health · meditation

Meditate on this – Christine decides on a slow build to a new habit

This isn’t going to be a post about how I fight my brain in order to meditate. 

A large maple tree branch full of leaves against a blue sky with a few clouds in it.
This is the view from my hammock in my yard, it gives my brain the same kind of feeling that meditation does.

 

In fact, I really like meditating and once I sit down, I enjoy the process of bringing myself back to my breath over and over. I like the IDEA of it, and I like the practice.

 

Yet, I don’t meditate regularly.

 

It’s not that I don’t want to meditate, I just have trouble *starting* to meditate. 

 

Changing activities is a real challenge for me.  Even if I want to do the next thing, my brain hates to let go of the thing that I am already doing and transition into the next one.

 

So, I have to use some tricks to make that happen.

 

Through trial and error, over time, I have discovered that I can get over the transition barrier (that trouble switching tasks) by identifying how long it takes me to start to enjoy something once I switch into that activity.

 

Writing, for example, takes 5 minutes to become fun. No matter how much I don’t feel like writing in a given moment, if I spend 5 minutes at it, I stop fighting myself. Then I start to find the fun it, it starts to become rewarding.

 

With exercise, it usually takes 10 minutes before I stop fighting myself, before I can quiet the inner temptation to do something else – anything else. Once I hit that 10 minute mark, I am in the groove and I have fun.

 

So, I don’t let those initial feelings of discontent convince me to switch activities in that ‘warm-up’ time and as a result I spent my time in an intentional, purposeful way.

 

Oddly though, despite my desire to meditate, I haven’t applied that ‘warm-up’ approach to meditation.

The author, a white woman in her mid-forties, with light brown hair, wearing a black shirt, lies on a green mat. Her eyes are closed.
I’m not actually meditating here, obviously (how would I get a photo of that?), this was part of a photo project. Let’s pretend it is a meditation simulation.

 

It’s on my mental list of enjoyable things to do in a given day, but it rarely makes it into practice.

A screen capture of the timer screen of the Insight Timer meditation app. The words 'Starting Bell' are at the top, and a bowl is depicted below with the word 'Basu' on it. Below the bowl are four oblong shapes indicating the duration of the timer (Meditation 3 minutes), the interval bells (none), the ambient sound (none), and the ending bell (Basu is listed again). The word Start is in a white circle at the bottom of the screen.
My timer screen for week 1. One of the things I like about Insight Timer is how peaceful all of the sounds are.

It’s time to change that.

 

In July, I am going to incorporate a short meditation practice into my day, lying on my yoga mat, using my ‘Insight Timer’ app to time myself and to journal about the experience.

 

In week 1, I’ll do 3 minutes, twice a day and if that is successful, I’ll increase in two minute increments each week.

 

I know those are very small goals but want to find that ‘warm-up’ point, and I want to keep the bar low. I’m not trying to do a great practice, nor a deep one, I’m aiming for a consistent one.

 

I’ll report back after week 1.

A screen capture of a phone app featuring a black screen with the word Journal at the top middle and the words 'Write your journal note here...' underneath it.
This is the journal page of my app. I like how plain it is.
body image · feminism · fitness · health · philosophy

Body image: the blog’s most popular topic

Image description: Pic of Sam (left) and Tracy (right) both smiling (photo credit Ruth Kivilahti) with text "Episode 69 Body Image with Samantha Brennan and Tracy Isaacs" and "PURPOSEFUL STRENGTH" and a quote "The difference is the treatment from etc external world. There are some kinds of oppression that larger people cace that smaller people don't but I think the internal stuff we all share." Borrowed from Sarah Polacco's Instagram.
Image description: Pic of Sam (left) and Tracy (right) both smiling (photo credit Ruth Kivilahti) with text “Episode 69 Body Image with Samantha Brennan and Tracy Isaacs” and “PURPOSEFUL STRENGTH” and a quote “The difference is the treatment from etc external world. There are some kinds of oppression that larger people cace that smaller people don’t but I think the internal stuff we all share.” Borrowed from Sarah Polacco’s Instagram.

Body image continues to be the blog’s most popular topic among readers. It’s been like that since the beginning. Over three years ago Sam blogged about “Why a fitness blog cares so much about body image.”

