Mandatory End of Year Reflection, 2022 (A Peterson Family Update)

So, yes, I have fallen off of the face of the earth lately and hadn't posted any blogs for all of December to this point.  I haven't figured out a writing schedule with my new position as of yet, particularly with the extra frills of the holiday season.  

It's been another eventful year.

The new view on my way to work

On Loss

Grandma Peterson died last year, the first of Andy's four grandparents to pass.  Given the vaccination status of some family members, I was not able to attend the funeral without risk to myself (as an immunocompromised person) nor my patients, tangentially.  This was its own source of grief, to emphasize that one of the loudest lessons I've learned through the course of the ongoing pandemic is that many people would not do the bare minimum to keep others safe, even others that would actively drill holes in their own lifeboat in the name of selfish freedom.  I have seen firsthand what the long-term effects of COVID can look like in the hospital setting and have no need to roll the dice there, subsequently meaning that I have less guilt in removing myself physically from certain situations and interactions.  It's a complicated grief, all the same.

Additionally, Andy and I have two other grandparents with waning health--there is an anticipatory grief in these circumstances, a quiet preparation for eventualities.  For my last remaining grandparent, my mother and I have had frank, clinical conversations on what pattern we see happening, acknowledging that knowing is both comforting and not.  These thoughts linger in the back of my mind, quietly simmering as I see other patients enact the same process in the hospital setting or in the occasional family mass text update.  

Certainly, though, the most significant upheaval in our home this year was when Andy was let go at Rivian.  There are still moments when it catches us, where we go "why Andy, of all people?" who proselytized Rivian with enthusiasm and joy.  But it happened.  And the logistics had to be addressed, allowing space for the emotional components to process.  There was a lot to think about, including (but not limited to) household needs, identity, and the health insurance we had been getting through the company.  

That last one in particular, I have been running orange for a while, just a gentle shove away from red-overwhelm on my internal status bar, watching the internal rpms of my brain and body rev to some dangerous sounds.  It is not healthy to run the system at that degree of stress for a long period of time, but I could not be settled until we were settled with specifics on insurance.  Now with a plan set in place, the system is still in the yellow until I see the household figures after the first month, but yellow is at least edging back toward a healthier green.  The survival voices have been loud the last few months, and the great injustice of how expensive I am to keep alive because of a disease that is not my fault, well, it's galling to say the least.  There is more grief here than I know what to do with, especially knowing how proactive I am toward my health.  There is no moral failing in having a human body that needs care.  There is a terrible moral failing in taking advantage of that to profit oneself.  

In short, we started the year as DINKs with a clear plan on a relatively viable (for this country) healthcare plan and our financial and personal goals laid out.  We end it still sorting some pieces out, having lost a degree of security in that upheaval.  My experience with the unknown means that we have had strong safety nets that have held us above immediate danger, but there is a degree of bitterness in needing to use them.  

Nothing is wrong with Andy's leg!
He's a good sport for letting me practice.

On New Adventures

So, we actually paid off the Rivian this year.  That's some crazy shit, yo.  We are Millennial Unicorns.  Our remaining debt is my nursing school student loans and our mortgage.  Depending how the student loan forgiveness elements shake out, we could potentially pay off my student loans by the end of the year.  Comparing to where we started our marriage to where we are now, it's extraordinary to see the progress we've made.  

We've had some great adventures this year, including a family vacation to Pigeon Forge, a few trips to the Twin Cities to hang out Josh and Morgan to seem them in different productions, an adventure to the Wisconsin Dells around my birthday (involving an escape room, axe throwing, and Wizard Quest), and a couples trip down to St. Louis to hit all of the Upper Limits gyms that direction.

Ah, yes, we started rock climbing this year.  Hard to believe we've only been doing that since May.  Andy--who never does things halfway--has been especially taken with it.  After a cooling period post-Rivian, Andy now works at Upper Limits.  I've been envious of the opportunity he has to climb, certainly, but delight in his excitement and my own milestones.  He's finding his footing.  

