Ejo #156 – The Coronavirus Diaries

DAY 0
Monday, 5th December 2022
David and I treated our friend Kayte to a night at a desert resort yesterday, as a present for her 50th birthday. Sadly we could only stay for one night, but we all had an absolute blast.  And yes, we are amazing friends.  When you visit us in Dubai as many times as Kayte has (five!), we might even do the same for you. 😉

The Ritz Carlton Al Wadi Resort in Ras Al Khaimah

After a leisurely buffet breakfast this morning, Kayte indulged in a relaxing massage at the spa while David and I indulged in a naughty skinny dip in our private pool.  Before we knew it though, the fairy tale was over and the three of us piled into David’s car for the 90 minute drive back to reality.  On the way home my throat started feeling scratchy, which I put down to the dry desert air playing havoc.  But as the day has worn on, my throat has started feeling worse, and I just know that I am coming down with something. 

I’m hoping against hope that I don’t wake up tomorrow with the same terrible flu that’s been spreading around Dubai like wildfire lately.  I had lunch with Zimmy last week and she’s been really sick with the flu for several days, so I’m a little worried.  I really can’t afford any more time off work.  I’ve already used up 14 days of sick leave, and any more time off will be docked at half pay.  Don’t judge me, it’s been a bad year for me.  I had influenza in February which laid me up for nearly two weeks, and I broke my ankle in October, so I’ve been quite the sickie this year. 

Kayte’s flying on to Australia tomorrow morning, but David and I have to wake up at an ungodly hour for work, so the three of us said our goodbyes, and went to bed.  As soon as I lay down, I started trembling uncontrollably, despite my skin feeling hot to the touch.  I shivered with a fever well into the night, until David gave me some paracetamol and ibuprofen and I finally drifted off to sleep. 

DAY 1
Tuesday, 6th December 2022
I woke up feeling OK.  Not great, but not fluey, thank god.  I went to work and napped during both of my breaks.  David and I had an early dinner and I’m getting ready for bed now.  It’s early, only 8pm, but I have another 4am wake up tomorrow and I’m just so tired. 

DAY 2
Wednesday, 7th December 2022
I woke up feeling pretty shit and my nose is super blocked, but I slept like the dead last night.  I think I just have a cold.  It doesn’t feel like the flu, so it looks like Zimmy’s off the hook.  I went to work and felt OK at the beginning, but slowly started to deteriorate later in the morning.  When I returned to the tower after taking a quick nap on my break, my colleague Bradwin took one horrified look at me and told me that I should really [his emphasis] go home.  At that moment, I would have loved nothing more in the whole world than to turn around and go home, but I knew that it would be frowned upon if I took another sick day, so I snapped at him that I was fine, and went back to work.  On my next break though, I realised that I wasn’t fine at all and that I was getting a lot worse.  Maybe I have the flu after all.  I told my manager I wasn’t feeling well and he sent me home without docking me sick leave, which I was really grateful for.  When I got home David made me a hot toddy, and I texted Zimmy to let her know that I was feeling ill and that I must have caught the flu from her.  Which is when she dropped the bomb.  She doesn’t have the flu at all. She has covid.  Uh oh.  

I immediately took a rapid antigen test to see if I also have it, and the test very definitively showed a positive result.  Did I already say uh oh?  David quickly arranged for a home PCR test for us, and the doctor arrived a couple of hours later, sticking his swab eye-wateringly deep into our brains.  Ouch.  We have to wait until tomorrow for the results, but during the evening, I have progressively become worse.  My head feels like it’s full of wet cement, and I feel dizzy, almost like I’m hallucinating.  My eyes are burning.  My nose is dripping, but when I blow it nothing comes out.  My mouth is dry.  My throat is scratchy, and my voice has become raspy.  The glands in my neck are swollen, and I don’t feel good at all.  David isn’t feeling great either, but I think he’s slightly better than me.  I really hope he doesn’t have covid.  I hope I don’t have it either. 

DAY 3
Thursday, 8th December 2022
We got our results this morning and we’re both positive.  I kinda feel like I just lost a global game of lethal tag after nearly three years of dodging this damn virus like a ninja.  Hopefully we don’t die! 

Today my brain feels way too heavy for my head, and my head feels too heavy for my neck, so it’s just kind of swaying around a bit, and it feels difficult to keep it upright.  My ears are completely blocked, so everything sounds muffled.  My eyes feel like they’re about to pop out of my head, and are watering non-stop.  My body feels numb, tingling like it’s entered a weird quantum state; a probability vibrating in place, with some kind of foreign, dirty electricity violently coursing through my veins.  So this is what coronavirus feels like. 

There hasn’t been a lot of movement today.  I’ve been sitting on our balcony looking out and not doing much at all.  The coughing is getting worse, triggered by a dry, itchy throat.  A doctor once told me that coughing makes coughing worse, so I’m trying really hard not to cough and to keep my throat lubricated, as I’m prone to chest infections, having suffered chronic bronchitis since my twenties.  Funnily enough, the pandemic was the first time in years I didn’t have my annual bout of bronchitis.  Masks, they work! 

Feeling like wet shit is coming in waves, like a heavy blanket being lifted and dropped on top of me, over and over again.  I’m really tired despite doing nothing, and all I want to do is lie on the couch.  I made an appointment for us to have a teleconference with a doctor to try and get some antiviral medication to help us feel better, but she told us that we didn’t need it and that we should just treat our symptoms.  Oh well.  I haven’t had much of an appetite, but I craved Chinese hot and sour soup for dinner so David ordered some for us and it really hit the spot.

DAY 4
Friday, 9th December 2022
Today I woke up early to watch the sun rise and get some UVA light in my eyes.  I’m planning on taking plenty of naps during the day so I don’t mind getting up at daybreak.  I wasn’t sleeping well anyway.  David tells me I was moaning all night long.  I plead no contest. 

