journal/

on-going mostly unedited stream of thoughts
June 12, 2022

working with my triggers

I used to get triggered really easily. Something seemingly innocuous would set me off – sometimes I was good at hiding my feelings on my face especially if it was in a work or social context, but inside I would be melting down: there would be this sinking feeling, followed by a deep emotional pain flooding my senses, and after the incident I would be replaying it over and over again in my head and thus reliving the painful moment over and over again.

I didn’t know that was not normal. I thought this happened to everybody. Occasionally in intimate relationships I would explode, not in anger but in tears. I attributed all of this to my personal character: that I was just emotionally sensitive.

Only in the recent years after reading a ton of books I learnt that not being able to self-regulate is not only a thing, but an unhealthy symptom of a much deeper cause. It seems so obvious now but I was not even aware of the concept of triggers. I was melting down so frequently I just thought I was sensitive to everything and was easily upset, I didn’t know there were specific triggers to me.

I started to notice. At first I was fearful of my triggers, and tended to avoid them. For a very long time I even avoided any human interaction (apart from my partner) because they were a major source of triggers. I accidentally found out when I was in a phase of unprecedented emotional stability when I was addicted to playing Stardew Valley so much that I ignored my phone for two weeks. Of course I thought it was being immersed in the game, but I slowly realised it was because I hardly interacted with the outside world because of the game.

I don’t know when, but there came a time when I started becoming amused by my triggers. I guess that is a sign of healing for me. I was amused that I was so easily set off by something so small. I could note the uncomfortable sensations and yet not spiral downwards. Sometimes I would still spiral, but feel incredulous afterwards. Once in a while I laughed at myself with my partner (of course I have to be the one to laugh first). One day, I suddenly had this thought that my triggers were a source of knowledge for me. It identified areas I was still struggling with, where I still felt broken and hollow. It was an alarm bell for allowing me to notice where I was still hurting, and where I could work towards healing.

For example, I get really upset if my partner interrupted me while I’m talking. If we look at it superficially, it may seem as though it is because of my fragile ego. But upon deeper reflection, this is a strong trigger for me because it subconsciously reminds me of all the times (especially during my childhood) when people talked over me all the time, shut me up with a sssshhh, making me feel unheard and unimportant. It was as though I didn’t matter, that I was invisible or annoying. Practically this seems like a very small issue, no one is going to die if they feel unheard. But existentially, it provokes a deep sense of despair – we might as well not exist if everything we say does not matter. It is part of human nature to want to be acknowledged and be seen. Perhaps when we were cave people this could be an actual threat because being unheard could mean we were being left out of the tribe which has real life and death consequences.

When I get triggered now instead of spiralling deeper and deeper into “I don’t matter to anyone I might as well cease to exist” territory, I take the opportunity to ask myself questions. Is it true that I don’t matter? Why do I feel like I don’t matter? Does it matter if I don’t matter to this person or this situation? Am I able to calmly manage the situation with the other party, either picking up the conversation where we left off, or explain to the other person why it is disruptive to be interrupted?

I try to see these as chances for me to work on my emotional resilience and self-regulation. If I’m emotionally stable such an infraction wouldn’t bother me, because I am able to look at the reality of what’s happening and be fully aware that the worthiness of my existence does not hinge upon somebody not paying full attention to me. Maybe I’ll feel slightly annoyed because I am only human, but I wouldn’t start feeling despair.

While searching my private journal I came across this entry I noted about Lady Gaga, who wrote an open letter about her triggers:

I also struggle with triggers from the memories I carry from my feelings of past years on tour when my needs and requests for balance were being ignored. I was overworked and not taken seriously when I shared my pain and concern that something was wrong.

– source

…her psychologist added a note at the end in response:

It is my opinion that trauma occurs in an environment where your feelings and emotional experience are not valued, heard and understood. The specific event is not the cause of traumatic experience. This lack of a “relational home” for feelings is the true cause of traumatic experience. Finding support is key.

In that journal entry I wrote that I was triggered by reading that open letter, because it made me relive my own memories of “my needs and requests for balance were being ignored”.

This was in 2016, which is interesting to me now because I don’t feel much emotional reaction from reading the open letter again. I think this is where taking notes and writing journal entries on our reactions and responses to various stimuli is useful, because it demonstrates the emotional distance we’ve made between our past and present selves. I take it as a sign of healing when I am no longer triggered by what used to upset me so much in the past.

When we are chronically wounded, we need time and distance away from our triggers. I think I would not be able to heal if I kept putting myself in situation where I was being repeatedly triggered. Neurologically our nervous systems would not be able to rewire its neurons if the same pathways keep getting activated.

I aspire to become more whole as a person, and instead of running away from my triggers I see them as a source of wisdom. What do I find threatening? Why? is there truth in the degree of threat in that particular situation, or are they shadows of my past haunting me even though I am no longer that fearful and vulnerable child? Once I find the answers, I try to see if there are ways to mend that crack in me, or is it something I would need to carefully manage for the rest of my life. I am not sure if I would ever get over my fear of abandonment, so I try to communicate to my partner the sense of safety I need to feel, even if it feels frivolous to other people.

Not everybody is able to get some distance from their wounds and triggers. Some people have much deeper wounds, many are trapped in a circumstance that does not allow them a space to even breathe. I know I am lucky in the sense that I was able to alter my environment as much as possible. I am also lucky to meet a partner who is willing to work through both our triggers instead of just attributing it to our “tempers” and personalities. We don’t erupt for nothing, there is always a root.

I feel like because I am able to work with my triggers and examine them, I am able to expand as a person. In general I am more aware how I cause hurt to myself and to other people, reducing my hurt footprint – how much my footsteps are causing hurt to other people – in the world. This is partially why I strongly believe our civilisation as it is now will never progress much as long as we don’t provide a strong psychological support to people, instead choosing to focus only on economic success. Heck, we don’t even provide a strong physical health infrastructure, much less psychological. We as a species really don’t prioritise our selves, despite contrary beliefs. We prioritise our self-short-term-material-interests, without knowing we’re pain distributors. Maybe we’re all just trying to survive in the ways we know how.

If only we can collectively progress towards examining our pain with curiousity, instead of directing it towards ourselves and other people.

June 5, 2022

when only words are left

I just finished reading “No longer human” by Osamu Dazai – the book is problematic because of its misogynistic themes but also representative of its times, published in 1948. I picked up the book because of a thread on reddit where people said it deeply disturbed and depressed them. I guess that says something of me.

The book did not disturb or depress me. I related to a lot of it (not the misogyny but the depressive themes), and because of the relatedness it was somewhat comforting. Most of us don’t want to be lonely and it was comforting to know of other humans who have similar disturbing thoughts. It also gives me a wider perspective when I am reading it from a third party point of view, whether these thoughts have any basis in reality or they are plain delusional – an outcome of an inability to rise above the mind’s narrow thinking. The truth is probably a mix of both: humans are neither only good or evil, they are a complex outcome of their complex circumstances. But it becomes a problem when we insist on only seeing things in black or white.

I appreciated the author’s mind, and it made me want to deliberately expand my reading repertoire. It wasn’t a book I would have come across if I did not discover it on reddit. I’m so used to looking for books in a very particular way, and because of time anxiety I am also caught in the trap of only wanting to read books that has a high rating (4.5+). Gone are the days when I’ll randomly read books based on their back covers. I am trying to correct my course though.

