One Sick Vet

A.K.A. Why We Moved From Colorado to Florida

On paper, moving to Colorado for retirement made a lot of sense. We’d lived there before and knew we liked it. We had friends who had retired from the military there. We had actual and potential job opportunities there. We could purchase acreage and grow some of our own food and raise some of our own livestock (chickens/ducks/a pig/maybe sheep).

So, after 9 months of looking, when we found the right Colorado house we bought it. We had five acres with amazing mountain views. Plenty of trees, but still some open land for a garden and a green house and some livestock. Country peace and quiet with easy access to town amenities. We were excited for all the things we would do.

And then I proceeded to get more ill than I’d ever been in my life. Orders of magnitude worse than when I’d “only” had chronic intractable migraines. I struggled to hold on to my goal of finishing my degree, and fought to get a diagnosis and a cure, but to no avail. Despite building a team of competent medical specialists in Colorado, I continued to get more ill and disabled. I often spent days or weeks on one story of our house because I didn’t have the energy or the knee capacity to go up and down the stairs. The scope of my life got smaller and smaller until I mostly lived in one room, leaving the house only to go to medical appointments. Spousal Unit handled all other interactions with the outside world.

When I finally realized that I might never find a cure, that I might never be restored to better health, I realized I might have to surrender not only my dreams of completing my degree and starting a new career, but also our dream of living in the Rockies. As I struggled to come to grips with my new reality, I eventually asked myself this key question:

Assuming my health will never improve, how do I want to live what remains of my life?

Crew Dog, One Sick Vet

I had been hung up on searching for a health cure; on finding a way to power through my dissertation and to complete my PhD; on fulfilling everyone’s expectations; on living up to my potential; on continuing to take care of others; on continuing to live a life of service.

But when I thought about accepting that my health had permanently changed, that, therefore, my life had permanently changed, it enabled me to consider possibilities.

I could continue to exist in limbo, frustrated that I was unable to complete my degree and pursue the career I had intended, or I could finally pry my bloody fingers loose from holding on to the end of my rope and get on with living my new life, my new normal.

It took *years* to relinquish those dreams and to accept that I was not going to be able to achieve those goals.

But when I started to consider other possibilities, when I started to consider accepting my limitations, I found freedom. Don’t get me wrong – the process of arriving at this destination was agonizing and included times when I didn’t see the point of continuing to live.

But I eventually discovered that accepting my limitations gave me permission to say no to other people’s expectations.

And once I stopped thinking I had to do what I thought I was supposed to do, I could start considering what I really wanted to do.

Eventually, I decided that I needed to leave Colorado to have any hope of improving my health. So we starting thinking about what we would want/need in a hypothetical new retirement location.

My joints hurt in Colorado, especially during the cold months. So I thought it’d be good if this hypothetical place was warmer. And my health seemed to improve when I was at lower altitudes, so this hypothetical place should probably be at a much lower altitude.

I asked myself what I would want my life to look like if all I could do was lie in bed all day. And I decided it would be pretty amazing if I could look out my window and see water. I asked myself what kind of outdoor exercise I’d like to do if I were capable of doing any. And I thought I’d like to walk on the beach, or walk/float in the water, or swim if I could. And I’d really love it if I could scuba dive again.

Spousal Unit & I weighed possibilities. And then we moved to a place that made far less sense on paper than Colorado. We’d never lived there. We did not have friends there. We did not have actual or potential job opportunities there. We couldn’t afford acreage there. And I would be starting all over building a new team of medical providers, leaving behind the really good team of providers I had slowly and carefully built in Colorado.

But this excellent team of Colorado healthcare providers had been unable to diagnose or cure me. The orthopedic surgeon had repaired my injuries and removed the associated pain. The rest of my team had provided the best care they knew. But my quality of life was continuing to diminish. I only left the house for doctor’s appointments, and I spent days afterward recovering. I had reached the point where I did not think I would survive another winter in Colorado.

So we sold our forever home in the dream location in the Colorado Rockies, and started all over again – in Florida.

It hasn’t been easy, and I can talk about that in another post. But I wanted to acknowledge that not everyone can afford to take such radical action, even if their lives depend on it.

Spousal Unit & I had the resources to be able to afford to start over again somewhere new. So many chronically ill/disabled people do not. We could talk in the comments about intersectionality, and the many ways in which I was disadvantaged in my youth, and the few ways in which I was not. But I readily admit that I was incredibly fortunate that Spousal Unit & I had already laid the groundwork for financial security before I became chronically ill/disabled. We are privileged that we had good health in our youth, adolescence, and young adulthood, and were able to attend and graduate college and get well-paying jobs. We were able to build a strong financial foundation. We were able to secure a military pension. Without this foundation, we would not have been able to move to our new location.

We’ve been here less than a year, but I already feel confident stating that my health is better in Florida. I still have a few days when I don’t get out of bed. I still have a lot of days when I don’t leave the house. But I rarely need the medications I was using almost daily for joint pain in Colorado. And I actually have energy some days. I’ve gone kayaking a few times (and spent days afterward recovering). And I’ve started scuba diving again.

Having the ability to leave a location where I had very low quality of life and move to a location where I have much better quality of life – to me, that’s what financial security is all about.

