I have been working for several months now to reduce the amount of flailing involved in finding more balance in my life. I was working on this before the first heart attack on 4/27 and I’ve attempted to tromp on, one foot in front of another, since the second heart attack on 5/5.

I have been overwhelmed but a month or so, I thought, “Just work on changing one thing.” The change I worked on was increasing the frequency of my walks, which had slipped from five days a week to three days a week. Last week, I walked five times, helped by the long holiday weekend, but I do feel like something has shifted in a positive direction.

My meditation practice had also dropped off. My friend, Nancy, and I are now back to taking a walk to and from her house to the Frye Art Museum for their weekly free sitting meditation, which is excellent. I rarely get the chance to socialize with my closest friends let along exercise and meditate, too!

Someone asked me recently, “How is your heart?” I said, “I don’t really know. It’s not like when I had breast cancer and people were checking on my all of the time.” I’ve stayed at the hospital twice, each for two nights, and had a half-hour long outpatient appointment with a cardiologist on June 2nd. That’s it. I remembered something from my June 2nd appointment. My cardiologist asked me if I wanted to do cardiac rehab. At the time, I thought it meant going to group classes to learn stuff I already knew. Honestly, I wasn’t entirely ready to think of myself as a cardiac patient. I am still working on that.

Meanwhile, I’ve been considering seeing a personal trainer to reinvigorate my physical exercise. I would also like to work on my physical strength and stamina. My hesitation in working with a personal trainer is that I am a cardiac patient. Hmm, maybe someone who specializes in cardiac rehab would be helpful?

I checked the website for the Swedish Cardiac Rehab services. Yes, there are some classes but there are individual appointments as well as an individualized health plan. There are many visits. I called and will start after I return from the Mayo Clinic.

I am relieved. They will be able to help me gauge my progress. They will be able to tell me what losing 45% of heart functioning does to a person. They will help me keep on track.

I coped with breast cancer extremely well. (It still sucked, by the way.) I had a really good self-care plan. But I didn’t make all of my life changes at once. I had forgotten that.

Last Friday, I had a moment that I noticed. It was an intense feeling of well-being. It reminded me of moments I had as a child sitting in the grass, picking dandelions, and blowing the seeds in the air. There’s that blissful moment of watching them take flight.

I am reflecting back on that moment today as I begin a new week. I am holding on to the feeling of letting go.

As always, peace to you, friends.

-Elizabeth

So much of life is waiting for situations to resolve, one way or the other. I received a notification from my insurance company a couple of weeks ago. They requested a medical record review to determine the “medical necessity” of some scans I have scheduled at the Mayo Clinic as part of my diagnostic work-up for Spontaneous Coronary Artery Dissection (SCAD).

When insurance companies ask for a record review for the kind of procedures I do as a clinical psychologist, the review can take a very long time. When I received my letter, I thought, “Okay, this trip to Mayo may not happen in July, or perhaps ever.”

The Mayo Clinic won’t see me unless I am able to do all of the things they do to assess SCAD. Plane tickets and hotels have been reserved. My schedule is open for the week of hypothetical travel. As a self-employed person, that means I have no income coming in that week.  I’ve invested emotionally, physically, and financially in this trip.

I tried not to think about this too much and I was about 60% successful. My daughter is transferring to Western Washington University in the fall. This is good news but it presents logistical and emotional challenges. She missed the deadline for student housing and needs an apartment. I saw an opening in my schedule to take her for a few days to Bellingham, WA, near the Canadian border, to look for apartments. I talked to John first. He thought it was a good idea. My kid thought it was a good idea, too. I then cancelled three days of work and spent many hours lining up apartment visits.

Meanwhile, all of us were freaking out about the girl moving out, in our own individual ways. The girl freaked out about living on her own. So did hubby. To make a long story short, I was the only one ready to make the trip to Bellingham. I was mad, to say the least. But I wasn’t mad for long. I had a chat with John and told him that apartment hunting was a one-parent job, not a two-parent job, and that I didn’t need to be the parent in charge. He was happy to take over. Then I hit the road and decided to make the three days a personal retreat, something I wanted to do this summer, anyway, and had to cancel due to the stupid heart attacks. I had a great time and came back home refreshed.

