2023, a personal review

Published in June 2024 (I know), but only covers 2023 - still relevant though!

Mental health.

This year was a continuation of last, so I won’t rehash all that as last year’s review was plenty long enough. However I did have the ultimate breakthrough of why the lockdown and working from home affected me so much. There’s a concept called object permanence - with a small child, if you show them an object then remove it they won’t remember it existed. Object permanence can also be lacking someone who's neurodivergent, so you can forget to deal with paperwork for example unless you leave it staring you in the face (and I mean totally forget - foreget it ever existed). After a conversation with a helpful friend (something that is really hard to come by), it suddenly occurred to me that perhaps object permanence applied to less tangible things like relationships, so I did a bit of hunting online to see whether anyone else suffers from this, and it is a thing! Suddenly it made sense to me why I always feel so alone - because I wake up each day unable to remember or trust that my friends care about me. I also forget what it feels like to experience joy doing activities, and that I am competent at my job etc. I forgot about that little fire inside me that has been inspired to train or get slim and fit. It’s a very odd thing, starting from scratch each day (not to mention only just realising that’s what you’ve been doing), you can’t even set routines to counter it as you don’t remember that you had made plans, or believe that you meant it if you do remember (there are overlaps here with something called executive dysfunction, which is another characteristic of neurodiversity). What usually brings it back is the work environment, feeding off that energy and buzz of people doing normal, everyday things, but of course with the pandemic working from home became the norm and the world around me that I was feeding off vanished. If I haven’t seen or spoken to a friend for a couple of days I start to get this odd (and fake, but believable) feeling that they’ve gone off me (there's another overlap with something else called Rejection Sensitive Dysphoria). Sometimes I need some evidence/proof that a friend is still a friend so I put out a test, for example a message for them to reply to or an invitation to do something. The test result often comes back negative and realistically I know this could be for any number of reasons, and I know the person didn’t know the result was so important, but it's the instinctive way to assess the situation and it told me my friendship has stalled so I fade away from them (whats the alternative? Repeatedly telling people how weird I am? It's just going to sound needy and nobody likes that). Even if the test is passed I have to do the same next time there’s a gap in contact and I start to lose my object permananence. It’s not just a case of telling myself it’s all fine either, because the feeling that the friendship has wilted is quite real and hard to counter without proof. This is just one of the reasons I get lonely, and the only one I can currently explain well. It’s taken a long time to reach this point, this realisation - 3 1/3 years in fact. I had already put a lot of other strategies and fixes in places to improve my mental health (routines, activities etc.) and wasn’t sure why I still felt bad and this is the missing link, finally I had it. But I've been living in such a persistent brain fog for so long I have no concept or memory of normal any more.

Often, working out the problem is more than half the battle and the solution is simpler, but it’s not that simple here. Working from home is here to stay, and even though I can go into the office, the place I have ended up in means it’s so hard to get up each day if I do go into the office I arrive late so my hours are very reduced and I get behind, so I have to work from home on other days to reclaim my total hours. Also it’s the presence of others that is critical, and I don’t control them neither do I want to. I’m having trouble asking for help with this, I don’t have that kind of personal support in my life (close friend or partner). I do ask people to help but it often backfires (different conversation styles etc.) then I feel guilty and I don’t break out of the cycle. Forever the pilot light and never the functional boiler. The funk is so established it’s not simple to change. Also, when you’re constantly in a brain fog, you can’t fix much, and the time you find the kind of normal enviornment that offers you an escape is when you then have other duties like work or you’ve gone away for a break so you’re busy with the main task. Also, when this is a fight you have to do Every. Single. Day., sometimes you burn out for a few days and just lose the fight.

Anyway, long story short, it took time to learn from this revelation, but when it came in August I had finally turned a corner. And then came the other issues...

