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Photo by Public Domain Pictures by Pixaby I saw my hospice patient each Thursday for 13 months. The first time was day after she turned 80 and the last time was just a month after she turned 81. That’s about 52 times that I got to be around her. She lived with exceptional grace and faith with Parkinson’s disease. Then she died, peacefully and comfortably, exiting this life with ease. I got to know her unemcumbered self. There was no extra stuff weighing her down; she was all about giving and receiving love. Her ego had been eradicated by the disease and she existed with a lovely equanimity, accepting every moment and every encroachment by the disease, with grace and faith. She didn’t resist or try to fight Parkinson’s. She had been a nurse. She knew what was coming and she let herself enter it. The disease showed her no mercy; she showed it faith. When I kissed her hello and asked her how she was, she always told me she was doing better. She always said she was at peace, comfortable, happy, except for the few times when she felt lonely or in pain. Early on, she loved to be outside and walk in the gardens. It turned out we had both lived in the same state 3000 miles away for many years. We talked about our lives on each coast. I met some of her wonderful sisters and nieces. We drew with colored pencils and markers I brought.We played Tic Tack Toe and Hangman. She prided herself on never losing at Hangman, no matter how long she took to guess the letters. As time went by, she became more wheelchair bound and then bed bound. She stilled loved being wheeled to the garden. She enjoyed watching old movies on TV. She could not chew and relied on pureed food and then only liquid nutrition. Her body grew more rigid as Parkinson’s seized control of her muscles. Parkinson’s stretched over every inch of her body, freezing her movement and expression, and yet she maintained mental control. She could communicate if she was hungry or not; if she wanted to be in bed or outside; the year she was born and married; when her beloved son was coming to visit again and how her grandkids were. The majority of patients who use hospice do so for under a month, and most of those for under a week. I got to be with her for 13 months. I got to sit with her bedside, hold her hand, wipe her brow. Her speech became very limited and mostly confined to saying yes or no. One time, while she was sleeping, she broke out in song. She sang clearly and effusively “Take me out to the Ballgame” six times in her sleep. I laughed so much that she woke up and we had a good chuckle. When I left her at the end of each visit, I always told her I loved her. She always told me she loved me very much. She made me happy and calm and grateful for each moment. She was a gift. Her memory is a blessing.

This is not a story about my hospice patient with advanced Parkinson’s and how over the year I have seen her every Thursday as a volunteer, she has given me the most meaningful encounter with grace that I have every known. This is not a story about leading Advanced Directive workshops and hearing from people in their 80’s who desperately want their wishes for their death known, but are stymied when it comes to actually committing it to paper. This is not about how much I want to have a good death so my loved ones can move on easily and so I am motivated to make sure my wishes are clear if I am no longer be able to speak for yourself. This essay is a loving push to remind you that you will die. No one, not even you, gets out of here alive.Good news! There is one thing you can do: Prepare for its inevitability. Let yourself embrace this reality. Let yourself step to death’s side for just a minute. Put down the fear for a moment.Can we pause together and breathe deeply? Consider this scenario: you are lying in bed and your death is imminent. Then ask yourself these questions. You can write the answers, think them, say them aloud. 1. Who would you want at your side? 2. Is it important to you to die at home? 3. Who do you have unfinished business with? 4. Would you want to live even if it meant being hooked up to a machine? 5. How important to you is it to be free of pain? 6. Do you have a will and trust? Are your financial affairs in order? 7. Are you leaving a lot of stuff at your home for your loved ones to sort through? 8. Do you have special things that you want to pass on to your special peeps? 9. Do you want a funeral or memorial service or something else? 10. What else is important to you to note? Think about it. Ponder it. Turn it over. Let me know if you want to talk about it. Feel free to reach out to rhyhalpern@thirdactcoaching.org or click here for more information. Death And Dying Consciousness Hospice End Of Life Relationships

or How to End Your War with Time in Your Third Act I used to think that the concept of an all powerful Boss, ie God, had been replaced by the great arbiters of modern life: Hormones and Time. All around me, I saw how hormone levels and the number of hours in a day literally drove and shaped everyone’s days. But as a former multi-tasking, stressed out working mom with long hours on the job, a long commute and then long hours managing home life, I mostly vibrated to the belief that Time was all powerful and all controlling. What surprises me the most about my life right now is my peaceful relationship with Time. It had always been a war. Wringing out every second. Making it count. Time was a commodity; something to possess and use obsessively. Piling up 2, now 14, which became 27, and jumped to 56 which rabidly divided into 719 things to do at this time.My life was crossing off items on lists diligently. Managing and tightening around the most important, non-negotiable