mizducky's migrations: a weight management blog with attitude

Weekly weigh-in: sigh ...

Ah, the numbers:

• Today's weight: 239.5 lb
• Change since last week: +0.5 lb
• Cumulative weight loss: 94.5 lb
• Average weekly weight change: -2.15 lb

Sigh. And this after I went through Thanksgiving in fairly exemplary fashion.

But truth be told, while I did stay away from the total food-plan killers like the desserts and such, I will cop to a certain sketchiness in my portion estimation at the holiday potlucks I attended.

That, and I didn't get any formal exercise in at all last week--I was nursing a cold, and also had a lot of stuff to do, so I was always either too tired or too busy or too crappy-feeling to get down to the exercise room. This week is going to be even wilder--plus suddenly I'm nursing a hurting knee I managed to torque out somehow while hauling laundry up and down stairs today. (I always manage to leave the laundry until there's so much that I either have to make two trips or haul a huge bagful all at once--either alternative means a risk of knee blow-out.)

All this is putting some new realities right in my face:

• The next bunch of poundage is in all likelihood not going to be as easy to lose as the bunch I've lost so far. It was one thing to keep a positive attitude while the weight was rolling off; I need to get ready to stay psyched even if weight loss slows to a crawl.
• I can certainly do my food plan a good bit tighter than I've been able to get away with in the past, but cutting anything out of the baseline is a non-negotiable "no."
• Since I won't be cutting my food intake, exercise is going to gain increasing importance, to keep the metabolism stoked for optimum weight loss.
• I'm going to have to get a whole lot more clever in how to exercise without bunging up my knee. I can't get into any kind of consistent exercise pattern as long as I keep having to stop due to overexertion damage.
• Meanwhile, I'm starting to get a life again, and the last time that happened while I was doing successful weight maintenance (back in my 20s), it knocked my whole program off its tracks. I need to do that smarter this time--make sure I stay focused on the goal.

Time to get on it, then ...

Recipe: roasted apples

This is ridiculously simple, but so damn good. Roasting removes some of the apples' liquid content, intensifying their flavor and sweetness, making their interiors soft and almost creamy and their cut surfaces almost like apple-caramel-flavored fruit leather. Who needs a baked apple all tarted up with brown sugar and butter?

Ingredients:

• Large, sweet baking apples -- Romes work excellently
• A full-bodied, on-the-sweet-side soy sauce -- like Chinese dark soy sauce, or one of the other styles of seasoned soy sauces
• Non-stick cooking spray or neutral-flavored oil
• Low-fat yogurt for garnish (optional), and/or ...
• Apple juice, brandy, etc. to deglaze pann (optional)

Method:

1. Preheat oven to 350 degrees F.
2. Cut apples in half, leaving skins on. With a melon baller or small sharp-edged spoon, scoop out the seeds from each half, leaving a small indentation.
3. Use a baking dish (preferably metal) big enough to hold all the apple halves in one layer with a goodly amount of room between them; spray the interior liberally with non-stick cooking spray (or grease lightly with oil if you're using that instead).
4. Place the apples cut side up in the baking dish. Dribble a scant half-teaspoon of the soy sauce into the indentations where the seeds used to be.
5. Place on a middle shelf in the oven. Roast for about an hour, or until the apples are soft and their cut surfaces well caramelized (check on them regularly so they don't overcook).
6. Use a spatula to gently lift each apple-half out of the baking dish onto individual serving plates. You may optionally place a small dollop of low-fat yogurt in each apple-half's indentation. Serve piping hot.
7. You may optionally use a small amount of apple juice, brandy, or other flavor-compatible liquid to deglaze all the reduced caramel-like juices off of the bottom of the baking pan. Use the deglazed juices as-is to drizzle over the apples; or add some additional spices or flavoring as desired or inspired to do; or maybe add a little bit of cornstarch slurry to thicken the sauce.

