I wrote about my medical shenanigans a way back, when I had an adenoma removed from the pituitary gland. I am happy to say that today's check-up (part of the aftercare) revealed no evil surprises, and all seems to be functioning as well as it should.

The only after-effect that I can really point out is that my nose feels slightly congested easier than before, which is a little annoying sometimes - but not too bad to live with. Having a lost or reduced sense of smell would have been much, much worse.

So I am good to go for another year and a half, until the next check. Hooray! 

I did learn a great deal during my week-and-a-bit in the clinic. One thing that's rather easy to learn if you're lucky like me, and go through your procedure and recovery with very little trouble, is - humility. There's a lot of luck involved in the diagnosis and treatment of any disease, and when you hang out in a clinic, you will usually see quite a lot of people that have it much worse. 

I also gained a much deeper appreciation, and a lot more respect, for the people working in the care industry. Everyone on my ward was always calm and friendly, even if there was a lot to do. They were going back and forth all the time, and put in some extra time before their shift and some extra time afterwards to make sure the hand-over was complete, and their colleagues were informed about everything. Whenever there was an issue, they'd be there, happy to help. Any questions were answered if possible, or if it was a question for a doctor, that was stated clearly and then the doctor would be asked about it. Once I was woken up for the night-shift checks, and the lady apologised for having to wake me - even though it was her job to do so, and I knew when I went to bed rather early that this would happen. 

Working a care job is a very hard job, but seeing the people on this team, you'd never suspect it. They were, one and all, really wonderful and I can't praise them enough.

Another thing I have learned? How to administer an anti-thrombosis injection to myself. Because of side issues of Cushing's Disease like a less effective immune system and a higher risk of thrombosis, I got extra antibiotics plus extra anti-thrombosis injections for a full 5 days, 3 times a day. That was a lot of injections... and I was offered, straight from the start, that I could do them myself if I wanted to. After a few of them, and after one of the ladies managed to accidentally hit a spot where it actually hurt, I did decide to try it. The trick is to pinch a fold of muscle in your thigh (or belly, but I went for the thigh), insert the needle, then let go of the pinch and slowly press in the injection. It did not hurt at all that way. (It got a little uncomfortable and stung afterwards, as the liquid moved through the tissues, but that can't be changed. You also inevitably get a "blauer Fleck" around the point, proof that the anticoagulation stuff is working!) 

When you get surgery like mine, you also get to do fun things for a while. Such as dragging an infusion stand around with you; I quickly dubbed him Hans-Georg. Though, admittedly, we had a lot of fun together, the nurse's declaration that he would be my new best friend was not completely correct. I was quite glad to officially break up with him on Tuesday night! 

I also learned that I tend to drink a lot if there's tea available right outside my door, and I have nothing to do all day. Except, well, hang around and sip tea, especially as that also seemed to help my nose to get less congested. And sniffing the tea was a nice way to try and wake up the sense of smell.

Finally, I got told (before surgery) to ask for pain medication afterwards as soon as I'd realise the pain was coming back, or increasing. Both the surgeon and my roommate at that point made it very clear that trying to just endure the pain would be a very bad idea. The explanation? Traumatic pain like you have after a surgery is harder to dampen down the higher it was able to rise, and there's a kind of memory mechanism that will kick in over a certain threshold. You do not want to have pain memory. So, basically, waiting too long before asking for more pain meds after a surgery will mean that they take longer to take effect, and that you will need more and possibly stronger ones to work. Since I was not planning on having more pain than absolutely necessary, I asked for some more drugs straight away when I noticed the pain coming in - and that did work wonderfully.

Fun side story: When I first came to again after surgery in the wake-up ward, I had some pain in my nose (which was to be expected) and in my left ankle (which was utterly unexpected). The pain meds made the nose pain go away, but the ankle persisted in being really painful. I told the nurses about it, and there was nothing visible, no swelling... and then they removed the foot part of the surgical hose, and a minute later, the pain was gone. There must have been a tiny fold pressing on a weird spot!

There's progress. Isn't that nice?

Said progress is going on in multiple areas. First of all, the personal/health thing is one part - I've been tracking all my food, which is annoying and a nuisance and sometimes feels really ridiculous (weighing out salad, thank you very much), but at least it's working. I've managed to more or less stick to the goal of not eating above a certain amount of calories, and it's showing on the numbers of the scale. That is nice, and motivating, and keeps me going even though it's hard at times. There's been a distinct and very lamentable lack of cake these past weeks, and reduced amounts of everything, especially the non-crucial stuff like chocolate. (Well, chocolate is crucial in some regard, but when push comes to shove, it's unfortunately empty calories, and there's not much space for these in my plan.) A few more weeks of this are looming ahead, which is sort of disheartening (soooo long to go!) but on the other hand, I managed to do this for months back in 2016 so I know I can do it. 

