I've been very good at sticking to eating well, or at least controlled. I started this determined round of weight loss on January 20, four and a half weeks ago. I've been focusing on the details of Atkins, not just the general principles. I've been concentrating on eating vegetables at every meal, even breakfast. And it has had results. I've lost about six pounds, and I feel great.
But now I'm once again at the crucial point. I've hit my "rubber floor", the weight at which I lose momentum, turn arounc and gain weight again. This has happened to me four times before, in the time I've been doing this blog. Here's my post on this from 2013, when I hit this point.
Here is what is going on that makes it difficult to keep going:
The weight loss has slowed. The instant and heady success of the first few days and weeks are gone. This week I lost weight but less than before. (This is using my simple average of the week's daily readings.)
The work of cooking is starting to seem to hard to sustain. I have other ways I'd rather spend my time.
The food is starting to get a bit boring. When I make a big batch of something, I get bored before its done.
I want to eat with my girl more often, but she often she doesn't like what I like in the limited selection I have available.
I crave certain treats which aren't allowed.
So here's what I'm doing to counter these problems, which are always the same:
I'm upping the exercise. I'm working towards the first 5K of the season in March. I've kept up with two weight training sessions a week besides.
I'm really focused on getting sufficient vegetables at every meal. This is often harder than finding the protein.
I'm really focused on portion control. Previous runs at Atkins used the food lists of "allowed" foods, without paying attention to how much of each is reasonable. Nuts, for example, no more than a quarter cup a day. Dairy, only a couple of ounces.
I am ratcheting up the carbs a bit. Atkins recommends adding in a wider range of foods, and upping the carb level slightly, when you are close to goal, which I am. But I'm striving to keep it down. The other point they make is the wider range of foods cannot be at the expense of the main foundation vegetables that you have to eat every single day.
I've got a set of "go to" quick and easy foods. A roast chicken from Whole Foods, for example, with easy vegetable sides. I found some Atkins and other low carb frozen meals when I stopped by a fancy new supermarket in a different neighborhood.
I'm reading recipes and finding new things to cook. This also helps in trying to find things for my girl - adding sides she will like.
I've got a couple of treats I allow myself, that are naturally low carb. (I tried a "low carb" Atkins brand chocolate-coated bar and couldn't stand the taste of malitol.) The two so far are blueberries (fresh or frozen) with creme fraiche or mascarpone, or crunchy almond butter with celery. I think anything with actual chocolate in it is too dangerous right now.
I've been giving myself some non-food rewards. I've bought some clothes, about which I may post later.
I'm making very short term goals. Right now I want to sustain this through the next weekend. It's likely to be a social weekend, and I want to have fun! But I'm setting parameters on what that can include.
So I've played with my data all morning while writing this post. Time to get out there and move!
Haven't been able to keep the energy level up, and now I'm running out of the food I made for myself. Plus, I will be cooking and eating in company a lot more often, which means compromises. But compromises are what life is made of.
But I did get out to the gym this morning, and then for a cold weather run with the dog. It was up to 40 according to the kitchen thermometer when we left. I was head-to-toe in specialty clothing, which helps to motivate me.
We're in training for the 5K season which will start in March.
It was a very bad week this week, maybe the second worst of my life. But on this, my diet and exercise blog, that's not the story. The story here is I took care of myself.
As stress built over the past couple of weeks, I had started a new diet and was making progress. I also started a training plan for the 5K I intend to run in March. As things got tense, I hunkered down and cooked and cooked and walked / ran with my dog outside.
When all hell broke loose, there was no time. But there was a fridge full of good food to reheat quickly. A couple of days, I hardly passed through my own house to grab and eat the food, and besides had essentially no appetite. But every other day, I ate well and adequately without having to waste energy on it.
There were two days this week that are tied for the fewest number of steps I took during a day, since I've been tracking my steps with the current devices. When I got a break Friday morning, I contemplated going out for a terrific breakfast. Instead, I suited up in my cool new running clothes, wired myself with all the tech, and the dog and I took my training run only a day late. This is what I wanted to do with my time. This was the best way to dissipate my stress. It was like meditating, it was so refreshing.
What an enormous change in my mindset - and for that matter, to my body itself.
After only one trip to the emergency room in the last twenty years, 2014 was my year of emergencies for myself. I've had many trips during that time and recently to ERs with family and friends, but it's very different when it's you.
The killer tree and the telephone pole it brought with it.
First, in August, was the Attack of the Killer Tree, the 100-foot tall, 100-year-old oak that decided to come down on me. I ran, it missed me, but when I looked over my shoulder to see if I was clear, the dog kept going and over I went, backwards. (Good to know I can outrun a tree, too bad I was so clumsy.) I cracked the back of my head open on the curb and ended up in an ambulance. It turns out ambulances have protocols of where to take people, but some discretion on how they do it. Head injuries were supposed to go all the way across the county; I talked them into the hospital in my neighborhood, just a half mile away.