Surviving the holidays, round one: Thanksgiving

I have a long-time habit of referring to New Year's Eve as Drinker's Amateur Hour--the one night of the year that even people who usually never touch the stuff tie one on, and then demonstrate that they have no idea how to handle it. Practiced drunks may do some pretty damned stupid things, on foot and behind the wheel, but at least they have some experience with being inebriated. The New Year's Eve amateurs and other weekend warriors don't even have that going for them, which is why I hate to be anywhere in public on that night. Let alone out on the highway.

Well, now that I'm well along on my healthy eating kick, I'm beginning to think of the holidays in general, and Thanksgiving in particular, as Overeater's Amateur Hour. Even many people who normally eat sensibly throw caution to the wind on Turkey Day, consuming quantities that would make a stevedore fall over in agony ... and then they wonder why they feel like a Mack truck hit them the next day. All the tricks of the trade that us seasoned overeaters have learned from years of practice--like pacing yourself, not wasting plate or stomach space on unworthy offerings, wearing loose-fitting clothing, having plenty of antacids and other stomach-settlers on hand--these amateurs are completely innocent of, and so they suffer. Or nod off on the couch from tryptophan-overdose with the football game blasting away on the TV.

Meanwhile, I find myself a newbie at a whole new type of holiday food game--how to get through the holidays as a healthy but non-self-torturing eater. On the one hand, the worst thing I could possibly do to my head on such a tradition-drenched food holiday as Thanksgiving is to make myself feel like a deprived martyr--that's just asking for psychodrama binge mentality to take over. But on the other hand, I certainly don't want to indiscriminately stuff myself just for the sake of gorging--the results of that were never pretty back in the old days, and they certainly wouldn't feel too good now. So, as in so many other situations, the quest here is for the middle ground, for moderation.

Fortunately, my current life situation has conspired to make this Thanksgiving a lot less tempting food-wise than in many previous years. For one thing, I have no immediate family here in Southern California, so therefore I had to attend no command-performance Thanksgiving dinners. Given the terrific cooks in my family, missing their feasts was kind of sad ... but at the same time, it removed a huge amount of temptation from the day's eating because, frankly, I've yet to eat a Thanksgiving meal to measure up to those turned out by my family.

It's a sad fact, but there are just a whole lot of people out there who, while posessed of many excellent qualities including generosity and hospitality, simply cannot cook their way out of a paper bag. That little gap in these folks' many talents becomes glaringly apparent when they invite you into their homes on Thanksgiving Day. But like I said, this does work to my advantage these days: I visit, I dine on just moderate portions of their generously-offered food, I feel no temptation to overeat, pure relief at having my regimen as an alibi for not taking seconds, and genuine pleasure at being freed to focus more fully on the more important reason for being there, that of companionship.

For another thing, the organo-groovy Unitarian Universalist church to which I belong has a full calendar of Thanksgiving goings-on which, while definitely food-oriented, help me take the focus off of feeding my face and put it on more important issues, like community, social justice, and giving aid to those in need. So on the day before Thanksgiving, instead of running around like a madwoman doing last-minute shopping and advance food prep, I was minding our church's distribution center for a pie sale to benefit a meals-on-wheels program for persons with AIDS.

And Thanksgiving Eve, I attended a church service and congregational potluck, where our congregation-wide sensitivity to healthier, more holistic food was very much in evidence. At our church potlucks, there will always be a few old-standby casseroles and gooey sweet desserts, but I can also always count on lots of vegetables, salads, fruits, meatless entrees, and other healthy options. And there are definitely a bunch of cooks among that group who know how to make such dishes sing.

And then on Thanksgiving Day itself, our church played host to a community dinner for persons with AIDS and their families, as well as others who might not have family with whom to spend the holiday. This was an incredibly heartwarming gathering, definitely reminding one that there were more important aspects of this holiday than the food. Which was good in more than one way, because, well ... not in the least to slight the outside caterers who donated the food, but it really wasn't all that good. Wholesome and nourishing, yes--and they did serve lots of veggies, including a decent mixed green salad. But ... oh hell, I dunno, I guess my family's terrific cooks really spoiled me!

But once again, the result was that it was relatively easy and graceful for me to resist overeating and stay present for the real feast, that of peace on earth and goodwill towards my fellow humans. And for that love feast I am definitely, deeply thankful.

