Tamara Unleashed

I have been waiting to get my first vaccination. I was fortunate to get the antibody infusion on January 11 when I had Covid. I had to wait 90 days to get vaccinated and got my first dose of the Pfizer vaccination this morning through Vanderbilt. It was a very well organized operation. I have been resting since the vaccination – out of caution. Unsure if I feel “previral” or or not but will take it easy the rest of the day.

Last Friday I had to do a telephone interview for a long-term care insurance. It was 90 minutes of questions under the penalty of insurance fraud. I knew there was going to be a memory portion to the examination so I purposefully scheduled the assessment several weeks after the time change and scheduled it immediately after I worked out when I normally feel great. I didn’t realize that I had pretest anxiety until I had incredible difficulty doing some of the exercises I have been doing for months. It happened several times which did not help my anxiety. The memory part was actually the least stressful. The questions about medical history were the poorly written questions, asked too quickly with different time frames – sometimes past 10 years, sometimes past 5 years and sometimes past 1 year. These questions were not written by anyone with skill in question writing assuming the intent is to get accurate information. The following morning, I woke up thinking about the 10 words I had been asked to memorize. Oak, list, servant, project, brand, cup, list, spring, rank – and now I have 9/10. As is classic for the health related insurance industry, they want to make sure they offer insurance to individuals who are the least likely to need it. I am not sure if I passed the test or not.

Sunday for Siblings Day I posted a picture of the 5Ts in 2018. My sister-in-law was able to find our most classic sibling photo from 1964. I remember that day, the blue spring coat and Easter bonnet. I was very embarrassed by this photo for several decades but now it brings me great joy. This was taken in the lawn outside of the farm house prior to going to the Beulah Methodist Church – out in the middle of the country between the two farms my parents grew up on. My parents were married there and the 5 siblings were all baptized there. The old country church was eventually converted into a home and I always wanted to go inside and see what it looked like.

Two days to get ready for Part 1 of my travel adventure.

Intermittent bladder infections have been a part of my life since grade school – 5th grade I think. I would go to the doctor in my town of 700 residents. The office was one room in his home and he would dispense sulfa tablets in a little envelope from his office. The symptoms would resolve quickly . I got one or two a year for a few years. As my mom also had bladder infections occasionally, no one was concerned.

My worst experience was when I was in my 40s. I had not had an infection in a few years when I got a low cramping sensation just as the airplane door was closed on a flight from Philadelphia to Phoenix. By the time the fasten seat belt light went out for the first time, I bolted for the toilet. The pain was intense when I peed. Before I got back to my seat I felt like I needed to go again. I had no idea how I was going to make it through the next fours. Fortunately I was in the aisle seat and the middle seat was empty. My incessant wiggly in my seat had less impact on others than it might have had. After about 4 trips to the toilet, I asked my aisle mate if she might have any medications that might help. Amazingly she had a few phenazopyridine, also known as Pyridium. I took two and they kept me sane for the rest of the flight. I spent over $100 on inflight calls arranging to get an antibiotic prescribed when I landed in Phoenix and talking with people to keep me distracted. I got the antibiotics on the way to the hotel. The first dose worked well enough that I was able to get through my speech the next morning. Symptoms were completely gone by the time I flew home at the end of the day.

Lesson 1: I started carrying my own water on long flights to stay hydrated. This was before the bottled water industry exploded and I always carried Pyridium and a few antibiotics.

Lesson 2: Up to that point, I was selectively allowing women with recurrent bladder infections to self-treat with antibiotics. Moving forward, for women that commonly traveled I made emergency UTI travel packs (Pyridium and a 3 days of antibiotics) available if they wanted. Over the past decade, with the availability of urgent care centers and concerns about antibiotic resistant bacteria and over use of antibiotics, travel packs may be less appropriate and necessary than twenty years ago – although I still carry mine.

