More on the medical industry.

Open letter to all doctors everywhere

Dear Doctors everywhere,

First off, I'd like to remind you that everyone is different.  I'd like to ask you not to judge a book by its cover.  If you saw my test results and then came in to talk to a skinny person, the conversation would have gone much differently.  You would have asked questions and let that person be a part of their health plan.

I have never been afforded such dignity.

It is my feeling that at least half of what comes out of your mouth should be questions.  The other half can be advice, but the questions should come first and if the advice discounts the questions, then let me remind you to always listen to your patient's answers!

Do not assume. It makes an ass of only YOU in this situation.

Also, the BMI has been discounted as an acceptable gauge to determine healthy weight in adults by nearly the entire scientific community EXCEPT DOCTORS.  Maybe you should go back to test results.  I'll grant you that my weight is a problem, but my friend is barely above the anorexic looking weight she used to be and was told she is obese at her last appointment.  She looks good, she's healthy, and she's super active.  My brother in law runs every day, looks super healthy, and everyone assumes he is, but his BAD Cholesterol is through the roof AND his GOOD Cholesterol is extremely low.  His doctor does not make him feel ashamed.

Consider that for a moment.  Are you shaming your patients?  Then stop it.

Now I'd like to point out that if an anorexic or bulimic person walks into your office and says he/she is depressed, you are likely to suggest therapy and sympathetic intervention.  You don't just say "Eat more" or "binge less" and send them on their way, do you?  No.  It's well proven to be about mental health (control issues ARE mental health problems, people!)

So why are fat people not considered as possibly having a root cause?  No.  It's just lack of will power.  That's dismissive.  I think anorexic people lack will power to look in the mirror and be okay with themselves.  (Whether I really believe that or not is beside the point.  You see where I'm going with that argument, right?)

And when I mentioned in my appointment that I lost a bunch of weight, got depressed, and gave up, why did that not alarm you?  Frankly, it should have.  Frankly, I've considered suicide at least a dozen times in the last two years.  Frankly, I don't know how to ask for help because when I do, people tell me losing weight is the answer.

But it wasn't the fucking answer.

Sincerely,
Patients everywhere (especially the overweight, chubby, fat, and obese ones)

Reboot 2014

Why wait until New Year's?  The holidays will be rough, but this isn't about weight loss or anything.  I'm here reminding myself not to lose control, though.  It's a problem.

Doctors
I'm not afraid of doctors.  I simply hate them.  I find them arrogant, narrow-minded, and judgmental.

Case in point.  Bio screen turned up blood pressure that was actually high enough to scare me.  Trust me.  That is beyond scary for a normal person.  So, made an appointment with a doctor.  We had to hunt down a new doctor because I didn't like that last one I had, the one before that, or, actually, any doctor I've ever had (except the OB/GYN my sister recommended who turned out to be awesome, but who cannot, of course, help with this problem.)

So, I go to this new guy.  Blood pressure was down a little from last week.  Good.  Not quite so scary.  Still securely in HYPERTENSION ALERT! category, not just "concerning".  He was nice.  Really nice.  Great guy.  Seemed smart.

He looked at me, made a judgement, and then began talking arrogantly as though he knew my life, and then when I tried to explain things, he narrow-mindedly pursued his judgement.  He started by saying "If you add salt to your food..."  Okay, a good doctor starts with "Do you add salt to your food?" Because the answer is no.  I have pretty much NEVER added salt to my food. So I tell him this and then say I look for low sodium soups and when I make homemade soup, I buy low sodium broths.  I say I realize they still have a lot, but I don't have them often.  Then he says "well, those soups have a lot of salt.  So do lunch meats.  Pretty much any processed foods."  Again, did he ask what I eat regularly?  Did he really acknowledge that I already knew they had sodium, but I don't eat them often?  No.  So he talks about salts in processed foods, none of which I eat, btw.  I have lunch meat, like, once a month and soups maybe once a week in the winter.

I could go on, but basically the whole appointment went this way.  He didn't ask me ANY questions.  he just talked AT me.  I had to interrupt him to tell him I had lost a bunch of weight, but I had surgery, got depressed, gave up, and gained back most of the weight.  He said "because fad diets don't really work.  You just gain it back."  Well, y'all here know it wasn't a FAD diet! Right!?  It was so insulting!