What I can definitely say is that it is easier now that I have the HRT to keep me sane, and sort-of-normal, and functioning on a basic level. I did try to do dieting stints in the past two or three years, but just didn't manage to get the necessary motivation and stick-to-it-iveness.While the basic fact remains that it is always possible to reduce calories and thus lose weight, there are definitely life and health circumstances that will make it harder, and depending on all kinds of factors, possibly also temporarily impossible. 

There's also progress on the shop stock overhaul; replenishing things, taking stock and finally getting new stuff into the shop did happen. There's a plan to rearrange some of the storage furniture here as well, which will take place after I've been to the Nähtreff at Rothenfels, because then the storage shelves will be more or less emptied out anyways (as a lot of the stock travels with me to be set up as a market stall). 

The website is mostly up and running, with a few remaining issues to be solved and some articles (that have been taken offline a while ago) to be re-written and placed back online, but none of that is crucial or really time-critical (at least not compared to other stuff), so for now, I'm good with how it works.

Next on the progress list is removing some of the old backups, and setting up a new (better) system; I've been using a backup programme that leaves me not so very confident in its reliability. (In case you're wondering: It's Acronis. The programme puts everything in a huge archive file, and when I try to access them on the RAID, there are sometimes hiccups that need to be resolved, probably due to the connection quality.) This means it's time to re-evaluate, and switch, and make space on the RAID to get the new version going. That's a slow progress as well, but things are happening here too.

Of course, there's the usual long list of stuff to be done - writing stuff, sorting stuff (in my next life, I will be more organised, and less messy, at least that is my cunning plan), organising travel for the next events. Preparing workshops at Rothenfels.

No progress yet on planning the next online workshops, something very high on the list... but overall, it feels like things are going okay. Which is a very, very nice feeling!

I've hinted at it yesterday: Other health issues. During the last two or so years, I've had some troubles that all seemed more or less unrelated, and that were all sort of not so bad that they'd merit a visit at some doctor's, and too squishy to really pinpoint them. However, they were gradually getting worse.

It started when we were doing a bit of strength training during the second lockdown, as the pandemic was still causing things to be cancelled - which resulted, for me, not in a strength gain, but in joint problems instead. Those got better with less training, but there was still a rather persistent niggle, and it was very easy for me to overload or overstress them. (Also made my motivation for strength training take a very, very steep nosedive.)

There was also the weight gain, not really quick but still a good bit more noticeable than in the years before. My hair stopped growing, there was more hair loss, and the braid became shorter and shorter as well. I had dry eyes, and a dry mouth.

And then... more joint pains, and muscle pains. Tender knees, tender hips, tender fingers. I got the impression that in spite of bouldering regularly, I lost strength instead of gaining it (or even just maintaining), and when trying to do a bit more, it quickly resulted in... more pain, due to overstressing something. Plus I got more and more depressed, and things just looked ever bleaker. This all got worse over time, and I was really at a loss as to what was going on.

Until I finally, in a stroke of sheer and pure luck, I listened to a podcast about menopause.

The symptoms list? Oh, how familiar it sounded. All of it. Well, almost all of it - I'd never had the infamous hot flushes, which might have been a hint towards what was happening. The way it was, though, I never had considered menopause as a possible reason (and it's usually not expected to start in the early fourties with such an impact).

Long story short, having ticked off most of that symptoms list, I found myself a doctor specialising in hormonal treatments, got an appointment, left some blood there, and a few days later I got the results: Early menopause, with really low levels in both estrogen and progesterone. (Well. You can insert a bad joke about being early for a change here, if you like - I've missed enough deadlines in my life, or cut it very close, that I really don't mind.)

Based on that bloodwork, I'm now getting hormone replacement therapy, and things are so, so much better. There's still some issues, but we're also not yet finished with the stage of figuring out what the proper levels for me are. The most important thing, though, is that I'm feeling like myself again, and am functional once more. Now I just have to remember to take one of the magic capsules in the morning and in the evening to keep things peachy. (There's actually a reminder app running on my phone now, just for that. Works wonders.)

The betterment, by the way, was almost instant. There was a real, significant difference just a few days after starting therapy, on all levels. I'm still not where I used to be, but gradually, things are getting better again, and I feel like I'm making progress once more instead of just stalling or things getting worse.

