sallyj

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Learned something new about the impact of bariatric surgery--low heart rate!  Had a colonoscopy (the joys of getting older) and had a resting heart rate of only 40 (normal range is 60 to 100).  I've known I have low blood pressure for some time and have had issues with coming out of anesthesia slowly.  But as I do, I had to go to the internet before I reached out to my doctor to see if this was a problem.  Turns out, lower heart rate is a known consequence of bariatric surgery.  Turns out that the heart strengthens to handle the excess weight, so when the weight is gone, the heart doesn't have to work so hard.  So unless there are symptoms such as lightheadedness, etc., all is fine. Good to know.

Happy New Year!

It has been, overall, a good year.  Two trips to Italy--spring and winter--, some extra money from consulting, some fun learning--sewing--, and most of the regained weight off.  But it has also had some challenges; changes in relationships, health/aging issues, lack of productivity.  And, of course, the American and world crises. 

But for the first time in a long time, I don't have a specific weight-focused New Year's resolution.  While I still have about 10 more pounds I'd like to lose so my pants fit, I'm at a point where the goal is more maintenance.  I do need to stay on top of things in order to not regain, but I am comfortable in general with how I feel and look.  And I will be honest, a lot of my motivation comes from how I look in clothes.  I do like nice clothes, and they simply don’t look the same on a larger scale.  I struggle in my thinking about that—I don’t think everyone should be thin, and I definitely believe large-sized people have a right to exist in the body they have (and that our culture in general does not support that), but I also know me.  I have more physical pain when I am larger, I don’t like the way I look, and I don’t feel as healthy mentally.  How much of this is due to cultural pressures, the way I was raised, etc., I don’t really know.  Would it be great if there weren’t cultural pressures to be thin, if the world built things for the real size of people rather than the “should be” size?  Yes.  Imagine airline seats for peoples’ real hip size!  And restaurant through which one could get walk without bumping into everyone else’s chair.  I learn so much listening to Aubry Gorden on the Maintenance Phase podcast about fat discrimination—and I want to be sensitive to that in my own thinking—but I also don’t want to be fat myself.  Another podcast I listen to, Pod Save America, has a year end review of their resolutions and new ones.  This year one of the guys, who has occasionally spoken about his weight issues, has been using one of the new weight-lose drugs.  He mentioned that this is the first year in which he also doesn’t have a weight related resolution and how good that feels.  Just to be in the world without that burden of self-consciousness.  He was never really large but also not “trim.”  It really resonated with me.  It is easy to forget, we are not unique in our processes!

So with the weight-focused resolutions off the table, what then?  I want to work on building community.  One of the reasons I am wanting to move to Italy is that I find it a more community-focused culture.  There is an openness to getting to know people, even on a casual level, but also on a we all help each other level.  I am not looking for a lot of “deep” friendships at my age, but a comfortable community in which I know people and am known.  I am trying to do that with the church I have started attending, but we are all on the senior side, shall we say.  But I am taking advantage of the opportunity to just hang out a bit with people and enjoy the hanging out itself.  Less focus on the quality of conversation and thought.  I could be quite critical when younger about how banal everyone seemed!

I also want to develop some resolutions about how I spend my time.  I waste a lot of time in the evenings.  So I am creating a vague plan for different nights of the week to be dedicated to things I want to do.  So one night will be for reading, one for sewing, one for jewelry-making, etc.  But not all nights will be “defined” and weekends will be free.  So some structure but not rigid. 

Well, enough for now.  Here's to a great new year for everyone.

Back from second trip to Italy.  Winter is a great time to go--even the "crowds" were small in Florence.  And the lights were just magical.  While I did travel to Ukraine while near my heaviest, I cannot imagine this trip at that size.  The walking would have been killer and all the stairs!  I can't even begin to think about it.  I would have missed so much just due to the pain.  I know there is a balance (and for each person it is different) between being accepting of one's physical shape and reality (I will never be 'thin') and the way our world works and the bodies it is built to accomodate.  The Tuscan area I have been in is very hilly and built for the generally overworked and under-nourished of medieval Italians.  I don't even like driving up some of the steep roads.  So know I reference the "Tuscan" diet--just walk up everything you eat.  I did eat more sweets than normal and less protein.  With my tasting issues, I wasn't really able to enjoy much else. 

I did lose a couple of pounds anyway over the two weeks, so I am about 8 pounds from my lowest post-surgery weight.  I'm at a good place about my weight, and am coming to acceptance about my shape--very heavy legs, droopy elbows, etc.--and am appreciating what I am able to do and figuring out ways to engage even when there are things I can't do.  Now I have to add in age!  I will be happy to play that card and take advantage of it where I can.  I've made it years past what I expected when I was young, so yeah me.

