Wednesday, July 30, 2008

Thoughts On Maintainance

At a little over a year out, I still weigh and measure everything. I still food journal daily. I have begrudgingly increased my calories, afraid that I will regain...or that my body will adapt to the new intake levels and start up with the chronic, insatiable hunger again. I am constantly afraid that these bouts with being unsatisfied (I'm usually pretty satisfied these days), unfull (which I am, most of the measured portions do not fill me up but they DO satisfy me) will just continue.

This, this is the hard work I think of being further out...and I am so very early in the further out stages. I have a lifetime ahead of me. It's work. Make no mistake about it. It's about diligence in my mind and habits. It's about that constant awareness to determine if it's real hunger, head hunger, or something else. It's about learning to accept that I'm not always going to do this perfectly, but that doesn't mean I am going to go into a downward spiral like I always have in the past. I have more armor to help me in the battle than I have ever had before. I just have to remember to use it.

Thursday, July 17, 2008

One Year Follow-Up at Heart & Wellness

I had my one year follow-up with my after (and in my case, before) care program. I met with Melinda today and will meet with Ellen next time I go in October. We reviewed my labs, all looked good. No anemia, so upping the iron has helped. My HDL cholesterol has come back up (it was below the normal range last November, it is now 54), and my LDL has continued to drop (it is 83). My overall cholesterol was 142, and my ratio was 2.7. Triglycerides were also down. :)

We used the Tanita Body Composition Analyzer to get a weight, BMR, etc. etc. My weight came out at 125, my BMR is 1301. To maintain my current weight, I need a minimum of about 1600 calories daily, possibly more. I have decided to revise my goal weight to be 120 (from 115). If I get there, fine; if not, that's okay too. My body fat percentage was actually low (in the athlete range) at 20.5%; essential fat is 12 to 15, athlete is 16 to 20, fitness is 21 to 24, acceptable is 25 to 31, obese is 32 and above. So I'm lean...I guess this flabby stuff really IS skin and not so much fat.

Melinda and I talked about the issues I've been having with horrible, quick onset fatigue, typically when working out. She said "yeah, it's called hitting the wall." And it's happening because my body's glycogen stores are gone. The reason eating has not improved the symptoms is because the things I'm eating are protein and vegetables...and what my body is needing is energy/carbohydrates. She told me "you're an athlete, your body is functioning like an athlete, and you need to start thinking like an athlete and fuel your body that way. You need an actual energy bar, not a protein bar, or at bare minimum, some Gatorade or fruit juice mixed in with your water during your workout. You'll feel a huge difference." I'm going to start putting about 8 oz. of Gatorade in my 20 oz. water bottle that I consume while I'm working out. Hopefully that will help. My daily fat intake at 30% of my calories would be 53 I've been low on that most days. Overall, it was a really good appointment.

I have to say that when she told me "you're an athlete, you need to start thinking like one," I just about cried. I've never been an "athlete"...not for any length of time. It feels great to know that the hard work on my body has paid off and shows.

Monday, July 14, 2008

Lots On My Mind

I have so much on my mind lately. I'll be changing roles within my company in the next several months. I'm feeling both excited and scared about the challenges and doing the job well. I have the greatest fears about being inadequate, letting people down, doing a poor job. Last week in therapy, I briefly talked about my feelings of being an imposter, thinking that someday everyone will realize that I'm not as bright as they think I am...that I've had them all adequately snowed/fooled for years. My therapist said we'll have to talk about that one more in-depth next time.

I've also been pondering changing my goal weight. When I first started pursuing weight loss surgery, I had in mind a goal of 125 to 130 lbs. It wasn't ideally where I wanted to be, but I knew I could be "happy" there, feel better, be fit, active, look normal. And then, when the weight loss started and seemed to go so well, I thought well maybe setting my ideal goal isn't such a bad thing, maybe I can attain it. For the past 2 months or so, my weight has been pretty stable. I have lost, at best, 3 lbs. The scale has reported my weight as anywhere between 124 and 128.5 lbs. My clothes fit, I'm healthy, feel well, have a normal BMI, look fit and trim (if not thin), so perhaps my original goal of 125 to 130 lbs. wasn't off the mark. I'm not willing to eat less or work more than I do now to lose more. If my weight stabilizes here, that will be fine. If I lose a little more, that's ok too. I've struggled with whether to officially change the goal as stated on my ticker and in FitDay. I know it sounds silly, but I feel like somehow, by changing it there I'm giving myself some kind of out, taking the easy way out. I know it's not rational. I'll be discussing it with Melinda and Ellen on Thursday, I think.