Weekly weigh-in: back on track before the holidays

Well, I went for my normal weekly weigh-in on Tuesday, but then the pre-Thanksgiving busyness descended upon me and I had no time to post until after the turkeys had flown the coop. But by the miracle of blogging software, I still get to post-date this entry to its proper date. So, without further ado, the numbers from Tuesday 11/21:

• This week's weight: 239.0 lb
• Change since last week: -3.5 lb
• Cumulative weight loss: 95.0 lb
• Average weekly weight change: -2.21

So, after the previous week's upward spike due to going off my diruetic blood pressure meds, I'm heading back down once again. There's no easy way for me to know if any of this week's weight loss is due to dropping some of the water weight I previously slurped up; I suspect not all that much, because I'm still seeing a little late-night edema in my feet. But I'm due to see my primary care physician in a couple of weeks, so I'll hopefully find out a little more then.

In the meantime, though--hurrah for getting back on track!

Re-banishing the bathroom scale

It all started so innocuously. I was just freshly home from the hospital after my hysterectomy, under strict orders to rest as much as possible and under no circumstances to get behind the wheel of a car until I no longer needed the Vicodin. So there was no way I'd be driving up to my HMO's healthy-lifestyle clinic to do my weekly weigh-ins, and so borrowing a home bathroom scale seemed to make perfect sense.

And when the presence of the scale tempted me into wanting to weigh myself more than once a week, well, that was a bit of a problem. But it did come in handy recently when I wanted to track what the hell was going on with my dehydration and water weight.

There was just one problem. I wasn't leaving it at just weighing myself a few times a week. Or even daily. Little by little, I found myself creeping back into the old dieting-insanity mindset of jumping on the scale several times a day. Just to see if my weight had changed because of that recent bout of exercise. Or that slightly heavier-than-usual meal. Or that bowel movement. Or sunspots. Or whatever. My old obsessive-compulsive scale behavior was back with a vengeance.

And along with it had crept back in a whole nest of crazee dieter's thinking. Yeah, I just slightly bent my food plan the other night--but look! My weight is down, so I "got away with it"! Or worse: look, my weight is down, so I can now "get away with" bending the food plan a little tonight! Or, damn! My weight crept up for no apparent reason, so maybe I'll skimp a little on my food plan for the next day or so. This way lies madness. I know it from past experience. Once dieter's mentality starts letting the number on the scale rule my brain, my behavior and thinking starts getting way the hell out of whack, until the inevitable finally happens and I start really fucking up the regimen.

The final straw was when, even though I knew the six pounds of water weight I put back on when I went off my blood pressure meds was weight I needed to put on, I could still feel a tiny corner of my brain bumming out. Instead of being within striking distance of 100 pounds lost, I now was set back several pounds--horrors! Or more accurately, horrors if I didn't nip this train of thought in the bud before it kicked me into a really stupid bout of the blues.

The scale is now put away. It's still in the apartment--in fact, it's still in the bathroom. It's just no longer right out there on the floor, where it was so easy to step onto after a shower or a shit. Sure, I could always take it back down again, but then I'd have to admit to myself that I am breaking my resolve to not use it.

The first couple of days after the scale banishment, It was fascinating, in a kind of unnerving way, to watch my obsessive-compulsive behavior tendencies flap around in the breeze. Every damn time I used the bathroom I caught myself getting ready to step on that no-longer-there scale. How quickly the old habits jump right back into place. Heh. It's like riding a bicycle--you never forget. It's mellowed out a little since then, but the pull to transgress is still there. If it keeps being this annoying, I'll track down the woman I borrowed the scale from and get that damn thing out of my house. But right now it's manageable, and kind of instructive, so I'm letting things be.

It's also instructive to watch my dieter's brain re-organize around scale-no-longer-present. Now, instead of obsessive thoughts about what I can "get away with" based on the magic number on the scale, Dieter Brain is re-realizing that the only remaining control it has over my weight is to stick scrupulously to the food plan. Voila--no more little rule-bending behaviors. Hey, if you can't erase the silly psychology, at least get it to work for you, I always say.