Concurrently I was also reading Ursula K. Le Guin’s “No time to spare“, and I learnt that she started blogging at age 81 because she saw how Jose Saramago started a blog at 85:

So though I have contributed a few bloglike objects to Book View Café, I never enjoyed them. After all, despite the new name, they were just opinion pieces or essays, and writing essays has always been tough work for me and only occasionally rewarding. But seeing what Saramago did with the form was a revelation.

Seeing her make the distinction between writing essays and blogging was thought-provoking. What exactly was the revelation to her? I mean writing a blog can be a lot more free and casual compared to writing an opinion piece on Washington Post, but is that what she had meant? Or did she mean that Saramago was able to express everything in his mind in a way that traditional publishing would never have allowed? Upon googling more:

I just have somehow always sort of hated writing essays. I could [laughing] just pretend that blogs weren’t essays, and so I could enjoy batting one out and then sortthe-notebook of polishing it, you know. Because the form is supposed to be short — I think I tend to approach an essay as if it ought to be 20 pages. I make too much of essays, before I write them. And talks. And so the blog — and you know, with Saramago — it was reading his blogs and thinking if he can do that, I wonder if I can? And just sort of write about what was on his mind. But thoughtfully. So — of course they are essays, aren’t they.

– Three Conversations With Ursula Le Guin, Leaflemming

I guess it is about the idea that blogging doesn’t have to be so formal and hence the cognitive friction to write is less. That is why I made the notes section, I want a form that is even more casual than blog posts. But even then it is still difficult for me to casually write a post and click publish.

Reading a good book is like having your brain tickled, just like good music or any form of art. I appreciated how different the tickle felt reading Dazai versus Le Guin. It prompted me to tweet this:

…and I wanted to write a post about the importance of self-expression but I remembered that I have already written one. Obviously we are not Dazai or Le Guin, but there were countless times I’ve come across some random blog post and I was like, wow, what a mind.

Minds are fascinating: they just meld things together in unexpected ways and we can see them expressed in art.

And if you’re like my younger self, maybe you’re like who cares about art. Isn’t it more important to build visible world-changing things like non-profit organisations and businesses?

I am biased of course. My disability – no matter how mild compared to many others – has stripped away most of the utility of my life, the parts of me who used to be able to contribute things that society has traditionally valued. When nothing usable is left of me, when I can no longer meaningfully design things, write code, perform manual labour – is my life still worthwhile to society, to people whom I care about, to me?

Only my words are left. I could still write in between days I am not bedridden with pain. I don’t have capacity for much else, the capacity that every one else possesses, that most people take for granted. That is why I am still refusing to meet people and travel, because writing is the only thing I have left and I am not sure if I can still survive if (long) Covid takes that away from me. I won’t be able to survive. The migraines are already hard enough, and they are already making me contemplate my life more than a human is supposed to.

My migraines have defined my life and me profoundly. Because of them I had no choice to go deeper into myself – because when my external life is robbed from me, there is only an internal life left to look forward to. I would like to think of it as a blessing in disguise, but I wouldn’t have an alternative to compare to. I am a lot less unhappy than my past selves, aided by the introspection that can only come from the immobility of a disabled self. But who really knows how would I have unfolded had I stayed healthy?

Yet everything that have been written here can only be attributed to a person like this, like me. Just like only Dazai could have written “No longer human”, or only Le Guin could provoke people with her blogged words at age 81, the words that have flowed consistently and unabashedly here can only have come from me.

I don’t have much to give to this world, only my words are left. There are hundreds of people that arrive here every month – probably most bounce because in a lot of ways this is not attractive reading, but there are some who stay, and once they stay they really stay. There are some who leave after a while because they can no longer relate to my writing or I’ve changed. That is okay, because that is representative of reality. We can’t expect to like the same things forever. We can’t even like ourselves forever. This impermanence is what that drives that incessant creativity of human beings.

When I look back at my words, are they enough to sustain an existence, to make my life worth while? I have increasingly come to believe that this is not a question I can answer. I can only write them because I have to. I can’t do much about what people do with my words. Even if nobody reads them I will still write them, because this is the only way I know how to exist, and this is also the only way I truly get to know myself.

There are only words left, but these are words that can only come from me. That makes them precious, even if only to me, and for me.

This is why for me self-expression and art is precious. They gift a dimension of life that is utterly useless but yet perhaps it is the only thing that can capture the soul of human beings. I can’t know much about you from your wealth, status, career, possessions – even people who are supposed to know you may not really know who you are, but your art speaks a truth about you that doesn’t come from elsewhere. It comes from melding everything about you.

When everything is said and done, what is left? For some people it may be a building in their name, others may have patents, memories, loved ones. For me only words are left. They may not indicate whether a life was worthwhile, but they express a life that is lived, reflected upon, absorbed and felt. Maybe we can’t really control whether our lives are well-lived, but I can at the very least, attempt to feel it, process it, express it – thoroughly.

May 29, 2022

my first week of wearing a continuous glucose monitor

I’ve mentioned in a recent post that I’d be inclined to try out a cgm (continuous glucose monitor) as I’ve been pricking my fingers more than 5 times a day in an attempt to understand my metabolism better.

I’d managed to pluck up the courage to finally try one last week. I got my partner to apply it for me because I couldn’t bring myself to press something that would puncture a hole in my arm. It was not entirely painless, my arm seemed to ache for at least half a day, but a week on I think it is worth that minor discomfort for the fidelity of the data I am getting.

I thought wearing a cgm would just be a more convenient version of pricking my fingers. But having an instant read of my glucose levels anytime I wanted taught me more than I expected. It also stores glucose values every 15 minutes in the background as long as you scan it every 8 hours, which you can then access as a downloaded spreadsheet online.

Things I learned

the first 12 hours are trash

I read on various online forums that the first 12 hours of the Freestyle Libre is inaccurate because the area around the CGM needs time to heal after the puncture (ouch). They recommend performing the first scan after 12 hours because the sensor counts its validity 14 days after the first scan. I did not heed this advice because I was too curious, so indeed my first day was full of low glucose readings.

how long does it take for glucose to spike after a meal

While using a standard glucose meter I tend to prick my fingers at the 1 hour mark post-meal, and sometimes 2 if the 1 hour reading was high. I had the assumption that the peak reading would be at 1 hour. But the cgm showed me that most of the time my peak reading would actually be at 30 minutes, and sometimes it actually peaks at 15 minutes, especially if I eat fruit. So if I was interested in how high my blood sugar would peak I should be pricking my fingers at 30 minutes instead. But 1 hour would be a good insight into how quickly my blood sugar can go back to its baseline.

This chart shows how I would have missed the 15-minute peak if I pricked my finger at the 1 hour mark as usual, but the CGM captured it (big blue dot).
This chart shows how I would have missed the 15-minute peak if I pricked my finger at the 1 hour mark as usual, but the CGM captured it (big blue dot).

how damaging are temporary spikes

For a very long time I was afraid of eating fruit because it would always seem to spike my blood glucose pretty badly. But with the cgm I learnt that while it does provoke a sharp spike, it does recover quickly. The medical literature is still unclear how high a temporary spike has to be to be damaging to our blood vessels. But it does show that high post-meal glucose is associated with an increased risk of cardiovascular disease, even when compared to a high baseline glucose levels:

Epidemiological studies have also suggested that postprandial spikes of high glucose levels may be a more robust determinant of CVD risk than average glucose levels. These episodes of high glucose levels increase oxidative stress, which in turn has several detrimental downstream effects, activating immune cells, and keeping the vasculature in a persistent state of elevated risk of cardiovascular events. To further support this hypothesis, postprandial blood glucose (PBG) levels are more predictive for CVD than HbA1c levels. Even in people without diabetes, PBG levels independently predict CVD in the non-diabetic glucose range.

