Category Archives: Health

Please help fund this Kickstarter for diabetics

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I am so inspired by Nial Giacomelli’s The Diabetic Journal. This is a personal project, an application to help manage all the overwhelming variables in a diabetic’s life, that has grown beyond personal use and into something that Mr. Giacomelli wants to distribute absolutely free as a smartphone app. He’s made no profit on it and will make none. He’s looking to Kickstarter simply to allow him to focus on the app, to get it out the door with more features and a more streamlined UI.

I have no horse in this race; I’m not diabetic. But I’ve been through a lot of health-related crap. I can only imagine what it must be like for diabetics to have to manage their illness every single day for the rest of their lives.

This app would help them. And it would be free.

But things are looking bad. The word’s not getting out, or people don’t understand, or some other problem is keeping the project far from its goal.

I’m a backer and I want The Diabetic Journal to get my money.

If you’ve got anything you can send, anything at all, please. For once, here’s a Kickstarter that isn’t about personal profit or entertainment or special perks. It’s about helping people.

Isn’t that something that’s really worth Kickstarting?

Back The Diabetic Journal

Knee pain

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I’ve had on-and-off knee pain throughout my adult life. Historically it has only been one knee at a time, and it usually passes in a few days. During these times, moving and especially bending the knee is painful. I have difficulty getting into and out of a seated position or going up and down stairs.

Last night both of my knees started hurting while I was curled up on the couch watching TV. My legs also hurt at the place where the femur attaches to the pelvis. Getting up from the couch I found myself stiff and wracked with pain. I took some Tylenol and went to bed–painfully, pulling my legs up onto the mattress with my hands.

I slept for only a few hours before awakening with even worse pain. I tried to lie perfectly still and go back to sleep because I did not want to have to get up, which would require me to move my knees. Ultimately, though, I was in too much pain to sleep, so finally I forced myself out of bed by maneuvering my straight legs over the side and propping myself up into a standing position. Limping to the bathroom, I bent at the waist to search beneath the sink for unused medicine, and thankfully I came across a pain pill from when I had my weight loss surgery. I took one, then sat on the loveseat with my legs propped up and surfed on my phone until the pain subsided enough for me to go back to sleep.

When I woke up a scant few more hours later, the pain was back again, so I called my doctor’s office and made an appointment. My doctor, Dr. M, wasn’t supposed to be in today, but apparently they called him and he came in especially for me, which was really nice of him. We talked about the pain symptoms, then he had me lie back while he moved my legs around to see what hurt and what didn’t. The hip pain, he said, is probably bursitis; he doesn’t think it’s related to the knees, which makes sense because I’ve never had the two symptoms simultaneously that I can remember.

However, if the pain in my knees is rheumatoid arthritis, it may be related to the hip pain after all. At this point we don’t know what’s causing the knee pain. From the exam we know that it is the tendons on the top of the knee that are the problem; twisting my legs doesn’t hurt while bending them straight up and down is incredibly painful. And we know that Grandma had arthritis. So Dr. M drew some blood to check for general inflammation and for arthritis in particular. He also gave me a prescription for more pain medicine, for which I’ve been extremely thankful today. While the hip pain is relatively dull and seems to be fading away, the knee pain just won’t quit. Moving around seems to help, but without the pain medicine, moving around hurts a lot.

Here’s hoping the bloodwork reveals something that can help me long-term. And short-term, here’s hoping the pain takes a hike soon.

More and more

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To start my new tradition of working out when I get up, I just did the TurboJam 20-Minute Workout. I chose that video because I wasn’t sure I could make it all the way through Cardio Party, which is about twice as long. But I found myself doing the entire video “high impact”, jumping around, punching and kicking full force, positively overflowing with energy. I sweated and got a little out of breath, but I never felt like it was too difficult or that I couldn’t finish. If anything, I felt like I could do more.

This stands in stark contrast to my previous experiences starting up this video series. I always found it challenging and had to build up to where I could finish a workout at low impact. I never did an entire video high impact, not even the 20-Minute Workout.

