Inner Critics Are My Own Worst Enemies

The good news: my heart is perfectly normal.

The bad news: my heart is perfectly normal.

Ok, that’s a really flippant, inappropriate answer totally mocking the good fortune of a healthy cardiac system. My sincere apologies to anyone suffering from a horrible heart condition.

What renders these results frustrating is that, once again, I’m nowhere closer to solving my persistent, debilitating fatigue.

I Need Some Nicer Critics

Because I was brought up with a completely stalwart Midwestern mindset, I’m my own worst enemy when it comes to talking about health problems. An entire chorus of inner voices shouts me down:

“Nobody wants to hear your problems. Come on; so you’re tired a lot of the time. Suck it up and get off your ass! If you weren’t so undisciplined, you’d lose that extra weight. If you weren’t so lazy, you’d make yourself work out. Those bad days–just an excuse to lay around and binge watch mindless TV.

There’s nothing wrong with you.”

My negative inner critic is disgusted. Her constant belittling has made me embarrassed around my workout friends, who she says are judging my lack of fitness. When I get dressed or eat, she reminds me that I’m a mere four pounds away from my heaviest pregnancy weight. On the rare occasion I confide in friends about this almost year-long battle, she chirps on my shoulder like a malevolent magpie, “Who cares, you old, dumpy, lazy whiner?”

There’s another inner voice joining the mix. She’s “reasonable.” She points out that many, many people would be ecstatic to be me: folks who can’t move in ways I do, friends for whom a walk of any effort or distance would be the happiest of days. I’m 55, so I shouldn’t expect to run like I did, skip from one workout to the next with ease, or eat anywhere close to what I consumed as a faster, sleeker, younger athlete. Lower energy, weight gain, inability to focus–this is what happens when you age. “Accept reality” is her mantra, so she clamps a firm hand over my mouth: “Shut up,” she says. “Quit looking for excuses.”

The Fatigue Update (or What the Doctors Say)

Right now, I’m having a hard time finding an external informative voice. Since this chronic fatigue popped up in August 2016, I’ve been working my way through a diagnostic checklist of doctors.

General Practioner: My GP of some 15 years agreed something was off and ordered a full physical and comprehensive blood work (normal). She recommended a sleep study, revisiting my endocrinologist, and seeing a rheumatologist. Then, she moved to California. I miss her so as I transitioning to a new GP (still working on this).

Sleep Study: An expensive item to check-off the list. Thank goodness my husband’s work provides the Cadillac of insurance. No problems there (but I did satisfy my curiosity about this weird test; see link in “Learn More”).

Endocrinologist: Since 2005, I’ve seen an endocrinologist for hypothyroidism. He’s the doctor who discovered my gluten sensitivity and had me test for celiac disease (negative). He did more blood work, checking for telltale traces of diabetes–it runs rampant in my father’s family. We reduced my thyroid medication and, in the spring, added a twice-weekly prescription-strength dosage of vitamin D. I’ve since been back and lab numbers are in the normal range. While these adjustments have made life more livable–I’m having fewer “I can’t get off the couch” bad days and exercising more consistently–the issue remains.

Rheumatologist: What a crappy medical experience…and I never set foot in the examination room. When I called the rheumatologist’s office, the receptionist asked extremely personal and detailed questions about symptoms and medical history. She also requested my Social Security number. Taken aback, I stammered a preference for discussing personal information with the doctor and refusal to give my SSN over the phone. Next, she said they’d need my medical records plus a $350 out-of-pocket fee (or was it $450? In my horror, I forget), and I’d be notified if I were a suitable patient. Wow. Despite two referring physicians, I needed to audition. Do I really have to tell you how this shook out?

Nutritionist: Since embracing running as an adult, I’ve tried to view my weight as the byproduct of maintaining a healthy balance of fuel and activity. I don’t exercise to become a certain weight: I’m a certain weight because I’m fit. My thinking then was, as long as my body was performing optimally, I’d embrace the results. Well, sleeping huge chunks of the day and an inability to exercise is not performing optimally. Even though I’d reclaimed some exercise, my weight continued to climb, so I turned to a trusted nutritionist for evaluation. Two consultations and a food log later, my diet was pronounced healthy and appropriate; the key, she cautioned, was properly adjusting intake on bad days.

Therapist: By November, I was depressed and decided to schedule time with a therapist–I’m still searching for the right one. I know I don’t look it now (even at my fittest, no one’s ever said to me, “You must work out!”), but whoever I unburden myself to must see me as an athlete who’s staring into the abyss of losing that identity. My spirits are better, and I thank a new workout group for this. I show up when I can, do what I’m able, and they love me no matter what. I don’t think anyone can ever know how important that unconditional acceptance and encouragement has been to my mental health.

Cardiologist: I’ve been opening up to friends lately, and when I mentioned my fatigue to one who’s a cardiac nurse, she questioned me closely about my family history. Relatives with heart problems, my dad’s quadruple by-pass surgery in his 60s, and several hereditary factors raised a red flag, and she suggested a heart evaluation. She recommended a doctor and even called ahead to his office. So I had a nuclear stress test (OMG, does everyone cry on the treadmill when they have to stop? No? Just me?) and echocardiogram (ah, the miracle of seeing and hearing your heart beat!). Today was my follow-up. The good news? My heart is normal and functioning as it should. The other good news is I now know a wonderful cardiologist in case Mother Nature ever hits me with the hereditary heart disease stick. And–this cannot be downplayed–he agrees that my fatigue is abnormal.

Next Steps on My Road to Wellness

Where do I go now? Recently, someone complimented my “beautifully analytic mind” (did NOT see that one coming, so it made my day), so here’s what I think are the next logical steps.

Investigate functional medicine. Several friends with complicated health issues have had good results from consulting a functional medicine physician. I’m going to do some reading and then make an appointment. New eyes may bring new insight.
Check out my genes. My Thursday walking buddy Dr. Stephanie has long encouraged me to undergo genetic testing. My online kit is on its way (yes, I’ll write about that experience, along with a recounting of last week’s nuclear stress test).
Focus on nutrition. Meredith Terranova, who’s guided me through all sorts of food-related issues (search her name here and you’ll see she’s been helpful in my weird allergy issues and a past bout of fatigue), has a special session this spring and I signed up. She knows me well and will provide educational and emotional support as I address this unhealthy weight gain.
Develop a kinder inner voice. This quieter commentator needs to pump up her volume. She tells me I’m doing the best I can. That working with what I’ve got isn’t the same as giving in to unhappiness and giving up on finding answers. That I’m more than a number on a scale. That friends and family love me for many things, not just the way I look or the activities I do with them.

She, my kinder inner critic, reminds me that enjoying life’s journey is what matters most. Some days, I just need to work harder to hear her.