Hi, it's been a while.

You know when you've put something off for so long that it just feels so daunting that continuing to procrastinate feels like the only way to make it hurt less?

That's where I have been for the past few weeks, or rather, few months.

This past year has presented numerous challenges, both personally and for those around me. 

I took a pause from writing in April after my surgery, and did so because it felt like the break I needed. I permitted myself not to put any pressure on myself, which, of course, is a catch-22. I've found that there is a fine line between holding myself accountable and committing to my goals and tasks, while also using and upholding rules for myself that truly serve me. What I mean by this is that if I've set a rule for myself to accomplish X because I know it supports my wellbeing and mental health, I will hold myself to it, creating general rules I must follow to achieve that goal. However, if those rules become something that causes me more stress than growth, whether it's because the rule or goal was unrealistic or perhaps the standard I am holding myself to is too stressful, then I have learned that maybe the rule isn't serving its purpose.

I live by rules that serve me, not just for the sake of rules, nor a life without any regulations. I lovingly refer to these rules as my "Daily Nonnegotiables." These include an assortment of things, such as:

• Spending at least 10 minutes outside every day

• Reading 10 pages of a book every day

• Journaling or writing at least once a day

• Practicing mindfulness or meditating at least once a day

• Drinking a gallon of water a day

• Eating at least five servings of veggies a day

• Moving my body for at least 30 minutes a day

However, sometimes life changes, and the things that were so basic and easy to do yesterday become quite challenging today. And when we compare our current selves to another version of ourselves, we might not be using a fair comparison, taking into account current circumstances or new challenges.

I spent the better part of this year regaining my functionality and also learning to trust in my body once again. I've had rheumatoid arthritis (RA) since I was seven, and it has caused me symptoms on and off throughout my life, to the point where I sometimes can't tell what my normal is, and it feels easier not to have to explain it to others. Some days are good, some days are bad. And I have been quite blessed to have lived with what I believe is only a mild case of RA, and to have achieved remission of the disease for extended periods of time.

I have also been fortunate to have an education and background in healthcare, which has given me a solid foundation for my wellness journey. When I had a flare of RA in college, I was in the midst of pre-med courses. I was simultaneously struggling while also discovering the importance of fueling my body with plants, avoiding less nutritious foods, and managing my stress with practices that soothe, calm, and relax my nervous system. In other words, I focused on the wellness aspects of my life that were within my control. I eventually got to the point where I believed my RA was gone. I was a significantly different and healthier person than I was a few years ago. In remission for several years, I decided with my doctor to stop my RA medication in August 2023. For the first time in twenty years, I was immunosuppressant-free. It felt great, empowering. That is, until I had a flare in my right knee about a year later.

I equated this flare with my own failure. My mind jumped to believing that I must not have been trying hard enough, that I wasn't caring enough about my nutrition and diet, nor stretching, meditating, and relaxing enough. How can someone who works in healthcare struggle with their own health? Not to mention the Daily Negotiable rules that I found much fulfillment in, suddenly became unattainable.

Because of the flare, I struggled in my day-to-day living, which stole much of my motivation and began to weigh on my mental health. To do too much one day meant I would be limited the next. To push myself to ski on a Saturday meant I wouldn't be able to leave the house on Sunday. Even the extra walking from a trip to the grocery store would sometimes mean I would be limping to work the next morning. I mourned for my past self, the one who had worked so hard to get to where she was, having just started mountain biking the year prior and trail running earlier that summer. It felt as though all my previous work to recondition and strengthen my body was thrown into the trash.

Because I felt out of control, I tried doubling down on what I could control, but this only led to more stress. I tried restricting my diet and digging deeper into inner work, believing there must be something I was doing to have caused this flare. Ignoring my own favorite quote, "We don't always have control of our health, but we always have control of our wellness." I had tunnel vision and a limited mindset, which made me resistant to my own reality, that I wasn't in control of my health, and I couldn't change the fact that I had RA.

I eventually succumbed to taking over-the-counter meds, steroid injections, and eventually surgery to remove my joint lining, hoping this could be a fresh (and pharmaceutical-free) start to calm the inflammation and reset my problematic joint. While I patiently waited for my synovium to grow back, I committed to my physical therapy to gain back my lost range of motion and strength. Unfortunately, a few months after the surgery, the swelling and pain returned. There wasn't much I could do. I had to recognize that many other people are less stringent when it comes to their wellness practices and don't deal with RA flares. My options were to continue fighting my reality and beating myself up over something out of my control, or to surrender and accept that I needed help.

I realize now that I was holding an untrue belief - that to take medication was to mean I was a failure. Working in medicine, I can now laugh at the irony. I am an advocate for patients to do what is best for them, yet I was holding a double standard when it came to myself. I had to accept myself and the fact that my body had some genetically unique characteristics, including the tendency of my immune system to create antibodies against my own tissues, and that no amount of my actions could ever change that. Indeed, I know I can influence the degree of my disease with my wellness practices, but at the end of the day, I'm still genetically me, Mallory with a touch of RA. 

And for anyone else dealing with chronic diseases or even just minor medical inconveniences, remember that you are human. We are soft and breakable, but also strong and resilient. It's often our own perspectives that hold us back the most, but they can also elevate us. Sometimes we cannot see it ourselves, but each day we learn and grow, becoming better. However, my advice is not to go it alone; ask for help and actually accept it. There are many specialists and professionals who can give you new ideas and better ways to support your health. It's okay not to take no for an answer. For much of my life, I was told to restrict my movement, that something as simple as hiking or running would never be attainable, but I have found a supportive care team that wants to help me reach my goals. And even if my achievements never quite match someone else's, I am grateful for the opportunity to try. I also recommend turning to friends; lean on the good ones who accept you as you are, no questions asked. Sometimes the distraction and laughter friends offer are the best medicines. And lastly, be honest with yourself and brave enough to accept your current circumstances. Be gentle and kind when you need it most, and be firm and accountable when you know you're capable. Create your own wellness practices that build you up, not tear you down.