Feeling the weight

I've written about hard subjects before, just take a look at my previous posts about anxiety, panic attacks and the EU referendum! But this is one of the hardest, maybe the hardest, at least for me. It may not seem that way when you read it, but this is a blog post I never thought I would have to write, about a subject I never thought would affect me. But affect me it has and it has hit me hard. I'm annoyed at myself because it feels like it's mostly my fault.

How thin do I look? I can't have been healthy!

I am close to being overweight, almost 11 stone, when for most of my adult life, I've been around 9 stone. Now I don't want to go back to that weight as I think it was unhealthy. However I reckon I have put on a stone and a half over the past year or so, I feel unhealthy with it and I should lose that. Luckily I can fit into most of my clothes still because I wear leggings, but I can't wear my jeans anymore. If I carry on like this, I'll have to go up a dress size. I have no excuse, but I have reasons. To try and make sense of why this has happened, to come to terms with it and hopefully do something about it, I'm writing this blog post.

I will have to go back to my childhood to explain. I was never interested in bad food: fast food, burgers, takeaways. I prefer simple food, simple ingredients, unadulterated meals. I'd choose a salad over a McDonalds. I don't like sauces, not even ketchup on my chips. I'm more interested in fruit and veg than sweets and cake. In fact, the first time I was off school sick, it was because I ate too much fruit! Even now, I can't walk past a fruit bowl without being tempted. When I was a teenager, people used to joke I was anorexic and I took it as a compliment. They'd pick me up, exclaiming how light I was. I was proud of it! But I never courted it. I just wasn't interested in food, never was. I'm still not really interested. I eat to live.

I love fruit, all fruit, even exotic fruit like snakefruit (right)

Things changed when I turned sixteen when my anxiety hit and I started having panic attacks. My life spiralled out of control. I went from having little appetite to having none at all. I still don't really have an appetite as such. I developed an eating disorder where I found it difficult to eat. It was both a symptom and a way of coping with my mental health problems, trying to control something when I couldn't control anything else. I stopped eating altogether at one point because it was easier than fighting through what I called the upchuck reflex. My friends had to forcefeed me when I started shaking uncontrollably. Since then, I haven't had a normal relationship with food, not liking eating in public for instance. My appetite, what there is of it, is the first thing to go when I'm ill, mentally or physically. When I can't eat fruit, I know it's serious. It's become a canary in a coal mine for me.

Now I have a handle on my anxiety, which used to sap my appetite, I have to deal with one. I must have had one before my anxiety hit, but that was more than 20 years ago and I don't remember. So when people learn to manage their appetite from childhood to adulthood naturally, I've had to deal with it all at once, which has been a bit much.

This is me under there!

However, apart from sugar cravings during that time of the month, I've been managing pretty well. That's why putting on so much weight is a surprise to me. It started before lockdown, before I knew I had endometriosis, which makes me bloat. My weight shot up on medication for my balance problem, but it went back down when I stopped taking it. That was the first time I went over 10 stone. I'm now on medication for the endometriosis and putting on weight is a side effect, but not to this extent and I'd prefer to take the tablets as the benefits outweight the weight gain. They've stopped the sugar cravings for one!

Due to my balance problem, I don't sleep well; I often wake up in the night and I sleep very shallowly, so anything can wake me. Sleep problems can make you put on weight, or more prone to putting on weight.

Me asleep(ish)

I'm not a great one for exercise and with lockdown, I'm currently only going in to work once a week; my cycle commute is my only real exercise, which was enough before, but it seems no longer. I will have to start exercising properly, which will be hard and I'll have to be careful what sort of exercise I do because of my balance problem. I definitely need to improve my cardiovascular health. The other thing is when I exercise. It takes me an hour to even get moving every morning; to say I'm not a morning person is an understatement. Vertigo upon waking due to my balance problem makes me groggy, so exercising before work is out. I'm knackered after a day working and exercise will knacker me further, for the usual reasons, but also my balance problem makes most physical things tiring. So I'm going to start at weekends and see how I go.

When I could fit in a dress like this

I don't eat unhealthily, but I do rely on ready meals and frozen meals at least once a week. The weird thing is, I eat the same thing as my brother; he has larger portions and eats more chocolate bars than me, but exercises less than me; even on our lunchtimes walks, he dawdles, whereas I try to keep the pace up; and his weight has barely changed.

Stress can do weird things to the body, to the hormones and goodness knows we've had enough stress lately. But I thought I was coping with 2020 okay, surprisingly well given my history of anxiety, including all the mental whiplash when things kept changing and first I was going to go in to work 2-3 days a week, then 4 days, and now one day a week. I had a few wobbles in the beginning, but maybe underneath I'm not coping so well.

One of my favourite photos of me, with my nephew Thomas

So between my endometriosis, balance problem and anxiety, which all cause the insomnia, that may be the reason behind my weight gain. This means it's not as much my fault as I thought. But the biggest cause is probably my age. I noticed a difference in my metabolism when I entered my 30s. I guess I can't eat what I'm used to eating without consequences anymore. So even though I haven't changed my diet any over the last few years, maybe even being a little healthier, I'm going to have to now. However with my history of an eating disorder, caused by the need for control, I'm going to have to be careful. I'm cutting sweet things out of my diet, which is no hardship, it's been easy over the last few days. I mostly eat them when I'm bored or watching TV. But I'm going to miss my Mum's flapjacks and scones. Then I'm going to build up to fewer carbs like bread (which I adore), pasta and rice. But I know it's bad to cut out food groups altogether, so everything in moderation. I will try to eat more vegetarian meals as well, I tend to choose them off the menu anyway. So all signs point to the fact that changing my diet should be relatively painless.

Turning 30

The first step has been getting over myself, stopping feeling sorry for myself and thinking this is temporary. I'm going to have to do all this as the trend in my weight has been steadily increasing; it's only going to go one way and will continue that way unless I do something. I have to lose the identity of my younger self who could eat anything and stay thin. I should also eat more slowly: due to my eating disorder, I ate fast to beat the upchuck reflex, otherwise I would have ended up eating nothing. That habit has stuck and I don't need it anymore.

