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alcoholism anxiety bipolar life lessons schizoaffective schizophrenia writing

Welcome

I hope it is easy to find lorib.blog, or lorib434.wordpress.com

i have been blogging, more like journaling for years, but not for an audience. I have published on The Mighty, recently started posting on Medium and published on Psych Central.  The title there is Triple Winner.

I have a diagnosis of schizoaffective disorder and social anxiety, along with overcoming an alcohol addiction. I plan to blog about those topics and other ramblings.

I will repost some but also have new posts here.

I will do my best to respond to comments.

where I can be found:

twitter lorib641

https://blogs.psychcentral.com/triple-winner/

https://themighty.com/author/lori-bernstein/

https://medium.com Lori Bernstein

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Calories coconut milk yogurt diabetes Fitbit intermittent fasting lactose intolerance Medication Myfitnesspal Uncategorized

Making coconut milk yogurt

Image. Coconut Milk Yogurt, luvele.com

I recently discovered I am lactose intolerant. I just bought a yogurt maker and was making yogurt with half and half, which was a simple recipe, but now I am trying to switch to coconut milk. So far, I have had little success. I have made gelatin, which tasted okay but was definitely not yogurt. I had a batch that did not set and one that turned out sour. I used them in smoothies. They are fine to eat, but not what I am looking for.

I am using this recipe https://www.luvele.com/blogs/recipe-blog/best-dairy-free-gut-loving-coconut-yogurt-recipe. It does not seem too complicated but I am having trouble. I have a new batch going now. Fingers crossed it works. They have a different recipe that uses coconut cream that I will try next if this fails.

I probably would give up and just buy non dairy yogurt, but I want to use the maker. I don’t know what else it could be used for.

I have been making green smoothies, too. I drink them most mornings now. Our blender died after 20 years so we got one that makes smoothies and is durable. I put in ice, soy or coconut milk, spinach, cucumber, coconut milk yogurt, ginger, chia seeds, plant protein powder and blend. It is pretty filling.

Image coffee mug with coffee and coconut milk, green smoothie

My weight has been stalled since I had a medication change in June, but my glucose is good and I am in ketosis (on ketogenic diet). I had been logging my food on Cronometer but I think it was overestimating my energy expenditure so I switched to myfitnesspal. You enter your foods and it calculates the calories, carbs, fats, protein etc. I am not perfect at logging but it gives me an idea of where I am at. I have it linked to my Fitbit and scale.

I am still doing 14 hour fasts. It is not too difficult for me. I have not noticed any changes with fasting. I do feel a lot better now that I am not having much dairy.

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coconut milk yogurt diabetes Digbi Health DNA lactose intolerance Virta Health

Going Dairy Free

Image bottle of milk and glass with red circle and slash

I am in a weight loss program with Digbi Health. I found it looking through programs offered through my insurance. Unfortunately, they do not cover me because I have type 2 diabetes and they refer me to other programs. I called to find out why it is not covered and the sales rep explained that to me and gave me a discount that expired that evening. I thought about it and maybe impulsively signed up.

I am still doing keto. Digbi recommends a lot of veggies with meals and I am having trouble staying in ketosis but my glucose is okay. I want to find a way to work the Digbi program and Virta keto together. I tried asking both how I can blend them but I guess I was not clear because I have not got much of an answer from either program.

With Digbi they do a dna and gut biome analysis. I got the dna results. Some things I found out are that I am lactose intolerant and my blood pressure changes with sodium intake. I have been making yogurt with half and half and have had some digestive issues but I had not put the 2 together. I tried making yogurt with coconut milk and it became gelatin. Not sure if that was the recipe, the coconut milk brand or me. I am going to try a different recipe next time.

I don’t know if i have to avoid all dairy or if things like heavy cream and cheese are okay. I found a sub on Reddit. They were helpful, but they told me it is an individual thing. I got some lactaid tablets, too.

Some other things I found out were vitamin and mineral requirements, like I need more vitamin A and Copper. They don’t test levels, it is how you metabolize. I also have a lot of weight gain tendencies which just means I have to be diligent. Apparently, I have high heart capacity, poor flexibility. I found it interesting. I am going over the results with my coach this week.

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anxiety Calories depression diabetes Donation intermittent fasting keto life lessons Marrow Medication mental health mental illness schizoaffective schizophrenia stigma Weight loss

Intermittent Fasting (IF) and Stigma in Plasma Donation

Image of insulin and glucagon levels over time source Digbi Health

I saw the image above of how insulin drops between meals and while fasting. While insulin is low, glucagon can burn body fat. I was intrigued. I am 10 lbs away from a healthy BMI, but still have abdominal fat. I am type 2 diabetic and asked my doctor if fasting would be safe. My glucose is pretty well controlled and I don’t have hypoglycemic episodes. She said it is fine, but recommended 12-14 hour fasts. Which is mainly cutting out the nighttime snacking and eating breakfast later.