– source

But our glucose does spike pretty high whenever we perform intense activities, so the body must be able to tolerate a certain threshold of spikes. It is just that so far I haven’t come across any research that specifies the threshold. Personally I would not eat a lot of fruit though, because only the liver can metabolise fructose and modern day fruit is now sweet beyond what nature intended.

how close are the readings between the cgm and finger pricks

I have read horror stories of how cgms are a lot more inaccurate than finger pricking, but surprisingly for me the readings are quite close, especially if I account for the 15 minute lag (the cgm lags 15 mins behind because it measures the interstitial fluid instead of the blood). I was expecting to see readings to be off by 1 mmol/L consistently, but it seems like their difference is typically less than 0.5mmol/L. There are however some extreme spikes when the reading was off: the cgm measured 6.8mmol/L while the finger prick measured 7.8mmol/L:

the values of the CGM were quite close to finger pricking except for some extreme spikes
the values of the CGM were quite close to finger pricking except for some extreme spikes

stress causes glucose spikes

I always knew this intellectually, but it was still provoking to see it in action. There were a few events last week that caused some stress, and my glucose went from a 5+ baseline to spike over 6+. I can imagine how chronic stress can cause cardiovascular disease: repeated spikes cause arteries to be damaged and then hardened. Those stressful events were not even that stressful, I cannot imagine the sort of spikes I had when I was chronically stressed by work and people.

Since illness is also a form of stress, my baseline glucose seems to run higher during the menstrual cycle and its related migraines.

the first sourdough experiment

Sourdough is supposed to have a low glycemic load because of its fermentation. I miss bread a lot, so one morning I ate one small slice of sourdough with some tuna, ham and cheese as an experiment. Surprisingly my glucose didn’t spike much, but it also took much longer than usual to recover to baseline. This coincided with a day with some stressful events, so I’ll need to try it again.

general patterns

Apart from whatever I wrote above, it was still very interesting to observe my glucose patterns in general. I thought apart from meals my glucose would be stable around its baseline, but it actually fluctuates up and down around +/-0.5mmol/L. It seems that the liver releases some sugar from glycogen every time the circulating glucose runs low.

It is also nice to see that apart from stressful days when I may be ill, my glucose levels at night are pretty low and stable – not doing anything crazy. There are a couple of spikes here and there as the body is probably repairing itself.

closing

This is just my first week so I am just documenting my initial observations. I’ll probably continue to wear a few more to decide whether it is something I would wear permanently. They are not cheap, but I was also spending quite a bit on glucose strips.

I am not sure what is the end game – if enough experimentation would form a subconscious database in my head and I wouldn’t need to do so much close monitoring to maintain my metabolic health. But I find the extra information useful for non-metabolic reasons as well, like if my glucose is higher than usual I should have an easier day because it indicates stress.

Also, it would be useful to monitor longer-term trends. For example, if I build muscle, would my glucose response improve with the same foods? Will there be a co-relation between my glucose control and my migraines? I’ve been allowing myself more carbs as an experiment, therefore producing higher post-meal spikes than usual. This cycle (right now in fact) I am experiencing a mild migraine. Is it due to my increased carb intake?

I’ll try to see if I can get a hba1c test (avoiding clinics because covid) to see if the reported a1c value by the cgm is accurate. I would also be interested to test more foods that I usually avoid.

related reading:

May 22, 2022

the box on our heads

This week I finished reading “What my bones know” by Stephanie Foo: a memoir on complex PTSD (CPTSD). Reflecting at different stages of the author’s story, it reminded me a lot of my own ongoing healing process.

Even though now at times it is still difficult for me, I do forget how bad it was for a very long time. Reading the book brought me back to those times, when I was always angry, sad, self-loathing, chronically suicidal, exhausting. Always. For decades. It has only been a few recent years that I feel like I am moving forward, a process that took a few million tiny steps. Like the author, knowing that I have CPTSD (someone recommended me Pete Walker’s book) was life changing.

If our bodies are hurting, we can only start to heal if we know where is the injury. Knowing the nature of the injury allows us to apply the appropriate treatment for it. Otherwise it is like walking blindly in the dark. For people with mental/emotional pain, we might not even know we are hurting, maybe because when we’re in the same state for years and years, we don’t know there is another possible state. We may think being in a state of constant hurt is the baseline for any human being. Some of us grew defences so thick all we feel is nothing. There is no hurt in nothing, right?

Reading Pete Walker’s book made me realise precisely why I was hurting, why it hurt so much, and why I always seemed to be going into these emotionally painful states very often. I wasn’t even aware how my life was coloured so deeply by these until I started to experience them less frequently.

The change was very slow and painful, but the accumulated difference is dramatic. Only upon hindsight I realised I was walking with a suffocating box around my head, limiting everything I see and experience. I had such a narrow view of the world, of people, of myself. It was constrictive and deadening.

CPTSD aside, I think the concept of having a box around our head applies to social conditioning in general. We’re all brought up with all these rules, norms, expectations, ideas.

illustration of small box around our heads versus a bigger wider sphere. by @launshae.
box vs wider sphere (illustration by @launshae)

How much more can we see and experience if we remove that small, tight box around our heads? We will always be trapped in a limited sphere of perception because we have inherent conditioning and biases as human beings. But we could endeavour to widen this sphere, to experience a fuller version of life, of this world, of other people and our selves.

This is one of the reasons why I keep a daily journal, and that I try to review my past entries, tweets, instagrams, etc on a daily basis. I get reminded of how small was the box on my head trapping me, and how much more I am seeing in my widening sphere. The differences are stark, and I cannot help but feel sorry for my past self. I have wasted so much time.

It adds to my time anxiety, that somehow I worry that something bad is going to happen to me just when I am beginning to truly experience the world and become who I am (this is also a symptom of CPTSD – always thinking the worst is going to happen). Having been chronically suicidal I never really cared about my future – which at times worked out well for me as I took on risks normal people would never take – but I have found myself caring about it in recent times. It is truly weird, to want to live a little more after so many years of secretly hoping I’ll get knocked dead by a car.

Similar to the buddhist belief that we are not our thoughts, I think we’re not the boxes on our heads. What lies underneath? I see people express their bigoted beliefs, and I wonder if they are aware of the boxes on their heads? How do we make people see wider than the limited views we’ve been conditioned with?

It is tiring, to be suffocated with limiting views all the time, to perceive fellow human beings as inherent sinners instead of actually seeing that we bestow ourselves with traps the moment we’re born. We all have to be obedient children, get good grades, get good jobs, fulfil our gender and societal norms, meet everyone’s expectations, achieve high status, etc, without stopping to ask what is the whole point of our existence? How do we wish to live, how do we want to engage with our fellow human beings Is a lifetime of condemnation and policing people including those we love a really good way to live?

Human beings seem to be self-sabotaging, I really wish we could see that. That we suffocate ourselves with unnecessary boxes.