I'm going to have to strike a fine balance between the problems exercising with a balance problem and changing my diet with an anxiety issue, but I'm up to the task. I'm the little girl who stopped biting my nails because I hated the way they looked, just like that. I decided to stop, so I did. I'm the teenager who stopped drinking alcohol because I knew I was drinking to drown my anxiety, so after my third hangover, I stopped. I now only drink on special occasions like celebrations and then only a few sips to be social. I got over a breakdown and am managing my anxiety. I've dealt with two chronic illness diagnoses and live with the symptoms daily. I can beat this too. All I need is an incentive like I've had before and one look in the mirror at the body I don't recognise anymore and one walk upstairs which makes me out of breath, that's enough incentive to be getting on with.

The most body confident I've been, taken by Dave Amann

The Framework Five - Critical Assessment

Summary
Critical assessment takes into account the origin, context and suitability of the information being studied, how it is influenced by not only the creator, but everyone involved in handling and disseminating it. These factors determine the authority and therefore credibility of the source of information, the most important assessment.

Personal
There are some very timely examples of critically assessing information I could use as my example: politics such as "he who I don't like to name" (could be one of two people in power to be honest) and Brexit; healthcare with the coronavirus; science with climate change. However all those are depressing and can be downright scary, especially now it seems the whole world has changed. I prefer not to dwell on them too long and the world of misinformation is massive and complex when it comes to these subjects, so this post would be very long otherwise.

I could be very British and talk about the weather, specifically weather apps as they seem to vary wildly, particularly about whether it will rain. But I'm going to get personal, hopefully not too personal. I have three chronic health conditions, meaning I have to live with them as they are not going to go away: anxiety, a vestibular problem and endometriosis. For two of which, I've had to fight the system for treatment and if I hadn't done my own research, I may not have been diagnosed in the first place. So it's something I feel I can talk about with some passion and authority, something I've proved myself in being adept at critically assessing information, but it wasn't always the way. Doctors can easily dismiss things you've looked up on the internet and don't like self-diagnosis, at least in my experience. When it comes to your health, you know when something is wrong; you know yourself, your body and your symptoms best. So you have to become an expert very quickly and advocate for yourself.

Without going into too much detail, my endometriosis has an "unusual presentation of symptoms" and vestibular conditions are hard to diagnose; you tend to get given the easiest answer and told there's nothing they can do. I have explained my vestibular journey in more detail on my blog before: Bittersweet Victory. Just click on the anxiety tag to see my numerous posts about anxiety, but this one is a good place to start: My Past, Present and Future. The endometriosis is a new thing, even though I've probably been living with it for many years, so I haven't written much about it yet.

Trust me, I'm a doctor

In the beginning, I thought healthcare professionals knew best and deferred to them. I didn't ask enough questions, or the right questions, assuming what they were telling me was correct. I always have a problem with figures of authority, quailing in front of them. I should have critically assessed the situation, their situation. I should have taken into account the little time they had, the fact they weren't a specialist in the field and whether they were doing the right tests to critically assess my symptoms to prove their assertions.

When I spoke to a specialist, they said what the previous doctor had told me was wrong. I was sent back and forth, given different diagnoses. When they gave me another diagnosis and told me there was nothing they could do, I researched it and discovered it didn't fit as there was one essential symptom I was missing, cross-checked it on numerous websites, some very academic full of sciencey terms I didn't understand. I looked them up and learned the lingo so I could speak their language when I saw them next to show them I'm serious: I am a mix of stubbornness and curiosity at the best of times and it stood me in good stead. I got a test done off my own back, returned with the results and with irrefutable evidence, they couldn't ignore me. I had to push for treatment and when I found the right person, the person who was willing to listen and didn't just dismiss me, I asked all the questions. I asked what tests they were doing and why, got them to explain the results.

When it came to the second diagnosis of endometriosis, I visited practically every department of the hospital so they could rule everything else out first. I didn't accept what they told me each time, knowing everyone is fallible, even doctors, and pushed for more, knowing what they were saying wasn't right. I critically assessed every person I spoke to, ensuring they had the authority to back up what they were telling me. I quietly defied them and did my research afterwards. They didn't listen to me, so I let them go through the motions, doubting myself. I held my ground, more in desperation than anything else. When they ultimately came up with nothing, that's when they listened to me, they were finally in the right place to listen. I came with a carefully rehearsed speech and proof from an authoritative website. I was proved right and it goes to show, sometimes the authority comes from you and not external sources.

My critical assessment during these medical journeys each took years, comprising the critical assessment of the doctors and specialists themselves, their job titles, specialisms and whether this was just their opinion or they had information to back it up from tests and other sources. I then did my own research, using books, websites and yes, blogs. Blog posts were especially useful for other people's experiences and other avenues to research, some even had links to read and advice. Finally, which leads me to my professional example, I joined a Facebook group for support and shared experience for better understanding of what living with the condition is like.

Capt. Benjamin Sisko (Avery Brooks)
from Star Trek: Deep Space Nine

Professional
In comparison, my professional example will seem downright boring and far less dramatic. It can be fun though as it's about social media. Social media is all about people and individual accounts, on Facebook, Twitter or whichever platform you're using. You can use hashtags and lists all you like, but it still comes down to the individual account. Twitter in particular becomes unwieldy very quickly the more accounts you follow. So now I use Hootsuite (other social media managers are available) to manage it better, and I've created Twitter lists on topics. I can separate social media accounts into three categories: macro, micro and mono.

First there is the macro, an account that covers a lot of people, or sites, such as the UL Twitter account; it may be one library, but it is vast and covers a wide range of collections, not to mention people. Then there is the micro account, one library such as the MMLL Instagram account or Classics library Twitter account. Finally, there is the mono account, one single channel, for one single person, such as my own Twitter account. So you have to take into account who they are representing, the context they are based in and who may be behind the account.

