Friday, February 27, 2009

All apologies

Many people seem to think fat people need to apologize simply for being fat. Some of them are fat people themselves.

I like tie-dyes, batiks, and bright colors. I don't purposely wear things that make me look like a pumpkin--horizontal stripes have not been a part of my wardrobe repertoire for quite some time--but neither am I afraid of color. I do try to wear colors that are good for me, fun accessories, etc. I've often been complimented on my fashion sense as an adult, which is still a bit of a jolt for me since I was the kid with the clothes from a garage sale (before that was cool) or the ugly K-mart fall-aparts. In my real adult life, I'm a T-shirts and jeans person by nature. (I do believe in good hygiene at all times, and foundation garments in public. Makeup, however, is optional.)

So on this day a couple of years ago, I was wearing a nice, not inexpensive, batik outfit from Junonia, a button-up shirt with matching pants. It was red, more toward the wine end of the color wheel than the Santa end. The coworker--who was at least my size, if not larger--said, "You know, I could just never wear anything like that," hastening to add, "but it looks fine on YOU."

My response was immediate: "I wear whatever appeals to me, what I feel comfortable in. I don't feel like I have to apologize."

I could have been offended, and I certainly had a knee-jerk flicker of that, but ultimately her statement brought forth my compassion. I was also really proud of myself, because I knew I meant what I said, and because it showed me I had come a long way. I know what it's like to hide in the navy blue or black sack (I still do it sometimes); women of all sizes joke about their "fat pants", and most of us have *at least* one pair. But it's one thing to have "fat pants" for your own comfort; it's quite another to feel as though you have to be dressed or presented in a certain, impossibly perfect way as an apology to the world at large.

Today, I happened to be wearing a bright tie-dyed shirt. I went to the pharmacy to pick up some prescription-strength vitamin D and some sugar-free candy. I saw the pharmacist give me that look, that "you should be in a big black trenchcoat, you fat hog" look. (She was fat herself.) It's that whole, "Don't just hate the way *you* look, be sure and spread it around" thing women are so programmed and socialized to do in this country from the time we are little girls--that catty, bitchy, competitive bullshit I've never had any time or patience for. (It goes without saying there were no feelings of compassion from me today!)

Apologizing for being fat goes far beyond the clothes we choose. A lot of fat people develop great senses of humor, not only as a coping mechanism, but as a way of being accepted. I know I certainly did, and have, and sometimes still do. (I consider humor the most healthy coping mechanism I have.) Growing up, on some level, I believed that I had to be charming and funny in order to be accepted, because I wasn't pretty in the right way (and I was smart and poor with a screwed-up family whose business everyone seemed to know). This is something I still deal with. Sometimes large women seem to be everybody's buddy or everybody's sister or everybody's mother figure. There seems to be an unwritten code that fat women are just going to take what is offered (bad romantic relationships, wishy-washy friendships, etc.) because they are fat and that's all they can get. Unfortunately, a lot of fat people buy into this.

There was a time when I bought into it--I was certainly programmed by those around me and my culture to buy into it, after all--and in low moments, I still wrestle with it. A lot of my life, I wouldn't wear a dress, and I did make a great effort to hide. I put up with more than I should have from people. I felt like I had to apologize simply for breathing oxygen and not being every other human being's idea of "hot". In my late teens, I got tired of feeling that way all the time, and I worked on it for years; it didn't happen overnight. I kept my good friends close, let the flaky ones go, and I found out there are good people (even men!) that judge me for what I am and do rather than what I appear to be. I learned to say things like, "If you don't like my peaches, don't shake my tree." And mean it. It's okay for me to be a real person with moods and needs and dislikes, whether or not I'm fat.

And I have nothing to apologize for.

Wednesday, February 25, 2009

Sugar-free candy

Me and my sweet tooth have been investigating sugar-free candy lately, particularly chocolate. It is rather expensive; a small bag has maybe six pieces in it and costs $2-3. I think my favorite sugar-free chocolate brand thus far has been Russell Stover. They have some good coconut, caramel, nougat, and toffee varieties and some or all are carried by most drugstores, sometimes near the pharmacy and sometimes in with the regular candy. I found sugar-free Turtles at Target that weren't bad, and the Hershey brand Reese's peanut-butter cups are pretty good in sugar-free.

I think buying candy online might be cheaper, and am still going to look more into that. I have used in the past and they have a huge selection of sugar-free stuff.

You don't save that many calories avoiding sugar outright in chocolate, but if type II diabetes or pre-diabetes exists, they are a good choice. Sugar-free chocolate can have a laxative effect, so there is a built-in motivation not to overindulge!

Taking care of business

That has been the order of the day/week/foreseeable future. I finally got our taxes done and e-filed today, and we decided that I was going to try and go for a Technical Writing Certificate at UW in the fall with the return money, if I could get in, etc.. The timing would all be perfect if I am even somewhat on schedule in terms of this surgery. So I have been looking into that as well. Mr. Salted has to have a gum graft, so we spent yesterday at the periodontist.

