Ankle

I saw the exercise physiologist yesterday. I told him the last session had blown out the ankle so bad (it hasn't been the same since) that I was finally going to bite the bullet and go to a specialist about it. He recommended someone, and I have an appointment with them Tuesday. (More medical bills we can't afford! Whoopdedoo.)

It surprised me how much even the strength training hurts it. My fear is that they won't be able to find anything wrong with it, but something has to be wrong with it, or it wouldn't be feeling like this. I did break it pretty badly back in the day (almost 25 years ago). It has been giving out randomly for the last ten years. The last year, though, it has given out more and more frequently, every few months, and then down to every few weeks.

I have my six-month session with the exercise physiologist next month, and the six-month nutritionist appointment a couple of days later. Then we resubmit to insurance for approval and after approval, I get the pre-surgery stuff done and voila! Surgery should definitely be in early July. I have to miss some fun stuff this summer while I recover, but there will continue to be fun stuff going on in the future--and hopefully, it will be a lot more fun for me because I won't have this permanent case of the drag-ass/lack of stamina that my weight exacerbates now. I was never a super high-energy person, even as a kid, but I have bursts of energy when something fun is going on. Hopefully I will get them more often!

****

I heard an old friend of mine, younger than myself, was diagnosed with ovarian cancer yesterday. This is the third person I know under the age of 40 to get cancer JUST THIS YEAR. I know there are no guarantees in life and all that, but still want to know why all the nice people get cancer while the psychotic jackasses (thank you, "Veronica Mars") seem to live forever.

Edit, a few days later: my friend had a 10-pound benign tumor removed by emergency surgery. Woohoo!!!

Nutritionist appointment, 5 months in

This picture is from my girls' night out last weekend, not the nutritionist...these were Derby Punches, in honor of the Kentucky Derby--bourbon and lemonade from someone's grandma's recipe. The cool glasses had all the Derby stuff on them and you could buy them for a buck and keep 'em, so I bought mine. I have always wanted to go to the Kentucky Derby just so I could wear the big picture hat, but in reality, I think I just want the hat.

***

I saw my nutritionist Monday. She was very encouraging and told me what a great job I was doing, which felt really good...I just feel like I'm treading water so much of the time. I had lost a couple of pounds, which surprised me because I haven't been exercising (my ankle is still popping and sore--my regular doc is sending me a written referral to have it looked at; one of my tasks for today is to find an orthopedist my insurance covers and to make the appointment). I've stayed within five pounds of what I was when I first went in to see her, but I still weigh less than I did at the beginning.

She praised me for using my time well by joining this group and really trying to get to the bottom of everything within me so I can succeed in the long run, and also complimented me on my food journal--its detail and follow-through. All of this just felt really good; too often, I am caught up in feeling guilty for being unemployed/not productive enough, not to mention overwhelmed by all the emotional stuff I'm working through. She kept saying things like how I was "on it" and "ahead of the game". This was my five-month appointment with her, meaning the six-month one is next month (June 12!) and the pre-op stuff can really begin then, if not before. (Another task for today is to contact the surgical center and see if I need to anything to start the ball rolling, as I know there are some pre-op procedures that need to happen--an abdominal ultrasound, bloodwork, etc.)

We talked about what I would be eating as surgery gets closer. I do not have to do a liquid diet prior to surgery as I had previously thought, but I do have to go to a very low-carb diet two to three weeks prior in order to shrink the liver. Low-carb in this case means a total of 40 total grams of carbohydrates per day. Fiber content can be subtracted against the carbohydrate amount. She gave me a couple of sample menus. The daily fiber goal is 25g, and the daily protein goal is 50g prior to surgery, but 60-80g after.

Thirty days prior to surgery, I will need bloodwork done. I also need to make sure my medications can either be crushed or will be available in a liquid form, and that I have vitamin supplements on tap for after--she recommends Bariatric Advantage.

I thought about getting a book on making baby food for afterward, but she referred me to a pureed diet on the Web through University of Pittsburgh Medical Center under "info for patients". She also said netwellness.org was a good resource for pureed foods information, and lent me Susan Maria Leach's book, "Before and After: Living and Eating Well After Weight Loss Surgery". Apparently this book is like the Bible of weight loss surgery, and the author also has a very comprehensive-looking website--I believe it is bariatriceating.com.