I have curated these streams and lists myself, populating them with people and places I know in real life, so I have critically assessed them in person and know what they are an authority on. Others I know by reputation, such as Orkney Library and know they have built up authority through other's opinions. Lastly, there are the recommended accounts, those accounts I have been referred to by people I trust.

Social media is a great source of information, but you have to know where it's coming from. So even the accounts I have critically assessed and deemed good, I still assess the information they provide. I don't take much notice of retweets unless they have made a comment. Tweets with links and images I can be easily swayed by, especially those with a suitable gif or meme; it makes their tweet or post seem more credible.

The Credible Hulk

Critical assessment is key in social media as there is a lot of misinformation out there, but also it can be a great big echo chamber where you only see the information that follows your cognitive biases, that agrees with you, in more ways than one. So don't surround yourself with people like you, curate your sources wisely.

Themes
Again, my information sources are centred around people: information from doctors and healthcare professionals, and information from individual social media accounts. I assess them by their job, professional knowledge of them and whether I have met them in real life. I feel more confident critically assessing information professionally as there are processes and policies to follow, known authoritative sources and places to use, as well as people to ask. You feel on surer ground.

My undoing

This is the hardest post I've ever had to write. I started it, but couldn't finish it. I've been emotional for more than two weeks. The reason? I left my job of 10 years. I’ve been drawing it out with a couple of secondments to different places in the University, but this time, it’s for good! It's so long and thanks for all the fish (I don't like fish).

Think this was during one of the conferences we held in the building. Photo credit: conference photographer

Being at Cambridge Judge Business School (CJBS) for so many years, seeing so many people leave and so many arrive, I never really believed there would come a time when it would be me saying goodbye. It’s a sign that I have been so happy, but it's also a massive change. However an opportunity that was too good to pass up came my way: a job in not just one, but two libraries I’ve always wanted to work for, have skills in and a fascination for the subject: Classics and Languages.

Dressed up to the 80s for the first work Christmas party, in my favourite colour

2009 seems such a long time ago, but trying to organise a team in my first week on the job for the 800th anniversary of the University of Cambridge celebratory University Challenge inter-department quiz seems like yesterday; our team lost in the first round to the Anglo Saxon Norse and Celtic department, but by a very close margin.

One of the many random things I had to do while at CJBS

So much has happened in the decade I've been working for CJBS, not least doing my second degree to become a certified librarian, two secondments to the Engineering and Homerton College libraries, being published in a professional publication, and speaking at a conference. On a personal level, being a bridesmaid twice and my nieces and nephews being born, moving out of home for the first time and moving house again, learning to drive, having a breakdown and being signed off work, finally getting a hold on my panic attacks and anxiety, two huge holidays (and numerous smaller ones), being diagnosed with a vestibular disorder which gives me vertigo, being diagnosed with endometriosis, film reviewing for community radio, and a lot of writing in a view to finally finishing the book in my head.

As Leela, for the space-themed Christmas party

I could only have managed to achieve and weather these significant life events with a secure grounding, at home yes, but also at work. I've been struggling with the change of job for that reason, not having the rock of CJBS any longer, though it has felt less of a rock recently. What's worse is that I've pulled the rug from under my own feet. But now life is feeling steadier again; I always adapt well to change, it's the anticipation that gets to me; I now feel able to finish this post.

Giving a presentation. Photo credit: camlibs

Cambridge Judge Business School has given me so much: my first permanent job after graduating from University; my vocation in life as a librarian; a chance to use my personal experience with mental health professionally as a Wellbeing Advocate which I can continue at the Faculty of Classics; and most importantly, friends for life. The attitude, community and atmosphere has made me feel I belong. To feel included is a wonderful thing. But I can't put it off any longer: to paraphrase Cecelia Ahern’s new book Postscript, just because saying goodbye is so hard isn’t a reason to stay.

Getting my staff recognition award. Photo credit: no doubt Dave Amann

Obviously this is an anxious time for me, with the uncertainty of what lies ahead utmost in the doubt I had about leaving. I must admit on the first day of my new job, I did think, "What have I done?" CJBS is a wondrous place. However this is mitigated by the places I've gone to to as I already know people, there is a great community around me, surrounded by lots of fantastic libraries and already knowing a lot of the software, processes and policies I've taken on. I've been reflecting on my reasons for leaving, which are numerous, questioning whether I've made the right decision; burnout is certainly in there; progression and development is a major factor; changes that have been made within the School, the team and to my job; and obviously the sheer number of years working there. I need new inspiration, to further my confidence and to find a new home knowing I'll always have this one to come back to.

Dressed up for my final work Christmas party in 2018

It made it so hard to leave, I felt so at home; it is a kind of grief, which I'm slowly coming out of now I've been in my new job for two weeks. But I took my leave in increments, telling certain people in person alone who I wanted to hear it from me, some were really positive, some were sad and one made me downright teary! It gave me the chance to show my appreciation and thank them for making my worklife better, easier and more fun. We don't tell the people in our lives what they mean to us, what their actions have done for us and what impact they have made on our lives. Being given the opportunity to do just that was a blessing. I hope it was as moving, uplifting and confidence-boosting for them as it was for me.

Another of the random things I had to do for CJBS, screenshot from a video filmed by Dave Amann (you can find the full video online if you know where to look (I'm not telling you!)

I'm not saying goodbye though as I'm going to stay in touch with many of the people, as you wish, even if it's just on Facebook, but I've not gone far, just down the road. Cambridge is such a small place, I'll bump into people, see them at events and on my commute to and from work. Now, bring me that horizon.

Cambridge Judge Business School e-luminate-d

P. S. I hope you found all my references in this post (Douglas Adams, The Princess Bride and Pirates of the Caribbean). The title for this post was taken from the document I wrote listing all the things I hold to take myself off of in terms of websites, databases, files, intranets, wikis and posters, as well as clearing out my desk, folders and any remnants of me that are left behind. I'm still doing it to this day! I literally have to delete myself.

