Thursday, September 6, 2018

Trials and Errors

My summer up through the first part of July was busy. To be honest, I've just enjoyed having quiet time to myself the last month and a half.

As an update from my last entry, I'm feeling a lot better mentally. I still have moments of doubt and all, but it feels like "normal" doubt. Not the depression monster in my head. I've gotten back into a groove with my working out, but eating has been a real struggle. I saw my pulmonologist and we've gotten the pressures figured out. He had to lower them a bit for me. Part of my struggle now is sinus issues due to allergies and the smoke from wildfires. I feel like I am permanently congested and sneezing.

The last 4-6 weeks have been a challenge. I emailed Dr. Hendrick to ask about the other weight loss meds he was thinking of having me try. At our last appointment, we started talking more about it again. He wanted to kick start my weight loss again. I was wanting information from him to do some more research. He was honest with me and let me know which ones he was thinking of, but that the good information is hard to find. There's a lot of less than reputable sites that give half the facts. He said he would give me all the information I could need at our next appointment in mid-September. 

I felt like I just wasn't making progress. I have been lifting back at full weights and upping my weights week to week. It even got to the point that I was looking at weight loss surgery again. Even going so far as to see which of the three different types of procedures I thought would work best. It made me sad to think I needed to do that, even if the surgery is just another tool for me to use. It is not the easy way out.

I don't really remember how it came about, but I started doing more research on intermittent fasting. I don't know if it was a news article, something I saw on Facebook, or what. It is something Dr. Hendrick has been wanting me to try for a while. I was reading up on the science and theory behind it for fat loss. I decided what the heck. At the time I started it, I had a month before my next appointment. I might as well treat myself as a science experiment and see if it works. On a random Tuesday morning, I decided to try it. It has been two weeks, and so far, so good. There are several different ways to do intermittent fasting, but I have been fasting for 16 hours and have an 8-hour window to eat.

The theory is that after you finish eating for the night, your body is in a digestion phase anywhere from 8-12 hours. Anything after the 12-hour mark your body is fasting and will start using fat as fuel. Eating more lean protein does help the body using fat instead of muscle as fuel. 

Overall it hasn't been too bad. It's been great having one less meal to plan, and I don't feel as rushed in the mornings. I do still get coffee in the morning, I just have to limit the flavored creamer so the fast doesn't get broken early. Aside from a few days where I felt very run down and had a headache I have felt great and have had more energy. On the days I have felt like crap, I have broken my fast early and eaten a protein bar or a piece of fruit. I felt better shortly afterward. As always, listening to my body is key.

As for breaking my fast, I break it around lunchtime after I have my workout. I have a little bit more than I normally would at lunch and dinner, but not by that much. When all is said and done I've been averaging around 1800 calories per day with a range of 1500-2100 calories. It depends on how hard I worked out and how hungry I feel. It has also helped me face my fear of hunger and get over it. Well, for the most part. Having a growling stomach in meetings is not the best thing!

Other things from the last couple of weeks:

  • I've dropped between 4-5 pounds. It depends on the day you look at my scale
  • Huge difference in how my clothes fit. I have 2 pairs of pants that I dare not wear outside the house
  • Pair of leggings purchased a year ago now fit. At the time I bought them they wouldn't go past mid-thigh
  • Better attitude
  • More focused at work
  • I'm eating less at meals and feeling satiated sooner
So right now I'm feeling hopeful and finding some success. Right now I just want to get back under 300 pounds, and I am so freaking close. This week or next and I should be there. 

I have also found that I do best when weighing myself every day or every other day. I need the data points to keep me accountable. By keeping my food logs I can go back and see what caused a spike in my weight. Anything from eating, to that time of the month, to too many carbs can cause my weight to spike as much as 4 to 5 pounds in a single day. It helps to see the trend of it going down though and knowing that the weight will come back down. I've been using an app called Libra to help me with this. They have trending weight, average loss, and projected weight loss. It's handy and I like it.

Wednesday, June 6, 2018

The Depression Monster

I've been quiet for because I've been struggling, but not sure how to vocalize it. Some days are better than others. I've been really resentful of the process. Exercising, eating, my schedule, all of it. This weekend was especially awful.

I've dealt with depression for years, but I have never been officially diagnosed. All weekend I was feeling kind of down, and by Sunday night I was retreating from the world and hiding. I sat and wrote in my journal for a good while and my husband kept coming to check on me. He knew some of what i had been dealing with and thinking, but not the extent of it.