But it just goes to show me, how easy it is to start backsliding, even after all the huge amount of psychic energy and effort I've poured into this project, not to mention all the positive reinforcement I've gotten from compliance. Looks like eternal vigilance is the price I must pay for freedom from dieter's insanity. But hey! At least I caught myself before I had a chance to really screw myself over.

Weekly weigh-in -- wow, that's a lotta water!

Okay, first weigh-in since my fainting drama of last week:

• Today's weight: 242.5 lb
• Change since last weigh-in: +6.0 lb (!)
• Cumulative weight loss: 91.5 lb
• Average weekly weight change: -2.18 lb

Assuming all of those six pounds represents water weight I put back on since going off my blood pressure meds, all I can say is: holy crap! No wonder I keeled over from dehydration!

Needless to say, I don't feel bad about putting back those six pounds--those are obviously six pounds worth of fluids my body desperately needed for proper functioning. I hate to think what other kinds of damage I could have possibly done to myself if I kept on being so severely dehydrated.

I continue to feel a tiny bit of edema-bloating happening in my feet and ankles at the very end of the day--like right now, for instance, at 10pm. Something I will continue to keep my eye on. On the other hand, ever since I went off my blood pressure meds, I have been feeling noticeably more bright-eyed and bushy-tailed. At first I thought the meds might have been having some kind of psychoactive effect on me that was now removed ... and then it dawned on me: duh! I was probably faintly woozy from dehydration for weeks, without knowing it. Just add water and swoosh! Brain perks right back up.

Meanwhile, life--and the weight management effort--continue onward. I got the stitches removed from my upper lip this past Monday. On Tuesday I felt sufficiently rehydrated to try my first bout of relatively hard (for me) exercise since the fainting incident: 30 fairly strenuous minutes on the exercise bike. I felt perfectly fine afterwards, from a staying-conscious-and-not-passing-out standpoint. However, today, the ol' left knee is feeling angrified at me. Sigh. And so it goes--once again, gotta nurse the knee back to relative happiness, and remember for next time to take it easy with the bike.

Geez, it's always something with me, innit? Oh well ... onward and outward ...

The silver lining: no more hypertension meds!

Today I went in for my med-readjustment appointment with the doctor subbing for my regular primary care physician. Turns out my regular doc was being medic-on-location for one of those Susan G. Komen breast cancer fundraiser walks, so my bummer over not seeing her was lightened considerably.

So this friendly gentleman took my blood pressure a few more times and did a few other relatively non-invasive doctorly things, and decided that I should try being totally off all my blood pressure medications for a month, at the end of which I'd come in for another followup appointment.

To have lost enough weight to have made that much of a change in a significant aspect of my health is a major breakthrough. So any remaining bummer I had been harboring over the stitches in my lip, and the scar that might remain, has also been lightened remarkably.

I can't emphasize enough my feeling of satisfaction over this. Not to mention my feeling of gratitude that my basic constitution is sturdy enough that it's capable of responding so positively to my work so far.

It will be interesting to see how my body responds as it begins to shed all remaining residues of the Maxzide, lisinopril, and potassium supplement. I know for sure one side effect is already underway; without the diruetic effects of those drugs, I'm beginning to retain more of the now more copious amounts of fluids I'm pouring into myself. I can feel a very slight bloat trying to happen in my feet and ankles, and one of my rings has gotten overly tight on the finger I had been wearing it on.

No doubt I'll be back up a couple of pounds at my next weekly weigh-in. But that doesn't upset me one bit--after all, that couple of pounds represents water my body desperately needs to keep onboard to function properly. As for the bloat business, I actually think it's just a rebound effect from cutting off the meds cold turkey. I'll watch it carefully, but I expect it to even out after a few days or weeks as my bod regains water equilibrium.

Maybe I'm imagining it, but I feel like there are other subtle changes going on as well. Like, I actually feel a little more clear mentally, or something. Placebo effect? Who knows? Worth at least paying attention to.

