The Heart of a Woman: Women and Heart Disease

Welcome -- and welcome to a new decade! It's hard to believe that "The Heart of a Woman" was written nearly TEN years ago! There remains only one chapter you have not yet seen, and then decisions to be made: other than this blog, my work is unpublished and do I continue to blog?? Updates abound, of course... I have also been meaning to tell you that the site does not italicize, but I have: anything I consider crosses the line from journey to self-help is in italics, so use your imagination and enjoy!
By the way, look for Go Red For Women, headed by my cardiologist, MaryAnn McLaughlin. The annual luncheon is on February 26th and will be well-represented. What a cause it is! You can google it (and me) to obtain more information.

Personalizing the Millenium: Love, Laughter and Reality

New Year's Eve 1999: Nearly fifteen months had passed, yet I could barely make it a mere four blocks - uphill, at night, chilly head winds - to a party I attended with all three generations of my family. It was the first time in many years that we were all in the same place at year's end, and it seemed particularly fitting. We were so busy down-playing this major event with all its international hype that we almost missed it! There was the ball dropping in Times Square, throngs of people from all over the world cheering, Dick Clark, who must be three hundred years old by now, doing his annual schtick, turned up a notch for the turn of the century. I think it was three days before it finally hit me: I was so "lucky" to be alive! Why shouldn't I be celebrating wholeheartedly! I had to laugh at myself! It is so easy to forget to appreciate what is, go on about our business as though no one day matters. Because every day is precious, we should act accordingly, but do we? I was eerily aware that I still was not consistent enough in practicing what I preach and called myself up short, resolving to greet each day with enthusiasm, pride and plans, not as simple a prescription as it sounds, as we all intrinsically know.
I keep going back to the importance of social contact, a healthy, universal need. You may be the type of person who is always surrounded, or perhaps you have one special friend and a few people on the periphery of your life. Even if you are a loner or non-joiner, hopefully you are exercising or enjoying special interests with people who are like-minded. The intellectual and emotional stimulation you both give and receive while in the company of others adds to your physical and mental health. Make wise choices, of course, continuing to put yourself in the midst of positive, supportive, fun-loving folks, welcoming their thoughts and ideas and cherishing the mutual contributions to one another's lives.
My journey was no longer dramatic, the heart-related symptoms having become routine, along with pill-taking and exercising, the highlight of each week's schedule. I still marvel at my friend's prognostication that I would come to love it, but he could not have been more endearingly and enduringly correct! If you are a non-believer - or, more likely, a non-exerciser - allow me to proselytize once again, just for a bit. Not only will exercising increase your physical tolerance, it may well increase the number and strength of your collateral vessels. While exertion on the various pieces of equipment may not be thrilling at the moment, the results are astounding. Most of us leave radiantly red-faced, perspired, inspired, almost giddy. Our blood pressures and heart rates are better controlled than ever and we are intentional, purposive, intense and consistent about our program. If anyone had told me a year ago that these words would come from me, I would have laughed heartily (pun intended) and sent them on their merry way. Okay, I don't love every minute of it and when the class is small enough so that I can monopolize the treadmill for a half- hour I have to force myself to stay on it, but what an accomplishment! My friends no longer have to ask if they need to drop me off before they park the car. I can walk briskly or climb a flight of steps without becoming winded - and that is with only 70% of my heart working! If you were never in particularly good shape, you will be so surprised at the benefits of a reasonable program targeted for cardiovascular fitness. Don't look for weight loss or muscle mass, but do expect to work hard - they don't call it working out for nothing - and then you can fully expect to reap the rewards. Now, how can you resist?
