Category Archives: Health

When your esthetician actually compliments your skin

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Since about 2013, I’ve been getting a facial about once a year to treat myself. There have been some anomalies where I’ve gotten two facials in a year, but that was either because I got a second one because of President’s Club at my last company, or because some friends wanted to have a spa day together. Then in 2024, I got referred to a skin clinic in Midtown Manhattan by a friend, and I really liked the esthetician who worked with me. Since then, I’ve committed to about two-ish facials per year, plus a few laser treatments since in my middle age, I’ve discovered a little hidden body dysmorphia (I have a great track record for being slow to almost everything…). In this entire time, I’ve pretty much never gotten any compliments on my skin other than that I’ve always looked young for my age. (I will note that when I went to my first and only dermatologist appointment back in October, the doctor said my “skin looks great!” But alas, she said this in the context of moles and potential skin cancer, so take that with a grain of salt). Other than that, most previous estheticians have told me that I have “very congested” skin, or a congested nose (I mean, I do have Asian genes, so this tracks). And in the last few years, I’ve been told that my oily skin has morphed into “combination skin,” meaning that I am dry in some parts but oily in others. So, this has been a lot of fun!

So yesterday, I went in for a facial with my now-regular esthetician. And after the full facial treatment, she took a few photos for me and compared these to when I first started seeing her in mid-2024. And she said to me, “Yvonne, your skin is looking so good! It’s so much brighter than it was before. Just look at these before vs. now photos. Have you been doing something different to your skin lately?”

Well, yes. I started an Australian 20 percent azelaic acid cream every morning since the end of December. And then I started 0.025 percent Tretinoin two days after my birthday in January for about four days per week, so I guess I have been doing a lot that is more intense and different for my skin than before. So maybe this is what is making it “brighter?” I have no idea. I look at my face every single day and probably scrutinize it more than I should, but if she didn’t show me the photos, I likely would have thought my skin was never going to do any better than it did in 2024.

It does feel good when an objective other person can share with you that something about you is improving for the better, though. I hope my skin health keeps up!

The high protein life

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One of my friends who has an insulin resistance recently gifted me three boxes of bean-based dry pasta: they are chickpea, edamame (soybean!), and black bean based. She told me that given her health condition, she actually doesn’t have any regular (wheat) pasta at home, so this is all she has when she says she eats pasta at home. I tried the edamame spaghetti and used it for this oven roasted tomato sauce I’d made about a month ago and defrosted. Chris tried the pasta before I did, so I asked him what he thought.

“The sauce is very good,” Chris said to me.

“Okay,” I started, “But what about the pasta?”

He narrowed his eyes at me. “The sauce is very good.”

Okay, so he hated the pasta. Then he eventually elaborated, saying that the edamame pasta was clearly not going to fool anyone who knew what “the real thing” tasted like. He said it felt like he was “eating for the sake of eating.”

Then, I tried the pasta with my homemade sauce, and I understood what he meant. It just didn’t have that nice mouthfeel and texture that durum wheat-based pasta has. Plus the texture was very questionable. I cooked it al dente according to the box cooking time, and this pasta… just felt like a lighter form of leather.

But I’m still going to keep going with this, and I will most definitely use and cook the two remaining bean based pastas. Today, I tried the tofu bread rolls I made from Hetty Lui McKinnon’s Linger cookbook. These tofu bread rolls are made with zero dairy or eggs: the majority of the dough is just silken tofu and bread flour for high gluten development (i.e. extra, extra fluffiness and lift). And while the texture and fluffiness were very good, I think it may have needed some extra sugar to be more of a standard dinner roll-type bread. I couldn’t imagine eating this bread plain on its own; it definitely either needed a high quality, salted butter, or a fruity jam.

So, this is the high protein life I am exploring. It’s an interesting one, and I am definitely learning a lot about how the foods we know can evolve!

All relationships are work

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The Oxford English dictionary defines work as, “activity involving mental or physical effort done in order to achieve a purpose or result.” If you know the strict definition of work, I think most would agree that all relationships are work. It doesn’t matter if it’s the relationship you have with your spouse, child, mother, friend, or colleague: all require a certain level of effort in order to sustain the relationship — at least, in some semi healthy way.