My weight loss surgery has given me an amazing gift. Losing those 120 pounds has made me able to accomplish things I never could before. It’s given me a huge leg up in physical fitness. I feel like I can do anything now!

Not everything is going to come this easily, and I will have to keep planning and working toward my goals step by step. But today’s workout showed me just how far I’ve come, and how much I have to be thankful for.

Traditions and willpower

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In the course of rearranging and organizing everything in my life, I’ve dusted off some goals and study materials that have been foundering or never even used and started making clear plan lists for using them. My Japanese language plan is the most robust so far; it includes steps for my WaniKani reviews, TextFugu, the collection of study materials I purchased from TheJapanShop, and reading and translating various Japanese-language manga and short stories I own. When I logged back into TextFugu for the first time in months, it reminded me that I had purchased the 30 Day ebook, a system for making oneself a better Japanese learner. So I added that to the list too and read Day 1.

The first day’s assignment is to make a task I dislike into a tradition rather than a chore. The idea is that if you have to force yourself to do something, you’re using mental energy that could be used elsewhere, and the more you can turn tasks into traditions, the more you’ll be able to achieve. I find this extremely interesting.

Since willpower is a finite resource (meaning the batteries only have so much juice before needing a recharge), being able to not use willpower becomes very important especially over time. If there’s a task you do every day with your Japanese, creating a tradition for it will essentially allow you to use your finite willpower to do something else, increasing the amount you can do and get done. Over time this adds up, so there’s no better time to start than now.

The mission is to pick any distasteful task, Japanese-related or not, set a time for it, and make it happen. I’ll probably go with “When I get up, I work out.” I don’t have a problem with doing laundry or the dishes these days…I just sort of do those things. (They’re already traditions!) But working out has always been a struggle. If I can turn that into something I just do, I bet I’ll feel a lot better about doing it, and I’ll have mental energy left over for other tasks.

I hope I haven’t chosen too difficult a task to turn into a tradition.

My new old relationship with eating

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Me at the Grand Ole OpryAs time has passed since my duodenal switch surgery (it’s nearly been a year!), the rapid weight loss I was experiencing has declined to possibly nothing. This was anticipated, and as I’ve reached an excellent weight of 136, not unwelcome. However, there is still the possibility of losing a bit more weight before the slight rebound I’ve been told to expect. If I can manage to lose a bit more such that I rebound to about where I am now, that would be great.

Things have become more challenging, though. In the beginning, I hated eating and had to force myself to do it. When I did, I could only stand certain foods. Over the weeks and months since, though, my tastes have started to go back to where they were before the surgery. My perspective has flipped right back to loving food and wanting to eat all the time. And I’ve become accustomed to the amount my small stomach can take in, such that I am able to pace myself and potentially overeat if I don’t pay attention.

Due to malabsorption, I should not be capable of becoming morbidly obese again so long as I don’t go crazy with my food choices, but there’s nothing keeping me from being overweight but my own willpower. This surgery, after all, is not a magic bullet. It didn’t do all the work of weight loss–I had to eat right and exercise–and it will not do all the work of keeping me at a healthy weight. My need to get enough protein has made me a label-reader; I must keep up that habit. Further, I am working to limit processed foods as much as possible, as this is the best way to keep my sugar intake down. This is very difficult now that I have a taste for sugar again. My ideal is to get my sugar fix through fruit, but when I want an actual dessert, I try to at least go for items sweetened with Splenda, honey, or real sugar rather than high fructose corn syrup. And of course, I don’t drink sugary filler.

Beyond eating right for health, I will also have to manage the side effects of this surgery for the rest of my life. One very unromantic side effect is that white bread, white rice, and normal pasta make me gassy. In the beginning I just didn’t eat those things at all, but now that my tastes are pretty much back to normal, I’ve been craving them. So I buy 100% whole wheat/grain bread products (not “multigrain”), and I try to only eat brown rice.

Pasta has been a different animal, though. Sean and I make a lot of use of those Knorr noodle packets, because they’re simple and fast. But they don’t come in whole wheat varieties. There was a whole wheat version of the Alfredo noodles at one time, and we tried it and didn’t care for it…and that must have been the general consensus, because I don’t see it anywhere these days.

