Early Beginnings

When I was a child, my dad was vegetarian, so as a default, our whole family was vegetarian. Back in the ye olde days of the 1980s and 1990s, being vegetarian was considered weird. Getting take out food was a challenge, but luckily my mother was a fantastic cook. At home, she would make vegetable soups, broccoli sautéed in butter, and delicious salads.

A Meaty Detour

When my parents got divorced, I stopped being vegetarian. My first taste of meat was when I was twelve years old. It was a star-shaped chicken nugget from a drive-through fast food restaurant. It tasted like a deep-fried kitchen sponge, but it was fascinating to find out what all fuss was about meat. From then on, I did eat meat, but I never lost my preference for vegetable dishes. 

In my opinion, what makes meat taste good is actually the sauces and marinades, which are made out of vegetables—usually some variation of tomato and garlic. Once you’ve chewed out the sauce, what’s left pretty flavorless. 

However, I liked the social capital of not being the “weird vegetarian” that other people had to accommodate. It made things easier when I went over to friends’ houses.

The Wake-Up Call

Everything changed in 2019 when I was diagnosed with vasculitis and prediabetes. My doctor at Kaiser suggested two nutrition classes: a meat-based ‘Pre-diabetes and Me’ class and a plant-based nutrition class. The former felt like a slide into despair, while the latter, led by an inspiring teacher, presented a hopeful path toward reversing chronic diseases. You can read more about my health journey here. The stark contrast between the nihilism of the prediabetes class and the optimism of the plant-based diet class made going vegan the obvious choice. 

Making the Switch

On May 5, 2019, I cleared out my kitchen of all animal products. The following books and resources were incredibly help to me in making the transition:

• Forks Over Knives, the documentary
• The Forks Over Knives Plan: A 4-Week Transition to the Life-Saving, Whole-Foods Plant Based Diet, book
• Forks Over Knives Family: Every Parent’s Guide to Raising Healthy, Happy Kids on a Whole Foods Plant-Based Diet, by Dr. Alone Pulde
• The China Study, by T. Colin Campbell
• The Game Changers, documentary
• How Not to Die, by Dr. Michael Gregor, and his free informational website Nutrition Facts.org
• Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven Program for Reversing Diabetes without Drugs, by Dr. Neal Barnard
• Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven Nutrition-Based Cure, by Dr. Caldwell Esselstyn
• Glucose Revolution: The Life-Changing Power of Balancing Your Blood Sugar, by Jessie Inchauspe
• I Contain Multitudes: The Microbes Within Us and a Grander View of Life, by Ed Yong
• Science Vs. podcast, “Vegans: Are They Right?”

The biggest help of all was the Forks Over Knives Meal Planner because it basically takes out all the mental labor for what to cook and what to buy. The weekly recipes helped me switch from someone who dreaded cooking, to someone who actually enjoys it.

Whole-food, plant-based diets are way cheaper than meat-heavy and processed food diets. An annual subscription to the meal planner more than pays for itself with how much we are saving on groceries and not spending on medical bills. (Note: I’m not sponsored by Forks Over Knives in any way. I keep recommending them, because I love their food.)

Transitioning Tips

I went vegan overnight, but most people usually need to ease into it more slowly. I recommend signing up for the Forks Over Knives meal planner, and start by switching one meal a week over the course of a month. (Week 1: Vegan breakfasts; Week 2: Vegan breakfasts and lunches; Week 3: All meals vegan!)

Remember, just because something is labeled “vegan” doesn’t mean it is healthy. Oreos are vegan. Potato chips are vegan. A healthy vegan meal is built around the four food groups — whole grains, legumes, vegetables, and fruits — in as close to their original form as you can get. This is why people sometimes refer to this as a “plant-based, whole-food diet” rather than a “vegan diet.” This means the majority of your shopping happens in the produce section.

A whole food, plant based diet has a lot more fiber than most people on the standard American diet are used to. This means that your microbiome will need to change to help you digest all this fiber. A slow transition over the course of several weeks or months will help you avoid surprising gut issues.

The great news is that high-fiber diets have been proven to have all kinds of positive effects on our bodies, such as keeping you regular, lowering insulin resistance, helping to stay lean, and with lowering inflammation.

How do you get your protein?

A varied diet of whole grains, legumes, nuts, and vegetables has all the protein you need. But I generally build at least one meal a day around legumes, for the protein and iron. Eating legumes legumes has been shown to increase lifespan. Bean burrito lunches are my favorite, but I also like vegetable soups with lentils, quinoa, chickpeas, and peas. I also make my own hummus and blended sauces using chickpeas as a base.

In order to avoid all the salt in canned beans, I usually batch-cook my week’s legumes in an instant pot during the weekend.

What about B12? (And vitamin D, and iron, etc.)

Surprisingly, people who eat meat and dairy are also low on B12. This is because this essential nutrient is made from bacteria in healthy water and soil — which we no longer have in many places. Animals in the livestock industry get their B12 from nutrition supplements in their feed. Vegans need to get their B12 from multivitamins and fortified foods.

During the covid pandemic, many of us discovered how important Vitamin D is for healthy immune systems. Your body can make Vitamin D when exposed to sunshine, or you can take a supplement.

Iron is also important for immune system function, and menstruating women are sometimes at risk for being anemic. I make sure there is plenty of iron in my diet by pairing legumes with a vitamin C source — or example: beans and tomatoes, lentils and peppers, chickpeas and lemon — because the vitamin C helps the body absorb more of the iron than the body would otherwise.

When making any dietary switch, it’s important to check in with your doctor and get all of your blood levels checked to see if you have any specific needs you need to address. You should also get a doctor’s check-up every year to ensure your blood levels are healthy.

Beyond Diet: Ethics and Environment

My primary motivation for going vegan was selfish self-preservation.

However, the ethical and environmental aspects are important to me as well.

Books  like Eating Animal by Jonathan Safran Foer and Mind if I Order the Cheeseburger by Sherry F. Colb, and the documentary Dominion really broadened my understanding of the ethical treatment of animals. (Content Warning: Dominion shows animal slaughter and animal cruelty in graphic detail. Do not watch with kids!)

The documentaries Cowspiracy and Before the Flood make a strong case that what we choose to eat every day has a tremendous impact on our environment.

I think that eating meat made sense, back in the old days when the global population was half a billion people, and when peak life expectancy was 35. Back then, animal flesh was basically a walking savings account for calories to keep us humans from starving to death when the only food available was snow-covered grass.

But we live in a different world now. There are more than 8 billion people and industrial food production has come a long way. As a species, we face different challenges than our ancestors did, and the best thing for our survival is to change our habits and evolve—rather than continue to cling to some romanticized, macho version of the past.

We’re witnessing a paradigm shift in awareness about the health, social, and environmental consequences of eating animals.

For me, veganism a positive and pro-active way to not just be healthier by avoiding chronic disease, it’s also a way for me to live my values by being kind to animals and in doing my part to solve world hunger and lower my environmental impact. Everything about it feels good to me. It is one simple choice that has tremendous benefit to myself and others.

My only regret is that I didn’t go vegan sooner.

Navigating Social Settings

Dealing with social settings as a vegan can be challenging sometimes, but over the years I’ve developed some strategies.

1. I let people know I’m vegan, but I don’t go into detail about it unless they want to know more. I wrote this blog post to answer some of the frequently asked questions I get about being vegan.
2. I eat beforehand. When hanging out with friends, it’s not a given that there will be vegan options available. If my family or friends give me the option of choosing the restaurant, I like to check HappyCow.net for restaurants with vegan options.
3. I bring my own food … plus plenty extra to share. If I’m going over to a friend or family member’s house, I usually bring my own food and enough food to feed everybody else.

If all else fails, I chose the best available option—which sometimes means ordering a baked potato and doing my best to scrape out the butter and pick out the bacon bits. 😝

Wow, it has been a long time since I’ve written anything for the public!

What happened? Where have I been?

Well, it turns out I’ve been doing a lot, but it has mostly been internal and personal work.

I’m one of those introverted-type people who tends to need a lot of quiet and deep thought in my life in order to feel balanced. The book Quiet: The Power of Introverts in a World That Can’t Stop Talking by Susan Cain explains my personality type, and the book Deep Work: Rules for Focused Success in a Distracted World by Cal Newport explains how I aspire to live my ideal writing day—with long stretches of deep work, followed by meaningful interactions with people I care about.

I have social media accounts, but I’m pretty much never on them. At most, I log on once or twice a year. The interactions on these sites don’t feel very deep to me. I’d much rather meet my friends face to face, and go on a long walk together so we could truly catch up on each other’s lives. Social media posts are shallow and external, when what really makes me feel connected to people is the deep and internal.

