Weight stuff

My weight has been fluctuating since this whole thing began. I’m supposed to pay close attention to this because rapid weight gain could indicate fluid retention, which would be Bad. However, so far I have not seemed to retain any fluids.

I started out around 150, but since I started watching sodium, my eating habits have changed some, so my weight dropped to around 140. It has been bouncing around that level ever since. Here’s a lovely graph:

a graph of weights for September and October 2016

Weights from September and October 2016

That spike in the middle happened during the New York trip, when all dieting efforts went out the window. I think the current low is due to a days-long period of depression that I think I am now coming out of.

I’m not really…concerned about this? I just wanted to document it because it’s interesting. So here it is.

(I feel like 140 is probably where I should actually be, since that’s where I seemed to level out initially after weight loss surgery, so that will be my “goal weight” going forward.)

More and more

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.

My new old relationship with eating

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.

久しぶりのRAMBLE

I’m in a share-y mood, so I’m going to go all stream-of-consciousness like I used to back in the halcyon days of this blog. No real topic, no defined start and end, no “point”. Just what I’m thinking.

The post title, if you’re interested, just means something like “A ramble, for the first time in awhile.”

I wrote this morning on Facebook that I wished I was better at humor. I’m extremely serious, and I tend to react badly when someone throws a discussion off-topic in a humorous way. Basically, I don’t understand and can’t really put up with trolls. This is why I never read forums. I also hate practical jokes. I love laughing, and I enjoy funny things very much, but I hate it when serious discussions are derailed for a laugh (or even to make a point, because I often have trouble figuring out what point is being made). I’d like people to just respond respectfully and openly rather than being what I interpret as summarily dismissive.

Other people don’t seem to have this problem, though, so I can’t help but feel deficient.

Abrupt topic shift! I started using the WaniKani beta yesterday. WaniKani is a kanji learning system that incorporates SRS and fun. I’ve really enjoyed it so far, and I hope I can stick it out. Other than watching lots of anime, I haven’t really been doing much with my Japanese study lately, so I’m really wanting to get back on track (or on a track in general).

Speaking of anime, I’m finding myself infinitely perplexed by anime genres. Polar Bear’s Cafe, which I adore, is apparently shoujo. I’m not sure what genre I would put it in if I had to choose, but when I think shoujo I think Sailor Moon, so obviously there’s a disconnect somewhere. I’m also confounded by the shounen genre, as evidenced by this post and comments. Either Japan is cool with young kids watching really violent and sexual stuff, or there are subgenres I’m unaware of…or something. I guess knowing what genre something is doesn’t really matter in terms of enjoying it, but I would like to find a good way to identify anime that I have a high chance of enjoying, and to know what to expect from it. The best I’ve come up with so far is that I generally like “sports” anime, where characters work towards a goal and compete with each other, and “slice of life” anime, especially high school. I generally dislike “harem” anime, where one male character is surrounded by a bunch of girls drawn in an oversexed way. But anime isn’t always labeled this way, especially on Crunchyroll; their “slice of life” genre includes surreal comedies, for example. I usually have to read a show’s description and watch the first episode before I know if I’ll enjoy it. Unfortunately for me, I watched School Days all the way through without knowing what I was in for, and that was just traumatic.

I recently watched the first season of Code Geass: Lelouch of the Rebellion on Crunchyroll. (Season 2 isn’t available.) The show isn’t what I would normally go for. It is intensely tragic. But somehow, it felt like it was what I needed to see at that moment. It was a reminder that we can become blinded by our own goals and ambitions, and of how much our pasts can define us if we let them. As you might imagine, I identified most strongly with Suzaku (voiced by my beloved Sakurai Takahiro). But there’s no way I could argue that Suzaku always did the right thing or made the right choices. You can’t say that for anyone in the show. That’s what makes it so compelling and real and, again, tragic. As the audience, you can see how everyone’s decisions come together to impact the entire country, and you wish so-and-so knew such-and-such or hadn’t made a certain decision. None of the decisions themselves feel fated, like there was nothing else the characters could have done. Instead, it’s kind of like in a video game where the choices you make build up to determine your character’s “alignment”. But as things progress, the options diminish, and the ones that could right a character’s path become more and more dangerous.

The story reminds me a bit of Song of Ice and Fire. No one has the full picture but the audience, who is left simply watching as horror after horror unfolds. Unlike Song of Ice and Fire, though, I feel like there is an actual purpose behind the story in Code Geass. Song of Ice and Fire just feels like a laundry list of bad things happening.

