Hypertensive? Me?

High blood pressure has been a chapter of my health journey for about a year now. I thought to share my experience and learnings for anyone who’s on a wellness journey, too!

How I found out…

In September 2022 I underwent a minor day surgery. I had a similar procedure done before in Germany, removal of a skin cyst. It’s 20 minutes: inject, cut, scoop, stitch.
My biker pal and surgeon of choice, Dr. Hungu suggested Nairobi Hospital for ease of billing. (My insurance kubwa in a smaller hospital would have meant reimbursement)

Now, Nairobi Hospital follows all sorts of international protocols for surgery.
I’m a bit annoyed by all the procedures (i.e. I had to fully undress, was taken to the theatre in a bed, and asked to remove my nose piercing 🫣).

My Blood Pressure was monitored for a whole hour and was between 135/90 and 145/100.
Must be the emotions, right?
Probably.
Doc suggests I buy a BP monitor for home use, just to be sure. Easy. MyDawa delivered the same day!

In the next two weeks I didn’t measure numbers below 135/88 and 145/100 on the upper end.

Indeed I was hypertensive! At 39!

I had been through triage at doctors many times but honestly had never paid attention to the BP they measured for me. Good lesson!

In October I had another surgery lined up. Something was growing in one of my ovaries. It was benign but I wanted it out and all mental energy went to preparing for this and finishing key work assignments.

My surgeon and anesthesist weren’t too worried about the BP in relation to surgery.
The numbers in the various checkups kept showing hypertension stage 1.

“But please see a specialist!”

Yes, sure. When all this is done.

I stayed in hospital for a night and someone suggested to call the hospital cardiologist as part of the ward round.
My encounter with said specialist was a disaster. After the laparoscopic surgery I was in pain. I could hardly walk as my core was still numb, my shoulder hurt like hell, my breathing was shallow, my voice hoarse from being intubated and the opioid side effects were just starting to wear off.

The cardiologist walked in with three other people who all lined up in a row in their white coats looking expectingly (I guess it was some sort of training?). I wasn’t wearing much under the back-open-hospital-gown. He asked to touch/examine my legs (not sure why).
Then gave me a prescription for Amlodipine and an appointment to see him 3 weeks after starting the meds.

😵‍💫

Needless to say I didn’t start the meds. I wasn’t heard. No questions asked.
I started crying when my gyna surgeon came to discharge me. He surely has seen hundreds of women in tears, but still. The great intention of linking me with an expert hadn’t been fruitful.

I recovered from surgery for around two weeks. Lots of time to research on blood pressure (German and English resources, medical sites and alternative sources) and interview both my parents separately for family history.

Other than a headache I hadn’t had any symptoms. But knowing that my heart is pumping my blood with high pressure around my body, for God knows how many months already, constantly affecting all blood vessels, which over years would damage potentially all organs incl my beloved brain and eyes was just crap.

I got a referral for a caring internal medicine physician from another biker doctor pal.

~~~ Diagnosis ~~~

I went to see her at her clinic at KNH. I carried the family history, my blood works for the last year and BP recordings for the month.
Dr. Jackie Kagima, although a busy clinician, took her time to review everything. She explained the body’s functioning and we discussed possible causes and scenarios (from lifestyle to medical). We talked about treatment options and while I was keen on lifestyle changes, in the end she proposed to start the meds as I was working on lifestyle. I learned a lot from that conversation and it put what I’d read online in perspective.

From the examination, she agreed that my heart is “loud”. Palpitations is the term. I always thought that everyone hears their heart beating, like I do! Apparently not. 🤯

Y’all okay never having heard your own heart beat? 😂

My thyroid results were okay. My sugar, cholesterol, and bone chemistry were great. A baseline cardiogram was neutral.

I had a diagnosis but no “medical” root cause.

Great news actually! Nothing was wrong with my body. I decided to stop searching.

And to rely on my intuition.

I just knew deep down that this was related with -1- big emotions around effort-output-ratio in various departments of my life, -2- lack of exercise since the pandemic which had also led to a few extra kgs, -3- some compulsive and anxious thought patterns, -4- not enough good sleep

In short: lifestyle changes were in order!

And I got the meds.

The tablet is tiny and easy to swallow. And the heart shape inspires one to take charge of cardiovascular health.

~~~~ Lifestyle changes ~~~~

Eating less salt wasn’t going to cut it. This is a private joke for anyone who’s ever eaten my food 😄

I immediately got the annual membership in the local Karura forest. 3-4 days a week I walked 4-7km. Soon I was able to incorporate sprints and sets of pushups! I rearranged my work schedule to find the 2 hours regularly. I got drenched during rain season, and met a fox at dusk. Friends cancelled forest dates but I still went until I knew all paths offhead.

I prioritised talking to people who would be supportive of my self-healing approach and who have high standards for their own wellness.

Mental health.
I cut down social media scrolling. I listened to many interesting podcasts. Read more books. Fiction but also nonfiction written by psychologists and therapists to gather new perspectives on my self and my relationship to myself.