Last year, I decided to wean myself off from doomscrolling the news as much as possible because my mental health was starting to suffer. This year I’ve also been experimenting with going on a news blackout. This interview on Hidden Brain with Steven Pinker, titled “Beyond Doomscrolling” captures the fallacy of the news: in a time when humans are at their most peaceful and cooperative, the news is a glowing, screaming screen, inches away from your face that scours the globe looking for the worst bits possible. News sites purposefully ignore the good in humanity in order to throw you into a state of fear and anxiety, which makes you more reactive and more willing to click on whatever ads are floating next to their doomsday headlines.

A book I read this year with my son was Pollyanna by Eleanor H. Porter. I know cynics like to make fun of Pollyanna for being naïve or overly cheerful. But I loved that book. I thought, If there was ever a personality from history or literature that I wanted to emulate, it would be Pollyanna. I loved the Glad Game, where you purposefully look for things in your life to feel glad about. It’s a lot like those [gratitude journals] that happiness psychologists recommend to rewire people’s brains for happiness. Pollyanna even goes so far as reframing challenging and uncomfortable things as opportunities for personal growth.

I think that’s why I love reading so much—especially reading fiction. These last two years have been tremendous reading years for me. Last year I read 166 books. To date, I’ve read 140 books this year.

What’s wonderful about reading is that you get to have these wonderful, deep interactions with someone. Fiction stories, in particular, often involve a character struggling through a horrible experience in a compressed period of time. But where fiction differs from life is that these characters are often on the lookout for how they can learn and grow from these terrible experiences. The character on the last page is often wiser than who they were on page one. 

I love this. I love being reminded of the human capacity for change, and that sometimes the sweetest fruits can spring from the rockiest soil. This is inspirational to me.

And it’s something I always try to include in my own stories.

These last two years I’ve been mostly focused on short stories because those are an even tighter form of characters forced into a crucible of change. Short stories are more challenging than novels, in some ways, because it’s a lot harder to “stick the landing” on a believable moment of character transformation in 2 pages than in 200 pages. 

Whereas an epiphany at the end of a novel often feels like a nice coffee after a long, luxurious three-course meal, an epiphany at the end of a short story usually feels like the floor dropping out from beneath you. Totally different feeling.

I’ve been working on gathering together the best of the short stories I’ve written over the last 17 years in a collected titled, What We Talk About When We Talk About the Apocalypse. 

For you literary nerds out there, the title is a spin on Raymond Carver’s “What We Talk About When We Talk About Love” and Nathan Englander’s “What We Talk About When We Talk About Anne Frank.” These are relationship stories.

My stories are also relationship stories. Couple relationships, friendships, neighbors, parents and children, and humans and animals. These are stories where a character is forced to re-evaluate what they thought they knew about themselves, their relationships with others, and their place in the universe. That’s what I aspired to do.

My stories often involve characters interacting with our current world, but I also play with genres a bit. I have stories with angels, stories with ghosts, stories with vampires, and stories about how technology is shifting our reality.

I hope to publish this collection by the end of the year. While you wait, you can read “Prove It,” which was published by Club Chicxulub online. You can also hear me read the story. They did a fantastic job setting a soundtrack as background to the stories. I highly recommend you check out my story and the rest of their literary magazine. They did a great job.

The Incident

A few months ago I was reading on my computer, when suddenly there was a blind spot in the center of my vision. It was about the size of a dime, and all the letters within that circle disappeared. I tried closing one eye, then the other, and moving my eyes around. I could see the letters on either side of this dime-sized blankness, but within the circle, the letters were just gone.

I stopped working, figuring I just needed a good night’s sleep.

But the problem was still there the next morning—albeit slightly better. Now the blind spot was the size of a pea instead of a dime. Should I ignore it and wait for it to get better? Or should I call the doctor?

I looked up my symptoms on WebMD and freaked myself out with a self-diagnosis of a retinal tear, which can lead to permanent blindness if not treated within 24-hours. So I called the advice nurse at the hospital.

“When you look in the mirror and smile, are both sides of your face moving equally?”

“Yeah.” My face? What the heck? It’s my eyes that are the problem, not my face!

“That’s good. Come down to the emergency room so we can figure out what’s going on,” the nurse said. “And make sure you have someone else drive you.”

By the time I got to the emergency room and was seen by a doctor, the problem with my eyes had resolved itself and I could see normally again. Just like a car that stops its weird clinking the moment you pull into the mechanic.

The doctors examined my eyes. Nothing wrong with them. Not a retinal tear, it turned out. They asked lots of questions. They had me do a CT scan. They took about a pint of blood. They consulted with all my other doctors and they came back with this: “We think you might’ve had a transient ischemic attack—a mini-stroke. We’d like you to spend the night so we can monitor you and run more tests. Call your family to let them know.”

By this time, my heart was pounding a billion beats a minute. A STROKE?!?!?!? But I’m only thirty-six! I’m too young to have a stroke! It’s just a little eye problem. But it’s gone now! YOU’VE GOT THE WRONG WOMAN!!! Let me out of here! This has to be some kind of mistake!

For those of you wanting a refresher on stroke symptoms, a good acronym to remember is BE FAST:

• Balance—Sudden balance or coordination changes
• Eyes—Sudden vision loss or double vision (I guess this was me)
• Face—Facial droop or asymmetry
• Arms—Sudden arm numbness or weakness
• Speech—Difficulty speaking or unable to speak clearly
• Time—Make note of the time the symptoms started and call 9-1-1

The difference between mini-strokes (TIAs) and regular strokes is that TIAs involve a temporary blockage of a blood vessel in your brain. They often clear up before any permanent damage occurs. (That was me.) However, TIAs can be a warning sign that a real stroke is just around the corner, so it’s imperative to seek treatment right away.

I called my husband and told him the news. I was going to have spend the night in the hospital.

Again.

And this time, it would be in the middle of a pandemic.

Taking Stock of My Health History

This was not my first time spending the night in the hospital. 

In 2019, I was hospitalized for Vasculitis henoch schonlein purpura, also known as IgA vasculitis. If left untreated, vasculitis HSP can cause kidney failure. It’s usually triggered by a respiratory virus that causes your immune system to run amok and start attacking your own blood vessels, like a cascade failure in an over-heated nuclear reactor. 

(Sound familiar? This is part of why I have been self-isolating super-hard during this pandemic. The early versions of covid were causing people’s blood to thicken, and their blood vessels exploded like sausages left in the microwave too long.) 

While doing all the tests for vasculitis in 2019, my doctors discovered I was also pre-diabetic. And anemic. And Vitamin D deficient. This one-two punch in 2019 absolutely shook my sense of self. Previous to this, I had considered myself to be exceptionally healthy.

The pre-diabetes was especially a surprise. Type 2 diabetes is usually found in people who are overweight and older. I was 34 years old, at the time, and had a BMI of 23, which is considered healthy. I don’t smoke. I don’t drink soda. I rarely drink alcohol. I don’t eat sweets that often. What’s going on?!

“You went from zero to hero,” my rheumatologist said. “Congratulations.”

Thankfully, my vasculitis was treated early enough that I made a full recovery, and I’ve been in remission ever since.

To treat the pre-diabetes, my GP recommended some nutrition classes.

At the first class, a fellow pre-diabetic woman (who was overweight and in her 70s) looked me up and down and said, “What are you doing here?”

“The margin for error is smaller in some people than in others,” I said.

The first class was called “Pre-diabetes and Me,” and it was not very encouraging. Basically, the gist was: Eat this way and you’ll still get diabetes…but maybe you won’t go blind and get your feet amputated as quickly as someone who slams donuts soaked in melted ice cream every day.

The second nutrition class I took was called “Plant-based nutrition.” It was a lot more optimistic: Eat this way and you can reverse diabetes, heart disease, and many other inflammatory diseases.

Heck yeah! Sign me up for the veggie platter!

I did a lot of research and in May 2019, I transitioned to an oil-free, whole-foods vegan diet with the help of Forks Over Knives. My blood sugar dropped to where I was no longer pre-diabetic. (Cured!) My total cholesterol dropped from 180 mg/dL to 117 mg/dL. My inflammation markers were all back to normal. I had plenty of energy. I felt great. (I still take supplements for iron, Vitamin D, and B12—as prescribed by my doctor.)

Fast-forward to 2021 and there I was, hospitalized again, feeling like the rug had been pulled out from under me. What the heck? Where had I gone wrong?

The Diagnosis

My doctors did every test they could think of to figure out what caused my TIA. Pretty much everything was normal. They couldn’t find any blood clots or damage anywhere. My blood pressure was 120/70. My glucose average was 95 mg/dL. My weight was healthy, with a BMI of 22.8.