Crew Dog, One Sick Vet

Whether you call it FIRE, financial independence, financial freedom, financial security, enough, early retirement, or whatever: working hard, spending less than we earned, learning about investments, and saving for the future enabled us to leverage our health privilege in our youth to provide for ourselves when we were older and had lost that health privilege.

People who are born with congenital conditions or who develop chronic illnesses or become disabled before they have these opportunities do not have this health privilege. I cannot speak to their experiences, although I can acknowledge them.

What I can say is this: If you are considering learning about personal finance, if you are interested in developing financial security, add to your possible list of motivations the consideration that health is possibly the greatest privilege of all, and it may not last as long as you had hoped it would. People like to think it couldn’t/wouldn’t happen to them – until it does.

At best, we are temporarily abled – eventually our capacities will degrade. Being fiscally fit will help you prepare for when you are no longer physically fit.

Crew Dog, One Sick Vet

Have you had setbacks on your road to financial security? Have you made plans and then been thrown a curveball? Have you never had health privilege? How have you adapted? We’d love to hear about your experiences in the comments.

To anyone who is reading: I just thought I’d let you know that the post content is going to expand here at One Sick Vet. Up until now, I have followed the advice of keeping my blog in a well-defined niche, but that feels too restrictive for me. And since I don’t have any reason to stay confined to the health/chronic illness niche, I’m going to expand my content and talk about other things that I think are important or interesting as well.

I think two of the most important aspects of life are managing your health and managing your money. To date, I have been talking about managing health. Although I have been a personal finance [PF] nerd for three decades, when I started this blog I didn’t think I had anything unique to contribute to the PF/FIRE [Financial Independence, Retire Early] blogosphere. But now I think that I do have a unique contribution to make, at the intersection of personal finance and health.

While talking about money is becoming less taboo (at least, in certain corners of the internet), talking about health and/or chronic illness and disability is not. So, I’m going to continue to blog about health, wellness, chronic illness, and disability, but I’m also letting my inner personal finance nerd loose to blog about money, and how financial security/insecurity affects health & wellness, and vice versa. I hope you’ll join me.

TL;DR: I am expanding the content of my blog, and will now be blogging at the intersection of health and personal finance.

I just gave Spousal Unit a haircut. Not a big deal – I’ve been cutting Spousal Unit’s hair for about 18 years.

But, there was a time when I was intimidated by that task. I was hesitant to try, because I was afraid I’d screw it up. Not because I’m afraid to try new things, but because how one’s hair looks is a big deal to most people, and no one wants to live with an angry spouse while it’s growing back.

Even though Spousal Unit had suggested I try it, I avoided cutting Spousal Unit’s hair *until* the day Spousal Unit came home with a bad haircut, to put it baldly (see what I did there?). I looked at that haircut and thought, “I can’t do any worse than *that*!” And so I began cutting Spousal Unit’s hair.

Now, there weren’t any YouTube videos back then on how to cut hair. So I just went for it.

And by that, I mean I nervously trimmed away small amounts until we both agreed I had done enough. The first couple of haircuts were not stellar. But they weren’t as bad as “The Bad Haircut” that prompted me to try it myself. And after a rocky start, the haircuts got better and better. I don’t do anything fancy, but I get the job done.

Spousal Unit likes the convenience and the amount of money we have saved on haircuts over the years. There was a small initial outlay for scissors, etc., and we have replaced items a few times, but we have saved substantial amounts ($$$) over the nearly 20 years I have been cutting Spousal Unit’s hair.

And yet, there are many folks unwilling to try to learn how to do things themselves, especially cutting their significant other’s hair! In the frugal community, it’s often called “insourcing” labor/services, rather than “outsourcing” them. Older (*ahem*) folks often call it DIY (Doing It Yourself).

No one is good at something the very first time they try it – it takes practice to become as good as experienced folks.

Crew Dog, One Sick Vet

This reminds me of a time when we were out to dinner with another couple, and Spousal Unit and I were making short work of a pile of crab legs. The wife of the other couple asked me when I’d learn how to crack crab legs. I couldn’t remember, and I blithely said something to the effect of “I don’t know. It’s something I’ve always known.” But that’s not accurate.

Here’s what I wish I’d said: “I don’t remember when I learned how to crack crab legs. I obviously didn’t eat them when I was a child [because we were dirt poor, and ate things like Hamburger Helper]. Somewhere along the way, it’s a skill that I picked up. I’m sure I looked silly doing it at first. But now I do it with a level of skill that looks intimidating to you. And it’s become so easy for me that I can’t even remember when and how I first learned how to do it. But that shouldn’t stop you from trying. Because you’ll get better at it with practice. And pretty soon it’ll just be a thing that you know how to do.”

Doug Nordman shared with me recently that a technique that helped his daughter overcome apprehension about trying things/taking a new course of action (when she was younger) was to ask her “If you did that, what’s the worst thing that could possibly happen?” Once they troubleshot various courses of action, she was comfortable proceeding with her chosen one.

That’s basically what I did before I started cutting Spousal Unit’s hair. I asked myself (and Spousal Unit) what the worst outcome could be, and we agreed that the worst I could do was a bad haircut, and that the hair would, eventually, grow back. Spousal Unit was ok with that worst case scenario, even though it might mean sporting a bad haircut at work. After all, I couldn’t do any worse than “The Bad Haircut” Spousal Unit had received from a paid professional.

