Tuesday, May 9, 2017

What's up Doc?

About a month ago I had a follow up appointment with my pulmonologist to see how my sleep apnea is doing. Thankfully it's doing really well and he is really pleased with my progress. Because it is so mild the benefits and changes are subtle. I am sleeping deeper, I'm not tossing and turning, and I am having more vivid dreams. The dreams are really screwy sometimes, and I wake up scratching my head as a result. Holy cow they are vivid.

In the conversation with him I mentioned that my weight hasn't really been going down and I am getting frustrated. I have cut my calories down, kept exercising and changed some of what I am eating. I am stuck in the same 5 pound range. He asked if I had heard of the bariatric specialist in town. They have worked with him quite a bit and he has a good success rate. He focuses on lifestyle changes, and he does not do surgery. The one thing he said that really grabbed my attention: "Dr. Hendrick is an actual MD. They bill to your insurance. It's not fad diets and woo woo bullshit."

So I made an appointment.

My first appointment was about 2 1/2 weeks ago. The first appointment is getting all of the baseline stuff done. Height, weight, percent body fat, percent muscle, and measurements. They use a body fat scale that has handles on it to get a more accurate picture of percent body fat. The ones for your bathroom that you stand on only send an electrical impulse up to the hips. The one with the handles actually goes up to the neck. They also do a DEXA (Dual Energy X-Ray) scan. This is normally used for detecting bone loss and osteoporosis. However, with the right software it can be used to determine bone mass and lean muscle mass. I also had to get a full blood panel to see where I am at right now.

I found out I have 140 pounds lean muscle mass. On the print out from the fancy scale they have what my Basal Metabolic Rate (BMR) is and how much I should aim to loose. It didn't put me automatically in the healthy BMI range. The weight it said I should lose would put me at about 180 pounds. They take into account lean muscle mass and don't want me to lose muscle to get to a healthy weight.

**MIND BLOWN** Never had a doctor think like that.

After I read that, the nurse crossed out the BMR and weight loss goal. Cue a very confused face from me and I was thinking they wanted me to go lower. Nope. They aren't setting a weight loss goal for me yet, if at all. There are more important things to work on at the moment than just the weight. It also depends on where I am happy, where my body is happy, and what is maintainable.

**MIND BLOWN AGAIN** might be ok if I only lose to 210 pounds? Yes. Yes it is. Because it is still healthier than where I am at right now. But I was told to not worry about that for now. I was also asked to track my food, but not to worry too much about calories right now. I'm not counting calories right now. Wait, what?!?

This is different from anything I have done before. Very different.

He looks at treating obesity as the complex disease that it is. He sees 4 facets to treating obesity. Nutritional, Physical, Metabolic, and Emotional. Per our conversation today:

"Weight loss won't make you happy. You have to be happy with your life and what you are doing, weight loss is a by product of that."

I also got my blood results back today. Everything is fine except my Vitamin D and my A1C (the marker for diabetes). The Vitamin D is easy enough to fix. However, I am officially pre-diabetic. My A1C is at 5.7% and the top end of "normal" is 5.6%. So I am just barely pre-diabetic, but we can reverse this. Given family history and my best friend's death, diabetes scares the shit out of me. Things just got real. Really real.

Dr. Hendrick is not above using fear as a motivator he said. It can be a great tool when used appropriately. I believe him. He wasn't mean about it, but he was honest.

We talked a lot about eating and emotions today, and I learned a lot. I guess I shouldn't say that. I saw a new way of looking at things.

- We eat to meet different needs. Sadness, stress, anger, joy, health, fuel, and more. No one need is better than the other emotionally. They are what they are. I just need to sit back and look at my meal and ask why am I eating. Is what I am eating now fulfill my health needs or is it fulfilling an emotional need?

- The reason we emotionally eat certain foods is to fulfill and emotional need we aren't meeting otherwise. So when we take out a food that is "bad" we have to replace that food with something that fulfills the emotional need in it's absence. Meditation, yoga, walking, doing hobbies. Anything at all that makes you happy and fulfills your emotional needs.

- If I am fighting a certain change or emotion I need to ask myself why and dive deeper into the why it is bothering me and how to handle it.

He is focusing much more on the mental aspects than anything else right now with me. I feel drained and overwhelmed.

I am to start working on changing the following things:

- 3 meals. Breakfast, lunch, and dinner. No snacks and no skipping meals.
- Track food, but don't worry about calories for now. I'm to eat and feel satisfied.
- No sweets or grains (breads, pasta, oatmeal, quinoa, potatoes of any kind, and corn to name a few). Since we are trying to reverse pre-diabetes this is key.
- try for a fruit and veggie at every meal.

He is pleased with how much I am working out and to up my workouts if I can without injuring myself.

I am not expected to be perfect. They want me to make baby steps. As long as I am making progress they will be happy. If I have any problems or frustrations I am to call them. They are there to help me.

Overall, I like the doctor as his staff. They are friendly and supportive. He lays no blame and doesn't shame. He genuinely wants to help.

Right now I am just nervous, scared, hopeful, and trying to be optimistic.

Ok, that's enough for tonight. I am going to post about the costume for Steampunk Sailor Jupiter tomorrow night.