Health-wise, I’m doing okay. I feel like I spend most of my day either trying to figure out what to eat or actually eating something. It’s pretty annoying. I have found a new, delicious Atkins bar, the Peanut Butter Granola. It is awesome and I’m very happy to add it to my arsenal. In terms of real food, I’ve found my George Foreman electric grill to be invaluable in easily cooking chicken, burgers, and tilapia, and I’m still relying on yogurt, cottage cheese, and cheese snacks to supplement my protein. I also eat a lot of peas. I’ve added other vegetables and fruits to my diet, in moderation. My biggest problem is carbs; I eat too many potatoes and noodles and too much bread, and I haven’t been as careful about choosing wheat over white. Sweets aren’t really an issue for me anymore, as I rarely find them all that delicious, though I do wish I did, sometimes.

Personal training is also okay. The worst part about it is having to deal with another person, but that is kind of the point. They’re there to motivate me and to give me something new to do. So I endure.

Actually, I am feeling better about personal training right now than I was when I wrote the previous paragraph, because in the intervening time I went to a personal training session, and while I was utterly depressed going in, I actually feel fairly good after having worked out. So there’s that.

I’ve been depressed off and on for awhile now. I feel immense pressure, mostly from myself, to do something, but I can’t seem to figure out what, exactly. I’ve been trying various things without success. I’ve also been running away from various things. I want to feel in control, to have a plan. It’s killing me not to.

I’ve also had a lot of time to think these past few months…perhaps too much time. I spent a long while trapped in misery, thinking of all the pain in the world and in my own personal circles that I am powerless to do anything about. It took an incident of extreme thoughtlessness on my part–an event in which I tried to help, but had no resources to do so, and ended up adding to other people’s burdens–that helped me realize I could prioritize, and that sometimes I have to say no. I’m happy to say that I have at least pulled myself out of that murky hellhole of guilt. I seem to keep finding other things to worry about, but I don’t think I will fall into that same chasm again.

I have, however, been increasingly down on myself lately, and I’m even finding myself resentful of others where I don’t want to be resentful. I’m projecting my own confusion and helplessness on them, judging them for the things I self-judge, and it’s not fair to them or to myself. Intellectually I realize that I am partially crippled by circumstance, and while I can’t use that as an excuse per se, I can at least be more understanding of myself and allow myself to make mistakes and learn from them rather than simply hating myself and spinning my wheels in frustration. But it’s so very hard not to blame myself for everything.

I’ve even found myself thinking despairingly, “I’m so fat,” when that is hardly true. It was always my old internal mantra, and I guess it just naturally comes out when I despise myself. I’ve been trying to remind myself that no, actually, I’m not fat, but that’s hard, too. My inner voice argues back, What about all that flab?

Further, when I think about all the things I want and can’t have–children, frequent world travel, a piano, even just eating out–all I can think is that it’s my own fault, that I should have done something differently, or I should be doing something differently now. I don’t know what, though. It makes me miserable.

I’m tempted to round out this post with an uplifting “I’ll just have to do my best!” paragraph, like usual. But I promised not to have a point or a real ending. So I won’t. I’m not really feeling that emotion right now, anyway.

Instead, I’ll just mention that I’ve been watching Glass Mask again, and I am so jealous of the heroine, Maya. Her life is hell, but she knows what she wants to do and she’s willing to fight for it. I wish I had that kind of commitment to something. Something profitable, that is. Of course I have that commitment in spades when it comes to my husband and family.

Maya gives up her family to pursue her dream. I don’t think I could do that. I think that sort of sacrifice is easier when you’re young; you want to escape and find something new. I felt that way in my early 20s. I don’t feel like that now, or at least not in the same way. I still want adventure, I still want passion, I still want to learn and explore. But I can’t abandon my family.

It’s hard to explain what I mean by that. I don’t mean I wouldn’t move to another city or country, for example. I just mean that I could no longer make that decision on my own, without considering other people’s needs. My life isn’t just about me.

Oh hey, I have another topic. It’s kind of weird, and I’m actually kind of afraid to talk about it. It’s men.

For much of my life, the story heroes I identified with most were men. I wished I could be like Anne of Green Gables, but I knew I never could (she was slender with slim fingers; I was shaped more like her friend Diana, of whom Anne was jealous but I was not). I also liked Pippi Longstocking. But for the most part, I always felt like being a girl was too complicated, and it would just be easier if I was a boy. (I know; the grass is always greener.) I don’t believe I am gender-queer or anything, just that I didn’t know what to make of myself, and I was trying to figure out what role I played in life. As a child I pretended to be boys plenty of times: Simon of The Chipmunks, Donatello of the Teenage Mutant Ninja Turtles. I didn’t want to be one of the Chipettes; they weren’t in all the stories and when they were they were often annoying. I didn’t want to be April O’Neil, because while she was cool in some ways, she wasn’t one of the core group, really. She wasn’t a ninja. She wasn’t a turtle. I certainly didn’t want to be Venus de Milo, the token female turtle, named not after an artist but after a work of art. Even as a kid that offended me. (I did pretend to be Smurfette when I was very young, but I didn’t particularly like it, because she was everyone’s love interest, and that seemed weird.)