For one thing, our readers care. But also, body image and fitness are inextricably tied together in many people’s minds. Especially as feminists, we are keenly aware of the way mainstream fitness narratives usually include thinness or at least weight loss narratives in central ways. It is highly unusual for someone to think of fitness independently of dropping pounds or getting leaner or needing to look a certain way (even if that way isn’t necessarily realistic or healthy — see “She May Look Healthy But…Why fitness models aren’t models of health”).

What’s interesting too is that Sam and I have very different personal body image stories, though we agree (as we frequently do) about the bigger picture of why it matters, why it’s a struggle for many women, and why we need to continue to give it attention on the blog.

We shared our latest thoughts on body image with Sarah Polacco for her amazing podcast, Purposeful Strength. You can find her podcast on iTunes, and if you’re interested in hearing our discussion of body image, check out Episode 69, out just this week. Here’s the iTunes link, but you can also find it on Soundcloud and no doubt other platforms.

fitness · health · rest · sleep

In praise of resting

I’ve been finished my teaching for the winter term for about a month now. Finals are over and marked; my campus office (which is moving this summer back across the lawn to my faculty’s newly – and beautifully – restored heritage building) is packed up. The book I was writing all autumn and winter is done, dusted, and in production.

So why am I still so tired all the time?

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(Peppermint Pattie, head on desk and looking glum, says: SO TIRED.)

I’m not one to give myself a break – I’m a high-functioning type-A kind of woman, and I am as productive and successful as I am professionally because of this.

But life isn’t work. And I am also 43 years old. I can’t pull all-nighters anymore. And TBH most evenings I am ready for bed by 10:30 (no more clubbing for me).

Now, sleep I get quite a lot of – and we are a blog that supports good, effective sleep habits as part of our human wellness. (Sam has written before about being a champion sleeper. I envy her ability to conk out on airplanes!)

But REST is more than only sleep. And for me rest is another matter.

I was at my friend Nat’s house for supper two weeks ago and we talked about parenting and sleep deprivation. Nat’s kids are still quite young and the 3am wake-ups are still happening. She feels insanely sleep-deprived right now, as does her partner.

We all talked about the idea that, if it’s a matter of choosing between exercise and sleeping, the sleep-deprived should hit snooze rather than clamber out of bed early to run 5 miles. (Read more here about the interrelationship of sleep and exercise.)

Similarly, I once had a cycling coach who reminded me that resting is as important as training – resting is a key part of training, in fact. And resting means resting: it doesn’t mean digging up the garden, staining the deck, cleaning all the windows upstairs, or even walking the dog for two hours in the forest.

8e67651b-a381-4d6a-ba38-914551149501

(Emma the Dog [a black and tan collie-shepherd-lab mix] on a path in Cootes Paradise, Hamilton, Ontario, surrounded by spring greenery and pink-flowering eastern redbud trees. She says: “Whaddaya mean rest doesn’t include walkies??”)

Rest actually means sitting or lying comfortably and allowing your body to replenish itself. It means sleeping if sleep is what is required. It means eating good, healthy food in good proportions, and/or eating specific foods required for your body’s replenishment before another day of training hard. These might include proteins, or carbs, or a variety of things.

Ice cream or cake too, if you’re looking for a cheery treat! I always go for the milkshake, personally.

I have realized over the last month of being on my summer schedule (which is not a vacation, at least not yet – summer is when academics write books and present research at conferences and travel to complete field research, as well as plan autumn classes) that I’m not resting enough. I’m exhausted all the time because my brain convinces me that I need always to be working – if not tapping on my computer then digging up the garden or cleaning the windows or walking the dog. I also train a lot – riding and rowing 2-3 times a week each, with one rest day somewhere in there – and the impetus to get in the boat, or on the bike for at least 90 minutes at a shot (and usually more like 3 hours at a shot) also often feels like “work” pressure for me.

So no wonder I’m tired. I’m running on empty a lot of the time!

I woke up yesterday morning realizing that, in fact, the world would not end if I did practically nothing that day. My boyfriend was visiting; we could spend the day together being pretty chill (including lying in bed far longer than usual) and hanging out and the sky would not explode. In fact: our rest would be blissfully productive for our well-being.

But when I looked at the clock and realized it was 10am I also felt a surge of guilt.