DVT

Unfortunately, I’d had some problems with physical health since April and they were about to get worse. I hadn’t felt right when running but didn’t know why; when orienteering at Easter I just wanted to sit down and stop. This was really weird as running was my escape, I couldn’t understand why I didn’t want to do it. I thought it was because my biological clock was telling me time is running out to have kids and running wasn't helping with that, but it was so persistent I also felt there must be a physical contributor. Looking back now, my difficulties with running desire started with a psychological issue (anxiety) that morphed into a physical one, so it wasn’t so obvious at the time that there was something physically wrong. I do know that my ankles went puffy on the 6th April and I developed foot pain on 14th April, followed by calf cramp on the 21st April that woke me up in the night, then my calf spasmed up and I could neither fully bend nor straighten it for 11 days. I went to the doctor to get checked for a blood clot as I’d started taking the combined contraceptive pull on 4th April after a 14 year break, and being over 40 the oestrogen puts you at a higher risk of clots. I was sent for a DVT scan but they said it was clear – it wasn’t made clear to me then that they don’t check the veins in the calves so it doesn’t mean you’re clear of clots, it just means that your deep veins are okay. I had three more bouts of severe calf cramp in August, early September and late September that lasted a couple of weeks at a time, that alternated legs, but the doctors hadn’t managed to help me nail down the problem. In August and September I was really struggling to breathe and it was getting progressively worse – first a single rally on Tuesday volleyball would have me gasping to get my breath back before serving, then I would have to pause on the slightest incline on short, undulating walks, then I couldn’t even walk up the ramp to the car without struggling. I had a series of tests with the doctor (an EKG, several blood tests, and echocardiogram), but there were no answers and didn’t feel like I was able to get them to take my symptoms seriously. I went on last minute holiday to Madeira in middle of that at the start of September as I needed to do *something* enjoyable that summer and it was one of my resolutions to visit a new country in 2023. I had to get assistance to board the plane as I couldn’t weight my foot due to extreme pain in my plantar fasciia (that wasn’t actually plantar fasciitis, it was a kind of spasm due to lack of blood flow in it), although thankfully by the end of the trip due to sheer persistence I was managing some hikes (on lovely terrain but without ascent as I was following the levada irrigation system, see photo).

On 2nd October things took a turn for the worse with a sudden pain in my left thigh that meant I couldn’t stand up and certainly couldn’t walk without agony. The photo shown is from the 5th October, showing the weird swelling and pittting edema. The doctor sent me for another DVT scan which I had on the 9th Oct and this time they did find a clot, in my femoral vein, the main vein in the thigh. I was a bit surprised (and I think the doctor was too, as he hadn’t put me on blood thinners like you usually have, as it was more to rule things out given I’d already had a scan in May), but the more I learned, the more the problems of the summer fell into place – I will never be able to prove it, but I am pretty sure I had 4 blot clots in my calves and one in my lungs (a pulmonary embolism), before the DVT that they found in my thigh which would be the 5th, and later a 6th in the popliteal vein in the back of my knee.

The symptoms I had from the confirmed clot were the same as what I’d already experienced, only raised to another level of intensity. They’d put me on a 3-month course of blood thinners straight after the scan, which meant my blood was able to get past the clot a bit (but only slowly, as the vein was considered totally occluded) and the swelling started to reduce a fraction, but as soon as I did anything that got my blood circulating, which included being upright for more than a minute (i.e. just moving around the house), my calf would go rock solid and it would feel like somebody had pumped it full of acid as it felt like it was burning away under all of the skin, especially down the back of the knee. This lasted for what felt like forever. It was after 12 days on blood thinners and remaining largely horizontal, that I felt the first improvement when I tried to walk – my leg still hurt and still swelled up, but it got to a certain level and pleateaud. I started doing short walks like this, keeping slow and increasing distance, until I had a checkup with the doctor and he said that if it was still hurting it was still too soon as I was at high risk of permanently damaging the valves in my veins, so I eased off. It was another month before the pain started to subside, by which time my fitness had steadily declined to nothing without me being able to do anything about it. I started to combine slow, careful walks with trips to the pool for training sessions (the first time I’d been in a heated pool in 4 years 5 months having switched to open water only, shame to break the streak but needs must - the first session was truly awful though after such a long break), and from 20th November I started to reverse the decline in my fitness. My calf remained swollen though, with the swelling increasingly rapidly as soon as I started exercising. Recovery was a very slow, gradual process as what I could do is very limited, but physical health is so important for mental health, just moving upwards at all is encouraging and gives you something to live for. It’s been so tough – the not knowing whether the clot will go (it’s meant to but not guaranteed); losing my coping strategies; having my world completely turned on its head due to being unable to do the things that I spend the majority of my time doing.

