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.

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**

Wait...it 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.

Sleep Apnea

I have probably started and deleted this post a dozen times over the last 6 weeks or so. I just couldn't bring myself to write and admit some of the things I am about to share. I'm slowly making peace with all of it, but it hasn't been easy for me.

Back in January I went to the doctor because I hadn't been sleeping well for a long time. I was restless, my legs were twitchy, my back was killing me, and I was waking up just as tired as when I went to bed. Poor Marshall has been wearing earplugs for years now in part because of my snoring (the other part is traffic noise). Then I was listening to a friend's follow up interview on Half Size Me. She and Heather discussed her diagnosis of sleep apnea from when she was overweight. Heather asked the question of what Brenda would say to those who have thought of getting tested, but haven't. Brenda's answer wasn't anything I hadn't heard before, but it was the way she said. Sleep is so important for all of our bodily functions and mental acuity. The part that got to me was when she said it is medicine that is just as important as any pill or injection you could take.

So I got a referral to a sleep doctor. I met with him and it wasn't IF I had sleep apnea, but how bad. So I did a home sleep study. Turns out I have fairly mild sleep apnea all things considered. I had anywhere between 11-40 events per hour depending on the stage of sleep I was in. And off I went to get my fancy pants CPAP.

I was not happy with the diagnosis, but I was glad to know what was wrong. I didn't want the CPAP but I was determined to give it a fair shot and use it. I had to see if it would help.

The first night was the worst, but not for the normal reasons. It wasn't because I had this mask and hose coming off my face. It wasn't because I look bloody ridiculous wearing the blasted thing. It wasn't because of the Darth Vader noises I now get to make.

It is the fact I have to wear it at all.

I went to bed early so I could lay down and get used to this thing under my nose and a new way of breathing. I laid down and started to read. I laid there for about 10 minutes and I burst into tears. I tore that mask off and sobbed. Marshall came in and was bewildered as to what had happened. I only cry that hard when something truly awful has happened. It took me a while to calm down enough to tell him what was going through my head. It all hit me like a ton of bricks.

How did I let myself get to this?

How have I not loved myself enough to take care of my body?

Why did I feel I have to hide?

What bully did I listen to and take their words to heart to believe I'm not worth loving?

All I can say is I have been beyond blessed to have my husband. He talked me down, hugged me, wiped away tears and just held me.

I felt like I truly had hit rock bottom. I have hit some really low points, but this last month has been rough. What little weight I have lost according to my scale I have gained back, but my smaller pants still fit so that's alright. But I have been self-sabotaging my efforts and eating like crap again. Some days I realize it and stop. Some days I realize it and give in. Some days I don't realize it until it's too late. But it's getting better.

Today I had my one month follow up appointment. My doctor is very proud and impressed.

I had 2 days out of 30 that I wore it less than 4 hours. I remember those nights too. I had gotten too hot and started coughing. If you cough while wearing a CPAP you feel like your are choking and drowning. It's awful. I was so asleep I didn't realize that I was coughing because I was hot, so I just tore the mask off and turned off the machine.

My average number of events is 0.2 hour, and every 4th or 5th night I'm not having ANY events at all. My doctor said this was phenomenal.

I am not tossing and turning as much and if I do it's because of my hips and back hurting. I'm sleeping deeper through the night. To the point I wake up disoriented because I was sleeping so hard.

I had been disappointed there weren't leaps and bounds in my energy or other improvements, but my doctor was fine with it. He reminded me that I didn't have severe sleep apnea and that I wouldn't see these huge changes almost overnight. Mine are going to be smaller and more subtler changes.

He asked me how I liked my CPAP and was very surprised when I told him I hate it. I hate that I have to have it and I hate using it. It serves it's purpose and is necessary for now. It is another medicine to get me healthy. I told him I working towards getting back to where I don't need it. He grinned, told me he loved my attitude and he would be more than happy to order a new sleep study when I get to where I want to be.

I'm not sabotaging myself like I was now that I have kind of processed all of this. I'm letting myself be angry and heal. I'm doing better, but it's a long hard road. If weight loss was just about calories in vs. calories out, I could get the weight off pretty quick. It's so much more though.

Lesson from all of this: If you think you have an issue, go get it checked out. It may not be the answer you want, but if you can get help and feel better it is worth it.

***

To end on a happy note I just got home from MD for a work conference with the US Pharmacopeia and the FDA. Flowers are already starting to bloom back there and I am jealous! It was a great conference. I learned a lot and met some awesome people. 

Sunrise Sunday morning in Denver

 In a weird fluke I got to fly first class going both ways. Now that I have seen how the other half live, I'm not sure I can fly in coach again!

Stuffed French Toast and fresh fruit. Notice the real plates and silverware!

Warm cinnamon roll

Supposedly looking towards Pittsburgh

Flying over the Appalachians

 Went to a nearby mall Sunday night to walk and have dinner. I drooled over Teslas and fancy pens.

 I brought a coat I hadn't been able to wear, but I can now wear again. I was thrilled when I found out it fit again!

A little tea treat for myself

 I also got to tour the little museum at the USP and I would have loved to browse through there longer.

Pharmacopeia from the 1800's. They would send out individual pages as they were requested with the latest updates.

The USP

 The flight home was a little turbulent. We were flying over some impressive thunderstorms. The sun was setting as I watched the storms roll by. I wish that picture had turned out.

Bowl of warmed mixed nuts

 Dinner was a seafood stew with rolls and a salad. We got a warmed cookie for dessert.

I don't know how I got so lucky to fly first class, but I won't argue!