I still feel weird, at once fuzzy and dense.  When I put my feet up, they prickle with pins and needles.  My head is so fucking blocked, all the way from the back of my throat, into my sinuses and up to my ears and eyes.  I feel light headed and tired.  Lethargic.  I’m not having trouble breathing, but the act of breathing feels laborious.  I’m trying to read a book but finding it difficult to concentrate.  We can’t leave the house, but we’re spending a lot of time outside on our balcony getting lots of natural sunlight and fresh air, and I feel like that must be helping. 

It was midday when I noticed that I have lost my sense of smell.  During a brief phase of feeling well enough to get off the couch, I went through the stack of unopened packages that have been piling up near the front door over the last few days.  I unwrapped a white jasmine reed diffuser that I bought for the bathroom and took a whiff to see how it smelled and… nothing.  I’m quite blocked up so I asked David if can smell it and he can.  A couple of hours later, when we were having our lunch, I realised that I could no longer taste anything either.  It truly is such a strange feeling, to be chewing on something that I am very familiar with the taste of, and not be able to taste it.  My brain keeps trying to fill in the gaps, knowing what steak should taste like, but it’s really not the same.  David confessed to accidentally over-salting the meat, but my taste buds were completely oblivious. 

Hmm, I think I’m hallucinating.  I was looking at some NFTs that I bought the other day and one of them seemed to change size, getting bigger on the screen.  I can’t tell if it’s supposed to do that or if I’m just imagining it.  It might only be 8pm, but I think it’s time for me to go to bed. 

DAY 5
Saturday, 10th December 2022
I’m grateful that I don’t feel any worse today, but I don’t feel any better either.  I still don’t have my senses of smell or taste, but I’m not too worried about it.  I’m trying to be patient, and just hope that they return soon.  This is no ordinary virus and I’m one of the lucky ones so far.  My cough does appear to have settled a little deeper in my chest, which is of some concern.  It’s also changed from a dry cough into a productive one.  That’s a polite way of saying that I’m hacking up phlegm. 

David and I are both still really blocked up.  We have trouble hearing each other at the best of times, but now our conversations sound like a comedy sketch, “Huh?”, “Huhh?”, “What?”, “Huh?”, “Did you say something?”  Despite being sick though, there’s nowhere else I’d rather be than with my husband in our beautiful home, locked in and everyone else locked out.  It’s a balmy 26° outside, and we’re chilling on our balcony in the glorious winter sun.  So it’s not all bad. 

My sense of chronology appears to be playing tricks on me.  Time feels slippery, and bouncy.  Things that I remember happening yesterday, apparently happened the day before.  And things I was sure I did only two hours ago, David assures me I actually did yesterday.  It’s very weird, but again, I’m trying not to worry too much about the dreaded “brain fog”, one of the legacy symptoms of covid.  I am in a total fugue state and nothing feels real right now.  I’ll just keep writing it down, and try to make sense of it all later, once the delirium has faded. 

DAY 6
Sunday, 11th December 2022
Today I woke up having turned into a big ol’ ball of phlegm.  Cannot stop coughing up the phlegm.  Cannot stop blowing the phlegm out of my nose. It’s phlegmageddon!!  Last night I had one of the worst headaches of my entire life so I’m grateful that I just have a regular headache this morning.  

I just received an auto-generated clearance letter from the Dubai Health Authority congratulating me on the completion of my mandated isolation, optimistically (and quite absurdly) declaring me asymptomatic and wishing me well in my return to work. Hahaha!

Today’s mood: I lay on the couch at 11.30am, knocked back the cough medicine that David slipped me, and passed out for the next five hours.  I just slept the day away, and still woke up feeling like a zombie.  David’s getting better every day, so I’m hoping tomorrow is the day I start feeling better too.

DAY 7
Monday, 12th December 2022
I did wake up feeling better today, for the first time since getting on the coronavirus rollercoaster.  The phlegm party is over, no more phlegm.  I’ve slept 13 out of the last 19 hours, so I’m well rested.  But I still have no energy.  I do one simple task and then flop for the next two hours.  This is no fun. 

This morning, while flossing my teeth, I was abruptly king-hit in the schnozz by the overwhelming fragrance of jasmine.  Just like that, outta nowhere.  I ran over to the reed diffuser and took a deep sniff of it, but couldn’t smell anything.  So bizarre.  I tried again, but nope, nada.  Had I imagined it?  I didn’t think so; the smell had been so very intense.  A few minutes later, a powerful punch of jasmine once again violated my nose.  I am starting to smell again.  Yay!!!  Taste is still nowhere to be seen, but one of my senses returning to life, albeit intermittently, gives me hope that the other will also soon reawaken. 

DAY 8
Tuesday, 13th December 2022
Overall, I’m feeling better today.  But the phlegm is back.  Where has it been?  Why did it return?  What adventures has it been on?  I’ll never know, but I do know that it’s all up in my shit.  And that it’s brought a friend back with it.  Hello again, sore throat.  My sense of smell is playing more games with me too.  While I was preparing breakfast, the stench of pig shit suddenly filled my nostrils.  It was only fleeting, but as you can imagine it was pretty fucking unsettling.  My sister has warned me of the horrors of parosmia, a common symptom of covid where normal everyday smells are interpreted by the brain as unpleasant, disgusting and even putrid.  Nice, right?  Also, I’m smelling the jasmine all the time now and I’m not even sure I like it. And why does the whole apartment smell of it? Is that the parosmia, or did I just buy a terrible bathroom fragrance? 

I feel gross today.  Dirty almost, as if there’s something toxic and metallic oozing out of the pores of my skin.  My cough has definitely worsened too. When I write about these symptoms, it’s not as black and white as oh, I have a cough.  Or oh, my throat is sore.  All of it is experienced through a thick veil of severe lethargy and fatigue.  Just sitting down and staring into space feels exhausting.  Every bout of coughing results in exhaustion.  Everything is an effort.  That’s what makes this so crap.  The good news is that David is almost completely better. 