Meanwhile, I was waiting on word from either my insurance or the Mayo Clinic. As it is, I used frequent flier miles to book two separate return tickets home. The first ticket is the “evaluation goes as planned” ticket. The second one is later, in case I need two days of extra scans and appointments. The Mayo Clinic suggested that I plan accordingly, so I did. I am hoping to return earlier not just to save money on hotels. The girls’ university orientation/registration/apartment hunting trip is happening on Monday, 7/24. I want to be there.

This is logistical complexity that stresses me out more than a bit. It gives me great empathy for the many folks for whom the logistics of healthcare dominate their lives. They have to live the rest of their lives on the edges, assuming that they don’t sleep through that part. Being sick is exhausting. Getting better from being sick is also exhausting.

I am a woman of some means and a hugely supportive network of friends and family. This experience makes me think about the rest of our country. What the hell, America? People are worth something. Healthy people are worth something, even if one is being selfish and crass. Oh yeah, this whole Trump being president thing is also a chronic stress for me. Imagine if I were an immigrant? Or any other marginalized person?

The good news is that I got my follow-up letter from my insurance two days ago. My scans have been pre-authorized. Some unqualified insurance employee has deemed that the Mayo Clinic can do their job and that I can benefit from their expertise. This is a positive outcome to a negative process. For now, I will focus on my trip to Rochester, MN.

Peace to you, dear friends.

I find myself quiet since my heart attacks. Although I am working about as many hours a week as I was before, I have reduced other responsibilities, which has freed up time and space. Further, my husband is working most nights right now.

At times, I find myself craving more to do, more to fill up the spaces in my life. At other times, I am thankful to have time and place to just be. When I was going through breast cancer treatment, my life was really busy with healthcare appointments but I also had significant amounts of time off from work to recover from surgeries. I did a lot of walking, writing, and thinking. Sometimes I got lonely but often I was in a mindful space where it was possible to feel and be and breathe.

There are more pauses in my life than there were before, especially when I was working my butt off in grad school, moving constantly, and adjusting to motherhood while building a career. The challenges between the pauses, however, are less predictable. Breast cancer at age 46. Almost exactly 5 years later I found myself hospitalized with two heart attacks. The heart attacks were even more surprising than the breast cancer. In terms of cardiac risk, the odds were strongly in my favor.  Even the report of the lipid profile that was run while I was in the hospital the day after HAVING A HEART ATTACK, has a summary at the bottom, “below average risk (female)”.  This estimate is not necessarily wrong, by the way. It does not read, “no risk” or “zero risk”.

When it comes to my physical health, I’ve had an unlucky five years. But I am lucky in so many other ways. One of those ways is the time that I have right now. I am headed to the Mayo Clinic in Minnesota next month to have an evaluation for Spontaneous Coronary Artery Dissection (SCAD). I scheduled my appointments to occur when I had planned to take a trip to the beach, by myself.  The part of the trip that is staying the same is that I am going by myself, which is my choice. My husband will attend my consultation with the cardiologist by phone.

Although it is true that I have had more fatigue lately, I honestly feel about 80% of my old self, most the time. Most of the 20% reduction is due to difficulties with my sleep. The daylight hours are long this time of year and with lots on my mind, it is a bit harder to get back to sleep if I wake up from the sunrise or my husband’s snoring. I do, however, continue to have a day or two out of each week that feels like the air was let out of my tires.  Nonetheless, I have returned to working in my garden as well as to the pottery studio. I find both activities highly meditative.

Silence is very important to my healing process. Today I feel a lonely kind of gratitude, but it is gratitude, nonetheless.

I wear two rings, an engagement/wedding ring, which I’ve worn since 1990 and an anniversary ring, which I’ve worn since 2005. I had the anniversary ring appraised after I had it designed. However, I have not ever had my wedding ring appraised. It has been 12 years since I had the other ring appraised. I have NEVER had them checked by a jeweler. That is something that I am supposed to do each year. Oops! Last Sunday, I dropped my rings off at a jeweler to be checked, cleaned, and appraised. I will pick them up next Sunday.

I am re-appraising many things, not just my diamond rings. Most of all, I am re-appraising my lifestyle. It’s the same that happened when I was diagnosed with breast cancer in 2012. And guess what? Having two heart attacks, out of the blue, also gives me pause and time to re-appraise my life and how I live it.

I have been coping, so far, rather well. However, I can realistically tell you that I am uncertain. I am afraid. I think these are reasonable reactions. I am working successfully to enjoy each day. I have embarked upon another voyage of ambiguity. This time, however, I may have a quite rare cardiac disease. Fortunately, I have found resources through the breast cancer blogging community, which is connected to other health care advocacy groups. Unlike my breast cancer treatment, in order to find specialists this time, I’m going to need to travel out-of-state.