I recently bought a bunch of plain whole wheat pasta in various varieties, but I haven’t made much use of them. That will require finding good sauce recipes and keeping those supplies on hand, and I haven’t figured all that out yet. I do still plan to try, but some days I consider it a victory just to leave the kitchen clean!

Luckily for me, the last time I went to the store, I found a 50% whole grain version of Kraft Dinner. Obviously this isn’t a perfect solution–at 50% that means there’s still gas-inducing content–but it tastes great and so far doesn’t seem to affect me nearly as badly as the regular dinner. Sean and I love macaroni and cheese, so this is an excellent solution until I get to the point where I can make my own pasta sauces.

I started some work as a temporary on-site contractor a couple weeks ago. I’d forgotten how the office environment encourages my boredom-eating. Having nothing to do but the work I’m there to do is good, obviously, but my creative, multitasking mind tends to get antsy. I like flipping back and forth between tasks; it lets my brain refresh itself and promotes my creativity. I’ve realized since going back to an office environment that I’ve used eating as a “task” to reboot my brain. I’d take a break to grab a snack and then munch on it thoughtlessly while working. This is obviously not a habit I want to get back into, so I’m working on replacing it with something else, like going to refill my water bottle or standing up at my computer.

Happily, I’ve taken advantage of working in a skyscraper to use the stairs. Four flights up and down! Unhappily, working full time outside the apartment has made it impossible for me to meet my personal trainer during the week. I’m trying to figure out what to do about that.

My first attempt at Mexican food

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In an attempt to save money and eat more healthily, I have started cooking more at home. Up until now this has mostly consisted of making a handful of stock dishes: grilled chicken, burgers, hot dogs, sausage, or fish, with a Knorr packaged noodle side and some sort of steamed vegetable. While this routine isn’t bad in terms of variation, after awhile it can get boring to cook the same way over and over. I’ve also been craving various types of food that I usually go out for, like Chinese or Mexican. Today I decided to plan ahead and make a Mexican-style meal.

I chose the following recipes from AllRecipes.com:

I also decided that instead of purchasing the salsa to be used for baking the chicken, I would make some from scratch. I chose this recipe:

Prep

The first thing I did was get two frozen chicken breasts out and put them into a dish in the refrigerator to thaw. I went ahead and put the spices from the Quick and Easy Mexican Chicken recipe into the dish and on top of the chicken.

My next step was to go to the store and grab some supplies–I needed the cilantro, jalapeno pepper, and lime juice for the salsa, the shredded cheese for the chicken (I chose a 4-cheese Mexican blend instead of cheddar), and the chicken broth for the rice. I already had tomatoes, onions, and cloves of garlic from the Marietta Square Farmers Market, and I keep frozen chicken breasts, brown rice, and various spices on hand.

I went ahead and did my shopping in the morning so I could prepare the salsa in advance, giving it time to sit in the fridge. It took me about half an hour to chop and mix everything. As I also spent time this morning on some freelance work, a personal training appointment, the grocery shopping, and of course my random desire to scrub my bathtub, it wasn’t until after noon that I started making the salsa.

The tomato, onion, garlic, and jalapeno were easy to chop, of course. The cilantro was technically easy too, I suppose, but I’ve always disliked chopping cilantro…it takes forever. Once I had everything mixed, I had to agree with one recipe reviewer that the end result seemed more like pico de gallo than salsa. Still, I figured it would be nice and fresh and good for the cooking. Though I scaled down the salsa recipe to one serving, it resulted in more than the half-cup needed for the chicken recipe. I put the rest of it out as a garnish alongside the sour cream, but neither of us ended up using it.