We talked a bit about sugar. I have been fairly successful in giving it up and just using artificial sweeteners. While a lot of programs suggest giving those up as well, I don't think it's realistic for me for any number of reasons. My diet is restrictive enough (and going to be even more so)--I don't want to set myself up to fail. I am not keeping it in the house, which seems to be a key point. Times like this weekend, I am always aware that this could be my last piece of pie or my last whole martini, and I have been enjoying those things in moderation and feeling fairly serene about it.

(Apparently the magic amount of sugar that usually causes dumping syndrome is just over 5g, though she cautioned me that this is not an absolute--some people take one bite of cake and that's it.)

I am going to have to discover all the natural stores in the area, which is previously uncharted territory (except for Trader Joe's). I need to start stocking up on healthy protein drinks, for one. Muscle Milk is one she likes, and Pure Protein drinks is another.

I have been using nutritiondata.com for a lot of my nutritional information for the food journal, but my nutritionist also recommends calorieking.com.

More meme-ing

The host of the famous Bravo series, actor, professor and host James Lipton asks actors these 9 questions (among many others).

1. What is your favorite word? This changes all the time, but three favorites I can think of right now are grace, onomatopoeia, and badonkadonk.

2. What is your least favorite word? c*nt

3. What turns you on, creatively, spiritually, or emotionally? Love, rest, quiet, music, animals, humor, kindness

4. What turns you off? hypocrisy, revisionist historians, bigots

5. What is your favorite curse word? the f-bomb!

6. What sound or noise do you love? my cats purring, a kid's laugh

7. What sound or noise do you hate? sirens, kids crying, jackhammers

8. What profession other than yours would you like to attempt? I want to be an actual writer who does it for a living.

9. If heaven exists, what would you like to hear God say when you arrive at the Pearly Gates? What were you worried about?

Meme fun

I'm doing these memes from elsewhere on Blogger until I get caught up with the serious stuff...

1. Do you feel that you have “a score to settle” with anyone? Only me.

2. Do you own anything that you think is unbreakable? My spirit.

3. Tell us about a crazy thing you did in high school. Went to Seattle with some girlfriends, picked up some strange guys at a grocery store and went home with them (?!?!?!)

4. Name the one talent of yours that you think is the best. Writing and photography

5. Who wins American Idol? (if you don’t watch, tell us about a reality show that you do follow.) I think it'll be Adam Lambert or Kris Allen.

6. What is your favorite movie in black & white? Some Like It Hot

7. What is one thing advertised too much on TV? stupid diet crap that doesn't work

8. What is your current favorite TV drama? Breaking Bad

9. What is your current favorite TV comedy? Everybody Hates Chris

Weird week

It's been a weird week. I had one night where I actually slept enough, and I can't remember the last time that happened. I felt fantastic, and met up with two old friends; it was the first time in 22 years all three of us had been together. That was a lot of fun. I was glad the sleep coincided with that day so I could enjoy it. It's been beautiful outside.

I haven't been exercising, which isn't good. My stupid ankle still hurts, but I haven't even done strength training. I don't know what it is. If I know I have to do something and be somewhere, I manage my time a lot better and get up and do things. When I know I don't have to go anywhere, I tend to be a lot less productive. It seems like human nature to me, but who knows?

Today is Day 111 of the blankety-blank food diary. I wish insurance didn't require the stupid thing, but they do. 180 days will be six months, so I guess that's the second or third week of June.

I want to get a move on this surgery process already. I feel like I'm not doing enough, because I'm not working, but I feel like I could never be doing this if I were working, so I'm trying to see the whole situation as a blessing as friends are encouraging me to do. I'm trying not to beat myself up too much over it, but I've been working since I was about nine. (At that age, I remember picking blackberries in what we called "urban renewal", this area of town that wasn't developed yet, and selling them to my neighbors for $2 a gallon.) My logical mind knows what it should know, but it can be difficult to stifle the old tapes in your head. My family always accused me of being lazy growing up; much of the world assumes fat people are that way because they are "just lazy". Physically, I am not the most energetic or driven person, never have been, but mentally is a whole other story. Anyone who knows me at all that I am a worker bee, but I do work to live, not live to work. That can be misconstrued at times. I've probably followed an exercise program for about half my adult life--they just don't seem to "take"--which is a lot more than many thin people I've known.

