Monthly Archives: September 2019

Best of the West: Best Towns West of Denver

1. Red Lodge, Montana. Red Lodge is a little town at the foot of the Absaroka-Beartooth Wilderness. It’s about an hour outside of Billings. The town is small, with a population of 2,200, and so charming. It’s Main Street is a throwback, but at the same time has loads of little adorable stores and restaurants. Red Lodge also has one of my favorite restaurants of our travels- Mas Taco. I could literally eat it every lday. It’s so delicious and addicting. What I like most about Red Lodge is that it hasn’t gotten too commercialized and elitist. Many of the towns we visited are incredibly expensive and prohibitive for regular people to live there. You can still buy a house in Red Lodge for a reasonable amount, and the groceries, food, and gas are all fairly priced (for being out in the middle of nowhere like it is). We are always able to rent affordable houses (via vrbo) right off the Main Street, so we can walk everywhere, which is my favorite! The people in Red Lodge are also amazingly friendly. We loved walking up and down Main Street with our dogs and stopping and chatting to people or letting them pet the dogs. Of course, the wilderness surrounding the town is some of my favorite in the whole country. Much for the same reason I love the town, it’s still not widely known about and there are some of the most beautiful trails and scenery around- including the most scenic drive in America, the Beartooth Highway. The ski area for Red Lodge is not very big or nice, which is a reason it hasn’t grown overly much. I only hope Red Lodge stays like it is and doesn’t expand and become unaffordable like so many other tourist towns. For now, I’m glad I’ve gotten to go there multiple times and experience its charms.

2. Crested Butte, Colorado. Well, talk about elitist towns. Crested Butte is a actually smaller in population than Red Lodge, which surprised me (population 1600). It is a very expensive town, with houses starting at at 400,000 for a 1 bed, 1 bath. Because of all the big money in town, it is really nice. Main Street is beautiful. It’s painted bright colors and absolutely adorable. It also has a lot of amenities like a huge new recreation and arts center and fancy schools. We stayed in a very charming small cabin right off the main drag, and again the walkability is amazing. It even has multiple trailheads right in the town, which is a huge bonus that we took advantage of. Now, everything is very expensive here, and it does not have a nice grocery store (which I found surprising, they need to build one!). The wilderness around Crested Butte was hands down the most beautiful that we encountered anywhere. The mountains, valleys, wildflowers are all stunning. They are also easily accessible, within a half hour of town. It’s also very close to the famed Maroon Bells- we will be back to visit that area, as it was inaccessible due to an avalanche this year. The ski resort is right outside town, and there are a lot of condos there. There is currently a bit of a battle going on with the city council to build affordable housing so the people who work at the ski resort and restaurants and shops can have somewhere to live. Fave restaurant there so far: Bonez. This town should definitely be on your bucket list, check out my upcoming hiking lists for the best hikes!

3. Moab, Utah. Just a few short years ago, Moab would have been at the top of this list. It is such a funky, weird, cool little town in the desert. This year we’ve gone there twice, and what we’ve noticed is that it has changed enormously in the 2 years since we were last there. It’s a bigger town, population 5,200, but I cannot believe how much it has expanded. Everywhere you look there is a new hotel or condo development. I have never see anywhere in the country grow this quickly. To be honest, it kind of sucks. I loved when Moab was a sleepy little town with hippie vibes- now it’s just so crowded and getting more and more expensive. I think the way to have the best experience in Moab is to go in the winter when it won’t be crowded, that will give you the feel for how it used to be. Of course Moab has the national parks, and one of our utmost favorite parks- Deadhorse, but it also has the La Sal mountains. These mountains are just 30 minutes outside town and rarely frequented by tourists, so we found the solitude we wanted there. There’s also a lot of BLM land that’s less crowded than the parks, which is good for us and the dogs. Strangely, I don’t have a must have favorite restaurant here- there are a lot of good places but I haven’t found one I’m obsessed with. Do get the Quesadilla Mobilla, it’s a cool food truck. Moab also doesn’t have a lot of single family houses for rent in the downtown area, so we usually stay a few minutes outside of town. That is fine, and we have a beautiful house we stay in there, but I miss the walkability of being off Main Street. There’s just something about Moab though, every time I drive in and see the river, canyons, and red rocks, my heart feels immediately happy and full.