tasks of the day. Constructing an efficiency machine that ran on getting to all my ‘have to’s’. It didn’t matter if that meant I worked 16 hours in a day or was up at 3 am working. I was obligated. I HAD TO. Have to prepare the powerpoint. Have to answer 130 high priority emails. Have to write the report. Have to handle this sensitive work situation. Driven. Compulsive. Hard. Have to. Fucking commute. I have to go food shopping so I can put out something for dinner that is half way healthy. I have to make sure homework is done, permission slips signed, clothes laundered, lunch made, soccer practice arranged. Have to. Have to. Ramped up high. Squeezing time. Can’t waste a minute. Lucky if I slept 5 hours. Do you relate? Always, always the things I yearned to do, needed to do to feed my spirit, those things waiting patiently at the bottom of the list, ignored again, sometimes grazed for a flirtatious moment and then abandoned. Stress. Sizzling, bloody, ugly stress. Chronic stress eating away at my soul. Do you relate? Now I can breathe. Ahhh. I have a plan for my retirement, otherwise known as My Third Act. Amazingly enough I do the things I used to yearn for every day. The formula has flipped. I actually ‘have’ time rather than ‘having’ to do. No more time wars. After 18 months of study and boards, I became a certified Functional Medicine health and wellness coach. Love it! There is the book club I joined last year (20 years of yearning). The writing club (same). The wellness cohort meetings. The total joy of afternoons spent reading (40 years of yearning). The hospice volunteering with patients as well as running Death Cafes and Advance Directive Trainings (10 years yearning). The Shabbat ritual every Friday night including relishing the words of Mary Oliver and Marge Piercy (15 years yearning). Staying in bed for more than 7 hours of restful sleep- sometimes even for 8 hours. Lingering in bed until the sun rises bringing light to the day. Such a luxury to not HAVE TO get up in the dark. Netflix binge watching (Pose! Work in Progress! Schitt’s Creek rules! Frankie and Grace!). Babysitting step-grandkids. Hanging with my daughters during breaks from college. Pilates and yoga. Meditation. Stretching. Soaking in the spa. Cooking healthy, simple food. Journaling. Developing a writing practice.Writing. Writing. Writing again. Thinking. Planning for coaching. Coaching. Decluttering and letting go of STUFF. Dinners with friends and travel to Morocco, Tahiti, Oregon, Montreal, the San Juan Islands, the California Redwoods. Ahh, time is my dearest friend, not a vengeful god! A life composed of lovingly having sweet time. Composing a life with time as a dear friend. Saying goodbye to my time wars. Unraveling those tight ropes and getting comfortable.I love having time. 40 years of time wars turning towards time peace. From ramped up too high, too much, too driven, to relaxing into less. Everyday a bit less of a grip and a bit more ease. Every day is the Sabbath, the holy time of renewal. Breathing out, I pray for many more days. Do you have a War with Time? What is your Third Act plan? What Feeds Your Spirit? Working Moms Stress Management Time Retirement Retirement Planning

You may have heard about a drug called naltrexone that is having major success helping addicts get off opiods, at a high dosage of 50 mg per day. LOW DOSE Naltrexone is prescribed at a dosage of under 5.0 mg. That means the dosage is 45–49.5 mg less than naltrexone used for treating addiction. LDN, or low dose naltrexone, is not for addicts. It is used to relieve people from chronic, non-responsive pain that results from inflammation. It helps people like me- and maybe you. LDN was discovered at Penn State University in 1980 and was found to slow down the growth of cancer, as well as to help treat autoimmune and inflammatory diseases, and chronic pain. I hemmed and hawed for two years before I recently starting taking it. It doesn’t work for everyone and it often takes months before symptoms are relieved. Some people immediately feel happier and healthier. So its a gamble.I desperately didn’t want to be one of the ones it did not work for after so many years of trying so many things. So I justified my indecisiveness by spending time learning more about LDN and how it works (check out ldnresearchtrust.org and ldnscience.org). I learned that it is used by more and more people every day; approximately 500,000 people worldwide as of 2019 numbers, with 100+ published studies citing its efficacy for more than 60 medical conditions. I have Hashimoto’s disease, an autoimmune disease of the thyroid. Some of the disease’s symptoms are extreme fatigue, sleep disorders, brain fog and memory problems, thinning hair and dry skin, depression and anxiety, chronic muscle and joint pain, digestive and elimination problems, insulin and weight loss resistance, hormonal imbalance, and sensitivity to cold, to name a few. People carry around the burden of feeling a generalized crappiness. Through years of diligent healing with my Functional Medicine doctor, I had gotten through the fatigue, insomnia, memory problems, depression, muscle and joint pain, hormonal imbalance, but still struggled with others. And since people with Hashimoto’s often have a second autoimmune disease or chronic infection like Epstein-Barr Virus, interstitial cystitis, systemic candida, I also had interstitial cystitis and candida. Inflammation is the gift that keeps on giving. Within the first week of taking it at a very, very low dose of 1.5 mg, I had a delightful feeling of enhanced well being. Sweet! It was subtle but it was undeniable. I surmised that the reason it didn’t help my low back pain was that my back pain was not inflammation based, but it was sure doing