Oh yeah, and I'll tell you one other change I'm definitely looking forward to. One of Maxzide's side-effects is sensitivity to sunlight, which has been a royal pain in the ass here in sunny Southern California, let me tell you! So while I still need to guard against basic sunburn, at least I won't have to totally take cover on super-bright days anymore. Huzzah!

A little emergency-room excitement (a.k.a. all's well that ends well)

As many of you are probably well aware, proper dosages of medications usually need to be scaled to one's body weight. A child needs to take much less of a medication than a full-grown adult; an elderly adult also often needs to take less than a younger adult due to decreased muscle/body mass. Likewise, a very fat person will need a higher dose than a skinny person, or else the med will be too diluted in that greater body mass to produce the required effect. Contrariwise, when you lose enough weight, you eventually need to get your prescriptions scaled down, or else you'll be taking way too much for your new body mass.

Now at this point I've lost around 97 pounds, which represents almost 1/3 of my original starting weight. I've been on a bunch of long-term prescriptions for some years now, including blood pressure meds (Maxzide and lisinopril), and figured I probably needed to get those scripts readjusted at some point, but somehow never quite got around to it. My excuse, and it's not such a flimsy one, is that it's a royal pain in the ass trying to get in to see my primary care physician--half the time when I call up, I get told she is booked up solid for the next couple of months, they aren't even taking appointments further out, and to call back in a month when they start taking appointments again. And then I'd call back in a month or so, and discover once again she was all booked up and they weren't taking any more appointments ...

Well, apparently all of this came to a head (so to speak!) last night.

We've been having unseasonably hot Santa Ana weather around here, so my home office has been a little sweat box. Still, I'd been soldiering on with my work, and had even snuck down to the exercise room when things cooled off after sunset for some stationary bike time. And I guess I wasn't drinking quite enough water, and then innocently compounded the mess by eating a bowl of low fat but extremely salty popcorn ... So in hindsight it was not so surprising that, around 10pm, I was sitting at my desk typing at the computer, and suddenly start to feel extremely woozy.

I was fading in and out, and had gotten as far as vaguely thinking "Gee, maybe I should go lie down..." when Mama Nature took matters into her own hands. I came to on the floor, next to my desk, with no memory of having fallen--just a head fulla fuzzy, and a lovely gash in the skin between my nose and upper lip. I still have no idea what the hell I caught my lip on--I'm thinking one of the corners of my desk, though there's no tell-tale blood spatters. In fact, thank goddess, the wound didn't bleed all that much at all. Didn't hurt anywhere near as badly as I would have expected either. But still--ow. And it was deep enough to definitely need stitches, and probably a tetanus shot too.

My roommate, bless his heart, was very oblidging about whisking me away to the emergency room of my HMO's hospital (which is fortunately less than 1/2 mile away). The ER folks of course got all concerned about why this lady fainted dead away out of the blue, as that could potentially be due to any number of things, some of them quite dire. But as they start running tests, they determined that my EKG and blood sugar and reflexes and such were totally textbook perfect, but that I was indeed severely dehydrated. And most entertaining of all was my blood pressure reading.

Time was when I'd regularly get systolic readings (the first number of a typical BP reading) up around 134, 140, and even higher. Meds would bring it down to 120-ish over 80-ish, which is considered normal. But last night, the ER folks were getting readings on me as low as 97/67. Yeowch! No wonder I fainted!

In fact, what I had experienced was a classic episode of syncope (the medical term for fainting) as is often seen with hypotension due to dehydration, such as can be brought on by the diruetic in Maxcide and by ACE inhibitors such as lisinopril, especially if there's also insufficient fluid intake. In other words, between the apparent excessive dose of BP meds due to decreased body mass, the hot weather, the not drinking enough fluids, and that damn salty popcorn, I guess I produced the perfect storm of syncopes.

So they dripped a couple bags worth of saline into my veins (it's amazing how much I perked up within a few minutes of them starting the IV), sutured up that lovely gash in my lip, and gave me a tetanus shot. They also got me an emergency appointment with another doctor in the same clinic as my primary care physician to adjust my meds--apparently even they couldn't get a toehold in my regular doc's appointment calendar, even for an urgent issue. They also instructed me in the meantime to not drive (yikes!--yep, definitely grateful this didn't happen while I was behind the wheel!).