The photo that is up on many of the University's pages. Photo credit: Sir Cam

NB: Parts of this post were shamelessly taken from the email I sent out to say I was leaving, crediting myself in case of self-plagiarism!

As a mummy for Comic Relief (yes, that is me in there)

Mental health and physical health

I feel like a fraud. It's taken me this long to write a post for Mental Health Awareness Week as I found out last weekend that my mental health problems stem not just from one chronic illness that causes my physical symptoms, but now two. I know I shouldn't blame all of my mental health problems on my physical health, but they play a significant part.

It is true that sometimes it's difficult to know where physical health and mental health start and end. Which is the chicken and which is the egg? For me, I question whether the physical health problems I didn't know I had caused the anxiety, or if the anxiety was there already. What a lot of people don't realise is the sheer gamut of physical symptoms mental health problems can cause. I've made a list at the end of this post of those I've experienced, differentiating between anxiety and panic attacks.

However my anxiety issues started, they are here to stay. They can be situational such as when I have to teach, go on a date, or travel by plane. They can be due to memories such as seeing a person who reminds me of bad times, songs that evoke negative emotions or anything that brings up when I was bullied at school. They can also be muscle memory as anything that increases my heart rate, gives me butterflies in my stomach or affects my breathing can bring on anxiety as my body equates those functions with an attack. Exercise can be problematic and I avoid being overly excited.

I have chronicled my vestibular problem before and the moments of seemingly random out of the blue vertigo started at a similar time to my panic attacks, which lead to generalised anxiety (GAD). However, after almost three years of again seemingly random out of the blue gut problems, which I initially dismissed as caused by my anxiety, then possibly by a tropical holiday, then by my diet, then by something more sinister, then dismissed as IBS, it turns out they're caused by endometriosis, which can cause dizziness and anxiety, along with other mental health problems. I was passed around the hospital, visiting many different departments, with frequent tests, procedures and treatments over those years; some were disruptive and some were downright disturbing, but I got to know how amazing the NHS is far more than I have ever done.

That said, when you have a history of mental health problems, no matter how great the system is, you will come across people, from the most harried of GPs to the most senior of consultants, who take one look at your medical record and write your symptoms off as psychosomatic or just another manifestation of anxiety. However I knew there was something wrong. I knew my body. That is one of the upsides of having a mental health problem, you become very self-aware, hyperaware almost. I'm an introvert and highly sensitive, so it's more pronounced for me. That's why I love that there's a move to rebrand hypochondria as health anxiety. So any change, yes you question whether it's just another anxiety symptom, but after living with anxiety for half my life at that stage, I knew it wasn't. Apart from the sudden onset and the fact that I was in the best place with my anxiety than I had ever been due to undergoing cognitive behavioural therapy (CBT), I knew the effects of anxiety inside and out; I had lived through the vast majority of them right up to and including a mental breakdown.

So I had to fight, just like I had to fight for my vestibular diagnosis. I wish I didn't have to, but I'm lucky that I haven't experienced as much of the stigma towards mental health as I know others have. Every test they did, there was a valid reason to do it and every time it came back negative, equivocal or there was no improvement, I forced the issue. That's why it took so long, they had to rule out a tropical disease with blood and stool tests, a parasite by sending samples to a special centre, coeliac disease with more tests, food allergies and intolerances with elimination diets, something more sinister with endoscopies, via a leftfield nuclear medicine scan until finally I had the third MRI of my life, which revealed the problem. I could have given up, but the doubters, including me at times, were wrong, my concerns had been validated and once more my perseverance has been justified.

Everything is interconnected and the endometriosis, which with hindsight has been causing increasing severity in my period-related symptoms over the years, but, in medical terminology, has an unusual presentation because the gynecological symptoms aren't significant and the gut problems are far worse. The only pattern, not dietary, not regular and certainly not serious, but still affecting my quality of life, was that time of the month. It is another cog in the wheel of understanding my gradually worsening health where it feels like my body is beginning to fail me and there's no cure, just management. The not knowing, the uncertainty was unbearable, but a diagnosis, that I can live with.

TRIGGER WARNING, these symptoms aren't pretty, but I don't get most of them anymore:

Anxiety:

• Weakened immune system leading to colds and bugs
• Lack of energy and motivation
• Lack of concentration due to racing and spiralling fixating thoughts
• Dizziness
• Breathlessness and shallow breathing
• Muscle tension meaning diarrhoea, constipation and stomach cramps
• Muscle tension leading to pain in the shoulders, neck, back and jaw
• Dental pain due to clenching of the jaw
• Headaches
• Nausea
• Restless legs, jitters and fidgety behaviour, including eye twitching
• Food cravings, usually sugar
• Loss of appetite
• Sudden need to pass water
• Intense thirst
• Sweating, including night sweats
• Hypersensitivity of the skin
• Sleeplessness and insomnia
• Hot flushes
• Reliance on distractions such as TV and alcohol

Panic attacks, in order of occurrence:

1. Hyperventilation (but you don't realise)
2. Pins and needles, usually in the extremities, but starting in the nose
3. Feeling of handcuffs around the wrists
4. Wind: burping and farting
5. Bodily functions stop such as sneezing, digestion and oxygen to the extremities
6. Tight chest so it feels like you can't breathe
7. Heart palpitations so it feels like you're having a heart attack
8. Hot flushes so severe you start to take your clothes off
9. Claustrophobia so you have to take anything constricting off including your bra and jewellery
10. Self-harming through pinching to relieve the pain inside
11. Vertigo meaning severe nausea
12. Throwing up
13. Shaking
14. The need to be as low to the ground as possible, usually on the floor
15. Can't take in food or liquid as throat closes off
16. Severe tension in limbs so you can't move
17. Severe tension in the jaw so you can't speak
18. Need to have people around, but not liking to be touched
19. Feeling of impending doom
20. Whiteout where you lose your vision and feel like you're going to faint

Afterwards I get thirsty but can only sip, the shakes, cold chills, diarrhoea and severe fatigue. That's the adrenaline comedown. It's good to feel the cold as that's the first sign I'm coming out of it. The next day I feel hungover and I often find bruises where I've unconsciously pinched myself.