DAY 9
Wednesday, 14th December 2022
I feel much, much better this morning so I think I’ll be fine to go back to work in a couple of days.  Today was the first time the veil of darkness hasn’t engulfed me.  I was also able to taste my food today, and while my appetite still isn’t what it used to be, it tasted really good (and was, of course, perfectly seasoned).  I am still coughing, and the cough has become raspy and wheezy, rattling in my chest, but apart from that I mostly feel OK.  Hey kids, this might be the beginning of the end of covid for me.  I’m keeping my fingers crossed that there will be no long-term health issues, and that I recover fully. 

DAY 10
Thursday, 15th December 2022
In a step backwards from yesterday’s progress, I once again feel the veil of fuzziness and lethargy enveloping me like a dark shroud.  What a palaver.  I just had another PCR test.  The person administering the test didn’t want to come inside (fair call, our place is a den of viral contagion) and so I had to submit my nostrils to being swabbed outside, in the corridor.  Oh, the humanity.  I’ll report the result as soon as I get it. 

I’m still being hoofed in the face every time I go to the bathroom.  The smell of jasmine is oppressively cloying and sickly to my newly sensitive sense of smell.  And ever since yesterday, I’ve had a funny taste in my mouth.  Not quite metallic, a little bit plasticky.  I imagine this is what the white jasmine oil would taste like if I drank it. Every damn day, it’s something new with this virus.  And I don’t like it at all. 

I got the test result back at 1.21pm.  Negative. 

PROLOGUE
More than two weeks after testing negative to covid I am almost back to normal.  I did feel tired in the days after returning to work, but not in a covid way, just in a regular shift work kind of way.  I was very gentle with myself and went to bed early every night, waking up early to watch the sunrise and get my hormones back in balance.  There was only one day, about a week ago when I experienced what felt like a relapse.  The cloak of exhaustion absolutely flattened me and I could barely move all day.  It was as though the production of energy in my body had simply shut down.  I was digging deep to find the strength to just get up off the couch, and there was nothing there.  I was empty.  I do think that this episode was triggered by going back to shift work so soon after being sick, but thank goodness it only lasted one day and since then, I’ve been fine. 

One symptom that has lingered, as feared, is this terrible, hacking cough.  I’ve been diagnosed with acute bronchitis, and have just finished a course of antibiotics which has improved it a little bit, but it’s still pretty bad.  Talking exacerbates it, but unfortunately my job requires me to talk to pilots all day long.  That’s what I do.  And so the worst coughing spells are at work.  It’s a horrible, irritatingly dry cough and it’s extraordinarily annoying – for me, and for the people around me.  My colleagues are being so lovely about it, expressing concern and offering me cups of tea and honey to soothe my throat.  But nothing seems to be helping.  I was told by a doctor, and a nurse, that my cough will probably last a couple of months.  Sad face. 

Oh yeah, and it turns out that the jasmine reed diffuser really was a dud. 

Ejo #155 – Let There Be Light

Last month I wrote about the health hazards of shift work, almost all of which are caused by the violence perpetrated against our circadian rhythms when we suffer from disrupted sleep.  Today I’m going to talk about why that matters so much.  Not just for shift workers, but for everyone. 

Over the last 50,000 years, we have driven the progress of our species forward at an alarming rate, transforming ourselves from primitive hunter-gatherers; first into farmers and then ultimately into what we are today (whatever you want to call that).  In most ways this progress has benefited us.  In many others, it has not.  The transition from hunter-gatherer to agronomist was thanks to the agricultural revolution approximately 10,000 years ago which is seen at once, as humankind’s greatest achievement, and our greatest failure.  It set us on the path that we find ourselves on today, by forcing us to settle in one place and allowing us to feed multitudes more of us, but it definitely wasn’t a benefit to our health.  Almost overnight, we went from chasing and eating a predominantly meat based diet, supplemented by tubers and the occasional fruit and berry, to a diet consisting almost entirely of grains.  It is commonly perceived that humans domesticated wheat, but the truer story is that wheat domesticated us.  And in doing so, it made us fatter and shorter, it made us more prone to disease and it significantly lowered our longevity. 

Things have improved, of course, and we now live long lives, full of creature comforts, mod-cons and all the good things that life has to offer.  But for all the progress our civilisation has made, our bodies lag behind, having evolved to survive the conditions that existed on earth 50,000 years ago.  We might be stuffing our faces with avocado toast and scrolling on our phones for hours, but our bodies still think we’re hunter-gatherers, roaming the plains of the Upper Paleolithic era.  All the progress we have made as a species has been truly remarkable, and the life that we’ve created for ourselves is an astonishing achievement, but for our animal bodies this progress has trapped us in a golden cage that is slowly killing us.  We no longer live in nature, and our bodies are paying the price.  To achieve optimal health, we all need to make more of an effort to return to our natural element, to get more fresh air, to move more and to get more sunshine.  This isn’t a new age, airy-fairy aspiration.  It’s a fact, rooted in hard science.  We need sunlight not just to thrive, but to survive. 

In his 1973 book “Health and Light“, which I recently finished reading, Dr. John Ott describes conducting research about how full spectrum light can improve our health, or make us sick if we are exposed to a distorted or incomplete spectrum.  Dr. Ott coined the term mal-illumination, which he compares to malnutrition, and which is caused by our widespread fear of the sun.  We aren’t doing ourselves any favours when we restrict our intake of full spectrum sunlight by shielding our eyes and skin behind sunglasses, tinted windows and sunscreen.  Doing so has created an epidemic of people who are deficient not only in Vitamin D, but in a very crucial, beneficial and life-promoting form of energy.  Sunlight. 