The increased exercise has done Andy a lot of good; I have also found a nutritionist and have made some good strides there.  It's been very gratifying to see some physical results of our mutual progress.

And because we cannot do household upheavals one-at-a-time, I switched from inpatient to ambulatory nursing working at the Wound Healing Center.  I'll have some further specifics on the new job in some upcoming blogs, but the short version for the moment is that I am delighting in expressing nursing in some of the ways I specifically went to nursing school for.  I still have one foot in the inpatient world and the relationships I've made there, and simultaneously I'm finding a groove in my new place.  Now that I've been a nurse for over a year, I'm simply amazed at how much I've grown and learned in that time, what tricks and processes I've learned in that time, how I've solidified setting boundaries, and so many unquantifiable workflows I've refined in growing my professional practice.  There is a rightness here.  

Mike started a new adventure, too, working toward radiology at Heartland, seeing his preparation pay off in completing his first set of required classes.  It's been fun talking biology with him, to share those spaces and even a couple of my textbooks.  

On Continuing Adventures

Luna is still and adorable little derp.  That's a beautiful constant at the moment.

We had to delay our Iceland trip originally planned for the beginning of December.  We probably could have made it work, but in retrospect it would not have laid nicely with my orientation to my new position--when we were juggling many things, it was a ball we could put down for now.  We'll be looking at doing that at some point in the next year.  

I had a wild hair the other day and bought hockey tickets for a Blues v Blackhawks game in January--looking forward to that mini-break already.  I have some additional ideas for upcoming hijinks but also finding the odd joy in being able to do weekend things, too.

As I've been continuing to think about the ridiculous amount of money that we spend to keep me alive in this country, I also cannot help but continue to think about leaving it for another one, finding what steps it might take to do that.  There's a lot to think about here.  

And Where it Leads Us

There was a lot of growth this year in unexpected places.  And all of it was certainly in that feeling of "becoming."  This year, I look forward to "becoming more."  Specifically, I would want for our household to work on becoming more of whom we are meant to be.  The three of us are in different transition states--I'm excited to think about what that can look like in another few months.  When I have my feet fully underneath me at the Wound Clinic, how will I move in that space?  How will Andy inspire his team and improve in his climbing?  How will Mike express his new learning spaces and enjoy the clinical time in the program?  

What new elements of self will we all discover in the process?  

So I approach the new year with optimism and curiosity, ready to probe some of those spaces.  ...And to find a new pattern for writing again.

Transition State

How's the new job going?  Great question!  Glad I pretended you asked.

Originally, I was supposed to start my new position at the wound clinic Thanksgiving week.  It happened that there were a few courses I needed to complete first before I would be allowed to work with patients--the way that timing worked in this case, I suggested that I take off the rest of the days during Thanksgiving week and then start with the classes the subsequent week.

So on the one hand, yay, surprise vacation!  On the other, well, the existential dread starts to creep in.  I get confused with time off and a little bit paralyzed with how to fill it.  When Andy was let go from Rivian, I was insistent, probably to the point of annoyance, that he take time to simple be and process the change and the grief.  I am shit at taking my own advice in these places.  

I've worked on the inpatient side of things, been a medical floor nurse for a year and some change now.  I have learned a ridiculous amount of things in this time, delighted in teaching the nursing students that came through in particular, and shared in many, many stories with peers.  There is a particular kind of grief in leaving that behind.  I have been avoiding processing it, for multiple reasons.  I am curious to see how I might process it given a bit more temporal space.  

And at the same time, I've got that roiling excitement and anxiety about starting the new position.  Hammering out the little details of when the first day is and logins and lockers and starting those new relationships on the best impression possible.  I think I've prepared just about everything I can:  we're simply in the waiting phases.  