And here’s the rub. Yes, I need to recalibrate my relationship to rest, but it’s not just a matter of me making a series of individual choices – this isn’t all about me and it is not all about my free will.

It’s also related to the way our culture moralizes movement and rest – in the same way it moralizes food, something we talk about on the blog a lot. (See here, for example, about food being beyond “good” and “evil”.)

In the so-called “West” or “Global North” many of us live in cultures that believe rising late is “lazy,” while getting up early to head off to toil at our jobs is a virtue. But why?

Research suggests this belief is not supportable: teenagers, for example, actually need up to 10 hours of sleep per night, and their shifting body rhythms are at odds with the wake-up-early-rush-to-school pace our cultures usually enforce. No wonder they are all yawning in 8:30am Bio! (See here for more on teenage sleep needs.)

My own body clock, I’ve discovered thanks to the flexibility of my job, works like this: I want to go to bed between 10 and 11:30pm (it can vary depending on when I had my last cup of coffee in the day), and I want to wake up around 9am. 8:30am is also fine. But if my alarm is set for, say, 7am, I’m usually woken in the middle of a dream (REM sleep), and I’m instantly fuzzy. The day doesn’t improve from there.

I like to sleep late. I really do. This used to drive my mother CRAZY; it seemed, well, “bad” and “lazy”.

And yet: I’m still a high-functioning professional. I was an A student. And I’m a good cyclist. And a good friend and partner and daughter and doggie guardian… and human being.

So let’s all try, together, to work on our relationship to the concept of rest. Even if you feel rested – especially if you do! – ask yourself how and why. If you don’t, or if those you love don’t, ask why. Think about the outside pressures that bear on your rest – including but not limited to your sleep patterns – and think about what among those are changeable. Can you advocate for flex time at work? A later start time or an earlier finish time, as needed? Can you advocate at your kids’ school for more flex around teenage sleep patterns – maybe with classes starting later, or more spares in the first block of the day?

Above all, on your own rest days, remember to put your feet up, grab a book or the Netflix, and don’t forget the milkshake. Not because you “deserve it” – but because you are simply human.

milkshakes

(A photo with two milkshakes in the foreground. On the left is a brown/chocolate one, with whipped cream and a cherry on top. On the right is a mint-coloured one with whipped cream and a mint leaf on top. In soft focus behind them and staggered to one side are two stainless steel mixing containers. I’d like the chocolate one, please!)

Be well-rested!

Kim

fitness · health

Women’s hearts: different doesn’t mean less deserving of attention

A line drawing of a heart beat, with a heart in the middle.
A line drawing of a heart beat, with a heart in the middle.

The Framingham Heart Study is one of the biggest and longest-running medical studies in the US, and it focuses on heart disease.  It turns 70 this year! It started in 1948, enrolling men and women (mainly husband-wife pairs), and then family members and their descendants. It started enrolling non-white participants in the 90s and has continued to enroll their offspring and descendants.  This project has amassed a huge amount of data to study heart disease and other medical (and some social) phenomena.

Heart disease is the number one cause of death for women and men in the US and the number two cause of death in Canada (cancer is number one). For decades, the medical community believed wrongly that heart disease was predominant in men and less common in women.  This mistaken belief was corrected as a result of research.  However, women with heart disease are still commonly dismissed and left untreated because their symptoms and clinical profiles are different from those of men.

Difference– we deal with difference all the time. Not all things are alike in all ways, so we respond accordingly. Some of my houseplants need a lot of water, and others would die if I watered them often. Here’s the definitive word on watering plants from Better Homes and Gardens:

Some plants need a period of dry soil for days or weeks. Others houseplants need more regular watering, with the soil allowed to dry between each drink. Still others prefer consistently moist soil. Many houseplants go through phases of growth when they require more or less water.

FYI: over-watering is the number one cause of house plant death worldwide. Don’t let this happen to you and yours.

Three plants-- one underwatered and wilted, one properly watered and peppy, one overwatered and wilting.
Three plants– one under-watered and wilting, one properly watered and peppy, one overwatered and rotting…

The fact that my plants are different with respect to watering doesn’t mean that some of my plants are standard and others are non-standard.  There is NO standard watering schedule; there are just a bunch of different ways to water, depending on type of plant, soil, humidity, season, etc. We adjust accordingly, and hopefully all goes well.