I went home with a 30-day heart monitor, and after an echocardiogram they finally found the culprit. It turns out I had a congenital heart defect called a patent foramen ovale (PFO), which is a small hole between two chambers of my heart. 

Most babies and newborns have this hole. It usually closes by adulthood, but about one in four adults still has a PFO. Usually a PFO doesn’t cause any problems, but sometimes tiny pieces of plaque can get through that hole and cause a TIA or stroke. PFOs are found in about about 55% of young people (people younger than 60) who had a TIA or stroke with no known cause. (Fun fact: PFOs are also often found in people who have problems with low blood oxygen, and in people who have migraines with auras.)

It’s normal to have tiny bits of plaque in your blood, but they usually get broken up as they knock around in your heart and get diverted to your lungs first before they go to your brain and the rest of your body. But because I had this hole in my heart, a tiny piece of plaque must’ve slipped through the hole and gone directly to my brain, causing the TIA and temporary blindness. It’s a good thing my LDL cholesterol was already pretty low (Thank you vegan diet!) because otherwise I might’ve had a real stroke… one where I might’ve been paralyzed, or even killed. According to stroke.org, strokes are the fifth leading cause of death, and a leading cause of disability in the United States. Yikes!

I felt like I’d survived a car accident and walked away with barely a scratch. I’d been lucky this time. But what if there was another Final Destination car (i.e. chunk of blood-plaque) out there with my name on it? Would I be so lucky next time?

There was some discussion with my doctors about whether I’d have to be on statins for the rest of my life, or need heart surgery to close the PFO. A whole panel of doctors met to discuss my case. They concluded that since all my other health markers were good enough, I didn’t need medication or surgery unless I had a second neurological event. They gave me a short list of activities to avoid (scuba diving, hiking in high altitudes, running marathons, and Valsalva-maneuver breathing), but they said I could go back to my normal life.

The only thing they said I should improve to lessen my chance of having another TIA or stroke was to exercise to shift my cholesterol numbers around.

My HDL (good cholesterol) was 46 mg/dL: it should be above 60 mg/dL. This can be raised with exercise. 

My LDL (bad cholesterol) was 54 mg/dL—which is pretty dang good! Low LDL-numbers is one of the positive side-effects of eating a whole foods vegan diet.

According to Dr. Caldwell B. Esselstyn in Reversing Heart Disease, having an LDL below 80 mg/dL is usually considered stroke-proof… But I guess that’s if you don’t have a hole in your heart. Because of the vasculitis, TIA, and PFO, the doctors said they wanted my LDL to be even lower than your average bear. Below 50 mg/dL. Ideally as close to 40 mg/dL as I could get it.

The out-patient doctor put it this way: “Whatever diet you’re on, keep doing what your doing. Your main assignment is to add in the exercise. LDL is like plaque clogging your internal pipes; HDL is like Drain-O. If you increase your HDL, it will lower your LDL.”

What I heard was: Exercise or DIE!

My New Favorite Hobby!

It turns out that having a normal weight and looking cute in a bathing suit isn’t necessarily an indicator of good health. After being hospitalized twice now, and finding out I have a hole in my heart, I basically feel like my body is out to get me. I’ve got ghosts in my blood. I’d better whip them into shape before it’s too late. 

Now is the time to embark on my new hobby: a lifelong quest to make myself as stroke-proof, heart disease proof, and diabetes-proof as I can. My family needs me to survive, and I still have things I want to do in this life.

Because I’m a major research-nerd, I thought I’d share some books I’ve read, and the things I’ve learned in the last six months of my fitness journey.

What Are My Goals?

Yes, I have specific weight, body-fat, and cardiovascular fitness goals. These have been informed by various studies and meta-analyses I’ve read about what body composition seems to have the lowest all-cause mortality.

(Answer key: While a BMI between 18.5-24 is considered healthy, the optimal weight for cardiovascular health for women seems to be a narrower range of a BMI between 18.5-21.9—although women who have a lot of muscle mass might weigh more while still having a healthy cardiovascular system. My goal is a BMI between 20.0-20.5 because it has the lowest risk for both ischemic and hemorrhagic stroke. My body fat goal is to keep it between 15%-24%, but ideally around 20%. I want my VO2 Max to stay above 40. I’d love to be able to run a 7 or 8-minute mile again. And I’d love to be able to do pull-ups someday.)

I also have blood lab goals based on my cholesterol, glucose, liver, iron, vitamin D, etc. (Answer key: HDL above 60 mg/dL. LDL below 50 mg/dL. Average glucose around 85 mg/dL, plus or minus 15 mg/dL. ATL less than 25.)

But if we zoom out a bit, my primary goal is just to live a good life. I want to stay healthy as long as I can—both for myself and for my family. I am committed to doing whatever activities are required to maintain this corporeal meat-suit as long as I can. I recommend this Dr. John Campbell video on the different components of good health, and Dana Linn Bailey’s Five Things to Know Before You Start Your Fitness Journey.

It helps to have some wonderful role models on how to age well:

Role model #1: When I was in college, I had this boss who got herself a personal trainer for her 50th birthday. “It’s either this or drink a bottle of wine by myself every night until I die,” she said. She started working out on her lunch break and after work.

Sometimes I’d join her on her lunch time routines. She was in way better shape than me! The first 5k race I ever ran was with her, and she left me in the dust!

Within a year, she started training for triathlons. I looked her up on Facebook recently. She is in her 60s and still does bike races. She looks great!

Role model #2: Many years ago, I went to a natural bodybuilding competition to support my friend, Alex. One competitor was a man in his late 70s. This was the fittest old man I’d ever seen in my life. He looked as if he’d been chiseled from granite. His muscles were HUGE and his skin was firm and tight. The only thing that was wrinkled was his face. I didn’t know 70 could look like that! This guy wasn’t old and broken. He looked and moved like was still in his prime. Is this what happens when you strength train?

Role model #3: My grandmother, Irena. She is 81 years old and does yoga and walks almost every day. A few years ago she had hip surgery, which is can sometimes be a death-sentence for women her age. However, because she was so strong, flexible, and resilient before the surgery, she could recover faster and more fully after the surgery.

Here are some other women who made an impression on me: 

• 70-year-old power-lifter Mary Duffy (who started lifting when she was 59)
• 81-year-old bodybuilder Ernestine Shepherd (who started lifting at age 56)
• 82-year-old cross-fit athlete Molly Hoagland
• 95-year-old Olga Kotelko (who started her track and field career at age 77)
• 100-year-old power lifter Edith Murway-Traina of Tampa Bay, who is in the 2022 Guinness Book of World Records as the oldest competitive female power lifter ever (she started at age 91)
• 101-year-old Tao Porchon-Lynn who was the world’s oldest yoga instructor
• Abbye “Pudgy” Stockton who was known as the Queen of Muscle Beach back in the 1930s and 1940s
• And this video series absolutely blew my mind, watching women lift more weight than I ever thought possible. It’s the Brute Showdown between Olympic weightlifter Mattie Rogers, CrossFit games athlete Brooke Ence, bodybuilder and Ms. Olympia Dana Linn Bailey, and power lifter Maddy Forberg. I love this video of their max lifts so much I’ve watched it about ten times. If you ever need help moving a refrigerator, these are the women to call!

What kinds of exercise are best?

Okay…back to the land of mortals.

I came across a nice acronym in Margaret Webb’s book Older, Faster, Stronger for the variety of exercises a person should be doing to age well:

(Disclaimer: I’m not a doctor! I’m just a regular Jane Shmoe. Before you change your exercise routine, see your doctors for their advice!)

F. A. C. E. Your Future:

• Flexibility—making sure you have the spine, hip-hinge, and leg flexibility to do basic tasks. Like tying your shoes, bending down to pick up something from the floor, or bending down to hug a child or a pet. These activities don’t seem that extreme…until you can’t do them anymore. 
• Aerobic—Everything in your body needs blood and oxygen, so good cardiovascular health is critical to staying alive. Cardiovascular health is also good for neurological health because the dilating blood vessels and increased oxygen and blood flow to the brain clears out the cobwebs, so to speak.
• Carrying a Load—muscular strength, which has a major impact on quality of life as we age. After age 35, people tend to lose about a pound of muscle every year (that’s 10 pounds in 10 years!) unless they are actively working to keep it. Maintaining muscle mass and strength lowers risk of death from all causes, and even a little bit goes a long way.
• Equilibrium—balance. This isn’t one I’d ever considered before, but apparently people’s ability to keep their balance degrades if they don’t consciously work to maintain it, thus resulting in those scary stories of old women falling, breaking a hip, and then dying shortly after.

Here are some other important components of health that should not be neglected: Sleep, Nutrition, Preventative Medicine, Stress Management, and Social Health.