May 15, 2022

why I prick my fingers 5x a day

Some time in 2018 I bought a glucose meter. I cannot remember exactly why – I was probably worried I was diabetic because I was frequently getting serious food comas after eating. By “serious” I mean the level of drowsiness was so overwhelming that I could not keep my eyes open no matter how hard I tried. I think I bought a glucose meter for a peace of mind, to assure myself that I was actually fine.

Like many people I was afraid of getting my finger pricked, but curiousity won so I braced myself. We imagine it is like a pricking our fingers with a needle but a good lancet is so fine and quick that the sensation lasts for less than a second. I remember panicking when I saw my first result – in the pre-diabetic range. Then I realised I did it after my regular 2-in-1 instant coffee (yes I love this actually), so I panicked less. But the result next morning didn’t seem ideal either.

home glucose meters vs blood-drawn tests

Glucose meters are home devices and are considered “accurate” when they are 15-20% within range, 90% of the time. Which means they are actually not accurate at all, because 20% can mean 5 mmol/l or 6 mmol/l. 5 is considered normal and 6 is considered pre-diabetic. But it is useful for monitoring trends, and there are meters which are known to be more accurate than the others. We could also get a HbA1c test at which checks for blood sugar control during the past 3 months.

Months later I plucked up the courage – this time real long needles are used – to go for a blood screening. I was also reaching a plateau with my migraines and wanted to see if there are any biomarkers that are abnormal. My HbA1c test then was 5.5. The doctor was like, “see, nothing is wrong” but the prediabetic range now starts from 5.6. I thought 5.5 meant that my blood glucose was also 5.5 mmol/L which is not ideal at all but still acceptable, but years later I found out 5.5 of a HbA1c actually means an average blood glucose level of 6.17mmol/L (111.3mg/dL) which I would consider pre-diabetic. Doctors are only concerned when our levels reach 7mmol/L, but by then it is indicating serious insulin resistance. Research shows that when we’re in prediabetic stage our beta cells are already 20-40% damaged. If this is caught early enough the damage can be reversed.

insulin resistance -> hormone imbalances -> migraines

concept map demonstrating how too many carbs can result in migraines

Honestly, maybe I wouldn’t care that much if being pre-diabetic means I could continue to eat whatever I want and get it managed by medicine. But insulin resistance causes hormonal imbalance (and polycystic ovary syndrome), which contributes to the severity of my migraines. Before I was on a regular low-carb diet I was frequently having serious PMS: painful migraines and breasts, wild mood swings, suicidal feelings. PMS aside I was frequently tired and it would be normal for me to wake up fatigued with serious brain fog. Medicine can only manage blood glucose levels, not improve insulin sensitivity.

I also do not want to surrender to the diseases we assume are all part of getting old. Currently my blood pressure is 100-110+/60-70+ (101/65 at this very moment) when many people around my age (41) or younger is already diagnosed with high blood pressure.

I think as a society we’re conditioned to only worry when things go through with our body, but chronic damage is invisible and takes a long time before symptoms appear. There is also a difference between optimal health and the minimal health that is required for survival.

I’ve never been healthy until the last 7 years, but now I feel like I have a taste of what it is like to be truly healthy.

pricking 5x a day

I went from pricking my finger every morning when I wake up to pricking it one hour post meals – which means I prick my finger 3x a day. In the recent months I have begun to prick my finger pre-meals as well, so that means 5x a day. Testing blood sugar post-meals can help clarify what food is creating unhealthy spikes, because they can cause endothelial damage – contributing to high blood pressure and cardiovascular disease. I now test pre-meals because they show if my blood glucose levels returned to baseline after my previous meal. If I eat a bad breakfast my blood glucose level can stay elevated for more than 3 hours – it should return to baseline by the 3rd hour – sometimes it would not return to baseline by the time I eat my dinner.

is it necessary

Some people only test their fasting blood glucose in the morning, but I’ve learnt that we can have a good fasting blood glucose but a bad hbA1c. It means that the body recovers enough during sleep to get to a good enough glucose baseline in the morning, but on the average our blood glucose can remain high in-between meals and throughout the day.

I also tend to succumb to temptations very easily, so a chocolate cake here and an ice-cream there. It is just once in a while, why would it be so bad? I ate “healthy” things like granola and apples – if you love them please do not test your blood sugar after eating them.

It was hard to ignore what my food choices were doing to my body when the data is so clear. I went through periods when I stopped testing because it was just easier being in denial and still eat my favourite foods.

Maybe many people can get away with less vigilance. But I know I can’t. Some people may think people like me have an eating disorder because I intermittently fast and can be really strict on what I eat. But trust me, I would not do this if I can eat anything I want and be pain free.

positive reinforcement

Testing my blood sugar frequently allowed me to see the patterns that come out of my food choices. I noticed eating a lower carb diet in general gave me stable energy levels (no more blood sugar crashes) and made me have a lot less cravings. I still crave, because I am addicted to food as pleasure and comfort. But the sort of cravings I get is not the type I used to get, those cravings were physiologically unbearable. I tend to think twice now when I feel tempted, because I would have to live with an ultra-high glucose reading later, and knowing the damage it could inflict just makes it difficult. Isn’t it a form of self-sabotaging if we know something is harmful to our body and yet we keep ingesting it?

considering the short people curse

Being short has its perks but it also means the ability to absorb glucose is a lot less compared to an average man. I think this is why many women deal with hormonal issues, because we are not very aware that we’re eating the same level of sugar as men. Imagine going to MacDonalds with your taller friend/partner. We both order a meal each right? But our body mass and hormonal status determines how we handle the resulting glucose from the very same meal. Think about bubble (boba) teas, starbucks drinks, restaurant meals. Short people ingest the same amounts most of the time as our taller counterparts. It is not like short people order short sizes and taller people order the ventis. Yes, biology and genetics suck sometimes. But my partner tells me I’ll survive longer if there is a famine. ;/ I have been re-evaluating the portions I consume ever since I had this epiphany about my height. It is very easy to over-consume sugar if I was not mindful that I am consuming portions that is meant for an average-sized human being.

balance & experimentation

I get less migraines now, and they are less severe. I have better mental clarity and have a lot less body aches and fatigue. My PMS symptoms are mostly gone, I don’t even get bad cramps anymore – just slight crampy discomfort instead of the disabling ones. I’ve been doing this for a few years now, with periods in between when I just take a “holiday”. Pre-covid I would also take a break whenever we travel. But I notice myself wanting less breaks now, because every I take a break it was fun and all during the break, but the suffering afterwards can be extremely painful and prolonged. I keep asking myself if that short-term gratification is worth the longer-term consequences.

I am still trying to find a sustainable balance, and experimenting with the amount of carbs I can eat without terrible spikes to my blood sugar. I hope to not avoid entire foods but rather eat reasonable portions. Sometimes I take a couple of bites when my partner eats a pastry.

I’m going to experiment with a continuous glucose monitor (cgm) so I can stop pricking my fingers 5x a day. I’ll probably be more adventurous with my food experiments since I can get a blood glucose reading anytime I want. I think pre and post-meal testing has actually expanded my food choices. Previously I would just avoid everything that resemble carbs. Now I am discovering my tolerance.