When we finished work for Christmas, I realised that work had been keeping me going, and suddenly I had no purpose and felt unwanted by the world and all people, and I lay completely listless for several hours as I processed that. I had lost my sense of self, and I also lost my sanity from the fact that my sense of self was tied up in achievements. There also wasn't much optimism for the future, as the research on DVTs and the treatment available are both very limited. It's interesting that the main diagnostic tests to see if you have a clot, is that your bad calf is at least 3cm bigger than your good one, but only at the very worst mine was only ever 2.5cm swollen, so it’s highly worth trying different doctors to find one that actually knows a lot of stuff, rather than one that just looks things up from a book. If you don’t exhibit the standard symptoms, then causes can be quite easily overlooked. For the treatment they simply give you 3 months of blood thinners and wait for your body to dissolve the clot, in which time you have to put your life on hold (well, you do if you’re any kind of athlete)… and then if you’re still getting symptoms they simply give you 3 months more! I was lucky enough to get a re-scan after my leg was still swollen after 3+ moths, which revealed the clot was still most definitely there, with a little channel up it through which some blood would pass, but it also showed occlusion behind my knee and it’s unclear whether that was there before as they didn’t mention it at the first scan, so it’s far from over, I don’t know if I’ll ever run properly again. The doctor and specialists have agreed that I can do some sessions of running 1 minute at a time times a few repeats in order to keep me sane (which is working out at 6-10 repeats, so less than 10 minutes of running total, when I’m more used to being out for hours, but it’s something), although it isn’t good for my blood vessels to run with occluded veins, so it’s about finding a balance between recovery and sanity

Being more 'me'.

My autism diagnosis of October 2022 had time to lead me to where I want to be. I realised how much of ‘me’ I’ve hidden over the years as it’s not deemed socially acceptable (not that I have a desire to be socially acceptable, but I simply didn’t realise I was doing it), and how much this has burnt me out. I decided to try and be more true to me - which is hard initially as it’s not always met positively and a bad reaction can drag you to be defensive rather than confident, so you start to anticipate the defensiveness and get stuck in a negative loop. Work had been amazing in supported to ask for things that would make my life easier, which was a real eye opener for me, so I tried to extend that to my personal life. I have realised I don't have to be in noisy places, or be in a cramped space where I'm always alert in case someone bumps into me. The trouble is, work fosters a culture where people are receptive to those requests, but the rest of the world doesn’t. If you're trying to be more authentic, some of your safety nets have gone and you have to request understanding of other people, which doesn't always go well. I lost a couple of long term friends, as I transitioned to a more blunt (more natural) way of communicating, and spoke up where a situation would make me uncomfortable. It's really difficult - you spent decades learning what you need, and when you reach out for help with it, you get told to take some responsibility and deal with it yourself - this *is* me dealing with it, and sometimes that quite genuinely involves others!

Due to all the physical and mental health issues I was really struggled with energy at times in the early summer due to neurodiverse fatigue which I'd not experienced before as I'd always managed to maintain a kind momentum and feed off stimulation. Now, if I did one activity to try and restore some normality to my life, I'd spend the next few days payijg for it and recovering from it. I didn't enjoy a long-anticipated trip to the Outer Hebrides in July, or Sidmouth folk festival in August. This fatigue meant I would be flat and unresponsive a lot, this is when friendly support would be most useful, and sadly is also when people write you off as you’re being weird and awkward (the photo is from one of these times). In fact that was a big theme of my whole year - this was when I needed my friends the most, and when people stepped up the least. I feel like people think they know me because I share things like this, and maybe they feel like the friendship is sustained as they know my news, but real friendship is sometimes actually desperately needed, active friendhips where people make the effort to check in on you. When so much challenging stuff is piling on top of you, and the people I have previously considered my friends didn't get in touch, that just gave me one more thing to deal with, to reassess who really does care about me, and it's a minefield to try and judge that right given the aforementioned object permanence issue. Thankfully there are a couple of local friends I have built up more of a day-to-day friendship with.

