, I have become an expert in being the troublesome one at the table. So if you are newly diagnosed with anything that impacts what you can and can't eat, and you are nervous about navigating the world of dietary requirements, take this advice from a seasoned pro:

1. Don't be embarrassed: This is absolutely the most important point of all! If you have dietary requirements then it is 100% reasonable, let alone necessary, to have these considered when your food is being made. Us British are famously hopeless when it comes to  speaking up about pretty much anything. The fear of being 'too much trouble' often means people don't want to mention that they are unable to eat certain things; the truth is that whoever is cooking wants you to enjoy yourself. They don't want you to be panicking the entire way through that there is something lurking in your bowl that is going to cause you untold distress before pudding even arrives. 

2. Be prepared to explain your condition to your hosts: I know it can be a deeply personal story, often with embarrassing symptoms, but explaining your symptoms to the person who is making alterations for you ensures they understand why it is important that they accommodate your requirements. I have done this so many times that I now have a brief synopsis of my life-story that I know by rote!

3. Pick your battles: This weekend I was acutely aware that Switzerland is a country built on cheese! Cheese is a migraine trigger for me and so I prioritised this on communicating my dietary requirements. If you have an allergy or intolerance then make sure this is top of your agenda when requesting a change to the menu. People can become overwhelmed if you give them a long list of foods to exclude, and may end up making mistakes. Minimise this by only listing foods that will actually make you unwell, and don't mix these in with foods you simply don't like. I have actually discovered many new ways of cooking with ingredients I never thought I liked after eating them as an alternative to something I couldn't! 

4. Haters gonna hate: Sigh. The most frustrating point of all. It hasn't happened often but occasionally people have been downright mean about what I am eating. Ranging from unnecessary observations such as "that looks disgusting" or "God, I prefer mine" to the ultimate annoyance of faux-comradery "I use to think I couldn't eat [whatever] either, but then I just got over it/saw a homeopath/cut out refined sugar*". It's frustrating and often upsetting, but it is one way to channel that British repression we spoke of earlier. Smile and bear it. Or give an acerbic comeback. I have definitely done my fair share of both. 

*delete as applicable. 

Happy eating everybody!