You would think we would apply this idea to something more important than plants and watering, namely people and their hearts. We know that both women and men get various forms of heart disease (heart attacks, heart failure, etc.), and their symptoms are different. How hard is this to manage?

Apparently too hard. Look at this excerpt from an article in this week’s issue of JAMA (Journal of the American Medical Association)

JAMA: Framingham data found that coronary heart disease symptoms are different in women than in men. Do you think these differences are recognized widely enough by women and their physicians?

Dr Levy: The medical community and the public are not as aware of differences between men and women and the symptoms of heart disease. Men often have a more classic presentation, whereas in women, an early presentation of heart disease may be exertional fatigue as opposed to classic chest pain.

Okay, there are a few problems here.

Problem one: Why isn’t the medical community aware of the differences in symptoms between men and women? Medical professionals deal with difference all the time– children vs. adults, bigger vs. smaller people, people with other conditions vs. people without– I could go on. This information has been around for a long time– long enough for it to have made its way into clinical practice. Claims of ignorance here are no excuse.

Problem two: calling chest pain a “classic” symptom of onset of heart attack, whereas exertional pain is considered non-standard or non-classic is making an implicit value judgment. It’s saying that we automatically investigate further for heart attack for chest pain, but don’t necessarily do so for other symptoms that women also commonly experience, like the following:

Men and women alike can experience the well-known heart attack symptoms like gripping chest pains and breaking out in a cold sweat. But women can also have subtler, less recognizable symptoms such as pain or discomfort in the stomach, jaw, neck or back, nausea and shortness of breath.

Now I’ve got a another problem.

Problem three: why is it that pain in the jaw, neck or back counts as subtler and less recognizable than pain in the chest? Less recognizable to whom? Surely the woman experiencing it is recognizing them and reporting the symptoms, otherwise, we wouldn’t know about them in the first place. What this means is that medical professionals consider those symptoms to be less important as ways to diagnose risk or onset of heart attack. And they would be wrong about that.

So what are we supposed to do about this? The American Heart Association created the group Go Red to try to educate women about heart disease. It repeatedly states that women’s lack of knowledge about heart disease and how their bodies and symptoms are different contributes to increased heart disease death rate among women. It also mentions that medical professionals need to be better educated, and more research needs to be done.  But it ends one page with this call to action:

Women need to become fierce advocates for their own health. So, it’s time to shout louder, ladies. Go Red and make your voices heard so that no woman is left questioning or ignoring her heart health ever again.

Okay, I’ll end with this last problem (for now). So the American Heart Association’s big message to women is that it is their job to advocate for themselves with the medical establishment about getting proper treatment for heart disease? That is NOT the take-home message I get from reading about differences among women and men with respect to heart disease symptoms and physiology. My message is this:

A meadow in background, with the words "Physician health thyself from sexist medical treatment"
A meadow in background, with the words “Physician health thyself from sexist medical treatment”

 

health · stereotypes · weight loss · weight stigma

6 things Sam hates about seeing doctors, as a larger person

None of this is true about my current set of health practitioners. But they took awhile to find. Right now I’m halfway between jobs and cities and I’m looking for a new family doctor to start. It’s tough. And here’s why!

1. They believe ridiculous things about me. See this article about doctors and bias against larger patient. “Much research has shown that clinicians have biases related to overweight and obesity, conditions that affect more than two-thirds of U.S. adults, Dr. Gudzune said. “[With] the magnitude of the effect of obesity in our country, a substantial number of people are experiencing health care disparities as a result,” she said. Studies have consistently shown that physicians associate obesity with such negative attributes as poor hygiene, nonadherence, hostility, and dishonesty, Dr. Gudzune said. “These types of attitudes are pervasive. It’s not just in the U.S. … [but] physicians across the world as well: Australian, Israeli, European physicians. … These attitudes have been documented as far back as 1969, and they continue to persist up until today,” she said. In surveys of primary care physicians, more than 50% view patients with obesity as awkward, unattractive, and ugly, Dr. Gudzune said. “They have less respect for patients with obesity. They also believe that heavier patients are less likely to follow medical advice, benefit from counseling, or adhere to medications, which are some of the things that are really critical in thinking about managing obesity,” she said. She added that these attitudes may extend to other health professionals, such as medical students, nurses, and nutritionists.” Not fun.