It always seemed like there was a group of cool, interesting guys, and then one girl who was put in to have a girl there. I wanted to be one of the interesting people. And, to be frank, I didn’t usually find the shows with lots of girls in them, or centered around girls, to be all that interesting. I didn’t care about hair and makeup and clothes. I wanted to see adventure stories.

One exception was Clarissa Explains It All; I adored that show and wanted to be Clarissa with all my might. She was very much like me; she programmed on her computer (though she did far more advanced things, like building video games in which she threw things at her little brother) and she wore the clothes she felt like wearing, which in retrospect were “cool”, but I felt like they expressed her personality rather than following trends. She also liked Star Wars, which to me was the epitome of awesome (in the hoary pre-prequel days).

As I got older I started wishing I was a boy not as much because there were few cool stories about girls, but because I started watching USA and Lifetime movies and seeing how often women were victimized by men. I thought if I was a man, I would have less to fear. It occurred to me only this morning that I spent a great deal of my life being afraid of men. To be honest, I’m still afraid of them. I spend a lot of time thinking about how to protect myself–maybe more than the average woman? I don’t know. It always felt like even saying the wrong thing could result in violence against me. There are things I still fear to do or say.

Intellectually (I like to evaluate things intellectually, apparently!) I realize that this is sexism on my part. The actual percentage of men who would respond to an offense violently is small, at least here in the US. I do all my male friends a disservice by thinking this way, though I can at least say I don’t think any of them would be violent. I just have this creeping fear inside. Seeing some of the online comments against women, all the legislation aimed at women recently, and all the violence against women around the world only makes me more paranoid. I don’t like living with this fear, but it’s been a part of me for so long I’m not sure how to get rid of it.

I hate when the strong hurt the weak. I have always hated it. As a kid I couldn’t stand seeing it on TV, even in cartoons. I still don’t like it; I won’t watch shows like Law & Order: Special Victims Unit. And I hate how casually people threaten violence against one another, especially online. I hate…hate.

Non-sequiturs to escape the previous topic:

Nichijou‘s first opening theme song, “Hyadain no Kakakata Kataomoi-C”, is awesome.

What is up with SKET Dance adding five million female characters with ever-increasing busts?

Natsuyuki Rendezvous is a weird-ass show.

I need to find a new place to explore.

Chobani’s plain Greek yogurt is the best.

Weight goal: achieved! Sort of.

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

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 :)

Weight loss surgery challenges

I am currently over eight months out from duodenal switch weight loss surgery. In that time I have lost 109 pounds and gone from size XL blouses to size M and size 26W pants to size 10. My shoe size has also gone from around 8W to 7, and I’ve had to have my wedding rings resized.

For the first few months of this process, my biggest challenges were emotional. As my body changed rapidly, I started to lose my sense of identity. I never realized just how much I identified as “the fat one” until I wasn’t anymore.

Now, though, the weight loss has decelerated, and I’m quite pleased with who I see in the mirror despite some lingering trouble spots. My biggest challenges have shifted to complacency and boredom.

You see, while I was focused on the rapid weight loss, while I could tell I still had plenty of weight to lose, I was very motivated to eat right and exercise. I thought at the time that the surgery was some sort of miracle cure for food addiction; I didn’t really crave anything, and though I got tired of eating the same high protein foods over and over, it didn’t really bother me because I had a goal, and because food wasn’t nearly as important to me as it once was. And I also knew that I had to make sure to work out during the rapid weight loss, so I would lose fat rather than muscle mass. While I wasn’t quite as dedicated to exercising–I never have been–I still did a lot of walking and spent more time at my apartment complex workout room than I normally would have.

But here I am, basically happy with my weight, not losing quickly anymore…and suddenly really wanting to enjoy eating again. I’ve slipped. I’ve had cookies. I’ve had sugar-laden sauces. I’ve eaten too much bread. I’ve gone for fried food–and fries. Thanks to my smaller stomach and rerouted intestines, I can’t eat or absorb as much food, but eating too much of the wrong kinds of food is still bad. It’s just so much harder to keep that in perspective when I feel good and look good and just want a snack. When I see TV characters eating these huge, delicious-looking meals, and I wish I could eat them too, and I know I could never finish those portion sizes. When I start to mourn the me who could enjoy a big slice of cake.

I’m in danger of slipping back into my old patterns of emotional eating, eating when I’m not hungry, eating just to eat.