The dawning of the new year provided yet another opportunity to continue on a clear, positive track. I paid particular attention to the blossoming of new friendships, choosing not to focus on my impending divorce. When you hear the voice of the optimist hesitate, it is the realism coming through, which is neither negative nor positive; it is just an indicator, a challenge of some sort, a green flag. For me, reality was based on being able to separate the provocative from the productive. You have the power to control your reactions, which are based on your unique interpretation of events. I have chosen to use that power to study life's seemingly difficult moments and then compartmentalize, carefully weeding through the emotions, coming to terms with the parts of the equation over which I may not have control. You need to neither overreact nor fall prey to the inevitably disabling inertia which is best defined as choosing not to make choices.
The issue of control, or more aptly withdrawal from the need to control, challenges me and probably always will. You will know from the reactions of people around you if you have become more "laid back", easier to be with, emotionally quieter. It will be a great feat if you were the typical Type A personality we all know but do not need to be, and it is gratifying and exciting to make the switch! Achieving this kind of growth is energizing, as opposed to the debilitating results of having to know everything, be everywhere, be everything to everyone. There is no loss here, just pure gain. I giggle at what I do not know that less than two years ago I would have been crawling through walls to uncover. We often think that there is a payoff in control, that it is empowering, but I have come to believe that it just makes us seem anxious and relentless. Think about it this way: is it logical, convenient and desirable or, in all honesty, is it intrusive, irritating and counterproductive? Bearing in mind that we repeat behaviors that work, that seem to end in a payoff, what is to be gained by the drilling and grilling and accumulation of drama generally associated with those who seek to control? Why would anyone knowingly subject him/herself to the grueling task of controlling people or situations when the alternative is to be peacefully aware and engaged, but not on the alert or on one's toes? If you need to confront your behavior in this area and modify it, you are guaranteed to feast in the payoffs.
Here are a few carefully chosen "givens":
- we all fear rejection and crave acceptance; we need approval and have difficulty fielding criticism
- fulfillment and gratification are essential ingredients in our lives
- plateaus are reached by devoting ourselves to thriving.
I am not suggesting that there is nothing you need to control and you should go through life under anesthesia! You and only you can control your reactions and your behavior. The good news is that you therefore have the power to re-shape the aspects of your life that you decide you need to address. After all, if we label surviving as a challenge, then thriving defines itself as the ultimate achievement. Another in the inevitable, remarkable series of turning points in my physical and emotional recovery surfaced when all the hoopla of the new millenium died down and I found myself wondering what was next in the saga. No longer dealing daily with the initial denial and having achieved a higher level of acceptance, I knew I had to embark on something meaningful, but what? When I first had the idea for this book, my thoughts ran the gamut from how dare I to how could I not share my story? But I was so tired: tired of being tired; tired of how hard it was to keep moving in the direction in which I believed; tired of the pill-taking, the doctors' visits, the side effects of so many medications. Logic dictated that I take a new direction. This was tantamount to an admission that I had not yet arrived, one of those situations when the good news and bad news are the same: I could take command, but only if I granted myself some leeway, gave in to the fatigue when necessary, cut myself some slack so that the continuation of what is in fact a life-long journey could be broken down into paragraphs, not unwieldy volumes. If you are one of those people who expect and demand too much from yourself, you are accustomed to tempering desire with reality. If you expect too little from yourself, then you will need to recognize that as a pattern which disables you, and redouble your efforts toward improving the quality of your life. How you do it will depend in large part on how you conquer your fears and ensuing moments of immobilization. There is nothing superficial about our journeying and it is by definition not simple. On the other hand, are you complicating it by staying on the fence, in a neutral position? Are you allowing yourself to settle for what is instead of moving forward, even in the face of some natural anxiety? Are you either over-analyzing or not thinking enough about where you are, relative to where you want to be? Again, you may benefit from keeping track of your thoughts through writing. You may want to make a list of what you have accomplished thus far and then another list of the challenges you wish to incorporate in the immediate future. You can knock yourself out of the race by being too smothering of yourself, just as you can thwart yourself by being unrealistic.