Waiting is not a passive thing.  Waiting is active.  Most every piece of preparation that can be done has been done.  It's time to let things happen and absorb all of that I can.  I am going to continue to be unsettled for a while now, and that is okay.  Expected, even.  And in the same breath, I know that my body does not sort out "excitement" and "danger" correctly sometimes.  There's a lot happening in our lives right now.  And it's okay to let that be.  I am feeling anxiety, but I am not my anxiety.  In the same breath, I'm certain that we'll work out all the kinks as we go.  Through all of those acknowledgements, it occurs to me that it is time to take that advice, to greet those parts of myself and name them.  

It's another period of transition and transformation.

...and before I can even gather those thoughts together, the week is done.  I've had my first full day shadowing and am just beginning to see the flow of the floor.  I'm trying to absorb EVERYTHING.  And it's exciting, and my brain hurts.  I'm also trying to get to know my new peers and to not be the "well, at my old job, we did it X way" person while also acknowledging that that is my basis for comparison.  This expression of nursing is different, has a different pace and utilizes different skills.  I have so much to learn.  

I feel uncertain in my steps but confident in my direction.  And that's not nothing.

All the THINGS

I've been working on processing a particular kind of grief lately.  

I froze to death and drowned quite a
few times with this one

When I read choose-you-own-adventure books growing up, I wanted to know all the possible outcomes, which lead to some very complex book-holding techniques as I had different fingers in past major decisions so that I could go back to them when I hit another dead-end.  Significant early decisions were granted a slip of paper for the next read-through.  Certain page numbers became recognizable as I flipped through again, fingers contorted in strands of plots and pages. 

I love learning.  When I meet people, it's something that sits in the back of my mind, wondering what kinds of new things they can teach me, what niche subject they are quietly passionate about until someone asks the right question.  And by listening, I learned a lot of random things over time.  Sometimes only enough to ask halfway intelligent questions; other times building off of past conversations.  

This made the idea of choosing a career very daunting.  In choosing a college, I knew I found the right place when they didn't bat an eye when I said I wanted to double major in biology and creative writing.  It was important to at least keep learning a vast breadth of things while sorting out the larger questions.  I remember hearing "Jack of all trades; master of none," and feeling the gentle censure, that I should knuckle down into a specialty of knowledge or skill.  But then I heard the rest of the phrase that is commonly left off:  "but better than being a master of one."  

All of this to say I'm processing a degree of grief at the moment in changing positions that I've been struggling to find a way to articulate.  This is my last full week on my floor.  Naturally, I think of my favorite workmates first when leaving a job--I will miss seeing and supporting a number of people on and adjacent to MOSU.  And I'm also frustrated that I'm leaving after I've been finding such a good groove lately.  I enjoy working with students.  I have almost all of my assessments done before ten-thirty each shift, usually two or three done before eight-fifteen.  I am learning how to pay attention to clues on when someone is ramping up on both pain and anxiety and preempting those spaces, setting better boundaries.  

It seems a terrible time to leave, when I feel like I'm coming into my own.  I have had a couple people tell me that I would be a good charge nurse, and I think at its right time I would enjoy it, finding ways I can support my peers.  

And in the same breath, I am immensely excited to start working with wounds, to learn all the nuances and tricks in this expression of nursing.  

I grieve that I cannot do everything.  There is simply not enough time to do everything.  And that is a particular kind of grief.  There are so many things I could do, and even things I could be good at:  I have to choose.  And I'm happy with my choice, but also am sad to leave things behind.  They exist in the same space.  My plan is to keep a foot in the inpatient world by picking up occasional shifts on my old floor, a beautiful intermediate and merging of worlds, and yet I know this won't be the same as it was before.  

There isn't enough time in life to do everything.  I have to choose how I want to spend it best I can.  I have pulled the metaphorical strips of paper out of the choose-your-own-adventure book on some past decisions, choosing to hold the book in such a way that gives my full attention to the pages I'm currently reading.  There is a grief, but there is also a particular kind of wonder in accepting the present whole-heartedly.  I want to find the best way to honor my transitions grief, while also acknowledging this side frustration of limited time on earth and the impermanence of existence.  

