An Unhappy Birthday

I’ve never really liked birthdays. In fact, I grew up dreading them. My mother almost always forgot the occasion. Relatives I hated swarmed in from out of town. People watching me eat meant I had to eat more. I felt I didn’t deserve any of the presents I received. The passage of time made me anxious about how little I’d accomplished. I frequently spent the day in a hospital of some sort. And then there was the cake.

The cake! Oh god, the cake! The cake was the worst part. I’d spend all year worrying about the cake, planning for the cake, calculating how many calories were in the cake, devising ways to compensate for the cake. A slice of cake had 1000 calories, right? So, if I ate nothing else that day, I could have half a slice and not gain any weight, right? Or I could eat normally and exercise for five hours to burn it off? Or I could purge it? No, that would only get rid of 30% of the calories, providing I did it properly, and I’d still have 666.66 calories in surplus. What if I restricted for two days before? Could I have a whole slice then? Or could I just have a bite? How many calories were in a bite? Or a tiny bit of the frosting? Just a lick! That was my favourite part anyway. But there would be crumbs on the frosting. How would I account for those calories? It wasn’t worth it. I just wouldn’t have any. But I would exercise extra anyway—just in case, to burn off the cake I didn’t eat.

That was my birthday every year, and it was miserable. Like many people, I used birthdays as an opportunity to beat myself up, to get down on myself for all the things I hadn’t done, for everything that I wasn’t. The event emphasised my biggest insecurities—failure and fatness—and I spent the holiday punishing myself for my ‘obesity’ and ‘idiocy’. Needless to say, it was not much of a celebration.

It was my birthday last week, and although my circumstances were not ideal, I tried to make the best of it. I bought myself a book I wanted. I didn’t receive many other gifts, but I’m glad I have this text for my research. I attended two dance classes. They weren’t the challenging jazz ones back home at Pineapple, but they gave me an opportunity to work on my technique. I redeemed my birthday reward for a free drink at Starbucks. Maybe I ordered my hot chocolate with nonfat milk and scraped the whipped cream off in a panic, but at least I challenged my fear of liquid calories. I spent some quality time with my cat Katherine. It was sad not to be in London, but Katherine is so adorable and sweet. I stopped at my favourite bakery. My cake was delicious even though my friends were not there to share it with me. Did I have the best birthday ever? No, not by any stretch of the imagination, but I know that I’m lucky to be alive having this birthday at all.

Birthdays can be hard, I know. You don’t have to like them, and you don’t have to celebrate them. You can treat them like an ordinary day if you want to! Just please, please don’t use them as excuse to hurt yourself–mentally or physically. Acknowledge who you are and where your at. You may not be who or where you want to be, but you are someone, somewhere. I hope you can appreciate that.

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Disclaimer: This cake was from the Saturday before my birthday. I enjoyed a chocolate cake on the day itself, but the icing smudged on the bus trip back to my flat, and consequently I didn’t get any good pictures.

Valve Disease Day

Heart valve disease is a generic term for any instance or event of heart valve malfunction. It includes both congenital and acquired abnormalities and applies to all four of the heart’s valves (aortic, mitral, pulmonary, and tricuspid). The three types of valvular ailments are enumerated below:

  1. Prolapse: When a structure prolapses, it falls down or forward. In the case of a heart valve, this means that the leaflets thereof do not close properly during myocardial contraction, flopping or bulging outwards instead. Often times, this leads to a condition known as regurgitation where blood leaks backwards into the chamber from which it came. In most cases, prolapse is relatively benign, resulting in a mere murmur or mild palpitations and warranting little to no treatment. It is commonly a phenomenon of the mitral valve, but technically, all valves are susceptible.
  2. Stenosis: A stenotic valve is narrowed and hardened. This makes it harder for blood to travel through the valve; consequently, corresponding chambers have to exert more force to achieve their purpose, which, in time, will lead to hypertrophic cardiomyopathy and/or heart failure. Regurgitation can also occur. Generally, stenosis affects the aortic and pulmonary valves (particularly in congenital cases), but it can occur in the other valves as well. Stenosis is a much more serious condition than valvular prolapse, and it is consequently treated much more aggressively. Surgical intervention (keyhole or open heart) is often needed, and although valvuloplasties provide a temporary relief, the aim is either replacement or repair; valvular stenosis can also be the underlying cause of problems that warrant other surgeries including but not limited pacemaker implantation and complete heart transplants.
  3. Atresia: Similar to stenosis, atresia is an abnormal closure of a bodily passage; the term is typically used to refer to mal- or non-formed heart valves where (nearly) solid sheets of tissue disrupt blood flow. It is typically a congenital condition, and it is most frequently seen in the pulmonary valve. Cases of atresia require immediate surgical attention; catheterization treatments include radiofrequency ablation, balloon valvotomy and/or sepsotomy, and stent placement while the open-heart options feature procedures such as shunting, the Glenn repair, and the Fontan procedure; in some cases, a complete heart transplant may be necessary.