To deal with the fatigue I knew I needed to free up my calendar but it took a while as there was a lot of stuff I couldn't cancel. Eventually I got my time back and I settled on a new approach of planning only 2 days at a time, I had to stick with this for a long time but it helped. I did eventually end up feeling good, like I was 24 again and fresh out of university, as the slower pace coincided with the object permanence realisation and took me back to a past life, but as previously mentioned it didn't last long due to the blood clot.

Achievements.

Due to all the above, I wasn’t able to do the things I usually do, work through my ticklists, or train for anything. I did what I could even when I maybe shouldn't have, as I felt I had to to survive. This list of the year's achievements would normally be representative samples as there’s too much to write, but this time it’s pretty much everything I did. I’m extremely grateful for all these events, they are good memories in the bad times.

• Due to the blood clots there was a period of time I couldn’t even walk, but over the year I covered 1,382 miles in total:
  
  • running - a paltry 555 miles over 100 runs, down 995 miles from last year’s total.
    
  • cycling - 30 miles over 2 rides
    
  • swimming - 37 miles over 64 swims. 4 which were indoor pool, 3 were unheated lido, 2 were abroad, and the other 55 open water.
    
  • paddleboarding - 44 miles over 9 trips
    
  • by deduction walking and hiking must equal 716 miles.
    
  I didn’t do one single run on the coast path despite that being such a big part of my life for the previous 3 years.
  
  
• Race events - I entered one 10k invited by a friend, and did a pub crawl marathon organised by the same friend which luckily fell inbetween my clots (see photo), and a few orienteering events. Nothing else. I had entered a swim/sup/run event in May but it got cancelled. No ultras, when ordinarily I would do about 3 in a year.
  
• I did 4 organised Beating The Bounds walks on Darrmoor, to learn more about the local area and enjoy a historic tradition: Moretonhampstead, North Bovey, Lydford, South Brent. On these I met a couple of other local ‘tickers’, similarly minded folk also working their way through the Dartmoor Tors or Dartefacts, whose names I’d previously only seen online. On the Lydford walk I was sat for lunch with a few of them, talking about places we’ve visited or yet to visit and I felt like these were my people.
  
  
• I swam six more parts of the south Devon coastline: Westcliff Cove to Piskey's Cove with Karen; the length of Slapton sands (6km) in June which I organised for me and 3 friends (see photo); Mountbatten to Jennycliff in June with Claire and Mayo; Peaked Tor cove to Torquay harbour in August with Selene; Meadfoot to London Bridge in September with Selene; Shoalstone to Freshwater slipway in September with Selene and Lee on paddleboard support.
  
• I got 45 new D365 squares (compared to 97 the year before).
  
• I visited 46 Trigs (triangulation pillars). I spent a while retrospectively ticking all my previously visited trigs off on the TrigPointing website, so that I had a record (and a map), I finished that in May and the lifetime total at that point was 220 unique trigs, 267 including repeats which became 300 by the end of the year.
  
• I made 139 ascents of classified hills, of which 132 were new summits. 107 of those were just TUMPs (hills with a 30m prominence - it’s handy to have these to go at when you can’t walk far). When I was able to walk again, I did a road trip to East Anglia where the hill summits are low and individual. I got my lifetime TUMP total to 1000 with my last one of the year on 23rd December.
  
• As well the trip to Madeira I also went to Outer Hebrides in July but this wasn’t a good trip. I went for a 6 day orienteering event but as I couldn’t run it became an exercise in loneliness exploring the island. I did get to enjoy the Clisham horseshoe though (An Cliseam is the highest point of the island, a Corbett). I ticked a couple of outstanding Munro tops on the way home too.