There is not enough time in life to do everything.  And that's okay.  

Dichotomous Thinking

I am not a fan of absolute statements.  There are a few absolutes out there, but there are a lot of things that have exceptions.  I like to leave space for those.  This frustrates Andy to no end when he's trying to get an answer out of me.  He'll ask me if we can do X or Y tonight and I'll reply with something akin to "most likely," not because I'm trying to be coy but because I cannot predict the future to know if some emergency will pop up or if either of us will run out of energy by that point or whatever else.  Sometimes, these are exercises in abstract thinking, I confess, trying to find the obscure reason why something is/isn't or will/won't, as my dedication to the idea continues and just the way my imagination works.  More often, though, it's about that space, leaving room for deviations and exceptions.

Consequently, when I hear someone use "this person ALWAYS/NEVER does X" or "people are either Y or Z" without acknowledging even backhandedly that there are other choices and shades of grey out there, I tend to feel a degree of doubt creep in around that speaker and their assertions.  Sometimes it's a sliver of doubt; sometimes it's a hefty helping of doubt, depending on the context.  

The world is richer in greys than it is in black and white.  Subtle value adds depth, adds meaning, when viewing the full picture.  

But we like our false dichotomies.  "If you're not with us, you're against us;" "my side or their side;" "democrat or republican;" "dog person or cat person."  These are easy.  They are comfortable.  We like patterns as humans, things that help us quickly put situations and people in boxes.  These don't serve us in all situations.  In fact, they are counterproductive in many.  We lose that value, that depth, and often someone's humanity in those spaces.  

There is a difference between a declarative statement and an absolute, and there are places where they can be confused.  An observation of the moment or circumstance can have a declaration.  If it then becomes something permanent, that it is the only way or generalized to all circumstances, that's where we negate other possibilities and create a false perception.  

I want to be precise in my language, which sometimes means I fail at being concise--I'm working on this.  Sometimes, I feel a rewording or adding in the full scene is helpful but respect that the recipient may hold a different opinion.  Ultimately, leaving space also furthers honesty, attempting to be more transparent by acknowledging the edges.  It is meant to further clarity, assert sincerity, rather than muddy the waters, though I know that's not always the impact.  

I tell my patients that I know better than to speak many absolutes in my field, when they are trying to pin my down on answers about timing or why their doctor is doing X or what will happen after Z.  I tell Andy a percentage when I don't feel I can give an authentic, firm yes or no.  And I tell myself that keeping a space for new ideas means that I can continue to grow and find those different perspectives.  

Peterson Family Update, Oscar Charlie Tango 2343

Things have been hella busy lately, but not necessarily in a bad way.  They are, however, hella busy in a way that I'm only able to take things in pieces at the moment, which means it's a brilliant time to deploy the bulleted list once again!

• Nutritionist meal plan is still going well. My anxiety around meal planning has decreased immensely and my body is adjusting to different macros and their appropriate portion sizes.  Now that the hypervigilance is continuing to recede, I think I actually feel...pretty good.  A few of my data points are moving in a good direction, too.  I also have not eaten out much since I started this, which is good in its own way.  
• Andy and I are still enjoying rock climbing and the last couple of times I have had some really good climbing days, where I felt I had more gas in the tank than I had previously and subsequently was able to complete a couple of routes that I have been projecting.  We have all learned so much since we started in May, and it's neat to see that progress in something tangible, tackling routes that seemed completely impossible just a few months before.  
• With the last Peterson Family Update, I announced that Andy's position had been eliminated from Rivian.  He has been spending a lot of his severance package time traveling, tackling house projects, the aforementioned rock climbing, and otherwise reacquainting with parts of himself.  
  

