Saturday, December 31, 2011

Ah-ha, I can so blame my mother, well at least her DNA

My friend sent me this article from the New York Times about an Australian study that addressed the question of why it's so hard to keep the weight off after it's lost.  They actually looked at physiological reasons rather then concentrating on the emotional factors of losing weight (which are important and I in no way mean to discount BUT it's an entire the physiology should ALSO be addressed - right? well I think so and it's my blog).

It was very interesting.

Not to mention it totally backs up the metabolically efficient theory for which I named my blog.

The premise is when a person loses weight, and it looks like it doesn't matter how quickly, the person creates a new set-point for themselves.  Creating that new metabolic set-point puts them at a caloric disadvantage.  A whole host of physiological changes occur that make it difficult for the person to 1. maintain the weight loss and 2. continue to lose weight (difficult -- but.not.impossible.).  Ghrelin increases (hunger hormone) and leptin decreases (satiety hormone) and a bunch of other hormonal changes geared to not only make you feel hungry but also to increase your cravings for high fat foods (can you say wooly mammoth -- cave man genes, they're a killer).   To add insult to injury, muscle fibers change becoming highly efficient (there's my theory back-up) reducing the fat burning capacity of the muscle (making them more low-twitch) which means that a brisk walk that normally would burn 200 Kcals now only burns 150-160 Kcals.

Sucks to be people like me.

Does explain why a a sausage biscuit sounds much yummier then a grapefruit though (I miss sausage biscuits).

I got distracted there for a minute, sorry.

Okay, back the the New York Times' article which also mentions there's a DNA component that makes some of us better equipped to gain and hold on to the gain better then our fellow pepsi-drinking-sausage-eating-chocolate-cake-devouring-skinny tribal friends  Most of the people on both sides of my family are husky.  I tip the scales, maybe I got a double dose? Or maybe I screwed myself over with a nifty eating disorder in my teen years.  Who knows.  I blame my mother.  She luckily never tipped the scales above 200, although close and it was amazingly close the the end of the world for her.  She would go on diets of one eclair in the morning and coffee the rest of the day.  Because her body was thin, she figured she was healthy.  She said she had no hunger -- although I suspect (and I could be wrong....snicker) that it was the continual supply of oxy and cigarettes that helped with that.  The oxy-cigarette-eclaire-coffee diet is not one that I've tried, but it did keep the pounds off of my mom.  So we have a combination of the constant reminders of the possibility of getting fat (and I wasn't actually fat when I was being reminded of this on a daily basis), the awesome nutritional advice (saltines -2 and broth for my lunch) and that awesome DNA.  Thanks mom (FYI, lots of counseling and a stint in an eating disorder unit in my twenties has given me a lot of closure...she is who she is and I love her, she's my mom, crazy mom, but still my mom and she really thought she was doing a good thing, so not evil, just highly misguided).   That DNA however, also blessed me with some awesome hair, great skin and enough intelligence to be able to become a nurse -- so I can't complain too much (even if I'm good at it).

Anyhooo, the thing is, even with all that DNA stuff, getting here was because of too many Kcals and not enough exercise.  Getting it off is difficult, keeping it off will be a life long struggle of being hyper vigilant about what goes in and how much you exercise.  Tara Parker writes, "People who are anxious to lose weight, don't fully understand what the consequences are going to be".

This is so true.

It's like having babies, you can read all you want about it, ask questions, understand intellectually the sort of the commitment you are making BUT, until you get there, hold one in your hands and become responsible for another human being, you just don't know.

When I get there, I hope I don't screw up, I'm not sure there's enough oxy to get me through a major weight-loss.

Thursday, December 29, 2011

An Observation

Last year around this time I joined Slimgenics and over the course of four months lost about 35 pounds.  Even losing that little bit (well it is a little bit given how much I have to go and that's not really a number I want to reveal just yet to the blogosphere no matter how supportive they are) made me feel a bit better, more comfortable in my body, breathing and sleeping a bit better.

Then I gained it all back.

Pretty quickly, I might add.

It started out as a plateau that lasted about four months THEN whoosh....

One of the things, I think I should do before imparting with vast amounts of our savings and subjecting myself to surgery is to figure out why.

The things that changed:
Started back with my master's program
Got a new job

Those are kind of whoppers.
The job thing is actually less stressful and I have more time.  BUT, I don't move around as much.  When I was a dialysis nurse, I was on my feet all.the.time!  I'd be up assessing 12 patients, checking on 12 machines, then getting the meds for 12 patients, answering questions and if there wasn't a crisis like someone's blood pressure dropping I'd have like 30 minutes to sit and chart before the next wave of patients came in.