So... what I learned, when reading up on the stuff: Menopause has a large impact on a woman's body, as there are estrogen and progesterone receptors about everywhere. EVERYWHERE. (Like in your brain.) Not getting enough of the stuff has an impact on overall health and well-being, including bone health and density, muscle strength (there's the explanation for my loss of bouldering strength) and cardiovascular health. There's a reason why women after a certain age have the same risk as men to get a stroke or a heart attack, and that's lower estrogen levels. Same reason for the brittle bones at a higher age.

Also - depressive mood swings, or full-out depression can be a result of too low levels of hormones. When dropping a pencil suddenly means that you feel like the day is ruined, because obviously you cannot do ANYTHING right... well. Not a very good situation.

Now mind you - every body is different, and there's some people that breeze through menopause and don't feel anything, but just in case you'll land in the other camp... if you're over 35, consider reading up a bit on menopause and peri-menopause (that's before the proper start of things stopping, so to say) just so you know what possible symptoms are. Maybe get your hormone levels checked on a day when you're feeling really good, at a known point within your cycle, so you have a baseline you can work from.

And once stuff starts happening... do consider a replacement therapy. These days, bioidentical hormones are available, which are what your own body would produce, and the side effects of those are very low. That includes the risk of cancer, which can be linked to non-bioidentical hormones that were used in some of the studies that caused a big scare about HRT some years ago. And in the sense of full disclosure: I was feeling so bad before the therapy started that I'd have gladly accepted a 10% increase of the risk for cancer, in exchange for feeling better again.

Now you're all up to date, and this blog will return to its usual shenanigans. Unless you have questions - then let me know, and I'll try to answer them!

This blog has seen one or the other post about personal stuff over the years... and it's time for another one. Actually, for two, but as they are relatively unrelated topics, I'll make two posts out of it.

Back in 2016, I went on a weight-loss journey that took most of the year, and I've been normal weight ever since I hit that goal weight in September. It did not stay at the goal weight very long - I went slightly above it pretty soon, as in one or two kilos, but that was okay with me. It was still a reasonable weight for me, and I did keep to this okay range for a year or two. Or, actually, even almost three.

However... since then I have gradually, slowly, sneakily gotten back into the habit of eating just a tiny little bit more than I need. Which means, Thank You Captain Obvious, that I've gradually, slowly, sneakily put on a bit more weight again than I'd like to have. Reasons for that (not the putting on, but the eating a tad more) are unclear, but they might include other health issues, a bit of emotional eating or boredom eating, old bad habits coming through again, a genetic predisposal to an appetite that is a bit too large, having the occasional bout of not sleeping enough, and there might be more, but I think that's already quite enough to have on the list, so I'll just stop here.

Now, back in 2016 when I was hardcore dieting, I logged everything I ate and drank to keep track of my calorie input, and very obviously, that worked as a strategy for me. It's a bit of a numbers game to play - how much have I had today already? Was it enough protein? (From experience, I know that I need a certain amount to feel okay, and not perpetually hungry.) Do I really want to eat that bit of chocolate or had I rather be finished earlier with the dieting? How much do I actually need to feel okay, and how much do I actually need for maintenance? It's amazing, and can be a real eye-opener, to weigh out portions and see how much or how little the same amount of calories can be. 

After months of logging all the food, it did get a bit old though. I wanted very much to be able to eat without logging everything as a crutch, and in the start, that worked fairly well. Over time, though, it looks like I'm prone to having just a little bit more than necessary. That's not bad if it happens once in a while and gets evened out by eating less on some other day, and lucky the person who does that naturally, but unfortunately that's not me. I just eat a little more occasionally, and never too little to even it out.

I've tried several times to lose some weight again freestyle, without logging, but it seems like I'm still not good enough at estimating caloric values, and at eating less without having numbers to cling to. So the smart thing would probably have been to do a week or two of tracking now and then, just to make sure my internal calibration, so to say, gets re-adjusted.

Well. I didn't, because I wanted so, so much to be able to wing it... and now I've gotten precariously close to overweight again, and while my clothes all still fit, they fit tighter now. So I've gone back to doing what works for me: Logging everything, and trying to go for a significant deficit each day. (Because I am also, still, an impatient person.)

And, surprise surprise, it's not as bad as I feared. Yes, it is a little more work when cooking, and preparing food. Yes, it also means taking care of what gets eaten (There's the protein quota to be met, which of course has an impact on the kinds of food that are smart to eat, and those that are a less smart choice). However... weighing and logging everything before I eat it also means that it's not as easy to just have a piece of chocolate, or a cookie, or another coffee (with milk, otherwise it wouldn't really count)... and because I'm a lazy person, that already helps with having less of the "boredom food" than I'd usually have. Snack fruit in the afternoon. The bit of chocolate in the break. Taking another small serving, just because it tastes so good. (I blame you, good-quality-food that does not even need a lot of cooking skills to taste delicious.) Having a last spoonful of whatever before putting leftovers into the fridge. All those little things... adding up.