Lesson 3: I gained a deeper empathy for my patients with IC (interstitial cystitis/bladder pain syndrome). The intensity of the discomfort/pain/urgency in my bladder was overwhelming – particularly when the fasten seat belt sign was on and I was not free to use the toilet. Prior to the taking the Pyridium on the flight, there was nothing that could distract me from my bladder. I was fortunate that I knew what was causing these symptoms and was confident that one or two antibiotics would get rid of the symptoms. But what if they didn’t? Many women that end up with a diagnosis of IC describe having UTI symptoms that just don’t go away. I now understood why women told me they sometimes fell asleep on the toilet or chose to sleep in the bathtub when symptoms were at their worst. While our understanding of the complexity of this often debilitating condition has improved over the past 30 years, treatment is still pretty much trial and error through a series of treatments that can work well in some women. We still have much to learn about this pain syndrome.

The flight to Phoenix may have been my first awakening to the prospect of prevention of bladder problems. Waiting for women to show up for care with often inadequate treatments was not good enough. I already understood the power of knowledge and behavior change to treat conditions, why not reposition these strategies for prevention? It took over 15 years for the awakening to evolve into action.

Last night I had the opportunity to go backstage at Grand Ol Opry and observe my fabulous daughter in law, Natalie, in the preparation for her hosting roles on Grand Ol Opry Live AND perform as a member of Runaway June. It was the first time since the pandemic started that artists were allowed to invite family backstage. The Opryland staff take Covid precautions seriously. I had such a good time and was in awe of the skill it took for Natalie to juggle all of the roles she had last night. I hope there is a daughter-in-law day soon. I have much more to say about Natalie.

Today is Siblings Day. There are 5 of us – Terry, Tamara, Timothy, Troyt and Traci (or the 5 Ts). I am the only one that left Iowa. We have all become parents and had very different paths through adulthood. While our views of the world are very different, we have always agreed on the importance of family. I will visit them in June towards the end of my travels. I hope we can all be together to update this 2018 photo.

I have had persistent loss of taste and persistent loss of taste and smell since Covid. I have grown pretty accustomed to it. I think the loss of taste decreases the desire for any second helpings which is a good thing. I can tell one flavored coffee syrup is different from another, but not what each flavor is. This past week I had my first glimpse that my sense of smell might be coming back. I thought I might have smelled the fresh salmon as I removed it from the packaging. Later than evening, I had a brief feeling that my environment had gone from black and white to color related to smell. It was odd, brief and not related to any pharmaceutical enhancement. The following evening, I feel pretty sure that I actually smelled the basil in pesto. I have hope.

My first Covid vaccination in Tuesday. I begin my travels on Friday April 16th. I am getting very excited.

Thursday I took my government issued equipment (one mobile, one iPad, one Dell tablet and one PC laptop) to FedEx to have shipped back to DC. It feels good to have one computer, one reading device and one mobile phone. I am working hard to readjust to the Mac OS as I have spent most of my time on a PC for 19 years.

I will greatly miss the great IT support staff that we had. I always had problems others did not seem to seem to have. I kept them challenged. They showed endless patience and were generally able to find a solution or “work around”. One of the things government employees are excellent at is finding the “work around” to the rules that need to b followed, but if followed too carefully are counter to getting the job done. The obvious solution to just changing the rules that don’t make sense or work is problematic because to change the rules, you have to go through Congress. Even a functional Congress would not have time to address all of the individual needs of the government offices, agencies, departments, institutes etc. So each government group must find ways to operate within the rules as best they can.

Sending my equipment off was a specific sense of finality. Leaving is not all positive and I am sure over the next several weeks, I will find I am not able to do things I was accustomed to doing with access to the VPN of the federal government.

During my first week of semi-retirement, I have been gradually integrating and updating contacts and files – trying to get organized for moving forward. I have starting putting entries on Medium (tamarabavendam@medium.com) I am loving writing more than I thought I would. I am not really sure what I am doing but I will continue to figure it out.

I am having my second cup of coffee on my deck for the first time. Sun shining through the branches that do not yet have leaves. Gorgeous. I woke up this morning thinking about the storytelling as one of the reasons I started this blog.

My mother and father were neither one storytellers. Consequently, I never really felt like I “knew them”. I felt I knew more about my father because he was an extrovert making friends with everyone and consequently he was reflected back through others. My mother who was in my father’s shadow. My father died unexpectedly before my mother. At his visitation my 4 siblings and I watched in amazement. as our mother emerged as a “Chatty Cathy”. Who was this woman? It was short-lived, but it was a window into who she was or might have been that I never knew.