4. Sedona, Arizona. Somehow the first time I went to Sedona was this year. I had heard a lot of good things about it, but it was always further south than easily fit into our travel routes. Verdict: I freaking love it. Yes, it’s expensive and very touristy, and bigger- population 10,300. But my goodness, the red rocks. The red rocks are mesmerizingly beautiful. Just like Moab, they hypnotize you with their immense beauty. We stayed at a very funky little cabin off the canyon road, and were in a little secluded Narnia land which included free roaming peacocks. I mean, what’s not to love. Sedona is somewhere we are going to need to go back to in the off season and spend at least a week there. It has a plethora of amazing restaurants, shops, and hilarious hippy crystal and vortex establishments (fave restaurant so far: 89 Agave Cantina).

5. Bend, Oregon. Oh, Bend. I went to Bend to interview for a job at a family medicine clinic, and immediately fell in love. It was winter and it was freezing rain the entire time I was there- and it didn’t dampen the trip one bit. Bend’s downtown is super cute and, being in Oregon, very hipstery. Yes, again, it’s super expensive, population 97,000, but it does not feel that big! It has a very small town feel. Bend also has Mt. Bachelor which is a huge, huge ski area, and where we plan to do a good amount of skiing this winter. And it is right on the Deschutes River, by Three Sisters Wilderness, and an hour from the very cool Smith Rock state park. I just love the vibe of Bend, and look forward to spending more time there since it’s a pretty short drive for us now!

6. Mammoth Lakes, California. An isolated town in the Eastern Sierras- the most beautiful, rugged wilderness in the lower 48, population 5,200. How many books have been written about the Sierras, Yosemite, and the Muir Wilderness? The dream is to one day hike the John Muir trail, but for now Mammoth has countless trails for all levels of fitness just 5 minutes from town. Also a huge ski area, which was open till Mid-August (!!!) this year thanks to the huge snowpack. It doesn’t have a concentrated Main Street area, it’s more spread out, so it’s not as charming as other towns.

7. Winter Park, Colorado. My brother lives just up the road from here, in Fraser. Winter Park is another typical ski town, but it has its charm. It’s main strip is very hopping and has great restaurants and bars (Volario’s for the win). Population is 30,800, but it feels smaller. It has a cool outdoor venue for music, and they get some pretty good acts for being so small. Really I just consider Winter Park and Fraser to be one town, they just flow into one another. Winter Park’s skiing is awesome, with some incredible views from the top of the mountain. There’s also a lot of hiking, and it’s very close to RMNP, which is nice. It’s starting to get more and more crowded as Denver people come up, so that’s a bummer! Best bartender and margaritas at the Ditch!!

8. Tahoe City, California. I specifically like the north side of Tahoe, on the California side because it’s less crowded and it doesn’t have all the awful casinos. It’s a small town population 1,557, but it has a cute downtown that’s very walkable if you stay close to it. It’s also very close to some of the major ski resorts, which is a huge plus.

9. Ashland, Oregon. This one’s just 20 minutes from our new home! I had never heard of Ashland (or Medford) until I found a posting for a job at the regional hospital. Ashland is home to a huge Shakespeare festival, and so it is brimming with culture and arts. It’s Main Street is lovely, and Lithia Park, besides not allowing dogs, is incredible. There are also a bunch of trails starting from the city, and it has a ski resort as well. It’s small- and right now is probably above my current skills, but I’ll get to those black diamonds with time. It has a university as well, so it has that college town feel. I think I’m really going to love this town, and getting to know it more.

10. Jackson Hole, Wyoming. This one was tough. The downtown area is super cool, charming, and has lots of neat stuff. It is also extremely touristy and the most expensive place we visited. Like so expensive we couldn’t afford to stay there and had to stay over the pass in Idaho. It has two ski areas, loads to do, including a ton of art galleries. We saw a celebrity here (Scott Conant from Chopped) and it is known as a celeb hot spot. It is just too big and has too much traffic for me to feel totally at home there, but surely worth a good visit!

11. Kanab, Utah. This is a town that reminds me of how Moab used to be. Small, quiet, kinda funky. It had the Best Friends Animal Sanctuary right outside town, and they do amazing work. Close to Grand Canyon and Zion, so it’s a good jumping off point.