Chris and I just hit our 10-year wedding anniversary last month. His parents sent well wishes on our family Whatsapp group. Then his brother wished us a happy anniversary, also saying, “Good work on reaching 10 years of marriage!”

I looked at his message and smirked. “Thanks!” I responded back. “Ummm, yes. It is most definitely work!”

I told my friend, who is uncoupled, that we had reached our 10-year wedding anniversary and had been together for over 14 years now. She was flabbergasted.

“Shit, I don’t know how you do it!” she said to me after wishing us a happy anniversary. “How can you stand someone for that long, constantly in your space and not doing things the way you want them done?”

This friend knows I am anal-retentive with cleaning. She knows I like everything done in a very certain way in the kitchen. She also knows that I have very strong opinions. And on top of all that, she’s met Chris a number of times now and has had the chance to speak with him a decent amount, so she said she could already imagine how ridiculous and intense our disagreements and arguments would be.

I always wanted to get married. Ever since I learned what marriage was, I wanted to get married and live “happily ever after.” But I don’t think Disney fairy tales or the example of what “marriage” is supposed to be like based on my parents’ relationship were ever the best examples that set me up for success. I’ve spent decades reading psychology and sociology articles and studies, and took a number of classes on these topics. Hell, I even took a sociology course on sociology of marriage and family in college. And when I did therapy two different periods of my life, I spent a good amount of time talking about my relationships with my parents, friends, and Chris, and what I want and do not want to be or become. All of this has been really hard work and required a lot of thinking and introspection. Sometimes, getting to a state of self-awareness can be quite painful. Yet despite all that hard work, I still mess up and do and say stupid things I don’t really mean to say or do in the way it comes out. It’s like every day, I am trying to break out of inherited intergenerational trauma and redefine what I want to be in my relationships with Chris and others I love. I guess everyone is a little bit like that: we only know what we know — until we try to break unhealthy cycles — again, assuming we have a certain level of self awareness, or someone helps point it out to us.

But the work we put into relationships with those we love most is important. It’s probably the most important work of your life. It’s hard for me to imagine a life without those who are closest to me who I love the most. Frankly, I don’t want to be my dad in that sense: I don’t want to be a total loner with zero friends. I also don’t want to be in a marriage where I feel emotionally estranged from my spouse. So while many reject close friendships or serious romantic partnerships, I guess at the end of the day, I am still a romantic and want all these things to be a part of my daily reality.

So, the work continues.

A sore left hip flexor, and when cortisol spikes in middle age due to slowing metabolism

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I only did one run this week on Wednesday, which isn’t normal for my weekly workout routine. I did my usual warm up, then as soon as the run was done, I could tell my left hip flexor was tight. Then annoyingly, it remained tight all day… through today. I’ve never had a tightness in my left hip flexor before. After weaning from breastfeeding and doing more high intensity runs back in 2023, I discovered tightness on the right side for the first time in my life. The amazing trainer at my gym gave me suggestions for strengthening exercises for my glutes, hamstrings, and hip flexor to prevent the tightness. In addition, I did more hip flexor stretches and incorporated a yoga session per week to increase mobility. That seemed to do the trick: I cannot remember the last time my right hip flexor was sore. But now, it seems my left hip flexor is crying out for help, asking, “Hey! Remember me! You need to help me, too!” Those exercises I did for my right side were also done on my left side, too. So this may just be a new weakness I’ve identified that may need to be addressed in a slightly different way.

Aging is a gift. Not everyone is lucky enough to see their next birthday, to live up to the age you or I am at. And I’ve embraced it with more confidence every year. But I will be honest: identifying these new changes in my body and trying to figure out how to troubleshoot them have not been very fun. I am extremely active, exercise far more than the average person does, and try to take care of myself the best I can to ensure optimal health and fitness. But finding out about all these new physiological shifts of midlife, such as declining estrogen that slow metabolism, is challenging. Just a few years ago, if I knew I needed to burn some extra fat, I would just do a harder, more intense run and for longer. I’d do barre or pilates fusion until it burned. And it always worked then. This isn’t the case anymore, and it isn’t that simple where I am now. I’ve already been going hard for the last few months since coming back from Australia and the Philippines, and I’ve only lost about 3-4 pounds out of the eight I wanted to lose. The extra belly fat is just stuck there and doesn’t want to leave. No one else would notice it other than me, though. Running more intensely is NOT producing fat loss because it doesn’t address this age-related shifts that slow metabolism. Plus at this age, steady-state running can even spike cortisol levels, signaling that the body needs to protect itself and guard the fat more, especially in the abdominal area. I guess that’s why I have a little more pudge around my lower waist than I did pre-weaning.