The thing is, eating these bad-for-me foods doesn’t really give me any joy. They taste better now than they did a few months ago, possibly because I’ve been eating them more and my taste buds have readjusted, but they’re not really satisfying. And then there’s what happens later. Too much sugar gives me severe abdominal pain. Too much fried food gives me diarrhea. Too much white bread or white rice gives me gas. There are compelling physiological reasons not to eat foods that are bad for me. But the delay between the eating and the punishment is just long enough that I can trick myself into thinking it’ll be okay, that the food will be worth it. It usually isn’t, but my emotions don’t remember that. I just want the food because I want it.

I must reiterate that until recently, maybe three or four weeks ago, I didn’t even have this problem. It’s like all of a sudden my food cravings woke up, raring to go…and now every meal choice is a struggle.

Then there’s the exercise. For awhile there I was taking pretty regular walks. Now, they’re intermittent. I spend most of my time sitting or standing at my computer, or lounging on the couch. Errands do take me up a flight of stairs, which is great but not enough. And I’m not doing any strength training. No toning at all.

My forearms look pretty good after all this weight loss. My upper arms do too, if you look at them from the correct angle. But then I raise my arm and you see the huge dangling flap of fat and wrinkly skin. Might this have been avoided if I’d actually committed to working out properly?

I look pretty good in a pair of jeans these days. But take them off and what do you get? Folds of butt skin. Disgusting.

And I still have fat to lose, on my stomach and thighs. Now that my body is smaller, it seems more striking, though I’m able to conceal it pretty well with clothing.

I said before that I’m pretty happy with how I look, and despite what I just described, I am. If this is where my weight loss is going to stop, then that’s probably okay (though I might have cosmetic surgery on my arms and butt).

But as I mentioned in my post about the weight loss deceleration, I still have over a year left to lose weight. It’s possible I could get rid of more fat, and maybe even tone up.

Being complacent about what I’ve already achieved isn’t going to get me there.

So, frankly, I’m a little scared. I’m scared that my boredom over food will continue to impact my meal choices. And I’m scared my complacent opinion that my body looks okay as it is will mean I’ll pass on exercise that not only might help me look better, but would keep me in better health.

I don’t want to give up so soon. I don’t want to say “That’s good enough.” I didn’t expect this hurdle, here in the end game where I really only have about 25 pounds to lose, if that.

So I’m making a different commitment. Before, when the surgery’s effects were new, it was relatively easy to change my lifestyle to adjust to them. Now I’m used to my new gastrointestinal system and will need to put more effort into staying on top of things. This means I will keep my apartment free of things I shouldn’t be eating, and make Sean’s treats off-limits to myself. I will think of the protein first every time, as I should have been doing all along. And I will try to come up with some method of meal planning that isn’t actually meal planning, because I hate meal planning. (I may just go to the store every day for awhile rather than trying to work out a week’s worth of dinners.) As for exercise, I am going to start looking into joining a gym and/or hiring a personal trainer. But while I explore my options in those areas, I’ll get back to doing workout videos that exercise all the muscles, and resume going on regular walks.

These steps should result in a healthier me, and if they also result in further weight loss and toning over the next year, then that’s great too.

When I chose to have weight loss surgery, it was out of medical necessity, but I was also committing to a lifestyle change. I’m not giving up on that change.

Deceleration

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.

Weight loss, body image, and girly-ness

I grew up half girly and half tomboy. I’ve always liked cute things, and I’ve always liked dressing up and looking nice, but I’ve also always enjoyed getting my hands dirty, wearing comfortable clothes, climbing things. As a child it always irritated me that my dad and brothers could go outside shirtless on hot days and I couldn’t.

me in middle school

Me at age 12

I tended toward comfortable and eclectic clothes in middle school–pink sweat pants, high top black or white sneakers over two pairs of alternating-color socks, large untucked T-shirts cinched with a thick leather man’s belt and giant belt buckle, brown trenchcoat. I don’t think any color pictures from that time have survived, but here’s one from when I was in the 7th grade, age 12. I was in the paper for participating in an English Composition competition. (One year I made it to state.)

It was funny after the summer between this year and 8th grade, when I put my belt back on for the first time in months and discovered I had suddenly developed curves. I vividly recall looking at a picture of myself from the previous year and thinking that my waist looked like a tree trunk by comparison.

It was probably at that point that I started thinking about looking more girly. Maybe Mom gently nudged me in that direction; I don’t remember. I do know that in middle school I was extremely arrogant. I got along better with teachers than with most other students, and that (plus my wardrobe choices) caused me to be shunned by the general school population. Food was thrown at me in the cafeteria, for example. I did have friends, but I didn’t respect them as much as I should have. I felt that I was above it all. I was, of course, achingly lonely, and to balance this I decided to passive-aggressively talk about people in front of them…to walls. This did nothing for my reputation and also caused some hell for my younger brother, unfortunately.