Flexibility and Balance

We use tying a shoe as a metric of flexibility and physical performance. Most people our age don’t think of tying a shoe as a physical performance. And yet when you would start to lose those things, I think you would have a radically different view.

Peter Attia, YouTube video, “Why You Need to Protect Your Joints if You Want to Live to be 100,” Peter Attia on Health Theory

My GP said that one thing he sees making the biggest impact on people as they age is flexibility and balance. Yoga strengthens up both.

My favorite yoga book is Stretch and Surrender by Annalisa Cunningham. This book was written for people in addiction recovery, but I’ve been using this yoga book since I was about fifteen years old and I still feel like I gain something from it every time I use it. It has mindfulness mantras to say with each move. It’s a wonderful yoga book for beginners, for people recovering from injury, or for people doing yoga at home. My husband and I do yoga multiple times a week using this book.

Strength Training

I got curious about strength training after watching this video with Peter Attia and reading this article about how muscle mass can reduce a person’s chance of developing diabetes because it basically acts as short-term storage for glucose, thus protecting your liver and other organs. Bigger muscles, more glucose storage. (Check out this Washington Post article, “Cardio isn’t enough. For a healthy heart, add resistance training.”)

Once a pre-diabetic, always a pre-diabetic, right? I’ll take whatever edge I can get in reducing my chance of developing that awful disease.

Since August 2021, I’ve started strength training at home using HER Body Solutions, which is a service owned by my friend, Alex Golodriga (formerly Alex Navarro). Alex is a multiple award-winning contestant in Ms. Fitness USA, Fitness Universe, World Beauty Fitness and Fashion, and Bikini competitions. She is a former wrestler and gymnast, and also a mom. She is a beautiful person inside and out, and I am so grateful to her for the personal training videos and home workouts she runs through HER Body Solutions. 

I’m an absolute novice in strength training, but Alex’s videos make it really accessible. Her app keeps track of the weights and reps, and I love I can re-watch the videos as many times as I need to, to make sure I’m using proper technique. The routines change every month, so it keeps the exercises both interesting and difficult.

Maybe I’m kinda stupid for missing the obvious here, but until I started lifting weights seven months ago, it had never occurred to me that “being strong” was a physical feeling. When most women talk about being strong, they usually mean emotionally strong. (For some reason, I thought weight lifting just made you poofy.)

It’s hard to convey how profoundly ignorant I was about strength training. I thought it was a guy’s thing. I thought it was purely cosmetic and that body building competitions were like the male equivalent of beauty contests. I thought everyone had a natural set-point of strength and there wasn’t much you could do about it. And I’d seen lean ballerinas and gymnasts perform incredible feats of strength and agility. It simply never occurred to me that muscle size had anything to do with anything, or why you would want it.

It wasn’t until I started being able to snatch a heavy bag of books off the floor like it was nothing that the epiphany finally hit me: Oh! Being strong means I can lift heavy things. And it doesn’t feel hard anymore. Duh.

I feel as if I’m developing a new superpower. Suddenly, it makes a lot more sense to me why all those swole bros at the gym act the way they do. Every time I’m able to increase the weights or the reps I feel like strutting around the house like a rooster, crowing “You see that? I did that! Somebody get me a pickle jar to open!“

And the time commitment isn’t that much (just 3 hours a week!) compared with all the incredible gifts strength training is giving me outside those workout hours. Almost every day I find my body moving in ways it has never moved before. My balance is better. My legs are stronger. My back is stronger. My arms are stronger. I feel as if my body is going through an upgrade and all of the sudden there are all these awesome new features I never had before. I can’t imagine ever going back to the way I used to be.

Another benefit of strength training: Vanity. I look AMAZING! I’ve always been pretty confident about my body, but suddenly I’m looking for opportunities to wear sleeveless shirts and check myself out in the mirror. DAMN, girl! Look at YOU! You look like Wonder Woman!

My arms and shoulders are more defined, and my hips and legs are tight and perky. The skin all over my body is more firm. I can especially see it around my waist. Wow! There are some muscles in there! 

I’m also much more aware of my posture and moving in a way that supports my back. It’s clear to me now why strength training is so critical to aging well. Those groceries aren’t going to carry themselves from the car to my house!

For anyone who wants to learn more about strong women throughout history, I highly recommend Haley Shapley’s book Strong Like Her. I learned about so many incredible female athletes. It’s easy to forget how new and revolutionary it is for women to do sports and train our bodies. Exercise and physical fitness are an act of feminism—and it’s important to never forget how tenuous these gains are. Reading Haley Shapley’s book has completely changed the way I see muscle on women. The book has incredible photographs of female athletes, from ballerinas, to para-Olympians, to strong women.

Aren’t you afraid of getting bulky?

No. First, a pound of muscle takes up less volume than a pound of fat, so even if I weigh the same I will actually look leaner.

Second, what’s wrong with having muscles, anyway? Women’s bodies are powerful and malleable, and I think we should celebrate all the incredible things we can do.

Right now, I’m still at the stage of my strength training where I’m hitting a new personal record basically every time I lift weights. I’m sure I’ll hit a plateau at some point, but for right now, I’m absolutely thrilled every time I can do more than I did the previous week. I’m already doing more with my body than I ever thought I was capable of. Why would I handicap myself to be smaller or weaker when I could be so much more? The limiting factor for me is how much I can safely lift with a PFO—not the female-body-police and their limited idea of “feminine” looks like. I believe I owe it to myself, my family, my community, and to the next generation to strive to be as healthy as possible.

It’s especially important for me to build mas many neural networks between my brain and my muscles as I can. My history with TIAs means that I am at a higher risk for stroke than the general population. God forbid I ever have a stroke, but if I do have a stroke someday, my hope is that it would be easier to reconnect those wires if they are already laid down, rather than having to grow all new neural-networks from scratch.

I’m basing this, in part, on what happened to Dirk Vleiks, who was a competitive triathlete and at the top of his game when he experienced a hemorrhagic stroke at age 32 as a result of an undiagnosed tumor in his brain. He nearly died. He had to re-learn how to eat, how to talk, how to walk. He had to start from square-one in re-learning everything, which is the title of his memoir, Square One: Returning to Life and Competitive Running After My Devastating Stroke. While he never recovered 100 percent, his original physical fitness was probably a huge part of why he didn’t die, why he could recover enough to live a functional life with his wife and children, and begin racing again.

Strength should be an attribute of all humanity. It’s not a gift that belongs solely to the male of the species.

Jan Todd, the first woman to deadlift 400 pounds.

[…] putting a limit on muscularity is like telling a female skier that she can only ski so fast […]

from Strong Like Her, by Haley Shapley

A woman’s physical strength cannot help but become psychological strength. Strong women make happy lives.

Mina Samuels, Run Like a Girl

“What about your joints?”

There seems to be evidence that resistance training is actually good for your joints, so long as you warm up, progress slowly, and use good form.

I’m still young and I haven’t been training for very long yet, but so far I’m pleasantly surprised at how good my joints feel. My knees and hips are noticeably springier than they used to be. I’ve suffered from periodic bouts of wrist tendonitis since I was in my late teens, but since I’ve started resistance training I’ve noticed that my wrists are less inflamed and the pain has gone away. Maybe it’s a coincidence?

“What about protein?!?!“ I hear you say. “Vegans can’t build muscle!”

Plants have protein. Not as much as in meat, but you actually don’t need as much protein as you think you do. For anyone who is concerned about not getting enough protein on a plant-based diet, I highly recommend watching The Game Changers, which is a documentary about some of the many plant-based elite athletes around right now—and there are so many.

For starters, just check out strongman Patrik Baboumian who is a world record holder in strength competitions, and Kendrick Farris who is the Olympic weightlifting world record holder—going vegan didn’t seem to make reduce their gains any. 

Even Arnold Schwarzenegger is on a plant-based diet. Last I looked, the governator is still looking pretty swole for a 74-year-old.

Here are the resources on strength training that I’ve found helpful:

Strong Like Her (book) by Haley Shapley

HER Body Solutions

New Rules of Lifting for Women (book) by Lou Schuler, Cassandra Forsythe, and Alwyn Cosgrove

Strong: Nine Workout Programs for Women to Burn Fat, Boost Metabolism, and Build Strength for Life (book) by Lou Schuler and Alwyn Cosgrove

New Rules of Lifting for Life: An All-New Muscle-Building, Fat-Blasting Plan for Men and Women Who Want to Ace Their Midlife Exams (book) by Lou Schuler, Cassandra Forsythe, and Alwyn Cosgrove

Game Changers website, for specific FAQ building muscle on a plant-based diet.

Weight Training for Dummies by LaReine Chabut (book)

Dana Linn Bailey’s Five Things You Need to Know Before You Start Your Fitness Journey, her video about her experience with overtraining and graves disease, and from that to this in 4 weeks, and her back day motivation.