Good to arrive in an ER via ambulance. They look at you right away, no waiting for triage. On the other hand, once they figured out I wasn't going to die from it, I spent a total of FIVE hours there. Luckily, a helpful neighbor had taken my dog home for me, and scooped up my purse and got it to me before the ambulance left. My kindle lives in the purse. As it turns out, that was at least as useful as having my insurance card. I read a complete VI Warshawsky novel. If you aren't familiar with VI, she is the original hardboiled female detective, by Sara Paretsky. It is not uncommon for VI, after having been beaten up or even shot, to get up and walk out of a hospital with doctors telling her not to. At once point, I considered doing likewise, but talked myself out of it.
Another helpful neighbor called my brother-in-law to tell him I was being taken off in an ambulance. I had texted him, something like "I'm off to get my head bandaged because I fell." But after the call, he came creeping into the ER, scared to death. This ER is fraught with pain for us. My sister died a few feet from where I was lying. He was reassured to talk to me, though the back of my head looked like I failed to outrun the zombies and they had some of my brains. He assigned my nephew to await my call to come get me when I was released.
Four metal staples, a week's worth of bad headaches, two weeks of no running or jumping, an inability to sleep on my back for several weeks, and eight weeks before I could get my hair colored, was the only aftermath.
I had to go back to the ER to get the staples out, because it takes a special tool. (Of course, the family kindly offered to go to Office Depot and take care of it, but I decided to stick with the professionals.) I estimated 7 am was the deal - after 6 am shift change, but before most walk-ins would get there. BINGO! One hour in -and-out, exactly.
The next adventure was much less exciting. I sliced a nice clean oval off my thumb the very first time I used a mandoline. (Thanks to my wood-working friend Jeff for the tip on the stainless steel mesh glove, which has enabled me to use the mandoline again, even though I twitch at the thought. Even more thanks to my girl for my new vegetti - like a pencil sharpener for vegetables. Still, I'll wear the glove when using it.) It's really hard to work your way into a first aid kit and sort through packages of bandages while blood is flowing freely from your thumb on your dominant hand. Pretty much, my bathroom looked like a slasher movie by the time I was done. The next morning, I asked the nurse at work to help re-bandage it. She took one look, and ordered me off to the ER. (I have since decided this was unnecessary - this is actually what "urgent care" is for. I had thought of them as the flu clinic, but they do bandages.) This time, I went to the downtown hospital at prime time. Still, they had two tracks, one for the easy things like my thumb. They talked to me and took my temperature, checked when last I'd been in West Africa, and had me back being looked at in about twenty minutes. Two times, they unwrapped it and pulled off the bandage, which started it bleeding and hurt like billy blue blazes. Gave me a chance to practice my cowboy cursing, and to realize you have to ask for painkillers. Two hours later, and I had a high-tech bandage that could stay on for 10 days without pulling the scab off again. I had to wear a waterproof finger cap over it during my sailing excursion, and I've got a nice scar now, but otherwise uneventful.
This last trip is the reason I actually started to write this. Two weeks before Christmas, on a Tuesday, I woke up with chest pain. I got up and started doing my morning stuff. The pain got worse. It was like a pressure, and to the extent I could localize it, it seemed to be coming from between my shoulder blades.
I was terrified and skeptical, all at once. I have a tragic family history of heart problems. My sister dropped dead at 46, waking up one morning with chest pain and declared dead two hours later. My older brother had a bypass operation while in his fifties. My grandfather died of a heart attack at age 52.
I had felt something like this pain before, intermittently and for brief (< 5 minutes) periods. I have had intense heart screening because of this family history, with no indication there is anything wrong. But I've read a fair amount about how women's heart trouble presents differently than men's. There was a recent article in the New York Times from a woman who wrote a book about her husband's heart attack and recovery, but who had a hard time believing she was having one herself a couple of years later.
I kept on getting ready for work. I drank some coffee. In the bathroom, I found myself with my eyes closed, leaning against the wall, feeling the pain and trying to push it away. I remembered how good I felt in the gym last night, as I worked my upper body with very heavy weights. "That's it!" I thought "That's what is causing this!", and then I closed my eyes again from the pain. A deep breath, which hurt to do, I straightened up, and went to the computer. I googled "chest pain in women" and came to a website with short anecdotes from women who dismissed their chest pain. "SECONDS COUNT!" was the theme between them. "I had a powerful pain between my shoulder blades and it hurt to take a deep breath" read the third narrative I read.
That did the trick. I would have told anyone else to go to the hospital. I might have been dialing 911 for them. I knew I needed to go get this checked out. Still mostly convinced it was the gym, I thought of my family, and how my fragile girl shouldn't have to go through this again. I might be embarrassed, but the embarrassment would be worth it. I got dressed-I'm not sure exactly what I was thinking, but I put on work clothes, though especially comfortable ones, except for the ankle boots. It was 44 degrees out, pouring rain, and 6:30 in the morning. I put on my foul weather jacket, grabbed my purse (the one with the kindle) and my car keys, rested my head against the door and tried to make the pain stop, and then headed towards the hospital.