Now, I follow one little sick boy around the school.  Even when I'm in the school clinic (when the little boy is too sick to come to school) I don't move like I did in my last job.  Next year when I get my own clinic and I'm off this one-on-one detail, I'm so going to have to put something in place to make sure I am moving more! that's stressful.  And to make it more so, I've been doubling up on classes so that I can get finished sooner (Next April, knock on it NOW, this is important!).  I'm doing well in it.  But it is a lot of work.  Because it's towards the end, I'm also working on my thesis/project/presentation.  Technically, it's not really a thesis but I'm not sure what else to call it, 'exit project' maybe, 'thing that looms over my head every waking second of the day because I can't graduate without it and I'm second-guessing my subject thing'  is probably more accurate.  Anyhow, the classes are all online, so basically, I'm sitting on my ass, uh rear-end for hours, reading, commenting on posts, writing papers, and putting together PowerPoints.

I've also discovered something about myself.....something that kind of sucks too.

I was looking at my son doing his homework and he was sucking on his shirt.  When I was younger, I chewed on my pencils and pens, or my hair when it was long enough.  That was in school.

When school is at home you have lots of stuff available to you that taste and crunch so much better then pencils, hair, pens or shirts.  But they all have calories.  I've read that some people focus better when their mouth is chewing, or their legs are bouncing (you know those people who sat behind you in class and vibrated your chair with their bouncing legs).  Anyhow, some people need that extra something to help them focus.  These people, of whom I suspect I am one of, probably have some form of ADHD (the last part is my own unscientific observation).  Anyhow, I've noticed that I'll stare blankly at the computer screen, get up and get a bowl of cereal, some chips, or whatever, come back and stare at the screen and be able to focus because I was chewing.

When class starts back up next Tuesday, I'm going to get some gum.

What's my project about? Well how to teach school nurses how to teach children about health promotion, in the area of eating healthy and exercising.  Because wouldn't it be nice to not get to the point where I am now.

Friday, December 23, 2011

Pulmonary Function Testing

So a couple days ago (before our nifty 1 foot snow storm) I went to the hospital to get a test to see if my pulmonary function was adequate for surgery.  You get to blow in a machine to make sure you're breathing well enough.  I think I did okay, they didn't give me like an A or a B...although my over-achiever self wanted to leave with a 4.0 report card on my breathing technique but all I got out of the tech was that I made it above the line....but I wanted to know if I made it above the line better then every body else.  She just looked at me like I might have been a little bit crazy.

Anyhow, I'm assuming I have decent pulmonary function because I'm alive and all.
See how great my nursing expertise is in this whole weight loss/getting ready for surgery journey can be.

She then gave me a pulse ox machine to wear all night that night.  I get to turn it in today (should have been yesterday, but didn't want to drive through town in a foot of snow with crazy drivers, most likely from California or Texas who think they can drive in snow because they bought SUVs when they moved here and then get stuck, because snow is snow and it doesn't matter what you drive, so stop driving like maniacs).  I digress.  I wore this thing all night, but kept waking up, because this thing was stuck to my finger.  I'm not totally a princess of Princess and the Pea mentality.  I mean this was so much bigger then a pea and every time I shifted or changed position this thing would get all tangled up.  Completely annoying.  And since I was up anyway, I'd check the numbers.


All night long it would dip below 90% saturation.

Side note: In most states you want above 96% saturation of oxygen, in Colorado we get a pass and only need above 90% because of the altitude (we have to change our recipes to bake it here, but there are sacrifices to be made).  I was dipping into the 85-88 range.  I'd quickly take some deep breaths and go back to sleep, only to wake up and see a low number.


Which means, I most likely have sleep apnea.  Which sucks.
Of course, I'm not supposed to diagnose, but I betcha I'll be getting a call to do a sleep study.

I've done one of those before.  I didn't have sleep apnea that time.  So they just gave me some sleeping pills, which felt worse then being tired all the time.  The tech did have her own opinion why I was tired.  At the time I was a housewife.  She asked me if maybe I was bored.  Uh, nope.  I have an uncanny ability to be able to entertain myself.  I actually kinda miss being a housewife at times -- I'll clue you in to a little secret, there wasn't a lot of me time, but there was a lot more me time then there is when working and still doing all the things I did as a housewife.  I digress again.  Anyhow, I hated the sleep study - uncomfortable bed, hooked up to a bunch of wires (more then just the pulse ox, you have them hooked to your chest, legs and forehead), you're being watched (weird...try sleeping knowing someone is watching you, especially knowing they probably think you're a total freak because you took the bed apart looking for bed bugs before getting in) and there was no remote for the TV.  Really a hellish experience.