• Luna is still a delightful fluffbutt.  She hasn't mastered my attempt at covering her eyes as a trick called "Eclipse," but leans on her side and paws up a bit so that you can move them up to her eyes, so that's a start.  
• Work has been tough lately.  Our current patient population has a lot of confused bodies for one reason or another, which means there are places where logic and reasoning don't apply.  I am solidifying some successful boundaries with a few of these instances.  Sometimes calling security is a way to stop things from escalating rather than waiting for them to escalate past a point--arguing with a patient can be more far agitating than calmly following through with putting them physically back in bed, following through on the choices that have been outlined.  I have wasted forty-five minutes attempting to convince people that cannot understand reasoning--there's no need to continue an unproductive conversation to this degree.  I pick my battles differently; I give choices where I can but not at the expense of anyone's safety.  
• Mike has been continuing in his coursework at Heartland.  We've talked about bones and the like a few times, and I'm trying not to get too pedantic in certain spaces.  
• Absolutely loving the fall weather lately--took an excellent trip to Starved Rock with some friends to catch up, see the foliage, and have a lovely walk.  
  

• The new sofa and chairs we had bought before hearing about Andy's job change arrived and we have rearranged our downstairs accordingly--it's neat to have a new perspective and see our space in a different light.  
• Andy is still sorting through what his next steps might be, but in the meanwhile our health insurance is still covered until the end of the calendar year.  Health insurance plans might sound great until we factor in a Tier 6 medication, in which case I focus only on the max out-of-pocket to compare one plan against another.  I have been managing a lot of spreadsheet action regarding health insurance and starting to look at other employers for different plans.  It's a shitty reason to have to leave my current job, but this is about survival and we'll do what we have to do.  It's a raw but real truth.  I will continue to feel unsettled until we both have coverage lined up for January.  
  

We cannot seem to do big life choices one at a time in our household.  I met some delightful folks at Big Brother Carle through the Ostomy Care Associate class I took who happened to mention that their wound clinic was looking for people.  

I got into nursing specifically to be a wound/ostomy nurse—my heart is in ostomy, with the ingrained compassion from my own experience; my brain, however, is intrigued by wound and the different problem-solving that entails.  I submitted for a transfer that will officially start mid-November.  My plan is still to pick up some weekends on MOSU, but otherwise I'll be commuting for a Monday through Friday, 0800-1700.  This way, I can simultaneously further my ultimate professional goals, keep the relationships I have, while also making some additional money to supplement a higher need insurance plan for my situation.  

I'm still very much feeling the season of change ramifications.  And I'm also optimistic toward the new adventures ahead.

Sound and Space

So, the cold fronts moving through as the change of seasons has been a bit of a different kind of wallop on me this year.  Normally I get a bit of a cold when the weather starts turning, just a week or so of sinus drainage and lamenting all of the moments that I had been able to breathe easily through my nose and then it's done.  This year, though, I completely lost my voice.  Just...gone.  I cannot recall a time when I had lost it to this degree.  

And, of course, it all started happening while I was at work.  Or rather, I discovered it after I had arrived at work.  Saturday, I had a sore throat from the drainage, with some pain in swallowing but otherwise no other major issues.  Sunday, though, I got to work and the first time I had spoken that morning, I ended up cracking like Peter Brady.  I hadn't had a reason to say much before leaving the house so that was a moment of "Ah.  Shit."  Over the course of that shift, it proceeded to get worse.  People I spoke with from different departments asking the cursory "how are you?" got a bemused "I sound like Peter Brady!" back from me, as all I could really do was laugh at myself and open up another Ricola from my pocket.  

By the end of that Sunday shift, though, it was no longer a question--two words out of my mouth made it apparent to anyone I was talking to.  Had a couple of patients tell me that I sounded a little hoarse as a bit of an understatement.  But giving report to the oncoming nurses, that was a particular kind of squeaky special.  And then I would laugh at myself which also sounded ridiculous and laugh a little harder.  When I left, I had told the charge nurse I would see how the night went and call off if I needed to, since I was scheduled to work that Monday as well.  

At around ten that night, I began to see reason and called work.  The call went something like this:

Me:  Hey, this is Larissa.