I guess I will need to embrace brisk incline walks a couple times a week now, in place of 2-3x week runs. I will see if it results in any change because I have a feeling my cortisol must be spiking. I suppose this is the right attitude: test and learn, test and shift when things don’t work! These are the new things I am learning to live with — the fact that I cannot control all the changes happening to my body as easily as I did before.

Transitional weather conundrum: what am I supposed to wear?

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The weather has been pretty wonky here in New York the last couple weeks. This last week, it’s been so cold that even after doing a thorough wash of our down-like winter coats to (originally) put away until next winter, I actually had to take them out again for Kaia and me. Kaia wore hers twice this week, and I wore mine once! It’s April, and we still need to turn the heat on at home…

So today, it was actually supposed to hit low 60s F in the city. Kaia wore a light jacket to school. I wouldn’t leave the house until the afternoon to meet my friend, and I had no idea what I wanted to wear. Because I tend to run cold, I put on a sweater, plus a medium-weight coat on top of it. I walked outside for two blocks and already felt too hot, so I took off my scarf.

Everyone who is into fashion always goes gaga for “transitional” seasons like spring and autumn. These people love their autumn or spring jackets, their cute tops and skirts, and count down the days when they can put together these nice outfits. I, on the other hand, am not at all a fashionista, truly dislike both of those seasons for dressing myself. I never have any idea what to wear, how to layer things. And since I run cold, I tend to overdress, which then means I will need to shed layers, which then means I will need to either carry said layers or stuff them in a bag. And that is so annoying to me. It’s even more annoying now that I have a preschooler, who always insists I carry her crap, as well!

I met my friend for tea today. After she hugged me, she looked me up and down, then back down and up. Then she said, “Are you a bit warm in this?”

Sometimes, I wish I could just go outside wearing a big warm brown paper bag and call it a day. That would be so much simpler.

Sluggish two days later

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On Friday night when we had dinner and a comedy show with friends, our friends got to the restaurant early enough for Happy Hour, so they ordered a bunch of items off the Happy Hour menu, including two orders of Korean fried chicken that came with two buckets of beer, for a total of ten beers. I figured they would get a single order of fried chicken with the beers, but I didn’t realize they would get two buckets. I had asked my friend to order me a specific Happy Hour cocktail without realizing they got so many beers. And because I hate waste, I felt bad leaving so many beers behind. So I decided that on top of my cocktail, I would have a beer… and then I opened a second beer and probably had a quarter to half of it. During dinner and the show, i felt completely fine. I did not turn red (no, I don’t get Asian glow). I felt sober and clear-headed.

That was until the next morning, when I woke up feeling sluggish in the mind and body. I wasn’t in pain, and I did not have that “hung over” feeling. It wasn’t like I couldn’t think straight, but I definitely did not feel good or refreshed in the slightest bit. I just felt… off. I could still follow conversations, do my usual tasks, and even did some yoga that morning. But “off” is the only word I can use to fully describe how I felt. And if that was not enough, today, which is two days later, I still don’t feel right. It’s like a foggy brain without being fully foggy, if that makes any sense at all. My motivation to do anything productive is extremely low. And given it was threatening to rain and did rain today, we ended up staying indoors all Sunday. I made one dish, and that was it.

I wonder if I would still feel this way if I didn’t actually know I was 40. I feel like because I know I am in my 40s now that I’m feeling more of these “your metabolism is slowing” feelings. As I read, your metabolism doesn’t just fall off a cliff at 40; that’s not really how metabolism works. It slows gradually over your late 20s, 30s, 40s, and 50s. Regardless, this wasn’t a great feeling, especially as I’ve actively cut back on alcohol in the new year. And I don’t think I can drink that much anymore — for my mental clarity, but also for my general fitness goals.