something for the autoimmunity-related symptoms. LDN works by staying in the body for a very short time, supporting the body’s ability to produce endorphins and to kick start the immune system into gear. (High dose naltrexone does not work in the body the same way.) The LDNscience.com website states that “LDN goes into the body and essentially tricks the body by forcing it to double and triple its output of endorphins and metenkephalin, also known as opioid growth factor (OGF). Those endorphins and metenkephalin, in turn, cause the immune system to [balance itself]. A nice way to think about LDN is that it is not like any other medication whatsoever. It is a way to strengthen (in the sense of regulate/modulate/normalize) the immune system.” Conventional medicine has been such a huge part of the reason why autoimmune diseases have proliferated wildly the last few decades. So, being skeptical of a new drug is reasonable for those of us who are weary of the health care system. However, I am totally excited by this drug which houses a new approach to improving the immune system. There is hope for those of us who do all the right things but have not been able to fully resolve the symptoms that come along with having our body mistakenly identifying our own cells as foreign invaders and going on the attack. “When immune cells are being produced in excess (leading to autoimmune conditions), OGF acts to slow down their proliferation.” Brilliant! Wonderful! You go, LDN! Reduce that inflammation! I am slowly titrating up, meaning my dosage started out very low at 1.5 mg and will go up to near its max daily dosage of 5.0 mg. I am in my second month and my dosage is at 2.5. The body needs to slowly adapt to it because it is stimulating very complex processes to occur internally. And from Dr. Tom Gilhooy: “…Reducing cytokines is thought by many to be the dominant effect of LDN. Until we have more research on the subject the debate about how LDN works will continue, but it does appear that it may have two anti-inflammatory mechanisms…” If you have inflammation- whether autoimmune, cancer or diabetes 2- you might want to try LDN. Your conventional doc probably won’t know about it, but you can try. LDN is available online through reputable pharmacies or telemedicine companies whose doctors can prescribe it.

I began using anti-depressants when my first marriage unceremoniously exploded. I couldn’t eat or sleep or concentrate and this went on for months, until I got a prescription for an anti-depressant. Thus the internal floor of my mind began to raise up just a little to re-enter the land of the living. Several years later, sleep-deprived with newborn, premature twins (and yes, with a new partner), I found I still needed them, albeit at a low dose. It was my only chance to stay sane during those precious but tortured months of them feeding every 45 minutes only to change my babies’s diapers every hour and a half, before it all started again. For the next few years, every time I stopped the meds for a few weeks, I felt that floor lower again. After about 15 years, I assumed that my biochemistry had adjusted and now I needed a low dose anti-depressant to keep myself on an even keel. Then, after years of encroaching symptoms like severe headaches, brain fog, sinus congestion, chronic sore throat, insomnia, joint and muscle pain, bladder problems, hormonal imbalances and severe, oh so severe, inability to lose weight, I finally was diagnosed correctly with Hashimoto’s- autoimmune thyroiditis- and working with a functional medicine doctor, completely eliminated gluten, detoxed and cleansed away, and ultimately dropped about 40 lbs on the hCG protocol (more on that in another story!). One morning before taking my thyroid pill and antidepressants, I realized that I no longer had headaches or joint and muscle pain. So I stopped taking the antidepressants and lo and behold, the floor stayed even! It took me a few months to sit with the notion that my depression was a symptom of thyroid disease. Then it took me a few more months to truly believe it. That was about six years ago and I have never felt the need for antidepressants again. I have been through really difficult times, trust me, but just the floor remained solid. I have also read a lot about depression as a symptom of many autoimmune diseases, estrogen dominance, candida, lyme disease, intestinal permeability and more. Depression is linked to inflammation. When your body is inflamed, you feel awful, including emotionally. Its that simple. How freeing it is to not be defined by an assumed internal messed up wiring. Along with autoimmune diseases, the rates of depression are at epidemic levels. I am here to say that there is a connection between inflammation and depression! Its not you, its the inflammation! Almost everyone is depressed and anxious these days. Antidepressants and anti-anxiety drugs are prescribed like candy. Many patients report that their antidepressants don’t really work. There is a reason for that. They are not getting at the cause! Can you allow for the possibility that feelings of sorrow and helplessness might be a symptom and not the problem? What if the SAD (standard American diet) was to blame, and toxins, pollutants, chemicals? I read regularly online about depression and inflammation and know we will be finding out more and more about the connection between depression and inflammation. My hunch is that the rate of depression will go down, corresponding to nutritional, environmental and healthy lifestyle change. I am betting on it. I know it to be true for myself and dozens of peers, and hundreds of patients of functional medicine. What if you could be free of depression? Who would you be if you were not depressed? I am betting on you.