And so it began. If you asked Spousal Unit about it, you’d receive this reply: “Yeah, the first couple haircuts were a bit rough. They weren’t that great. But after those first few, they’ve been good ever since, and we’ve saved a lot of time and money.”

What is something you’d like to learn how to do, but may have been intimidated? Are there videos you can watch to learn skills and techniques? Or books you could check out from the library? Do you know someone skilled who could teach you? Or is it something you could learn how to do through trial-and-error? Why not start developing your DIY skills? Sooner than you think, whatever it is you wanted to learn will transform from something you were apprehensive to try into a thing that you know how to do.

P.S. – In case you were wondering, Spousal Unit eventually took the plunge and started cutting my hair too. That doesn’t happen on the regular, but Spousal Unit does a really good job (most of the time). So now cutting hair is a thing we both know how to do.

February 2014 I slipped and fell while on a scuba vacation, and it took 5 surgeries over the next 4+ years to repair the damage done to my arm – 2 shoulder surgeries, 2 wrist surgeries, and one elbow surgery [You can read about them here, here, here, and here.

December 2018 I finally dove again – just a short skills refresher dive. News Flash – I was rusty. But it was great to be back in the water again after nearly five years.

Fourth of July weekend 2019 I made another dive. Again a short shore dive. But this time I felt much more comfortable under the water.

This week, Spousal Unit and I are boat diving. It feels great to be back in the water again. We made two dives today, and so far my ears are cooperating (meaning I have been able to equalize the pressure in my ears throughout the ascents and descents during the dives). My ears don’t equalize as effortlessly as they used to, so we take our time descending from and ascending to the surface.

Before we dove today, I did physical therapy stretches and exercises and some very light therapeutic yoga. Post-dive tonight, I have a heating pad on my back. Getting older ain’t for sissies.

But I am very grateful just to be able to dive again. Scuba is something Spousal Unit and I really enjoy doing, and we have been diving together for over twenty years. It would have been a great loss if we were no longer able to dive together.

I have to pace myself – we aren’t doing much else on days we are diving. I prep for our dives with the exercises and stretches, we eat a healthy meal in our travel trailer, make a couple dives, and then come back to our trailer, hang our gear out to dry, take showers, cook a simple meal, and relax on the heating pads while logging our dives.

I may be doddering along. I may accept help from the boat staff to lift my gear on and off the boat (which I never would have done when I was younger and healthier). I may not be eating and drinking in restaurants and seeing the topside sights. But I’m here.

And I am willing to do whatever is necessary in order to be able to keep diving with Spousal Unit. I hope we have many more decades of diving together.

And I appreciate, in a way I never did before, that being able to dive is a privilege. Even if you set aside the costs involved, many people don’t enjoy sufficient health to be able to dive. For nearly five years, I didn’t have sufficient health to be able to dive.

So I’m going to enjoy every dive I get, and I’m going to do whatever it takes to be able to keep diving with my favorite buddy.

There is a certain personality type that is always looking for ways to make things better – themselves, their jobs, their lives, their communities, and possibly even the systems that shape those things. And, to a certain extent, that is useful.

Perhaps you have this personality type. Perhaps you agree with the playwright, George Bernard Shaw, who said:

“The reasonable man adapts himself to the world: the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man.”

George Bernard Shaw, Man and Superman

Perhaps some people are able to sustain this mindset their entire lives, continuing to alter their environments to suit themselves or to pursue altruistic perceived improvements. Perhaps these lucky few are able to sustain happiness, satisfaction, or contentment.

But perhaps not. Instead, many of us find that we reach a point where we are no longer able to shape our environment.

Toni Bernhard was instrumental (through her books) in helping me really “get” that I would be less discontent, and possibly might even reach a state of equilibrium, if I acknowledged that my expectations did not match my reality and let go of my expectations. At the time I first started contemplating this idea, I was thinking about my chronic illness and disability.

But recently I’ve been thinking about this idea while reflecting on my time in the military. I separated from military service because my last unit had bad leaders and a toxic work environment, and because I was not permitted to make any changes that might improve the situation.

I had reached the point where I woke up every morning dreading getting out of bed and going to work in that environment. But what if I had managed my expectations? What if I had shifted my perspective?

It is not in the nature of most military members (nor is it nurtured) to walk past a problem without attempting to solve it. In fact, military members are strongly encouraged to fix any problem they see or hear about.

But, having given it my best shot, and having been told my input was unwelcome and the situation was not going to change, what if I had adjusted my expectations? Would my work situation have been more tolerable if I had reframed the situation, and told myself that even though the situation was untenable, I was making money for financial independence? Perhaps the frequent deployments would have been less aggravating if I had seen them as opportunities to make tax-free money for retirement, rather than interruptions of my home life and education.

My discontent has always lain in the space between what “should be” and what is.

Crew Dog, One Sick Vet

There comes a point, with chronic illness and/or permanent disability, when you realize that your old life is over and it’s not coming back. People in these communities call it “accepting your new normal.”

Now, you may argue that not accepting “one’s limitations” is empowering, and that refusing to accept that your illness/disability has to change your life will motivate you to get better and to accomplish things you (and the doctors) never thought possible. That may be true for a select few individuals. What is true for a great many more is that, no matter *what* they do or don’t do, their health or abilities are not coming back. And acceptance of this reality, this “new normal,” is the path to good mental health.