So he put me on a water pill to flush my system of water and sodium hoping that will help.  Well, I do hope it helps because it's cheap and it's not something your body adjusts to so that you can never get off of it like other blood pressure meds, but a part of me hopes it doesn't work so I can say "See?  It wasn't just about the sodium!"

I asked him about side effects and he mentioned peeing a lot and such so I specifically asked about potassium because that's usually a concern with water pills and he said "it's a good idea, but this one's pretty mild" so I'm thinking okay.  We'll see.

But I just know, KNOW that when I go in next week that he's going to be all proud of the weight I've lost.  Notice he did not mention that side effect, but it will happen.  I just wonder if he's going to try to spin it like "doesn't that make you want to lose more?"

Oh yeah, and he never asked me if I get any exercise.  He just lectured me about how getting out for even 10 minutes at a time if that's all I can handle will do a world of good.

I wonder if he walks 1 1/2 - 2 miles every day.  We walk a minimum of 30 minutes if we don't know the distance we're going (we do the mile and a half in about 30 minutes at home) which sometimes includes hills or terrain that slows us down.  Either way, it was rather narrow-minded of him to assume 10 minutes might be hard for me, don't you think?

Refocusing my efforts
Btw, the rest of my test results are on the high to mid level green HEALTHY so kiss my grits, everyone who thinks fat automatically equals UNhealthy!!  Based on weight alone, they say I'm a risk.  This is my frustration.  It's the things like cholesterol and blood glucose that should be putting you in "high risk", right?  Not the weight ALONE?  Okay, the BP, but they referenced the weight first in my report.

As I said, I'm not really going for weight loss, though, but once in a while I've been letting myself lose it a little.  I'm going to slow down and enjoy.  I want to feel better so I can do more, but I have this foot injury that's been slowing me down a lot.  It's getting better, but I am reminded of my age by how long it is taking.

I'm recording all my stuffs on SparkPeople.  It didn't work for me before, but I had already been doing great on my own.  I feel like maybe it will be easier to reboot with the app's assistance and I figure maybe I can record what I eat (I'm not really changing my eating habits this week.  I want a week to gauge myself.) and the sodium is low, I can stick it in his damned face.

$$$$!!!
Not to mention, I was a new patient so they wouldn't count it as preventative care?  WTF!  $105 later for him to listen to my breath sounds and insult me.  Plus come back in one week after charting my BP and taking the water pill to see how it's going.  Probably another $105.

I miss $30 co pays right now.

And if he says I have to come back in another week, I will tell him to Fuck Off and I'll leave.

Happy Accidents and Annoying Struggles

Why is this extra delicious?

When we started our diet ages ago, I pretty much cut peanut butter out of my diet.  I love it immensely, but when calculating the amounts, I just didn't get enough long term satisfaction and often felt pretty hungry before dinner came along.  In actuality, I cut out tons of sauces, jams, and the like and started eating most foods plain (and often kind of bland) because those were calories I could spend better elsewhere.

Then we went off the extreme diet and tried to just eat healthy.  I'd have a good old pb&j (with less j than the old days and still on low cal bread) or I'd just have it on an apple slice or banana so I could still enjoy the flavor.  The point is, this made PB last months in our house.  I buy at Costco - 2 large jars.  I bought them a year ago and we just ran out last month so I picked up a regular jar at Target thinking it would last anyway.

Well, last week, I cut up and apple, doled out 2 tablespoons of peanut butter, and had it with coffee for breakfast.  Holy cow.  I thought "Is this what fresh peanut butter tastes like?  Were those jars older than I realized?"  So tasty!  I knew I had the same brand and had picked up creamy as usual.  Next morning, I had it on banana and could not get over how delicious it tasted.

Third day, I'm making a pb&j for Jane's lunch (we only do it about once a month or so because kids don't need all the sugar either, right?) and I look at the jar.  Huh.  Did they redesign the package?  It seems a little less blue.  Nope.  It's 25% less fat - and by this, about 50 calories less per serving!

Long story to say that I love love love when you think something tastes better and then realize it's better for you!