I haven't heard from the insurance yet on the psych eval and whether or not they will cover it. It's been lovely not having any appointments of my own this week so I could just take care of things. I've been finding tons of books I wanted to read--both regarding weight and body issues and not. We really cannot afford any additional counseling for me right now and so I'm intending to read as much as I can and also check out online support groups. I know there are many.

Tuesday, February 24, 2009

My review of "Gaining: The Truth About Eating Disorders" by Aimee Liu

I found this book astonishingly good, the best I have ever read on eating issues. Informative, well-researched, well-written, the combination of facts and personal stories made it a far more engaging read than one would expect. Not only was every stage of life addressed, there were many insights into our culture. I may not agree with every single thing in this book, but I think anyone with eating and weight issues would find it illuminating, validating, and ultimately healing...I also think it could benefit those who are trying to support a loved one with these issues, as the style is not just dry technical jargon. I also appreciated the fact that the author is an older woman whose recovery from anorexia began decades ago, when research and treatment was in its infancy...she was able to give a historical perspective on eating disorder research, treatment, and recovery as well. I doubt there is a woman in America who could not glean something of value from this book.

Saturday, February 21, 2009

Strength training and salsa workout DVD

Today I started at home with the strength training exercises. He gave me a sheet and we went over how to do them all at my last appointment. I bought an exercise ball and some two-pound weights; my exercises consisted of a dumbbell shoulder press where I push up; a two-handed dumbbell row where I get in linebacker position and lean over while rowing backward with both arms (this one was hard because I feel like I'm going to tip over); a couple of hip abduction exercises (basically leg lifts where I lean up against a counter, one with heel in, one with heel out); a standing bicep curl with the weights; and a standing leg curl, which is basically the bicep curl with the legs. He also wants me to do a ball squat with the exercise ball, but that one's really painful for the knees and you feel like you are going to lose your balance at all times, since you are leaning against the wall with most of your weight on the exercise ball and moving down the wall into a squat and back up again. I am supposed to do the strength exercises 2 or 3 times a week with 15 reps of each, 2 sets, and 30 seconds in between sets.

My cats seemed particularly disturbed by the bicep stuff; I think the weights freak them out. (Of course, it takes very little to freak them out.)

Yesterday I did my salsa workout DVD for the first time; it's something like "Sizzlin' Salsa Dance off the Inches". There's a 17-minute section with the steps done slowly and then moving up to tempo--mambo, Latin twist, cha cha, hip roll, etc. Lots of hip movement; I could really feel it there. It was fun, but I was glad no one could see me doing it, and I think it will be a lot easier when I'm lighter. Of course, all physical activity will. Today? I hurt like hell.

Friday, February 20, 2009

The awful truth

This is a typical occurrence following every. single. bloody. appointment. I've had thus far:

1) Letter from husband's insurance comes in the mail. Letter says as far as they know I have my own health insurance and to please provide them with further information. (I have called them and provided them with said information at least eight or nine times, and they have been covering my prescriptions without a question since last June, when my own health insurance was no more.)

2) I call the insurance company. I try not to be pissy and probably fail in tone of voice, but say please and thank you and have all my information conveniently at hand. I have to speak slowly and clearly into the clown's mouth to get routed to the proper agent, who may or may not route me to one or more agents or divisions, who may feign surprise, make reassuring yet noncommittal sounds I am convinced they send them to training specifically to learn, apologize, or not. It's a white-knuckle rollercoaster ride of fun and frolic, let me tell you! (Is this kind of unbridled excitement why people love to gamble? I like my money too much to ever let go of it long enough to find out.) I always wonder if I'm *really* being recorded or monitored for quality assurance.

3) Every single solitary time the claim I am calling about has been a covered service. I don't go to out-of-network providers; at least 95% of the time I check ahead of time that things are going to be covered.

Today's wrinkle is that they are trying to bill me for the psych eval that they required prior to this surgery. I specifically went to the only provider they covered at the wellness center because he was the one they covered; if I'd had my choice, I would have gone to a female practitioner, because that's just the way I roll.

So I call the behavioral/mental health division and tell them what's up. They tell me it's a medical claim because it's relating to the bariatric surgery. They also try to tell me the provider isn't in network, and I cut them off at the pass. They transfer me to the medical division.

The medical division listens to the situation and tries to send me back to behavioral/mental health and I say no, this evaluation was ONLY performed because it was a required step prior to bariatric surgery. They hem and haw, put me on hold to research it, and then come back on and say they will have to research it further and then call me back. So now I get to wait for them to call me back.