I have been super frustrated with my weight loss or lack there of. I've been maintaining in the same 5 pound range since November. In the last 2 weeks I've crept back over 300 pounds a couple of days. There's been a lot of reasons for all of this, that logically I know. But there comes a point when logic doesn't matter. Here's what's been going on the last couple months:
  • Finishing up physical therapy for my knee. I had pulled back from weight lifting so I didn't hurt myself more. I love weight lifting and can't stand cardio. Where I could only really do cardio, I didn't want to go to the gym.
  • I haven't been sleeping well. Even with my CPAP I've been restless at night. I finally figured out the pressures were too high and needed to call my pulmonologist.
  • My self worth was in the septic tank. I had a record going over and over in my head that I was worthless. There's no point in keeping trying as I have failed before and I was stupid to think that I could do it this time. And on and on and on. 
  • Continuing on from 3, flashbacks of being bullied and the horrible things I was called as a pre-teen and teen.

I had Marshall read my journal entry. All he did when he finished reading it was hug me tight and said he was never letting me go. No matter how much I wanted to pull away. Then we sat and talked.

He brought up a good point and that was my depression symptoms have gotten worse since I've gone off of the Contrave pill I was using. My obesity doctor and I decided I should go off it because it didn't seem to be helping much. I wasn't struggling with cravings or the like so I went off of it. Well, one of the reasons my doc chose that med is that one of the active ingredients is also a mild antidepressant. We had talked a bit about my personal history and he thought it would be good for me to be on one. Nothing major. Marshall pointed out other times this has happened, including times family members do it. So there's every chance this is a bit genetic as well. I felt so much better after talking with Marshall about it all. I had an appointment with Dr. Hendrick on Tuesday. I was originally going to reschedule it. I've finally been getting back to the gym and strength training again. I wanted to even have a week to say "This is where I'm at!" But in the discussion about depression I decided I needed to keep the appointment. If I'm starting to struggle this badly with depressive symptoms I need help. I can't put it off. So I went.

Dr. Hendrick was very supportive and helpful as usual. He wouldn't prescribe an anti-depressant for me. He wants me to work with my primary care physician on that. The ultimate goal is for me to get the weight off, be good at maintenance, and not see him anymore. So there's that. So here's the run down of my meeting with him.
  • I've been doing great at maintaining. He thinks that when i get down to a good weight my body is happy at, I should be able to maintain it with minimal struggles. With a caveat of what I already know. Maintaining is harder than losing in some respects. But he said I'm already showing skills to do well at maintaining my weight in stressful situations, so there is that. 
  • My eating habits are doing really well. He's really happy with the progress I've made on that front. With what I'm eating and when. What I do when confronted with unhealthy food situations. My job is a landmine of cookies, brownies, and sweets. It's awful. As he put it, it's borderline abuse. 
  • He wanted me to follow up with my primary doc about getting on a med and talk about other treatment options. He warned me to be careful of talk therapy. It means digging up messy emotions that could trigger emotional binge eating, which we don't need. 
  • I also needed to get my cpap pressures changed so I can get good sleep at night. 
  • He's very hopeful for me and was very happy I came in and asked for help. He also said I'm really fragile right now. 

So I saw my primary doc today and we had a good chat. She put me on the same med as in contrave, but at a lower dose to get started. Luckily the med I'm on is one of the few that doesn't usually cause weight gain. I go back in 3 weeks for a follow-up and see if I need to see a counselor. She was very empathetic and understanding. She also agreed with Dr. Hendrick about going into counseling with caution.

I also called my pulmonologist. I will say my CPAP is awesome. He was able to remotely adjust the settings so I didn't need to go in and see him. He did have his nurse ask me if I had lost more weight since I was in for my 6 month visit in October. I'm down maybe another 5-10 pounds. Turns out he has the pressures set pretty much as low as they can go. I have a follow up in 3 weeks to see him too. I'm hoping that this is good news and I may be getting off my cpap. We'll see though!

I don't have an official diagnosis of depression, but I'm on a low-dose antidepressant. I hope this helps. I have felt so crappy and apathetic the last few weeks and I'm over it. The last few days have been better. Not perfect, but better. It helps I've been able to get back into strength training. I've been taking it really easy so I don't overdo it and hurt myself again. So I started back at squatting 65 pounds last week and I'm already up to 85 pounds this week. I'm hoping by the end of the month to be close to where I was. 150-ish pound squats, 65 pound bench press. Those are the two I remember for certain.