I am not a person who is constantly driven; I can lay back, pet the cat, watch mindless television, but there always comes a point that I encounter unmet social needs or am dissatisfied with staying still. Sometimes you will be able to capture a vision of yourself with that movie camera in your mind's eye and become excited by what you see, as I did when I conceived this book. Trust yourself to get started, use your resources to jump start you if that is what you need, but make friends with your thoughts, your frames of reference, your goals, plans and desires. The focus cannot remain on your illness - you will bore yourself to tears! How many times do we hear people exclaim: "I just knew it was time to move on!" Try Iyanla Vanzant’s method of rewording your messages to yourself to formulate an action plan and then kick-start yourself. Believe me when I tell you that the pride and courage you demonstrate will feed on itself and keep you highly motivated to remain on your chosen path.

Women and Heart Disease: The Heart of a Woman

As I post this chapter of my writings, a new year -- a new decade -- has begun. There are challenges and opportunities; there are difficulties and demands; there are, as always in my life, beginnings. Happiest New Year to All, and now please read on...

Beginnings: Life Changes, Life Laws and Letting Go

The sense of "here we go again" was ringing in my ears. I was hypersensitive, attuned to my body as well as my feelings, quite aware that my emotions were raw and tenuous. On one hand, I was in a honeymoon phase of living with myself and enjoying it immensely! Nothing moved unless I moved it; there was silence broken when and how I preferred it; effort was expended in the directions of my choosing. I continued to work, but no longer for the business, so the phones were quiet, the voluminous paperwork non-existent and the endless diplomatic interventions with staff and clients absent. On the other hand, this immediate change in life style was shocking, and it would not be long before I had to ask myself what was next.
Following Phil McGraw's Life Laws and intertwining them with my own philosophies, I began the first leg of this necessary journey. All ten of his laws have incredible merit and I highly recommend both of his books, "Life Strategies" and "Relationship Rescue". Your ways of handling the particular challenges you face will likely be augmented by his ideas.
Life Law #2 states that you create your own experience and are accountable for acknowledging and accepting what you have created. This does not imply that if you have had a heart attack that you have chosen it or are to blame or are a hapless victim. In fact, there are no victims, according to Dr. Phil, just "volunteers". The truth is that you are responsible for reclaiming your life, for putting yourself back on track and moving forward past the point of survival - you have won that battle - and onward. "Change" is not a dirty word; it is inevitable, meaningful, exhilarating and strengthening. I can almost hear you thinking "Easy for her to say, but I'm frightened and I don't want to face any more difficulty than has been thrust upon me ". But you have already begun anew and you have proven yourself. You have emerged victorious at least on a physical level and I believe that without a reservoir of desire to stay in this world that you might not have achieved that. Give yourself more credit and begin to realize that a beginning has crept into your life scene, and in confronting it you are astronomically increasing the possibility of thriving! If you insist upon fighting change, you are failing to acknowledge that you are accountable for your choices and the consequences of those choices. You are taking away from yourself rather than embarking on the quest to become more.
I could not remain numb because to do so would have robbed me of the payoffs of new, or at least improved behaviors, ways of being in the world that would enhance me.
Although it was tough to face, this was actually a good time for me to go through the separation. It was an opportunity to re-examine my choices and decisions, rejecting what had not worked and welcoming different strategies. We cannot allow emotional blindness to thwart us or frustration to stop us. I knew that I was foisting myself into a fearsome state but that avoiding it would keep me burdened with the tension and stress of staying in a situation that was not working. Fear and escape from pain have a seductively narcotic effect, but that anesthesia leaves you emotionally stranded, disabled from taking positive action. This is real life and you need results, not excuses. Harsh though it may seem, my goal is to help jet-propel you to where you need to go. Your job is to trust the process, immerse yourself in it, embrace it with open arms.