I read recently in the NYT about a Dartmouth professor, David Bucci, who as chair of the Department of Psychological and Brain Sciences, became responsible for handling a serious complaint by female students into three male faculty members’ alleged pernicious patterns of sexual harassment of many years. In what became a class action lawsuit, Dr. Bucci was eventually named as a conspirator; he was not charged with sexual harassment. He was a smart man who did research in the basement of an old building at one of this country’s Ivy League universities. He was white and fifty years old. He did not sexually harass or assault women. He, unlike the nine women in the class action lawsuit -and the thousands of others in campuses all over the U.S. for decades and even centuries- had not been sexually harassed by the three named male faculty members. Some of the very changes he had spearheaded to stop the harassment were finally being implemented. I did not know him or the women in the case, but I can’t stop thinking about it. This is what I gleaned and why it is so painful: It was a grueling few years and he was excruciatingly upset. He felt his reputation had been harmed. He never got the chance to be heard, nor did he get the written redemption he fervently craved when the case concluded. He became seriously depressed, an illness he struggled with twenty years prior, and spiraled into complete despair. And then, he took his own life, silencing himself forever. He killed himself. Dead, permanently. Not because he was guilty but because he was silenced. At least that is what I believe. He could not bear being absolutely denied his right to speak. There was no way to correct his tarnished reputation, the burden of guilt by association weighed heavily on him, and he could not bear the glaring lack of redemption that would have cleared his name. Why did he fall under the wheels of the proverbial Mac truck of this outrageously common, virtually text book story of oppression of young women by powerful older men, so very obscenely common in academic institutions for decades? After all, many women have endured equivalent pain and silencing. Think of the history of rape, incest, sexual assault, sexual harassment around the globe and through the ages. The number of women’s voices that have been silenced is impossible to count. It has touched every home and workplace in the world. Professor Bucci was silenced. Muzzled. Denied his human rights. His hands were tied. Isn’t that how oppression works? Its the pain, the suffering, the loss of one’s voice that kills the spirit. The woman who was raped by another student at college, by a colleague in the workplace, by her father who cannot say a word. Think of the victims of the grand misogynist Roger Ailes. The black person denied work or housing or stopped by the police again, who suffers and rages without a voice. The deaths resulting from domestic violence, rape, racism, homophobia, injustice. Did Matthew Shepard’s family have a voice? Maybe Dr. Bucci never had been silenced before, like so many others have, and could not put up and shut up. Due to laws around retaliation in cases of harassment, he literally could not speak. He could not stand up for himself. He could not say his side of the story. If he did speak at all, it could be used against him and against the lawsuit. It could be perceived as retaliatory, even if all he stated aloud was “I am upset. I am humiliated. I feel trapped.” But the university’s lawyers needed his silence in the name of legal processes. And so his life became an unanticipated tragic casualty of the whole stinking situation. Without his voice, he was a dead man, quite literally. Was his pain more important than the pain the women went through? Absolutely not. But it was so futile, ironic and without the possibility of hope. This is the dirty mess of the unanticipated consequences of oppression. People who have experienced oppression- women and people of color, gay and trans, differently abled and survivors of violence and persecution- we have been fighting for social justice for along time now. Trying to balance the power dynamics between men and women, white and black, straight and gay. We have reached a tipping point where we are not going to take it anymore. And men- whether like Harvey Weinstein or all the hundreds of thousands of university professors who have had sex with their female students or harassed them into thinking they were not smart enough to get credit for their research or underpaid them to do their teaching- have to stop and be stopped. But can we not stop for a moment and feel the very real pain of people who are unwitting bystanders and who may get caught in the maelstrom? Does fighting oppression mean oppressing others? Or others oppressing themselves? Dr. Bucci’s death stands for and with the hundreds of thousands of other people whose spirit was broken by having no voice, by being silenced. And his pain will linger in his wife as she does her best to provide for their three children. His young kids will be forever wounded by the suicide of their daddy. A friend of mine in college once told me when I was railing against the rich, that the point of the struggle for equity was not to strip those with too much of everything, but rather to lift up those with too little, until the scales were equal. Dr. Bucci slipped through the cracks because we could not hear him, because he had no voice, because he was silenced. If only we could ensure that only the misogynists, only the perpetrators of oppression would suffer the consequences of the reckoning. If only we could ensure that the number of victims would not increase. If only we could stop the bloodshed of the innocent bystanders in the unanticipated raging storm of oppression. Oppression #MeTooMovement Sexual Abuse Feminism Misogyny