All of the above share relatively similar symptoms, including fatigue, dizziness, weakness, palpitations (and other non-perceived arrhythmias), heart murmurs, angina, edema (especially in cases of stenosis), and cyanosis (especially in instances of pulmonary atresia). They also have common risk factors including age, hypertension, diabetes, drug use, and an unhealthy body mass; connective tissue disorders (such as Marfan Syndrome), pre-existing heart disease (e.g. a history of myocardial infarction and/or atherosclerosis), and prolonged infection also predispose patients to valvular illness; congenital defects, although themselves idiopathic, are also causes. If you experience any of the aforelisted symptoms or display any of the above risk factors, consult a doctor immediately. These ailments are diagnosable through uninvasive, relatively inexpensive tests (a physical exam, an EKG, and an echocardiogram). Getting heart-checked does not take long, and it might just save your life–this Valve Disease Day and every day!

World Heart Day

Did you know that heart disease is the leading cause of death globally, killing an appalling 17.5 million people a year? Did you know that every forty seconds one person in America will have a heart attack? Did you know that 657 people in the United Kingdom will have a stroke today? Did you know that over 25% of Australian men suffer from hypertension? Did you know that heart disease costs the Canadian economy over $20.9 billion annually? Did you know that a quarter of all deaths in India can be attributed to cardiovascular disease? Did you know that heart disease takes twice as many lives as cancer in Malaysia? Did you know that over half the Mexican population is at risk for heart disease? Did you know that 278,933 Russian males died of coronary heart disease in 2009? Did you know that 26 million individuals suffer from heart failure? Did you know that 1 in 100 babies is born with a congenital heart defect? Did you know that 42 million women worldwide have a heart condition? Did you know that 98% of people do not survive out of hospital cardiac arrests? Did you know that things are only getting worse?

Heart disease is on rise. There has been a 60 million to 1 billion person increase in cases of uncontrolled hypertension between 1980 and the present. 1 in 10 school aged children are now overweight. 7% of the world smokes cigarettes. 23% of adults do not get the recommended amount of physical activity. Diabetes has increased in many countries by 50% in the past ten years. These risk factors, combined with the aging population, urbanisation, and inadequate prevention, are leading to a cardiovascular epidemic. By 2030, heart disease will have an annual death toll 24 million as well as a global economic burden of $1044 billion. These statistics are terrifying, and it is time we start taking heart disease seriously.

So ask yourself, are you at risk? Is your weight healthy? Do you follow your national heart association’s recommended exercise guidelines? Are you a non-smoker who drinks less then 14 units of alcohol weekly? Is your cholesterol below 200 mg/dL? Is your blood pressure 120/80 or lower? Are your electrolytes and blood sugar within the normal ranges? If you answered no to any of these questions, you are, indeed, at risk. Go see a cardiologist as soon as possible. You should also schedule an appointment immediately if you experience any of the following: chest pain (angina) or discomfort, palpitations, shortness of breath, arm/jaw/stomach pain, any cardiac arrhythmia, fatigue, nausea, and/or sweating. It is better to be safe than sorry.

Please, please be heart smart this World Heart Day. Know your numbers, get heart checked, and commit to a healthy lifestyle. Protect yourself and those you love. I know you may think you’re invincible, but heart disease can happen to anyone; don’t let it be you. Thank you so much for reading, and I hope you have a happy, healthy World Heart Day!

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Rebirthday

I died on August 29th of last year. My heart stopped, and anorexia killed me. I was technically dead for three minutes.The doctors didn’t think I would make it. I was too far gone. The defibrillators weren’t working; my heart was too damaged; I would never recover from anorexia. Why bother trying? They called my cardiologist to tell her patient had died; she told them to try one more time.