By the time high school rolled around I was ready to reinvent myself. Toward the end of 8th grade I visited the high school for some function–I think it was probably related to French, which I’d started taking that year–in a cuter outfit than I’d normally worn throughout middle school: jeans, a knit red sweater over a beige blouse, and earrings. While there I met a guy who knew nothing about my wall-talking, crazy-dressing, antisocial behavior, and we got to talking. It was not the first time a guy had expressed interest in me, but it was the first time it wasn’t someone I’d known since elementary school. It was exciting.

I dressed better in high school, and kung fu kept me in relatively good shape. I was convinced I was fat, though, and then one day my dad, trying to be helpful, told me I was “a little overweight.” This drove me to screaming tears. I had always suspected it, you see, and the outside confirmation just made it worse.

One time I was sexually harassed during gym class. A boy touched me on the backside, and when I spun, startled and scared, he was leering. I fled to the locker rooms and wouldn’t come out. The female gym instructor came to talk to me, and I told her I didn’t think I was pretty. Somehow, I had conflated the incident with my insecurity and concluded that only “ugly” people got touched inappropriately. The instructor didn’t figure this out, though, and simply assured me, “You’re not the most beautiful girl in class, but you’re certainly not the ugliest.”

(Later, I was getting a soda from a vending machine, and as I bent over I felt something touch my bottom. I freaked out and accused the boy in line behind me of touching me. He swore up and down that he hadn’t done it, and he looked angry to even be accused, so I immediately changed my story. After all, why would a cute guy like that want to touch my bottom? I must have just brushed up against something.)

I had no boyfriends in high school. I had likes, and I had crushes, but I could never get close, or never let someone get close. The boy I’d met at the French event ended up in my freshman year French class, but while at first I’d found his behavior flattering and chivalrous, eventually it became tiresome and oppressive and even embarrassing. I wasn’t attracted to him, and I didn’t know how to handle it, especially given the long love notes he would continually write me. Somehow, eventually, I told him I wasn’t interested, and he turned his attentions to one of my friends instead, much to her chagrin.

That, unfortunately, was about the best I would do in high school. I spent most of the rest of my time crushing on a boy who wasn’t interested, and occasionally attempting to pursue other boys. No boys pursued me, with the exception of a senior who wanted to take me to prom my freshman year (my parents said no) and a guy who was already dating my friend (and who I therefore cold-shouldered mightily, with restraint I should have shown later in college). I met someone really nice and interesting at the BETA Convention one year. He saw me alone at the hotel restaurant and invited me to eat with him and his friend, and then we explored around the hotel together, and after that we were going to go out on a real date and everything…but I bailed at the last minute out of fear. I was afraid we hadn’t really made a connection, that he was just trolling for a chick. I didn’t know how to trust. I never saw him again.

My first actual boyfriend, therefore, didn’t happen until college. My husband doesn’t like hearing about him (for obvious reasons, but also because they are very different people), but I am pretty thankful I had him in my life. He helped me to accept my body and be comfortable with the way I look, and that change was extremely powerful. I wish I had been a better person then, had been able to treat him better, especially given everything he did for me. I don’t think we should have ended up together, not by a long shot, but I should have broken up with him and stayed broken up when I realized that the first time. At least I know he’s happy now.

When Sean and I first got together, I weighed around 150 pounds. I’d lost a lot of weight due to cancer. I looked pretty good, I was dressing well, and a lot of local guys were noticing me. Sean and I were dating, but he lived nine hours away, so sometimes it didn’t feel real, and I’d entertain the notion of having a local significant other. Ultimately, I didn’t act on these ideas, but I did tell Sean about them; reading the chat logs later, I couldn’t believe how heartless I’d been. I suppose I was coming into myself as an attractive woman who was aware of that fact, and not thinking about the consequences to those around her…not even the man who had already professed his love.

me in 2000

Me in May of 2000

As time passed, I started gaining weight, and when I’d buy new clothes, they weren’t cute. They were comfortable. I had a lot of stretchy pants and big t-shirts. Every now and then I would “dress up”, but for the most part I was, well, slovenly. I was in a relationship; I didn’t need to find anyone. My guy was two states away. There was no one to impress. Really, I wasn’t thinking about these things at all. I was just putting on clothes.

It was actually Sean who got me started dressing nicely. I’d gone through the “I’ll dress how I want because I’m better than you” phase; I’d gone through the “I’ll dress to hopefully please guys, but I hate myself” phase; I’d transitioned into accepting my body; I’d gone through the “Hey, I’m thin! Look at me!” phase; and now I was in some sort of “Whatever” phase. Then there came a time when I was visiting Sean, and I threw on my normal t-shirt and stretchy pants and went to go say hi and bring him a snack at work.

And he was so cold to me. He got rid of me as fast as he possibly could. And he made it perfectly clear that it was because of what I was wearing, that he was embarrassed to be seen with me.