Charge Nurse:  Oh, I can tell.

I started laughing and she joined.  

Charge Nurse:  I'm sorry, it's not funny.

Me:  It is a little funny.  

I explained that I felt it was prudent to call in and recover; she agreed that was probably a wise decision.  *end scene*

So, I slept in the recliner that night, since that felt better than flat with the sinus drainage again.  Andy made me a hot toddy, and I was going to be on vocal rest for the next day.  I think I spoke less than two hundred words that day.  Lots of Throat Coat Tea, honey, water, and a bit of rye whiskey, but little speaking.  To my dog, we have gestures that we do along with commands and she was able to do quite a bit with just the gestures, once she realized that I still had a treat available.  Getting her attention involved whistling and kissing sounds.  

Talking with the other adults in my household, though, that was a bit trickier.  I had to think about my communication differently and how much space I take up regarding sound.  I couldn't have a quippy reply or theorize what might happen next along with the show we were watching together--communication had to be prioritized and triaged to short ideas or not shared at all.  And trying to get an idea across involved some basic signs that I knew, mouthing, and voicing only a few key words for context.  Andy would repeat whatever he was understanding from me, which helped us confirm immediately in the moment and try again as needed.  

I enjoy ruminating on words in a normal day, but this was a different kind of overthinking.  And then I noticed that I was also walking more quietly, paying attention to the sound of my body in my own home a little differently.  I felt quiet in space as well as voice.  It was a unique moment of awareness of how I take up space in a different manner.  

When I'm in a public space and someone is taking a call on speakerphone, I'm annoyed, particularly when there are glares that seem to imply that you shouldn't be listening to their conversation--sound takes up space differently and they decided to have a private conversation, loudly, in line at the mall.  There is a breach of consent here, that a shared space has been taken over by non-typical intrusion.  While hiking at Starved Rock this summer, there were multiple groups that were blasting their own music while walking the trails.  Some held a tighter radius, where we could hear it coming but the sound left with the group; others interrupted the natural sounds for minutes on end, loud enough that even the group had to yell to talk to each other.  Public space intruded.  It wasn't against any rules, but it felt rude, a breach of courtesy.  Coughing, though, as another example also breaches a shared sound space but it seen as more acceptable, understanding that it is usually out of control of the body in question.  But there is still a point where excessive coughing requires different rules--I've slept in the recliner a few nights, now, half for my own comfort and half to ensure I do not disturb Andy more than necessary.  

There are invisible rules for how we take up space, and these boundaries do vary.  It was interesting to think about it for a while, even in my own microcosm of shared space with my housemates.  We have unspoken rules about when music or a podcast can be played.  Tor example, someone cooking the kitchen has priority.  And if someone was in the space first that can also grant priority, but there are consent check-ins, the easy "is it okay if I play X?"  It's also okay for us to request someone to use headphones or turn down the volume.  I won't say that we're perfect at it, but there are some good practices.  

And then there's Luna who borks anytime her great nemesis, the UPS truck, goes by.  Human social norms are clearly not her thing.  

Whelp, in the meanwhile I'm continuing to let this round of seasonal blah make it's way through, coupled with another Covid booster last week, I'm ready for some good days again on the other side.  I'll continue to take up space differently for a little while longer, including extra mugs, Ricola wrappers, and a more coughing.  I'm allowed to take up space; and it's interesting to consider it in a new light.  

About Food

I have a weird relationship with food.  Funnily enough, having an autoimmune disease that affects my digestive system.  Honestly, I would go as far to say that I have disorganized thinking around food.  There are a number of triggers and patterns that have made food a touchy subject for me.  