They say you can't pass out due to a panic attack, but I beg to differ, particularly when they're this severe. Also, they say they only last 15 minutes, which may be true, but you can have another straight afterwards; I had panic attacks all day every day for almost a week which came in waves and left my legs black and blue as I had been pinching them so much. I wish I'd taken a photo so people can see, but also not as it could encourage self-harming and it was that shocking, I don't want to remember.

However writing posts like this is important as it not only helps others understand their own mental health conditions and if I help just one person, then that's a success, but it also shows me how far I've come, what I've lived through and how strong I can be. Some days I need that.

Brain fog

The frog equivalent of fog

Or as I like to call it, my brain frog. Brain fog is a technical term, doctors use it to describe the feeling when you're trying to use your brain, but it's harder than usual: the mental equivalent of trying to walk through mud, or, as it says, thinking through a dense fog. Many of us experience brain fog without even realising it. When you're exhausted, drunk or hungover, you will have gone through brain fog. For me, it's when my vestibular problem hits, when the vertigo is so bad I can't think straight. My concentration is shot, that includes with my eyes, it takes a few more moments for something to sink in and, for me, it manifests the most when I speak. My brain frog is a literal frog in my throat, robbing me of my usual powers of speech. I can be a Mrs Malaprop at the best of times, but it gets worse when the brain fog manifests. My vocabulary gets more limited and the words just won't come out, or the wrong words do, usually ones that are very similar. That's why I call it my brain frog because, when I try to describe it to someone when I'm living with it, I invariably tend to say frog instead of fog.

For someone who reads a lot and prides themselves over their use of words, it's frustrating. For someone who usually thinks nineteen to the dozen and has a quick mind, it's horrible. For someone who's trying to write this blog post, it's almost impossible and takes ten times as long. Of all the symptoms of vertigo and the consequences, such as the lack of sleep which doesn't help in itself, the balance problems, the motion sickness, the nausea and the energy it saps from you just getting through the day, the brain fog is the worst as it makes you feel like you're not yourself anymore. It can last for hours and sometimes days, even after the main spinning sensations have gone, leaving you feeling hopeless.

There are ways of dealing with it, not least taking it easier, going slower, triple checking what you're doing, making notes and creating reminders. I rely on muscle memory, especially when I'm getting around, remembering routes, room numbers and people's names. So don't take it personally if I get your name wrong or don't say it at all. Mostly, you have to be kinder to yourself, like me forgiving myself for the little mistakes my anxiety usually berates me over and over again with and managing your own expectations of yourself. Chronic illness is difficult if you remember how you were before; you have to accept the fact that person is gone. So I have befriended my brain frog and have even become amused by it. It's a funny friend and one that is here to stay.

Holiday anxiety

Going on holiday causes me a great deal of anxiety. Don't get me wrong, I love travelling, seeing places, experiencing other cultures, being embedded in a new world. However, the going on holiday, that's an altogether different thing. First off, there's the anticipation. Our recent holiday to Costa Rica took months of discussions, much planning and it's a long flight. So there was a lot of time to think about it, the distance, the difference and the disturbance. For my previous big holiday to The Philippines, I tried to bury my head in the sand, which didn't work out, as it only caused more uncertainty; a week before I was having panic attacks and it was an exceptionally fraught journey. So I did the opposite with Costa Rica, reading two guidebooks cover to cover way in advance of booking anything other than the flights and involving myself totally. Knowledge helps as anxiety is all about uncertainty. So understanding what the place is like, reading up on it and knowing where we're staying and what we will be doing really helped and the result: no panic attacks at all.

A nicer way to travel: horse riding at Arenal

Then there's the actual travelling. Car journeys are tough and we've done some long car journeys: up to Scotland several times (8 hours), deepest Wales (6 hours) and all the way across Europe to Germany (days). I've only had panic attacks a few times on car journeys and they weren't about the car journey: bad weather where vehicles were aquaplaning all over the place; I was already having a panic attack and had been having them for days during my mini breakdown; and due to my balance problem causing me to feel like I was on rollercoaster and I'd just seen the final Harry Potter film at an old-fashioned cinema and it had messed with my head. Boat trips are worse because I get seasick, but I can handle it better as it's easier to combat it. Big boats like ferries are no problem as you can barely feel they're moving. With smaller boats, I just go to the front and watch the horizon, so no panic attacks there. It even gave me a indelibly memorable moment in The Philippines: I was alone at the front of the boat and a whole flock of flying fish just erupted before my eyes. But plane journeys, they've caused several panic attacks. I don't like being in situations I can't get out of easily, not enclosed spaces as such, things like lifts, caves, tunnels, planes, queues, even complicated clothing... The plane panic has got so bad, I've been physically sick and that was on a 4-hour flight. The Philippines took two flights of seven and then eight hours. I was dreadful on the first flight. On the second, I was simply exhausted. However on the flight to Costa Rica, a journey of almost 11 hours, I was fine, apart from a small blip after eating and when I was between films; I just have to keep my mind preoccupied.