Of course we need to be sensible and not overdo it, because too much shortwave UV light is harmful, and can cause sunburn, premature aging and skin cancer.  But most UV light is long wavelength light.  It’s a nutrient, that nourishes us and gives us energy, and is just as important as the nutrients we consume from food.  In fact, it doesn’t matter how good your diet is, or how much you exercise, if you’re not getting optimal sunlight (infrared light, followed by red light, followed by UVA, and then UVB, in that order) you will never reach peak health.  You will always be operating sub-optimally.  And the scientific world has known that for a long time.  A 1967 study into illumination for health concluded that, “If human skin is not exposed to solar radiation for long periods of time, disturbances occur in the physiological equilibrium of the human system, resulting in functional disorders of the nervous system, vitamin-D deficiency, a weakening of the body’s defences and an aggravation of chronic diseases.” 

Speaking of Vitamin D, why are so many people supplementing with exogenous Vitamin D when all they need to do is go outside for a few minutes each day and commune with the almighty, life-giving sun?  Why are we all so happy to just pop a pill, when the answer to our health problems literally hangs in the sky outside our front doors.  Factors that affect your personal Vitamin D levels include where you live in the world, how old you are, what colour skin you have, how much you weigh, what foods you eat and what other conditions you might be suffering from.  How can all of that be effectively corrected with an over-the-counter course of vitamins created in a factory?  It can’t.  When we go outside and expose our skin to sunlight, the body knows what it needs to do.  It knows how much Vitamin D to produce and it creates the most bio-available form of it.  Two recent studies showed that increased blood levels of supplemental Vitamin D actually caused elderly people to fall over more often, and to suffer more frequent and more severe bone fractures.  And taking Vitamin D supplements has been shown in countless studies to actually increase the overall risk of cancer, and even death.  So stop popping the pills please, and just get out in the sunshine!!!! 

Sunlight isn’t just a requirement for Vitamin D synthesis.  Almost every living organism on earth dances to the beat of a circadian drum.  We all possess biological processes that naturally occur around a 24 hour cycle, usually in response to the position of the sun in the sky.  Humans are no exception to this.  Sunrise and early morning exposure to light kickstart the circadian rhythm into motion, communicating to every single cell in the body, and setting them all up to synchronise their tasks for the day.  This messaging is vitally important and we miss out on it if we don’t get that early morning light in our eyes.  But how many of us are willing to sacrifice that benefit so we can sleep in just one more hour.  Almost everyone has some level of chronically disrupted circadian rhythm, so it’s no wonder that so many of us suffer from constant fatigue, low mood, anxiety, infertility, erectile dysfunction and a plethora of metabolic issues.  And for some reason, we just normalise that.  We just accept that we feel that way.  And that’s not cool.  These symptoms are all treatable, and the prescription is sunlight. 

From daybreak to nightfall, the sun shines its magical and wondrous light on us, bestowing us with life and good health – that is, if we don’t hide ourselves away from it.  Sunshine contains light from the full spectrum; of course visible light, but also infrared, red and ultraviolet light. And all of these wavelengths are transformed by the body into energy which is required for a myriad of biochemical reactions.  The proportion of each of these wavelengths of light changes, depending on what time of day it is.  Infrared and red light is present in all sunlight, but is more concentrated at sunrise and sunset.  Infrared light is soothing, healing and anti-inflammatory.  Ultraviolet light appears sometime within two hours after sunrise, depending on your location.  UVA comes first, when the sun is around 10° above the horizon, followed by UVB some time later.  The Circadian app is a great source of information about what light is present at what time of day in your part of the world.

The Circadian app tells me exactly when UVA rises and sets in Dubai.

Receiving indirect UVA sunlight into our eyes comes with an abundance of perks, so for maximum benefits make sure to take off spectacles, sunglasses and contact lenses, but please don’t look directly at the sun, mmmkay. Morning UVA actually prepares our bodies to receive the stronger UVB light later in the day.  Clever, right?  It’s almost as if we were designed to be outside in the sun.  UVA is also the precursor to the release of thyroid hormones that are needed to regulate our metabolism, energy levels and weight, as well as hair, nail and skin growth.  And it also releases a beautiful rush of feel-good hormones like serotonin (which makes us feel happy), dopamine (which makes us motivated and curious), norepinephrine (which focusses concentration) and beta endorphins (which give us a runner’s high and makes us lust after sunlight even more).  These are the same hormones that get people hooked on drugs, alcohol, gambling and other problematic behaviour.  The only difference is that when you’re addicted to morning sunlight, you’re getting high on life.  Literally! 

Sunlight is the trigger for so many biological processes, and we receive that signal not just in our eyes, but also through our skin.  The skin is an amazing self-regulating organ which not only protects our insides from spilling out, but also allows us to experience touch and changes in temperature.  It quietly and efficiently battles the harsh external world, ensuring that our body remains in homeostasis on the inside, despite what might be happening on the outside.  It does this by facilitating constant two way communication between itself and the immune, endocrine and central nervous systems.  Our skin is a beautiful, complex and elegantly designed system, which has evolved over millennia to absorb UV light for beneficial metabolic and biochemical reactions. 

One surprising benefit of exposing our skin to UVB light is an increase in the sex hormones oestrogen and testosterone (both of which are present in men and women), resulting in a natural increase in libido.  And who couldn’t use a little pick-me-up in that department?!  In his very informative, and fascinating, podcast about the health benefits of light Dr. Andrew Huberman suggests a protocol designed to boost reproductive health and libido.  All you have to do is expose as much skin as you (decently) can to the midday sun for about 20-30 minutes a day, two to three times a week.  This protocol is based on studies conducted on humans that showed not only a significant blood serum increase in oestrogen and testosterone, but a psychological increase in perceived attractiveness of others as well as an increased desire to have sex.  I mean, c’mon, if that sounds as good to you as it does to me, let’s get on out there in the sunshine people.  Testosterone levels in men have been declining for years. This is a beautiful way to remedy that. Following this protocol takes about a month to start feeling more randy, so what are we waiting for?  Let’s go get it.

UVB doesn’t just make us horny.  It’s the magic ingredient for producing that essential, endogenous Vitamin D we were talking about earlier.  And when our eyes and skin are exposed to it, it also increases our pain tolerance, and boosts our mood and energy levels throughout the day, and I don’t know how you can put a price on that. 