And no strength training recommendations list would be complete without also recommending Pumping Iron, the 1977 documentary about bodybuilding featuring Arnold Schwarzenegger; Shredded – One Woman’s Journey into Mature Age Body Building, the 2021 mini-documentary about 58-year-old Wendy Abrahmsen’s journey into body building; and Ripped: Inside Women’s Body Building, the 2017 mini-documentary about female body building.

Cardiovascular Exercise

Since I have both a vascular disease and a heart defect, getting this one right is really important to me. 

Through strength training and my regular daily activities (i.e. walking the dog around the block, jumping on the trampoline and riding bikes with my kid), I’m already meeting the American Heart Association’s guideline of getting 150 minutes of aerobic activity a week.

However, as Dr. Michael Gregor points out at NutritionFacts.org and in his book How Not to Diet, this isn’t anywhere near the ideal dose of for keeping a healthy cardiovascular system. From reading many studies, meta-analyses, and this Wikipedia article on preventing heart disease and heart failure, the ideal dose seems to be around 450 MET minutes of exercise per week, or approximately 7.5 MET hours per week. (MET means “metabolic equivalent of task.” For example, 30 minutes of a vigorous exercise, like running, might equal the same MET as 60 minutes of light exercise, like walking.) This works out to between 60-80 MET minutes per day, 3-6 times per week, depending on how hard I’m working. I have my Garmin watch set to calculate this automatically.

There are lots of ways to get aerobic exercise, and the key seems to be to choosing something that can be done consistently.

I love walking and running, so those are going to be my focus.

Walking is an excellent way to maintain cardiovascular health. It’s good for losing weight, it’s gentle on the joints, and it’s good for building a strong base of aerobic health. Walking has always been there for me. Stressed? Go for a walk. Bored? Go for a walk. Fidgety? Go for a walk. Part of the reason I love owning a dog is there is always a ready excuse to go for a walk.

But I’ve always wanted to be a runner. I love running. Even in high school P.E., whenever we’d have to run a lap around the field, I’d bound away like a Labrador through tall grass. On lunch breaks, I’d run a mile around the track just for fun. In college, I once ran a sub-7-minute mile. I love the feeling of sprinting barefoot on the beach, like I’ve got wings on my ankles and I’m barely touching the ground. I’ve never been a consistent runner, though, and that’s something I’d like to change.

Now that my life depends on keeping my heart healthy and my BMI and cholesterol low, I feel like the time has arrived for me to figure out this running thing. According to this article by UC Health, running might be “the perfect antidote to a congenital heart defect” in some cases. (So long as the patient has gotten guidance from their doctor.) 

But I can’t just go from zero to running an hour a day—that’s a recipe for getting an injury. For the last six months, I’ve been walking for 60 minutes, three or four times per week. My goal has been to lose weight, build a stronger aerobic base, and get my muscles, bones, and joints in shape before I start a running program. 

In February 2022, I started the NHS Couch-to-5K program, and eventually I hope to work up to running 50 minutes, three times per week. I’ve done C25K many times and I highly recommend it. (Except for the bad advice in the second episode to run with a heel-strike gait. Most studies seem to show that forefoot running is better at preventing injury… which makes sense since every running animal, from horses to cheetahs, runs on their forefoot.)

Running is a high-impact, vigorous activity and comes with its own risks, as cardiologist James O’Keefe explains in this TEDx video about the link between extreme endurance athletes (marathoners and ultra-marathoners) and atrial fibrillation. He explains that there is a sweet-spot for running, which seems to be between 10-15 miles per week, at a speed slower than 8 miles per hour… ideally a leisurely 10-mile per hour jog.

A friend of mine, fellow writer and runner Neroli Lacey, kindly sent me this video about Slow Jogging, which can be a lot gentler on your joints.

This 10-minute/mile jogging pace comes up again in 80/20 Running: Run Stronger and Race Faster by Training Slower by Matt Fitzgerald, and also in Older, Faster, Stronger: What Women Runners Can Teach Us All About Living Younger, Longer by Margaret Webb. This is called heart rate training. 

The general idea behind heart rate training is that 80% of your weekly runs should be at a light, leisurely pace, keeping your heart rate between 50%-77% of your maximum heart rate. The remaining 20% of your runs would be high-intensity-interval training where you sprint for short periods of time, with your heart rate between 90%-100% your maximum.

In order to keep track of what my heart is doing, I do all my workouts while wearing a Polar heart monitor, which syncs to my Garmin watch. I have the different zones programed into my Garmin so that it alerts me whenever I run too fast. I’ve found the external input of the heart monitor and the watch to be absolutely necessary to help me pace myself. Because running slowly feels really freaking slow…like, it barely even feels like running. Without the watch constantly telling me to slow down, I know I’d go too hard, too fast and burn out.

My running goals are pretty modest. I’m not planning on being competitive or breaking any speed or distance records. Maybe I’ll eventually participate in some short or middle-distance races socially, but my top reason for running is to take care of my heart. Being healthy and being competitive in a sport are not the same thing.

I’d eventually like to run 15 miles per week, split between three running sessions. This seems to be a nice modest amount that most people can run without getting a stress injury. Twelve of these miles would be at a nice slow jog, and the 3 miles would be part of some sort of interval training via sprints around the track, hills, or fartleks. It’s probably going to take me another six months of training to get up to this maintenance-level goal. My current jogging pace is 18-minutes per mile with me keeping my heart rate between 60%-75% of max. This is almost slower than my walking pace, so I have plenty of room to improve before my “slow” jogs are at a 10-minute-mile pace.

Because of my PFO, I have to breathe continuously throughout each of my strength exercises. If I held my breath while straining to pull a weight, the pressure could build in my chest and flip my PFO open. This means my strength routine doubles as an aerobic routine as well. I wear my Polar heart monitor while I’m doing strength exercises to make sure I stay in the aerobic zone.

This is my current exercise routine: Personally, it’s easier for me to maintain a habit if I’m doing it every single day than if I’m only doing it a few times per week. I’ve set aside 60-80 minutes every day for exercise. I prefer to exercise first thing in the morning. (I even sleep in my workout gear to ensure it happens.) I usually do 10-20 minutes of yoga as a cool-down after running, or as a warm-up before my strength training days. On my running days, I walk for 5-10 minutes before and after as a warm-up and cool-down.

• Monday: Running day 1
• Tuesday: Strength day 1
• Wednesday: Running day 2
• Thursday: Strength day 2
• Friday: Running day 3 (eventually, part of day 3 will include a HIIT session)
• Saturday: Strength day 3 (optional, if I feel the need to have two rest-days in a row)
• Sunday: Rest day. Maybe some light stretching or a walk if I’m up for it. 

Rest and recovery days are an important part of my training routine. I know I have a tendency to overdo things, so I plan rest days ahead of time to make sure they happen. I also schedule a full week off every 6-12 weeks to prevent overtraining.

One of the most depressing things I’ve learned is that fat acts like a savings account, but fitness does not. All those hours I spent as a high school athlete, twenty years ago, don’t count for beans now that I’m in my mid-thirties. A person can take 3-6 consecutive weeks off from training without losing too much muscle mass or aerobic capacity. But after about two months, those hard-won gains start to evaporate. So, I can’t bank my exercise. The magic only works if I’m actively doing it.

According to my calendar, I spent about 7-10 hours a week exercising (which includes rest periods between sets, and the time it takes to set up and put away my gear). Yes, it’s a lot, but according to the graph in this NIH article, the upper limit on the benefits of exercise seems to be 40-75 hours per week, and I’m well below that limit. That being said, the margin for error is smaller for me than for most people, so I’m keeping a very close eye on my energy levels. I’d rather go slow and steady than risk burning out, or getting an injury, or triggering a vasculitis relapse. My number one goal is to keep the ghosts in my blood in check—not to break any world records.

Even though I’ve only been keeping this routine for the past seven months, I already feel like it has enhanced my life in so many ways. I’m stronger than I’ve ever been in my life. Every week I’m surprising myself by doing things I never thought I could do. I love how my body looks, and how capable I feel, and I would much rather spend 10 hours a week exercising and getting strong than have to take medication or get heart surgery. And when I think about my family, it’s a simple choice. I’m willing to do whatever it takes to ensure I stay healthy and in good working order for as long as possible so I can take care of my family.

Here are some running resources:

Older, Faster, Stronger: What Women Runners Can Teach Us All About Living Younger, Longer by Margaret Webb—This book inspired me to run again, above all others. Like Margaret Webb, I want more life and I see training my body as a key component to aging well and protecting my health. I found this book incredibly inspiring.