They did, and that’s when the miracle happened. That’s when my heart started beating again; that’s when my lungs started breathing again. That’s when I opened my eyes; that’s when I learned to see. There were sparkles on the ceiling and jewel-drops in my eyes. There was a buzzing in my ears and a million voices in my head; I could hear them all clearly, and they were telling me the truth–the cold, hard, cement-stairwell truth: They told me I couldn’t go on like this; they told me I had to recover. 

And they were right; I knew they were. I couldn’t go on like this, and I didn’t want to. I had to make a change; I had to do this once and for all; I had to recover. 

And so on August 29th, 2016, after ten long years, I finally began my recovery journey. I sought the help of a dietician, psychologist, cardiologist, gastroenterologist, psychiatrist, general practitioner, and liver specialist. I underwent extensive physical and psychological therapy. I gained thirty-eight pounds. I got in touch with my emotions. I learned to eat and exercise in moderation. I found freedom with food and within myself. I broke away from anorexia, and I came back to life.

I was reborn on August 29th of last year. My heart started, and I beat anorexia. I’ve been alive for approximately 525,600 minutes. I survived. The doctors saved me; my heart conditions are now managed with medications; I am recovering from anorexia. Who would’ve thought? I made it out alive, and you can, too. 

It Won’t Happen to Me

It won’t happen to me: That has been an overarching theme in and out of my recovery. I’m a smart girl; I did my reading. I knew anorexia had its consequences; I just refused to acknowledge them. Hair loss, muscle weakness, dry skin, fatigue, osteoporosis, amenorrhea, organ failure, death. Whatever. It wouldn’t happen to me.

It can. It would. It did.

Let me tell you about August 3rd, 2016: Light rain dribbled from the sky, and there was slight, dull ache in my chest. Thinking nothing of it, I got up, put on my favorite red lipstick, and popped three diet pills. My favorite scholar was lecturing on Shakespearean sexual suicides today, and I wanted to get to the hall early to tell him what I thought of Cleopatra’s death, how I read it as an extended enactment of the Renaissance ‘die pun’. I sped down the Selwyn stairs so quickly that I ran out of breath. It must’ve been the running that caused me to feel a little ill. No, I’d been sick earlier, too, right when I’d woken up. The pills, perhaps? A bout of violent vomiting truncated my contemplations.

The pain in my chest was worse now, heavier, and I was dizzy, so dizzy that the world spun around me and lights on passing cars danced like fireflies. It felt like someone was squeezing my left arm. I couldn’t breathe. I practically fell onto the ledge in front of the college, clutching at my chest with tingy, claw-like hands. A sensible passerby must’ve called the British equivalent of 911 (999?), because the next thing I remember was screeching down the rainy roads in a screaming ambulance.

I woke up–if that’s the right phrase?–with my face pressed into a green white tile floor. I turned my head a little to look around; I saw chairs, and couches, and a vending machine. There were legs, too, sneakers and swishing pants, voices and people, wheelchairs and carts. ‘Do you have an emergency contact?’ I heard someone say. Did I? Was she talking to me?

Hands grabbed my feet and my shoulders, sore, soared off the floor. I found myself sitting up, back against a bendy chair. I was confused. Why were we moving? Where we going, gliding and sliding, sliding and gliding? Or were we? Was I imagining this, dreaming, nightmare-ing? I tried to pinch myself, but my arm wouldn’t budge.

Wrinkled white paper crinkled underneath brittle bones as they dropped me into the hospital holding bed. Nurses–well, I assume they were nurses?– started sticking things on me, red and white circles with wild, winding wires. I could see a sea of them, all over me like some horrible kind of rash. I wondered what they were. No, I didn’t want to know; I didn’t want to have to know, if you know what I mean?

A woman in blue told me to stay very still. They were going to do an EKG now, and I had to stay very still. But what was an EKG? Would it hurt? Did they have to take any blood? Is that what the circles were for? Hadn’t my psychiatrist wanted me to get one of these a while ago? I had so many questions–and so little breath to ask them.

A whirring, a tapping, a scratching. The printer in the back of the room spat and choked, gagging on a scroll. There was a wrenching, ripping sound as someone broke it open, tearing out its contents. With furrowed caterpillar brows, the printer surgeon examined his specimen. He handed it to the woman in blue who nodded and left the room, muttering something about something called an echo.