I was still coping with changes in medications, trial and error additions and subtractions attempted according to my doctor's wisdom. Every test, every symptom, every report had to be examined. Fatigue was limiting, fear was still hard to quash and the reactions of doubt and anguish among my closest friends and family made me so emotional. Although I was optimistic, I could not help but become impatient with the slowness of the healing process. Not knowing what to expect, what baseline would eventually be achieved was baffling. I so wanted a working crystal ball! When would I reach my maximum in terms of energy level? When would I stabilize on the medications and perhaps reach the lowest possible dosage levels? What could I reasonably expect of myself in rehab? We all pose similar, unanswerable questions and doubt creeps in even when we are determined to remain positive -- it is the reality check syndrome. Once again, the issue of control, or lack of it, enters into the picture in its many shades of gray. I consider myself to have a rather high level of self-awareness, and well I should, but I was amazed somehow that the further I was from the heart attacks, the more I was able to give over control. It was taking root more and more deeply, sometimes consciously and more often as a matter of course. To me the latter provided a modicum of proof that this was going to become permanent, not just situational. Some examples seem minute, but they were winking at me on a more regular basis: "Where would you like to go for dinner" would be met with "It's up to you" and not followed by suggestions, complaints or comment. I did not have to participate in everything but could allow others to take the ball. Life had become easier because I had made it become easier! It was not mysterious and certainly not impossible.
I had yet another opportunity in November to go to Florida with my wonderful, supportive, spirited daughter and she made all the arrangements, she drove, she navigated, she led me. I was calmer than ever, easier with myself and finding that the smallest pleasures put a silly grin on my face. Thriving was taking on so many definitions, including simply enjoying life and recognizing it. The full blown meaning (prospering, succeeding, growing or developing vigorously, flourishing), could be taken down a notch to mean feeling content more frequently. It is important to take notice of your own progress, especially when it is inherently slow. I was not entirely without responsibility for my medical condition, but once I could at least allow my doctors to guide me, I could bow out of the brunt of the work that I was not knowledgeable enough to handle. I was careful about food, exercise, rest, pill-taking, but the rest could be up to them. I had chosen them wisely and had a high level of trust and respect for their judgement. If I was too hesitant to report to MaryAnn an incident known to my support system, I could accept their nudging me and make a phone call, without resisting. One of the byproducts was a reduction in my general level of fear, the affliction of "what-if". In fact, days after our return from the trip I was scheduled for another stress test and was actually excited rather than unnerved. This time I would be strutting my stuff instead of fearing that I would fall apart! Indeed, my exercise tolerance had grown, but there were still abnormalities evident, just as on my ECG's, but nothing dire, and, most importantly, I was continuing to develop collateral vessels, "extra" blood vessels capable of taking over for blocked, plaque-filled ones that may have caused the heart attack. Hurrah for rehab!
Perspective is of such great import and, by definition, can take place only with the passage of time: Thanksgiving was coming again and the differences in the long year that had passed were actually dramatic. I was brighter and cheerier, much more energized, had greater stamina and concentration. Overall, I was involved, enlivened, peaceful and filled with optimism, quite a counterpoint to the dulled, tired, unenthusiastic participant just twelve months earlier.
My strong sense of realism was at play, too, and I knew that I would be thrust into periods of sadness and loneliness despite my inner strength. I had made a decision that was not without difficult consequences. My initial inaction was inherently emotionally costly but now I had to develop strategies that would allow me to cross this next threshold, not a simple task. Bathed in a variety of side effects from the many medications I had to ingest, ranging from the ridiculous (a puppy-cold nose) to the sublime (those wondrous vessels), I had to admit that it would be with considerable difficulty that I would move forward.