(Fittingly, I bought a copy of Michael Moore's movie "Sicko" the other day; I am a big fan of his films in general, but have a feeling this one's going to be my favorite. I will never forget when he had his TV show "The Awful Truth" on Bravo--the most memorable episode for me featured a man--the father of a small child, and he may have been her only surviving parent, if I recall correctly--whose health insurance provider refused to pay for an organ transplant that would save the man's life. Moore staged an elaborate mock funeral for the man on the lawn of corporate headquarters, complete with casket, pallbearers, the works. Following this, the insurance company paid for the gentleman's transplant.)

Thursday, February 19, 2009

Exercise physiologist

Saw him yesterday. I think it was a better appointment. We joked around about our cats and how crazy they are. It's amazing how many people I've met who I had nothing in common with except telling pet stories. It's made many conversations and situations a lot less awkward over the years.

I did 25 minutes on the treadmill, and I could feel it, but wasn't in pain and am not today, thankfully. I am going to try walking again as my regular exercise and hope my ankle doesn't give out. He suggested I get a walking stick. It will double as a weapon, so that cheers me. Giggle.

He also taught me some strength training exercises. They were really similar to the type of exercises I've been given in physical therapy in the past. (I need to go buy an exercise ball to do a couple of them. I hope the cats don't pop it.) I also need some heavier free weights; mine are only a pound.

He told me I wasn't the most difficult patient he's ever had, which made me laugh, because it can be a lot more difficult if he wants; I am actually making an effort not to be. He also suggested I see a psychologist if I was able to because it might really help with my feelings around exercise. I know I need to, but I just don't think we can afford any more copays. I did call the insurance for a list of providers.

The towels at his office say "MOVE IT" which I guess, on some level, is cute, but in that sick-making way that makes my face twist like I've been sucking a lemon. (I'm not one of these motivational types, or perhaps I should say I'm not motivated by what is "supposed to" motivate people. Never have been.) He also said something about how exercise shouldn't be too comfortable or it isn't really doing you any good, because you have to push your body past the point of what it has adapted to. My response to that is: if you have had any part in motivating me to exercise three times a week for more than a month or two, you have effectively performed the miracle of your lifetime. I'm not going to turn into a triathlete, nor am I trying to. I'm trying to remember what my friend said about his guidelines being for an ideal world.

It all goes back to perfectionism, too--not wanting to do anything you cannot do perfectly, much less that you might fail completely. I've already failed at it completely several times. I think of exercise as torture, because it has essentially been used against me that way in the past, and not just in P. E. classes in school like everyone else. That's probably why I need the psychologist. Sigh.

Tuesday, February 17, 2009


This last week I have felt rather uninspired to tow the line. I totally blew my diet as of Valentine's Day, if you can call it a diet...the half-price chocolate was just too tempting. I haven't been in the mood to exercise that much, and I see the exercise physiologist again tomorrow. I'm really going to get to the bottom of why I have to see him; if he's not going to teach me something I don't already know, I'm not going to keep racking up the fees just to write more crap in a journal or whatever.

Had a really good talk with a friend of mine today; she was talking about how what "they" want me to do is in a perfect world, not what a real person is going to end up doing, and that I'll have to modify their guidelines to fit my life and not take it personally if I don't meet every goal they set, because all their advice and suggestions aren't going to work for me. It made total sense.

My friend and I talked about some other interesting stuff too--such as the way exercise forces a person to be present in their body, whether they like to be or not. Articulating that fact made me realize (dingdingdingding) that is *exactly* why I am so uncomfortable with exercise, considering that separating myself from my body has been a coping mechanism for me for most of my life, and when I'm not separate from my body, I'm hyperaware of everything that touches it. If I'm not physically comfortable, I am completely freaked out--even when I just get dressed up, I'm really irritable until I can get into comfortable clothes again, to the point where I can't even enjoy myself because I can't stop thinking about how miserable the clothes feel.

The nutrition piece of this process isn't bothering me nearly as much as the exercise stuff is; I've been working on eating healthier for a long time. It is a trip for me to be eating things like raw zucchini with hummus on a regular basis; I've come a long way from the Doritos and other convenience store staples of yesteryear. But so many other issues are tied up in the whole exercise thing than I ever really realized, and that is really discouraging to face right now.

Sunday, February 15, 2009

Four Strategies To Control Cravings

This is the exercise the nutritionist gave me to do when I saw her last. I'm completely flunking this entire assignment. Turns out I'm rather strong-willed! Who knew? :o) Everything in parentheses is me being snarky about what the assignment says; it's my blog and I'll snark if I want to.

1. Self-talk--use motivational statements that reiterate the benefits of sticking to a plan and remind you of health goals.