I have never been much of a story teller (or at least I don’t think I am) for many aspects of my life. I have never thought my experiences were very interesting but I don’t my son to feel as I did at the end of my life, that he really didn’t who I was. I told him the other day that I regretted feeling like I did not know who my mother was. Because I have very few boundaries, he already knows more about me than I ever knew about my mother. My musings on this blog will be there for him whenever he wants to know more.

I was born in California when my father was in the USAF and moved to Iowa when I was 2 weeks old. I consider myself native of Iowa. I left Iowa when I was 30 and have lived in CA, WA, PA, NY, and MD. I thought MD would be as far “south” as I would get but when it came time to picking a location for putting down roots I decided to go to Nashville where my only son lives and was likely to stay. I figured one of the best gifts you can give to your child is to make it as easy as possible for them to provide whatever support is needed as parents age.

I am a liberal, progressive, feminist, I understood that Nashville was more progressive than the rest of the state as most larger cities are. Tennessee mandated fewer Covid restrictions than the DC Metro area where I moved from but Nashville had mandatory mask requirements so I felt reasonably safe moving in August 2020. I made it through getting a driver’s license, changing car registration, voter registration, voting in 2020 election, as well as getting my health care established, finding a hair salon and finding a great personal trainer.

The fact that I was now living in a Red State came crashing into my world when I heard about this story on WPLN the local NPR station — https://www.usatoday.com/story/news/politics/2021/02/18/tennessee-abortion-bill-fathers-would-get-veto-no-rape-exception/6796871002/

Did I mention I was a feminist? The females’ unique ability to get pregnant and give birth is necessary for the survival of humans but as natural and necessary as pregnancy and childbirth are they are not without significant risks to the mother. I believe it is absolutely the woman’s decision as to whether she wishes to have sex, get pregnant and have a child. I also believe it should be the woman’s decision whether she wants to have vaginal childbirth or an elective C-section. Laws such as above are about male power above all else.

The importance of state politics has never been as clear as it is right now. We all need to pay very close attention to the state elections. We must support younger persons in seeking elected office. I have always lived in Blue states (or at least they were when I lived in them) so I am going to have to figure out the most effective way of using my voice in Tennessee where it might make a difference.

My son moved to Nashville in 2004 so I have had plenty of opportunities to visit Nashville but my visits were primarily summer or winter. For the past month, being able to sleep with my window open and wake up to the sounds of bird chirping has been wonderful. Today as I was still partially asleep, I heard a rooster crow and it took me back to the Iowa farm for a brief period of time. Monday was in the 70’s with sunny skies and 25% humidity. I was transported to summer in Seattle. I didn’t know the humidity could be that low here.

The past 2 evenings, I have had wine on my deck with no bugs – not sure how long that will last. I am a magnet for anything that bites so we will see how well I am able to control the pests during the summer so I can continue to enjoy my deck..

I just had a visit from the HVAC man who do the inspection prior to buying the condo last fall. He was very friendly and said ‘mam” in the most charming way. He knew I was new to Nashville and asked how I was trying to build my community. That was a lovely gesture.

I am really looking forward to being on the other side of the pandemic so I can actively building a new community. My first vaccination is scheduled for next Tuesday. I am so excited to put my arm out for the injection.

I am working to understand vaccine hesitancy – on NPR this morning heard that one third of adults are not planning on getting vaccinated. Some of those will likely never be convinced it is the right thing to do. But I think is a reasonable percentage of those that are justifiably confused and can be convinced with different information. I am concerned we have not done enough to understand where there is confusion and need for clarification but have instead just assumed those that are hesitant believe the misinformation which is difficult to counter. I think we can do better….

By the way, a few people have asked how to subscribe to the blog – I wasn’t sure so I figured it out: At the top of the Page on the right you should see Blog About and Contact. iClick on Blog, it takes you to a different view of the blog and at the bottom of the page you can subscribe. It is fun to have followers.