I could never be as relaxed as a sloth, especially those at Toucan Rescue Ranch

I had prepared, taking: a book I was already really into and couldn't wait to find out what happened next and another book which was a romcom I had been itching to read; a puzzle book which occupies my mind like nothing else; music and noise cancelling cordless headphones including tracks explicitly designed to combat anxiety, so much so they advise you not to listen to it while driving or operating machinery; a pad of paper so I could get my thoughts down if I needed to; my notes on my book in case I wanted to do some actual writing; and my pills as an emotional crutch. I didn't need any of them; turns out, all I needed was the in-flight entertainment, being careful of what I watched, sticking to family films, comedies and light drama; I saw five films there and five on the way back: Early Man, Ferdinand, Peter Rabbit, Lady Bird and Alan Partridge: Alpha Papa on the way there and Peter Rabbit, Love, Simon, Blockers, I, Tonya and Isle of Dogs coming home. Yes, I watched Peter Rabbit twice, I just loved it so much, which was a surprise as I adore Beatrix Potter, heard bad things about it and probably wouldn't have seen it if not for the flight. I even found some wellbeing videos while investigating what was on offer: BA provides for their customers.

My bedroom on Tresco, in the Isles of Scilly

The other issue is I'm a complete and utter homebody. I like my own bed. In fact, there's only been one holiday where I've slept well and that's because the bed was amazing: Tresco in the Isles of Scilly. I can't sleep on anything that moves, or I can feel moving anyway, so planes are completely out, cars and smaller boats are problematic, but big ferries are fine. Because I was the last person to lock our front door and even though I did it in such a way as I would remember, using my left hand instead of my dominant right hand, I still spent the entire holiday in Costa Rica thinking I didn't lock the door. I had, obviously. But anxiety makes you believe you're an idiot!

I adapt very quickly and we were on holiday for three weeks. Three weeks is a long time and I didn't realise how much I'd adjusted until we got back. It’s enough time for the roadworks that were the bugbear of my daily commute to move elsewhere, for the goslings I see every day to become indistinguishable from their parents and for my team at work to change again. I could no longer overtake anyone on my bicycle, probably due to the lingering virus, rather than being unfit; we did a lot of walking. It's enough time for cobwebs to grow on my bicycle locks. It's enough time for the UK to get better weather than Costa Rica!

Some of the beaches were all but deserted, like this one in Montezuma, despite being beautiful

A strange thing happens when I'm on holiday: I don't get anxiety, not full-blown anxiety anyway, just your ordinary run-of-the-mill anxiety that most people experience, but not me. I was challenged, but my anxiety didn't take over like it usually does, even when I was ill having caught a horrible virus; being ill on holiday far from home is my worst nightmare; even when there was a massive thunderstorm for hours on end, even when we were driving roads with massive potholes (Great Britain has nothing on Costa Rica) along high roads with steep drops in the middle of nowhere. It helps that in The Philippines and Costa Rica, we were visiting family and I had my niece and nephew to concentrate on. Home is not a building, but the people you love. But it's happened on other holidays too. It's like being away from home is a holiday from the worries of daily life, a vacation from reality. I do things that I wouldn't normally do like going surfing when my balance problem should stop me, using an outdoor shower without thinking about the huge bugs and trying new food when I'm a picky eater. I'm trying to hold on to that now I'm home.

Me swimming with trout in a waterfall river

I won't be doing any night walks again though; we did ours from Monteverde, but you can do them from practically anywhere. It was a great experience; there are no pictures as my camera wasn't good enough, though we saw a sloth, kinkajou, armadillo, tarantula, snakes and many birds and insects. We got better photos on our own night walk in Arenal. But it's not something I'll be doing again. I probably wouldn't have booked it for myself, just like the surfing, and for the same reason: my balance problem. It's easy to see how being permanently off kilter would stop me from surfing, but you wouldn't think it would affect me walking around in the dark. However it's one of my biggest problems. We had torches, though when we had to turn them off to see a scorpion in UV light, I had to grab hold of someone for fear of falling over. There was an added complication. My niece wanted to hold my hand, so I spent practically the whole time with her, apart from when I got annoyed at her jumping over things and flashing her torch in my face, but she came back to me. This would normally be fine, but when I'm concentrating so hard to keep myself upright, having to look after her as well and fearing that if I go over, she'll go with me was difficult. However it did help with the anxiety, having someone else to focus on!

A red-eyed tree frog on our own night walk in Arenal

I must admit it’s difficult being back. Not for the usual reasons: tiredness but not jetlag, back to reality, back to work, back home and the football and Wimbledon being over. It’s for more subtle reasons, other than missing my family of course. When I open my curtains in the morning, it’s not a hummingbird I see but a pigeon, bunny rabbits not agoutis and the birds flying overhead are not vultures, but pigeons. Everywhere is yellow and dry rather than lush and green. In Costa Rica, everywhere is so full of life, wildlife, from birds to butterflies, from lizards to insects. I keep looking at tress moving, expecting to see a monkey and seeing a squirrel, looking at every bird expecting to see something interesting and listening out for rumblings in the sky in the afternoon. My alarm clock is my phone, not howler monkeys, thunderstorms or my niece creeping in to see if I’m awake. The fruit is smaller and less exotic. The potholes are smaller and less numerous.

Me with an owl butterfly at La PazWaterfall Gardens

However the holiday has changed my world view, more so than when I went to The Philippines and Bali, but less so than when I went to Tunisia as a teenager. Costa Rica, for all its wildlife, beauty and landscape, has made me grateful to live here, despite the politics, due to the health and safety (though we have gone too far), advanced infrastructure and less obvious poverty. It has taught me to look around more closely; you never know when you’re going to see a different bird, lizard or something interesting; to walk bare foot and to try new things like swim in a trout-filled river! Above all, I have returned with a renewed sense of confidence, though that has taken a knock as I was stuck in my glasses while waiting for my contact lenses to be redelivered. I'm proud of how well I coped. With that confidence comes an acceptance of unconditional love and friendship; my limpet of a niece didn’t want to spend all that time with me because I have a radiant personality, looked good or am witty, it was because I’m her “Auntie Sarwah.” So my experiences have lead me to an acceptance of who I am, to accept me for me, which is no small thing. I have made a resolution to take the holiday spirit and apply it to my anxiety. Let's see how I get on!