I am not sure if people find posts like this interesting. But it would have helped me a lot if I read something like this early on in my health journey, instead of searching blind in the dark. Maybe someone struggling with PMS and migraines would find experimenting with the blood sugar readings helpful. Since managing my health is such a large part of my life, I foresee myself writing a lot more similar posts with experiment findings, and probably finally working on a wikipedia-style notebook that pulls together everything so it can be used as a public resource for anyone stumbling onto this site.

May 8, 2022

insights from a forest monk

I like to read Buddhist books because it serves a radical narrative compared to the ones we’ve been served in mainstream society. It teaches us to understand the nature of our suffering, and tells us it is possible to liberate ourselves from that suffering. That even the Buddha said that it is important to investigate our experiences, not to believe him wholesale. In a largely materialist society, it is important to know that are alternatives to our mainstream way of living, which is to control, conquer, acquire, consume – almost always a more of everything. Buddhism teaches us that control is just an illusion, it is not by having things that we can gain true joy, but rather learning how to let go and accept the impermanence of life.

A while ago I picked up “I may be wrong” by Björn Natthiko Lindeblad at a book sale. These days we seem to only pick up books when it is “trending”, so it was a lovely experience to actually go to a physical book store, browse books on a shelf, and pick up a book because something about it called out to you. It could be the cover, the synopsis at the back. In this case I liked that it was a memoir of a former forest monk. I’ve read books written by Tibetan and Zen monks, but none from a forest monk yet. And a Swedish forest monk?! The forest monk tradition is considered quite obscure compared to Tibetan and Zen Buddhism.

Photo of book: "I may be wrong"

I thought I’ll note down some favourite bits and share it here. In the prologue, it opened with:

“What I value most from my seventeen years of full-time spiritual training is that I no longer believe my every thought. That’s my superpower.”

That we are not our thoughts is not new to people who are familiar with Buddhism, but seeing it explicitly called out like that by the author was still provocative to me. I have found more emotional freedom ever since I learnt to examine the reality of my emotions at a distance, so I deeply related to that statement.

He tells many stories about the wisdom he had learnt from his fellow forest monks. The title of the book came from a lecture by Ajahn Jayasaro:

“The next time you sense a conflict brewing, when you feel things are about to come to a head with someone, just repeat this mantra to yourself three times, sincerely and convincingly – in any language you want worries will evaporate, like dew from the grass on a and your summer morning. I may be wrong. I may be wrong. I may be wrong.”

We’re living in a world where everybody wants to be right, and it has led to divisive conflicts that has detrimentally impacted life for many people. We insist on being right, there is no room for differences, negotiation, accommodation, empathy. We start citing lines from books on why we are right, and we want to be right at the expense of people’s lives. The idea that anyone of us may be wrong at any given time could be life-saving in many situations.

The line that stuck most deeply with me was from Ajahn Anandabodhi, a forest nun, something she said to the author when he was tired and overworked:

“Natthiko. Don’t forget: responsibility – the ability to respond.”

I have never thought of “responsibility” as the ability to respond before. The word “responsibility” just sounds like something we must do or carry no matter what, regardless of who we are, how we feel or think. It is like a moral obligation that must be undertaken, something that doesn’t give the freedom of choice.

But thinking back on all those times people/I thought of me as irresponsible, and all those times when I felt other people were irresponsible – both causing much internal suffering in me – I realised most of the time, it is not that people choose to be irresponsible. It is simply because we don’t have the ability or capacity to respond. Life can be very overwhelming, and due to the inherently violent and traumatic nature of society people’s capacities can be very limited. How do we have room to carry more and heavier things when all our lives – since the moment we are aware we are conscious – we have been weighed down and scarred by so much? There is no nurturance, no gradual scaffolding. We can’t ask someone who has never run before to run a marathon. The capacity to respond like training for a marathon, has to be gradually developed.

Insights like these, they slowly free up space in my small, constricted heart. Instead of resentment I just feel sorry. For people, for myself. This sorriness makes it harder for me to resent. I still do, just less.

The other notable parts of the book I appreciated are about the lifestyles of forest monks. They eat only one meal, and they can’t eat after noon. They cannot handle money, so they rely on alms from the generosity of the public, which means they eat anything that people donate. Here I am, regularly feeling sorry for myself (again) when I intermittently fast and eat a “strict” diet. I can still choose whatever I want to eat within the boundaries of my chosen diet, and I can eat a large and varied meal if I choose to omad (one meal a day). Comparatively to the forest monks, it would seem like I am feasting. Of course life is not a suffering competition, but the whole point of these practices is not to teach them to suffer, but rather to practice how to respond when life is not within their control:

Monastic life was designed to frustrate the mechanisms we employ to exert control. That was one of the reasons we didn’t handle money, weren’t allowed to choose when or what we ate, who we lived with or which hut we slept in. Being forced to relinquish control was a deliberate part of the learning process. And the result was wonderful. It’s a gift to be able to rest in trust when life becomes uncertain, to be comfortable with not knowing.

This is something I want very much for myself. I don’t agree with everything he/Buddhism preaches. He uses the word “trust” a lot, like life is something to be trusted. I don’t share that faith, at all. I think life is ambivalent, it just is. But I do believe it is helpful to live life for what it actually is – that it is uncertain and impermanent. I think there is freedom that can arise from being fully aware and present to what life can gift and take away from us. A lot of suffering comes from the illusory belief that we can control our trajectory, and also from the avoidance of pain/death. When we are willing to meet things upfront, we save a lot of energy from all the time we spend trying to avoid it.

I am still struggling though. It scares me to think about people I love dying. But I think about it regularly, I try not to shy away from it. It will not lessen my grief, but at the very least I will not be surprised with a ton of regret when the times come.

How do I increase my own capacity to respond? I think it takes constant practice and meditation – maybe meditation is the practice. I don’t trust life inherently, but I do trust my capacity to change, because I know how much I’ve changed – or rather learnt to understand myself better so I can stop repeating unhealthy behaviour. I have so much gratitude towards books and the will of authors to write them. Without the generous sharing of their insights, who would I have become, or worse, who would I still be stuck in?

May 1, 2022

10 things I am thankful to my partner for

Tomorrow will be our 6th year together. I like documenting our relationship as the years go by, because everything is always changing. I feel tremendously grateful that despite all the shifting variables – especially that we’re both different people from the time we’d met – we can still be together. Maybe for other couples they make one final decision and try to stick together no matter what, but we are both people who don’t like to feel stuck. If she were to become unhappy with us one day, I would let her go. I wouldn’t want someone to stick with me despite all the unhappiness because we said so once upon a time before. That is not my definition of love.

That is why it feels precious to me that after 72 inseparable months we still like each other very much. I think contrary to convention, it is much harder to like a person for a prolonged period versus love. The emotion we call love can come with sentimentality, with time, with familiarity and proximity. But you can’t make someone like another person just by putting them together for prolonged periods of time. I know love can exist without liking. It just wouldn’t be very pleasant. But liking, liking is what that makes one look forward to spending a lot of time together, because every moment is infused with potential. Love that exists with liking is turbo charged.

I thought to commemorate 6 years together – my longest relationship so far – it would be appropriate to write down a list documenting what I’m thankful to my partner for:

1. She likes what people consider broken about me

The reason why she plucked up the courage to slide into my DMs in the first place was because she read an essay I wrote about being chronically depressed and suicidal. She said that made her want to hang out with me. Till today I’m like “wut”?

one of her recent drawings of us. what does this say about her?