The support group is great, but emotionally draining. I do get overwhelmed by it; I'm pretty much good for nothing the day after it meets. I can see why I put off dealing with food issues the longest of any others that I've worked on.

A guy I used to work with died this week, which was sad. He was 40, the same age as I, and had a wife and kids. Things like that always make you remember how lucky you are to wake up in the morning.

Steal-a-meme

1. Is there a particular smell that turns you on? If so, what is it? Mr. Salted

2. Have you ever tried or considered trying a Master Cleanse type method to lose weight? I haven't.

3. When you browsing a book store for reading material, do you find yourself checking out a book solely based on the cover design? No, but I do check out books because I like their titles.

4. Which 80's trend were you least happy to see come back this year; big shoulder pads or neon? I didn't know shoulder pads came back. Joan Crawford must be smiling in her grave.

5. How long do you think could you disappear for until someone would notice your absence and start looking for you? If I stopped answering the phone, probably just a few hours.

6. Have you ever walked out of a movie and asked for your money back? Which movie(s) and why? I walked out of "Feeling Minnesota". I didn't ask for my money back, though.

7. Have you ever changed your plans because of something you read in your horoscope?
Nope.

8. If you owned a CB radio what would your "handle" be? Madame Black.

Hydroxycut recall

FDA says dieters should stop using Hydroxycut now

Government health officials warned dieters and body builders Friday to immediately stop using Hydroxycut, a widely sold supplement linked to cases of serious liver damage and at least one death.

By RICARDO ALONSO-ZALDIVAR
Associated Press Writer

WASHINGTON —
Government health officials warned dieters and body builders Friday to immediately stop using Hydroxycut, a widely sold supplement linked to cases of serious liver damage and at least one death.

The Food and Drug Administration said the company that makes the dietary supplement has agreed to recall 14 Hydroxycut products. Available in grocery stores and pharmacies, Hydroxycut is advertised as made from natural ingredients. At least 9 million packages were sold last year, the FDA said.

Dr. Linda Katz of the FDA's food and nutrition division said the agency has received 23 reports of liver problems, including the death of a 19-year-old boy living in the Southwest. The teenager died in 2007, and the death was reported to the FDA this March.

Other patients experienced symptoms ranging from jaundice, or yellowing of the skin, to liver failure. One received a transplant and another was placed on a list to await a new liver. The patients were otherwise healthy and their symptoms began after they started using Hydroxycut.

Iovate Health Sciences, which makes the diet pills, said it agreed to the recall out of "an abundance of caution." The company is based in Canada and its U.S. distributor is headquartered near Buffalo, N.Y.

"While this is a small number of reports relative to the many millions of people who have used Hydroxycut products over the years, out of an abundance of caution and because consumer safety is our top priority, we are voluntarily recalling these Hydroxycut-branded products," the company said in a statement on its Web site. Consumers can get a refund by returning the pills to the store they purchased them from, the company said.

Dietary supplements aren't as tightly regulated by the government as medications. Manufacturers don't need to prove to the FDA that their products are safe and effective before they can sell them to consumers.

But regulators monitor aftermarket reports for signs of trouble, and in recent years companies have been put under stricter requirements to alert the FDA when they learn of problems. In 2004, the government banned ephedra, an ingredient in many supplements, linked to heart attacks and strokes.

Katz said it has taken so long to get a handle on the Hydroxycut problem because the cases of liver damage were rare and the FDA has no authority to review supplements before they're marketed. "Part of the problem is that the FDA looks at dietary supplements from a post-market perspective, and an isolated incident is often difficult to follow," she said.

The FDA relies on voluntary reports to detect such problems, and many cases are never reported, officials acknowledge.

Health officials said they have been unable to determine which Hydroxycut ingredients are potentially toxic, partially because the formulation has changed several times.

Public health researcher Ano Lobb, who has studied Hydroxycut and other dietary supplements for Consumer Reports, said the problem may be an ingredient called hydroxycitric acid. Derived from a tropical fruit, it's been linked to liver problems in at least one medical journal study. Lobb said it's likely that other supplements containing the same ingredient remain on the market.

"You really have to be careful about dietary supplements, especially weight-loss pills," said Lobb. "People believe that the FDA has verified that these products are at least safe and effective, and that's really not the case. When you see fantastic claims - that's generally what they are."

*****

How many drugs are they going to kill and/or permanently damage people with before they get it? Remember Phen-Fen?