I went back to his parents’ house and sat down at the desktop computer I had lugged down there and just cried. Honestly, I hadn’t thought about this at all. It was shocking to me because it had never occurred to me. I was that comfortable with myself; I just assumed that he was my boyfriend and he would like how I looked no matter what. What a difference from just a few years prior–I never would have assumed such a thing in high school!

A lot has changed in the intervening years. Sean has become far less brusque with me than he used to be. Where once he was abrupt and cool, now he is gentle and supportive. Warm. Tender. Meanwhile, I have become far more attuned to how my actions affect him: how I dress, the things I say. We each enjoy doing things that make the other happy, and we’ve learned a lot about that in the nine and a half years of our marriage.

Now Sean can tell me that an outfit doesn’t really work for him, and it’s fine. I may choose to wear it anyway, if I like it. Or not. And I can express to him what sort of support I need when I need it.

me in February 2009

Me in February 2009

Sean’s fondness of dressing well started to rub off on me fairly quickly after that work incident. I began to choose prettier, more flattering outfits. I started to rise out of the mindset that being overweight or obese meant I didn’t need to worry too much about how clothes looked. Fortunately for me, stores were starting to come out with some plus-size fashions that I really liked. I tried to avoid wearing a lot of plain black, because although black is slimming, it’s not pretty. I started to get a good idea of the types of fabrics and the clothing styles that flatter my body type versus the ones that make me look awful. I embraced “work casual”, nice blouses with black slacks, on weekdays, and wore t-shirts and jeans on the weekend. I kept this up even as my weight ballooned.

I looked at other people as inspiration, people who always dressed well and looked great despite not fitting some arbitrary shape requirement for beauty. I didn’t work on my appearance hard enough to be on their level, but I did work at it a lot more than I had before I realized it was something worth working on.

I don’t want to undercut the epiphany I had in my post on beauty, but I’m realizing that I already felt beautiful, and still do. I knew I didn’t look like a model or like my ideal self-image, but at the same time, I knew I could make myself look nice, and that was powerful. I also knew, and know, that at home, there is a man who loves me, who finds me appealing. While I can dress up for him, and enjoy doing so, I can also just be completely naked, and he’s happy. It isn’t an ideal he wants, it isn’t the image I create by putting on certain clothes. It’s me, and everything that I am.

So now I’m losing weight. I have so much more energy, and I’m finding myself pouring more and more of it into being girly and cute–new outfits, pedicures, trying different things with makeup. Maybe I’m becoming more “acceptable” or more attractive to the world at large. But that was never the point. This weight loss was never about that. It was also never about me finding happiness in myself, because I already did that. This is about getting healthy, living longer, being able to do more, just enjoying life. It’s stirring up so many memories as it happens, though, so many thoughts about my body that I haven’t really worried about in years. I suppose I’m losing some emotional weight too.

I’ll let it all slough off me and emerge stronger and even more vibrant.

me on April 1, 2012

Me on April 1, 2012

Six months out

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!

No longer obese

me at 167 poundsAs of yesterday morning, I weigh an astonishingly low 166.6 pounds. That’s a hundred pounds less than the highest weight I ever reached, and 90.4 pounds less than I weighed on September 26, 2011, the day I had weight loss surgery. Now, six months out from that surgery, my BMI has plummeted from 45.5, class III obesity, to 29.5–toward the top of the “overweight” range.

I am no longer obese.

I am no longer obese.

I knew this was coming. Whenever I saved my weight in Weightbot on my iPhone, it would tell me my BMI, and I knew that as soon as I hit 29.9 I would no longer be obese. I felt like I was in the 30s forever. I thought about checking to see what weight I’d need to reach to get out of the obesity range, but I somehow never got around to doing that. This month I ended up traveling a lot and didn’t have access to my scale…so while I usually try to wait a few days to a week between weigh-ins, yesterday’s came after a far longer data-free period than usual.

I didn’t even really realize it had happened when I tracked my weight. I saw the 29 and it just didn’t register. It was only this morning, when I weighed in on the Wii Fit, that the truth resounded in my ears: a different, higher in pitch humpty-dumpty “you’re fat” melody, and the Wii Balance Board character, who for years has admonished me, “That’s obese!”, chirped instead, “That’s overweight!”

I don’t know how much more weight I’m going to lose. I’d need a BMI of 18.5 to 24.9 to be considered in the “normal” range; for my height, that would mean a weight between 104.5 and 140.5. I’m really not interested in weighing 104.5. My mid range, a BMI of 21.7 at 122.5 lbs, seems about as small as I’d want to go. I don’t really know what I’d look like at that weight, because in high school, at my most fit, I weighed around 145 to 150.