Group fitness classes after nine years

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While I was staying at the Omni Grove Park Inn and Spa in Asheville, I made sure to exercise the first two mornings I was there. One of the perks of this fitness complex is that it offers group fitness classes, which I haven’t taken at all since 2017, when we moved into our current building with a gym facility. The classes are folded into the “resort fee” we pay to stay at the hotel. The fitness complex is so big and extensive that it actually allows for external, non-hotel guests to pay for membership, so many of the people who go to this fitness center are actually not hotel guests. I signed up for a 90-minute flow yoga class and a 60-minute body sculpt class.

Since they are group fitness classes, they are meant to match the fitness levels of everyone, so both were a lot slower moving than I am used to. Plus, I could see from the clientele that most skewed much older than me. Most of the people in the classes looked like retirees. At minimum, there was a ten-year age gap, with them being older. Although it was slower, it was luxurious in yoga class to hold poses for longer. It also felt nice to have a group to sweat with again. There’s definitely an energy you get when you exercise with others that doesn’t always exist when you are exercising solo.

A few of the members came up to introduce themselves after the body sculpt class on Friday. They asked if I was a guest at the inn (of course, it was pretty obvious that I wasn’t a local since everyone else was White and at least 10-20+ years older than me!). Many of them lived within a 5-10 minute drive from the inn/fitness complex, and they had moved from areas like the Tri-State area and California. They were looking to slow down, have a more relaxed life, and not deal with as much daily traffic.

“The traffic has definitely picked up here in Asheville since more people have discovered it and are moving here,” one of the transplants said to me. “But when people complain that there’s a lot of traffic, that usually means their commute has increased from 9 minutes to 12!”

Even if I couldn’t work out and sweat with my friends, it felt good to change it up and sweat with some very friendly retirees during these classes!

Khmeli suneli

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One benefit of being on the east side for my mammogram appointment earlier this week was that I had an excuse to go to Kalustyan’s, a popular spice shop on Lexington in the east 20s. I took the 6 train down to 28th Street, along the route I was already planning to take to pick up Kaia from school later that afternoon. While there, I forgot how overwhelming all the different global spices can be. It’s two floors of spices, sauces, and treats from around the world! My goal was to pick up khmeli suneli, the Georgian spice blend I learned about during my Georgian cooking class last month. The earthy and fragrant flavor would absolutely be needed if I wanted to make any Georgian dishes in the near future. The spices that are included are usually blue fenugreek (not the same as Indian fenugreek!), coriander, marigold, savory, dill, amongst others. The blend I picked up, the only version Kalustyan’s had for khmeli suneli, had about 12 different spices in it. Since I was already there, I did some more browsing and also got a little packet of salted kombu, which I was inspired to get from a recent Japanese restaurant we ate at.

My first use for khmeli suneli would be Georgian eggplant rolls with walnut paste, or nigvziani badrijani. The walnut paste is made with toasted, ground walnuts, khmeli suneli, lots of garlic, vinegar, salt, and pepper. Then, you take long, wide strips of roasted eggplant, add the walnut paste in, and then roll them up. They’re usually topped with pomegranate, as well, for a finishing touch. The interesting thing about this paste is that there’s no oil in it; it all comes together by combining hot water. The hot water makes all the ingredients come together, and it also does an added (or included) step of “cooking” the spices. I guess that’s the water way of “blooming” spices the way you do with Indian spices and oil. I love this technique! It’s so interesting how different cultures came up with their techniques for cooking and coaxing out as much flavor as possible from the ingredients they have. It comes together really quickly, and the only other thing you have to do is slice and roast the eggplants!

I’ve got 60 grams of khmeli suneli to use, so I definitely will be finding more ways to use it in the near future!