So far, no change. My weight has been stalled for awhile. My diabetes medication was reduced in June and my biometrics went south. Glucose up, ketones down, weight up. Thankfully, that stabilized but I can’t get my weight to go down. I log my food on an app (Cronometer) but sometimes I estimate weights. I am going to have to get better at calorie counting to start losing again.

So I am gung ho on intermittent fasting. Watching Dr Fung YouTube videos. Then, I saw this study. https://pubmed.ncbi.nlm.nih.gov/34135111/
A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults

All I can see is the abstract and I heard a review but this is what I got out of it. There were 3 groups. One calorie restricted, one calorie restricted (same as group 1) but alternate day Fasting and a third group with no calorie restriction. The calorie restricted groups both lost the same amount of weight but the non fasting group lost more fat.

It was a short study 4 weeks, I think, and these were lean adults. Also, they were doing longer fasts than I am. But, I don’t know what to make of it. I would have expected the fat loss to either be similar or more for the fasting group since they have lowered insulin during the fasting period. if anyone has any insights let me know in the comments. I will stay with 12-14 hr fasts and keto diet for now.

I tried donating plasma at a donation center. I tried calling ahead to ask about restrictions but they do not give that information over the phone. And, they don’t take appointments for first time donors so I had to walk in and wait. For what it was it was not too bad. First someone checked my veins, which are fine. Then I had to fill out a bunch of paperwork. Then, I watched a video on plasma donation and read through a manual for first time donors.

Then, a woman, I don’t know her title, took me to an office to go over my paperwork. She got to the medications and asked what each was for and looked them up in a huge book. I take 7 medications for various conditions. After she goes through the medications she goes over them with me.

Most were fine. I take antidepressants but as long as anxiety and depression are under control it is fine. But, I take metformin for diabetes. She said that is a temporary deferral. If I was off it for a year I could come back. I don’t know what the likelihood of me maintaining my diabetes by diet alone is, my husband is able to, so possibly. Then she got to abilify which is an antipsychotic although it is sometimes used along with an antidepressant for depression. But, I told her I take it for schizoaffective disorder. That is a permanent deferral.

Bone marrow donation has the same policy. It is not the safety of the product. They consider me a safety hazard. I have been stable for 15 years but still people are afraid of me because of a diagnosis. They should have a sign out front: schizophrenics need not apply. So, I would not have had to waste my time.

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CGM diabetes empathy keto mental health mental illness support Therapy

Empathy Postcards, CGM, and my week

Image Cover of Empathy Postcards

As part of a gift in a gift exchange I was given Empathy Postcards by Emily McDowell. It reminded me of a time I was hospitalized for my mental health . In art class I made a card to myself. No one brings cards when you are you in the behavioral health unit. I think they just don’t know what to say. These empathy Postcards are perfect for times like that. I think I will use them for friends when they are having a rough time.

Image if this is God’s plan, God is a terrible planner (No offense if you’re reading this God. You did a really good job with other stuff, like waterfalls and pandas.)

I also was given some keto friendly snacks, a little stuffed poodle that looks like my dog, dog treats and a nice note.


As far as keto, things are going well. My labs were good last month, so.my Dr took me off of one med, Januvia. Everything went wacky for a few weeks. My weight was going up, glucose went higher than when I started keto and I was out of ketosis. My Dr gave me the option to give it a couple of weeks more or to go back on Januvia. I decided to see how it goes in a week. It started improving. My weight started dropping and fasting glucose lowered. I am back in ketosis


I asked my coach from the program I am in, for type 2 diabetes, Virta, about a CGM, continuous glucose monitor. The Virta Dr called in a prescription for Freestyle Libre 14 day sensor. I got a voucher from the freestyle libre US website to bring to the pharmacy. It is a free trial. My insurance won’t cover more sensors but I am getting a lot of data. My glucose drops in the early morning and then rises. The sensor does not always agree with the fingerstick. It reads interstitial fluid. The range is set at 70-140 mg/dl and I am in range. I am going to lower it to 126 to see if I can tell the difference. It has a graph but it is hard to read. It is small. So far the biggest rise in glucose is just from waking up and not from my food. The app lets you write notes to go with the readings.

I have sleep apnea and wear a dental appliance. After my dentist adjusts it, he orders a home sleep study. I have done about 4 so far. I did one this week and have seen the results. I wore a t-shirt with tennis balls that is supposed to keep me in my side but the device read as if I was on my back most of the night. I still have mild apnea with the appliance so he will most likely adjust it more. It is not painful but it gets uncomfortable the more he moves my jaw forward and it takes time to get it back in position in the morning.