Discontent arises from reality not meeting expectations. You can insist that George Bernard Shaw was right, and that forceful visionaries improve their environments by insisting that reality conform to their expectations. But this is also the path to burnout and dissatisfaction.

In the end, the most useful advice may come in the form of the Serenity Prayer, known to many alcoholics:

As we grow in maturity, as we become older, and/or more infirm, may we seek for the serenity, the peace of mind, that comes from knowing what we can change and what we cannot change.

Our spending habits we can change. Sometimes even our salaries we can change. Our eating habits we can change. Many times, our exercise levels we can change. Our sleep habits we can change. (But that may not “cure” our insomnia.) We can try exercise plans, dietary supplements, prescription medicines, but sometimes we eventually have to accept that our bodies are permanently broken or ill or dysfunctional.

And coming to terms with our limitations is incredibly difficult. Most people say it’s an ongoing struggle, rather than a one-and-done. But if, as Toni says, we can reach a point where we acknowledge and observe our situation, experiencing the associated feelings and then releasing them, accepting what is – that gives us emotional freedom. Serenity, even.

So, as you seek to optimize your life, your organization, and/or your community, ask yourself this: What can I change and what can I not change?

Perhaps you’re allergic to shellfish. No amount of wishing it weren’t so is going to change that. Perhaps you have COPD, and living at altitude makes it more difficult to breathe. Maybe you have shoulder problems, and your doctor has told you never to do pull-ups again. Nearly all of us have some kind of limitations. The biggest challenge is learning which limitations to fight and which limitations to accept.

Perhaps the Rolling Stones couldn’t “get no satisfaction” because they should have taken Led Zeppelin’s advice and accepted “what is and what [can] never be.”

Having spent most of my life employing courage to change the things I can, I am now transitioning to developing the serenity to accept the things I cannot change, and the wisdom to be able to identify which is which.

Are you wasting resources fighting a limitation that you cannot change?

Tell us in the comments if you’ve struggled with a limitation and what you learned from that experience, whether it has to do with health, finances, or some other aspect of your life or environment.

I can’t remember how I first heard about minimalism, but I’ve been lurking observing the minimalist movement for years. Not only is minimalism aesthetically appealing, it also promotes good mental health and anti-consumerism.

People are drawn to minimalist lives for a variety of reasons. Joshua Becker decided he’d rather spend his time with his family than on maintaining stuff. Courtney Carver received a chronic illness diagnosis and decided to simplify her life and live it to the fullest. Béa Johnson moved to a smaller home and found that she not only didn’t miss all the things her family had in temporary storage, but she felt happier without them. That experience, coupled with her growing interest in environmentalism led her to inadvertently start the zero waste lifestyle movement.

While I flirted with the idea of minimalism for years, only now am I fully committed. What changed? We moved to a much smaller house, in a hurricane zone.

Crew Dog, One Sick Vet

Our current home is approximately 1,050 square feet. Although twice as big as a “large” tiny home, this is not a lot of space for two adults and a medium-sized dog. Especially two adults who have been mindlessly letting possessions accumulate for decades. Even though we tried to get rid of things before our cross-country move, we clearly did not get rid of enough, and it is now painfully obvious what does and does not fit into our new home.

If I’m honest, I would have preferred a house that was in the 1,800 -2,200 square foot range. That would have given us more room for guests and hobby equipment. But, as it turned out, this smaller house was what we could (mostly) afford in the area where we wanted to be. Location, and all that.

To be fair, our new house does have approximately 500 square feet of covered screened porch, which gives us more room when the weather is nice. However, we are learning that everything in Florida molds, mildews, rusts, or rots, and we need to be careful what we put on the porch.

To a certain extent, this applies inside the house as well, which has been a strong impetus to reduce the number of books and papers we have. Suddenly, this chore has switched from something we’d get around to someday to something we’d better do quickly, before it’s all ruined.

All the old family photos we’ve inherited? Better scan and save them before they’re ruined. Old paperwork we’ve been saving? Same.

As if this weren’t enough incentive to finally pare down our possessions, there’s also the threat of a hurricane destroying it all. We are taking the approach that it’s not a matter of if, but when. The goal is to have all the important photos and papers scanned and backed up, and to take the storage drive and the few critical papers with us in a waterproof firesafe when we evacuate.

I find it very curious that I struggled for decades to release my sentimental attachment to my stuff and to actually follow through on dedicating the time to make the difficult decisions involved in paring down my possessions, but now that I’m in this situation I find those chains falling free and the decisions becoming much easier.

It’s hard to say whether those decisions have become easier to make since I developed strong allergies to dust and mold. On the one hand, I know that it would be better for my health to get rid of old dusty paperwork and old musty books. On the other hand, I have always loved books, and I resent that it is not my choice to get rid of them – it is largely because my health requires me to do so.

So I find that I am able to part easily with the books that I read once and didn’t feel a need to read again. But the favorite books that I read over and over, or the reference books to which I frequently refer are a different story (see what I did there?). And, no, for me it is not the same to just buy the electronic copy. They are less tangible, and part of the pleasure of reading is lost. I also find it harder to quickly access the highlighted section(s) to which I want to refer, and notes aren’t the same when they’re not written in the margins near the relevant text.

