This is Not the Article I Expected to Write: On Grief, Stress, Sleep and Immune

But it’s the one I needed to write; by the end you’ll understand why

🎧 Listen

Bruticus Maximus. Resting in love. Forever at peace. Copyright Helena Fowler.

This piece is unexpected for me. I sat down to write about hot flashes, heart health and the role of sleep. See, it’s American Heart Month, and the impacts of heart disease affects women disproportionately, but it’s not a well-known fact. And, now, with removal of content of what feels like anything that’s non-male-gender-specific (aka, anything about women, LGBTQIA+, and anything that has a whiff of a term I’ve come to dread hearing: ”woke”), women practitioners, like me, who stand for women’s health—which goes far beyond reproductive and “bikini” medicine— should be doubling-down on our efforts to continue to have conversations about silent killers like heart disease.

But, that’s not what came out when I sat down to write. Instead, I found myself writing about grief, stress, sleep and the immune system. And, if you bear with me, I’ll explain why—albeit, in a rather circuitous way.

I’ve been thinking about sleep a lot lately. Like I said, bear with me. I’ve been thinking about sleep a lot lately, because 1) it’s been in short supply and 2) it’s my secret gatekeeper to one of the key things that determines the state of my health: my immune system.

When I don’t get enough sleep, I feel quite literally hungover. Without ever having consumed a drop of alcohol. If I have several consecutive days of severe lack of sleep, my immune system takes a hit, and I’ll start feeling a tiny bit of a sore throat, maybe an ear ache. The fatigue will be unreal. That sore throat is like the early warning alarm—the opening salvo—of my body saying: Shit’s about to get real, if you don’t get some rest.

It is the PEAK of cold, flu, RSV, and COVID season. Not the time to play Russian roulette with my immune system. I’ve been particularly proud of the fact that I’ve used all the tools in my health and wellness tool box over the Fall and Winter seasons to sidestep getting sick—even when my husband has been sick multiple times. Even after a high-stress October with back-to-back travel into November, and then the holidays, and my husband traveling and bringing back all the goodies of travel bugs.

Buuuuut. Out of nowhere. With no warning (which has never happened to me, btw). I went from the hint of a sore throat to full on snot-fest (technical term) in 20 minutes, which then turned into the worst head cold I’ve had in a really long time. The brain fog was unreal. I don’t remember having experienced brain fog with a head cold before. Took me down for a solid week. I could tell my body was teetering at the edge of something worse. The intermittent body aches. The roller coaster of improvement and then a haha-just-kidding-let’s-actually-get-worse vibe. It didn’t show any real signs of improvement until I actually got some rest. And not just physical rest, but cognitive rest, as well. I mean, the brain fog got so bad at one point, there was no other option but to just rest (or, in my case zone out on 90s sitcoms), because I couldn’t concentrate, read, comprehend, or create any meaningful cognitive output.

And that is THE WORST. I’m a high-achieving woman who is actively building several businesses simultaneously, I don’t have time for this shit. I don’t have time to be sick. To be taken down by mucus. Let alone to the point that I can’t coherently put two thoughts together.

Except. I was. And with wisdom (aka learnings from previous burnout) that I’ve acquired over the years, I knew I wasn’t going to side-step it through sheer force of will, alone. No, I knew rest was what every sign and signal in my body was telling me was needed.

So I took the time. I started to feel better. Then, came re-entry. Getting back TO IT. I took it slow. Took a dance class (from home), being careful not to push it. Kept the healing foods and supplements going. And then … you guessed it. Then came one of my biggest traps: “I’ll just do this [small thing]”, which invariably isn’t a small thing. Left me feeling drained. Got some sleep, got back on track. Next two days, I drained what little cognitive power I had regained AND allowed myself to become sleep deprived, again. What do you know? There’s that hint of a sore throat.

This isn’t about just avoiding a relapse of a cold. And I’ll address why in a moment.

But, first, some additional context about my life.

I’ve been in a semi-sleep-deprived state for some time partially due to trying to grow three businesses simultaneously, partially due to not respecting and enforcing my own boundaries when I full well have the opportunity, partially due to a lot of change happening all at once, and in large part because our boy dog and our cat routinely keep us up.