I recently broke my ankle and was stuck at home for three weeks doing ATC office work.  It was the perfect time to start a morning sunlight protocol, as I wasn’t doing shift work, and I was able to stick to a consistent schedule.  My routine is extremely simple, but provides outsized benefits.  Every morning, I get up and go outside to watch the sun rise, staying outside for about twenty minutes.  Even three or four minutes is enough to get some benefit, but I like to stay out there for longer.  I gaze up at the brightest part of the sky, while avoiding looking directly at the sun (obvs).  After twenty minutes, I go inside to prepare and eat a high protein snack, before stepping back out and spending another twenty minutes exposing my naked eyes to the light, just as the UVA wavelengths begin to emerge. 

Catching the early morning rays from my balcony.

I’m not gonna lie, when I first started my routine, getting up so early in the morning was hard.  It was really hard.  Like, so, so hard.  But after just three days, I actually started looking forward to waking up before dawn.  I crave it now.  I love being up when most people are still in bed.  I love listening to the birds singing in the trees, feeling the cool sea breeze on my skin and witnessing the creation of each new day.  It’s a truly beautiful experience and a wonderful way to start the morning, setting me up to be healthier and happier all day long.  Getting UVA actually makes me feel hopeful, happy and full of love.  It washes over me like a warm blanket, giving me a wonderful feeling of wellbeing, and I finish each session with a huge smile on my face.  I feel so fucking good from making this tiny change to my routine.  The vast improvement in my mood, mental health and energy levels absolutely makes it worth getting up so early every day.  Going back to shift work has unfortunately made it slightly more difficult to be consistent in my routine, but I still make an effort to get early morning sunlight in my eyes, every single day, even after working a night shift.  Sunlight is the cure, and I’m out there every day, religiously taking my dose of medicine as if my quality of my life depended on it. Because it does. 

So we’ve talked about what we need to do during the day to improve our health, and now it’s time to discuss what happens at night.  We learned that UVB is great during the day, but it probably won’t surprise you to learn that it’s not so great after dark. 

We’ve all heard of melatonin, right?  It’s well known for helping us fall asleep, but it also has several other functions in the body, both regulative and protective.  These include stem cell production to make our bones stronger, the regulation of cardiovascular function and activation of the immune system.  Physiological melatonin has also been shown to have a very dynamic anti-oxidant effect, and even some anti-cancer properties to boot.  Contrary to popular opinion though, this doesn’t mean that we should all run out and start taking supplemental melatonin.  Far from it.  The anti-cancer properties occur with the natural rise and fall of the hormone.  Taking supplemental melatonin for long periods of time, can severely reduce adrenal output resulting in the suppression of cortisol and epinephrine, which may be known as stress hormones, but which are actually required by the body in order to function properly.  Supplemental melatonin tends to be an unnaturally fixed, and usually extremely high dose of the hormone, and taking it at the same time every night drastically differs from the way in which melatonin is naturally released by the body, gently rising and falling according to the time of day and the seasons. 

So, what is melatonin, and how does it work?  It’s a hormone secreted by the pineal gland, which is found in the centre of the brain.  The excretion of melatonin from the pineal gland is dependent on what time of day or night it is, and is actually governed by light.  Bright light turns off the production of melatonin, and darkness prompts it to be secreted.  The pea-sized pineal gland, however, is located very deep in the brain, so how on earth could it possibly know what time of day it is in order to regulate the production and release of melatonin?  I’m glad you asked.  There is a fancy-pants cell in our eyes called the intrinsically photosensitive ganglion, also known as the melanopsin cell, which is responsible for absorbing sunlight, and escorting the signal through a series of messaging posts in the brain until it reaches it’s destination, the pineal gland.  Morning sunlight in the eyes is the catalyst that signals to the pineal gland that it’s time to gently reduce the release of melatonin, while at the same time triggering production of it for later that night.  Yes, paradoxically we need sunlight to produce the hormone that will help us sleep. 

Melatonin also communicates information to our bodies about how much light is in our environment, and therefore what time of the day it is and also what time of the year it is, which is just remarkable.  The environment around us, i.e. light, changes the environment within us, all thanks to the super-hormone melatonin.  Which is why we should be vigilant about getting more sunlight, as well as making an effort to avoid artificial light at night. 

Of course, in this (marvellous) modern day and age, it’s difficult to avoid artificial light after dark.  It sure would be awesome if we could all have open fireplaces, and homes lit with romantic candlelight.  And I can guarantee you that we’d all sleep a hell of a lot better if we did.  But unfortunately, that’s probably not going to happen.  So we need to focus on what we can do.  If you have dimmers, turn the lights all the way down at night.  If you don’t have dimmers, try lower wattage (or lower lumen) light bulbs.  A really important thing you can also do is stop watching TV and scrolling on your phone about an hour before bed.  So many people are in the habit of falling asleep while looking at their phones.  This is the absolute worst thing you can do for the quality of your sleep.  Sure, it might help you drop off, but you definitely aren’t going to have a restful sleep.  So give your eyes a break from all that blue light.  Let the melatonin do it’s thing.  These small changes in our environment can make a huge difference to sleep quality.  

Knowing that light has such a severely inhibitory effect on melatonin should serve as a warning about exposing our eyes to bright lights at night.  Even something that might seem as inconsequential as turning on the light to go the toilet in the middle of the night, immediately causes your lovely, sleepy-beepy, high levels of melatonin to crash to near zero.  The artificial light immediately shuts down melatonin release.  Chk! Chk! Boom!  And then of course you’ll have trouble getting back to sleep.  Melatonin naturally begins to rise early in the evening in preparation for bedtime, but it continues to increase as we sleep, well into the night.  So if you habitually get up in the middle of the night to go to the toilet, and turn on the lights every time you do, your melatonin signalling is going to be up shit creek, aka chronically disrupted.  You’ll have issues, not just with falling asleep every night, and being tired all the time, but with all the other things that melatonin regulates and protects in the body, that I mentioned earlier. You’ll forget what it feels like to feel your best.  Most of us have already forgotten. 