But, by and large, I am surprised how much easier it is to designate things for elimination that I once found too precious to get rid of. Spousal Unit stated recently that, due to the overwhelm of too many possessions for the house size, it feels like we’re living inside a storage shed, rather than a home. Put another way, I’m sick *and* tired of stubbing my toes on all this crap. Besides, it’s just going to mold, rot, rust, or mildew anyway…

So we’ve both embraced the tiny living mindset. Finally. That part’s important too – both. We’ve had several false starts in the past, when one of us wanted to get rid of stuff, and the other one wasn’t onboard (this alternated). And while you can still get rid of your own personal stuff in that scenario, eventually you lose motivation or run out of personal stuff to downsize, and you’re left with all the joint stuff that just sits there taunting you. Since we didn’t want to fight over our stuff, that’s where it would always stall out. [Dealing with this scenario? See this helpful article from Joshua Becker.]

But now we’re both highly motivated to get rid of stuff. In fact, if we ever leave this house (hopefully many years in the future), we don’t plan to take much with us at all. You could say that we’re doing our “moving to an old folks home” downsizing now, several decades early. So far, we’ve done one road trip with the travel trailer we bought last year, and we loved the freedom. I suspect we’d like to get to the point where we have exactly what we need to travel comfortably, and just a few more things at home that make living there more comfortable – nomads with a very small home base is the lifestyle we’re aspiring to.

In addition to the mental and physical freedom that would come along with this tiny, minimalist lifestyle, there are other benefits too. Not only would we not have to worry about what’s being destroyed by a hurricane (since all the critical stuff would either backed up electronically or with us in the trailer) and not have as much to replace after a hurricane, we also will be bringing less into our environment. We care about our oceans and we care about our ecosystem. By consuming less, we’ll be bringing less into our environment that will eventually be disposed of and need a place to go. Less in the landfill. Less to run-off into our oceans. So, by having less and buying less, we will be bringing less pollution into our ecosystem, and we’ll feel good about that too.

After all, we both saw how little we truly needed to live satisfactorily when we were in the armed forces – someplace to sleep, somewhere to store your gear, someway to stay healthy, something to educate and entertain, and somehow to keep in touch with your loved ones. While we mindlessly accumulated (many) more possessions along the way, in the end that’s all we really need.

Crew Dog, One Sick Vet

So we’re getting rid of everything else, and if you want to find us, we’ll either be in/on/under the water or on the road, living our curated right-sized mindful best lives.

I saw a new specialist last week. The appointment didn’t go very well. I went for specific advice, but received only general advice. In fact, it’s the advice many doctors give when they don’t know or don’t care how to help you: diet and exercise.

Don’t get me wrong, diet and exercise are fundamental to good health. But I already know that. That’s not why I drove for hours and spent money to see a specialist.

Of course, the specialist had no way of knowing she was seeing me at my worst – I had a strong allergic reaction to something on my way to the appointment, and was very bloated. All she saw was a technically obese patient with knee problems who should obviously lose weight.

But, as you know, I committed publicly here on May 21st (weeks prior to the appointment) to lose weight. It has been three weeks, and I have lost 6 pounds, which is a very healthy rate of weight loss. According to my home scale, I was not obese when I committed to losing weight. I was just barely still in the overweight category, but not obese. But in the specialist’s office, on her scale and very bloated from an allergic reaction, I was obese. C’est la vie – that’s how it goes.

The specialist was not an allergist, a dietician or a nutritionist, but she felt qualified to tell me that I should try removing dairy, gluten, sugar, and processed foods from my diet for three weeks and then see how I felt. I tried to pin her down on specifics, but she was very disjointed and hopped around a lot. She didn’t actually say it in so many words, but she implied that this would reduce my chronic systemic inflammation.

Again, there is nothing wrong with the advice that she gave me. Except that she has no knowledge of my specific allergies, nor did she ask what types of diets I have already tried under doctors’ supervision. She told me to reintroduce the types of foods (dairy, gluten, etc.) individually after three weeks and see how I felt. I told her I’d already done a very strict elimination diet under the supervision of an allergist and with advice from a nutritionist, and that I did not currently have dairy in my diet – was she advising I reintroduce it? She did not answer my question. I told her that I had already determined that I felt better without grains (except rice) – did she want me to try reintroducing them again anyway? Again, she did not respond.

Telling a patient with known allergies to haphazardly tinker with their diet is irresponsible. And telling a patient to try an elimination and reintroduction of foods without a protocol detailing the most effective way to do so is frustrating for the patient and may lead to inconclusive results.

And yet, her advice was not wholly bad. I do need to lose weight, and inflammation is very bad for one’s body. In fact, research links chronic inflammation to the following diseases: cancer, heart disease, diabetes, arthritis, depression, and Alzheimer’s. And research suggests that certain foods or types of food may cause or reduce inflammation, although this research is still in early stages.