I am someone who deals better with adversity if I have some past experience dealing with it. I am not grateful for having had cancer in the past, but I’ve got to tell you that I learned a lot in that experience and I am drawing on it now.

Today, it is beautiful and sunny. I’ve had a good work day, part of which included time with a kindergartener. I came home to my loving husband. For now, I will meditate on that.

I remember playing the game, Risk, with my brothers when I was a kid. I don’t remember much about it except that I think the goal of it is world domination. That’s probably why I stopped playing it. I don’t like, Monopoly, either. Go ahead, call me a socialist. What I do remember is that the game board is a map of the world. Being a word lover, I was taken with some of the place names. One of them was “Kampuchea”.

I haven’t thought about the word, “Kampuchea” for a long time until recently, like last month. I was in Cambodia and silly me, I did not know that the Cambodians call their country, “Kampuchea”. When I was informed of this, I thought back to the game.

I also thought of the risks people take in life. We hired a driver in Cambodia, Tong. Tong is a man in his 30’s, married, with two children. He was obviously smart, knowledgeable, and very personable. Tong had to work full-time on the family rice farm after he finished elementary school. His parents were from Phnon Penh and had lived through the Khmer Rouge, Pol Pot, the genocides of the Killing Fields, a secret (not to them) war waged by the U.S., and civil war.

Cambodia has been through unspeakable horror. Although they are currently in a period of stability, they are still a country with four millions landmines, yet to be located. Every year, people are harmed or killed by landmines, leftover from the past. Tong told me that his parents do not like to talk about war times or the genocides that they witnessed first hand. Tong, however, took the risk of telling me about it. He took us to a Killing Fields outdoor memorial exhibit in Siem Reap. Tong told me the stories. He told me the details. I asked questions. At one point, he gently asked me to speak more softly.

Tong later explained to me that the area was a temple and the monk that is in charge of the temple has close ties to the Communist Party.  Although Cambodia is supposed to be a democracy, it is not. It is controlled by the People’s Party and the elections are not fair. There is no freedom of speech in Cambodia. Tong, from the safety of the inside of his car, explained to us that he has to have “pineapple eyes”. Telling us about his concerns of corruption on every level of government, even in the public school system. (School is supposed to be free but the teachers charge the families money.)

Sometimes we seek out risks. Other times, we cannot escape them, because of war, violence, natural disaster, or disease. It is fascinating to me how the scared part of my brain can put all risks into the same undifferentiated category. I am learning to get perspective. All risks are not created equal.

Some risks just involve getting past discomfort or manageable amounts of stress. To be honest, though I love to travel, I had put off taking a trip to Asia. The flight seemed way too long, I don’t know any of the languages, and Asia is crowded! Further, Cambodia is an extremely poor country. Though it’s economy is growing, the average annual wage is $7500 USD. I had to face the discomfort of my own wealth and privilege, which is really just luck.

I got past this and we had a fabulous vacation. I also contributed to the economy of countries that need it. As for Tong, the tip that we gave him paid for three terms of school for his daughter. He is working for more opportunities for his children. Tong is making sure that they learn English and Mandarin, for example.

Maybe I’ll even start playing, “Risk” again. It’s not real world domination. It’s just uncomfortable. It’s just a game.

I am two weeks into our trip to Thailand and Cambodia. The current time is 14 hours ahead of Seattle. The current place is 500 miles north of the Equator. It is almost always tomorrow here. This is the closest I have been to summer, while still being in winter.

There is much about time and space here. There are so many sacred spaces. I have visited amazing temples of the past and the present. Some of the temples are centuries old and currently in use.

One of the things I have noticed is that there is often clock next to the main buddha statue. Some clocks are antique. One that I saw was a large electronic clock with green L.E.D. letters, surrounded by antiquities. I thought, “What is THAT doing there?”

To my sensibiities, it didn’t fit. It was an anachronism that harmed the aesthetic and spirit of a holy place. Then I started wondering about many similar scenes that I’ve witnessed during this short time in southesast Asia. I started asking questions about my own culturally influenced aesthetic. I observed how different I am about having my photo taken in front of antiquities. I appreciate having maybe a photo for the day to remember how I felt about the experience, but mostly I think of inserting myself into the scene as detracting from it’s beauty. I am an anachronism in my performance sneakers and modern dress.