It is what it is.

At least I have this marked off the list.
Going to my general practitioner next week to get a check up.  I've been postponing it because last time I was there I had just lost a bunch of weight, all of which I've gained back.

It's a really big list, getting ready for this surgery.

Thursday, December 15, 2011

For the love of food and being loved

I recently gave a party.  I love giving parties.  I love planning the food, I like displaying the food, and I like making sure everyone has something they can eat (gluten free, high protein, low sugar, dairy free, vegetarian....I have a variety of friends)...I want people to feel at home...through food.

See a trend?

Paula Deen said at the end of one of her shows, 'if you make this they will love you" not it, but YOU. I'm all over that, well that and that she uses a stick of butter in everything.  There was a movie a few hundred years back, called "Like Water for Chocolate" it was a beautiful film, but the only scene I remember is where the protagonist (oooh, English major jargon coming out) was in a sorrowful mood and this beautiful meal she created made people cry, not just because she was an amazing artful cook, but because the tears she shed while making the food transferred itself though the food to the people eating it. I totally get that, food and emotion and home and love are all intertwined.  "Dearhubby jokes with me when I make something that people will love me when they eat it.  And I need to be loved.

Unfortunately, for some reason a creamy cheesy lasagna says "love" way more then grilled halibut.  Even the way the words roll off the tongue..."lasagna"....that sounds lovely, "halibut"...not so much.

In my quest of being healthy, I need to figure out how to say, "I love you" in a low-fat, high fiber, moderate protein kinda way.

Saturday, December 10, 2011

What is Metabolically efficient?

Most of you all know when you set out to lose weight, even after weight loss surgery (at least this is what I'm reading on a lot of your blogs out there) you plateau (which sucks).  I asked the Doc why that is.  I love the way he answered, because the weight loss "specialists" at WW, Slimgenics, Nutrisystems, Jenny Craig, my regular doc, the two different personal trainers, oh, wait, three different personal trainers I've tried out all said, 'you must be doing something wrong'.  Nothing like hearing those words, after struggling for a week or two, will make me want to go for a pizza with an oreo blizzard chaser.

The bariatric doc said that I was metabolically efficient.

I understood what he meant....cuz, I'm a nurse and all.

Dearhubby said, 'huh'?

It's like this, if you dropped me in a desert without food, I'd last weeks.  My body would shut down and preserve every ounce of energy (fat) and sparingly use it when absolutely needed.  Someone who is more inefficient, you know those guys in the grocery line ahead of you whose carts are loaded with sodas, ice cream, steaks, chips and jujubees, they need food all the time in order to sustain life. They burn it off quickly and DON'T STORE IT (hate them -- no not really we all have crap to deal with -- okay maybe a little hate them).  It would suck to be them during a famine, but since one of those isn't coming up any time soon, they get to eat like maniacs and still have the hip bones of a super model.  Where as I stand in line with my basket full of salmon, free range chicken and rice cakes.

Denver Bariatrics has a great team.  When you do plateau, they will help you through it, without judgement.  Even if your plateau was caused by a couple or few extra caramel mocha frappacinos.  He even said, that sometimes it's a matter of adding an extra high protein meal at 10 at night so that you don't go 12 hours without eating.....seriously, eating at 10 at night? Don't most diet gurus say NOT to eat after seven.  The thing is, people who are 'metabolically efficient' will put their body into starvation mode if they go 12 hours without eating. And when your body is in starvation's gonna shut down and preserve every little tiny calorie until you prove to your body that you live in the 21st century and you're choosing not to eat and it's not because the hunters of your little nomadic group couldn't bag a wooly mammoth.

So there you have it, I'm a freakin' genius at being metabolically efficient.

Friday, December 9, 2011

moving it over here

So I started a weight loss journey blog on WordPress. But I can't figure out how to use that site to save my life, so I'm coming back to trusted blogspot. Unfortunately, it means that I'm now linked to my Zimmerhouse and people who know me may see this, or not....because in reality, not many people really read my blog, so I think I may be safe.