The specialist told me to eat lean meats, Omega 3 fish, fruits, and vegetables. There is plenty of research that supports this advice. It was unclear what her advice was regarding grains, although research supports eating whole grains as part of a healthy diet. She also recommended the meat come from grass-fed animals. According to the Mayo Clinic (my research, not hers), grass-fed beef “may have some heart-health benefits…[but] it’s generally more expensive and there is limited long-term research to definitively prove that grass-fed beef is better for you.” So, does it really matter if you eat grain-fed or grass-fed beef? That’s up to you to decide. One important thing to know is that grain-fed cattle typically are fed corn or soy. If you are allergic to either of these, you might want to avoid grain-fed meat. This really informative Healthline article breaks down the differences between grass-fed and grain-fed beef, including differences in fatty-acid composition and vitamin content, if you’d like to know more. Their conclusion:

Most people are beginning to agree that the most important thing is to eat real food.
Some people like to take this idea a step further and only eat real food that eats real food. After all, grasses and herbs are a more natural diet for cows than corn and soy.
At the end of the day, the choice depends on your preferences and values.

Healthline (see previous link)

After a cooling off period (during which I was thinking “Such a waste of time and money!! She didn’t help me with the problem for which I went there!”), I was able to admit that her advice wasn’t bad, per se. She recommended diet suggestions that are in line with current research (except the gluten-free part – if you’re not celiac or gluten-intolerant, there’s nothing wrong with gluten in your diet, and excluding it might lead to nutritional deficiencies). It sounded like fad advice, initially – “no dairy! no gluten! no sugar! Nothing from a can or bottle.” But it wouldn’t hurt me to try it for three weeks, like she recommended. So I have been. Today is day seven, and I haven’t noticed a difference yet, except that my joints are more loose and painful, which could indicate that the inflammation in my body is decreasing. Inflammation is the body’s way of stabilizing a loose joint and reducing pain caused by rubbing.

The specialist also recommended that I walk 20 minutes minimum per day (in water, if necessary/preferred) and try mat pilates to strengthen my core and build muscle strength. Again, this advice is in line with recommended exercise guidelines for people with my conditions. I have not tried pilates before, so that will be something new to explore. But, like with diet, she didn’t ask what I was already doing.

Along with improving my diet, I had also already committed to more cardiovascular exercise, muscle strengthening, and resumption of physical therapy exercises. Since my baseline health has improved after our move to Florida, I have been walking periodically, as my knees, ankles, and S/I joint pain permits. As a result of seeing the specialist, I have increased the frequency of these walks to every night (except one, so far, when the pain was too much). I have also begun kayaking in Florida. To begin with, I have only been able to kayak on calm days, as battling the wind and waves causes my left hand to go numb and depletes so much energy that it takes days to recover. Baby steps – it’s still better than lying on the couch all day in Colorado, unable to do anything.

I have also resumed the PT exercises my excellent Colorado PT had assigned. I do those daily. After I finish those, I have added foam roller exercises I learned from The Malleable Mom and *her* physical therapist, Jennifer Balducci:

I have found that these foam roller exercises have reduced my neck and lower back pain, help fight my hyperlordosis, and reduce the occurrence of sprained ribs.

Additionally, I have resumed therapeutic yoga, using routines created for me by a restorative/ therapeutic yoga instructor. In my case, too much flexibility is a bad thing, but I do mat-based exercises (laying down) to strengthen my muscles, improve my range of motion, and release stress.

After I have completed this morning routine, I try to end with meditation, if my body isn’t too uncomfortable. Some days the pain or discomfort doesn’t allow me to lie there and relax. I am gradually working my duration back up to at least 15 minutes. I’m averaging about 6 minutes so far. [As I was writing this, I remembered that I like to meditate to music. Time to find the iPod!] I don’t personally use guided meditations – I prefer mindfulness meditation. I just lie on my yoga mat with a yoga bolster under my knees and focus on my breathing and how my body feels. If something hurts (my knee, for example), I focus on that for a while, until it starts to feel better. I try to observe my thoughts and then let them go – much easier to do when I’m listening to music. If When I find my mind wandering, I just re-focus on my breathing and check back in with my body. Not only do I feel better when I meditate every day, I also find I can call on those skills to calm myself when I am in pain or when something makes me upset (like bad drivers!) or anxious (like being in pre-op).

Will I take the specialist’s advice and add mat-pilates or planking to my daily routine? Probably. But only after I’ve established a solid routine (and habit pattern) of exercises I’ve successfully used in the past, which I worked with therapists and other specialists to create for my specific needs.

My takeaways from this appointment:

1. As always, write down exactly what I want to discuss with the doctor and make sure it all gets covered. Didn’t do a very good job of that this time.
2. Non-impact or low-impact core and muscle strengthening exercises are best for me. [Already knew that.]
3. I need to lose weight to relieve stress on my joints. [Already knew that.]
4. Diet is thought to impact systemic inflammation. Learn more about this.
5. No one cares more about your health than you do. A good specialist can fill in pieces of the puzzle for you or point you in a new direction, but you always need to do your own due diligence. [This visit was a harsh reminder.] [This also applies to your finances.]
6. Just like a bad supervisor can motivate you to perform better out of spite (“I’ll show you!”), a dismissive doctor can motivate you to renew your commitment to take better care of yourself.