Saying no to requests. Not volunteering for projects. Taking it easy when things go south. Smiling instead of getting mad/sad. More memes.

Arts, mental health meetups, breathwork, massage. Reiki, herbs, types of cooking oil. More home cooking, no more caffeine. Reducing evening carbs, cutting liquid calories. A lot of experiments.

I made fruit juices and baked oven vegetables. All my life I’ve incorporated exercise into my holidays and long weekends (cycling, hikes) now adding meditation and stretching sessions.

It helped that my close peeps are also fitness and outdoors freaks. We catch up over a walk, not a coffee.

With some friends we started a WhatsApp chat group to share our fitness and wellness updates. Determination is contagious 😀

Sleep.
I read up on REM sleep and sleeping tips.
The social media and bad news detox helped. Time in nature combined with cardio helped. Cuddles helped. But a major insight was skipping the last bottle of water before sleeping so my bladder wouldn’t wake me up. Sometimes it’s random things like this 😳

Anyways, taking meds daily for many months is interesting. They soften your blood vessels, in turn lowering the pressure. It works like charm. Within 3 days on this really low dosage, my BP was down by 10/8 points more or less.

Now my BP hovered around 120-130/83-86 which is considered upper range but not hypertensive.

(They cost around 2300 KES for a month’s supply btw. Not everyone will afford them!)

I was of course measuring regularly. Tracking apps.

Do you know I carried the machine around East Africa for 4,613kms on my motorcycle roadtrip? Wueh. 🥲

~~~ Getting off meds ~~~

Around two months after starting the meds, I stopped them. The internet is full of confusing advice on how to do this.
Anyways, it failed. My blood pressure went up again to earlier Stage 1 values after around two or three weeks.

I met another doctor, a holistic thinking GP, my biker friend Dr. Tasneem.
I was now back on the meds but my goal remained to get off them. She mentioned that even the most radical lifestyle changes can take a year to take effect.

Makes sense, right?
Your cardiovascular system has clogged up for years yet you expect it to clean itself up in four months?
I’m ambitious 😁

It’s not linear

Some days the BP goes up. Or morning is great, evening not. Then I wonder what you did “wrong” or what “right” you ommitted. Then I worry about it. Then you remember that you shouldn’t worry too much because stress is a trigger. (See the compulsive thoughts mentioned above? I set out to rewire my brain to stop them whenever I noticed them. Lots of )

What’s the right balance? Not getting too attached to immediate changes while staying attentive to the trends. Exhausting sometimes. So the meds really come in handy. Swallow, relax and forget about all this for a bit.

And I should say: When I accepted the meds as a (hopefully temporary!) partner on my journey, my spirit and emotions became lighter.

~~~ Success in unexpected places ~~~

Honestly, meds or not, I was loving the changes. I was feeling great. Fit, sexy, stronger. Very in touch with myself. Connecting with animals. Doing great work for my clients. Being creative. Having energy for things I love. Waking up refreshed.

I got back into Ashtanga Yoga, doing the full primary flow without needing breaks. If you know about Chakras and Prana/Chi/Qi, this definitely contributed. I hiked up hills and mountains.

I felt 30 again.
Well, no.
I’m just saying this to show how worth it was for me to invest time in myself and my fitness and wellness.

I saw other friends with similar intentions who weren’t able to pull through. I honestly don’t know how a wellness journey on an 8-5 job plus nasty Nairobi commute and a toddler would look like.

It feels like our environment is just not set up for wellness. If this statement rings true, I highly recommend this reading: The Myth of Normal by Gabor Mate. (In short: why “normal” isn’t necessarily “healthy” and what we can do about it as individuals and society)

Yet, I was on meds. Btw, on the lowest dosage (2.5mg Amlodipine). It’s not even on sale in that dosage in some countries!

Around my 40th birthday I decided to try something new. Every time I decide to learn a new skill without an end goal, it’s transformational.

I signed up for the gym with the sole goal of trying out weightlifting. I have no interest in indoors cardio, or being counted for or motivatingly shouted at.

I want to be able to lift my motorbike if I drop it. (It’s around 170kgs)

And I was curious if the benefits for hormones and bone health would come through for me now having entered the 4th floor as people call it.

A good friend and experienced lifter suggested a 3-day-split. A what?

It’s been fun! Learning the techniques, names for different exercises, listening to my body and distinguishing different types of sensations and pain. Oh, and actually getting stronger every single session is incredible!

Four weeks in, I got a bad cold.
After all, 50+ people were breathing heavily together in a closed space.

I lost my appetite for many days.
I only realised a week later that I forgot to take my meds.

Alarmed, I went to measure. My BP was great. I even took a photo

What?!?

I decided to dis-continue the meds.
I continued the weightlifting.

I’m still a gym newbie! But there’s something amazing about lifting 20kg weight above your head or moving 60kg with your lower back!

Apparently weight training is highly recommended for management of hypertension, diabetes, thyroid and other diseases.