I've also been thinking quite a bit about my potential to have more children. As I get older, and I remain single (despite my best efforts), the reality of me meeting someone and adding on to my family becomes less and less likely. I have never done particularly well with hormonal birth control, and barrier methods have proven less than comfortable for me (latex and spermicide sensitivities). As a result, I am also having a consult with my OB/GYN on Thursday to discuss the possibility of getting an IUD. I have always read that I would not be viable candidate because of my previous tubal pregnancy. But, I'm going to ask because I'm not quite ready to consider tubal ligation...though I imagine it's something we will also discuss on Thursday while I'm there. And it makes me feel really sad.

Zachary has been having a really difficult time lately. Last week, he went into a complete meltdown about eating his dinner. That led to him being unable to calm himself down because he started thinking about (dwelling on) his size, his "friends" at school teasing him about his small stature, and he finally asked if I could please just help him calm down. I asked him how I could do that and he said "just say something nice to me." My heart broke for him. And we had a very long talk and cuddle session. We spoke about the importance of friends being kind to each other and treating each other well. A person who makes another person feel badly about himself is not really a friend. This was very distressing to Zachary since he considers some of these children who have said mean things to him to be his closest friends. From there, he went on to be upset about how he has only one friend who isn't mean to him. We talked more about that, and we listed all of the people who ARE good to him. I stressed the importance of him sticking with the people who treat him well, who are good to him, and that he does not deserve to be treated badly by anyone. I also gave him some strategies that I hope he will consider using when people do say and do mean things...because they will, that is how life is sometimes, unfortunately. But it made for a very sad evening for him, and as a result, for me.

Last night, as he was heading to bed, Zachary was telling me how lucky he is to have been born. I ask him why that is, and he said "well because usually people aren't born to people who aren't married, and you weren't married." I said "well actually lots of people have children when they aren't married. It's not the only way obviously, but there are many people who have children when they aren't married." Then he said he misses his dad and wishes he could spend more time with him. I asked him if he had told his dad that he would like to spend more time with him and he said no. I said "well, you could try having overnights again with daddy, and that would give you more time with daddy." He said that he didn't want that, that he meant more like he wanted a week. I said "well, we can talk to daddy about that too, but if you spent a week with daddy that would include overnights too." And then he said "I wish you and my dad had been married." I asked him why that was and he said "because then I could spend all the time with both of you, not so much time driving back and forth in the car. I'm really sad." I told him I understood that and I was sorry.

He's a deep little thinker, my little guy. He has asked lots of questions about things I would never have thought he'd ask at this age. I've always answered him honestly, and tried to deal with whatever feelings he had as a result. But it's hard sometimes...and it tugs at my heart strings.

Wednesday, July 9, 2008

All In A Year's Work

I know it's typically "Day's" work, but today, it's been one year since my bypass surgery. It's hard to believe that a full year has passed already. It's really been quite a year (well, and a little more if I include Cardiac Risk Reduction and everything else). I know I'm the same person I was, but I feel like a different person with a different outlook, a different body, different aspirations. I feel like I have life ahead of me now, instead of it being some chore I'm muddling through.

There are many new anxieties since I'm so very close to maintenance of my weight. Number one on that list is regain. I'm petrified of it. I've never in the past managed to keep my lost weight off. In all honesty, I can't even say I know what it was that has derailed me in the past. All I can focus on is the here and now, and making sure I don't get off track. One day, one minute, one second at a time it seems.

To celebrate, I did a little shopping. I haven't bought many clothes except for bras and underwear. I've been ever so fortunate in that I've been clothed by absolutely fabulous hand-me-downs from my cousin. She has fantastic taste in clothing and she's short and teeny like me. I decided to splurge a little on some dresses, because I have none of those. I'm sure they (and I) will look a lot better when I've done my hair and makeup.