12. Ouray, Colorado. “The Switzerland of America” is a charming small town in a beautiful mountain valley. It has a ton of trails starting just from Main Street. That said- Main Street is lacking really good restaurants and just didn’t have that special something. And there are way too may RV parks all around, packed like tin cans! More beautiful from a distance than up close.

13. Florence, Oregon. We only stopped here for a night but it’s historic downtown on the waterfront was so charming. Reminded me of Wilmington, NC back east. Worth a stop if you are in the area.

Best of the West: Scenic Drives

I had a lot of time to think and write on this trip (while my wonderful hubby drove), and I’ve compiled a few “best of” lists. The first is scenic drives. There haven’t been many scenic byways we have passed up on this trip because it really just is always 100% better to take the scenic route.

This is our 25 favorite drives, west of Denver. Some of these are remote scenic byways, and some are major interstates, but they each have magnificent views. I should note that these are all legitimate, paved roads. A great amount of our time spent driving scenic roads is on dirt, rocky, rut-filled forest roads or even “off-road” trails. That is it’s own separate experience, and takes a bit of know how. These drives are accessible and for everyone.

1. Beartooth Highway 212, Wyoming and Montana. (Pictured above). This is hands down, the most beautiful drive you will ever take. Make the trip, go out of the way, just do it! I recommend driving from the bottom up, starting in Red Lodge, MT; it’s a cooler experience.

2. Zion National Park via East Entrance to Visitor Center

3. Yosemite National Park via Tunnel View and the Loop around the Valley Floor

4. Trail Ridge Road, Rocky Mountain National Park

5. Going to the Sun Road, Glacier National Park

6. Upper Colorado River Scenic Byway 12, Moab, Utah

7. Highway 89A Flagstaff to Sedona, Arizona

8. Newton B. Drury Scenic Parkway, California

9. Redwood Highway 199, California and Oregon

10. Million Dollar Highway, San Juan Range, Colorado

11. Highway 14 eastern entrance of Yellowstone National Park to Highway 191 all the way through Grand Teton National Park

12. Highway 163 Arizona, through Monument Valley

13. State Highway 135 St. Regis to Paradise, Montana following the Clark Fork River

14. Dead Indian Memorial Road (I know, the name is awful!) from Klamath Falls to Ashland Oregon

15. Black Canyon of the Gunnison, South Rim Road

16. California Routes 88 to 89 going to South Lake Tahoe

17. Pacific Coast Highway 101

18. US Highway 160 in Colorado over Wolf Creek Pass

19. Historic Columbia River Highway, Oregon

20. State Byway 44 through Badlands NP, South Dakota

21. Shoshoni Wyoming to Thermopolis Wyoming, State Highway 20

22. Colorado State Highway 125 through Willow Creek Pass

23. Highway 395 Eastern Sierras, California

24. Interstate 70 through central Colorado

25. Interstate 90 from St. Regis Montana to Coeur d’Alene Idaho

Traditional and Alternative Therapies For Anxiety and Depression, My Personal Experiences

I’ve written about my personal experiences with anxiety, panic disorder, and depression. I have had some form of anxiety since my teenage years, and intermittent bouts of depression. I have largely tried to ignore this as much as possible, and to power through on my own. I college, during a time of deep depression brought on by a breakup, I ventured to the student health center, but chickened out and left before getting help. As a medical student I went as far as going to cognitive behavioral therapy with psychiatrist, who gave me a Zoloft prescription I never took. In residency, in the wake of a serious injury, I lay around for days, weeks, even months without doing anything. I didn’t leave the house. I sought help from my mentor and our residency psychologist, but soon was lying and telling them I was fine when I was anything but.