In our moments of greatest difficulty, forward motion seems so daunting. Getting real, accepting what is, holding yourself accountable for where you are - all of these notions that I hold dear - will sometimes leave you feeling overwhelmed. Life may seem so difficult to manage, as though you need to be made of steel, while feeling more like Jello. As a people-person, I can vouch for the value of being active and among those who make you feel most alive. It is a natural phenomenon to feel alone from time to time, even if you are in a rewarding relationship, working, parenting, taking advantage of avocations, participating in group activities or individual counseling and invested in attending to your own needs. There has always been some controversy regarding the differences between "alone" and "lonely". In my experience, heart patients who identify their lives as being full still speak about a specific type of loneliness/aloneness that is based on the uniqueness of the nature of the disease. You may feel a distance from your significant other, best friends, close family members who can sympathize but not empathize and an uncanny closeness to your classmates in a cardiac rehab program. When you awaken with symptoms in the middle of the night and you are alarmed - "Oh, no, is it happening again?" - your doctor, your trusted medical resource, is not likely to be present and neither are your compatriots. Your spouse may be lacking patience, certainly lacks expertise and/or may not know how to be available to you in the way you need him/her to be. These are moments when you are most likely to feel like you are in a morass and on your own (alone) and unable to use the usual resources to fill the immediate need (lonely). I made reference to the 5 AM syndrome concerning my mother, but it still happens to me some early mornings, too. If I am awakened for any reason at that hour, I have to remind myself of all the positive results of my last tests, convincing myself that no, it is not happening again, that I am receiving excellent care. My only job is to soothe myself back to sleep; anxiety breeds like little rabbits and can drive you needleessly nuts! It is essential to have a well-thought out plan of action in case serious symptoms arise, since logic so easily gets thrown out the window when anxiety slinks in. Perception, your own personal way of reacting to a situation that presents itself, is the key: I can feel a flutter and decide I'm in trouble or I can choose to process my reaction through a decidedly calmer filter. I can panic or I can summon my most forceful, diligent, rational thinking mode. I can run for the phone, get all worked up, no longer able to distinguish between fact and fear, and create a vicious cycle leading to a place I do not want to be; I can also be still, pause, listen. Just as in other aspects of our lives, we can use as life lessons the issues of the past without allowing ourselves to be controlled by them. It is not our particular life situations that shape us, but rather our reactions to them. We all have a certain way of filtering our perceptions, so the physical stimuli can be distorted or addressed calmly. You need to be aware of whether you are creating an opportunity to examine yourself, or falling apart in advance of true knowledge, even at five in the morning. How many times do you hear about someone screaming through childbirth while the woman laboring in another room is brimming over with delight and awe? Their pain thresholds may be similar but their filtering systems are likely quite different. One may be frightened of the unknown and the other more educated; there may be many elements to the equations, but one thing is certain: the screamers among us often find themselves reacting to their difficulties with less forethought, probably in large part due to their lack of ability to test their assumptions prior to exhibiting their reactions. So what does all of this mean in the scheme of things? How can our perceptions help us simplify our lives? How do we objectify reality so that we can make sense of our thoughts, actions and reactions? When we sift through Phil McGraw's ten laws of life, we begin by becoming accountable for our lives, willingly, purposefully and consistently, without blame and with true acknowledgement. When perception is clouded by past experience and negative expectations, we fall prey to limiting rather than challenging ourselves. Self-fulfilling prophecy can cut both ways: if we believe that we can get well and fight for ourselves, the outcome is nearly always positive; conversely, if we are pessimistic, refuse to accept what is, become filled with self-pity, we are apt to induce distress and exacerbate the negatives of our situation.