Full Disclosure

People often ask if we've lost more weight.  Simple question, but by now you've probably guessed it's kind of a pet peeve.  Frankly, it's no one else's business.  Mostly I buck up and admit we haven't, but we're trying to maintain.  Sometimes they say that's great, as long as you're not gaining.

But the secret is I do gain.  And lose.  And go back on the diet and fall off the wagon and up and down.  It's about a 10 pound fluctuation so it's not really anything to be concerned about, but I'd really like to go down down down.  Who wouldn't?  The stupid thing is I'll be doing great on the diet, lose a little, then get depressed before I fall off the wagon.  You'd think depression would come after?  Maybe my hormones are still off from the surgery last year, but... that's eighteen months ago.

Either way, I'm super frustrated and feeling again like there's no support.  When Scott wanted to lose weight, I supported him; just like when he wanted to go back to school and the time he wanted to change jobs after 16 years at one company.  Where's my support?  Not to complain because I've been appreciating him a lot more recently, but... when it comes to this, we can both stand to lose.  His balance isn't awesome at all, he's not very flexible, and he still gets winded if we speed walk - three things that are not true for me so on the overall health, it seems like I've got less work to do.

Well, anyway, now I'm high on frustration because I've been counting calories, working out extra, been very careful for two weeks now.  Just weighed myself and lost 1 pound.  In two weeks of feeling very stressed and working really hard, that number changing so slightly makes me angry and frustrated.  I don't know what to do to increase.  Yeah, I should be happy about one pound, but I can't be when I'm working as hard as I was when I was able to lose an average of 2 pounds a week - and the first weeks I lost more because of the change in diet so why isn't it working?

I guess because we weren't going way way overboard, but honestly the last couple of months, we have.  Makes me tired.  It also makes me want to hole up in the house whenever someone asks if I've lost more weight.  I mean, the fact that we did is obviously proof that we can and as we know, everyone else gets to decide my happy weight (insert 'sarcasm' sign here) so please.  Ask me about it more.  It's the only thing I am of value; my weight.

Off to do my first workout of the day, now, and try not to get discouraged.

Update

Yes, we've been neglectful.  We've actually been back onto good eating habits along with continuing our walks for the last few weeks.  My scale broke, but if my pants are an indication, I've lost at least a few little pounds.

Back on track
Things that are hard to get back to resisting: baking (I so LOVE to bake!), putting sauces on food to make them more palatable, and choosing butter OR jam for toast; not both.  In comparing stories, I hear much about how people think they are eating better, but can't lose weight.  One thing I notice on counting calories is they skip counting cream in coffee, butter on toast, etc, etc.  So, this is my official statement to remind people, you must count everything that passes your lips, even if they are hanging on to something else like a little parasite.  Low fat, low calorie dressings still add calories to your salad.  Nuts may contain good fats, but also a lot of calories.  Adding croutons, nuts, raisins, OR bacon bits to a salad can make it more tasty.  Adding all of them makes it a hamburger (from the calorie perspective.)

It's all about choices and when you are confining yourself to a strict diet of difficult choices, it makes other things easier to avoid.  Today I thought I might treat myself to that leftover cupcake from book club last week.  I kept it covered, but took a bite and...it was tasty, but a little dry.  Not delectable so I realized that in my moment of weakness I was about to sell out several hundred calories for that disappointment and I threw it away.  If I'm going to have a goodie, it better be melt in the mouth, taste-bud party delicious.  Otherwise I'll save it for a reliable tasty goodness like my favourite creamer in coffee or a little cheese on my tomato bisque lunch.

Other things: I turned on TV the other day to while away some time while making a Halloween decoration only to be confronted by a certain TV doctor (from over the rainbow?) who I regard highly, but who I do disagree with on rare occasion, touting the evils of artificial sweeteners.  Look, I know they aren't good for you, but I still say if you are trying to lose weight, unless you are the rare breed who can change their life completely overnight and not be tempted by anything, then it's a lesser evil.  In order to make the whole diet thing doable, I, personally, being a human being with thoughts, feelings, temptations, and weak moments, must have one treat a day to get me through.  For me, it's diet soda.  Sure I'd do better if I quit the soda, but that's unrealistic.  Asking someone to be 100% perfect in how they eat and how much the exercise is the unrealistic bit.  For some people, having nutra sweet makes them crave MORE sweets so if that's the case, they shouldn't use this substitute.  No one can do our exact diet because it wouldn't work for someone else.