Mammogram – a first time experience

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After the annoying ordeal with the front desk worker regarding health insurance and coverage yesterday, I was at least relieved that all the lab technicians who worked with me for my mammogram and breast ultrasound were very polite, friendly, and professional. While I’d had the experience of breast ultrasound twice before (my first one being in 2013, annoyingly), I’d never had a mammogram before. A mammogram usually takes anywhere from 10-30 minutes and is essentially a low-dose x-ray procedure where a technologist uses this massive machine that is ceiling high to compress each breast between two plates to capture clear, detailed images, from both top and side angles of your breast. It wasn’t anything like what I was expecting; I thought I was going to be put into a CAT scan type machine (not sure where this idea came from, but this is how I envisioned it!). You stand the entire time. The technician angles your body, chest, and breasts into the right positions, then asks you to hold your breath for about five seconds for each angle so they can get the right snapshots. Oh, and the other fun (not really) part: they apply these small patterned band-aids on your nipples, each with a tiny little metal bead where the tip of your nipple is!

The technician during the mammogram was very empathetic and caring. She kept asking me throughout if I felt okay, if I was dizzy, or if I needed a moment. I felt fine; I just wasn’t used to having my breasts squeezed in every which way by a massive machine! The breast ultrasound procedure was what I expected it to be based on prior experiences: you lie down on a table while they squeeze jelly all over your breasts, then they run the ultrasound machine all over your breasts and under your arms to get every possible view inside.

At the end, they told me that it would take about three business days to upload my images to my portal; then, either they or my doctor would call me with any results that needed follow-up. If everything looked fine, I should expect to not get contacted. So, it sounded pretty straightforward and normal.

All I have to say is: I hope both breasts are doing just fine. They both got me through fourteen months of breastfeeding, so I think they did a pretty good job!

The stupidity of American healthcare strikes once again

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When I made my mammogram appointment over a month ago, the provider I was referred to by my OB-GYN had an online portal that had you fill out the usual paperwork in advance online, so I was able to do things like upload my driver’s license, front and back of my insurance card, and fill out any personal and family history ahead of time. What it also did was give me an estimate of what my out of pocket cost would be at the time of appointment check-in. This was a rude awakening: it said based on my health insurance that my out of pocket cost should be around $350 for a mammogram and breast ultrasound.

None of this sounded right. Mammograms are standard and covered by pretty much every health insurance for women over 40. Breast ultrasounds are covered in New York state (and apparently… not in Kansas, where a friend of mine lives, and where she had to pay $300 PER breast out of pocket). I called my health insurance, who confirmed to me what I suspected: I should have zero out of pocket costs, no co-pays, for either procedure. They gave me a reference number to give to the provider. I then called the provider, gave them the reference number, but they said they could not tell me the cost until I came into the office, which seemed not only completely inefficient, but just plain stupid. “If you ask me to pay for this out of pocket when I come in, I will decline the procedure and walk out,” I said sternly to them over the phone. “I am asking if you can correct this ahead of time so we don’t waste your time or mine?”

The person on the phone seemed totally unfazed, like she didn’t care (and frankly, probably wasn’t paid enough to care). She told me there was no way to confirm until the day of the appointment when I came in (which seems false the way health insurance works, but whatever). So she told me to just come in, and she doubted I’d have to pay anything out of pocket.

Well, I came in this afternoon, and lo and behold, that same $350 amount showed up as what I owed at the time of service. I insisted to the receptionist I wasn’t paying it. I gave them the reference number once again, and she made a flippant response: “Breast ultrasounds are not typically covered, but okay, we’ll call your insurance.” Her associate called my insurance. Twenty minutes later, they confirmed that I was correct, that I did not owe them any payment… but, I would be required to pay $20 copay for the breast ultrasound.

“Copay – is just for the breast ultrasound?” I said to her, still skeptical. I made a mental note, planning to call my insurance to contest even this amount after I paid it because this still goes against what my health insurance stated to me on the phone, which I wrote down with the reference number.

“Yes, that’s what I said,” the front desk person said, clearly annoyed with me. I’m not sure what her problem was — it wasn’t like she was getting the money. Their office was the one who screwed up, not me.

I paid the copay, then had both the mammogram and breast ultrasound done. I walked out of the office much later than I estimated I would, so the whole experience was pretty frustrating, especially since I tried to prevent foreseeable problems way in advance, which this office obviously thwarted. But this is just one of many stupid, frustrating and senseless examples in my personal experiences of why our healthcare system in the U.S. is so fucked — an example of what not to be. I also made a note to ask my OB-GYN for another radiology provider because I definitely do not want to go back here at all ever, ever again.