During a rehab session recently, an upbeat, pleasant, bright woman suddenly sat down, lowered her head and nearly passed out. Her blood pressure had soared, her face was blazing and she was dizzy and near tears. She was attended to by the nurse and doctor on staff and told to sit quietly, stop exercising and just breathe. I made my way over to her and she immediately began telling me exactly what she was reacting to. Her daughter-in-law had written a letter to her filled with complaints about the difficult issues in her marriage, demanding that Lois do something about her grown son. Lois reacted strongly and negatively to the nerve of this woman. Upon reflection, she realized that whatever the intent of the letter, it was her responsibility to own her reaction. She slipped, forgetting that this woman could not cause her to react in any particular way, and that Lois's reaction was purely driven by her own thoughts. The daughter-in-law did not make her blood pressure rise, Lois had done that to herself. The good news is that when it happens, we all can take the liberty to adjust our reactions. She nearly slipped further by chastising herself rather than using the "Aha" moment to assist her. She was proud to come out of the incident with her thoughts intact and her blood pressure back to normal. She will write a positive, simple, short letter back acknowledging that married life can be difficult and that she is certain that they will find solutions on their own. She went home feeling renewed and relieved that she does not have to solve their problems and she does not need to allow herself to be negatively affected by their issues. We can choose what to react to and how much precious energy we want to expend. We do not have to drive ourselves into a tizzy unless there is something at stake that is worthy of our attention, and then we can work through these moments in ways that are helpful, not harmful. A "heartache" can be dangerous, even life-threatening for us. We absolutely must protect ourselves from reactions that can bring about an array of symptoms that can become precursors to disaster. We are fully responsible for managing our dis-ease, which is good news! We have ample motivation to make sense of each troubling situation with simplicity and clarity. There are no guarantees, but it is tempting to tell you that if your thinking is sound, your judgement will be too, and your life will be easier, more pleasant and healthier if you learn to think before you act or react. Lois had allowed herself to become immobilized by the frustration and annoyance inherent in the situation, and it had affected her health. Her stark awareness will be a terrific reference point so that she can choose other ways of handling similar incidents if they occur.
So now I had to ask myself some questions: would seeing clients, writing diligently, going to dinner with special friends, a birthday party for Mom, the routine of seeing the dentist, going to doctors, exercising three days a week enable me to practice what I preach and live what I had not only learned, but was teaching? Questions like these served as markers for my worst moments, red alerts to remind me to empower myself. I was nearing empty and refueling was a necessity. Back to the wisdom of Iyanla Vanzant's quiet pause. Back to the trust in my abilities. Back to the life experiences that prepared me for this one. Forward, using what I call the "movie camera" in our brains. Time to reflect on reasonable, short-term goals. Time to appreciate and luxuriate in the joy of my daughter, the dearness of my mother, the specialness of my friends and family, all earned by my being who I am. Time to enjoy the holidays and the coming of a new year - the millenium, in fact! There were days that getting out of bed in the morning was a chore and sleep a refuge. There were days that dragged on slowly and days that were unproductive. There were thoughts that demonstrated a longing to know my future and conflicting ones that knew better than to take more than a day at a time. If all of this sounds familiar to you, that should not be surprising, but while it is happening it is so difficult to take it all in. Becoming entrenched in a negative mode is a prescription for trouble, limiting the ability to filter and to be open to finding new ways of coping. Rather, you need to remind yourself yet again that you have survived, so you have already come out on top! Your attitude about striving to thrive is where your power resides. You may have been knocked down by your heart attack, but what matters now is getting back up and staying there! You're not on this life journey alone, and you do not have to be totally in control, but you must take charge of managing your life. I have often joked with clients that if challenge builds character, we can readily understand why there are so many characters among us! Expect the hurdles, but don't label every situation a disaster; know that there will be pain and difficulty, but do not react in advance, daunting yourself before you have the opportunity to create an efficient, realistic plan. Become your own top-flight manager, allowing the perhaps unexpected, yet predictably present changes in your life to function as opportunities for furthering your growth. I recently asked the director of a private school for children with learning disabilities what she would like to do differently in her already remarkable school. She told me that she starts every day as though she was about to be replaced by someone else. She then becomes that new person - a new broom, as she phrased it - and she tries to be that new broom every single day, because a new broom always does a better job. She is always open to new ideas and approaches and is an incredible motivating force for both staff and students.