Even just one night sleeping in a moderately lit room has been shown to increase your sleeping heart rate, decrease heart rate variability, overstimulate the sympathetic nervous system and increase waking insulin resistance.  All very bad things.  A good guide is, if you can see your hand 30cm in front of your face while you’re in bed with the lights out, your room is too bright, and I’m sorry but you are not going to get a good night’s sleep.  David and I live in the middle of a big city.  When I’m in bed with the lights out at night, I can actually read a book by the external ambient light coming in through our floor to ceiling windows.  Even when we’re sleeping with our eyes closed, ambient light penetrates our eyelids and makes its way through our grey matter to the pineal glad, where we know it causes sleep damage.  Having this occur regularly is very harmful because sleep is supposed to be the time when the body and brain regenerate, and heal.  A lot of stuff goes on when we’re sleeping – our body temperature drops, our breathing, heart rate and blood pressure lower, our brains sort through all the information it received that day, removing what isn’t needed, our immune system kicks in to repair the body, and the brain stem temporarily paralyses our muscles.  And of course, the beautiful symphony orchestra that is our hormonal cascade has free rein to work it’s magic as we sleep. 

It seems, these days, that almost everyone is tired, all of the time.  So perhaps more of us would benefit from being more mindful of our bedroom’s light hygiene at bedtime, and ensuring we sleep in as dark a room as possible.  If installing blackout blinds or curtains isn’t practical, consider sleeping with an eye mask.  Eye masks have come a long way, and there is now a multitude of designs, so finding one that is comfortable for your face and sleeping style should be easy.  David and I recently started using them at night and it’s been an absolute game changer for me.  Actually, it’s much bigger than that.  Along with my morning light routine, it’s been life changing, and I’m not even joking.  I’m sleeping better than I have in my entire life, and waking up feeling more rested, despite working shifts.  I honestly cannot rave enough about it, because the transformation in the quality of my sleep has been simply extraordinary.  I always had this dumb kind of boastful pride about being able to sleep without curtains on our windows after a night shift, with the bright sun just streaming in.  And for many years I did myself a disservice because of that.  I feel like a bit of an idiot for waiting so long to try wearing an eyemask to bed.  But I’m well and truly on the bandwagon now, and I’d really recommend it to everyone to at least try it out and see how they feel in the morning. 

Disrupting sleep with light pollution does more than just make us tired.  It makes us ill.  It makes us ache and feel low and unmotivated.  It makes us fat, depressed and prematurely old.  It makes all of us function less than optimally.  And it doesn’t have to be that way.  But the wonderful thing about it is that you don’t have to take a pill to feel better.  You just have to go outside and let the sun shine down on you. 

Ejo #154 – ATC 101: Shift Work (aka Fatigue)

I’ve been an air traffic controller for over 22 years.   It’s part of who I am now.  And a big part of being a controller is the crazy shift work hours.  But what exactly is shift work, anyway?  It’s basically anything that requires people to work outside of regular office hours.  Restaurants, hospitals, nightclubs, fast food joints, bodegas and milk bars, call centres, media outlets, retail shops, security and airports all run by the grace of those of us who sacrifice normal lives to work shifts.  We’re a weird bunch, that’s for sure.  But I wouldn’t have it any other way.  I absolutely love shift work, and wouldn’t go back to an office job with office hours in a million years.  I love having time off when everyone else is at work, and I really love being at work on the weekends, when the desk jockeys of the world flock to the beaches, the shops, the cinemas, and all the cafes, bars and restaurants.  Have at it normies!!  Fill your boots. I’ll be eating out next Tuesday!

So yes, I do love shift work, but I don’t want to sugarcoat it.  It’s pretty hard yakka.  Regular people work some variation of nine to five, Monday to Friday, with weekends off, right? We don’t get weekends off. Or public holidays.  What’s Christmas, what’s New Year’s Eve, what’s Easter, what’s Melbourne Cup day?  Also, what’s Saturday, and what the fuck is Sunday?  I do not recognise any of these days.  They are meaningless to me.  For I am shift worker.  Honestly, I never have any idea what day of the week it is.  Occupational hazard, I guess.  Our work week is six and a half days long, and we are rewarded for that toil with three and a half days off.  Your cycle is seven days.  Ours is ten.  And it looks a little something like this.

Rinse and repeat.

The truth, however, is that even though this is the “standard” work cycle for ATCs in Dubai, our rosters are a lot more fluid, and a lot less predictable (we usually find out what shifts we’ve been rostered to work for a given month about half way through the previous one). I very rarely work the prescribed cycle of two mornings, two afternoons and two nights.  I wish I did, I would love that kind of stability.  But unfortunately due to staff shortages, training, annual leave, sick leave and controllers being seconded to the office, the roster is usually all over the place.

 

On the left, the standard roster template for 2018. On the right, the actual 2018 roster. Oh Mr. Hart, what a mess.

So, how does a typical work cycle actually play out?  Let’s start with morning shifts.  We are required to be at work by 0545 for a 0600 start (I’ll be using 24 hour time in this post, as per aviation convention), but I do like to get to work a little earlier to let the night shift zombies go home.  So, for me to be at work by, say, 0530 I need to leap out of bed at 0400.  I actually like to snooze my alarm for about 45 minutes before I actually get up (yes, I’m a weirdo).  This means that my first (of many) alarms goes off at the ungodly hour of 0315. 

Sleepy beepy!