NHS Couch to 5K—podcast with music to help go from inactive to running 30 continuous minutes. Once I complete the 9-week program, I usually add 2 minutes to each of my runs each week until I get up to my desired maintenance level.

Zombies, Run!—podcast with a zombie story running in the background to get you sprinting.

Tales from Another Mother Runner, edited by Dimity McDowell and Sarah Bowen Shea—Essays by mothers who have taken up running. The essay I connected to the most was the essay titled “Running for My Life” by Nicole Knepper in which she talks about how she watched family member after family member die of preventable metabolic disease, and how painful those losses were and that she doesn’t want to put her children through that loss. She wanted to take care of her own body the way she takes care of her children’s bodies. She wanted to be a good role model for her children, both so that she could have a longer, healthier life herself and inspire her children to live a good life. This essay resonated with me because I, too, am running to save my own life so that I can be there for my son as he grows up. Another Mother Runner also has a podcast.

Run Like a Girl: How Strong Women Make Happy Lives by Mina Samuels—It hooked me from the first two sentences: “This book is about women, sports, and happiness. How the confidence women build in sports translates into the rest of their lives.”

&Mother—While female athletes have broken a lot of barriers in participating in sports, there is still a lot of prejudice experienced by female athletes who are mothers. I highly recommend reading the New York Times opinion article by Alysia Montano “Nike Told Me to Dream Crazy Until I Wanted A Baby.” I love &Mother’s Instagram feed, which has many inspiring photos and videos of female athletes who are training and mothering at the same time.

80/20 Running: Run Stronger and Race Faster by Running Slower by Matt Fitzgerald—The heart rate training handbook, mentioned above.

The Beginner Runner’s Handbook: A Proven 13-Week Walk/Run Program by Ian MacNeill—This is the first running book I ever bought. It has a 10k walking/running program I like.

Run for Life: The Injury-Free, Anti-Aging, Super-Fitness Plan to Keep You Running to 100 by Roy M. Wallack—The key takeaway is that the best way to avoid injury is to run with proper form, and to cross-train.

Born to Run: A Hidden Tribe, Superathletes, And the Greatest Race the World has Never Seen by Christopher MacDougall—Like any good raconteur, MacDougall has written a tall tale full of larger-than-life characters. It’s a thoroughly entertaining book. The things MacDougall says about overly cushioned shoes causing a lot of running injuries made sense to me. While the science is still out on barefoot running, the consensus seems to be that landing on your forefoot (as opposed to landing on your heel) seems to be best for avoiding injury.

Running for Mortals: A Commonsense Plan for Changing Your Life With Running by John Bingham and Jenny Hadfield—A forgiving and humorous book of encouragement for beginning runners. I especially liked the chapters where they talk about the different emotional experience a beginning runner has to the activity. That anyone can start a hobby, but getting past third week can be hard. And that the energy and improvements a person gets in their running routine during the first three months differs from the stable maintenance point they often reach after three years. It was a helpful metaphor for me.

The Long-Distance Runner’s Guide to Injury Prevention and Treatment: How to Avoid Common Problems and Deal With Them When They Happen edited by Brian Krabak, Grant S. Lipman, and Brandee Waite

Eat & Run: My Unlikely Journey to Ultramarathon Greatness by Scott Jurek—Ultramarathon runner Scott Jurek talks about how his vegan diet has been a critical part of how he has broken so many world records and participated in so many ultramarathon races. If Jurek can run hundreds of miles on a vegan diet, then it stands to reason that I should have no problem running a modest 15 miles a week on a vegan diet. No big deal.

Runner’s World Run Less, Run Faster: Become a Faster, Stronger Runner with the Revolutionary 3-Run-A-Week Training Program by Bill Pierce, Scott Murr, and Ray Moss—This book is about training for marathons and half-marathons by doing HIIT sessions, running three times a week, and by giving your joints a rest by cross training with some other low-impact aerobic activity like rowing, cycling, or swimming. As Margaret Webb points out in Older, Faster, Stronger, running is a specialized activity that only trains some muscles while ignoring others; it makes your body weak in all the ways it doesn’t make you strong. Therefore, cross training is essential for being able to run long-term and to maintaining a healthy body. While I don’t plan on running a marathon, I may consider doing a half-marathon someday and this is probably the training program I would use in order to exercise my cardiovascular system without over-straining my muscular-skeletal system. In some ways, I’m already training this way by alternating strength days with running days.

Sleep

I highly recommend Matthew Walker’s Why We Sleep: Unlocking the Power of Sleep and Dreams, and his TED Talk “Sleep is Your Superpower.” It’s both funny and informative.

The quickest way to screw up your health is by not getting enough sleep. Sleep is essential for so many parts of our health, including mental health, our immune systems, and our metabolism.

While I’ll never know for sure, I think part of why I got vasculitis was because at that time in my life I was operating with a lot of stress on very little sleep. I was trying to do too many things and waking up at 4 a.m. every day to get stuff done seemed like a good idea at the time. I learned my lesson the hard way. I caught an upper respiratory infection. My body wasn’t strong enough to fight it off. A trip-wire went off in my body that caused my immune system to over-heat and start attacking my blood vessels. If I hadn’t been chronically sleep-deprived, would my body have overheated like that?

When I was in the hospital for vasculitis, my attending doctor had asked me what I do when I’m tired. “I stomp on that feeling and keep going,” I’d said.

“Wrong answer,” she said. “You’re supposed to slow down and rest.”

Seems obvious in retrospect.

Matthew Walker’s book changed the way I thought about sleep, from being an annoyance to being the foundation to protecting my health. If I have to choose between exercising and sleep, I choose sleep because that’s where I’ll get the biggest benefit. Sleep went from being at the bottom of my list to being at the top.

Nutrition

After my auto-immune debacle in 2019, I read I Contain Multitudes: The Microbes Within Us and a Grander View of Life by Ed Yong, which gave me a better idea of what a huge impact the bacteria in our guts play in managing our immune systems. Our microbiomes are like an extra organ that we acquire after we are born. One important caveat: if you don’t feed them what they like, they will eat you. It turns out that healthy gut-bacteria likes to eat the most is fiber.

As I mentioned earlier, I use the Forks Over Knives meal planner for my oil-free vegan cooking. I highly recommend the Forks Over Knives meal planner because it takes the mental labor out of what to shop for and how to cook something that’s both tasty and healthy. I also love the weekend food prep section that they added because it makes the weekday cooking much easier. The app costs about $120 a year, but I’ve found that the app pays for itself because a) the whole foods we buy are cheaper than processed foods, b) there is less food wasted, c) the food is so delicious we aren’t eating out or eating prepared foods anymore, d) eating healthy is way cheaper than medical bills! Diabetes costs patients $9,000-$16,000 and cardiovascular disease costs patients about $18,000 a year in medical bills. Look at all the money I’m saving by not being sick!

If you have a vegan in your life or if you want to learn more about plant-based nutrition, here are some additional resources. Consult with your doctor before making any major lifestyle changes.

• This 30-minute Science Vs. episode on veganism tackles some of the basic questions people have about veganism, in terms of health and the environment. Questions like “Do you need milk for strong bones?” and “What about B12 and iron?” etc. (For the record, animals do not make B12. B12 is made by bacteria that lives in healthy soil and water. Animals have only acted as the middle-men in humans getting at that B12. Since the animals most people eat nowadays are factory-farmed, those animals are getting B12 supplements as part of their feed. Eating meat is no guarantee that a person has sufficient B12, and many people who eat meat are also low in B12 and need to take supplements. Personal note: I take a daily multivitamin, as well as B12, iron, and vitamin D, as prescribed by my doctor. I also get my blood checked every 6-12 months to ensure my blood chemistry levels are in a healthy range.)

Forks Over Knives (documentary)— This documentary was recommended by Kaiser’s plant-based nutrition class. My husband, son, and I all watched it together, and it convinced us to learn more.

Game Changers (documentary)—I think much of people’s reluctance to veganism has to do with the machismo around meat eating. “Steak. It’s what a Man eats!” This documentary by ultimate fighting champion James Wilks talks about the health, recovery, and training advantages plant-based food can give athletes. The documentary features many of the strongest, most macho, elite athletes in the world—athletes who also are vegan.

The China Study: The Most Comprehensive Study of Nutrition Ever Conducted by Colin T. Campbell PhD and Thomas M. Campbell II, M.D.—This book convinced me and my family to go plant-based. I still laugh when I remember the all-caps text my husband sent me when he was listening to The China Study audiobook: “ICE-CREAM GIVES YOU ASS CANCER?!?!?” That was all he needed to know to be convinced. (We now get our ice cream fix by making “nice cream,” which is frozen bananas, soy milk, peanut butter, and other flavors, blended in a food processor to a creamy texture.)