Anyone who wants to eat healthy must hear the news every day and consider becoming anorexic because it's impossible to make sense of one study after another.  That being said, This TV Dr. mentioned the cancer risks associated with artificial sweeteners and this bothered me.  Just because you've heard something for decades doesn't make it true.  The fact is the one study showing cancer risks to mice in the 70s has been dis-proven hundreds of times.  I lost the article with the exact numbers, but I assure you it was a reputable source.  Besides, artificial sweeteners do not affect diabetes or tooth decay.  (I thought it did, but according to a New York Times article comparing sweeteners, they do not!  Good to know!)

I have some to realize that the knowledge we gain in high school health class is like basic math.  It's find for everyday life, but in order to solve REAL problems (like imbalance, losing weight, gaining weight, making up for allergies, etc) you need to know Calculus Nutrition.  I'm becoming a bit more Algebraic Nutritionist with all my research, but the way I live and eat day to day is more remedial.  I just feel so bombarded with information saying whatever choice you make is the wrong choice.  It's completely overwhelming! Of course, the information they fill our heads with is maintaining perfect nutrition.  If you're off, you'll need to compensate, and if you need to lose weight, well, forget it.  There really is, imo, no way to lose weight and still eat everything you're supposed to eat.  Still, it's better than OVEReating bad fats so I'll only defend the choices to a point.

When you are in a group, especially with women, there will always be that person who has the answer to your problems, too.  If you tell them you are doing everything, they will have the key to why you aren't losing weight.  They can be wrong, but still convinced because it is what worked for them.  There are the ones who convince you it's easy if you just hit the right formula or do this one trick they know.

It does get easier, I'll give them that, but it's not easy.  I repeat, is in not easy.  Not at any point, and especially at the jumping off point.  I think it's the combination of too much BAD information from sources people trust (the news, TV doctors, and uninformed physicians - who act like experts, but let's keep in mind they are required to stay refreshed on their specific specialty and between that, patients, and a personal life are unlikely to become armchair experts in anything else like nutrition), pressure from friends and family, people who make it sound like your social obligation to be thin, and people who make it all sound so easy that sets many people up for failure when it comes to weight loss.  At some point, just close your eyes, point, commit to a plan, and follow it no matter what else you learn along the way.  Of course if you realize you're not eating foods with potassium, you could adjust your diet to include bananas or if you have low iron, it might be good to pile on spinach to the salad or eat more meat, but every time a study pops up or someone tells you you are doing it wrong is not enough reason to quit or sabotage the plan.

Workouts
Last note, a few weeks ago I was told about a webpage <a href="http://www.skimble.com/">Skimble</a>.  It has a great variety of workouts and it's easy to find what you need to focus on.  It is designed as a smart phone app, but for those of us who like our phones stupid, it's still easy enough to navigate and do in front of the computer screen. We walk 7 days a week, but I do my other workouts 2-3 times a week (my goal is 3-4, but I have to be proud of every little accomplishment these days!) and I have found mixing these in keeps it lively.  Not all require equipment, but many do.  It's just another nice resource.

Back to Blog

We fell off "the wagon."

Actually, we held hands and jumped off. We still ate reasonably, but no counting calories. Scott went for short walks, I...did what I could, working up to longer walks. This means we gained a few pounds over the last few weeks.

Everyone is surprised I didn't lose weight after surgery. I think that's only for people who spend the first two weeks in hospital, but with this modern age of "drive-thru surgery" as I've heard it termed, we spend more time recuperating at home where lovely friends and family help out by bringing delicious foods. Meanwhile, there's too much pain in discomfort to walk the miles a day I did before. Of course I gained weight. I know some people can keep weight off just by walking a little. We all know people who can keep weight off by eating reasonably even if they don't exercise much. If that worked for me, this diet and activity regimen we are on wouldn't be necessary.