I will say this though. If you are having frequent bouts of self-doubt, lethargy, apathy or other depressive symptoms. See your doctor. It doesn't matter if it's weight related or not. They can help. Your mental health and well being is far too important to ignore.

Sunday, April 1, 2018

Back on track and feeling hopeful

I haven't posted in a long long time it feels like. The holidays got in the way initially, then I felt like I didn't really have anything to say, and then I didn't know how to articulate what I wanted to say. I know I needed help, but I didn't know what I needed help with or how to ask for it. Silly I know. The last 4 months or so I have been maintaining my weight. I have yet to figure out if I took a true maintenance break or if it was a plateau. At least I wasn't regaining weight.

I have slacked off on my workouts lately too. I've been battling a head cold and sinus infection the last couple weeks. Part of it is dealing with a knee injury. The irony is the non-runner has runner's knee. I've only had two PT appointments though and my knee is almost completely better! The other part of it was February and March blahs brought on by just getting tired of winter and deep in hibernation mode. All that means is I was feeling exceptionally anti-social due to seasonal depression. I'm not one to be out in the sun a lot, but damn I miss it when it disappears for a few days. On the upside I have been trying to go swimming a couple days a week with a friend, so that's been a lot of fun. It's been great girl time.

This last week I finally feel like I've gotten back on track with my eating. I bought a lot of easy foods for healthy and fast meals last week. Breakfast has been eggs, toast, and coffee. Lunch was low-carb wraps, with a variety of fresh veggies, fruit, and some cheese. Dinner has been a variety of things. I immediately started feeling good again and having more energy.  I also noticed that my craving for sweets diminished quite a bit too. I ended up having a great loss at TOPS this week as well. It was 2.25 pound if I remember right.

Friday I had a follow up with Dr. H. I am down 3 pounds from the last visit. Again we had a great discussion. He was concerned because it looked like my weight loss had slowed down quite a bit. So he brought up if I thought the Contrave was still working, and maybe changing it out with a different one. He was also concerned about costs for me, which I appreciate. In the discussion about other possible meds to try we went on to discussing changing up my eating habits. We talked about three different options.

1) Go down to two meals per day. I wouldn't be cutting out any calories, just the number of meals. I'm not sure how feasible this is during the work week for me, but on the weekends this usually ends up being the case anyways.

2) Change up my calorie distribution - make breakfast my biggest meal of the day, and dinner the smallest. Easy enough change to make.

3) Intermittent fasting - Going 24 hours without eating. He would like me try it one day a week and see how it goes. If I'm feeling up to trying a science experiment. Damn him speaking my language! haha

All 3 options have had a variety of studies done and have been shown to promote weight loss. Those who participate in intermittent fasting usually do it 3 days week (every other day) but it has been shown to be helpful with even one day a week.

The biggest part of our discussion surrounded option 2. There was a study published this last week that had very positive and amazing results. It was looking at type 2 diabetics and what happened if they had 6 small even sized meals versus 3 meals with breakfast being the largest and dinner the smallest. Both groups at the same amount of calories. The group that ate the 6 small meals ended up gaining 2kg over the 3 month study and using 2 units of insulin more per day. The group that ate the small dinner ended up LOSING 5kg and using 20 units LESS of insulin per day. That's a huge difference! Dr. H said they weren't sure if it's the large breakfast, the small dinner, or a combo of the two that helps with weight loss. While I don't have to worry about insulin use, I will definitely be giving this a try.

Towards the end of our meeting I went back to the earlier discussion about changing up the med. He said he wasn't going to for two reasons. The first is I didn't seem particularly excited about it. The second is that given some comments I made about eating mindfully and the like, the contrave is working. He said he thinks he was just making a mountain out of a mole-hill. The slight gain I had was over the holidays. We'll see how things go this next month and go from there.

I'm so happy I started seeing him. He seems to know exactly what I need to feel like I'm getting back on track and get me moving in the right direction again.

In other news I was a division winner in my TOPS chapter this last year. Each division is broken up by how much you weigh at the start of the year. I lost 26 pounds last year.

 So far things are looking up. I really want to try and do more blogging this year. I enjoy the writing as an outlet. Hopefully I can keep this going.