Here are the two posts I put on WordPress that I'm copying and pasting over here:


I'm not new to blogging but am new to Word Press, it may take me awhile to figure this out -- like why there's a ship wheel as my header?).  My other blog is full of fluff, family stuff, decorating, know what kind of blog I'm talking about.  This blog is going to be about my struggle to lose weight and my decision to make the plunge and do the weight loss surgery.
A month ago I went to a seminar on weight loss surgery, given by Dr. Snyder of Denver Bariatrics.  The funny thing is that I knew two people on the panel of successful weight-loss participants.  One was a friend of my father's from years ago - I lost touch with her after my father died, the other, a friend from the neighborhood.  I didn't actually know this fiend had done the surgery. She most likely would have told me, if we were in a private spot, but I only see her when we're around a big group of people.  I even commented on her weight loss (and she's done fabulously well).  After the seminar, we talked, she has chosen to keep her decision to use this particular weight loss tool from people because, well, you never know how people will react.  It's this conversation that made me realize, that I too may not be ready to share with my tiny corner of the world about my decision.  Instead, I'm sharing with the faceless people out there who do not know me.
So this seminar was intriguing.  In my mind (sometimes warped mind) I saw surgery as a last ditch, failed everything else, easy out, back up plan.  Well, it won't be easy.  The way the surgeon explained it is that it is a tool, not a cure (damn it). Doing this procedure won't make life easier and the weight won't just melt off (damn it again).  But it'll help where I have failed before (whew).  It took me a bit after the seminar, but I made an appointment with the surgeon.  I met with him yesterday.  He thought I was a good candidate. I had a good support system.  Even though I'm horribly over weight, he's seen worse (and that's so not PC, but to be fair I'm the worse to other people's weight loss issue - it's all relative :D). I don't have any major health issues (yet), and he thinks I'm emotionally sound (dearhubby snickered at this one -- he went with me, and yes, he's my emotional support).
In our meeting the doc said that he understood that no one at work, none of my friends, my family and dearhubby cared that I was overweight but that it was me who has the tapes running through my head, every minute of the day, about what all this extra weight looks like, feels like,  and makes me feel less of a person. Which is a bit weird, how extra weight makes one feel less of a person.
Anyhow, that made me want to cry (but then, lots of things make me want to cry).  Because my family and friends do love me.  They don't care that  I look the way I do. I care. I hate that I don'd do things with my family because I can't, or won't fit, or feel uncomfortable.  I hate that when I'm on a plane I won't use the restroom because I don't want to walk down the little aisles bumping into people.  I don't like clothes shopping because 1. nothing cute is in my size and 2. for some reason when they make fat clothes they somehow think that fat people arms grow at the same rate as the rest of them and I can't find anything with regular arm length...or with regular neck-line sizes, seriously neck lines do NOT need to be THAT plunging - I am not a bawdy serving wench even if I have the ta-tas of one.
So, yes, I'm going to do it.
My insurance doesn't pay though
But, dearhubby is getting a new job so cross your fingers about the new insurance plan.
otherwise we're going the self pay route.
Now, I need to look through a bunch of paperwork, get signed off by a bunch of doctors, one of them a psychiatrist (hmmmm, dearhubby had fun with that one). The doc also wants me to start cutting down on my caffeine (seriously?) and start exercising, higher protein meals etc.
I can do it.
Even the caffeine part.

and 12/8/2011
I can't ask for help.  I can't even ask people to bring a side dish to a party. I want to do it myself. And truth be told, I enjoy baking and cooking and when people come over I want to give them the 'gift' of food and drink and not have them worrying about bringing a side dish. On the other hand, it's also a part of my make-up that permeates into other areas of my life. One of which makes it hard for me to ask people to help me, emotionally or physically.
I am getting my master's, right now I'm doubling up on classes and starting my thesis project. I work full-time. I have two very active boys to raise - basketball, karate, choir etc. I'm planning a party with like 40 people this coming weekend, yes, I'm doing all the cooking AND making 40 homemade ornaments (and really this isn't a complaint, I do enjoy it). This is just a little blurb to say, I keep myself really really busy.
I think, partially, I'm compensating for being overweight. If I can make other parts of my life perfect, maybe people won't notice?
or hopefully they'll still like me?
or I'll believe I'll be deserving of love and happiness?
I don't's just that being so big is really a stigma; my size screams laziness; gluttony; lack of self-will and I don't want to fall into that definition.
I am learning though, part of me wants to jump right in and do the surgery right now, but I know that with all that's going on in my life that would be a bad idea and I would set myself up for failure.
I get the summers off. I'll be done with my master's and so I'll do the surgery then.  I plan on having it next June so that I can take the time and get used to this new 'tool', take time to get into a new routine, and take time to find out who I am.....well around swimming practice, baseball games, karate tournaments and everything else the kiddos do during the summer. Oh, and who am I kidding, I'll probably try and take in a class or two, if available, to help me do better at my job, and maybe I'll finally take up quilting.
Okay, truth be told, not only am I compensating for being fat, I really enjoy learning new things, doing things for others, and keeping busy -- I guess this is partly who I am, I just need to learn a little more throw a party where I do it all, but just not at the same time I'm getting my master's.
Oops, too late for that :D