Noone told me. Now you know 😜

Let’s see how it goes from here! Right now my blood pressure is normal. Who knows about next year?

Wellness clearly is not a destination but a journey.
And it’s not a straight line either. You get there through trying out things, self-observation, seeing what works, engaging professionals as thought partners, applying research to your context, combining things and building on your learnings.

And accepting that your body and your soul will throw some curveballs at you but you’re becoming amazing at catching.

I’m currently integrating everything. Strength training, mindfulness, nature. I’ve upped the carbs again to support the heavy workout and muscle building, of course healthy carbs. I still go to the forest and prioritize yoga and stretching sessions. I drink coffee with no effect on my BP.

Wherever you are in your journey, I wish you all the best!

💜

Epilepsy and 1900 KES monthly

The reason why I don’t want to have a car in Nairobi (besides the ones we all think of: jam, repairs, cops, cleaning…) is that I could miss out on what makes life. You see, Kenya is a walking nation and many real human encounters happen while walking.

After lunch I walked to the nearby mall (beautiful sun today) as just before the entrance a lady walking in front of me collapsed and had a seizure. I stopped to support her face and head. While shaking, she injured her face and tongue on the tarmac and started bleeding.

The medication she needs to control her epilepsy are 450 per week and 1900 a month. With Corona and no work, she doesn’t have that money, she told us after she recovered and sat up against a wall in the dirt. She had visited her sister to get money but in vain. As she walked home she had 3 attacks, me witnessing the third one.

During Corona, do you touch a bleeding stranger? Support her back while she sits? A few others walking nearby stopped and after initial concern helped and one lady offered to accompany her home on the same bus (another 4km walk was ahead of her). The mall security got her water to clean her face. The security chief and I went to the pharmacy and got her meds for some days days and gave her bus fare. (Why do the fancy mall pharmacies not sell generics?)

Can you believe it? She cried from exhaustion. 1900 a month and even worse, the generics are nowhere to be found currently, another lady who stopped and who previously suffered from epilepsy but recovered, explained.

I could have gotten mad at our health system failing us and her.
But I know that we need a civil society stronger than our challenges.
I got the opportunity to have a conversation with 5 previously unaware strangers about this disease and how we can support.

I remembered the saying that God has no hands but our hands.
Don’t walk past someone in need, if you can help.
Do a first aid training. And please learn and educate others about epilepsy. It’s noone’s choice, not contagious and it’s not a curse.

#epilepsy #nairobi #sisterskeeper #firstaid

Noise pollution & your health being at the mercy of others

Yesterday my friend Gigi and I refused to pay the fare on the bus, as the driver had ignored our repeated requests to reduce the volume of the deafening music.

That threat quickly led to the desired change. The volume came down and finally we could communicate verbally with the conductor: “Will you pay our hospital bill and hearing aids when we need one?”

My friend told the crowd: “Now you think the loud music is cool and I’m a crazy woman. But in ten years you’ll be deaf and remember me!” She further explained to the other passengers what influence loud music has on the human ear, especially when exposed at a young age.

I couldn’t tell whether the mothers on the bus holding infants were listening or understanding. Certainly the adolescent males on the bus laughed it off.

Low information of issues affecting health in the general public.
It’s the same issue with cars and bikes driving directly behind lorries and their passengers inhaling all the unfiltered Diesel smoke for several minutes before overtaking. Similar to cabbages being stored on the muddy road side, where village sewage flows.

Learned helplessness frustrates me so much: This is not an earthquake or flood which can only be controlled through action on a macro level. These are the actions of human beings right in front of our eyes. We HAVE influence on them.

Musings on nail fungus and procrastination

It must have happened in Uganda. Or maybe in India, Rwanda or Kenya. Or even in Mexico. It must have been when sharing shoes or using communal showers. Or maybe when dancing barefoot in dirty places. God knows.

But it must have been in the year in which I worked in Uganda. I know that because my favorite pedicurist near Makerere University was the first to tell me. “You need to treat this” he said pointing at my toe nail.

I really didn’t pay attention to the advice. Not that I thought he was wrong. But really, it wasn’t a concern. It didn’t hurt, did it? Usually wearing open shoes I covered up in purple, pink, red, blue or green.

Beautiful on the outside, increasingly discoloured below the polish. Everybody had some expert advice and so over the next years periods of half-hearted creme treatments with exposure to fresh air alternated with months of covering-up. I can’t say that I didn’t try. Somehow.

When I finally consulted a doctor, the lab results were negative. You see, I took the step, but my environment just wasn’t supportive. And I was busy, too!

I was in Kenya, when the nail fell of. Coincidence? I starred at it. And now I had proof. And what I saw below didn’t look healthy. After a liver function test I was allowed to swallow tablets for 6-9 months. One daily. To stop the evil at the root. By treating the root.

4 months later 3 millimeters of progress are visible. 5 millimeters of ugly past are also still visible.

I celebrate the progress, though it makes snail pace resemble speed of light.

Healing takes time. And patience. And commitment.

Which fungus are you treating in 2014?