Getting back on the bandwagon can be difficult, too. I don't know why. Every day starts out great, but by end of day, I'm famished and craving things I haven't even craved for a long time. Still, the exercise part has been easy to re-commit to. In fact, this week I walked one mile in the morning and another in the evening. Doing two miles at once would probably be hard on me, but splitting it up means I get a good workout every day without too much discomfort. I'm not quite up to our old speed, but I'm close. Now I've lost all but two of the pounds I put on while I was laid up. It's definitely time to start eating better in the evenings. Even eating a couple things I know I shouldn't each day, I'm still under 2,000 calories (except one or two days where I went to an event and threw caution to the wind) so with exercise it goes to show your body does learn to adjust.

Meanwhile, I've noticed a few things.
1) The three step program. Several commercials, ad campaigns, and books advertise that losing weight is a three step program. Eat right. Exercise. Buy My Product.

I mentioned this to Scott saying it's actually a two step program of eating better and being more active. The whole point I'm trying to make with this blog and with life is that it doesn't take money to do everything. Spending money on a program might make certain people commit to a program, but if you are truly ready in mind and spirit, spending money doesn't have to enter into it. Walking, hiking, borrowing friends' exercise equipment (everyone knows someone with a neglected treadmill!) costs less than a gym membership. Taking the time to figure out what and when to eat costs less than weight watchers. Yes, it's more work and in this busy world, we have to make time for it, but for some, just doing the work makes it enough to commit.

Well, having decided that it was a two step program, Scott and I we saw a billboard with syndicated characters (I want to say Mickey Mouse and friends, but I can't recall for sure now) who had the ultimate three step version which I would gladly endorse.

Eat healthy. Be Active. Have Fun.

Don't forget that last step! It is certainly the most important.

2) Several self-help health "gurus" are really bothering me. The new comment making its rounds is that overeating is immature. They talk about how giving in to a craving is childish and tell people to "grow up".

Of course, I hate it because they are attacking me so I automatically want to disagree, but I do have an argument against their propaganda that I think is fairly sound.

All animals eat. If you put a dish of cat food and a can of tuna in front of a cat, what are they going to eat? The cat food is healthier for them, but we all know they'll gorge on tuna. It's base animal need to eat and it's basic animal instinct to eat what tastes good. This isn't about maturity unless you are going to say a woman desiring sex when she's ovulating is also immature.

What's immature, really, is thinking that we are so important that we have to answer our cell phone calls as soon as they come in - no matter what we are doing. To me, maturity is demonstrated when a person understands and accepts consequences for their actions. Believing you can talk on a cell phone whilst driving and still give 100% to both is ignoring the fact that there could be consequences for your actions. Dismissing a person's human struggles by calling them childish and immature is a bit of a bullying tactic.

The latest "guru" I heard using this tactic was a motivational speaker pushing his book on the news. This isn't news, kids. This is a guy who has worked to make money without working by persuading and probably bullying people into thinking they are stupid if they don't agree with him. Of course, my experience with motivational speakers so far is that you take a dash of charisma, a modicum of logic, and a lot of useless words to convince people you are right when, if you are smart enough (and MATURE enough) to see the bigger picture, you realize their logic is flawed, their charisma is fake, and their words contradict each other as much as they try to hide reality. It is also my opinion that 90% of self-help books are just mass market motivational speaking. "If I write a book with my 'hook' (a line that is useless and nonsensical, but sounds good and is often catchy so people remember it even if it's lame. The Secret springs to mind...) I can reach millions with my garbage and even if it is garbage, I'm $1,000,000 richer so who cares?" They don't care about your health and well being. They care about their money. It's a get rich quick scheme that is sadly working the world over because people need an answer. The want it to be easy and quick so badly that they will pay anything for it.

It's hard to believe that it really is just as easy as eating better and exercising more. I know that. For years I couldn't figure that out because I ate somewhat healthy and exercised some. It just wasn't enough. If it's not working, eat even healthier (cut more calories or substitute more carbohydrate-high foods for broccoli and protein) and exercise even more (find more activities to do or get heart rate a bit higher). Of course, this is still just my opinion. If you listen to it without question, then I'll become one of those loathe-some motivational speakers...

Okay, now. Where were we?

I now weigh 223 lbs. That is 107 lbs from my highest weight and 77 lbs from the weight I was when I began this process. I am wearing the size I wore my senior year of high school. I suspect my wedding dress would be a bit baggy.