At 18 years post-surgery, I can only affirm that this has been the best thing I ever did for myself.  I wish there was less stigma around it and more insurance support for it.  It isn't a magic fix-all, but it is a medical treatment for a medical condition that also has behavioral contributors as well.  Like diabetes or high cholesterol. 

I need to give some thought to what my health focus will be for the coming year.  This year was to get my weight back down, so maybe 2024 will be more about getting strong.  I keep reading about the need for strength building as we age. 

I am now 18 years out from my RNY and am at my surgery goal weight.  Not quite at my goal weight--which is more about clothes size than weight, because I have clothes I want to fit more comfortably.  But I am comfortably hanging around this weight.  I did regain weight and have to lose it again, but I was able to in a way I never could prior to surgery.  The management of obesity as a disease continues

I have been dealing with "burning tongue syndrome" for a couple of months now and a gradual loss of taste.  Oddly enough, that makes me want to eat more, not less.  I keep trying to find something that will make me feel satisfied.  For a while I could taste strong salty or strong sweet, but now even that is mostly gone.  Fruit was one of the first things to go off--it literally tasted as if it were moldy.  Well, that and wine, which tasted hot and peppery.  I've gotten a referral to a rheumatologist to test for Sjogren's syndrome (as I have several of the symptoms but just chalked them up to old age!).  Just something to be managed not cured--like so many things.  I am taking additional vitamins in part for the tongue, but also because I know I'm not getting enough nutrients in what I'm eating.  So in addition to the standard calcium, B12, and vitamin D, I've added omega 3 (dry eyes), magnesium, iron, and zinc.  I am now one of those old people with the daily pill dispenser! 

I need to stop eating my wonderful popcorn as well due to Sjogrens as the dry mouth creates gum issues and popcorn kernels exacerbate that.  I did get a water pik on the recommendation of the periodontist, and that seems to help.

I’m hoping I will get my taste back soon—and have noticed my sense of smell is diminishing as well—and I’m having friends over for Thanksgiving!  It would be nice to be able to season things appropriately!  At the start of my weight loss journey, I knew I needed to address my psychological as well as physical relationship to food, and I guess this is the most extreme aspect of that.  When all pleasure from food is gone, what is its role?  The communal and relational aspects of food remain, even if I can’t taste anything.  If I’m only cooking for nutritional reasons for myself (well, maybe also texture), what opportunities does that open up?  Will I be able to handle Brussel sprouts? (which I actually can’t stand).Get my green veggies in for a change?  Maybe I can try some protein drinks again—those used to taste awful to me. 

Anyway, the saga continues.

It has been a while since I've blogged.  Things have been tough--they always seem to be tougher the closer one is to goal

I've been struggling with stress/anxiety eating even though I know what it is.  I just don't have a lot of other tools in my toolbag to address the stress.  I'm not a meditation person, so that doesn't work.  And I sure don't need to be spending money, so shopping doesn't need to be my go to.  I'm trying to use sewing, but that doesn't work when I'm at work.  So still trying to figure it out.  Sometimes, I just tryi to pay attention to what it is my body seems to be craving--salty vs. sweet vs. fatty, etc.--and find a relatively healthy or limited way to meet that need if only with a few bites.  Popcorn seems to be one good solution as it is chewy, salty, and with a bit of fat.

My doctor suggested I might have Sjogren's Syndrome, an auto-immune issue that could account for several of my symptoms, including my new burning tongue issue.  I hope to follow up with some actual testing to get a confirmed diagnosis but with the current state of affairs in Spokane health care, it may be awhile!  But as there really isn't any treatment or cure other than managing each of the symptoms, it isn't pressing. 

The worst thing that happened last month was the death of my dog.  My wonderful Vasi was hit by a speeding car and killed. It has been really difficult and I miss him each day. 

I am at a point where, while it isn't at my goal weight, it is at least an acceptable weight.  I still have some clothes that I want to wear which require me to get down about 15 more pounds.  So I will keep at it.  It would be great to be at goal for my 18 year anniversary date.

Have been struggling for the last few weeks with my eating behavior.  It is odd after doing so well for so long--including while in Italy--that now is the time my behavior reverts.  It just confirms that obesity is a life-long disease for me and not a "lose the weight and all will be good" point in time. 

I listen to a vlog by Jackson Galaxy (about cats) so wound up also seeing an interview with him and Myiam Bialik.  Both of them have had disordered eating and addiction issues.  For some reason much of what they said resonated with me about the childhood eating patterns being triggered by anxiety.   And to be truthful, I really hadn't heard people speak openly about some of the disordered eating behaviors I also had.  I have never really "owned" that I had an eating disorder as I think of that as more severe and clinical (for lack of a better word) than my behavior.  I am more comfortable with "disordered eating."