I am not a scientist but I am a wellness person who spends a few hours each day devoted to learning about how our bodies function, so hang in here with me as I share my take on autoimmunity, which I have been studying these past five years or so. It is amazing stuff even if you tend to view numbers as a soporific. You possess billions of these itsy bitsy teeny tiny things but can’t see them or feel them; without them you would not be alive. I am talking about the approximately 1 trillion human cells that make up your body. According to the Human Microbiome project of National Institute of Health, “…there are approximately 10 trillion bacteria in (and on) our bodies versus only 1 trillion human cells. That’s right. We have 10 times more bacterial cells than we do human cells,” states Dr. Marc Ryan, LAC, in his book “The Healing Hashimoto’s Diet”. That means 10,000,000,000,000 x 10. That is a crazy big number. Ryan goes on to say: “Even though there is some dispute among scientists as to the actual number of bacteria and human cells, there is basic agreement that the microbiome is a big deal. Functional Medicine understands that inflammation at some point involves the gut. The microbiota can overwhelm its host by a factor of 10-ish, causing microscopic tears in the gut lining, where contents, meant to stay inside the intestines, are released to travel throughout the body, thereby poisoning the body with what the body can only recognize as foreign substances. This is known as intestinal permeability or leaky gut.” So we know that inside our body are a whole lot- a veritable mind-blowing, quantum amount- of human cells and even more microbiota. It’s a bona fide universe inside each of us. We also know that we have an epidemic of autoimmune diseases in the U.S., most of which did not even exist 100 years ago, let along affect ap. 60 million people. Autoimmune diseases are described, perhaps inaccurately, as the body attacking itself. We know autoimmunity signifies high levels of internal inflammation, where the white blood cells, so good at rallying to defend you against cuts and colds, become so ineffectual as to surrender their armies and attack the wrong enemies in the body. Why would the body’s amazingly-designed white blood cells, heroically guarding your systems against foreign invaders, get so confused as to attack its own cells? Let’s stick with Dr. Marc Ryan to see what he says about the war against foreign invaders: “What’s common in Hashimoto’s and other autoimmune diseases is that triggers contribute to your body developing something called “a lack of self-tolerance.” This is when the body is no longer able to recognize its own tissue as part of itself, but instead starts viewing its tissue as a foreign invader. It is no longer “tolerant” of itself, and this is what leads to an autoimmune condition. What happens can be described as a case of mistaken identity. First, (bacterial) cells from an infection actually do trigger the body’s immune system to attack the invading cells. Triggers can be food sensitivities, nutrient depletions, toxin exposures, chronic infections, a poor stress response, and a number of other things. Some triggers can actually also lead to intestinal permeability (leaky gut) issues as well, such as with what happens with gluten sensitivity.” The body ‘attacking’ itself due to mistaken identity on a mass scale makes a lot of sense. The body is trying to protect itself from the invasion of billions upon billions of foreign invaders, misreading its own cells as the enemy. Dr. Mark Hyman explains: “When your body senses foreign invaders, a specific cascade of events is set off in which your white blood cells and some special chemicals called cytokines mobilize to protect you. This normal type of inflammation is a good thing. It helps your body protect and heal itself. But, when your immune system shifts out of balance, inflammation can run rampant — causing a chronic, smoldering fire inside your body that contributes to disease.” The body is trying to protect itself from foreign invaders. It is certainly not trying to attack itself. Those valiant white blood cells, barraged by this endless assault of 100,000,000,000 + bacteria per millimeter multiplied by many millimeters in the intestines, get overwhelmed from the endless deluge. It’s a tsunami of inflammation. The body’s finely tuned immune system goes haywire and blows up, dazed and confused. When you think of the pesticides, the glycosphates in Round-up, the low-nutrient processed foods we consume, the nonstop ingestion of white death, electro-magnetic pollution, the over-proliferation of plastics, toxic chemicals in our water, mold in our homes, mercury in our dental fillings, the over 150 inorganic items we use each morning when we shower, apply skin care items and makeup, the overprescribing of drugs, aren’t our bodies trying to protect us, by attacking them, even though them is us? The body is smart. It knows something is wrong on the cellular level. It senses danger and foreign bodies and goes on the attack, without correct differentiation, because it knows the bad guys when it sees them. The body is trying to protect us from whatever is inflaming us and ironically, in the process, we become more inflamed and get a full-fledged autoimmune disease. Those hot cells need our attention and help to find their natural state of health and wellness. The body hues towards healing. We can turn autoimmunity around. We can calm down those hot cells. We start with the gut. We start with a breath. We are on the mind-body journey to healing our very own precious cells so that they can all live in peace inside our bodies. #Holistic Health #Inflammation #Autoimmune Disease #Infection #Bacteria #Microbiome #Functional Medicine #Gut health

Or Is the Pause in Menopause A Thing? Due to some interesting but strange conversations I have been having of late, I can’t tell you how many men have stated, with sorrowful or raging gravity , that since entering menopause, their wives have lost all interest in sex. These men are in despair, facing a future of a deserted marital bed, and fading in to the oblivion of sexlessness. Whenever I hear that comment, I take a pause. I wonder. Do these women just need some space? Are they still working full time and raising kids? Truly, maybe they just need some space. Are they dealing with hormonal imbalances, chronic pain or an autoimmune illness? I think they need some space. Are they continually stressed, feeling overwhelmed and without a moment to think? Yes, they need some space. Are they carrying the larger share of the load in your relationship? Hey, give them some space! If there is any purpose to menopause, besides officially ending years of fertility, childbearing and childrearing, it is the need for a pause. A pause creates space. And if your woman’s life is anything like most women’s lives, heck yeah, she needs some space. She needs some space to go inside. To find herself again. To regroup and reconnect with herself. To mentally prepare