Whole: Rethinking the Science of Nutrition by Colin T. Campbell PhD, and Howard Jacobson PhD—This talks about how many diet books are missing the forest for the trees, in terms of the basic principles of eating healthily.

How Not to Die by Michael Gregor, M.D.—Nutritional advice that will help you manage or keep you from getting heart disease, lung disease, diabetes, and many of our other leading causes of death. 

How Not to Diet by Michael Gregor, M. D.—Nutrition and exercise advice on maintaining healthy weight through a plant-based diet.

NutritionFacts.org by Michael Gregor, M.D.—Whenever I have a random question about nutrition, like “What about gluten?” or “What’s the deal with ketogenic diets?” I’ll look them up on NutritionFacts.org where there is a very helpful meta-analysis of what the science says.

Prevent and Reverse Heart Disease by Caldwell B. Esselstyn, M.D.—Heart disease is the number one cause of death in western countries. According to the CDC, “One person dies every 36 seconds in the United States from cardiovascular disease. About 659,000 people in the United States die from heart disease each year—that’s 1 in every 4 deaths.” Dr. Esselstyn is a cardiac surgeon who ran a lifestyle an intervention study with several patients who were basically knocking on death’s door with their heart disease. By switching his patients to a plant-based, low-fat diet, he could reverse their heart disease.

Dr. Neal Barnard’s Program for Reversing Diabetes by Neal Barnard, M.D.— According to the CDC, “37.3 million US adults have diabetes, and 1 in 5 of them don’t know they have it. Diabetes is the seventh leading cause of death in the United States. Diabetes is the No. 1 cause of kidney failure, lower-limb amputations, and adult blindness. In the last 20 years, the number of adults diagnosed with diabetes has more than doubled.” As we’ve seen with this latest pandemic, diabetes was one of the most significant co-morbidities for people who caught covid-19. There are two types of diabetes. About 5-10% of people with diabetes have type 1, and they need to take insulin daily to survive. About 90-95% of people with diabetes have type 2 diabetes, which is caused by diet and lifestyle choices.

In the United States, every 17 seconds someone is diagnosed with diabetes, and every day 230 Americans with diabetes will suffer an amputation. Throughout the world, it is estimated that every 30 seconds a leg is amputated. And 85% of these amputations were the result of a diabetic foot ulcer.

Foluso A. Fakorede, MD, as quoted in “Diabetic Amputation May Be Rising in the United States,” in the American Journal of Managed Care

According to Neal Barnard, switching to a low-fat, whole foods plant-based diet can help reverse type 2 diabetes, and it can help people with type 1 diabetes manage their insulin levels better.

Breaking the Food Seduction by Neal Barnard, M.D.—Dr. Barnard discusses the serotonin and dopamine pleasure cycles that hijack our brains when we eat sugar, cheese, chocolate, and meat. He talks about brain chemistry and the withdrawal people experience when switching to healthier food.

Power Foods for the Brain by Neal Barnard, M.D.—Dr. Barnard discusses what he’s learned about how food impacts our brains as we age, and how eating low-fat plant-based foods may help prevent and postpone Alzheimer’s and dementia.

Undo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases by Dean Ornish M.D. and Anne Ornish—Dr. Ornish’s interventional medicine approach to reversing many diseases through diet, exercise, stress management, and social support.

The Forks Over Knives Plan: A 4-Week Meal-by-Meal Makeover by Alona Pulde M.D., Matthew Lederman M.D.—I found this book to be incredibly helpful in transitioning to a plant-based diet. This book basically goes week-by-week with assignments, such as going through your pantry with a list of ingredients to watch out for. It recommends switching one meal a week to being plant-based, so as to give your gut time to adjust. I also learned that to feel full on a plant-based diet, I have to eat a greater volume of food; I have to eat more frequently, and I have to eat at least one legume-heavy dish (lunch time burritos!) in order to feel satisfied. It also gave really helpful cooking tips, like how to do weekend prep with all of our grains and legumes, and to ensure the freezer is always full of healthy home-made meals, which makes it really easy to not have to cook something from scratch every time I’m hungry.

Forks Over Knives Family by Alona Pulde M.D., Matthew Lederman M.D.—Providing plant-based food for your kids at home is easy, but how do you teach your kids about healthy food choices when every playdate, birthday party, vacation, and school-event surrounds your child with junk food? Basically, try to model healthy eating as best you can, and hope your kids continue to make healthy choices once they’re grown, but expect some level of rebellion and experimentation. I have some personal experience with this. I was vegetarian for most of my childhood. For me, “comfort food” was vegetable soups and the veggie tofu and lentil dishes my mom would make. Because my flavor-palate was already used to things like tofu, Bragg’s liquid aminos, and nutritional yeast, it made it really easy for me to switch to being vegan as an adult. Eating plant-based wasn’t alien to me, and one gift I want to give my son is a taste for healthy foods, and the knowledge of how to shop and cook healthy food.

The Complete Idiot’s Guide to Vegan Eating for Kids: Bring Delicious, Nutritious Vegan Dishes To Your Child’s Plate by Andrew Villamanga M.D. and M.Sc., and Dana Villamanga, M.S.J.—This is another great book with lots of practical advice for being plant-based with kids.

Mind if I Order the Cheeseburger? And Other Questions People Ask Vegans by Sherry F. Colb—Colb answers some of the many ethical questions vegans get, like “Is eating honey vegan?” “Are vaccines vegan?” “But what if plants are alive? Is it ethical to eat plants?” etc.

Eating Animals by Jonathan Safran Foer—This meditation on food, culture, and factory farming definitely sold me on veganism for ethical reasons, even though that wasn’t my initial reason for going vegan.

Dominion (documentary)—A film about how we treat animals. It’s pretty gruesome. Don’t watch with children.

Preventative Medicine

It’s easier to maintain good health than it is to get it back once it’s gone. An ounce of prevention is worth a pound of cure. Truly. Let me illustrate with a story from my family about two people who both had skin cancer.

My mother had melanoma when she was in her mid-thirties. She lived because she got the mole removed before the cancer spread.

My father had a slow-moving skin cancer that was diagnosed when he was in his fifties. But he didn’t believe in western medicine, so he refused to go to the doctor to get it removed when it was nice and small. Instead of going to the doctor, he spent every nickel he had on half-baked herbal cures, homeopathy, and “energy healing.” The cancer spread throughout his entire body, gave him heart failure, and caused a stroke that left him with diminished mobility for two full years before he finally died. And this was after twenty-five years of suffering with an open, weeping wound that spread like a fungus throughout his entire body and smelled like rotting flesh.

All because he was too scared to spend three minutes under a scalpel.

I don’t know about you, but I think I would’ve preferred to get that sucker removed nice and early when it was the size of a freckle.

This shows the power of prevention, early diagnosis, and early intervention.

Every year on my birthday, I get a full bumper-to-bumper check-up. I get my labs done. I get my freckles checked. I get my eyes checked. I have an OB/GYN exam. I get my teeth cleaned at the dentist (this happens every 6 months). I make sure I’m up-to-date on all my shots—including the covid-vaccine and flu vaccines.

Making the appointment for my birthday makes it easier to remember.

Vaccines? I love ‘em! 

I collect vaccines like other people collect Pokemon. Chickenpox? Vaccinated! Shingles? Vaccinated! HPV? Vaccinated! Tetanus? Vaccinated! Polio? Vaccinated! Ebola? Gimme a vaccine! Dengue fever? Gimme gimme gimme! Flu shot? I get a new one every August! Covid vaccine? I get the latest model as soon as it’s available! 

If it were possible to vaccinate against vasculitis, diabetes, or heart disease, I’d be first in line to get vaccinated for those diseases too. Until then, I’ll do my best the old-fashioned way by getting adequate sleep, eating plants, exercising, managing my stress, and hoping for the best.

Stress Management

Stress comes primarily not just from what happens to us but, more important, how we react to what happens to us. How we react is a function of our lifestyle and our beliefs. In short, even when we can’t change what’s going on in our lives, we have a lot more choice about how we react to it than we might have believed.

Dean Ornish, UnDo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases

Everyone says meditation, mindfulness, and breathing exercises are helpful for all kinds of things, from stress management to increase resiliency to lowering inflammation to making you smarter, or whatever.

I have to admit: I have a lot of resistance to this one. I know meditation is supposed to be good for me, but the moment I sit down and try it my mind is filled with a zillion other things I’d rather be doing. A huge part of my reluctance comes from watching my dad and all of his buddies spend hours (Years! Decades! Wallowing in self-absorption!) meditating…and still make stupid decisions that caused harm to themselves and others. (Who knows? Maybe all that meditating helped them be better versions of themselves than they would’ve been without it?)