2. She has almost never discouraged me from pursuing any interests or choices

If she has, I don’t remember it. I wanted to learn to play the keyboard, she was like why not? Years later the keyboard is mostly untouched, and she’s like “maybe one day you’ll play it again”. When I started to get interested in bicycles, everytime we’re out she would suggest visiting a bicycle shop nearby. She has never made a snide remark about my ever-changing interests. She likes that I get interested in new stuff. She knows that it indicates my sense of aliveness. That it is better I am interested in something new rather than nothing. This may sound trivial, but I grew up actively discouraged from pursuing new interests because I can’t seem to remain committed to one thing. This has induced a sense of guilt each time I get obsessed with a new thing. Now I see it as my superpower. I think it is a wonderful thing in life to want to learn new things all the time, because everything brings lessons we don’t expect and their learnings seep into multiple areas of our lives.

3. She has given me a home

I was fostered out when I was an infant and had always felt displaced when I returned back to my biological home later. I moved out during my late teenage years and spent my 20s and 30s hopping around multiple rentals and countries. Because I had never felt safe anywhere, I had never known the concept of safety and what it means to feel safe. She was the first person who have gifted me the concept of safety. We bought our first home together, and she is also my psychological home. I know I can always return to her.

her art of us fitting together like a kueh (cake) and its mold
her art of us fitting together like a kueh (cake) and its mold

4. She is transparent with her thoughts and feelings

I was so used to playing mind games with people that I was surprised there weren’t any with her during our early days of dating. She was always so open with what she wanted, there was no sudden distancing or withholding (I know, I was always attracted to the wrong people). Later on in our relationship, this trait served us well when there was conflict.

one of my favorite photos of us: taken in the 3rd month of our relationship. We were co-working, and she puts her feet over mine.
one of my favorite photos of us: taken in the 3rd month of our relationship. We were co-working, and she puts her feet over mine.

5. She doesn’t hold grudges

You know when people fight they start digging up everything that happened in the past and the fight just becomes one giant mess about who did what to who. She claims she has a low memory cache, so she doesn’t remember upsetting things that have happened in our past. These six years we have fought quite a bit, but we hardly stack our resentments against each other in a fight. I think it is because of the tendency to openly communicate, so everything is usually resolved. At least I hope.

6. She is obsessed with her art

What has this to do with our relationship you may think, and why am I thankful to her for it? To truly experience this, one must live with an artist obsessed with their art. It is almost like living in an animated movie where one beautiful thing turns up after another. The beautiful things are never the same, and they continually surprise. I am someone who is barely alive, so I am very thankful to live around a presence that is full of spirit. Her spirit makes me contemplate my own relationship with my work.

7. She makes me laugh

I am someone who carries a large amount of sadness and heaviness, but since knowing her I’ve laughed more than ever in my entire life. She’s just so funny. I am laughing right now just thinking how funny she is.

8. She takes the effort to understand and learn about me

In the early days of our relationship she called me “cheerful” and I got upset. She took the effort to understand why was it so upsetting for me to be labelled cheerful. I have many difficult thoughts and feelings about life – the common reaction is usually “why do you think so much” – I guess because of point #1 above she is always interested to examine my feelings with me, and vice versa. Being able to process experiences together is powerfully bonding.

9. She is my witness

Because of the way I am I have always felt like people only get to see 20% of me. But having a partner live so intimately with me has this effect of making me feel much more whole as a person, because even I don’t trust my own experiences. I often gaslight myself, like I would ask myself if things were really as bad as I remembered. She has been there in the past six years to see me through some difficult and painful times, especially all those times I struggle so helplessly with my chronic migraines. She has heard me horribly retch many times in the bathroom because of the nausea that comes with the migraines. So many days of curling like a ball in bed. People don’t know how much life I had lost because of my migraines. But she knows, and that is enough for me.

10. She is a really good home organiser

I have become a neater person over the years before I had met her, but she is really good at providing structure and sense to all our household things. It is a subtle sense of security, to know things are always where they are supposed to be.

launshae's crocheted printer cover
She made this lovely cover for our printer. I guess everything has a “home”?

There are probably a million more things I am grateful to her for. But it is getting late, and I want to publish this because it is sunday! Hope there are many more opportunities to write posts like these to come.

April 24, 2022

bearing witness

Everyone is trying to move on with life declaring the pandemic is over, while a conservative estimate of 10% of the world’s infected population will face potential lifelong complications of the virus. I guess there is not much of a choice. No matter how much suffering there is and how many tragedies we face – pandemic or not – we can only try to move forward. This sort of moving forward can only be possible with some magical thinking mixed with denialism, and a lot of looking away. Maybe the difference is that I know I am looking away.

I’ve been entertaining thoughts of wearing a n95 mask with goggles to get on a plane so we can travel. Yet I know I will not be able to forgive myself if my partner happens to be one of the unlucky 10%. Who knows? Do we want to play this russian roulette? I feel very envious browsing through the instagram stories of friends who are overseas right now. But I have no courage to do the same. Maybe the way I approach life has been forever tainted by my chronic illness. I remember I was in my 20s the first time Singapore had SARs, and I didn’t give a shit. Oh, the ignorant blissfulness of my youth, the unwarranted confidence in my body back then.

I personally believe the world will face some sort of collapse, if not multiple collapses in my lifetime. I don’t think I’ll suffer the brunt of climate change, but I’ll suffer the brunt of the many events that are already occurring because of climate change. Looking at how we responded to the virus I am not optimistic at all. Nobody wants to believe or know that things will be bad, so we’ll all try to live life as normally as possible, whatever normal means. Prevention is better than cure, but prevention is also a lot of hard work.

Unlike my younger self I don’t blame people for wanting to stay in their made-belief Disneyland while fire is burning outside. Even without all the issues we face, life is inherently difficult. I think we have limited emotional and psychological capacity. We’re like puppies, we just want to run around, smell the wind and have some fun along the way. We wish to love and be loved. Not crank for exams, tire our bodies out, exhaust our brains – just so we can pay bills and look good to each other – over and over again. But to survive we have to pay bills, and to pay bills we have to crank for exams, manage our parents, children, colleagues, clients, bosses, our unhinged psyches, our suffering bodies. On top of that we have to care about justice, the environment, politics, violence, society. I too, want to retreat into my own Disneyland.

I am one of those people who will write posts like this over and over again and offer no solutions. I can barely cope with my existence prior to this. I just want to lie on the sofa, sip my coffee and read a book. Not live through a million guilt trips of how much more I should have done as a human being or a thousand nightmares of getting long-term disabling illnesses.

I will continue to record these observations and feelings. Maybe I’m only good writing down these convoluted words so I can bear witness – to the world and her people, to myself and my hypocritical feelings. I will look away, but first I’ll acknowledge.

Meanwhile I’ll still try to savour whatever’s left of the world’s goodness: books, music, art, cooking, films, love, in the sanctuary of my own make-belief Disneyland.

April 17, 2022

diet & feast: biometrics & lessons

A while ago I celebrated my birthday by going off my strict-ish diet for a few days. I thought it would be interesting to document some observations with biometric data from the Oura ring.