2. Distraction--trying not to think about a craving, doing or thinking something besides about the craving

3. Breath-based relaxation--breathing that allows the mind to return to its rational base

4. Mindfulness--noticing and witnessing craving thoughts as they pass, without an attachment or identification to them.

Psychologist Pavel Somov, author of the book Eating the Moment (note: the bulk of the nutritionist assignments come from this book), recommends testing each strategy to determine which is most effective for you in treating your cravings. Then you can use which one works for you best when you need it. This will help take the guesswork out of it when you are in an unpredictable situation. Use the following exercises from Somov's Eating the Moment, keeping a log to determine which craving control method worked best for you. You might want to log how long the craving took to subside. You can even try combining some of the strategies. Mindfulness and breath-based relaxation work particularly well together.

Exercise 1--Mindfulness

With mindfulness, you are letting go of any attempt of your mind to block the craving. Instead, you let cravings into your mind and just notice them as thoughts and sensations. Mindfulness is a form of control by letting go of control.

Create a craving control routine. Choose a location in your home for your craving control area. Make it a place where you can sit. Then allow yourself to notice your thoughts and witness cravings. Avoid eating in the craving control chair at all costs.

Think, "This is just a craving. I am not a craving. A craving is just a part of me, a fleeting, transient, insignificant part of me, not even worth my attention." Then add a touch of bravado, notice the craving with scorn, and give it some attitude. "A craving, whoopdedoo. This shall pass. Craving, my ass!"

(OK, first it said mindfulness was just noticing and witnessing the cravings. Then it wants me to define the whole thing and get all metaphysical and, dare I say it, control the craving with my newfound bravado. I wasn't identifying with it in the first place, because they told me not to, so why do I have to tell it off? I am not threatened. Is this not contradictory as all get-out?)

2. Exercise 2--Breath-based relaxation

Find a place to sit down. Close your eyes. Self-induce a craving.

(This made me snort; no self-induction of a craving is necessary in my world. Wait a a little while, one will happen on its own, just like the sun, moon, tides, etc. Trust me.)

Pay attention to your breath. Notice the up and down movement of your chest, air in and out of your nose, and the in and out of your stomach. You can practice pausing after you exhale. Don't hold your breath, just pause. Do this for a few minutes or until the craving passes. Imagine inhaling relaxation and exhaling the craving.

(So I breathe in and out a couple of times and suddenly I don't want the chocolate anymore? I'm not seeing the connection. I just want it slightly more calmly than I did before.)

3. Exercise 3--Self-Talk

Self-talk is what you tell yourself. It is an internal dialogue of the pros and cons of a behavior. (italics mine) (Really? I just thought it was that voice that told me, more often than not, what a worthless piece of shit I am, and then there's an argument...oh brother.) The first way to test self-talk is during a craving to make a list of pros and cons, either in writing or mentally. (The pros and cons of eating the chocolate? Or not eating the chocolate? It isn't rocket science, people.) The other test for self-talk is to determine a mantra or repeating phrase to yourself. These can be self-affirmations, motivational statements, or catchphrases. One example might be, "I eat to live, not live to eat." (This may be true, but (a) platitudes annoy me and (b) chocolate tastes really, really, REALLY good, it makes my deep breaths better and more productive, it gets me closer to my happy place, and I'm *extremely* sick of the raw vegetables, the endless water, and the blankety-blank-blank !@#$%^&* food diary. I want some damn chocolate. I want some damn chocolate. I WANT SOME DAMN CHOCOLATE. NOW!!!!)

Exercise 4--Distractions

Distractions are a way to purposely divert your attention from the craving onto something else. (I thought that only worked for dogs, cats and sometimes toddlers.) The more involved or intense the distraction, the more likely it will succeed. One test is to take a cold shower during a craving. (My skin would fall off if I took cold showers every time I had a craving, and I'd keep my husband awake.) It is likely you will crave a warm towel rather than food by the end. (Yeah, but I know me. I'll crave both, as they are not mutually exclusive. I'm no fool.) You can try your own distraction as well if this sounds too radical. If you choose a different distraction, stick with it for a minimum of fifteen minutes and don't reenter yourself into your trigger environment. (My brain *is* my trigger environment. If I knew how to turn it off, I would sleep well and be ever so much more perky, now wouldn't I? Hell, I'd leave it in a locker for a few days every once in a while.) Some examples are 1) if you listen to music, crank it up and dance for at least 3 songs or 2) if you do a crossword puzzle, yell out the words as loud as you can.

(Sigh. I'm all out of words.)

Pain level still crazy high

I tried to do the bike again yesterday, made it ten minutes, and woke up with the off-the-charts pain level again today. This is insane. Why would a recumbent bike cause this much pain, all the way up the spine and back of my neck? I'm going to try something different tomorrow, either walking or aerobics from one of the DVDs. I might have to bite the bullet and find a way to get a pool membership despite the fact we really can't afford to do that *and* keep me in bathing suits (decent fat-lady bathing suits are not cheap) with me not working. I'm definitely going to talk to Mr. Exercise Guy about it.