Then last year, I had what I’ll call a breakdown. That may be a negative term, but it’s exactly how I felt, like I was breaking down. Like I was some old rusty piece of equipment that wouldn’t work, that instead just took up space and caused annoyance. Suffering from anxiety and panic attacks, plagued by chronic pain and daily migraines, I finally sought help and followed up. At first I went to the ER. If you were to look in my chart you would see the classic signs of someone having physical symptoms of anxiety. Several trips for migraines, neck pain, and even for passing out. I understood empirically what was really happening, that I needed to treat my anxiety, but I continued to think I could just will my body into feeling better. The day I passed out at work in front of my colleagues was the day I knew I had to get real. I continued to seek help separately for my migraines and neck pain, but I went to my PCP for prescriptions for medication. I initially wanted to just take Buspar, but she convinced me that I was in crisis and needed an SSRI for stabilization. SSRI stands for selective serotonin reuptake inhibitor, and it’s job is to increase serotonin levels in the brain to lessen depression and anxiety. My SSRI, Celexa, did its job and helped increase the serotonin in my brain, and made me less depressed. It took about 2-3 months to work. Interestingly, for me personally, it did not make me happier. It made me less sad, so that I wasn’t just bursting into tears for no reason. It made me much less anxious, and it’s the only time in my life I’ve actually slept restfully. It was very much “sleeping like the dead”. However, instead of happiness, the Celexa just made me feel apathetic. It brought about the complete absence of emotion. I understood that this was happening, and for some months, I continued to take the medication anyway. After all, isn’t the absence of emotion better than the unrelenting chasm of depression and the constant panic of anxiety? (If you’ve read the book My Year Of Rest and Relaxation, you’ll have some idea of what I’m talking about).

Then we underwent the horror of euthanizing two of our dogs, Josie and Pippin, on the same day. At that point I finally had a flood of emotion briefly come back, as I sobbed over their cold limp bodies, and I realized how robotic I had become. I wanted to feel, even if it was a negative emotion, I wanted to, I needed to experience it. In the months following their deaths I weaned myself slowly off Celexa. There is no scientific weaning protocol by the way. A mental health advocate, Laura Delano, has developed some informal guidelines and helps people wean off medications as she herself once did (I read about her in the New Yorker and found her story fascinating). The fun part about coming off psych meds is that many can and will cause discontinuation syndrome, which can cause symptoms worse than the disease you originally set out to treat. More docs are wise to this now, and can help work out a weaning schedule designed to help minimize those symptoms. For me, I used my symptoms to guide my weaning. If I started to feel sick (nausea, dizzy, anxious), I stayed at the current dose or went back up slightly for a few weeks until the symptoms dissipated. This got me safely off of Celexa within about 2 months.

So what is life like now? Am I cured? No. I remain on Buspar for anxiety. It helps make the anxiety manageable and tolerable. It does not have the same severe dampening of emotion that the Celexa did. Buspar works differently that SSRIs, and we don’t really fully understand how, but it is a serotonin receptor agonist, meaning it has a strong affinity for binding to those receptors It’s also been side effect free, and in general has very low risk for side effects. It’s a great medication for anxiety, and I prescribe it frequently in my own practice when applicable because it is safe and effective.

What about alternative methods? I’ve tried more than my share over the years.

The foundation of alternative treatment is three things: healthy diet, regular sleep, and exercise. All these things I go on about and struggle with all the time, affect mental as well as physical well being. They are sooo important!!!!

Meditation and deep breathing. This is the first line treatment I recommend my patients do as well. Simply being quiet and still, inhaling deeply through your nose and out through your mouth is an effective treatment for anxiety. It slows the heart rate and stops the nervous system firing off fight or flight signals, thereby acting as a instant calming method. Repeated habitual use of these practices will help to prevent anxiety. Yoga works in this same vein, and I will practice yoga for the same effects. Mindfulness practice is in this same category as well. Simply being mindful and acknowledging your emotions is a powerful tool. For someone like me, who’s main instinct is to bury and suppress emotions, acknowledging them is the first step.

Massage. I initially got massages for my neck pain and migraines. I found that these did not help those issues at all (bummer). Massages did greatly help my anxiety though, that time for full on relaxation was very helpful.

Acupuncture. I’ve not been very successful with this. Acupuncture has been proven to help a variety of conditions from anxiety and depression to acute and chronic pain. The military uses it regularly on soldiers, and have had good results. I tried acupuncture about a half dozen times, with varying practitioners over the years. I flat out just didn’t like or was creeped out by a lot of them, but one woman of Chinese background was the most thorough. I tried a few sessions with her, but did not find any relief. It’s something that I would try again, though, I think with more persistence it could be valuable.