This post ended up quite lengthy so I broke it up to several sections. Feel free to skip some parts:

Why I am on a diet

First off, I really like to eat. So much that I think I have a food addiction. If not for my chronic migraines I may have continued to consume a very unhealthy diet for a very long while until visible symptoms (diabetes, high blood pressure) from metabolic issues would inevitably surface as I get older. When I was growing up I was taught to believe that having high blood pressure is the norm as you get older. As a child I knew no one above the age of 40 who diid not have high blood pressure. I guess this is the norm when one of our popular breakfast options look like this… 

Nasi Lemak
Nasi Lemak, Wikimedia

…and other popular meal options are also delicious food full of carbs. Now I am not demonising carbs, I envy people who can eat them and sustain good-enough metabolic health throughout their lives. I am sadly not one such person. Even before I learnt that migraines could be related to glucose metabolism I had food comas right after meals and chronic drowsiness in general. Back then, I didn’t know enough to realise those were symptoms of unhealthy glucose metabolism (when I first started testing my blood glucose I was close to the pre-diabetic range). From childhood till my 20s I could eat McNuggets at 3am and not suffer from obvious side effects, so I thought that would be my norm for the rest of my life.

I have never realised that short people are at a disadvantage metabolically until recently. We require less calories to thrive, but the food portions of most meals are geared towards tallish men. This is especially true in the US, where I am pretty sure a typical meal can feed me 3x a day metabolically. But I was conditioned not to waste food, so I ate a full meal like my tall peers regardless of where and what I was eating, even when I lived in the US.

Imagine I need about 1200 calories to survive – maybe 1500 calories as a moderately active person – but I could eat a 800 calorie meal with bubble (boba) tea *and* dessert. Seriously, this was my norm for a long time. Again, if I could not suffer metabolic consequences I would do this everyday, because that’s how much I love to eat.

I wrote all of that to express how much being on a diet for health reasons can be difficult for me. But I really wanted to see if it would work to manage my migraines, so I had to try. I resisted doing this because of how much I love eating.

I’ve been on low-ish carb meals on and off throughout the years but from end-December last year till end-March this year it was the first time it was sustained for so long with almost no deviations, and also the first time I cooked most of my meals to control my macros, and avoid seed oils and high heat cooking.

It worked. I avoided having migraines completely for my last menstrual cycle. I cannot say it worked 100% because of my diet, because I did other things in tandem like getting 10,000 steps everyday, supplementing iron for the first time among many other supplements I take daily, and fasting at least 16 hours. I also stopped any form of intense exercise during my luteal period to reduce as much oxidative stress as possible.

In exchange I had terrible sleep for some nights and a horrible rash. So I started adding carbs back to my diet in order to heal from the rash, and I decided to take a break around end March, coinciding with our monthly anniversary and my birthday celebrations.

Biometrics from the Oura Ring

In those days I ate dinner later than usual, had 3 meals (usually I do 2), and I ate a lot of what I wanted and have been missing: noodles, waffles, french toast, french fries, cakes, a tamago sandwich (omg). It was still within reasonable control: I still ate half portions of the noodles, and I shared almost everything else with my partner.

Not surprisingly I could immediately see the effects on my Oura ring – my resting heart rate spiked for days:

screencap of Oura ring on the "worst" day
screencap of the Oura ring app on the “worst” day during my break

Compare the above to my last “worst” day of my previous cycle, during my luteal phase:

screencap of Oura ring on the "worst" day of my last luteal phase
screencap of the Oura ring app on the “worst” day of my last luteal phase

My resting heart rate went up by 7bpm! And it took almost a week to get back to my recent norm of around 50bpm – 52bpm during my luteal phase. My heart rate variability tanked to levels I have not seen for many months.

My heart rate also spiked till the 80s during sleep, and took longer than usual to recover to a restful heart rate:

screencap of oura ring: heart rate during sleep in the feasting phase
screencap of oura ring: heart rate during sleep in the feasting phase

Compare the above to the “worst” day of my last cycle – it still has spikes but it barely hit 70bpm, and my average heart rate was also 7bpm lower.

screencap of oura ring: heart rate during sleep on the "worst" day of my last cycle
screencap of oura ring: heart rate during sleep on the “worst” day of my last cycle

On a good night it could look like this – early recovery and barely any spikes:

screencap of oura ring: heart rate during sleep on a good night – barely any spikes
screencap of oura ring: heart rate during sleep on a good night – barely any spikes

Observations and lessons

At first I felt like I had “relapsed” and “failed”, but I realised it took me a pretty short time to bounce back into moderately healthy eating because I didn’t have to restart from scratch. I was restarted with compounded knowledge and skills from previous attempts. Also the feasting phase taught me valuable lessons about myself as well. If I didn’t give myself a break to feast I wouldn’t have known how far I could go.

I attempt to share these in the following:

Lessons learnt during the three-ish months I was on a strictish diet

  • cooking the right way for myself to sustain eating almost the same food everyday
  • cooking in way shorter time as I learnt to experience how to manage food prep, dishwashing, and cooking methods
  • the portion and ingredients I can use to keep me satiated for a long while
  • what spikes my blood glucose in general
  • learning to weigh my food so now I can roughly gauge how many grams is in a fistful of raw ingredients – this is to ensure I get the right macro-nutrients
  • long-term ketosis is not very good for my sleep and rashes, for now until I learn how to deal with it

What I have learnt from my feasting phase

Morning blood glucose started to trend much higher

I learnt that if I eat more carbs than I should for a day my body was quick to recover. Eat badly for a few days in a row my morning blood glucose trended 0.6mmol higher than normal. This effect lasted for a few days even after I restarted low-carb again. This is because our glycogen stores fill up rather quickly, and whatever that cannot be converted into glycogen remains in the blood stream and/or gets converted into fat.

Improved insulin sensitivity

My insulin sensitivity seems to have improved due to the 3 months of strictish dieting. I can now tolerate a moderate amount of carbs and observe a reasonable glucose spike post-meal instead of hitting terrible numbers like before. I also no longer get food comas in general. So far despite veering off-course my migraines or chronic pain did not get triggered, but I am not done with this month’s menstrual cycle yet so I am still keeping my fingers crossed.

Longer sleep with caveats

On a low-carb diet I could only sleep an average of 6-6.5 hours a night. Since I slept around 10pm it means I woke up around 4-4.30am every morning, wide awake. My mental energy was insane during the mornings, but I found myself needing to take a nap around noon. Some people in the keto community believes that the need for sleep is less because ketones is a cleaner fuel, and the body takes less time to repair and recover. But this is unproven – though there is a study that shows that people who sleep more than 6.5 hours a day was associated with more cognitive decline, another one that says people who sleep 6-7 hours a day live a longer life than those who slept 8 or more.

With more carbs in my body I could sleep till 6-6.30am on average, which is 2+ hours more. But as you could see from the graph above, the heart has to work for a much harder and longer to recover.

Long-term policing versus the impermanence of life

I felt so deprived I probably ate more than I should, but I wasn’t aware that I felt so deprived in the first place. It is like getting used to being homebound all the time that one doesn’t realise how much we’d missed the outdoors. I know that I have an unhealthy relationship with food, but in my opinion life is too short and unpredictable to restrict myself completely for long periods of time. Someone online mentioned that she wanted to eat a bun once in a while, but she ate lettuce wraps instead because she was on a diet, however she developed parosmia (change in smell and taste) and now she wished she had just eaten that bun.

I want to be healthier and migraine-free, but I don’t want to regret not eating that bun once in a while. Who knows war may breakout, food supplies may go into shortage, my health may be compromised in other ways – unpredictable events which may change the food we can consume?