I cannot take off on my travels until I get my first vaccination. I had Covid December/January and was fortunate to get the antibody infusion on Jan 11. Thus I cannot get my first vaccine until after April 11th. After my first vaccination, I will go to DC for a medical procedure I cannot get done in Nashville and spend a week there visiting friends – with appropriate masking and distance precautions. Nearly everyone I will be visiting will be fully vaccinated ahead of me. From there I will spend a week in the Spartanburg, SC area where I spent last July after I left the DC area. At that time, SC was still figuring out how seriously to take pandemic. After being in the DC Metro area where everyone was taking it very seriously, I was anxious but with appropriate precautions, all worked out well.

Last August, once I arrived in Nashville my son, daughter-in-law and I gradually established a pod where we did not mask with each other. We lived a mile apart and perhaps got together in doors once or twice per week, maintaining distance for the most part. My daughter-in-law was fortunately able to work during Covid with a at least weekly opportunities to be on camera without a mask. While she was a careful as possible in the circumstances, it was a risk that I accepted for am a small sense of normalcy. I suspect that Covid exposure occurred was the day that we were all together photographing my new headshots and we were closer than 6 feet for a short period of time. It was a very fun day in early December. A week later, I dropped by their home while biking. I was stopped before I could enter and received a text indicating they woke up with loss of taste and smell and mild viral symptoms. They tested positive the next day. I noticed loss of taste and smell 36 hours later. I experienced mild fatigue and myalgia but tested negative twice over the next 10 days. I assumed I had a mild case in spite of testing negative. Quarantine ended on Christmas Eve.

I decided to resume working out with my trainer the following week (Tuesday and Friday). As it was nice weather I biked on the other days. It helped to restore a sense of well-being and energy. Unfortunately after 6 days of increasingly feeling better, I got a bit of a cough on day 7 and decided not to bike. The cough remained mild so I worked with my trainer on day 8 per usual. Later that night I got a low grade temperature which kept rising. I tested positive the next day, day 9. Every day of my Covid experience was different as is every individual’s Covid experience. The lungs were never the worst part for me – perhaps because of the antibody infusion. The worst part was waking up every day the first week wondering if this was the day it was going to get REALLY bad. My worst constellation of symptoms occured in the second week – neck spasm, headache and nausea which persisted for days. I could only sleep sitting upright for a week. In all, it was 3 weeks before I felt comfortable that I was on the “other side”. I GRADUALLY returned to my previously level of physical exertion over 2 months this time. I feel fortunate that my only residual is no sense of smell and diminished taste.

This is not an experience I want to repeat and I anxiously await my vaccination. I observe the vaccine hesitancy with confusion and frustration. However, I can understand some of the hesitancy based on the information on various government sources. I will address the concerns that I can understand in my next blog. I think it will take me a very long time to give up my mask in any sort of public venue and hope that it can be a new norm post pandemic to wear masks in public any time we think we are coming down with a cold or flu and to stay home when sick. It is one way we can continue to look out for each other’s health.

I will return to Nashville for my second vaccination in early May and then head out for 6-8 weeks – fully vaccinated. I will visit NC, DE, PA, NJ, NY, VT, OH, IN, IL, IA, WI and MN with possible short stops in MO and KY. One of the perks of moving around so much is having friends everywhere.

What was I looking forward to most in leaving federal service? I couldn’t wait be to able to speak without worrying if I was saying the wrong thing to the wrong person at the wrong time. My comfort zone is gray. I have a strong ethical core and rudder so in general I do not need a lot of rules. At the NIH, there were so many rules that made no sense to me. In my view there was often a huge disconnect between the intent of rules and their execution. If I couldn’t understand the rules, I couldn’t remember and apply them. I was never sure if what I was saying was right or wrong for the circumstance. It was exhausting. For many colleagues, application of the rules seemed rather obvious, but not to me.