My husband and I are not people who equate their animal companions to children. But they’re certainly more than just pets. At times it’s unfathomable that they are even just dogs or cats— these four-legged, otherworldly beings that gift us with so much … certainly “dog” or “cat” is simply inadequate. I choose “animal companion” to describe them because they offer me companionship that is as meaningful, and quite often, more meaningful than the human connections in my life, and I have some pretty great humans in my life. My husband and I are childless (by choice), and our two senior dogs and one senior cat are some of the biggest sources of joy and love in our lives. And I 1,000% want to spend more time with them, than most people.

Our cat, Misha, is a sassy and opinionated soon-to-be 19-year old who has been there, done that and wants to tell you ALL about it. Usually while we’re trying to sleep. She yells a lot. Sometimes all night. Often, while standing on the bed (or standing on us) or in the hallway where the acoustics amplify her operatic overtures.

At her age, she has an IBD and, as of six months ago, is in kidney failure, though her labs have all come back saying she is “fine.” She does not have kitty dementia, poor hearing or eye sight, or any of the other common causes for cats yelling throughout the night … believe me, we’ve had her checked. Also believe me when I say we have tried evvvveerrrrrything to get her to stop. While some of her yelling is undoubtedly attributed to discomfort, the vast majority is simply because she wants attention (or because she’s a jerk, probably both). And because we’re sleeping, we’re not giving it to her. Love me, she says. But on her terms, of course. Some nights are better than others: not all are bereft of sleep.

Our 11-year old boy dog, Bruticus Maximus, has some health issues. Six months ago, we were told there was a high likelihood he has a brain tumor along with a potential spinal injury. Having had a previous dog that passed due to a brain tumor, we weren’t entirely convinced (and given it's been six months without the traditional presentation, we’re still not convinced … what we are, though, is grateful for the extra time).

What it really comes down to, symptom-wise, is failing eyesight, neurological-based weakness in his hindlegs (that had been masquerading as arthritis), and fecal incontinence … poor kid tries to make it to the door but his body just isn’t giving him the cues soon enough to 1) recognize the need and 2) to get outside to go (it was legit a source of embarrassment for him the first half dozen times it happened). He also has this uncanny ability to grow fatty tumors and skin tags all over (we’ve had so many removed over the years) … he’s a grower, our Bruti boy.

Bruti’s way of dealing with stress is to freeze. Always has been. He doesn’t fight or flee, he just becomes an immovable object. Hunkering down (we have that in common, he and I). And occasionally pacing. Usually at night. When his eyesight would cause him distress (soft lighting helped alleviate much of that). The fecal incontinence … well, when he got up, you never knew if it was to pace or if there was something that would need to be cleaned up—I mean, the smell would alert you eventually. But, if we could help him get to the door and go outside, we would do our best to make it happen (he would make it maybe 15% of the time). That meant getting up at least twice a night. Eventually we established a rhythm.

Unfortunately, this week, things have escalated to the point where we will likely have to make a very hard decision in the near future (we’re talking days, here). Those issues are both physically and emotionally draining for him and us—he’s 85 lbs (like half of that is his big giant noggin) and his back legs have all but failed. There’s some movement he simply can’t do without our physical help. He’s in obvious pain and discomfort. And, as I type, we are waiting to go to an appointment to go see the vet to see if it’s as bad as we suspect.

To say I feel stress … well, that’s putting it mildly.

No panic, spiral or freaking out, that’s not really me in this type of situation. No, the falling apart lies in wait for the silent moments, not the moments that require action. During one such moment yesterday, I got him snuggled on the couch (his happiest place on earth), and I just sat there with him. In the quiet of the living room. No devices. No visual stimulation. Being present to him with the backdrop of Jon Batiste’s Beethoven Blues, creating a calming in both of us, as the sun started to make its slow descent inviting the inevitable dark.

Aaaand that’s when it started to hit. The grief. Looking around and seeing and feeling the hurt, the loss, the unnatural quiet that will come from his absence. Seeing the future empty spot where his food and water bowl are currently; the future awkwardness of only seeing a single crate in the bedroom (was the room always that big/small?); all of his favorite pillows that Cleo, our girl dog, can’t be bothered with. Reflecting on 9 years of memories.