• I've lost thirty pounds in a month before because it was too painful to eat and I had no appetite--Crohn's flares are a beast
• Trying to force yourself to eat when the back of your mind screams that there will be Terrible Consequences! while simultaneously another part of your mind is screaming that if you don't eat there will be Terrible Consequences!...well, this results in Terrible Consequences! AND anxiety 
• Already experiencing a reduction in much joy of eating, eating something I don't feel I'm in the mood for is not something I can muscle through can be a special kind of nausea
• Back in 2016, I went keto and found that I felt better by sticking to that diet; I also felt very left out of the community aspects around eating
• The past few years, I've been doing a "lazy keto," where I attempt to stay mostly on diet but end up feeling terribly guilty at least twice a week
• Living with two vegetarians made it harder to find recipes that worked for all of us, which increased the emotional energy it took to plan out meals and groceries for the week and also meant that I reverted more to pre-packaged options and less cooking for our household overall

I know that it is unfortunately always a matter of time until my next Crohn's flare--that's what chronic illness do.  I acknowledge this truth at the same time I am relentlessly pouring my efforts into ensuring that this happens in the far-future rather than the near, always working toward a better state of health.  

All this negativity toward food, there is plenty of room for improvement, here.  So I spoke to my GP about a nutritionist.  And I met with said nutritionist.  Now I'm working through unlearning and relearning in some of the same spaces.  

Probably my favorite lunch so far

So far, I think it's going well.  Feeling full on keto compared to feeling full on my individualized meal plan is different--my body was conditioned to feel even the same portion sizes differently, in terms of registering the physical feeling of "full."  I've also had the chance to rediscover foods that I haven't had without significant guilt in a long time.  Homemade apple butter in Greek yogurt?  Hells yeah.  Even the general burden of what should I eat/cook this week is cinched down into seven days that I pick from, already designed and with dinners accessible to my housemates so that we can cook and eat together.  

I'm at the end of week two, now, still fine-tuning the rules and nuances.  At this point, my bodily hypervigilance is going to start to back down a notch or two, which will allow a more gentle introspection into how I am physically feeling on the plan, now that the crisis marker systems checks won't be flashing in background.  The anxiety parts of my brain that try to help protect me by planning through catastrophizing remind me that this could still go terribly wrong, but I have also learned to acknowledge them and work through those spaces only as much as they are productive.  Most interestingly, though, will be the emotional introspection about food in this time.  Eating is always an emotional experience, and I have a lot of negative associations to shake off.  There is space for reclamation, and, better still, there is opportunity for it.  

After a month, we can take a better sampling of change and adjust accordingly.  I get quarterly bloodwork for my Crohn's disease management as it stands, so a request for a couple of add-ons for my own curiosity and to check for progress in other metrics is also easily feasible (A1C to check if I have adjusted in sugar management from keto to a diet that has reintroduced carbs, for example).  I have many, many places that I watch concerning my health, where I can watch trending data, as well as keeping a general impressions subjective log.  

Ya'll--I am high maintenance in some interesting ways.  And I have fought for a long time to get to this degree of "healthy."  There are places where I have accepted a new normal; there are places where the current "normal" has been challenged and improved; and the line is incredibly difficult to discern. Having the emotional and physical energy to poke at it, though, requires a base degree of stability that I have not always had.  My limitations can change daily; the ranges that they can be found in, however, have been steadily increasing, advancing how good a good day can be and minimizing how poor a bad day can be.  It takes a lot of its own energy to manage this.  I'm grateful to simply have enough spoons to be able to investigate or even make an appointment in increments at a time.  I also have the blessing of a diagnosis that I can point to--not everyone managing their own care has this easily, languishing in the "unknowing" space.  There have been times when I had thought things wouldn't get better on a particular front and been right--this was a path, then, of radical self-acceptance and then leaning into how to make accommodations for that need.  There have been things that have improved over a period of years.  That's what it is to live with a disability, slowly sifting out what can be improved and accepting what can't, while simultaneously ignoring a lot of bullshit advice, even when it comes from a well-meaning source.  

So today, it's food.  A fundamental concept that I am deconstructing and re-interpreting into my life as it is now instead of my life as it has been.  And when life parameters change, so will the requirements.  And we will adjust again, with a necessary amount of grumbling.