But back to anxiety and eating behaviors.  I'm not sure why I perceive "anxiety" as something different than "stress."  Maybe stress is more external?  Stress from turmoil at work--because of how someone else behaves or a project due date.  Where as anxiety seems more internal--a personal physical response that may be more generalized?  And there is a bit of a more negative association with anxiety as people are labled as being an "anxious person" or having an anxiety disorder.  Does anyone have a "stress disorder"?

Now I think about the generalized anxiety in today's culture due to Covid, the political fiasco called Congress, climate change, etc. and how just reading the news can generate a low level anxiousness.  So while I've never considered myself a particularly anxious person, I am seeing how some of my behaviors in the last couple of years really can be an expression of anxiety.

So what have I been anxious about the last few weeks that might be triggering my disordered eating?  There are some financial committments that, while I have budgeted for them and aren't a problem, they are more of a committment than usual.  So that is new.

Also, I have been successful in losing most of my excess weight regain, just about 20 pounds left to go, so even the pressure of success and "will I reach goal" can be a self-imposed source of stress. 

And I've been dealing with low-grade chronic pain in my left leg due to a sacral joint issue that physical therapy is helping but not resolving.

So, okay, I've got some anxiety.  How can I manage it with something other than disordered eating (which just adds to the anxiety)? 

I need to start a knitting project that is small and transportable--socks? a camisole?--that I can use to focus my thoughts, use my hands, etc.

I have signed up for a sewing class online that will give me a new project to focus on--creative, can't eat while doing, etc.

I can work on my garden when the weather is good and decluttering when I need to stay in the house.

I can review my budget to continually reaffirm that things are okay.

And I can set a different eating goal not about weight but about behavior--excluding all highly processed foods.  More than half-way there normally so not a big change.

Got back from two weeks in Italy last night.  Weighed this morning and had only slightly less than two pounds gain.  I'm pleased, considering the sweets and pasta consummed, but had hoped the walking had addressed that.  Which I'm sure it did or I would have gained more!  It was odd not having food be a central part of the trip, considering it was Italy, after all.  Had more bread, wine, pasta, and sweets in two weeks than I've had in a year.  But delicious.  And I treated myself to a couple of fine dining chef tasting menus--which were wonderful.  And actually too much food!  While each portion is small (just a perfect amount to explore the taste/texture), they add up.  By the time the desserts hit, I was stuffed to the point of discomfort.  The sommeliers were really helpful with selecting one wine to go with the whole meal instead of different wines for each course as I can't drink that much wine.  At 4 oz. I'm good.  Beyond that, well, I don't like how it makes me feel.  But now there are some flavor combinations and techniques I want to explore for my own cooking.  Who would have thought to sous vide beets!  Or use a sweet bread with raisins and walnuts with chicken liver pate? 

I did notice that at restaurants, there weren't many vegetables--focus was more bread and pasta with a bit of protein.  And I'm trying to work in more veggies myself.  Not a big veggie person, so was surprised that I noticed the lack of them.  I wanted to try artichokes, this being the season, but didn't see them on any menu.

But the trip was wonderful--planning another maybe in December--but made me so grateful, again, for the weight loss surgery.  And my recent re-lose.  I don't think I could have done it at my highest weight--definitely not all the walking and stair.  And even the plane discomfort--I don't know I could have managed that for the long flight (10 hours) and the two smaller plane flights.  As it was, my hip was giving me grief, so I used the passenger assistance at the larger airports.  I definitely could not have walked fast enough to make my connections.  Will keep that in mind for now on. 

While I would never want to shame anyone for any body size and think our cultures need to be more inclusive, I also know from personal experience the difficultly of navigating normal everyday activities when larger, much less travel.  The wight loss really has provided me with more opportunities for adventure:)

Things are coming along slow but steady, which is what I know is the process.  Spring is upon us calendar-wise but not weather wise, and I often find it more difficult to eat well when it gets warm.  I'm hoping that won't be the case this year with the emphasis on seafood (lots of easy cooking shrimp).  I still struggle with the veggies--just don't like them much--and tend to go overboard with the salad dressing if I go that route.  I don't like the wastefulness of the single serve salads in the plastic bowls, but they do give me some veggies with limited dressing.  They always include a cheese--which I don't like--so I can toss in some more little shrimp to up the protein. 

I would like to find a place in town where I can do an indirect calorietry test to get a more accurate resting metabolic rate.  I think some of the sports medicine/nutrition places do them.  I would really like a better handle on my caloric needs as I move into the maintance phase come fall. 