2. They prescribe weight loss for everything. The evidence bar is very low. If there’s even a small chance that weight makes a difference, they mention it.

3. They don’t believe my attempts at trying to lose weight. I just haven’t tried hard enough apparently. It’s as if once a have a serious medical reason, like putting off knee replacement surgery, I’ll snap to it, get down to business, and the pounds will just melt away.

4. They don’t have anything useful to say about how to lose weight. See this post on unwanted weight loss advice. “Why do doctors weigh patients and offer weight loss advice? Other than “eat less and move more” which is kind of like the weight loss equivalent of “buy low and sell high,” what recommendations do they make and why?”

5. But they recommend diets anyway even though the most likely outcome is that the patient weighs more at the end. In this post I wonder if doctors would do that with any other “likely to fail spectacularly” treatment. See Well intentioned lies, doctors, and the diet industry: If weight loss is impossible, ctors-and-the-diet-industry-if-weight-loss-impossible-then-what/

6. They never believe my blood pressure readings or my cholesterol levels. I’ve had a complete work up with a endocrinologist who gave me a clean bill of fat health but still, it’s an uphill battle being seen. See this post and this one.

I know Catherine and Nat have blogged here about issues with doctors. I often think, hey we’re all strong feminists with serious amounts of post secondary education and some good attitudes, we’re white, English speaking, able bodied, if we have problems with doctors what’s it like for other women who don’t share our bundle of privileges? If you’re a larger person, what’s the medical world like for you. We want to know.

aging · disability · health · injury · monthly check in

Sam’s monthly check-in: What’s up, what’s down, the May version

May! Finally warm weather. The best thing about May is riding my bike. It was 50 km the first week and 60 km the next . Weekdays I’ve been exploring my new home, Guelph, after work and running errands on bike. That’s what’s up. It feels great.

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Not so much “up” is my left knee. It doesn’t feel great.

I met with the knee surgeon again. Total knee replacement still looks far away. At least I hope so. See 9 Things No One Ever tells You About Getting a Knee Replacement for details. We’re still seeing how things go with the goo injections and the brace.

I’m wearing the brace for walking. I’m doing physio still. And I’m riding my bike. That’s all good.

The surgeon and his team are busy telling me that all the activity I’ve done isn’t responsible for my knee osteoarthritis. They do also tell me never to even say the word “running” again. Fine. See Sam struggles not to run, ever!

But they do say I’d be in less pain if I lost weight. More seriously they say that losing weight would help me put off total knee replacement. That’s big.

Now they used to also say that knee patients should lose weight first, before the surgery. See Researchers Find Weight Loss Not Necessary for Joint Surgery

But if you think you must lose those extra pounds before a knee or hip replacement, think again, as researchers with UMass Medical School found long-term relief from joint replacement surgery was almost the same in obese and non-obese patients.

“The conventional wisdom is that the lower your body weight, the lower your body mass index, the better you will do in joint replacements, and there has been an increasing push to say that if you are obese you should not have joint replacement – either knee or hip replacement,” Dr. David C. Ayers, chairman of orthopedics and chairman and professor of orthopedics and physical rehabilitation at UMass Medical School, said Thursday.
Dr. Ayers is the co-author of a study reporting the findings published last month in the Journal of Bone and Joint Surgery.

“What this study shows is that people who are overweight and are obese get the same type of pain relief and improved function that non-obese patients do,” he said.

Surprise! Fat people are people. Fat bodies are bodies. And knee pain hurts a lot no matter what your size.

The old wisdom sounds just like, “You’re fat so must pay the price! Suffer! No knee replacement for you!” Doctors can be jerks.

But in my case we’re not talking about weight loss before surgery. The issue is weight loss to put off the necessity of joint replacement. Total knee replacement is worth avoiding. Right now knee replacements last 20 years max. So if all goes well, I might need a second one. It’s big painful surgery with a very lengthy recovery time. I don’t want to do it twice.

See here. Point 1: “For many, weight loss is a basic but crucial way to help avoid knee surgery. Shedding just 15 pounds can cut knee pain in half. And should you need arthritis knee surgery later, you’ll decrease your risk of complications and reduce strain on your knees, which will make your rehabilitation go more smoothly.”