On a recent call, a colleague said something like “you mean you have not been speaking your mind”? I am apparently more straight-forward than most. In that moment, I decided I would start a blog the first day I was no longer under these restrictions called Tamara Unleashed. I would never again have to hear “we are just trying to keep you off of the front page of the Washington Post”. My response to this concern was always that I would welcome the chance to be on the front page of the Washington Post. What great exposure for women’s urologic and other benign urologic conditions. While I personally would not have minded “going down with the ship” I did not want to take anyone with me so I “towed the line” as best as I could. I never made it to the Washington Post – front page or otherwise.

While the “cloak” of federal government felt like a straight jacket to me, there was a different “cloak” associated with the pharmaceutical industry making it 20 years of one restriction or another on my voice. I am unleashed and having fun.

In Iowa in the 60’s and early 70’s opportunities for organized sports for girls were limited. In small high schools, half-court basketball was available for girls. Three players per team on each end of the court. One end of court playing offense and the other playing defense. It was apparently felt that girls were not strong enough to play full court basketball. This actually became a part of the messaging used against approval of the Equal Rights Amendment in Iowa in the 70’s. The ERA would make half-court basketball for women illegal. As we now know, girls and women are quite capable of playing both offense and defense and running up and down the full court.

In was the second of 5 kids (boy, me, boy, boy, girl). My brothers were year round athletes and I was reasonably uncoordinated. There was track and field and volleyball for girls in my high school which did not have girls basketball. I did shot put and went out for volleyball for a couple of seasons but fitness was not prioritized. Going out for a walk for fitness was not a part of the farming mentality. In retrospect I have reflected on this believe this is in part due to the the fact that generations ago, farming was very physically challenging for the men in the fields and the women doing house/gardening and or field activities. There was always work to do and except for Sunday for church and family, there was. no down time. Everything you did must have a purpose and that belief was embedded in my psyche. During my decade in NYC where we did not have a car, I found myself resistant to walking for exercise or pleasure, but I could walk for long distances for a purpose. We would pick a movie theater two-five miles away and walk there and back, etc. The distance was not the problem, I needed a purpose. I have gotten over this to a reasonable degree.

I am tall and “big boned”. I always felt “fat” in part due to comments by my older brother and his friends and in part because Twiggy was the new icon during my junior high years. I gained a lot of weight during pregnancy and was on many popular diets in the world throughout my adulthood. I did successfully lose 40 pounds in my mid-thirties but fairly quickly put in back on because it was through calorie control alone.

On one fateful day in August 2017, a friend and mentor who had become a huge fitness advocate post retirement told me I should join a group she was putting together to celebrate her 80th birthday. Her celebration was to cycle the 444 mile Natchez Trace (Nashville to Natchez, MS) in October 2018 – 14 months from then. I had just started to work with a personal trainer as I was now over 60 and had the time and resources to prepare for growing older. I said yes. I hadn’t been on a bike in 40 years. I went to a bike store and decided to start with a hybrid. I was very nervous about drop handle bars and thin tires. I know from exercise cycles that I had problems with perineal/labial numbness after riding 15-30 minutes and this was a challenge on my bike as well. On my third saddle (seat) I found one that did not cause problems and worked my way up to riding 40 miles. In August of 2018, 2 months before the start of the big Natchez ride, I decided I was ready for a road bike. I felt very secure on my new bike and it was a more efficient ride that I felt would be better for the days where we would ride 40-70 miles. The “saddle-soreness” resurfaced and I knew I didn’t have it right when we started the 9 day trip so I took 2 saddles with me and alternated. A couple fo days I had to end a bit early because of pain, but I did log 400 of the 444 miles.

It appears saddle technology and options have improved significantly in the past several years. I really appreciate this recent article https://www.bicycling.com/health-nutrition/a35982610/bike-seat-pain-saddle-sores-women/ I have a saddle that works well enough for now, but may explore some of these newer designs. Training for the Natchez ride was a BIG GOAL and I while I continued building strength with my trainer, I did not know if I was going to be able to ride for 9 consecutive days – if I could keep up with the rest of the group that while older were fit and experienced cyclists and skiers.

Fortunately, I did not slow the group down and I discovered that I loved cycling – I found my sport. I have continued cycling regularly since the big trip. Thanks to Team 444 for supporting me during the BIG ride and showing me that age is irrelevant to enjoyment of sport and staying fit. It is never too late to find your sport.