‘Printer problem.’ Someone said, stomping on the sludgy silence.

‘Yeah.’ An awkward laugh, a sigh that filled the room. ‘Must be. This can’t be right. That wouldn’t happen to her.’

It can. It would. It did.

The woman in blue returned with cart. ‘We’re going to do an echo now’ she informed me, as if I had some clue what that was. Strangers stripped me, black scissors bisecting a brassiere back. Folds fell to the floor and like a ragdoll I flopped forwards, arms contorted backwards, purposefully pulled into a hospital gown. Cold hands nudged my shoulders into a sinking pillow, and suddenly something chilly crept across my chest. Blue goo, lots of it, glittered like snow drifts under a fluorescent sun, and a probe skated over me, making my heart beat loud, loud over the hospital beeps.

‘Okay.’ Voices whispered. ‘Okay.’ The word bounced off the whitewashed walls, fleeing the room, fleeing like a mouse trapped a hungry snake’s cage. ‘Okay.’ They all looked at each other; I could feel the fear in their eyes.

‘You tell her.’ They said, speaking all at once. ‘No you, no you.’

Tell me? Tell me what?

Doors slammed, footsteps hammered, and faces leaned towards mine. I saw a mouth move. A man said something, something no one should have to hear. ‘You suffered,’ he informed me, looking down at the stack of papers one more time. ‘You suffered an acute electrolyte-imbalance-induced myocardial infarction.’

‘I what? A what?’

‘You had a heart attack.’

‘A what?’

‘A heart attack.’

A heart attack? No, that was impossible. Only old, fat men had heart attacks. It wouldn’t happen to me.

It can. It would. It did.

I had a heart attack that day, and I’m glad I did. Yes, I’m glad I had a heart attack. It almost killed me, but it saved my life. It was a wake up call, a slap in the face, a red flag in the neverending haze. It forced me realize what I couldn’t on my own: I am not immortal; I am not invincible; I am not immune. It could happen to me–and it did.

Darling: A Letter to My Present Self

Darling,

I know you like it–that feeling of hunger, that stomach-scooped-out kind of bliss. I know fantasize about it–the chalky taste of your fingers down your throat, the way they filled you up when you were so, so empty. I know you dream in it–the heavenly haze as you ran and ran, the world blurring, your legs burning. I know you reach for it–the sour raspberry taste of the quasi-legal diet pills, the big red capsules that stuck in your mouth. I know you long for it–that beautiful thin physique, that scary-low scale number, that delightfully dangerous BMI. I know you miss it–miss it more than the world, miss it because it was your world.

But I also know that you remember–that you remember dropping out of school, that remember being uprooted from your home, that you remember going to the hospital after overdosing on diet pills, that you remember having a heart attack, that you remember being technically dead for three minutes, that you remember what it was really like to be anorexic.

It wasn’t glamorous; it wasn’t pretty; it wasn’t romantic. It was a miserable, dark, agonizing, cold, lonely, hell and you are lucky to have made it out alive. You danced on the brink of death for too long, and now it’s time to move on. There’s nothing there for you, so take your broken heart and come with me; we’ve got a life to live, a world to see, a person to become.

Fries Not Lies: Rant On an Image

I was horrified when this image popped up in my newsfeed.

Yes, trans-fats from some french fries will raise your LDL-cholesterol levels and yes, buckets-full will probably lead to obesity, but this infographic is highly inappropriate; the message it sends is disportionate not to mention disordered.

Consider one of each: One cigarette is actually going actually harm you; the carcinogens will reach your lungs, and the nicotine is immediately addictive. One french fry does not have the same effect; your arteries won’t suddenly clog, and you won’t drop dead of a massive heart attack. In fact, on occasion, fries can actually be good for you. They’re fun, delicious, and if your body is craving them, what you should eat.

French fries are not the enemy, and food is not the problem. Weight and diet are contributing factors to heart disease because of extremism and excess (on both sides of the scale). So, cardiovascular health community, please stop fat shaming and please stop vilifying food. Advocate for moderation instead. Encourage people to maintain a healthy weight, exercise regularly, and eat a balanced diet–which, yes, does include french fries!

(original image by Instagram user @epatientbrazil; vandalism thereof by yours truly)