The philosophy behind the myriad alarms is that my everyday alarm tone is a very soothing harpsichord sound, designed to gently rouse me from my slumber.  At 0315 in the morning, however, this doesn’t always do the trick.  The choice of alarms is progressively more likely to penetrate my repose. To that effect, the duck tone alarm is quite annoying.  The bark tone alarm is extremely irritating.  And the Leanne alarm (the back-up alarm of last resort) is actually my telephone ringtone which is the sound I would hear if I did accidentally sleep in and my watch manager was calling me to see where the fuck I was.  It instils enough fear and panic to wake me up no matter how sleepy I might be.  Committing the cardinal sin of sleeping in for a morning shift is a really horrible feeling.  Not only are you late for work, but there’s someone in the tower who has worked an eight hour night shift waiting for you to come and relieve them so that they can go home.  And they’re not allowed to leave until you actually get there.  I’ve only slept in for a morning shift once, and let me tell you it’s a very discombobulating situation. 

Another reason for the plethora of alarms is that it’s virtually impossible to get a good night’s sleep before that first morning shift.  I spend all night tossing and turning, subconsciously worrying that I’ll sleep in, inducing anxiety, which (of course) prevents a good sleep.  It’s a vicious circle.  Plus the only way to get eight hours in bed before my alarm goes off is to retire at 1915 the night before.  Which is impossible.  I always harbour well-meaning intentions of going to bed super early before my morning shifts, but usually turn the lights out sometime between 2100 and 2200 giving me about five or six hours of downtime. Not only do I usually wake up tired for the shift, but the entire cycle is off to a terrible start.  Welcome to shift work world. 

So I get up at 0400 and I get ready for work.  My routine at this time of day is so well rehearsed, it’s as smooth as Swiss clockwork.  Everything is done on autopilot.  David and I dance around each other like a beautifully choreographed ballet.  I don’t rush around like a crazy person, but every minute counts and there isn’t a lot of room for unforeseen variables.  The last couple of years I’ve also had to factor in an extra five minutes sprawled on the couch for the inevitable early morning hot flush episode that has become a stalwart component of my routine.  Menopause is fun! 

I’m usually out the door by 0450 and get to the tower by 0530 to take over position.  Depending on how many controllers are rostered for the morning, I might rotate through two hours in position, followed by a two hour break for the eight hour shift, or I might work two hours in position with a one hour break.  The maximum number of hours I can legally work is two and a half, after which I’m required to have at least a thirty minute rest period.  These rules are set by the General Civil Aviation Authority (GCAA), which is the regulatory body for aviation in the UAE.  And they lay down a lot of other rules regarding shift work in the tower, which I’ll talk more about later.  At the end of my shift, I’ll usually leave the tower some time between 1330 and 1400 and reach home by 1500 at the latest.  Those of you who read my previous ejo know that this is the ideal time for a coffee nap, and I almost always have one after a morning shift. 

Afternoons are my least favourite shifts.  The whole day is kind of fucked for getting anything done.  We usually get up around 0830 which isn’t super late, but it’s still an extra four and a half hours sleep than the previous two days so it feels like a real luxury, and actually plays a large part in our sleep debt recovery.  We have a little over four hours to get shit done before leaving for work.  Shit includes going for a walk followed by a yoga session, showering and washing my hair, reading my emails, playing Wordle, responding to messages, cooking and eating lunch (which is usually a delicious, juicy steak) and then doing the dishes, and also preparing something to snack on at work later that evening.  It can be a bit hectic to be honest.  I normally get to the tower at around 1330, send the morning shift on their merry way, and settle in for the next eight hours.  Maybe it’s because the shift straddles the transition from day to night, but afternoon shifts just seem to drag on and on and on.  They’re boring as hell and by the time I get home at around 2300 it’s way too late to do anything.

Morning shifts used to be my favourite because I’d get the whole afternoon off, but lately I’m starting to really feel the exhaustion of having to wake up so goddamn early.  Let’s not mince words, I’m an old lady now.  My new favourite shifts are night shifts.  Sure it’s tiring having to stay up all night, but when there are only two of us rostered, we work a great schedule that gives each of us a two and a half hour break in the middle, so that we can both have a good rest.  This means that I have the entire tower to myself for a couple of hours at a time while my colleague naps.  It’s me time, baby. I play a little background music, I eat a little midnight snack, I talk to some pilots in my night shift voice, I plan holidays, I water the tower plants, I do some squats and I work on my ejos.  I actually have a really good time.  David doesn’t have it so lucky.  Night shifts at DXB are usually the busiest shift of the day, so while I’m dancing around my tower, David’s working his ass off in his. 

Despite me having it relatively easy on the night shifts, I still have to be awake and alert at an hour when most people are fast asleep.  By the time David and I get home at 7am after a night shift, we are both pretty fucking knackered.  We’ll have a quick shower and go to bed for a few hours, and get up just before midday.  It’s definitely not enough rest, but sleeping into the PM messes with my circadian rhythms too much. Everyone deals with night shifts differently and a lot of the local guys sleep until the late afternoon following a night shift, but there’s no way I could do that. I subscribe to the jet lag school of thought, sticking as close as possible to my regular schedule, even though it’s exhausting, and even though it means I need a little extra time to recover. At least I’m not completely screwing up my sleep/wake routine. David and I tend to take it very easy in between night shifts, rarely scheduling social engagements or appointments that would require us to leave the house.  We lay low and make sure to squeeze in a 20 minute coffee nap sometime during the afternoon.  It ain’t a lot, but it definitely helps.  And later that evening, we lock up the house, get in our cars and set off in opposite directions to our respective airports to do it all again. 

The day after our second night shift is called a sleep day, or a rest day, for obvious reasons.  It isn’t actually considered a day off (since we’ve worked the first six hours of it), but it’s not considered a full work day either (since the shift started the previous day).  When I was a younger woman, I secretly did think of sleep days as a day off.  Oh, the impertinence of youth.  These days it truly is a day of rest, and it generally takes me the whole day to recover from having worked the cycle. 