Has anything changed as a result of my visit to the specialist last week? Yes. I decided to play along with her diet recommendations – no dairy, no gluten, no sugar, no processed foods for three weeks. So far, this has prevented me from eating fast food for convenience sake at least twice in the first week. I have also been much more diligent not to eat potato chips and sweets. [It would have been easier to rationalize eating them without the clear line of “no sugar, no processed foods.”] My GI symptoms have not yet improved, and I still had a major allergic reaction to dinner one night. I have also increased the frequency of my walks to daily, as mentioned above.

The same week I saw this specialist, I also read an interview with Dr. Lisa Mosconi about brain health. She is both a neuroscientist and a certified nutritionist, and I found the article fascinating, so I bought her first book, Brain Food: The Surprising Science of Eating for Cognitive Power. I’ll be devouring the book and anticipate reviewing it here on the blog. While I am not aware of a hereditary disposition toward Alzheimer’s in my family, I am interested in discovering if diet can improve the severe cognitive disfunction (brain fog) that is a symptom of several of my conditions, and that is responsible for my medical withdrawal from grad school.

Although this disappointing specialist’s visit was a good reminder to stick to a Mediterranean diet for good health, I anticipate, based on the article by Dr. Mosconi, that I will reintroduce dark chocolate to my diet once the three weeks are up, because I don’t anticipate that giving up sweets entirely is a sustainable lifestyle for me.

I guess the appointment was a reminder that:

1. Managing chronic illness/disability is difficult.
2. Doctors have a wide range of levels of competence, and just because they’re a specialist doesn’t mean you’ll get good care or good information.
3. You gotta do the work yourself.

As mentioned previously, we have been downsizing for years. In fact, you could argue that we’ve been struggling to downsize ever since we got married.

Spousal Unit & I were a bit older when we got married (our ages averaged to 30), and we each had our own places with plenty of stuff. In fact, we estimate that we gave away enough duplicates after we were married to basically furnish a one-bedroom apartment. But we’ve struggled to get rid of certain things, especially books, papers, photos, and sentimental items.

Due to my poor health, last year we moved to Florida, which means we now live in hurricane evacuation territory. Somehow this has sharpened our focus and strengthened our resolve like nothing else has ever done.

We know that we live with the risk that a hurricane could destroy nearly all that we have. And that has made our perspectives drastically shift. First of all, we acknowledge that everything we own is temporary. I think people tend to ignore that fact in day-to-day life. But we are now holding our possessions with a much lighter grasp.

Secondly, we are much less concerned about buying just the right version of a thing for our home – it may not last even if we buy the deluxe model. We’re no longer buying for durability (as much); we’re buying good enough function, good value, knowing we might have to replace it much sooner than we’d hope. Most importantly, we have an evacuation plan that consists of loading up the most essential things into our vehicles and travel trailer and hitting the road.

Thus, we are beginning to look at everything we own and asking “Would this go with us in an evacuation?” This tends to lead to the follow-on question, “If not, why are we keeping it?”

Now, of course, there are things which would not go with us that still contribute to our quality of life here (spare bedding, outdoor furniture, etc.). We intend to keep those “nice extras,” but we realize that they might be destroyed by a storm and then we would need to decide whether or not to replace them.

Another factor that has influenced us to finally get rid of things is the stark realization that no one will want our things when we’re gone. We don’t have children, so things like yearbooks or photo albums will mean little to anyone once we’re gone. [Not to mention that younger generations would probably rather have digital images than photo albums anyway.] But even if we *had* children, they probably wouldn’t want most of our stuff anyway, as this article in Forbes points out.

Realizing that no one will want our stuff when we’re gone has helped us to release emotional ties to some of our stuff – we’re no longer holding on to “family heirlooms” because “someone might want them someday.”

And, since this house is much smaller than our previous house [in fact, it’s the smallest house either of us has ever owned], we’re tired of trying to make all the stuff fit. We’re tired of tripping over stuff. The clutter is stressing us out. So we’re finally facing all the stuff we’ve been hauling around for decades and ruthlessly eliminating the extraneous.

Of course, we’ve bought a few new things since we arrived. We updated our scuba gear, for example, and bought a fishing kayak. We hope to fine tune our possessions, so that they support our interests without weighing us down.

After all, even though we can haul the essentials with us when we hurricane evac, in the end we can’t take it with us to the afterlife.

And, having dealt with the estates of several of our parents already, we don’t want to burden our loved ones with a bunch of stuff to deal with when we die. To put it in military terms, we need to police our gear, get our affairs in order, and make sure everything is shipshape.

It’s difficult to be fit when you’re chronically ill. Either you’re too tired, or you are in too much pain, or you physically can’t do certain exercises, or you’re allergic to outdoors or indoors or both. You might not be able to afford a gym membership or a pool membership or the cost of exercise equipment.

And then there’s diet. Again with the allergies. And lack of energy, or lack of motivation. Or confusion: “Let’s see, I should try the low histamine diet for this condition, but I also am allergic to these foods, and I can’t eat these other foods because they interact negatively with my medications…” Pretty soon you’re either on the ice cubes and air diet or the “Screw it, I’m just going to eat ALL the Oreos” diet.