I don’t even really know what weight I want to be. I used to say I wanted to go for 125 and that I’d be happy with 140, but I can’t imagine what I would look like at either weight. I’m actually pretty happy with how I look now, although I’d like to get rid of some flab. I hope I don’t lose so much weight that my natural curviness goes away.

Regardless, I am extremely pleased with the results of my hard work so far, and I hope I can continue refining my body and becoming even more healthy. I updated the comparison photo I made three months after surgery, and included clothes sizes this time. It’s amazing to me to look back at the changes. (Click to embiggen.)

before and after photosI’m wearing the same shirt in the first two photos, and I thought about wearing it again in the next two, but once a shirt is too big for you, it starts getting unflattering. I did put it on this last time, though; here’s a picture. Rather than hiding fat, the ruffles now hide my lack thereof, which defeats the entire purpose! ;)

Fat dream

Last night I dreamed about going to some sort of meeting. I don’t really remember what the meeting was about, just that there was a guy who seemed to be the leader who said several things that he’d already said in the email he sent out when he called the meeting. I was glad to be there; I felt I was with like-minded people and that we could perhaps accomplish something, though I don’t remember what.

What I do remember about this dream is catching sight of myself in a mirror and being taken aback by how fat I looked. I was wearing jeans and a pink-purple sweater, an outfit I’ve worn before, and I was sitting down, which is the worst way to see yourself when you’re obese. I didn’t look the way I look now. I wasn’t 179 pounds. I was probably 260.

I looked something like this:

me at approximately 260 pounds

me at approximately 260 pounds, June 2011

It was really jarring…and yet really familiar. I recognized myself. I wasn’t happy, but I wasn’t horribly depressed. I had a sort of resigned acceptance, like, “Yeah, that’s me.”

The thing is…that’s not me. I don’t look like that. I look like this:

me at 179 pounds, today

me at 179 pounds, today

And there’s another weird thing. I can’t recall ever identifying as obese in my dreams before. In my dreams, I always just identified as me. I kind of assumed that my dream self embodied my ideal self.

Maybe my subconscious is confused now that my real body is transforming into something closer to my ideal body than to my obese body, so to keep the existing balance, it’s just flipping the roles. But I really don’t want to think of myself as obese when I’m not. (Technically, I’m still obese, but I won’t be forever.) I want to have a healthy understanding and acceptance of my body as it is. I don’t want to wish for an impossible ideal or long for my known, comforting blubber.

I’ve been thinking more about how I’ve used weight as a shield. I’ve used it as an excuse not to bother learning how to do hair and makeup, because why bother to try to look pretty when you’re fat? Only now when I want to look cute or beautiful, I don’t know how. I’ve used weight as a security blanket, irrationally believing that no one would want to rape me because being fat made me unattractive, and this is now leading me to irrationally believe that I’m turning myself into a target by losing weight. I’ve used my weight as a way to avoid fundamental questions I’ve been having as to what it means to be a woman–the fatter I was, the less feminine I felt. (The infertility contributed to that, too.) I’ve quietly used my weight as an excuse as to why I’m not a social butterfly, why I don’t get invited to parties, why people all around me seem to instantly forge connections while I struggle to make one good friend. That “people would like me if I was pretty” feeling defined my high school existence and sent ripples out into my adulthood, even though I knew the real reason was that I’m simply not an extrovert. I felt comfortable getting fatter and fatter because I could use it as an excuse as to why no one ever called or texted me.

Thankfully, in recent years I have begun to deal with that last problem, so I probably won’t be shocked when I become thin and the world doesn’t come rushing to my door. I have friends, good friends, relationships that I have worked to maintain. I may not be clubbing or partying or whatever, but that’s not who I am. I’m happiest when I’m learning, discussing, hearing someone’s story, appreciating beauty, exploring. And I’ve found friends who also love those things.

But that still leaves all the other things, and perhaps more issues I haven’t identified yet.

So, right now, I reject the idea that my obesity and infertility make me less of a woman. Hell, I reject the idea that womanhood can be so easily defined, and I reject the idea that it needs to be. I reject the idea that obesity defines me. I reject the idea that it’s too late for me to learn how to do hair and makeup–please! And I reject the idea that I can or should do anything to my body to make myself more or less appealing to a lowlife rapist.

I’ll press on, one foot in front of the other. I’ll keep writing when I need to. I’ll identify these mental demons when they rise up, and then I’ll knock them the hell down.

me at 179 pounds, today

Women’s clothes sizes

Shopping has always been a pain for me. I’ve tended to only go to a few stores, where I’m reasonably confident I can find things that fit and flatter. I never really thought about why it was so difficult to find clothes; I just assumed it was because I wasn’t proportioned like a fashion model. But it turns out that the stores themselves make things unreasonably complex by each using their own sizing system.