The news about erthritol was bothersome--its links to heart attack and stroke.  I have been using it multiple times a day in my tea (to get my hydration) and have an issue with blood clots.  I don't like the other artificial sweeteners, so this was a great option.  I will try to wean off of it over summer

I'll be heading to Italy in ten days, so that will be an adventure on many levels.  The friend who was going to travel with me probably won't be able to, so it will be a solo adventure as well!  My habit is to see travel as a stress eating time, so I am going to do my best to not go there.  Not taking snacks for the airport (I'm flying business so there will be snacks and meals on the long flight), and plan to stick to my two meals a day approach.  But I know I will be doing substantially more walking, so that should help burn off the pasta!  My goal is to just eat like a normal day with just a few exceptions.  So limit the sweets and carbs (can you say gelato and pasta!).  I don't want to eat out every meal--I'm staying in AirB&Bs so I'll have access to kitchens--but I don't have a sense that they do doggy bags like in America.  Probably because they don't serve excessive portions to begin with!  The main goal is to see what it might be like to live there, so grocery shopping and cooking at home are a part of that. 

I'm getting close enough to my goal that I don't want to buy/make more clothes but also don't quite fit into much of what I have.  What a wonderful problem to have.

Progress is slow but steady; now just 32 lbs. to reach original loss weight.  I wish I could find some solid research on the impact of RNY on base metabolism.  I know I don't need as many calories as the easy-peasy formula calculates--which I don't think acknowledges the non-thyroid medical aspects of obesity.  I lost a lot of muscle back in 2006-07 as well.  What I have experienced over the years is that the RNY impacted not just the size of my stomach but a host of hormones and other bits.  So as I age, what are my "real" caloric needs?  I tried to find some research studies but haven't had any luck.  They seems to focus just on the nutrition (can we say supplement companies?), not the calories. 

Anyway, another big change I am making is changing what I'm making:)  A large part of my relationship to food was the creative aspect of cooking.  If there was an unusual ingredients, odds were I had it.  I have a ton of cookbooks and, I admit, am a bit of an ingredient snob.  It was a way of expressing myself and my values.  But I have decided that needs to be scaled back--way back--so my scales can get back as well.  So I am focusing my creativity into sewing.  Being me, that doesn't mean "hacks" and lots of projects but couture techniques and maybe four projects a year.  I'm working on my first project--a coat--and have really gotten into the details and learning (taking an online course).  Not only does it give me the skills and creativity focus, but it keeps me busy and out of the kitchen--reduces the grazing!  My intention is to be at goal size by August when I will be taking a live pant fitting class.  My legs have "issues"--to put it kindly.  Lots of excess skin and fat lumps and an undiagnosed (not without trying via multiple doctors) issue—cellulitis? edema? –that makes my legs rather ugly.   Cankles extraordinaire!  So I can never find pants that fit, so that will be my fall project. 

A lot of irons in the fire at work and personal, but am keeping on track with managing my eating.  Weight loss has slowed a bit--as I expected it would, but I'm at a point where it doesn't mess with my head in the same way.  I feel very fortunate to have the hormonal changes as well as the stomach size reduction that comes with the RNY.  I don't have the hunger and lack of saity that undermines the efforts of so many.  I do still get the stress eats, but by tracking things, I can keep that reasonable and within my plan.  It's not like I'm never going to stress eat again--not in this world anyway!

There's been a lot in the news lately about obesity--with the new drug and medical guidelines--that I think is good for the conversation.  There was even one opinion piece in the post by a doctor about the anti-fat bias and general lack of knowledge on the part of so many doctors.  Losing weight does not cure heart disease, cancer, MS, lupus, etc. yet many people who struggle with weight get poor treatment becasue of their weight, not their health.  The default and simplistic statement that everyone overweight needs to lose weight to be healthy is not actually true and deflects real thoughtfulness.  I thought it was interesting when the doctor wrote about learning to replace the phrase "obese person" with "person with obesity" like we do with most other medical conditions. 

But I do worry about all the quackery and extremest thinking that comes with all the highlighting of these issues.  I love the podcast "Maintance Phase" and their highlighting of how much of our "wellness" language and actions really emphasis the rejection of a large person's body and right to exist is space. 

How much of my desire to lose weight has to do with my own ingrained bias (I don't find my fat body attractive), health (I really do hurt less when at a lower weight), or just vanity (I'll definitely own this one as I like nice clothes and they simply aren't available in larger sizes).  And I remember the first time I had to sit in the middle seat on an airplane once I lost weight and how great that felt.  For once, fellow passengers didn't have that look of dread in their eyes when I said that was my seat!

Such a complex issue!  And so little information that isn't filtered through some marketing language with a very different agenda.