herself for her next reiteration. This is not a time for her to give; it is a time of retreat, to cocoon and face inward, as she meets herself anew. Having come through the other end, I can say that those active years before I became post-menopausal (technically defined, by a male for sure, as 12 continuous months without menses) were a time for my own cocooning. I simply could not give at the same rate. And working full-time, being the major bread winner and major caretaker of my daughters, meant that something else had to go. My stress level was off the charts and I had full-blown, mis-diagnosed autoimmune thyroiditis. I was at a breaking point. So what could I let go of that would not bring down the proverbial house? Seems like it was sex with my long time spousal unit. Am I saying that sex with your partner is expendable? I would say that for a time, women may need to withdraw. And men may need to go with that need in a supportive and loving way. Some women tell their guys to get their needs met elsewhere; some would leave if they did. If you are having extra heat- night sweats or hot flashes- having sex may not be very appetizing. If your ability to put up with a lot of daily shit is waning, intimacy may not be very appealing. If you are just holding on to the ‘I have to do X, Y and Z right now or everything will fall apart’, having a few moments to yourself before you fall into what may be, at best, restless slumber, may be your priority. You might not have an iota of space for your guy. That does not mean you don’t love or care about your partner, or that you don’t miss being intimacy. It just means you need to turn inwards. Take a pause. Take a breath. Reflect. Renew. Reinvent. And it doesn’t last forever. Really. It is temporary. Now that I pulled in on myself, experimented with and found a path to renewed health over the last half dozen years or so, I can say my sexual desire is alive, different than before, and well. There is nothing less regimented and fixed than our sexuality. Menopause is all about doing gray. We are straddling at least three development stages at once. Our earnest dudes need to take a pause themselves and let their women go through something, something that requires retreating inside themselves, as the moments of pause increase, crescendo and calm. Just like an orgasm, or the tides, or a normal cycle of life. Take a pause. #Menopause #Menstruation #Relationships #Sexuality #Meditation

I have Hashimoto’s disease. So do about 30,000,000 other Americans, give or take a few million. I wonder if you might have it? It’s the most common of all autoimmune diseases and more than ninety percent of people (mostly women, natch) who are hypothyroid have it, even if they don’t know it. The symptoms range from brain fog, sleep disturbance, extreme fatigue, unexplained weight gain, intolerance of cold, joint and muscle pain to low libido, digestive issues, bloating and puffiness,a tendency to get carpal tunnel syndrome, etc. I have been ingesting prescribed thryoid hormone- either natural or synthetic- for thirty years but I did not know I had Hashi’s until about 6 years ago. That’s because conventional medicine does not differentiate between autoimmune thyroid and hypothyroid, because it treats them identically, so the doctors didn’t bother to tell me. If you had cancer, would you want to know what kind of cancer you had, even if the treatment of chemotherapy and radiation would be used no matter what type of cancer it was? I know so many women who have been told their blood levels are fine, so their complaints must be psychosomatic. Sheesh! (which means full out SCREAMING RAGE without adequate outlet. Do I hear the sounds of the largest class action suit in history?) The real question is why is the thyroid gland- the master gland of metabolism that communicates with every frigging cell in your entire body- so often ‘attacking itself’? At this time in our history, the U.S. has a veritable epidemic of autoimmune diseases, which are said to affect well over 60,000,000 people, or about one in five. Next time you count about 25 people in the grocery line while you wait impatiently, know that 5 of them have so much inflammation in their bodies, that their bodies are confused and attacking their own cells. Probably 3-4 of them have Hashimoto’s. Autoimmune diseases were extremely uncommon a century ago, so we know we have created and are responsible for near epidemic numbers of people with autoimmunity. There are now over 100 autoimmune diseases that are new to medical lexicon and are occurring at alarming rates. Our polluted environment, nutrient-deprived foods, and the ingestion of toxins like additives, plastics, mercury fillings, as well as unresolved trauma and highly stressful lifestyles result in chronic inflammation, which gravitates to an organ or bodily system that has some type of inherent weakness, causing the profound distress that eventually becomes an autoimmune disease. Our bodies cannot take the toxic ingredients that they are tasked with assimilating or the toxic environments they must live in. Virtually every chronic autoimmune disease shares in common that the body appears to be attacking itself (more on that in a future post), including but not limited to: multiple sclerosis, rheumatoid arthritis, interstitial cystitis, fibromyalgia, systemic lupus erythematosus, Graves’ disease, Hashimoto’s thyroiditis, Sjögren’s syndrome, systemic sclerosis, dermatomyositis, primary biliary cirrhosis, ulcerative colitis, Crohn’s disease, psoriasis, vitiligo, bullous pemphigoid, alopecia areata, idiopathic dilated cardiomyopathy, type 1 diabetes mellitus, IgA nephropathy, membranous nephropathy, relapsing polychondritis, and pernicious anemia. Hashimoto’s is by far the most common autoimmune disease, affecting 30,000,000 people. Alzheimer’s, sometimes referred to as Diabetes 3, and other memory disorders are now considered autoimmune disorders of the brain. How do cells go from being healthy and happy to pissed off and inflamed? The cellular breakdown happens over our lifetimes and autoimmunity is the expression of prolonged inflammation building upon inflammation. However, now more and more children have autoimmune and chronic health issues at such very young ages and we can see that our kids are inheriting our chronic conditions, thereby starting off their lives with tendencies towards inflammation. How to deal with the overwhelm