I couldn't get the heart monitor that I had bought to work, so I have to get Mr. EG to help me with that, too. I purposely bought the least complicated one and still couldn't figure it out, nor could my husband.

Friday, February 13, 2009

Pain level off the charts

Yesterday--the day after the exercise physiologist appointment--I was a bit sore, particularly in the hips. It was what felt like a "normal" level of pain the day after after working out like I did.

So today, I wake up and my pain level is off. the. charts. Hips, shoulders, my entire spine, my neck. I get up and soak in a hot bath, thinking maybe I'll try exercising later in the day. The way I feel now post-bath, and I'm supposed to do all this cardio today? Bitch, please. The t'ai chi would probably be about all I could take.

I used to take neurontin for pain management (prescribed by a shrink) and it was somewhat effective. After a couple of years, I didn't feel that it helped enough to warrant the dosage (I was taking 3600 mg/day) and expense, plus I didn't like what I was hearing about the drug. So I stopped taking it a couple of years ago. I haven't been on anything continually for pain since. I try to get by with the occasional Advil, Tylenol, and if it's really bad, a muscle relaxer called Robaxin/Methocarbomol that is an "as needed" prescription. Our progressive Canadian friends have made it over the counter up there, bless their hearts; wish we weren't consistently so far behind when it comes to OTC drugs.

I have wondered for about 15 years if I had fibromyalgia or some other chronic pain issue, but with lack of insurance and/or all the other health problems I've had, checking it out thoroughly has always been on the back burner. I also know how doctors are; most see I'm fat and stop listening. (My thin friends with similar physical challenges have been treated verrrrry differently.) Now, of course, I hope that weight loss surgery is going to help by giving me a tool to help lose the weight and not put so much stress on my body. I think I can do cardio three times a week, but I may have to work up to it.

Thursday, February 12, 2009

More about exercise physiology (from our friend the Internet)

Exercise physiologists are physiologists specializing in exercise. They monitor and assess cardiovascular and metabolic effects as well as the mechanisms of exercise, replenishment of fluids during exercise, and exercise specifically as it pertains to cardiac and musculoskeletal rehabilitation and health.

An exercise physiologist may perform fitness evaluations and recommend exercise programs to maintain overall health. They can also choose to focus on specialties such as cardiology, sports medicine, respiratory therapy or physical therapy. Their duties may include the identification of risks in their patients or rehabilitation programs in conjunction with those of other healthcare professionals.

In an academic setting, exercise physiologists may teach courses pertaining to medicine, physiology, or any number of other health-related fields. Other settings that may employ exercise physiologists include community organization venues, health clubs, recreation centers, or commercial and industrial facilities. They may also be employed in clinical settings prescribing exercise for cardiac and pulmonary patients. There are also many potential opportunities for research on aging, rehabilitation of muscle injuries, and the health benefits of exercise in general, particularly since the emphasis on illness prevention and promoting good health through exercise continues to increase.

Education requirements for an exercise physiologist may vary depending on the employment setting. A master's degree in exercise physiology is usually the minimum requirement. To hold an exercise physiology position in organizations or commercial settings, an undergraduate degree in physical education, exercise or health sciences, and nutrition may be helpful. Additional training in physical therapy and kinesiology is valuable for employment in a health-related setting. For an academic career in research or teaching, a PhD is required. Certification requirements for exercise physiologists in most states are not yet well established, but for those not pursuing an academic career in this field, the certification is available through the American College of Sports Medicine for exercise test technologist, exercise specialist, or health and fitness director. ACSM's highest certification is currently program director; continuing education hours are required every four years for recertification.

Exercise physiologist

I saw the exercise physiologist yesterday for the first time. Due to the various continuing insurance snafus I'm dealing with, I have been without sleep medication for weeks and without antidepressants for several days, so I felt about an inch tall when I went in there. (Thank G-d, they both got here today.) He was nice, and I was my usual blunt and honest self, so I'm sure I presented quite the challenge.

I have a T-shirt that reads: "I get enough exercise just pushing my luck." (I do push my luck, at least verbally, but I think of it more as participating in life than anything.) I really, really hate basically anything to do with exercise. The things I like to do best are all sedentary activities--reading, writing, watching movies. When I travel, I like to relax. It doesn't mean I just sit on a couch stuffing my face with cookies, it just means I like to read and be on the computer and don't tend to move a lot. Dancing is a lot of fun, and I really enjoyed doing that when I was younger and lighter. Of course, there is also the possibility of negative comments, which make it a lot less fun. I do still dance sometimes, but I get uncomfortable quickly and don't have much stamina. I enjoy lap swimming, although anxiety surrounding being in public in a bathing suit cancels the enjoyment out of it. The arthritis/bursitis/joint pain I've had since I was young (it started to get bad about age 25 for me) doesn't help, and it's a vicious cycle; you don't move because it hurts, and it makes it harder to move when you don't move. Feh.