But I believe people when they say meditation changed their lives for the better. I aspire to learn more about this eventually, just…not right now. There are only so many new skills I can learn at any one time, and right now I’m working on getting my body into shape. I’ll get around to this one, eventually. Promise.

In the meantime, here are my preferred ways of managing stress:

I give myself permission to experience pleasure, without the guilt—This might be a weird one to start the list with, but it’s actually really important. I sometimes get so caught up in meeting my goals or being productive that I forget to just let myself be happy and have leisure time, without having to feel guilt or apologize or explain myself. I have to remind myself that it’s okay to just enjoy myself, without multitasking or trying to fill every scrap of time with “homework.”

Spending time with family and friends—I’m very blessed to have so many wonderful, loving people in my life. Spending time with them almost always brightens my day.

Journaling—I’ve written in a journal daily since I was eleven years old. Spending 10-45 minutes doing a freewrite every day just makes me feel like I’ve cleared the gunk out of my mind so that I can face the day with more patience, attention, and equanimity. The past few years, I’ve been gratitude journaling as well. Here’s a neat Kurzgesagt video which talks about gratitude journaling being an antidote to dissatisfaction.

Writing fiction—I would say that writing fiction is an extension of the journal-writing in that it’s a way for me to grapple with thoughts, emotions, and issues in a way that feels more constructive. It’s a way for me to play, to escape, and to find order and meaning in the chaos. Lately, two books that have influenced the self-care and therapeutic way I think about writing are Never Say You Can’t Survive: How to Get Through Hard Times by Making Up Stories by Charlie Jane Anders and Rewrite Your Life: Discover Your Truth Through the Healing Power of Fiction by Jessica Lourey.

Writing is just organized thinking.

Drew Emery

Exercising—Whether I’m walking, running, doing yoga, or lifting weights, it just feels good to get out of my mind and into my body. Spark: The Revolutionary New Science of Exercise and The Brain by John J. Ratey M.D. is on my to-read list. Or check out Wendy Suzuki’s TED Talk about the brain-changing benefits of exercise.

Reading—Either for escape or to understand things better, reading is one of my favorite things. I’ve been combining exercising with reading by listening to lots of audiobooks as well.

Listening to music—I especially like listening to happy music when things are difficult. Back when I was pregnant, listening to music and humming along helped me control the nausea. There’s something magical about how music can change everything about how I’m feeling. Dance music is my ultimate stress antidote. Check out what I’m listening to here.

Social Health

The pandemic has put a spotlight on isolation and loneliness. Some of us have spent the past two years alone, like in Cast Away. Some of us have spent every waking moment of the past two years working, schooling, exercising, and dining-in with our families or roommates and are starving for a little more alone time.

Let’s just take a moment to acknowledge that the last couple of years have been totally nuts, and none of our people-skills are what they were before this pandemic started. Many of us have experienced loss. We’re grieving. We’ve been afraid. We’ve faced hostility or indifference from people we thought were on our team. Families have become estranged. Lines were drawn in the sand. Everyone’s lives were put on hold. The world changed. We changed. Our expectations changed.

And now we are all emerging from our respective bunkers and having to share oxygen with each other again. How do we do this?

On the theme of friendships and relationships, here are a bunch of books and podcasts on the topic that are on my reading and listening list. Maybe some of these will help you too?

On How to Make Friends, Keep Friends, and Navigate Friendship Changes

Undergoing any major life change—like getting married, or having a child, or going into recovery, or getting divorced, or switching careers, or financial changes, or starting a fitness routine—can shake up the people in your life. Change can be threatening. Starting a new diet or exercise routine can have a surprising impact on friendships, and sometimes the people who you thought would be most supportive will withdraw, or even turn hostile and try to sabotage your goals.

I think it’s important to try to bring people along with you. To explain why you need to make this change and why it’s important to you. (I guess this blog post is my attempt to do just that. To explain what I’m doing and why.) But friendships are voluntary relationships and just because someone was friends with you when you were one type of person doesn’t mean you will jibe the same when when you turn into a different kind of person. Some friendships may end. New friendships might begin—maybe within your new community of people who have shared interests. And some special friendship will rise to the occasion, and the friendship will evolve in surprising and wonderful ways.

I’ve been really lucky in how supportive my husband has been of my health goals. He changed his diet with me. He has spent hours listening to me talk and process my feelings about my health—our health. He read some of the same books I read. He gave me his weights and showed me how to use them. He started doing yoga with me. He isn’t a runner, but he frequently asks me how my runs went. He makes us breakfast while I shower after my workout. I feel so lucky to have him as my cheerleader, and I really feel how proud he is of me and the progress I’ve made.

Life Kit (podcast) has several episodes about friendships. “Accept the Awkwardness: How to Make New Friends (And Keep Them)” has tips on making new friends and strengthening the friendships you have. “How to Be a Better Neighbor” is about just that: neighborliness and communities. “How to Be a Supportive Friend” is about what to say when a friend is struggling. “Friendships Change. Here’s How to Deal” is about the times in a friendship where you might need to talk about your relationship and where it’s going.

Tedx Talks (YouTube) Shasta Nelson: “Frientimacy: The Three Requirements for All Healthy Friendships”—Nelson talks about how we are saturated with many shallow social connections, when what we crave is more intimacy in our friendships. She talks about some of these same concepts in her book Frientimacy: How to Deepen Friendships for Lifelong Health.

Tedx Talks (YouTube) Brene Brown: “The Power of Vulnerability”—How the courage to be vulnerable strengthens our health and our relationships.

Quiet: The Power of Introverts in a World that Won’t Stop Talking (book) by Susan Cane—There is this joke: “The way introverts make friends is by being adopted by an extrovert.” This book helped me make peace with the fact that I’m not the sort of person who is going to throw big dinner parties or be comfortable making small-talk with strangers, but I am the sort of person who loves hanging out one-on-one or with a small group of friends. 

Invisibilia (podcast) They created a “Friendship Season” with six episodes on different friendships. “A Friendly Ghost Story” is about how friends sometimes break up by fading out of each other’s lives. “Nun of Us Are Friends” is about what happens when the choice part of friendships are removed. “International Friend of Mystery” is about the frienemy relationship. “Poop Friends” is about the kinds of friendship where you talk about the most intimate matters. “Friends, With Benefits” is about the messiness that can occur with sexual friendships. “Therapy, With Friends” is about friendship relationship counseling.

Vox (blog) “The Modern Family”—is an essay about found families replacing the traditional family amid estrangement and distance.

Forgive for Good (book) by Fred Luskin—Many years ago I attended a workshop with Fred Luskin, who is a forgiveness researcher from Stanford. It’s hard to go through life without at least one experience of having someone doing you wrong. This is a book about how to deal with those feelings and how to move on.

On Female Friendships

Friendships Don’t Just Happen!: The Guide to Creating a Meaningful Circle of Friends (book) by Shasta Nelson—Once we leave school, it can become more challenging to make a circle of friends. In this book, Shasta Nelson talks about the different circles of friends we need to feel fulfilled, and how to maintain, let go of, and increase intimacy.

The Atlantic (magazine) “Why Women’s Friendships Are So Complicated”—The gratifying intimacy of female friends, and how they can sometimes disappear.

The Social Sex: A History of Female Friendship (book) by Marilyn Yalom—A historical survey of female friendships through time.

Read Brightly’s list of 11 Great Books About Female Friendships (blog)—(The Girls from Corona Del Mar has been on my to-read list for a while because I loved author Rufi Thorpe’s essay about motherhood on Vela Magazine: “Mother, Writer, Monster, Maid.”)

Book Riot’s list of 12 books about female friendship (blog)

On Male Friendships

Hidden Brain (podcast) “Guys, We Have a Problem: How American Masculinity Creates Lonely Men”—How the American hyper-masculine ideal creates men who are lonely, physically ill, and suicidal.

Harper’s Bazar (magazine article) “Men Have No Friends and Women Bear the Burden”—Lonely men are asking their female romantic partners to fulfill all of their emotional needs…and women are suffering because of it.

Life Kit (podcast) “Men Can Have Better Friendships. Here’s How.”—Advice for men hoping to have better friendships.

The New Yorker (podcast) “Dave Eggers reads ‘Bullfighting’ by Roddy Doyle.”—A delightful short story about four men who have a long-standing friendship that they have maintained through many phases in their lives.

Elderbrook “There’s Something About You”—A beautiful music video.

Thanks for reading this super long blog post about all the health stuff I’ve been going through. I don’t plan on writing a whole lot about my health, other than maybe a quick update now and again. But if you’d like to be updated, feel free to sign up for my newsletter so that you can be notified about my latest blog posts. As a thank you gift, I’ll send you a short story.