While I'm waiting for my meds to be redone I'm also supposed to take my blood pressure daily with my home BP unit (which of course I had not done in weeks), and if it's well underl 120/80 again to just skip my hypertension meds for that day. I took it this morning and it was around 107/mumble, so no Maxzide or lisinopril for me today.

So how's that for a fun evening of excitement? (Insert glyph of sarcasm here.)

But seriously, I really am glad I had this incident in the relative safety of my own home as opposed to out in public--especially out in traffic! Obviously, I wish that somebody had warned me about the hazards of letting this meds-readjustment thing go unaddressed for so long--alas, the person overseeing my HMO's weight loss group, while a trained weight loss counselor, is not a physician. But still, I think there should be some sort of warning about this kind of thing somewhere.

Which is another reason why I'm blogging about it so extensively here. On a certain level, losing enough weight to mess with one's meds is the kind of problem you don't mind having--after all, it means you're actually getting somewhere with the weight loss. But when one's goal is healthy weight loss, it's still a problem one wants to avoid. I'm still annoyed at myself about the gash--even though the doc took great care stitching it up, I'll probably wind up with a little scar--but I'm glad that's the worst I got off with.

P.S. I'm now wondering why this problem didn't surface when I was in the hospital for the full hysterectomy this past August, or during any of the followup visits. After all, they took my blood pressure about a bazillion times throughout that. But I make a point of seeing what reading they get when they do my BP, and right now I'm not recalling any excessively low readings. I'm also wondering if the surgically-induced menopause from the removal of my ovaries might also have added to my little hypotension mess in some way. Who knows?!? It's a puzzlement to moi!

Weekly weigh-in -- down again, creeping up on the century mark

The numbers:

• Today's weight: 236.5
• Change since last week: -1.5 lb
• Cumulative weight loss: 97.5 lb
• Average weekly change: -2.38 lb

And now we're creeping back down again--hurrah!

By the way, it has not escaped my notice that I'm slowly but surely closing in on the 100-pounds-lost milestone. Obviously, reaching that goal has only symbolic significance, but it's pretty damn cool even if I say so myself.

I'm trying to think of the last time in my life that I weighed less than 240, and I think it might be as far back as sixteen years ago or more. That's pretty darned trippy, I must say. Even more trippy: I might have to do another round of clothing replacement pretty soon. I for damn sure need to buy some new bras and undies (maybe that's TMI, but those of you who have been reading this blog for some time should be used to that by now).

I'm also closing in on my first, extremely tentative goal weight, namely 200 pounds. I still want to re-evaluate when I get to that weight, to see how it actually looks and feels on me before deciding whether I want to just stay there, at least for the time being, or keep going. But right now I still think it makes at the least a reasonable reality-check point.

There are some slight downsides even to something as positive as weight loss. I am definitely beginning to develop some loose skin around my neck and lower face, giving me the beginnings of a little turkey-wattle and jowl business. Ironically, when I was at my top weight people would actually think I was a good ten years or more younger than I am--all that fat filled my face out so I was all round-cheeked and wrinkle-free! Now, I'm actually beginning to look my almost-50 years ... which is not necessarily a bad thing by any means, just different enough to take some getting used to when I look in a mirror (especially in a bathroom lit by flourescents--damn, those things make every funky facial feature stand out like the Grand Canyon!)

Anyway ... another jam-packed work week ahead of me, so no doubt any further posts I make this week will probably just be more annotated links. But never fear, I hope to get back on the beam with longer missives Real Soon Now!

Yet another diet drug "wonder" in the pipeline...

... as in: "Wonder how much this drug, and the others currently in development, will screw up people's health this time?" Apparently, though, it's the financial rather than the health risk/benefit analysis  which is uppermost in the minds of investors lining up for a piece of this lucrative Big Pharma pie:

Link: Amylin's weight loss drug�is risky but promising - Nov. 3, 2006.