I started walking outdoors a lot last year, but my ankle kept giving out at random and getting twisted and sprained, plus you never know when some jackhole is going to drive by and scream or throw something. I bought a recumbent stationery bike, but it hurts my joints (knees, ankles, hips) to even do that for more than 10 minutes. ("Why don't you read on the recumbent bike?" my friend asked me. My response: "It interferes with my cursing.")

So optimally, they want me doing 30 minutes in the target heart-rate zone and 15 minutes cooling down after that four times a week. I'll do the best I can, but when stuff starts to really hurt, I stop doing it. (In the immortal words of Daffy Duck, "I don't like pain. Pain hurts me.") It sounds like I'm just making excuses, but people don't see me walking around like Quasimodo in the mornings with my joints sounding like popcorn. The t'ai chi is basically worthless--it's a good "day off" activity--but is it really a day off if I'm still doing t'ai chi? A day off means hallelujah, no exercise. Feh x 2. Of COURSE the t'ai chi isn't worth anything, I was actually enjoying it and it wasn't causing me physical discomfort!

The exercise physiologist was explaining to me about different kinds of pain with exercise, oxygen getting to cells, etc., and how after about two weeks the good kind of pain dissipates. He also told me the latest research showed that it wasn't beneficial to stretch cold muscles, saying that it was better to just do it after a workout. That was something I had never heard. People in better cardiovascular health have a better chance of not developing complications from surgery, recover faster, etc., which goes without saying.

The first part of the exercise physiology assessment was cardiovascular, so I did about 15 minutes on the recumbent bike with him. True to form, everything hurts today. I see him again next week for the strength part of the assessment. I bought a heart-rate monitor that is kind of cool--you put a band around your upper abdomen and wear a watch, so you know what your heart rate is. I went for the bottom-of-the-line model with basic information; there was one available with more bells and whistles that tracks calories burned and stuff like that, but I don't want to go there. I can look at a clock and tell how many minutes I've worked out, and the number on the watch is the heart rate, so that's straightforward enough. I'm just going to make it part of the food journal in terms of tracking it.

I told him my biggest concern with exercise is learning to motivate myself to do it just because it is good for me/for my health, not to be so *extremely* goal-oriented that it feeds into old perfectionism/defeatism and eating-disordered behaviors, etc. (Although I didn't say "eating-disordered behaviors"; I probably should have. But he's not a therapist per se, I didn't feel like I should tell him my whole life story. Of course, I really didn't want to be there in the first place, so there was that, too.) Toward the end, he asked me if there was anything else I wanted to tell him and in retrospect, maybe that was a hint that I should have disclosed more. I can always tell him next time.

I didn't know what an exercise physiologist even was, so I asked him a lot of questions. He said it was a lot like a physical therapist that also focused on the heart and lungs as opposed to just joints and muscles. It sounds like a very competitive field. I'm glad he is such a nice guy. He was certainly patient.

I saw the term "exercise resistance syndrome" in a book, which cracked me up. I think it's safe to say I have it. With bells on.

Tuesday, February 10, 2009

Navy Bean with Bacon Soup

1-1/2 cups dried navy beans, rinsed
2 cups cold water
6 slices thick-cut bacon
1 medium carrot, cut lengthwise into halves, then cut into 1-inch pieces
1 rib celery, chopped
1 medium onion, chopped
1 small turnip, cut into 1-inch pieces
1 teaspoon dried Italian seasoning
4-14 oz. cans chicken broth

Soak beans overnight in cold water.

Cook bacon in skillet, drain and crumble. Combine carrot, celery, onion, turnip, Italian seasoning, beans and bacon in slow cooker. Pour broth over top; stir. Cover and cook in slow cooker on low 7-1/2 to 9 hours or until beans are crisp-tender.


I made this today; the cookbook intended it to be a chowder, but I tweaked it a little--it sounded better as a soup. It came out really well.

Edit: it was even better the second day! ;o)

40: not just a U2 song

I turned 40 on December 3rd, which means I have to get mammograms every year now. I already had a baseline in 2002 because of some family history, so I kind of knew what to expect this time. I wore my "Chicks Rule" shirt, and on the way out of the hospital parking lot, cranked "The Bitch is Back" just to bring the whole experience around in a circular fashion. However, no chocolate or shopping was involved.

My 40+ female friends who are reading this, go schedule your mammograms now if you haven't already. :o)

Edit, 2-17-09: I got the letter today that the exam came out normal, which made me want to find even more empowering music to turn up!

Monday, February 9, 2009

Nutritionist appointment today

Day 30 of write everything down that I ingest; appointment number 2 with the nutritionist. I was surprised to learn that I have lost four pounds, not that I get that excited about losing four pounds at this weight. I know all I have to do is look at a piece of apple pie and I will gain 20; to paraphrase comedian Ron White (who, it should be noted, makes me laugh until I snort most unbecomingly), "I know. I've seen me do it." Still, it was nice to receive praise, even if it made me think of what positive rewards for toilet training must be like (I was relieved not to receive any sort of sticker). I maintain that I lost the four pounds because dread burns calories.