I realized I was grieving him … while he’s still right there, alive, next to me. Mourning the loss of him, before he’s left. No longer being present to him and soaking in and enjoying every moment of him in his ALIVE form. We shouldn’t grieve for what has not come to pass; yet, I found myself silently weeping over the void, the absence I could already feel coming. Void. As if that word could accurately describe it; there isn’t a void in my heart; there isn’t an empty space in my heart … it’s filled to the brim, overwhelmed with loss and sadness. And it hasn’t even happened, yet.

This isn’t the first time I’ve circled these feelings of pre-grief for Bruti and have had to snap myself back to the present. But this time … this was the most visceral.

I’ve learned over the years not to be an emotion-denier. I’m not always super-great at it … what I’m super great at is compartmentalizing. But that also makes it really easy to push aside the BIG FEELS to deal with them “later” and, often, that later never comes. Sometimes that’s fine. Sometimes it’s to the detriment of Future Me and the festering wound that lies dormant waiting for just the right time to erupt. No, this time, I let the emotions (and the tears) flow. I did not, however, dwell on them. I did not wallow. I let them come, and then I let them go.

Why does all of this even matter for the context of this article?

For two reasons:

1) It’s how I came to think SO much about sleep and the role it plays. Sleep can be that super-hero that helps to keep all of your life together and functioning even when allllll the other shit is falling apart. It’s when your body does most of its healing and the only time you have things like memory consolidation happening. It’s both preventative and an important part of healing when ill or injured. And, yet, we’re so cavalier with it. So willing to toss it out the window (sometimes out of necessity), declare it unimportant or something we can do when we’re old or dead. And for me personally, it is THE gatekeeper of my immune system.

2). Stress + illness = an easy path to an autoimmune disease. And, that, my friends, is not a stop I want to add on my life journey. When our immune system is already working at max capacity, or close to it, and then we add stress on top of it … especially stress like grief, which is both acute from a stressful event and chronic from the lasting ripples, it makes it a lot easier for our immune system to become confused and start targeting our body’s own cells. I’ve had many clients who have developed an autoimmune disease/condition after a period of illness combined with a stressful event. I can walk through these mechanisms and the causation/correlation aspects in another article.

I don’t have a list of foods or practices for you today. No clear arc and conclusion to this story. Just a reminder: Be kind to yourself, friends.

Don’t underestimate the role that simple things, like a good night’s sleep, nutritious foods, and a walk outside can do for you.

I don’t know what Bruti’s fate will be.

At the time of this writing, we are 30 minutes away from his vet appointment. The not knowing—the uncertainty—is simply just the worst sometimes.

But one positive thing has come out of this awful head cold and stressful time, and that is reminding me how important sleep really is. It’s so powerful yet so underrated … and it shouldn’t be that way.

So, what do I do when I see a problem or concern and want to share a solution? I create a program; I raise awareness with the platforms that I have. I did it for Heart Month and heart health with my free self-paced program Heart Wise: Nutrition + Cooking for Heart Health. And now I’m doing it for sleep: I’m launching Sleep. Well. The 10-Day Sleep Reset in the month of March.

I know it’s rarely as simple as problem-solution. No, there’s too much context, nuance, and life that adds layers of complexity. But, I guess programs, education and guidance are my ways of offering something—putting something—out there that I hope will help, because we need YOU high-performing, high-achieving women. We need you to drive change. We need you to not be over-burdened by stress Every. Single. Day., so you can continue to step into the world and make collective strides toward solving the biggest problems we face in humanity, so you can continue saving lives, so you can continue contextualizing life through art … so you can continue shining a light. We need you sharp. Bringing your A game. And you can’t do that if you’re sleep deprived. Or taken down by silent killers like chronic stress, heart disease and cancer.

---

ADDENDUM

My heart breaks in writing this last bit. We took Bruti to his vet appointment, and, unfortunately, we were not able to bring him back with us. We had to say goodbye to our dear Bruti Boy. He was severe enough that even bringing him home to say goodbye in the comfort of his space (he absolutely hated the vet) would have been potentially incredibly painful and dangerous for him and selfish on our part. I feel like I got the wind knocked out of me. And that moment where your body and brain try to play catch up while it gasps for air is stretching for eons.

Nothing feels right. That “pre-grief” seems laughable compared to what I’m experiencing now.