of having an autoimmune disease, getting medical advice that does not help and living with chronic pain? How to move into resolving the health problems and healing? I am here to say that many, many of us are doing it, sometimes quickly and other times slowly. For me, it was very slow and sometimes imperceptible. It happened over two decades and continues, as I also had chronic back pain, interstitial cystitis and systemic candida. I no longer have brain fog and my digestion is better. I sleep well and have as much energy as I need. My overall fluish feeling and muscle pain of twenty-five years has disappeared. My bladder is not overactive. I still have intolerance to cold which I manage with a lot of extra warm sweaters and socks! I am here to say that there is hope. I did it slowly and often my healing journey was frustrating. I was my own guinea pig. I no longer have any mercury fillings. I do not eat gluten, processed foods, or soy. I eat very little to know foods with dairy or sugar. I use stainless steel and glass containers, having gotten rid of plastic tubs and teflon. I have ingested Chinese herbs and all sorts of supplements for years. I have seen every type of healing practitioner imaginable. I have tried so many different approaches to food and eating and fasting. I have done therapy and coaching. I have prayed for clarity and guidance. Now there is so much more information and options. People are healing faster. Their trajectories are a lot more linear than mine was because we know so much more. So don’t give up. There is relief and support waiting for you! If you are struggling, try working with a coach and learn how to take small steps towards success! #health #autoimmunity #thyroid #cell

I am post-menopausal for about a decade and find societal attitudes about women’s sexuality in this stage of life fascinating. Menopause is a new frontier. We don’t know nearly as much about it as pregnancy or diabetes or heart disease or even dying. Is it because its women’s health and thus a lower priority? Sure, that is part of the reason. But we also don’t know a lot about menopause because we have never lived long enough to adequately understand it. We used to die a lot younger, often before we went into menopause. In “Flash Count Diary: Menopause and the Vindication of Natural Life” author Darcy Steinke calls it “an enigma,” and a rarity in the animal world. Few species have long post-reproductive lives. Most female primates in the wild die before they stop cycling.” Menopause is best seen as a modern, human developmental phase, much like the onset of our menses in adolescence. It was not too long ago that women who were getting older- and perhaps more assertive or more melancholy- were written off as dingbats or hysterical or worse. How many were locked up? Now we know the change is a lot more complex, with many implications for wellness, aging and a woman’s personal reckoning with herself and her life. Are we getting darn tired of the male medical gaze into our postmenopausal vaginas yet? Do we want our vaginas described as shriveled, dry and not necessarily receptive to {their} male organs? The male perspective makes us dismissed, invisible, and desexualized. In fact, when I searched for synonyms for the word ‘menopause’ in the online Power Thesaurus, the equivalent words appear to be the epitome of the male gaze: Unproductive, Unfruitful, Sucked dry, Unplowed, Dried up, Wasted, Drained, Exhausted, Desolate, Fruitless, Fallow, Dry Jejune (meaning dull, flat, boring, banal, tedious, uninteresting, insipid, vapid) Look around, fellows! Do women over 50- running companies and making art and leading movements and keeping it all going- deserve such descriptors? Does Nancy Pelosi or Meryl Streep or the late Toni Morrison seem fallow to you? What about the sexy Helen Mirren? We are also knocking it out (despite my dislike of sports metaphors) in the bedroom. The reported rise in STD’s in people over 60 attests to that. How shall we seize and recreate the definition of menopause? What does the post-menopausal vagina feel like from the female gaze? Perhaps a bit smaller due to the converging forces of gravity and childbearing. Perhaps the vaginal tissue is a bit thinner with less estrogen circling about; often resolved with lubricants and specialized organic creams. What word honors the decades of fertility and menstruation that gives way to a new period characterized by confidence, calm, reflection, not putting up with anyone’s shit, and hopefully pearls of earned wisdom? Menopause- or perhaps womanpause- gives us the space to pause, take a breath, and proceed with absolute, quiet clarity. #Menopause #Menstruation #The Male Gaze #Womens Health #Sexuality

The timeline for my bombed vagina starts when my father punched me in the face in one of his tirades when I was about 12 years old. About a decade later I had a hole in my skull the size of a quarter. The nerves of two teeth had died, typically due to blunt force trauma, and infection was taking the place of bone. My dentist put me on antibiotics to knock out the infection before I could have surgery to clean out the decay in the skull and seal it off. The antibiotics took a full year to kill the infection, thereby beginning 15 years of inflammation in the form of countless vaginal yeast infections and urinary tract infections, that ultimately morphed into systemic candida and interstitial cystitis, replete with chronic burning in my vagina and urinary urgency. This made sex very uncomfortable, albeit painful. The pain was at its all time high when I met my future x-husband and it came to shape our sex life. Now that I know about how antibiotics ruin the gut microbiome and cause intestinal permeability, and then brain fog, muscular and joint pain, hormonal imbalance, I realize that I was having a full body implosion, as inflammation and dysbiosis ruled my every day. But it was the bomb that went off in my vagina that caused me the most burning and searing physical pain. Its many years later now and with the aid of functional medicine, acupuncture, herbs, supplements, homeopathic, the elimination of sugar, processed foods, gluten and soy from my diet, I am much better. My exploded vagina has healed through trial and error- and the extreme avoidance of antibiotics. And if I indulge on sweets very occasionally, my vagina lets me know in no uncertain burning terms to lay off, so it can get laid again.