She looked at my food diary and actually said I was doing well there, too. The only thing she would have me change is to get in another serving of vegetables a day, which is exactly what the last nutritionist I saw told me to do. I told her I could do that. And I can.

Insurance wants me to see the exercise physiologist, so I see him Wednesday. He looked young and nonthreatening and seemed upbeat, but not in a vomity way, so it might be okay. We'll see how it goes...hey, if insurance pays, I'm there with bells on; I am nothing if not educable.

We also discussed my sweet tooth, my nocturnal need for sugary sustenance, and my assignment for the month is about cravings. She gave me four strategies to control cravings. The point of this is to write about which strategies I try and how they work or don't work. More on that later.

After going grocery shopping post-appointment and buying all kinds of healthy food, I am tired and on the way to celebrate my meager weight loss by getting in bed with a book--even better, a trashy true-crime book that has absolutely no redeeming social or academic value. Let's hear it for the printed word!

Friday, February 6, 2009

Night moves

Waking up in the middle of the night wanting sweets has been part of my life since I was seven years old. I don't remember exactly how it began, but I can certainly put it into some context.

My father was in prison; my mother had died five or six years previously. It was the third U. S. state in which I had lived in my short life, and was at least the third family group with which I shared a household. I was just beginning to figure out that my mother was really gone for good and what that might mean, but I didn't talk about it with anyone; I had long since learned that the more invisible I could make myself and the less demands I appeared to have, the better off I would be. I had also been molested by this age, and as a result, did not sleep well.

So--I'm seven. I'm living with a relative I'll call Mr. Forced Starvation, who I mentioned previously in this blog. Mr. FS has a wife, too, but, as I recall, she mostly serves as a Greek chorus for his (largely negative) pronouncements, though she has a few choice ones of her own. Needless to say, they are not the most pleasant of people to live with. He seems to really enjoy eating in front of me, talking about what he's eating, taunting me about how I can't have it--and it's usually chocolate ice cream, which is my favorite. To add insult to injury, some friends of theirs have a little girl who comes over to our house frequently, and she's allowed to eat whatever she wants, whatever they're having. A point is made to send me to my room, where I can hear everything that is going on. I haven't misbehaved; the only way I have failed at this point is to be born shaped in a certain way. In the pictures from this time period, I'm not particularly heavy yet, but I'm definitely a child that a practiced eye can see will be struggling with her weight later--even if the environment in which I was living wasn't already handing me an eating disorder on the proverbial silver platter.

I can remember waking up in the middle of the night and looking out the window, hearing other people's snores, knowing I had reliable privacy for the moment. There was a tendency in this particular household to be walked in on in the bathroom, a distinct overall lack of healthy boundaries. This household taught me not only the necessity of, but joy, even revelation in my own ability to hide: not only who I was, but what I felt and needed, and simply to get away from the world.

I remember the light of the moon shining down on my contraband roll of Sweet Tarts, which I had either stolen from the store or stolen the money to buy (probably the latter). As low as the moonlight often was, I can still remember the sound the wrapper made as I peeled it off, and the quiet shot of glee within me when I could distinguish that the next piece of candy was pink or orange. How appropriate this memory is now, more than thirty years later, when I still awaken in the night with similar cravings. This memory, and many others like it, contain the presence of the only true sweetness I was able to rely on for the first half of my life; but the very weight of articulating this truth is sour, and its tartness burns.

How I can end up spending the better part of a day on the phone with insurance and the doctor's office

The past week has been incredibly frustrating. I was turned down for three of the five jobs I'd applied for; I didn't hear anything on the other two. My sleep continues to be on and off, which can make a person a little crazy all by itself. I tried to force sleep a couple of nights by taking two Benadryl, which resulted in grogginess the entire day after and still waking up every couple of hours. I took a generic version of Unisom tonight and was (am) up after 2 hours.

