on-going mostly unedited stream of thoughts

precarious health, and bringing the whole self to every encounter

I had another health episode this past week after our penang trip. I have a habit of measuring my heart rate and heart rate variability every morning when I wake up to test the physiological stress level of my body – usually my heart rate while sitting straight up is within 60-80ish bpm, 80ish if I am very stressed and fatigued. I started panicking when I saw that my heart rate kept overshooting the 90s and reaching the 100s. Usually it will lower if I go into a relaxed position like lying down, but it was still in the 90s. I also had a mild 37°C fever for a couple of days.

The last time something like this happened, I tested positive for covid. The second time it happened, I fainted twice. So you can imagine my distress. That fainting episode seemed to be due to dehydration, so this time around I gulped down water with 1/8 teaspoon of salt (the amount of salt I was taught to use from the Stanton migraine protocol).

Thankfully my heart rate did somewhat go back to its normal range after salting, but it remained unstable for days. It would shoot up to 100+bpm while standing or walking, reminiscent of the days when I got infected with covid. I would be taking a slow walk in cool weather and it would be 110+bpm. My usual range is 90ish, and prior to getting covid it was 70s-80s.

The increased need for salt and unstable heart rate are symptoms of Postural orthostatic tachycardia syndrome (POTS), which is a more common than people think post-covid condition, and some people’s long covid get triggered months after the acute illness, so I was worried my symptoms would not resolve.

But it did, over a week. With a lot of careful watching over my electrolyte imbalance and heart rate when I am walking. In case you’re wondering, I did test for covid which turned out negative thankfully. Also salt did not help to lower my heart rate during my covid infection, which made me have high heart rate even when sleeping. However this time around my resting heart rate while sleeping was just slightly higher than normal.

What triggered this episode? If it was dehydration, why did I get so severely dehydrated out of a sudden? I don’t have the answer, but I have several hypotheses:

  • travelling stress made my post-covid nervous system go into overdrive
  • mild stomach infection after eating salads or some other unknown infection. I did have some loose stool. But an electrolyte imbalance can cause that too
  • I started eating a low-carb diet again after penang, and the sudden loss in glycogen caused a massive loss in electrolytes
  • PMS, which can also cause an electrolyte imbalance
  • an unlucky co-incidence of all of the above which may explain why my electrolyte imbalance was so exaggerated

I did not have these sensitivities or issues prior to getting covid. Previously I could transition from high to low carb almost seamlessly, salads did not cause me any issues, I would be fatigued after an overseas trip but I would recover within a couple of days.

I think all my autonomic functions are dodgy after getting covid. Since covid is known to cause long-term damage, I am not surprised. I am just thankful I got away with relatively mild symptoms for now. After all, almost every day I read of someone’s debilitating struggle with long covid.

It has only been about 3 months since my infection so I wouldn’t be so quick to say that this is something I will have to struggle with for the rest of my life. But since the virus can set off invisible negative feedback loops in our body I also wouldn’t be surprise if my health worsens as time goes on. Viruses like hiv and epstein-barr (mono) cause mild acute symptoms too, but their disabling conditions only show up decades down the road.

I feel like this time around psychologically I coped better compared to previous times when I suffered health setbacks. I was still anxious and worried, but I did not spiral into a deep dark pit. I think with the ongoing situation these days something clicked or died in me and I realised there is so little within my control. I cannot avoid unfortunate events in my life. I can sit very still to avoid encountering misfortune but shit is still going to happen.

I really appreciated this quote from “How to cook your life“, a book I am currently reading:

Magnanimous Mind is like a mountain, stable and impartial. Exemplifying the ocean, it is tolerant and views everything from the broadest perspective. Having a Magnanimous Mind means being without prejudice and refusing to take sides. When carrying something that weighs an ounce, do not think of it as light, and likewise, when you have to carry fifty pounds, do not think of it as heavy. Do not get carried away by the sounds of spring, nor become heavy-hearted upon seeing the colors of fall. View the changes of the seasons as a whole, and weigh the relativeness of light and heavy from a broad perspective.

Source: How to Cook Your Life: From the Zen Kitchen to Enlightenment by Eihei Dogen, Kosho Uchiyama Roshi | link

“Magnanimous mind” is translated to “大心” in chinese – I am not going to go into an in-depth analysis of this passage for now (haha I almost did) but in context with my health struggles I think it is beneficial to develop this sort of capacity, a capacity to be alive regardless whether it is a sick day or a healthful day. It is about throwing our whole selves forward in every encounter:

Big Mind, then, is not a matter of meditating on some vast, floating, spatial dimension. Rather, it is the practice of entirely devoting your life to each and every thing that you encounter, no matter what it might be.

Source: How to Cook Your Life: From the Zen Kitchen to Enlightenment by Eihei Dogen, Kosho Uchiyama Roshi | link

What does this really mean in practical terms? I don’t know because I am still exploring. But for me now it means to have the creative flexibility to know how to be in any given moment, to know how to conduct myself when things are not going well. My partner asked if this is similar to positive thinking: my thought now is no, it is not asking of us to be positive regardless of the situation, it is asking of us to bring our whole selves to every situation. For me, it means to grieve when it is time to grieve, be joyful when the time calls for it, allow myself to measure the appropriate response and attempt to see the entirety of the picture instead of having a disproportionate or habitual response to a single trigger. To be present to what is truly happening instead of living out my old scripts on auto-pilot.

On days when I am not well, sometimes it is truly debilitating. But there are days when it is my despair that is debilitating. My despair clouds and traps me, like a haunting that would never go away. It is not something I can think out of, but rather a neurological response to traumatic triggers. But I am hoping to build the psychological infrastructure to co-exist with it better.

I wonder if I would have noticed that there was something physiological wrong with me if I didn’t religiously measure my biometrics. I also wonder how many people are walking out there without knowing they are somewhat unwell – that their hearts are highly stressed. Just recently, a 24 year old suffered sudden heart failure in Singapore. They didn’t link it to covid of course, but the risk of getting a cardiac event is dramatically increased post-covid. Even without permanent damage our hearts are working in a compromised state post any-viral infection, but this is not common knowledge. People feel well after a week or so and they go back to stressing their hearts like before.

I am still disturbed by the overall public messaging on the ongoing viral waves. For me covid is nowhere near over. I wish it can be over but it doesn’t seem likely at this point because we don’t seem to be interested in seriously eradicating it. More effort can be put into researching better vaccines for example – current vaccines can reduce some risk but it is not that substantial. A lot depends on a healthy immune system, but I am skeptical how many of us truly possess a functioning immune system in our modern stressful societies with harmful environmental factors, and repeated infections may deplete our immune systems further and even cause lymphocytopenia – a condition which we no longer have enough immune cells to fight off infections, which means previously mild infections can become fatal (or we may develop cancer because we need our immune system to kill mutating cells too). Maybe people think I am fear-mongering, but the research is out there for everyone to read and decide for themselves. Unfortunately it seems people do not read.

At this point – more than 3 years later – I have learnt that I can only take care of myself and to an extent my partner, in terms of covid safety. There is no getting past people’s strong denial/avoidance mechanism. Even with prior knowledge there is also the “it won’t happen to me” attitude. There is no other explanation for the willingness to go entirely maskless with a potentially life-threatening virus still lurking around. And I don’t mean life-threatening in the sense that it may end our lives, but for me what is worse than dying is to have a life but be unable to live.

This is something I am learning to co-exist with – the dissonance, especially with family and friends. I am thankful I have very little social needs. I have to learn to apply the above zen attitude and focus on carving out a life that is at least not dissonant within me.

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