A mother and baby spider monkey, just because

Here are my reviews of the places we stayed, it's mostly about the animals I saw as I'm a nature-lover:

San Jose
The first place we stayed in was my brother's place near to San Jose. From there we visited three wonderful places, though I can also recommend Museo Nacional de Costa Rica in San Jose:

My brother's place

Zoo Ave
You will see wild animals in amongst the rescued ones. You will see animals you won't see anyway else, including a tapir (unless you're very lucky), peccary (unless you're very unlucky as they're dangerous) and pumas (to see a big cat is highly unlikely). You will see how we should always put wildlife before ourselves.

These squirrels were everywhere

La Paz Waterfall Gardens
Known for its waterfalls and its hummingbirds, my favourite part was the butterfly house. They also have sloths, toucans and poison frogs. You won't see one of their residents anywhere else, unless you're very very very lucky and that's a jaguar. The walk down to the waterfalls is actually quite easy, though it is a lot of steps and they'll bus you back up. However just sit by the hummingbird feeders by the entrance or down by the excellent restaurant and you'll marvel at the wonder of nature.

A jaguar at La Paz Waterfall Gardens

Toucan Rescue Ranch

One of the most memorable places I have ever visited. It may be named after the toucans, but they have lots of other animals including big cats like the ocelot, porcupines, raptors, parrots and most famously, sloths. If you want to see sloths up close, baby sloths and how a country should treat its wildlife, then this is the place for you. You will need to book a private tour and you will get an informative and passionate guide to show you round. It may be a tiny place, but it will occupy a huge space in your mind.

This is hard to see, but it's one of the lucky ones as it's at Toucan Rescue Ranch

Casa Frangipani, Montezuma
This was one of the standouts of the entire holiday and we almost didn't go; it was a last-minute change after our flight to Tortuguero was cancelled as the airline had a fatal crash and weren't flying. You will need to take a car ferry there, but it's worth it. We were high up, overlooking the coast so we could see the ocean and we were surrounded by rainforest. We saw more animals in the first day than we'd see staying next to a National Park! Vultures perched on a tree branch, howler monkeys including babies in the trees next to the pool we were swimming in, agoutis bounding around, hummingbirds flitting from flower to flower, flycatchers and other birds chirping from the canopy, leaf-cutter ants constantly marching in line and countless butterflies. The accommodation was nothing outstanding, but it had an amazing balcony, a roof terrace we never used and an outdoor shower only I used. Montezuma, the village nearby has a great Italian restaurant, a bohemian feel and incredible beaches just up the road. I can highly recommend the tidal pools and surfing beaches, where you'll see pelicans diving for fish. Beware, the roads are terrible.

The pool at Casa Frangipani

Club Del Mar, Jaco
On the way, stop off at the bridge over the Tárcoles River to see the crocodiles. We were in Jaco when I was ill, so I didn't explore much, mostly dosing and getting through two tissue boxes, but we saw an iguana climb the tree just outside our place on the first day and it proved to be a regular visitor, scarlet macaws flew over and fed from the trees by the resort's beach every morning and the butterflies again were amazing. The accommodation was the best we stayed in: spacious, comfortable and with superb facilities. The resort itself was fantastic with a great breakfast every day and excellent staff, a lovely pool and beach I didn't use complete with surfing lessons and a chilled-out atmosphere. Jaco is basically a strip of shops and your typical white sandy town beach, not that I'd know.

One of the residents at Club Del Mar lazing by the pool

La Posada, Manuel Antonio
Its location cannot be faulted as it's right next to the National Park entrance, but it's also its downfall because it's in a busy area with street sellers touting their wares all day; the bird whistle sellers were a particular annoyance. However I saw my first and only raccoon here, there were hummingbirds around, iguanas, lizards and giant insects. We never saw any monkeys or sloths though until we entered the park, including on the castaway-like beach which is a must. The staff were so helpful and welcoming, the pool was perfect for our needs and the accommodation was spacious and comfortable. We got a good breakfast every morning and there was a supermarket incredibly close and bars nearby. For the restaurants though, don't go down to the strip, get in the car and drive up to those overlooking the sea, such as El Avion which has an airplane in the middle of it! Do not stay here if you don't like touristy places, stay in Quepos a few miles away and do go on a river trip as the mangroves are very close; it was one of the highlights of our trip.

One of the sights on the mangrove boat tour: a capuchin monkey

Arco Iris, Monteverde, Santa Elena
It can get very hot, sunny and humid by the coast. In the cloud forest, it's colder and wetter, with weather just like an English Summer, except more humid and with regular thunderstorms. Santa Elena is a strange place, a town in the middle of nowhere, high up and with cloud forest all around. The wildlife in our hotel was almost nil, except the resident cats my nephew adored, but the breakfast was the best we had, full of locally sourced and grown ingredients, including on site. The emphasis here is on the environment, and the accommodation and resort reflected this. It was lovely, like alpine chalets and the town has everything you could need, though it can get very busy with its tourist shops. The local cloud forest we visited is easily accessible, but more about the trees than the wildlife, though we did see a coati, but in the car park!

A hummingbird in the cloud forest

Arenal Observatory Lodge, Arenal
For me, the best place we stayed in, saving it for last! The accommodation we had was a bit odd though, with the sink and toilet in separate rooms, but the shower was brilliant. The roads are shocking, but the place is stunning. We saw more bird life here than anywhere else, including a resident hummingbird right outside our lodge. There were also coatis, monkeys (both howler and spider monkeys), butterflies, frogs, geckos and my Dad saw a kinkajou. Nearby are numerous hot springs, if that's your thing. We went to Baldi as it has water slides and the lodge booked for us as we got a discount. The observatory has everything you need and were very helpful. The breakfast was fantastic and the views by the restaurant and bar are breathtaking of both the volcano and the lake. The grounds are extensive with hanging bridges, a swimming pool, massive jacuzzi, gardens, a waterfall and nature trails. Visiting the frog pond at night is a must. You can go horse riding and take advantage of their other activities. I could have stayed here forever just watching the changing landscape, exploring the trails and seeing some new creature every single day.