My mom got her wish for death on April 25th, 2017, exactly 5 years and 2 hours after her eldest daughter, one of my two sisters, died. She was 94 years old. She had a great death. A brilliant life-affirming death. She wanted to die. She embraced it. She was ready and open. A few weeks earlier I begged her, tongue in cheek, not to die when I was going to be out of town in NYC for a week with my family. Two days after I returned, she took to her death bed, after what hospice called ‘a cardiac event’. When I came to her room at the assisted living facility, the hospice nurse was already there and my mom looked at me from her bed and said weakly but with a knowing smile, “ See? I gave you New York! Now its my time.” And it was her time. I had moved her out to be near me four years earlier from Florida, also known as “God’s Waiting Room”. At 90 years old, she chose to give up her house, her car, shopping and cooking her own food. Her husband had died a few months earlier, and she had taken care of him and my sister for the prior year. She was worn out with advancing COPD. When she arrived at her new home near me in the Bay area, my mom was convinced she had a year left to live. Her amazement over her longevity never ceased to fascinate her, and I watched as she held on to the desire to live, in part to be there for my other sister who was struggling with health issues. She was warm and very loving, always with a big smile for everyone in her facility and for me, my spouse and my daughters. I took her every Saturday to get her hair done, followed by a family dinner out on the town. She loved pastrami sandwiches and hamburgers. A wheelchair lived in my trunk so we could go to the coast or to a museum or Macy’s for bargain tops for her. She had been on hospice for 2.5 years before she died. She used oxygen daily and loved the attention of the facility’s aides and the hospice caretakers. The hospice nurses fought over who would get to see each week as they all loved her so much. She loved getting showers the aides provided and chatting with her many visitors. The other residents adored her for her fashion and jewelry and warm smile. But in her last year, her ability to hear faded, her need for a walker increased, and her OCPD and congestive heart failure progressed, she would sleep for longer and longer. She fell six times in as many months and started to complain about not wanting to live in a body that was falling apart. We had to have the facility’s nursing team administer her meds due to her short term memory loss and sometimes confusion. This was a big blow to her as she had been so in charge of her meds and loved correcting the medical team. She spoke about not feeling her life had purpose or meaning. She felt her quality of life was compromised and her desire to live was waning. So she was ready. Things turned as her fear of death became second to her desire for it. She started the process for physician assistance in dying but like many others, ended up passing away before she completed it. Her readiness was something else. She was full of love and light. She was surrounded by love and love emanated from her. I got to sit with her for most of those eight days and tell her how much I loved her. She sang me the song, “Don’t cry for me Argentina” and told me she loved me and my sister with all her might. She gradually became less responsive and needed more meds. Her granddaughters and son in law came to say goodbye. Her niece got to say goodbye by phone. The nurses were amazing. She was ready to go and was at peace. She had transformed into love and light. By contrast my mother in law, who had died 10 months prior, was not ready for death and faded quickly and unexpectedly. She did not have a great death, although she was greatly loved by her family. My spouse struggles with the pain of not having gotten to say goodbye. When I miss my mom, I am quickly filled with the love we shared in those last days and the four years we had together. Knowing she was ready and wanted death is a great comfort to me. I am filled with that love whenever I want. I am so comforted by her readiness and willingness to meet her death that missing her quickly turns to a quiet and joyful love. My mom gave me life and the gift of unconditional love for all her days. She gave me an amazing and awesome gift in how she died. I am forever grateful.