One of the major responsibilities of parenting is to instill in our children the ability to adapt to change, for we know that it is inevitable. We also know that beginnings are created by endings, even unwanted ones. I could not know what the future design of my life would bring, but I certainly knew that I would be the driving force. Why-me and what-if questions are debilitating and unnerving, involving a remarkably useless expenditure of energy, yet leaving us devoid of answers. I had to re-invent parts of myself, mindful of my good skills and abilities as well as my areas of lesser ones. The natural fear of the unknown is based on needing to know the answers to unanswerable questions. In terms of CAD, great advances are being made in the field, so I feel assured that within the next five years and subsequent similar blocks of time, I will benefit from gains in the treatment and management of cardiac patients. I know that closure in the relationship was critical and had to be addressed fully in order for me to move forward without having a chip on my shoulder, let alone, as my mother phrases it, “an entire lumber yard”. Determination and commitment are central in this important task. Remember, too, that behavior is purposive and self-rewarding. It is essential that you reflect on why you act the way you do so that you can choose to eliminate behaviors that limit you. You will have command only if you take note of the consequences of your actions and you will move forward by planning, not wishing, hoping or dreaming. It is a tall order, this life based on deep thought, but I assure you that having been through all you have - and I say this with true empathy - the rewards are going to be extraordinary. One of the ways that I can assess my own progress is by noticing the reduced frequency and duration of the inevitable lows. It may serve you well to keep a diary or a journal as you go along, particularly if you are experimenting with new strategies. It will keep you honest and involved and help you to integrate the new with the old. You already have a core from which you operate, based on your lifelong value system, experiences, desires, needs, expectations, successes and failures. You may need to make adjustments, admissions, acknowledgements. You may actually find that you are closer than you thought to achieving your goals, attending to the meaning of your life and becoming your own patient, realistic manager. It is magically uplifting to see yourself recognize the quality of your life plan as it takes shape. Of course, the path is bound to be bumpy. It is appropriate to demand command of your own life with conviction and boundless determination. Don't cut corners by setting your standards too low. Try to find a balance between striving for great heights and deciding it is too difficult to create a life that can be more than it is right now. Neither settle for nor create an unrealistic scenario that is bound for disaster. Success breeds more of the same and as you and the people around you notice that you are fighting for yourself and are determined to become more, you will flourish.
You may want to ask yourself specific questions, such as:
- Am I managing my financial life appropriately?
- Am I killing time or utilizing and appreciating it?
- Do I need to develop my interests or select gratifying hobbies?
- Am I remembering to see the humor in quirky situations?
If finances are problematic, you have a real battle to wage. In my family we say that money is not a problem -- lack of money is a problem! Again, utilize the knowledge and experience of those you trust or to whom you are recommended. If you neglect this issue, I can promise you that it will ferment, grow and taunt you. Solutions abound and must be sought out.
The issue of time is precious. Having come so far, gained so much, worked so hard, your time is so vast in its value. It is not about "one day down", but rather a matter of reveling in the treasure of using and delighting in every moment of every day.
Perhaps you will come to realize that you always wanted to DO IT! Pottery? Reading? Canoeing? Whatever enters your mind, if you cannot arrange to do it, then read about it, talk about, engage in any possible aspect in it, but do not drift away from it.
Humor is my favorite topic. It is health-giving, life-extending, both immediately gratifying and endlessly referential. Sometimes I feel like Dudley Moore in "Arthur", all by myself and just laughing at my own thoughts. It is a lifesaver and a true necessity, especially in tough situations. Whatever brand of humor appeals to you, whether from a book, a comedic performance, a movie, a joke, use laughter as a lifeline - trite as it may sound, every chuckle is worth a million times more than even the slightest frown.
There is every reason not to set yourself up to believe that everything will always work, just because you are designing your life with more thought. To quote Dr. Phil, “Sometimes you make the right decision and sometimes you have to make the decision right". Keep on track, but remember that the softness of the path you are designing allows for flexibility and once you have taken responsibility for struggling to mold it, then your strength lies in not rigidly clinging to what does not work. It is your life, you are the managing agent and you will be able to figure out what works best for you once you commit to the idea of honing your skills and reaching for your particular star.