I’ve been overweight for a while now, but my weight has fluctuated a bit the past few years. I lost 40 pounds while on an allergy elimination diet, which brought me to the normal weight range for my height. But I was having allergic-type reactions to nearly every food I tried to reintroduce, and was winding up with very few foods I could tolerate. Later, I found out from other chronically ill folks that not being able to successfully reintroduce foods can be a common reaction to an elimination diet *therefore you should weigh the pros and cons carefully and have a thorough discussion with your doctor before attempting an elimination diet.*

“Luckily” for me, I trialled a new medication which caused me to crave junk food and never feel full. I regained a great deal of the weight before I successfully reduced the medication dose to a manageable level at which I did not feel compelled to eat junk all the time. But it broke the reaction cycle.

So I had lost 40 pounds, but I have since regained 30 -35 pounds, placing me back in the overweight range for my height.

I know that losing weight would help with several of my health conditions (such as my arthritic knees). And now that we’re past some of the stress of moving, I am publicly committing to losing weight again.

I currently need to lose a minimum of 30 pounds to be back in my healthy weight range. I have been able to do some walking again in the new location, as long as I respond to what my knees are telling me. Some days I need to slow down, and some days I need to cut the distance short, but some exercise is better than none.

I have also been kayaking a few times. Due to my health conditions, I need to go on days that are not too windy or choppy. But when the conditions are right, I can do it. I also intend to start riding my bicycle – there is a bike path nearby, and the terrain is very flat.

I am currently 30 pounds overweight. In order to lose this weight, I intend to make sure I am drinking enough water, do daily physical therapy exercises to strengthen my muscles (especially my core), stop eating sweets (other than dark chocolate), greatly reduce fried foods, increase my fruit and vegetable intake, and work my way up to at least 30 minutes of (low-impact) aerobic exercise at least 5 days per week.

Everyone is different, and you have to figure out what works for your body. While I am not celiac or gluten-intolerant, I appear to have fewer allergic-type reactions when I follow a grain-free diet such as Paleo or South Beach, so I will also be eliminating grains from my diet (except rice, which I seem to tolerate). And I’ll be reviewing the information we gained from the BBC series, “What’s the right diet for you?” Like Dave, I’ll be looking to transition to a high protein, low glycemic index diet.

Also, I have known for many years that all-or-nothing works better for me than trying to simply reduce quantities. In other words, I’m an abstainer, not a moderator. This is why I’ll be very specifically avoiding all sweets except dark chocolate. “All sweets” is very concrete and doesn’t allow cheating or making willpower an issue. But allowing dark chocolate will keep me from going insane or falling off the wagon.

Additionally, I know that I tend to stress eat, so I will be watching for that and attempting to deal with my stress by exercising or meditating, rather than eating.

Furthermore, I tend to not pay attention to my hunger signals until I’m hangry, and then I tend to choose high-energy, high-calorie foods like potato chips or candy bars to quell the hunger quickly. So it will be important for me to plan meals in advance and know what healthy snack options I have available, and to eat before I get hangry. IOW, eat at regular intervals rather than waiting until I’m ravenous. Drinking plenty of water will also help manage this.

Of course, it will also be important to continue to take my medications and to pursue diagnoses and treatment for my health conditions so that my baseline health is stable enough to allow me to have the physical energy and mental capacity to carry out this plan.

Does anyone want to be my wingman/battle buddy this year while I lose weight and get healthier? We all know that accountability helps us stay on track.

I plan to talk about this a lot more here, but being chronically ill and disabled led to me taking drastic action in an attempt to have better quality of life. So far, it has been hella frustrating and difficult.

Although we have tried various times over the years to downsize (Spousal Unit and I never seemed to be on the same page at the same time with this), we still wound up moving entirely too much superfluous stuff to Florida. Given that a) this house is much, much smaller than our house in the Rockies; and b) this house also needs significant renovation, the result has been that we have mounds of stuff that has nowhere to go and those mounds keep getting shifted from place to place as we need access to the spots where the mounds have accumulated.

To me, right now, our entire life feels like the chaos section of this bookstore:

I am sure it will get better – eventually. Right now, however, I am wishing that we had been able to get rid of much more *before* we packed and moved thousands of miles.

The interesting thing, psychologically speaking, has been the shift in our attitudes once we moved to a radically smaller house and transitioned to a climate where things mold, rot, rust, and otherwise decay so much more quickly. Sentimental attachments have all but disappeared. The “but we might need this someday” fear has been overcome by the realization that, in this climate, by the time we’d “someday” need it, it’d probably be decayed beyond usefulness anyway.

We are now confronted with the stark reality that a) we have too much useless stuff; b) no one is likely to want our stuff once we’re gone; and c) if we have to stub our toes on it all the time, we don’t want it either!

My final hurdle is that I am allergic to mold and dust, which makes it very difficult for me to go through all the old papers, pictures, and books and decide which things I want to keep. And yet, I’m afraid to just chuck it all, because some of these things do still have value for me (sentimental and otherwise).

However, many things which have been hauled unquestioned literally across the globe (across oceans and back) are now being jettisoned.

Because my quality of life depends on a healthy environment and removal of stress, and because I am no longer capable of physically maintaining so many possessions, I am letting go of things (like my books) which I clung to for so long. Spousal Unit and I joke that it’s the same kind of survival minimalism that the pioneers experienced when crossing the Great Plains – “There goes the piano!” “The oxen can’t carry the load any more – say goodbye to the heirloom grandfather clock!” Hard choices are being made. But, under the circumstances, they don’t seem as difficult as they used to. The ultimate choice is survival.