I don’t have to go all or nothing, once again.

Desire to return to a healthier baseline

In my previous attempts I gave up completely once I went back into feasting. But this time around with close monitoring biometrics and data it was clear to me I cannot do this long-term for the sake of my health. It was disturbing to see elevated blood glucose for several mornings in a row especially when I have been managing it so well for a very long while. I also felt extremely uncomfortable and bloated after meals and before sleep. All things considered, I knew I had to return to managing my diet with some modifications from all the lessons learnt.

A few modifications which I’ll experiment for a few months:

Prevent deep ketosis

I am eating more carbs and also eating dinner later (4-5pm instead of 3pm). This is in hope that it would prevent my sleep issues and rashes. I still go into mild ketosis overnight (0.5mmol) if I eat a relatively low carb meal for dinner. Maybe I’ll try going full-on keto again if I am in better shape. I read that ketones can repair the myelin sheath which can get damaged from migraine attacks, on top of healing glucose metabolism. Overall I do feel less inflammed, I used to get these facial, neck and shoulder pain almost everyday, but they are mostly gone for now.

Eat in moderation

Despite the better than expected results from the previous phase I decided that eating in moderation is better than going too strict. On hindsight I realised giving myself a break for a meal or a day occasionally is better than restricting all the way and then having a multi-day break. One of the reasons is because the body gets too used to routines, and eventually what may positively contribute before may lose its intended effect. Based on personal observation I think it is better to expose my body to some measured stress once in a while versus letting it get used to being too “healthy”. I observed that now my heart rate doesn’t recover during sleep if I eat later than 5pm, whereas I used to be able to eat at 6-8pm with minimal issues. I do believe fasting earlier in the day has positive health effects because the body can focus on repair instead of digestion during sleep, but I don’t really want eating dinner at a reasonable time to become detrimental to my health.

Mix it up

I kept a strictish routine during my last diet phase. I ate the same times, cooked roughly the same food. But now I would like to experiment with mixing things up because the body becomes more resilient when we throw a spanner in the works occasionally. So I’ll probably vary my fasting windows and the amount of food, cycle in more carbs once in a while, try different types of exercises.

Push some limits

Like I mentioned I avoided anything else than walking during my last luteal phase, but this time around I have been adding some zone-2 jogging. I thought that if I don’t push my body’s limit and risk having a migraine, I would never become stronger. I don’t want to prevent migraines from purely restriction, I hope to become metabolically stronger so I can endure more stress before a migraine gets triggered. I aspire to have an improving quality of life.

I would like to incorporate strength training soon, so hopefully I can tolerate more food without having heart palpitations and/or food comas from eating. It would be nice to be able to eat a Nasi Lemak (picture above) once in a while.

Moving forward

I know I would probably have undesirable results from my latest modifications, especially if I push my boundaries too far. But failure, and learning what has caused the failure is part of the process of experimentation. If I don’t experiment, I would have to be resigned to my status quo, a state with a reduced quality of life because I am so afraid to trigger a migraine. There were months where I practically did nothing except to recover from my attacks and pain. It is one thing to suffer the physical pain, another thing to endure the mental exhaustion and despair from being in pain and/or recovery all the time.

I am not sure how this will go, and if I am not careful I’ll probably relapse into having frequent migraines again, but I hope to keep on learning and experimenting. Maybe I’ll have to go through many more cycles of “failure” in order to know what truly works and is sustainable for me in the long-term.

April 6, 2022

41

I read last year’s before writing this. Last year I wrote that I was profoundly sad – that sadness is a feeling stuck in the depths of my body. This year I think I am still profoundly sad compared to the average person, but I am less profoundly sad compared to my younger self one year ago. 

At the 2-year mark of the pandemic, I exist in a complex feeling of acceptance that this is the new normal, and yet also fatigued like everyone else. At the beginning it felt like so much was taken away from me. The flip side of it is that now I am used to having a lot less stimuli than before. I am more home bound than ever, and every trip out to the world seems like a delight. 

Everyone seems ready to move on from the pandemic as government measures are opening up. I am too, hoping to move on like everyone else but I wouldn’t. I still care very much about my neurological health: do I want my cognition or do I want to travel? 

It is interesting to contemplate that at this rate I may never get to travel internationally again. I try to observe my bodily reactions when I think of that possibility, and it seems to not upset me too much anymore. I zoom out and look at the history of humanity: the freedom to move around liberally was never a given, why do I feel so entitled to it? 

I realise the last few decades of progress and relative peace has made us take everything for granted, and that we feel entitled to so much. I don’t really know if it is in our prerogative to feel entitled, but I do know from a buddhist sense of perspective, this feeling of entitlement is a source of suffering. That my life should be a certain way, it should have all these qualities – if not, I would feel miserable. 

Say if covid never ever goes away, the world descends into WWIII, and the effects of climate change starts to compound while we are all still alive. This would be enough to depress anybody. But one out of those three is already happening, the other two are still up in the air but I wouldn’t call them unrealistic. 

Apart from these meta events, there is still the reality of people around me gradually growing old, getting sick and dying. I may get sick and die sooner than I expected. What matters is from now till then, how am I going to approach living? 

I don’t want to shrink into a hole of depression and despair if covid never ever goes away. I asked myself what is the quality of life I will get to have if I have to be mostly homebound for the rest of my life. I think about how I used to think of becoming a monastic, and the possibility of being homebound for the rest of my life doesn’t seem so absurd anymore. I am not Buddhist, but I like the concept of being able to let attachments go in order to suffer less. Also it is not just about suffering less per se, but it is the capacity to find richness in a small, inner life. 

Maybe this is all a coping mechanism but I think that is what year 41 of life for me is about: to learn how to cope. I am either not very good at coping or extremely good at it depending on how you see it. After all, I have been coping my entire life. I have coped with a sense of no self, a sense that I was unloved, a sense that I was never good enough, that I would be permanently depressed and suicidal, abandonment, sudden changing circumstances, debilitating migraines, etc. Life is just full of non-stop coping for me. 

But I would like to learn how to cope in a different way. How different I do not know yet, but not languishing in despair and torment. I want to find space for other aspects of myself to emerge, to experience more dimensions of life, to discover other ways of being. 

They say a leopard never changes its spots. But I have gone through so much personal transformation in the past few years – gone through states I would have thought impossible when I was younger. Many people feel like as you get older more doors close, but for me it has been the opposite. Maybe the types of doors that open for me are not the types that people want. 

For a long time I felt that being unhappy was a valid reaction to life. I still believe so. But life is already inherently tragic: terrible things happen to good people, many times there is no justice, there is massive inequality, people get randomly sick and die, we have scarcity programmed into us but yet we’re expected to be moral, kind and generous, life is quite shitty for many people yet we have to “think positively”. There are no extra brownie points for being stoically unhappy because that is a valid and probably correct response. Life is probably more blissful for the blissfully ignorant. But maybe there are other states apart from painfully aware and blissfully ignorant. Perhaps calm acceptance? Humour at the absurdity? Rich aliveness even there will be grief? 

I don’t know, and I am glad I don’t know. There are points in life where you can be lulled into thinking that everything will remain the same or start on a path of degradation. At 41 I am more curious than ever about the life that may unfold ahead of me. Yes there will be pain and grief, but maybe there will be spectrums of emotions and experiences new to me.

I write one of these every year.