We'll see how it goes now, playing this numbers game this time around. I will be trying to figure out my current daily energy needs while I'm at it (there's a brilliant spreadsheet hanging out on reddit for this), hoping that fluctuating water levels will not muck up things too much. And then, for the future, I hope I'll be smart enough to do a week of logging for re-calibration sooner and not later, so there's less to lose should the numbers go creeping up again.

I know that weight and weight loss can be a sensitive topic for a lot of people, and it used to be for me as well - until I got all my dieting myths and preconceptions blasted by the book "Fettlogik überwinden", which in the meantime has also come out in English, as "Conquering Fat Logic". So...if you have any questions, please feel free to ask.

It's time, again, for me to sit down and do the bookkeeping stuff. It's not a thing that I particularly enjoy, but, alas, it has to be done. And that in regular intervals, as I have to hand in the VAT accounting every quarter. (That's actually a good thing, for me, as it means that at least every quarter, I automatically get an overview about how things are going.)

Usually the hacking in of numbers and checking them, and jotting down reference numbers on slips of paper and putting documents into the document folder of the accounting programme goes fairly smoothly, and I'm done relatively quickly. Sometimes though, some little-but-nasty error slips in, and then it's hunting down what happened and where and when and fixing it. I had one this time around, and it took me a while to get where it came from... but now everything lines up again, and looks fairly good, and I've sent off the numbers and paid my dues.

Which means that I can give you a celebratory picture of the little cat with a very silly face:

and then get back to all the rest of work waiting to be done today. 

Thankfully nothing that involves heavy lifting, because I did get the booster shot with the updated vaccine (including the Omicron variants) yesterday, and though I have no other side effects, the area where the jab went does hurt some if I lift the arm overhead, or stretch it out completely.  Side note: The German StiKo, the committee giving the guidelines on who should get vaccinated, still lists only a few groups and people over 60 years of age. Even though there's enough vaccine to get a lot more people immunised. So when I went to get my shot, I had to get an "advisory talk" with a doctor, who had to ask me why I wanted the booster... which you can get even when not on the StiKo list, but only after that advisory talk. Next thing she did was tell me that she personally thought it rather stupid that they'd still not made the list longer, or recommended it to everyone, since the incidence numbers are rising and people still get Long Covid, and there's enough of the vaccine for a lot more people... 

Ah well. Nobody expects the Spanish Inquisition, and nobody understands politics.

My plan was to finish some sewing project today - but it has been thwarted... well, I could technically do it, but I'm choosing to let my thumb marinate as recommended instead.

If you're now wondering what I mean... my left thumb currently looks like this: 

It looks much worse than it actually is. That is a moist cover to keep a small, slightly infected wound open and able to ooze out anything that will ooze out. I tried to get a (rather large) pill into a poor sick cat yesterday evening, and that was only partly successful as in part of the chewed-up capsule landed inside the cat (good), and part of the cat's teeth landed temporarily in my thumb (not so good). (The cat is not to blame, by the way, as he was not trying to bite me - he had only two wishes: To close his mouth again, preferably with the pill outside of it, and to get away from this horrible situation. My thumb just happened to be in the way of achieving wish number one.)

Because cat bites are notorious for getting infected, and I need my hands in good working order, I did the very sane and grown-up thing and went to the doc this morning. So now I'm getting antibiotics for a few days and the (tiny little) wound gets a spa treatment. It's not hurting much or really heating up, but there are signs of infection, and since the fascia in the fingers are plentisome and those are not agreeing at all with infections, better to act quickly and hit the bugs with antibiotics than get real issues later on.

Bonus, though: I got reminded of the fact that one of my basic vaccinations needs a refresher, and got the shot while at the doc's today.

So. Lessons to learn from this? If you need to pill a cat, consider wearing (thin leather) gloves right from the start. (Thick gloves will not work, you can't put pressure on the small spots at the jaw joint then.) 

Most importantly: Don't get bitten. If you do, it's a good idea to go to the doc straightaway, as soon as there are the first signs of any infection. Don't wait around, cat saliva is evil stuff.

(Bonus tip: Go check your vaccinations and see if they are all up to date. Second bonus tip: If you're getting antibiotics for any reason, get yourself something to build up a healthy gut biome again while you're in the pharmacy anyways. These meds kill bugs first and never ask, and that includes the ones that are supposed to live happily in your gut.)

The irony of the whole thing, by the way? The pill for the cat was antibiotics...