Note to readers: DON'T DO THIS! Never drive yourself to the emergency room if you suspect you are experiencing something that could incapacitate you along the way. It is as bad as driving drunk. You may be endangering other people which you don't have the right to do. Always always call 911 for yourself or your spouse. The folks on the ambulance will start treating you when they arrive, saving some of those precious seconds that count. This is true even if you live a quarter mile away from the regional cardiac care center's emergency room, with just two right turns and one traffic light to get there, and you are already somewhat embarrassed about making a fuss about probably (but only probably) nothing.
I parked at the hospital visitor parking, and stood under the overhang just out of the rain and outside the door literally turning in circles, "It's nothing", I thought. "I don't want to be here and I don't want this to be happening", I thought more honestly. This place is fraught with tension for me. My sister died right here. What is going to happen when I walk through that door? One thing I know for certain, a chain of events is going to start that I won't be able to control.
I walked into the ER, and sat down at the intake window. "Why are you here?" asked the lady I recognized from my staple-pulling visit. "Chest pains", I said, wishing I was anywhere else. She scooched her chair back, called "chest pain" to someone over the cube divider, scooched back, and asked for id and insurance cards. I had them out, and requested she double check the address because of a mixup in the billing statements. She asked who my primary care doctor was. "Well, my cardiologist is Dr. B" I said. "Dr. B!" She said with reverence. She scotched back and said over the partition, "Dr. B's patient!" A nurse came out and asked me to come back. He took me into a little room and put those little electrodes all over my chest and did a quick EKG. He said the doctor would look at it but but it looked fine to him.
I don't know what I expected to happen but this was really low key. My mental images had been of the noise, confusion, and many many people surrounding my sister, overlaid with several seasons of ER on TV. This was almost bucolic, and certainly anti-climactic since I had worked myself into such a tizzy. I had on a hospital gown on top by now, but I walked behind my nurse to a work station, carrying all my stuff, thinking now I'll just get dressed and head on to work.
Not so fast. I described my symptoms in more detail, first to the nurse and then to the doctor, how I'd been having intermittent pain for some days and then big pain this morning, continually adding that I'd worked out with heavy weight the night before and it certainly could be muscle pain. "But then why have you felt it before?" I said I was fine and I wanted to leave to the doctor, and she said fiercely, "There is no place else you should be right now!" I stayed. I sent an email to work, "No Nan today" with no other explanation.
The rest is even more of an anticlimax. I was there for some hours, during which time I was hooked to cardiac and blood pressure monitors, had two lines for blood draws/drug pushes put in my arms, given aspirin, nitroglycerin, a proton-pump inhibitor (for acid reflux, because the odds were growing it was not cardiac related), and an MRI. I resisted other stronger drugs that were recommended, and when the doctor talked about admitting me to stay overnight I really grew alarmed. At that point, my pain was less but not gone. It's really hard to listen so closely to your own body and distinguish sensation from suggestion after a while. I took my own notes on my iPad about what was happening when, and what my symptoms were. I regretted the ankle boots, which I was still wearing, along with my comfortable work trousers. My own cardiologist, the important Dr. B, (who had done all those tests on me before) practices at that hospital, so the ER doctor talked to him on the phone. "Dr. B will be coming to see you himself" she told me with some awe. When he came, he looked through all the charts again and sort of apologetically told me he really needed to use his own stethoscope with his own ears to listen to my chest. The doctors agreed to let me go if I took the PPI and went for a follow up at his office for a stress test.
So yeah, I'm fine. I did an echocardiogram a week later, running on a treadmill at maximum effort then having an ultrasound of my heart while it was going fast from the exercise. The crew had to repeat the test because we didn't move fast enough. It turns out I'm in such good aerobic condition my heart rate dropped too fast for them to catch good video of it pumping hard. When I reviewed the overall situation with the glorious Dr. B, he said every marker said I was very healthy, and he was impressed at how long and fast I was on the treadmill. "Well, yeah, I ran some 5Ks this summer", I said, then very grandly, channeling our friend Chris, "it is my intention to go vigorously into old age". Quickly then, hearing the hubris echo in the room, sheepishly, "I'm going to be 60 this year. I have to think about these things." "I'm right there with you" he said with a grin. He basically told me it appeared I won the genetic lottery, mitosis had favored me, and there was no reason to believe I had any cardiac problems, I should take the medicine for the acid reflux and follow up with my own doctor.
But I think I did the right thing. Here is something to think about during this red month of February -"just a little heart attack".
So that's my ER stories from last year. It's all over but the billing and insurance paperwork, which may last for some time to come.
