On preventative maintenance
On preventative maintenance
Or, I know how I will probably die
My father, as you may know, is dead.
What you probably don't know is that, while he died two years ago this month, he had a near-fatal hemorrhagic stroke in 2014. Wait, you actually might know that, I talked about the stroke in my post about [the book my mom hated so much it saved his life, which I very nearly just mentioned by name before I remembered what that post was about]. Just like irl, sometimes I forget what stories I’ve already told. Besides, I like to think of every issues as a stand-alone, like a 90s sitcom meant for syndication that ideally has enough context that you can follow the plot even if it’s your first one.
Anyway, back to my dead dad. He had eight long years of malingering after that stroke. He was in a care facility during Covid and didn't die. He broke his hip and didn't die! All I can figure is that it was out of spite, because neither he nor anyone else was enjoying his final days or years.
My family of origin probably has a bleeding disorder (we know one of my siblings has one, but it can be both acquired and genetic so we're not sure if it's what's wrong with the rest of us) because most of us have had Blood Troubles, including dad's stroke. Strokes and hemorrhages and clots, oh my! Add in Covid and that the medication I take (as infrequently as possible!) for migraines also might increase risk of stroke, and I can't help but feel like I already know my eventual cause of death. (I realize it could be literally anything and will probably be something entirely else after worrying about strokes for decades.)
There's only so much one can do about stroke risk; it’s mostly lifestyle things. My blood pressures is solid, my endometrium seems to be where it should be, I don't smoke, I'm not on hormonal birth control, I take my triptans as infrequently as I can. My cholesterol is a teeny bit high, but it's been quite consistent over the years, so that's just like, what she do. (I even went to the doctor last week for blood work! He’s not overly concerned.) Really, the biggest thing left is…exercise.
The stroke prevention guidelines (which they updated literally last week!) emphasizes the importance of regular exercise as one of the most important steps to reduce stroke risk. (They also mention the Mediterranean diet, but somehow I don't think “eat five pitas at the restaurant and take home a to go container of baklava” is what they mean, which is how I prefer to live it.) They suggest 150 minutes moderate or 75 minutes vigorous exercise spread out over the week for optimum stroke prevention. Conveniently, that’s also in line with the prediabetes suggestion, which is also a concern, yay.
Since September 10th, I have made it a point to walk 30+ minutes a day (the + is to get to 5k steps, because if I have a lot of meetings at work, I end up with practically zero steps during the day). Mostly it's been on the treadmill, because summer last forever now, but I have had a handful of walks outside in the last few weeks, which is fantastic. Initially it wasn’t even to reduce my stroke risk, it was because Elle Woods taught us that exercise is important for mental health. And you know what? I'm sorry to say it, but it turns out exercise does all the things they say it does!
I'm not saying a 30 minute walk is a 1:1 substitute for SSRIs, but I spent most of the summer feeling like I was going to cry. Like, all the time. And since I started walking, I don't! I’m less stressed, even though my job is a lot more stress for zero ($) more dollars. I feel better, both in my body and about my body. From a moderate amount of not-that-fast walking!! I honestly can’t recommend it to you enough.
The other thing I recommend to you is the Book of the Biweek, Four Weekends and a Funeral by Ellie Palmer.
The book starts with an amusing premise: Alison goes to her ex-boyfriend Sam’s funeral and no one knows that they were broken up. Despite him dumping her, he hadn’t told any of his friends or family, except for his sister. His sister begs Alison to not tell anyone, so they can think that he’d finally found someone and was ready to settle down. It’s one day, what can it hurt? So she agrees. Fake dating, but one of them is dead. Sign me up.
Except that she kind of volunteers to clean out Sam’s condo so his parents don’t have to. But his best friend Adam insists he should do it, so she’s like, “FINE, we’ll both do it.” And then they fall in love, etc. Classic romcom.
But on top of that story line, her personal arc has to do with dealing with her feeling like she cheated death but isn’t doing enough with her second chance at life. See, when her mom was diagnosed with breast cancer, they found out that she and Alison both have the BRCA1 gene mutation. But unlike the boring lifestyle changes I have to do every day for forever for the sake of my brain’s delicate blood vessels, Alison got a preventative double mastectomy. She then feels like she has to become a thrill-seeking outdoor adventurer to make her life meaningful—which was how she met Sam in the first place. It is kind of the crux of the conflict, that she feels like she has to remake herself into someone else to be worthy of skipping the cancer that she was “meant” to have.
It’s such an interesting concept, and so different from anything else I’ve read recently. I was reminded of it again when my slightly surly post-vaccination child asked, “But what if I got these shots and I never would have gotten the disease?” Having the BRCA1 mutation isn’t a sure thing that you’ll develop cancer. What if you’re preventing a thing that never would have happened? Was it still worth it, despite the toll on your body, just for the peace of mind? (Not saying the Tdap shot is comparable to a double mastectomy, no matter how sore one’s arm was, lol.) There’s no one right answer to that, although at least as far as vaccines are concerned, my answer is always “Yes.” And of course, when the prevention is “go for a walk,” the answer is, alas, an even firmer yes.
In Other News…
In other news, I’ve been toying with the idea of adding this little segment, which is about as self-indulgent as the intercalary standup comedy bits in between scenes on Seinfeld, a show that was already self-indulgently about nothing. Almost too apt, when you think about it.
Anyway, in other news, my new hyperfixation is making Instagram Reels that poke fun at bookstagram influencers. They are always so peppy and smiling and well-lit, and I realized that, while pretty much everyone’s #content is probably a caricature of themselves, trying to be upbeat is tooo faaar of a stretch for me and I needed to exaggerate the other direction. Thus was born The Book Nook, where I make (otherwise entirely genuine, heartfelt) book recs with an absolute dead face. It’s so fun? For as funny as some* people find them, nobody is more amused by them than me, and I love that for myself.
*At least three other people are genuinely amused by them, and only one of them is married to me