Fatigue caused by shift work is a massive concern in the aviation industry, and there are very strict rules about the hours that air traffic controllers can work.  I already mentioned that we need to take a break every two and a half hours, but there are many other rules governing our rostering principles.  For instance, a controller can only work a maximum of ten hours in a single shift.  And we must have a minimum of ten hours between shifts.  We can’t be rostered to work more than three night shifts in any rolling ten day period.  And if we’re rostered to work seven days in a row, we must have a minimum break of two and a half days (or 60 hours) before coming back to work.  And there are lots of other restrictions that get a little technical, things like “Within 720 consecutive hours (30 days) the aggregate of duty periods and standby duties shall not exceed 300 hours, provided that duty periods do not exceed 200 hours.”  Blah blah blah.  At the end of the day the rules are there to protect us, the controllers.  But they’re also there to protect the unit.  And our employer.  And the airlines.  And the pilots. And the flying public.  Fatigue is no joke. It causes errors in judgement, and that’s something air traffic controllers simply can’t afford.

Working a reverse rotating shift cycle (starting with early mornings and progressing through to night shifts) is supposed to be the least fatiguing roster, and I actually prefer it to the forward rotating cycle that we used to work in Melbourne tower (which started in the evenings and progressed through to morning shifts).  But at the end of the day, fatigue wins.  It always wins, and it’s impossible to avoid. All we can do is mitigate it, but it will always be a huge issue in air traffic control.  As I mentioned earlier, I need to be functional while doing a relatively complex job at a time of night when all my body wants to do is curl up and go to sleep.  And that takes a toll.  Shift workers are notoriously prone to a cornucopia of health problems including heart disease, obesity, high blood pressure, reproductive issues, ulcers, diabetes, depression, low testosterone, insomnia and stroke.  In fact working shifts is so bad for your health it even has a disorder named after it.  Yay? 

As a bonus, we are also way more susceptible to death.  In a very large, famous, longitudinal study, The Nurse’s Health Study, researchers followed 74,862 nurses over a period of 22 years and concluded that the nurses who worked rotating shifts for more than 15 years were 38% more likely to die from heart disease, 25% more likely to die from lung cancer and 33% more likely to die from colon cancer than their counterparts who worked day shifts only.  Sobering.  In fact it’s so unhealthy that in 2007 the World Health Organisation declared that shift work was a probable carcinogenic.

So how does shift work wreak such havoc in the body?  It’s all to do with circadian disruption.  Having to be wide awake at 0200 isn’t just a pain in the ass, it also throws a spanner in the body’s finely tuned chemistry, creating hormonal chaos and laying waste to our biological homeostasis.  This is such an interesting and expansive topic that I’ll be writing about it in my next ejo, so keep an eye out for that.  In the meantime, all you need to know is that my highly paid job is almost definitely killing me. 

But I do not want your sympathy.  Absolutely not.  Fuck that noise.  I’ve made a choice to stick to this beautiful career, and despite its pitfalls I feel absolutely #blessed.  If you go back and have another look at that 2018 roster, zoom in and check out all those greyed out dates.  Those are holidays, bitches.  In January we went to one of our favourite destinations, Japan, spending time in the ski fields of Nagano, as well as drinking our body weight in sake in bustling downtown Tokyo.  In February we took a short four day trip to Sri Lanka during our days off for David’s birthday.  In mid-April we travelled back home to Australia to see family and friends.  And five days later we jetted off to France for a couple of weeks, attending a close friend’s wedding in the French countryside.  In June/July we spent two and a half glorious weeks in Amsterdam, introducing my youngest sister, Pieta, to our favourite city.  And in mid-August we were lucky enough to be able to travel to America for six days to go to the wedding of another close friend.  When we got home we had enough time to do some laundry before heading straight back out again three days later, visiting Sicily for the very first time.  We obviously loved it because we went back in October, this time with my sister Mary in tow.  So yeah, while my job is basically murdering me, at least I’m having fun with the time I’ve got left.

So now you know what it’s like to be a shift worker.  Or rather, now you have an inkling of what it’s like to be a shift worker.  If you dare, I challenge you to simulate just one of my night shifts and see how it really feels.  One Saturday morning, just get up at your normal time and go about your day.  Remember to have a coffee nap (or maybe an even better idea might be to have a proper, long nap), and then at 2050, get in your car and drive around for 45 minutes.  Come back into the house and start working on something.  Maybe you have some office work to do, maybe a hobby.  But you’re not allowed to watch TV or use your phone (coz we’re not allowed to either).  At 2330 you’re on a break for two and a half hours.  I suggest trying to sleep.  But don’t forget to set an alarm (or four) to make sure you are up and ready to take over again at 0200.  This is the tough part.  It’s usually quiet on the night shifts, but sometimes you wake up from your nap and you have to hit the ground running.  You can’t afford to give in to your sleep urges.  Feel free to have a coffee if you think it’ll help.  I no longer drink coffee on the night shifts (in fact I only have it for coffee naps), but I’ll often have a little snack right around this time for some energy.  A boiled egg or a few strips of bacon.  But you do whatever you need to do to stay awake.  And don’t forget to work.  You’re in position until 0430.  You can’t slack off. And you can’t fall asleep.  So keep working.  Naps on the job will get you fired.  Or, worst case scenario, kill people.  At 0430 your imaginary partner takes over and you can chill for a while, but you can’t go home yet.  Not until the morning crew arrives to relieve you from your duties.  You can have another little nap while you wait, but at 0600 you need to get up, get in your car and drive around for another 45 minutes.  When you finally get home on Sunday morning, you’re done.  Congratulations, you’re an honorary shift worker.  How do you feel?  Now do it again.  And repeat every ten days for the next twenty years.  Bet you can’t.

So, think of us… next time you have a late night pizza delivered, next time you need to go to the hospital in the wee hours of the morning, or have to call an Uber to take you home after a big night out. Think of us when you need to call a locksmith, or have to catch an obscenely early flight.  Think of us, the weirdos, the shift workers.  While you’re sleeping, we keep the world turning. It’s tough work, but someone’s got to do it.