Tourists from many Asian countries are vastly different. Getting one’s photo taken in front of every key area of a building is very common. People wait in long lines to do so. There is usually two or three young Chinese women at each major site wearing fancy modern dresses, getting many pictures taken at each stopping point, model style, by a young man taking the photos with a smart phone. I will admit that in addition to bemusement, by week two of having the frame of my shot blocked by an amateur model making five poses in a doorway, I felt minor irritation.

In the west, we treat time differently, I think. The past is something to be preserved and unchanged. It is something to be worked for in the future. It is fascinating to me to think about how this view may have impacted our aesthetics, our sense what belongs where.

I did a Google search about the clocks in the temples, by the way. I don’t know if the little bit of information I found is true or not but it indicated that the clocks are there to help monks avoid meditating through meal times. The anachronistic clock helps the monks keep the past in the present.

Peace to you, friends.

A week from Thursday, I leave for a three-week-long trip to Thailand and Cambodia! It is a two-year’s belated 25th wedding anniversary trip. I am so incredibly excited. My husband and I have been planning this trip for months. I typically pack too much and check a bag. However, for this trip, I will be paring down to the essentials so that I can to with just a carry-on suitcase and a personal bag.

It is winter here and we live about as far north as a U.S. citizen can live, at least ones who do not live in Alaska. We are traveling far east and considerably south, close to the equator. It will be very hot and humid. A certain level of modesty is requested when visiting temples, specifically that legs and the tops of shoulders be covered. Having lived in Florida and traveled in Egypt, I also know that there are advantages to being covered up in loose long clothing. It’s cooler and it provides sun protection. I have chosen my travel clothing carefully, for maximum versatility. We are also taking a short tour in Beijing, China on our way back home, and it will be considerably colder there. I have a lot of light clothes that can be layered.

One of the bigger challenges to packing a carry-on bag has been fitting all of my liquid toiletries into airline approved containers that all fit into an airline-approved-sized plastic bag. I have sensitive skin. I am picky about what kinds of cream I use as well as sun protection. Some of my skin creams are prescription and not something I could easily buy overseas, anyway. I am not the only one who is challenged by this because there now appears to be a whole industry devoted to providing liquid products in solid form, for travel. I have solid shampoo and solid conditioner. Did you know that there’s mosquito repellent available as a solid, in the form of a bracelet? There’s toothpaste that comes in pill form. Last, but not least, I have SPF 50 facial sunblock that’s  a tinted powder.

I have also found room for a few luxury items. I have not taken a really long flight since I was a 24 year-old newlywed, flying from Cairo to Seattle, in a series of many flights, including crossing the Atlantic. The flight from Seattle to Beijing will be 11 hours with no stops. That’s a long time to be sitting on a plane. We bought our tickets with frequent flyer miles but paid for an upgrade to business class, which means that our seats will fold down into a bed. I am bringing a memory foam neck pillow (I may want to drift off while in the airport), a sleep mask, and noise-cancelling headphones. I typically have a terrible time sleeping during travel. I hope this will help.

As I’ve spent the last few weeks, narrowing my choices, preparing for places I have never traveled, I think of how I’ve spent the last few months of my life. My country has scary people in charge of government. I am preparing for the times ahead by deciding what is most important in my life and where and how I will spend my resources.

Self-care is something that has been a challenge these days. I am committed to being an activist and to make enough time to do that. That is helpful but it can also be stressful. But I am doing my best and I see benefits from my efforts from the simplest actions such as no longer reading the news or engaging in social media while I am in bed. It really wasn’t a good idea before but now it makes the difference between a restful night and a stressful night.

My husband doesn’t know this but I actually thought we might have to cancel our trip when I learned who had been elected our 45th president. I felt a flash of shame at being a U.S. citizen, even though I know that I am not responsible for this mess. I can always be a better citizen of my country as well as the world, but this election result and the current administration are beyond the pale when it comes to bad choices on the part of many U.S. voters. More often than not, it is like living in two countries. Actually, that doesn’t really capture. It’s like trying to live my real life while stuck in a badly written James Bond movie.

We are going on this trip to celebrate 27 years of marriage. I am so fortunate to be able to travel and see the world.

As always, peace to you, my friends. (Also, stay tuned for travel photos!)