Wednesday, July 2, 2008

Food Transgressions

Let's talk about food transgressions the past couple of days specifically. Monday night, Zachary and I went to dinner at Vinny T's. I had one piece of bread from the basket, torn into bits and dipped in olive oil. It's my "treat" when we go there. And it always helps to keep my digestive track running smoothly. For dinner, I ordered the gorgonzola, apple and walnut salad with grilled chicken on top. And of course Zachary and I had, in no time, eaten the entire head of roasted garlic (he's worse than I am these days at scooping out the cloves with his knife and eating them straight, not even spread on the bread). Anyway, when dinner arrived, I focused on eating my chicken first, and it was yummy. I didn't finish it all, but I worked on the salad (lettuce and cheese first). Lastly, I finished with the apples and walnuts. Yup, I ate the whole thing except for probably about 2 oz. of chicken. And I felt ill. Really, really ill.

At first it was just an overfull feeling (not pain, just really overfull). But then I started feeling really hot and sweaty. I thought "oh great, I'm going to dump...just great." We finished and we left the restaurant and went home after stopping quickly at Bed Bath and Beyond. I was doing ok except for the really gross overfull feeling. But I got more and more uncomfortable the more time passed. I got into pajamas (it was maybe 7 p.m.) and I asked Zachary to do the same. And then, I went to lay down on the couch beside where he was playing Guitar Hero...because I sure as heck wasn't capable of sitting upright. I felt that carb coma actually feels like being ridiculously drunk/out of it, without the "good" part of being drunk. I cursed myself for eating the whole salad and the one piece of bread. An hour and a half after finishing dinner, I was still miserable. I told Zachary we were going to bed. He wasn't tired. Too bad, I said...I am incapable of staying up at this point and you can't stay up on your own. It's can read in bed but you need to be in bed." He complied. And I pretty much passed out. Unable to get comfortable because my stomach hurt, I don't know how I actually fell asleep (passed out is more like it), but I did. It was several hours before I woke up and realized that I finally felt better. Blech.

Fast forward to Tuesday evening and a work party/bbq at a coworker's home. I plan to eat clean. Some grilled chicken and some salad. Well, some events transpired at work late in the afternoon and so I indulged in about 2 oz. of a frozen mudslide drink when I first arrived at the party. It was enough that I felt it, but not too much, and I didn't want anymore. And I ate my chicken and steak and salad. And I had some potato salad. And then I had some of this dessert that had crushed vanilla wafers and pineapple and butter and whipped cream. And then, maybe an hour later, I ate the cupcake that Zachary had licked all the frosting off of. And about an hour after that, I started snacking on Doritos and some dip. And then, I felt really, really sick. Wishing I could just go in a corner and die somewhere for a few hours sick. After feeling that way for an hour, I took two Rolaids...which promptly made me finally sick and not much of anything came up but I could still taste the damn mudslide. And then, I started to feel less queasy. Finally. And then, my blood sugar started to crash and I had to eat an apple to keep from feeling like I would pass out. Then, we went home and went to bed. It was late, I was spent, and disgusted with myself and grateful for my tool.

This morning I woke still feeling queasy and with a pounding headache. It was as though I had a killer hangover, from 2 oz. of mudslide. Even the protein drink I opted for this morning for breakfast didn't feel good going down. My tummy has recovered throughout the day, and I've eaten "cleanly" all day. And I've thanked my lucky stars for this tool I have to remind me just how crappy it feels to abuse my body with food. Alcohol isn't the issue...I don't miss drinking, wasn't drinking really before I had surgery. But now? Well, I just see no use for it in my life ever. None. Thankfully. It's an easy choice.

Food, on the other hand, I'm sure there will be other days that my demons come to haunt me. I likely will cave to temptation again at some point. I hope it's a good long time from now though...and that's up to me. Because I want it to feel this cruddy again. The validation that I made the right choice in having RNY is wonderful. As cruddy as my body feels today (and last night and the night before), it really is a validating experience.