The Guardian’s DataBlog has a new piece: What’s your perfect fitting top, skirt and dress on the highstreet? Author Anna Powell-Smith, frustrated by how difficult it is to shop for women’s clothing, gathered data from all the shops she could and compiled them into an online application that tells you what sizes to look for in each store. It’s called What Size Am I?

What Size Am I website screenshot

What Size Am I? website screenshot

This is going to be very useful to me when I hit my final weight and finally go on that shopping spree I’ve been planning. All you do is pick whether you want UK or US stores, inches or centimeters, and then put in your measurements. Right now the app tells me,

Your closest fits are probably:

  • Top: Express size 16
  • Skirt: New York & Co size 18
  • Dress: Express size 16

Being supremely unfashionable, I wear pants most of the time, so I wish those were included. Maybe the skirt size works for pants too? [Edit: Ms. Powell-Smith let me know on Twitter that skirt and pants sizes were the same at most stores.] Regardless, it will be neat to put my measurements in as I continue to lose weight and see what my sizes change to.

The US stores included in the app are Abercrombie & Fitch, American Eagle, Ann Taylor, Anthropologie, Banana Republic, Express, Forever 21, Gap, H&M, Hollister, J Crew, New York & Co, Old Navy, The Limited, and Urban Outfitters. I am pretty sure I have never bought anything from any of these places! I think I remember trying on a blouse in Ann Taylor once. And I walked into a Gap one time, but all their sizes looked too small, so I walked right back out. So yeah…when the time comes, this is going to be an adventure.

Beauty

They tell you when you decide to have weight loss surgery that the physical changes you undergo will touch off emotional reactions. Here’s how my handbook puts it: “Although you have intentionally undergone the surgery to resolve your obesity, weight loss changes the life style you knew so well. Even with its problems and tensions, obesity was comfortable, it was known. Now that life is gone.”

This is not something you really understand until it happens. I read these words. I read about the stages of grief, which many patients go through after weight loss surgery. I thought I knew what it meant. I thought it meant that I was comfortable with my old eating and (lack of) exercise habits, and that I’d have to be strong to adjust to the changes.

So I prepared myself to change my eating and exercise, and I’ve worked really hard at both. And while I do find it depressing that it’s difficult for me to get enough protein each day, I’ve felt strong, and I’ve persevered. Every day is a victory.

But that wasn’t what the handbook was talking about at all.

Today, I am just barely (by .1 pound) into the 170s. My body has changed so much. Sometimes I don’t recognize myself. My face is slimmer, but to me it looks like Play-Doh, like a field of enormous dimples. In the apartment complex fitness center the other day I looked in the mirror and saw an ugly old woman, thin hair pulled back from a big pasty face. It was me.

When I look at my naked body in the mirror, I can see that I’m starting to have a more pleasing shape. But I can also see how being fat has destroyed my skin. I’ve got the surgery scars, of course, but worse than that, I’ve got stretch marks. Everywhere. Stomach, arms, legs, breasts, everywhere.

I have always held in my head this perfect image of how I’d be if I wasn’t fat. I’d look great in a bikini. I’d have a cute face with big eyes and smooth skin. I’d look young.

I’ve never really worried about age before. I’ve never worried about whether or not I could look like my perfect image, because I never thought it was possible to not be fat.

I didn’t really know this until today.

Now I’m looking at myself in the mirror and I’m disappointed. I’m not approaching that perfect image. When I reach whatever final weight I reach, I’m not going to look 22. I’m not going to be able to wear a bikini.

I had never thought of myself as vain before. I always thought I was “above” that somehow.

Now I know that I was just using my obesity as a shield.

I’m sick. :(

I have had a cold for over a week. Last Wednesday, January 25, I felt it coming on–a few sniffles, a sore throat, some coughing. It’s been nonstop since then. The cough’s gotten worse, then a little better. The sniffles turned to sneezing and lots of nose-blowing. My throat is no longer sore, but I have sinus pressure and a headache, and for the past few nights I’ve had trouble getting to sleep and then staying asleep. I’ll be in bed for 12 or 13 hours but I’m not sure how much of that time actually involves rest.

My mucus is clear and I don’t have a fever. There’s been no throwing up or anything like that. It’s just a head cold. But it won’t go away.

At this point I am considering trying to use my CPAP to get some restful sleep. I haven’t needed it in weeks thanks to weight loss. I’m not sure if it would even work, but I feel so terrible, it’s worth a shot.

Since I’ve been sick, I haven’t been able to work out properly. I’ve tried a couple times, only to feel exhausted and lightheaded way too soon.

I’m wondering if the rapid weight loss period after weight loss surgery makes one more susceptible to illness. Is my immune system weakened by the ordeal my body’s going through? If so, is there anything I can do to break free of this cold? I do have some generic cold medicine, but that of course treats symptoms, not the cause.