Cooking

I started to actually make dinner at around 7 o’clock. I began with the rice, since it had the longest cooking time. After the rice had been cooking for about 15 minutes, I got the chicken out of the fridge to brown it in the skillet as per the recipe. Unfortunately, the breasts weren’t quite thawed, so I didn’t follow the recipe exactly. Instead of cooking in the skillet until there was no pink left, I simply browned as much as I could of the chicken, removing it from the heat before the outside could get chewy. I transferred the chicken to the baking dish, topped it off with the homemade salsa and shredded cheese, then put it all in the oven. I ended up having to cook both the chicken and the rice longer than expected, finally getting them both done around 8:30.

Meanwhile, I warmed the refried black beans in a pan on the stove and three wheat tortillas in an aluminum foil pouch in the oven.

Time Analysis

With the shopping, morning prep, and evening cooking time, this meal took about two and a half hours from my day.

Cost Analysis

Here’s what I spent on necessities for the recipes ($6.68 total):

  • Cilantro: $0.50
  • Jalapeno pepper: $0.05
  • Kroger brand canned tomatoes: $0.67
  • Kroger brand chicken broth: $1.99
  • Kroger brand lime juice (bottle): $1.79
  • Kroger brand shredded Mexican-style cheese: $1.68

Here’s what I spent on extras to go with the meal ($4.28 total):

  • Bush’s refried black beans: $1.29
  • Daisy sour cream: $1.00
  • Wheat tortillas (8): $1.99

Together, that’s $10.96, or $5.48 per person.

It’s a little harder to add in the cost of the ingredients I already had. Unfortunately I don’t have the receipt for the frozen chicken breasts, which came from a 5-pound bag of frozen, boneless, skinless breasts from Walmart. I want to say that bag costs around $10, but I’m not sure. I’m also not sure how many breasts were originally in the bag, but I think it was at least 10. If so, that would add just $1 per person. As for the vegetables from the farmers market, I know I got four tomatoes for $3, so the one I used in this recipe adds $0.75 total, or $0.38 per person. I don’t remember how much the onions cost or how many I got. I have a feeling I had a basket of five or six originally, and that wouldn’t have cost more than a few dollars. If we pretend each onion cost as much as a tomato, that would put the total cost per person up to $0.75. The head of garlic is negligible; it contained many cloves.

A rough total including the frozen chicken and farmers market vegetables would therefore be $7.23 per person. This is an overestimate, as the chicken broth, lime, cheese, and tortillas were not all used today.

The Yum Factor

I was fairly happy with this meal. The main weakness, I’d say, was the pico de gallo “salsa”. It was all right, but not really my cup of tea. The rice was delicious, though, and so were the refried beans. The beans were actually Sean’s favorite part of the meal, which is kind of sad considering I had nothing to do with their flavor. Indeed, the part of the meal I spent the most time on was the least memorable, while the part I spent the least time on was the most.

Despite the weakness of the “salsa”, the chicken came out moist and tender, and I wish there had been a bit more of it–the breasts were rather small. I ate a tortilla with my meal, but Sean didn’t have any tortillas at all, so I may as well not have bought them. We did, however, both use sour cream.

Conclusions

Ultimately, I’m not sure I’d say this meal was worth the effort. If I try it again, I’ll probably buy the salsa instead of making it myself. I do think the price was good, though.

I may eschew the oven baking entirely and grill the chicken next time, then add a sauce when it’s done. Grilling is very easy with the George Foreman electric grill my parents got me for my birthday this year, and there’s no thawing required. :)

Weight goal: achieved! Sort of.

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Me, July 20, 2012As of today I am at the weight at which I said I’d be content, 138 pounds. I look good. I feel great. At this point I could just say “mission accomplished” and go on with my life.

But there’s more to these life changes than meeting an arbitrary weight goal. The post-surgery weight loss period lasts up to two years, and I’m just now ten months in. There’s a whole year left in which I can work to sculpt away my remaining flab. And after that, it’s not like I’m going to go back to eating and living the way I did before. My food tastes have changed, and I am loving how energetic working out is making me. I’m looking forward to maintaining a healthy lifestyle forever.

I mentioned before that I wasn’t going to be paying as much attention to weight. And I haven’t been; I rarely weigh in. But I’ve decided that when I do, I want the various trackers I use to reflect my current reality. I’ve reached one goal. Now it’s time for a new one.