My primary-care doctor is about three hours away and so I conduct a lot of business with her via e-mail. My husband's insurance has been hounding me to get all my medications via their mail-order program, so I have been trying to transition them all. There are seven or eight of them. The health insurance took so long to process the initial switch that I ran out of everything for several days, requiring several frantic phone calls back and forth with insurance and the doctor's office, paying almost $20 to have overnight delivery, etc., and after all that neither my antidepressant nor my sleep medication were included. I've emailed my doctor two or three times in the last couple of weeks to have those things transitioned as well. Of course, the emails were never answered and I found myself playing the call-everyone-involved-two-or-three-times game a couple of days ago to try to get those medications transferred to the mail order pharmacy program before I ran out of them, having to request expensive overnight delivery again. My doctor and I have had a long-standing relationship, and she has never had a problem changing a medication for me. Unfortunately, I think her staff is getting their signals crossed now; I haven't had any direct communication with her at all on this issue, and after thinking all was said and done and the medications were ordered, I get a call yesterday from her staff saying I had never gotten the new sleep medication from her previously and that they were just going to discard the request from insurance to fill it--because insurance had referred to it as "a refill". (I had made it clear to insurance that it was a new medication.) Of course, this was left on my voicemail at home while I was out; of course, I received it after their office had been closed on Friday afternoon; and of course, they acted annoyed, like I was trying to put something shady past them, sounding rather indignant with me on the message they left. And of COURSE, the sleep medication is the one being disputed.

Doubly frustrating is the fact that I tried repeatedly to get the fax number for the doctor to send a request for the new medication to insurance, but insurance would not give it to me, preferring instead to fax something to the doctor and have her fax it back to them. If they had simply given me their fax number in the first place, I seriously doubt this would have played out the way it did. I left a frustrated message on the doctor's office voicemail in which I doubtless sound like a total freaking loon, telling the entire story for what felt like the 500th time and trying desperately to say the right polite words at proper intervals.

"How do you not go mental?" a friend asked me not long ago. I chuckled somewhat ruefully; I think it's too late to refer to it as "going" mental at this point.

Thursday, February 5, 2009

Not much to report

Have not felt like writing much the past few days. My sleep is still all over the place. I notice I crash after 2 days without it; last night I took a couple of Benadryl to help it along, and it did the trick.

I have spent most of today on the phone with doctors and insurance, trying to get new sleep medication ordered, and then a "health advisor" from insurance called and advised me to check in regarding the appeals process. So I did, and as I thought, I don't have a leg to stand on without that 6 months of documentation, which I am in the process of obtaining.

I see the nutritionist Monday, and I have a lot of questions for her. A friend recommended the South Beach Diet, or at least many of their recipes, so I've been reading the book. It seems like a reasonable diet in the 3rd phase, but Phase 1 throws me into a panic. I don't think I feasibly can go to that extreme, and I hope I don't need to--just being able to have some sugar-free pudding or Crystal Light helps tremendously with curbing my appetite for sweets.

I have gotten a couple of hip-hop and salsa dance-based workout DVDs that I am enjoying and alternating with the t'ai chi. I don't look as cute doing salsa dance steps as the instructor, but thankfully, there is no one here to see me trying to learn them but the cats.

I've also been applying for a lot of jobs.

Monday, February 2, 2009


I think I was optimistic about how quickly Ambien leaves the system. While I am getting more sleep and largely good sleep, I am also more tired. I have also had a couple of stretches of being up for two days and then wanting to crash for extended periods of time. When I am up, at least for the first day, I feel good, have more energy, am more productive. By the end of day 2 I'm completely exhausted and overwhelmed by everything. My husband is the most laid-back, accepting person--he made me laugh at my own ridiculousness yesterday. I'd been awake for 48 hours, it was late Sunday morning, and I knew I needed to just go to bed and pass out. I was at the point where my brain was not working, I ran into a wall because I was so tired, and I had less-than-zero patience with anything (and I'm not an incredibly patient person to begin with). I went to the bedroom, switched on the TV to set a recording for a show, and there was some ad with Marie Osmond talking about weight loss. I have nothing against Marie Osmond at all (except for her dolls, but I hate all dolls equally, not just hers), but I just said, "I hate everyone!" and turned off the TV abruptly.

My husband laughed and said, "I love you, sweetie."

I looked at him, asking, "God, WHY? I'm a mess."

He smiled and said, "You're just so honest. I love that about you." He has told me that before, saying things like "I never have to wonder what you're thinking" and "I always know where you stand". It's a good thing he feels this way. It won't be changing anytime soon.

I am a big believer in honesty. Get it out there, talk about it, don't let it fester. Honesty can be construed as a weapon and a defense mechanism, but I think the functions of honesty are mostly positive ones. I can only speak from my own experience, but I know I have been the sickest when I didn't talk about things or refused to feel them; I went through a huge chunk of my life like that, and it almost killed me. They say in twelve-step groups (which are not anything I'm into, but they work wonders for some folks, so I'm glad they exist), "We are only as sick as our secrets", and I tend to agree. Secrets are usually connected to shame and ultimately self-loathing. For me, honesty is something that makes me feel better and figuratively, if not literally, lighter. Honesty for me is refusing to allow my voice to be silenced. You can love me, hate me, think I'm full of crap, but at least if I say my piece, I cannot be called a victim without any agency.

About Me

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Seattle, WA, United States
This blog focuses largely on a personal journey to and through weight-loss surgery. It's also about reading, writing, animals, photography, love, humor, music, thinking out loud, and memes. In other
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