So, what to do?

I’m reading a lot about knee pain and weight. No surprise there!

But I’m also researching weight loss for medical reasons. Maybe like me you thought that weight loss is hard but once you’re told you need to lose weight for medical reasons, you just do it.

I’m here to tell you the sad news that it’s not so simple. Your body doesn’t care what your motivation is. It’s not like it ignores the diets for beauty’s sake and pays attention to the diets for urgent health reasons.

I think when I was younger I even thought it would be good to have a medical reason to lose weight because then you’d be serious about it and just do it. I could be a feminist and be skinny because I was dieting for health reasons. Bah.

Now I have very good reasons, I’m being serious about it, and I’m still struggling.

Tracy and I were chatting today about whether it ever makes sense to talk about weight and weight loss on the blog. It’s not something we talk about much. It’s a blog about fitness not weight and shape and we’re very keen to distinguish these things. In this case though weight loss isn’t a goal that I want to result from my fitness efforts. Weight loss may be necessary to keep me active.

We’re all about staying fit and strong in midlife and beyond. That’s the overarching message of our book. But given my knee and the state it’s in, staying active may mean losing weight. I’m trying. I won’t post much about my successes and failures. I know that’s too much for those of you with histories of disordered eating. Even though I’m one of the larger bloggers here, that’s not me. I like food and my relationship with it. But I also feel the need to be honest on the blog about what’s up with me fitness wise.

Have you had or contemplated having knee replacement? Have you struggled with medical reasons to lose weight? Tell me your story

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Also, hello May, I’m tentatively making plans. There are plans afoot for bike/boat holidays, for canoe/camping trips, for long bike rides. I love the summer and I’m going to enjoy it.

health · Sat with Nat

Nat learns a little more about the nuances of blood pressure

It’s that time of year for my annual “my high blood pressure journey” post. (Please remember I’m not a health care professional and what follows isn’t advice on what you should do. )

Last month the guidelines around what constitutes high blood pressure were changed in Canada and the US. You can read about it here. It created a mild ripple of panic as folks were surprised to find they suddenly had “high blood pressure”. It certainly gave me pause to think about my own numbers just days before my regular check up.

I showed up to my appointment to discover my family doctor no longer working Wednesdays. The thought of seeing a different doctor filled me with panic. I’ve been having follow ups for many years and am really comfortable with my doctor. Other doctors, well, it’s a mixed bag. I tried deep breathing and relaxing while anxiety washed over me.

I met with the new doctor, a lovely human who stared at my stomach while we talked. I had shared that my numbers were creeping up over the years and I was worried. She offered that once hypertension sets in it slowly worsens over time as we age. She talked about how lifestyle changes were very important and that pills only did so much. I smiled and waited for her to go on. I couldn’t muster the courage to confront her assumption that I hadn’t already made those lifestyle changes, initially 20 years ago and really honed in on things about 5 years ago.

She asked how my at home monitoring was going. I had never seriously tracked my blood pressure at home despite having been gifted a monitor.

She offered that I didn’t need to come in unless my at home blood pressure was regularly over 130/90 as my prescription could be renewed via fax.

I walked out confused but committed to tracking my blood pressure at different times at home.

I was shocked to see a few trends. After my morning coffee my blood pressure spikes by 20 points. By mid afternoon I’m regularly sitting at 105/60. Way lower than the reading at the doctor’s office. It was such a shock I had my partner measure his to make sure the monitor was working. I tried different sizes of cuffs. All good.

I keep thinking about those “lifestyle factors” that are within my control. The big ones most folks are familiar with: be a non-smoker, move your body, avoid high amounts of alcohol, eat a healthy diet. Just this week a CNN article boasted we can all extend our longevity by 10 years doing those things and maintaining a healthy BMI.

https://www.google.com/amp/s/amp.cnn.com/cnn/2018/04/30/health/life-expectancy-habits-study/index.html

I’ve got 4/5 and, as the Meatloaf song goes, that ain’t bad. I have decided that the long view of my health and wellness are the biggest assets for me. I look for ways to make it easy to make healthy choices and get movement in my day and that seems to be working out damn fine.

Four smiling humans gather in for a sidewalk selfie on a warm sunny day

Me and my favourite humans walking from home to see a movie downtown.