Today is my new “start date”. Based on my weight loss slowdown, I decided a pound a week was a reasonable rate. I put in 125 as my goal weight; two programs tell me I can reach that weight by the end of October.

I don’t know if I’ll actually get there–muscle weighs more than fat, and I expect to gain more muscle as I continue working out–but it’s nice to have a modified plan with a fresh goal line to start with.

Here’s how my SparkPeople goal line looked originally. As you can see, the deceleration of my weight loss caused my tracking line to approach the goal line (click to embiggen):

Weights from September 26, 2011 to July 23, 2012 with goal lineHere are my weights from April until now, showing the approach more dramatically:

Weights from April, 2011 to July 23, 2012 with goal lineAnd here is the beginning of my new goal line!

New weight loss goal and start of goal lineI’m pretty excited to start with a new plan and goal, and I’m looking forward to seeing how things play out in the next three months.

One-month personal training fitness evaluation

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As I mentioned previously, my weight loss post-surgery has decelerated. This is to be expected. As planned, I looked into gyms and picked one and started working with a trainer. I see him once a week and supplement that activity with other workouts the rest of the week (though I need to be better about that). One nice thing about the gym is that it has a three-lane indoor pool. Another nice thing is that the gym is not prohibitively expensive, like the “athletic clubs” in this area.

On July 5, I weighed in at home at 140.2, a weight that put me in the “normal” BMI range for my height. At that point my total weight loss since surgery was 116.8 pounds.

As I wrote on Facebook,

Now my goal is to turn more of my body weight from fat into muscle. I’ll stop worrying about weight and BMI and start looking at body fat index. On June 8 my body fat was measured at 31.8%, and my goal is 17.4%. I started working with a personal trainer on June 19. I’m looking forward to building up more strength and endurance :)

Today I had my one-month fitness evaluation. The baseline was taken June 18; I didn’t start personal training until over a week after I signed up due to a trip out of town. (Not sure why June 18′s body fat percentage is 0.8% less than the percentage taken on June 8.)

Baseline
6/18/12		 1 Month
7/13/12
Body fat % 31.0% 29.9%
Weight 144 144
3 Min Step Test 138bpm 138bpm
Upper Body Strength Test 25 lbs, 15 reps 25 lbs, 26 reps
Lower Body Strength Test 50 lbs, 8 reps 50 lbs, 11 reps
Flexibility 10 in 6 in
Muscular Endurance (Wall Squat) 50 sec 40 sec

I’m very happy with already coming down a whole percentage point on body fat! The weight measurement isn’t accurate, because the first weight was taken at home, in the morning, before I ate anything and without any clothes on, and the second weight was taken at the gym (and was actually 146, but he took two pounds off). I don’t really care about the weight measurement, anyway.

I’m not sure what the 3-minute step test heart rate measurement is supposed to be looking for. It consists of doing the stair climber for three minutes. Today I felt like I was strong throughout, whereas for the baseline I was barely able to finish.

I was unhappy with the lower body strength test, because I had just done ten minutes on the Precor (sort of a cross between an elliptical and a stair climber) and then three minutes on the stair climber, and my legs were tired. We did the lower body test before the upper body test, and I don’t think my legs had enough time to recover. Also, the trainer who does the fitness evaluations has a bad habit of “helping” you lift the weights, and I think he might have been doing that the first time, and not this time.

I’m extremely happy with the upper body strength test. I know my arms are stronger, and they certainly look it. My flexibility seems to have improved as well–for that I just try to touch my toes and the trainer eyeballs how far my fingers are from the floor :>

The wall squat started hurting my knees, and my legs were pretty exhausted. I’m unhappy that my time was lower than it was before, but it is what it is. The gym usually also does a situp test, but since I can’t do ball situps the way they want (I have to support my head or my neck has severe pain), we skip those.

Now for the most interesting data: the measurements! These were, of course, taken before I started all those strength tests above.