Essential oils/aromatherapy. I’ve tried many of these. I do find lavender, when put in my bath water, is relaxing. I like this methodology more for my headaches, though. I use peppermint oil on my skin and in a diffuser and it helps my headache lessen a little. My wonderful work family got used to our little office area smelling like the North Pole for awhile, when I was in the thick of my migraines.

Vitamins and supplements. I cannot even remember all the different ones of these I’ve tried. Needless to say none of them helped (my migraines either). I do still take melatonin to help with sleep, it is a standby. Some of the duds: valerian, L-theanine, GABA, chamomile, passionflower- just a handful of others I’ve tried over the years. the good thing about vitamins and supplements are that MOST of them are safe- but not all! So talk to a doctor before you start piling them on.

CBD. Yep, tried it. I acquired it in Colorado and tried if for several months. (Aside- I’ve tried on my dogs as well, for they be crazy like me, but it made them more agitated!) There is no dosing guide for CBD. Basically it’s trial and error. I tried various dosages over several months time. I ultimately found none of them to be effective. I’m sure CBD helps some people, but I was not one of them. It is something I recommend people try, though. It is safe without much evidence of side effects, so I think it’s definitely worth people trying.

Hypnosis. I am mentioning this because at one point I was desperate enough to consider it. I even went to an appointment. My logical brain quickly shot down the practice, and won out. There is no empirical evidence that hypnosis works, and I don’t recommend it.

Nature therapy. This has been the big alternative therapy in my life. Looking back on my life, I realize I’ve been employing it without knowing since I was a child. I was always happiest and felt safest in the outdoors. When I felt sad or upset, I would venture out to the woods for relief. And this is what I still do today. Nature has been shown to have some of the same effects on serotonin levels as medications. It doesn’t need to mean becoming a hermit and living in the woods- it’s as simple as taking 5 minutes out of your workday and sitting outside on a sunny day. Now I’ve been lucky in that I have been able to take an extended break where I have traveled for several months and hike nearly everyday. It has been so restorative. I know I should be more stressed about starting my new life in Oregon, but when I’m out on the trails all that falls away and I live in the serenity of the moment. It makes me be in the present only, and not ruminate and stress about all the what-ifs of daily life. So how am I going to keep this going once I start my new job? Definitely mini-breaks to get outside during the day, those are great pick me ups. Also walking my dogs everyday. Even if it’s just around the block, it’s time outside and it’s meaningful. We plan to travel and hike as much as we can when I’m not working, and see as much of this beautiful country as we can.

Coast to Coast Adventure, Days 62-67. The End.

My husband Rob and I have quit our jobs and are moving from Dayton, OH to Medford, OR with our two dogs Moose and Schuyler. Before we settle there, we embarked on a 2.5 month adventure across the US. I’ll be working as a hospitalist when we get to Oregon starting in just a few short weeks!

The end is here. Not many people get to call a time out on life and travel for over two months. We made a conscious choice to do this. We spent all our savings so we could have this freedom. We are going into the unknown, with just each other. Will it be worth it? Will we have a good life in Oregon? Will our relationship withstand the severe stress of moving cross country to where we know no one and where I’ll be the only one working? These are the questions on my mind today as we drive to our new home in Medford.

We spent the last week of our trip in Victor, Idaho. We had an amazing little “tiny house” that we rented there. I would really like to have a house like that build for us for our next house. It was small, but had everything you need. And it wasn’t truly “tiny” it was probably 600 square feet at least of space. We stayed here because it was adorable, but also because Jackson Hole was sooooo expensive it was out of our reach for what I wanted to spend. It was only 30 minutes across the Teton Pass to Jackson, and 45 minutes to the Tetons.

We had some good hiking days here. Most were pretty chillaxed because we did one epic summit hike. The tiny house was not a good place to leave the dogs, so we did not get to hike any in the Teton park itself. Our first hike was up to a nice subalpine lake, Ski Lake, off Teton Pass. There is a TON of dog friendly hiking off the pass. We did this chill hike and then drove around the park. The great thing about the Tetons is that you can appreciate it so much from your car. The mountains are right there, just framed like a painting.