All this weight loss makes a person reminiscent of the past - of the time when I weighed this much or even less. 25 lbs from here is the weight I had on my first driver's license; although I lied about my weight then. I don't remember how much I weighed, but I said 197 just to keep it under 200. I think my next goal might be to actually BE 197 lbs.

Of course, goals and plans get set aside from time to time in our lives. That's okay. I was set to have surgery to remove an offending organ from my body on the 18th of July, but after a second blood transfusion, my doctor and I decided it might not be a good idea to wait any longer so I had a hysterectomy on the 7th of July.

When we first made the decision, I told people about the upcoming surgery and was surprised to hear concerns over weight gain - not necessarily my weight gain, but weight gain after surgery in general or their weight gain. I started researching on the internet about my surgery to put my mind at ease and make sure I knew everything I needed to know and came across a plethora of concerns about weight gain related to surgery as well.

All I can think is who cares!? Why are we so concerned about weight that we freak out at the idea of gaining a little after surgery? If it was elective surgery or cosmetic surgery, sure. You don't want to be further behind, but whether you are at a healthy weight or not; whether you are on a diet or not, just worry about getting better, not weight. This is all, imo, part of this system where we focus TOO much on weight and not enough on HEALTH. These are not always synonymous despite popular belief.

I can walk around, but not for long before I feel some pain. I eat what's brought to me and since we have such generous and lovely family and friends, many delectable dishes have been brought. I craved tapioca and butterscotch pudding so my husband bought me tapioca and butterscotch pudding. It's not an excuse to overindulge in fatty food or eat too much, but frankly, I don't care if I gain some weight. I'll just lose it again when I'm on my feet. I have faith now. I know from experience that it's not that hard. This is life.

Of course, the problems I've been having definitely explain a small portion of why I kept losing weight and not feeling better. Admittedly, it was making me bitter to lose weight, eat better, know better, have confidence that I can accomplish things and yet to feel trapped because I never knew what my body was going to do. Would I bleed heavy that day? Would I have pain? I didn't know from hour to hour, let alone day to day.

Now, thankfully, it's over! That stupid fibroid that was causing increased problems over the last year is gone. I can't wait to see what life is going to bring once I'm up and around again.

Just to kick things off, here's post number one.

Our plan is simple.
1. Try to keep a balanced diet, but stick to 1200-1500 calories each day.

It's tricky at times and occasionally hunger or cravings really do a number on things. We don't believe that you have to give up your favorite things, but some of them may have to be consumed in much more moderation. Moderation here taking on the meaning of "feels like once in a blue moon!" It does get easier and the cravings get fewer and further between. Substitutions are also our friends. We do eat well, believe it or not!

2. Exercise at least 30 minutes every day, but a minimum of 5 times a week.

When we started, He had suffered from an infection that made his leg swell to the size of a tree trunk. Because of the pain and cumbersome bandages, it took 30 minutes to walk just a quarter of a mile. We're at approximately 9 months later and we can go 2 miles in just over 30 minutes.

3. Save money.

Losing weight can be expensive. There are dozens of programs who assure you that you can lose weight if you just fork out the cash. Well, we like to spend our money on cool things like books and games - not to mention new clothes to fit our smaller bodies! While we try to save some money, the bottom line is that eating healthy can cost money. In the end, though, we found that by cutting out the treats and most of the fast food, it freed up money to buy the low calorie foods that are more delicious.

4. Be awesome.

We don't really believe that losing weight will make us happy. We're already happy. If your view of yourself is dependent on your weight, then you have a lot of psychological work to go through before dieting will ever help you. Remember the important things. For us, it's that we have this really awesome daughter and a supportive family. We love each other and stick together through... well... I probably should avoid saying 'through thick and thin' right here. Even when we hate each other, we get along. It isn't as though we've never had rough patches with our appearance, either, but it's a matter of trying to squash out those negative voices and replay the positive ones.

"It's not about losing weight. It's about being healthier. The weight just happens to be fleeing the situation so let it go!" (I use this one a lot when the digits on the scale get stuck.)

"Sure that tastes good and isn't terribly unhealthy, but you've eaten your calories for today so just remember; it will still be there tomorrow."

"Oops. I messed that up. Oh well. Start over right now."

(I'll set up a small album of photos soon so people can see progress.)