I talked with my therapist this week. She asked how much time I spend online. I don’t know so I told her that, but it is a lot. She said she spends an hour. She wants me to keep track. I don’t have to change but she says I should know. I like her but don’t like her assignments



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anxiety Co-occurring job keto Medication mental health mental illness peer support psychosis schizophrenia support Weight gain Weight loss

The Keto Roller Coaster

Image of roller coaster

I have been on a ketogenic diet for about 5 months to help treat type 2 diabetes. I was taking 2 medications. Metformin and Januvia. I am monitored through a program called Virta. I have a coach and a physician through Virta, it is all done virtually. There is also an online community for people on the program. It is covered by my insurance.

At the beginning of this month I had labs that my endocrinologist had ordered. The results were really good. A1C of 4.8 and fasting glucose 98. Everything else was normal, too. For some reason my endocrinologist office cancelled my appointment so I had to reschedule for August. The Virta dr said that I could try going off Januvia since my labs are so good.

So, I go off Januvia and everything goes screwy. I get ravenous at night and have to eat after dinner. I had been slowly losing, now I am gaining weight. My fasting glucose is higher than before I started keto. I test my ketones and they are low. I chatted with people in the community and they tell me to stick it out, that my body will adapt. I am not so sure. I put in a message to the Virta dr to ask for his opinion but I won’t hear until at least Monday. I did not even know if the Januvia was doing anything but I now notice a difference without it.

I rarely talk about work, but here I go. My opinions do not represent my employer.

I work in peer support in a 20 bed mental health crisis stabilization unit (CSU). I have worked in peer support at an activity center for people with mental health issues and in a residential program. The people we see are much more symptomatic than I had worked with in the past. I am available to talk and offer groups but I don’t get much interaction because people want to sleep, are too symptomatic, want to be left alone etc.

It is a new facility and peer support is a new position for my employer. I have been there about 5 months and still have not found my footing. My boss is aware of the issues of people not wanting to interact and told me to keep being available and offering groups. She is going to give me some additional duties once they are approved.

It also can be anxiety provoking when patients are loud or aggressive. I am not involved with dealing with those situations but I feel tense. I help out where I can. I like the place and what we do.

Categories
bipolar Dual diagnosis Forgiveness hams harm reduction Inner demons mental health mental illness moderation NAMI pandemic psychosis Recovery relapse schizoaffective schizophrenia sobriety suicide

What I Have Been Up To Lately

I had therapy last week. I started seeing this therapist after the pandemic, so all my sessions have been virtual. I forget what she asked but I mentioned I remember mistakes from the past, 20, 30 years ago or more and they torment me. She wanted me to share but I am not comfortable with that. I feel such shame and they were mistakes that I feel are unforgivable. If I did not feel shame there would be something wrong. But, I don’t want to delve into them.

My father did not believe in mental health treatment even though schizophrenia, schizoaffective disorder and bipolar run in our family. When I started therapy he discouraged it saying talking about the past just makes everyone sad. I did not understand what he meant until now.

My therapist wants me to work on forgiving myself.  I have to explain to her that some of these things are best kept hidden.

 

 

I have been able to stay alcohol free after my planned intoxication in April.  My plan is sobriety until our wedding anniversary in October.  It was pretty easy to get back to it.

 

 

I posted a link to an In Our Own Voice presentation I did for NAMI, National Alliance on Mental Illness, in a different post. I have not been speaking much lately. I saw a different program by NAMI called VOICES. It is geared towards first responders. I signed up to be a speaker, but am having trouble figuring out where to start. My initial interaction with mental healthcare and police was not until I was 39, but since mental illness runs in my family that was not foreign.

My brother had a psychotic break in college at 20 (I was 15). He refused treatment and would get picked up by the police for 72 hour observational holds in the late 70s. His is a sad story. He was severely symptomatic for 6 years when he finally was placed on a different medication that he responded well to. But, he started becoming symptomatic again, paranoid, edgy, and probably needed his medication adjusted. He went to Yosemite while symptomatic and fell at a waterfall. I don’t know if it was accidental or not, but he died from the fall.

This is supposed to be a story of hope, but it is part of my story.  If I had not seen him so ill for so long I may not have accepted treatment, but I did not want to be stuck in psychosis like he was.  I think it is okay for first responders, but not sure if it will scare the general public who may be worrying about their own children.

My story is much different.  I did go in and out of psychosis for 3 years, but I have been stable since 2006.  I have not been hospitalized for 16 years.  I am married, have healthy grown children, work part time.  I still have some doubts about what was real from the past, but I can function.

 

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Brain keto Medication mental health mental illness schizoaffective schizophrenia

Advice From a Dietician on Brain Health

Image of highlighted brain

I zoomed with a dietician this week.  We talked about ketogenic diet and brain health, specifically schizoaffective disorder.  She gave me goals for macros and ketones.  I am having trouble just staying in the requirements of Virta, the company that is monitoring my diabetes, so she suggested following that and then make changes.