Baseline
6/18/12		 1 Month
7/13/12
Neck 13 12.5
Chest 38 37
Shoulders 40 39
Waist 31 31.5
Hips 40 39
Bicep (R) 12 11
Bicep (L) 12 11
Thigh (R) 21 20.5
Thigh (L) 21 20.5
Calf (R) 15 15
Calf (L) 15 15

So, nice losses everywhere except the calves (which is unsurprising) and the waist (what is up with that?). On the whole, I’m pleased, especially with the arms, and I’m looking forward to seeing more improvement.

We finished out the evaluation with cardio. The trainer told me to do the Precor machine for as long as it took to burn 250 calories. When we did this for the baseline, he said 200 to 250 calories. It took me 31 minutes to get to 200 calories and I was bored out of my mind, so I quit there. Today I was still bored, but determined to do better, and so I ramped up the resistance and my speed when I could and just forced myself all the way to 250. And what do you know? I managed it in 29 minutes.

It looks like personal training was the right choice for me. It gives me direction and motivation that I couldn’t provide for myself. I still need to work on getting to the gym more and/or doing other exercise, but even with my uneven workouts outside of training, I’m getting results. That’s really inspiring :)

Deceleration

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This morning I weighed in at 149.8 pounds. Into the 140s at last! This puts my total weight loss since surgery at 107.2 pounds. In just a couple more pounds I will hit 147 and a BMI of 26, which I was told is the average BMI at which patients of the duodenal switch end up.

I have noticed that my weight loss seems to be decelerating, as evidenced by this graph from my SparkPeople account:

Weights from September 26, 2011 through May 20, 2012

Weights from September 26, 2011 through May 20, 2012 (click for larger size)

My weight goal in SparkPeople is set at 125, to be reached on August 28, 2012. The yellow line shows what it would have looked like if I’d had consistent weight loss since my surgery to get to that goal. As you can see on the blue line of actual weigh-ins, right after surgery there was a huge weight drop, and then for awhile my weights went along roughly parallel to the yellow goal line. Now, though, they seem to be drawing steadily closer to it, indicating a slower rate of weight loss.

I don’t know if I’ll actually reach 125; this was an arbitrary goal I put in based on the mid-range of what is considered a healthy BMI for my height. And I don’t know if I’ll end up at 147, which is where I would stay if I was exactly average. I’d love to get below 141, which would push me out of “overweight” and into “normal weight” territory, but I just don’t know what’s going to happen.

I already look and feel so good that it seems like I should be almost done with my weight loss. But this process can take up to two years, and I’m only just shy of eight months out from surgery. I’m not even halfway there yet, so it won’t do to get impatient. I may yet have more weight to lose; it just might take longer than it has up until now. Based on the rate of deceleration, I should be prepared for the possibility that my actual weight loss line will cross my goal line–that I won’t reach 125 by August 28, if I reach it at all. This should not be discouraging, because the goal was arbitrary; I put it in purely for the sake of analysis, not as something I was actually striving for.

And so I am leaving my final weight in the hands of fate. I’ll do what I can do be healthy by eating right and exercising, and then I’ll see where I’ve ended up on September 25, 2013.

Six months out

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I recently had my six-month phone checkup with the office that performed my weight loss surgery. They’re very pleased with my progress, my protein levels look good, and I’m getting enough of my other nutrients; on the other hand, my cholesterol might still be an issue, and we’re waiting until June to see if my pseudotumor cerebri has improved. Still, everything generally seems to be dandy.

While I had them on the phone I inquired as to how much more weight I might expect to lose. They told me that on average, their patients reach a BMI of 26. For me, that would mean a weight of 147.

This is consistent with my high school weight range, but it’s a little higher than I was hoping for. A BMI of 26 is still considered overweight, for one thing. For another, at 167, I don’t really feel like I’m all that far from 147, and I’m not sure I’m prepared for this to be done in just another 20 pounds. Now that I’ve lost so much excess weight, I’m painfully aware of all my sagging flab, and I want it gone too. I don’t think 20 pounds would do it. I almost feel like I have 20 pounds of flab just in one thigh!

So I’ll keep eating right and working out and letting the surgery do its thing, and we’ll see what happens. And I’m going to really try not to worry!