The next day we did our most ambitious hike yet with the dogs. We hiked 10.7 miles roundtrip to the Summit of Jackson Peak. What’s so cool about this hike is that 3 miles in there is an alpine lake! I fucking love alpine lakes so much. We stopped to swim here for good half hour. There were few bugs, the water was cold but not freezing, and best yet: no one else was there! I will always always cherish having a lake to myself.

We then pushed up to the summit. The last mile was the hard part, steeply graded up the mountain ridge. We took plenty of breaks and then enjoyed ourselves at the summit. Moose and Sky kept trying to pull us off the mountain in pursuit of chipmunks, so we had to be on our toes. It feels amazing to be on a summit, looking at the 360 degrees views and feeling the wind in my hair.

We spent our remaining days doing some short hikes (the dogs were toast after that big one). We relaxed in town and in the tiny house and just enjoyed the freedom of our last days.

And now we are driving again. This time for the last time. What’s to come? I hope nothing but good times and more adventures. Thanks for following along. ❤️

Coast to Coast Adventure, days 54-61

My husband Rob and I have quit our jobs and are moving from Dayton, OH to Medford, OR with our two dogs Moose and Schuyler. Before we settle there, we are embarking on a 2.5 month adventure across the US. I’ll be working as a hospitalist when we get to Oregon in September.

We grudgingly left Moab, that little oasis that draws us back year after year, and started on the road for Colorado again. I wanted a little taste of the San Juans without having to drive too far south, so we settled first for a couple days into Ouray. Ouray bills itself as the Switzerland of the US, I guess since it’s in a lovey mountain valley and everything is super expensive? Anyway it is a cute town, and the cool thing is that it is literally tucked right into nature. There are miles of trails starting right from Main Street that go to waterfalls, creeks, up the mountains, and all around the town. It’s pretty cool how integrated it is into its surroundings. We hiked some of the perimeter trail, and there we great views of the mountains and valley. We had an awesome vrbo right on the river, and the sound of it rushing constantly was intoxicating.

We elected to go further out from Ouray to Ridgeway to hike the Blue Lakes Trail. This is a hard trail, 8.5 miles round trip just to the bottom lake, and it was steep and difficult going the first 1.5 miles. Really steep switchbacks that kill your knees and quads coming back down. Eventually we were rewarded when we got up to a waterfall and then the trees parted to reveal a gorgeous turquoise lake set in the basin of Mount Sneffels. I will never ever get over or stop loving alpine lakes. They are like magical little Narnias. We chilled out by the lake for awhile, it was too cold to swim, and then hiked back out. It was already starting to get dark, so we didn’t hike the upper lakes, but we definitely will need to if we get back here again.

From here we were on our way to Crested Butte, but first with a stop in the Black Canyon of the Gunnison. My brother told me this was a must see stop, and he was right. It is such a rugged canyon. We hiked a bunch of the short rim trails, and the views were amazing. I can’t help myself for climbing and scrambling on the rocky cliff edge, luckily I didn’t plunge into the canyon and die.

We were taken aback just driving into Crested Butte. It is an absolute charmer. Elk (Main Street) is a string of beautiful colorful old buildings that house amazing shops and restaurants. We were a block off the main drag, in an adorable little cabin we got through vrbo. The town sits in a scenic valley, surrounded by mountains on all sides. We loved waking around the town with our dogs. I wish we could live here!!!

Our first hike was the absolute best wildflowers we have seen on this trip. Even the drive to the hike, was just fields and fields of flowers. It was an easy hike up through Washington Gulch to a view point that gives you 360 degree views. My legs were still spent from our tough hike to Blue Lakes, so I was grateful for the gently graded switchbacks that offered stunning views in every direction.

The next day we did what has become my very favorite hike. Scarp Ridge Trail to 421, which is above Irwin Lake about 3 minutes west of town. This is a fairly strenuous hike up to a 12,500 ridge-line. It is hard to fully describe how beautiful it was. It was a place that stunned me to silence and brought tears to my eyes. There are mountains everywhere you look. We had perfect clouds dotting the sky, making the whole thing look like a canyon. It was just a dream.

We are going to the Tetons today, our last stop before going to our new home in Oregon. I wish I could do this full time; I am going to miss this life so much.

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