The swimming pool at Arenal and the volcano

A few tips about Costa Rica: if you're driving, get a 4x4; don't worry about power cuts or internet outages, they happen; always close the screens on windows and shutters otherwise you'll let the bugs in; revel in the wildlife, Costa Rica is a nature-lover's paradise; Don't spend all your time taking photos, some of my best memories are just sitting and watching the animals, my family and the world around me.

A crocodile chilling out by the bridge over the Tarcoles River

Music therapy

I have brought music back into my life. I realised how little music I listen to, just as part of film and TV soundtracks and on long car journeys: the only time I listen to the radio. It was a big part of one of my old jobs and it was crucial there; working at a police station can be extremely stressful. We listened to the radio, all day every day. I have a playlist full of music from that time and after the annual Cambridge Librarians conference I created a new one, which you can see on Spotify.

It's one of the three new year resolutions I made; I know, I don't usually make them, but I find myself at a transition point in my life mentally and I needed to make some changes: music via some cordless headphones, health and fitness (the first part being out of my hands and in the doctors') and writing my book, which is going slowly. However this is helping as music is a big part of my book. I toyed with the idea of at the beginning of each chapter naming a song as a thematic device, but that became too unwieldy. So, using Scott Pilgrim as inspiration; the author listed the songs he listened to when he was writing the book at the end; I have created a playlist for the book, which I will put on Spotify if it gets published.

Scott Pilgrim

Music helps me emotionally, so I don't know how I've done without it for so long. However I know why; in-ear headphones affect my balance as it changes the pressure inside my ears. Over-ear headphones are fine, but the cord gets in the way, so I needed cordless headphones. They're the best Christmas present I've had for years as they have changed my life. Listening to music over lunch has improved my mood no end, especially as I've been tipping towards depression. It's been long overdue as it is quite common with anxiety sufferers, but now I have a handle on my anxiety, it has started to manifest. The Guardians of the Galaxy soundtrack has been helping. The conference was too much for 70s and 80s music to combat though. Big social occasions overwhelm me, on three fronts: mentally, physically and both together. The social anxiety of having to mingle and make conversations, alongside crowds of people putting me literally off balance due to my vestibular condition and all the noise, commotion and activity affecting my high sensitivity. So, just like with the Christmas party, mentioned in my Quiet book review post, I was grateful to have a job to focus on; because my workplace was hosting it, I helped make sure our library looked the best it could be, creating posters and plasma screen slides beforehand and displays on the day. When I felt overwhelmed, I had the excuse to pop back and check on things, plus my natural conscientiousness drove me to do that anyway! There, I could deal with fewer groups of people, showing them round. However, unlike the party, I had to focus and listen and take things in. I had to engage my brain, so I really had to manage my issues which was doubly exhausting.

After the conference, I had adrenalin overload, a consequence of the anxiety. I did pop my head in the pub afterwards, but when I cringed every time I said anything, imagining social fauxpas, I knew I had to go home. I was right, as it kicked in when I got in the door. So I had to slow things down. If I don't do anything, it could trigger a panic attack and the subsequent adrenalin comedown, both aren't pretty and make me feel awful. So keen to avoid that, I went home and listened to my wind down playlist as I call it. The One Show and Death in Paradise, cosy, good-hearted and mildly challenging TV helped too. There are few Cafe Del Mar type pieces of music as my chillout tunes need words and lyrics, otherwise I can't connect with it. Let me know your own wind down music. Books are the ultimate way to wind down for me though.

I won't include the full list of songs here as you can see, and hear, it on Spotify; I've called the playlist wind down obviously. Instead, here is some of the reasoning behind my song picks: blur as Damon Albarn's just-got-out-of-bed voice is soothing and has real meaning behind it, not the youthful exuberance of their earlier songs, excepting The Universal, but those from Think Tank; Travis, my favourite band would always make an appearance, their mellower later tracks are beautiful and Fran's lyrics and melodies speak to me like nothing else; Leftfield as I'm always lulled by their tunes; The Levellers' Elation is a song that sends me to another place; Moondance is one of my favourites of all-time and the version from the film August Rush reminds me of a great moment; Shakespear's Sister is a real nostalgia trip and Stay takes me back in time to listening to the radio on my way home from swimming, all sleepy and relaxed; Sit Down by James has some of my favourite lyrics which make me feel like I'm not alone; Vangelis is one of the best film composers and his music is so out of this world I'm not me anymore; there are songs that bring back memories from great films and TV like Disney which would always make it to any of my playlists, the dreamy The Life Aquatic, seductive performances in The Bronze on Buffy, the excellent Veronica Mars soundtrack and music from my favourite TV series Alias; Elbow's Mirrorball can send me to sleep in the best way; Into Dust by Mazzy Star is trance-like; some songs are self-explanatory just from their titles such as Moby's Down Slow, Will Young's Let It Go  and Simon and Garfunkel's The Sound of Silence, one of my favourite songs ever; some artists are just perfect for winding down to such as The Lighthouse Family's smooth tones; and finally Gotta Get Thru This was the soundtrack to my first panic attack-ridden months and was one of the things that literally got me through. I will be forever grateful to Daniel Bedingfield for bringing that song out when he did, so the acoustic version is my go-to to wind me down when nothing else will work.

There are songs I wanted to include, but were either too emotive like Sarah McLachlan, come from films or TV programmes that had too big an impact on me or were songs that remind me of a part of my life that isn't conducive to relaxation. The exception that proves the rule is the Star Trek: Voyager theme as it reminds me of early evenings when I was a kid, warm and snuggly after I'd had my bath. I hope you find some of these helpful, they mostly have a slow rhythm that mimics a relaxed heartbeat and none of them are melancholy, but hopeful and neutral.

Bonus: Here's a Travis song not on Spotify, a lovely Viennese Waltz style song all about me!