The suggestions she made was: going from 30g carb a day to 22g. And, cutback on artificial sweeteners.  Keep my protein the same, and increase fat.  She also suggested, for my particular issue, that I should have 2-3 mmol/l ketones in blood.  When I started keto, I was getting numbers in that range, but now it runs around 1.0 so she suggested adding mct oil.  She also suggested balancing the unsaturated fat I use with some monounsaturated fats.

I am trying to hit the macro targets now, but will really start in earnest in May.

I had asked my psychiatrist if he would talk with the Virta doctor and he agreed, but I don’t think he has called. I have been stable a long time, and am wary of making any medication changes. The dietician told me to work with my psychiatrist about any changes, which I would do anyhow.

I really can’t believe I have stuck with this as long as I have. I want to make it a lifestyle change but it is hard. I feel good and am thinking clearly. My main issue is that something does not agree with my gut. My fasting glucose has dropped 20 pts. Still not low enough to change my diabetes meds, but it is an improvement. I have lost about 1 lb/week, it’s not melting off, but I think it is reasonable.

I am in a medically monitored nutritional ketosis program and working with a psychiatrist for my mental illness. Please don’t try this alone.

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anxiety bipolar Coping skills distorted thinking Medication mental health mental illness NAMI psychosis Recovery schizoaffective schizophrenia stigma Therapy

In Our Own Voice Presentation

Yesterday I did a presentation for NAMI Orange County on my recovery.

https://us02web.zoom.us/rec/share/8I-z9RKNONCJ958C7klIYBjCf3ZzCXs_BD743CKZD0QUzGcCtPbtjjVcYygq5hk.nKTSbzmA_Jj3DrvG


Passcode +6$T%coQ

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keto mental health mental illness moderation schizoaffective schizophrenia sobriety Therapy Weight loss

Medical ketosis for psychiatric illness

Image of highlighted brain

I have been on a ketogenic diet to treat type 2 diabetes, through a company called Virta for about 3 months. I have lost about 1 lb/week, my fasting glucose has dropped 20 pts, and I feel good.

My friend was pushing me to try the diet and now he has been pressuring me to find out information on medical ketosis for psychiatry. He says it has greatly helped his depression. My provider from Virta agreed to talk with my psychiatrist about how a keto diet can affect mental health. But, I started wondering what am I doing. I have schizoaffective disorder controlled with medication and also take medication and use coping skills for anxiety. I don’t know that I want to change anything.

My therapist coached me on how to tell my friend thanks, but I feel pressured. I am not great at setting boundaries. I took her advice and he was cool. He said it is not his business what I decide to do and he is just making suggestions.

Then, I read a post on Reddit where someone is working with a dietician from the Charlie Foundation on a keto diet for schizophrenia. They work on keto for epilepsy in children and have expanded. I emailed and they gave me info on a dietician and I made an appointment for a zoom call on Wed.

The diet I am on now is 30 g total carbs, 13 oz protein containing food and fat to satiate. I am sure the dietician will have something more precise with macro g or percentages. Right now I weigh some but estimate amounts, where I will be measuring more.

My therapist gives me homework. The last thing she gave me was to give examples on where I could be more assertive, like with my friend. And to think of things I am grateful for and proud of. I am grateful for many things. The people in my life, especially my husband and even my pushy friend. My car, dog, food, home… i could go on, but proud of had me stumped.

I work and take care of my family but there is nothing I can identify as I am really proud about. I thought some more. I am proud I have been alcohol free for 6 months and have a plan for moderation. I am proud I have been able to stick with keto 3 months and with the results.

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12 step AA hams harm reduction moderation peer support sobriety Uncategorized

Slippery Slope

Photo of hamster

I have stopped going to AA meetings.  I felt pressured to attend meetings and pray daily.  I am not religious and I did not find that part helpful.  There are things I gained.  I don’t think I would have stayed sober this long without starting with AA.  The accountability was helpful.

I belong to a couple of Facebook pages. Secular AA, Moderation Management and HAMs. (Harm Reduction, Abstinence and Moderation). We are called HAMsters. I am leaning towards trying to moderate drinking to about two times a year. We are going out of town over my birthday. Someone gave us a bottle of champagne and I plan to have some. Then I plan to go alcohol free until our wedding anniversary in October.

My therapist warned me it is a “slippery slope” and how do I not know I won’t go back to drinking more often. And, that I plan to drink because we have champagne makes no sense to her.  I feel like if I have a plan, I can stick with it.  And, that AA is not the program for me because I want to be able to drink occasionally, like twice a year.  I won’t be alone.  I won’t be driving.

Am I just asking for trouble?