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Tuesday, September 30, 2014

Trip to the Pain Management Doctor


I went to the pain management doctor today.  I was a little worried that they would try to take me off of pain meds.  When he looked at all my records, he was marveling that I was functioning as well as I am.  He said I have a multitude of problems in my lower back, each of which would cause me substantial pain.  He asked me if the pain meds helped and I said they did.  He asked if they worked well enough and I said not all the time.  They actually just make things bearable.  He wanted to put me on oxycodone (and did).  He said it would handle my pain much more effectively (including the headaches) and that it is not as hard on the body (because it has no acetaminophen, which is hard on the liver).  He had asked me what my goals were and I said to get my pain under good enough control so I can get enough exercise to help with weight loss.  I would like so much to be able to walk on the treadmill with a significant incline, like I used to, which gave me a good calorie burn.  I cannot do that yet because of the Achilles tendon problem, but hopefully in the not-too-distant future!

 

We talked about the fact that a fusion is what they would ultimately do for my back, but I told him I did not want a fusion.  I hoped weight loss would bring my pain to a level where I never had to have a fusion.  He agreed with that.  He said I didn’t want a fusion even if I was as skinny as a bean-pole.  He kept saying I was just too young, but I had to remind him that I was not as young as I look (which he agreed – he was surprised I was older than he was).  Now if I could just feel as young as I look….  Maybe I will get to feeling good enough to where I feel more like getting going again.  It is very hard to be motivated when I am dealing with this much pain all the time, particularly the headaches.  I have been doing a little better the last couple of days, anyway.

Monday, September 29, 2014

Enough is Enough


Enough is enough.  I have to pull myself together.  (I wrote that before seeing what I titled my last post.)

 

The headaches had gotten bad the last few weeks.  I mean, “I don’t think I can take this anymore” bad.  I have been doing a lot of things to work on them.  Interestingly, one thing I have found that helps is chewing gum.  I noticed it would stop hurting when I ate, but would start right back up again shortly afterwards, so I thought it might be something mechanical making the difference.  So I got the idea of chewing gum.  And it really does help.  I still have to do the other things – muscle relaxant, work on my posture at the computer, stretching, etc., but chewing gum helps ease up the really bad ones.  Another thing I noticed is that I have really been clinching my teeth at night.  I’m trying to be aware of that and I think it has improved a little, but it’s hard to be totally aware of it when you are asleep.  I had a night-guard, but I don’t know where I put it.  If I can’t find it, I may need to buy another one.  I can tell when I first wake up whether I have been doing it.  This morning, I felt much better.

 

I have noticed a difference with the second anti-depressant.  I have noticed an improvement in my motivation in other ways; now I just need it to affect my eating.

 

I’m spending quite a bit of time alone, which I know is not helping.  My knee is REALLY bothering me the last week or so, and I know the added weight is affecting it.  Some mornings when I first stand up, I really notice the extra weight and feel like I can’t hold up under it much longer.  I must get it going back the other direction.

 

Enough is enough.

Monday, September 8, 2014

Pulling It Back Together

I struggled a little this weekend.  The main reason was, I was not paying enough attention to my dosing schedule on my pain meds and before I would know it, I slipped into withdrawal.  That makes me want to eat everything in sight.  And it takes a while after I take the next dose for those feelings to go away.  I don’t know what to attribute the lack of attention to needing the pain meds to – in the week, it is that I get so busy, and I might be closed up in an office with my boss and don’t think about it being time.  Invariably, though, if I do that, my pain will get “out of hand” for a while until I get it to settle back down.  I need to take one with me if I’m going to be shut in with the boss, so I can take it discreetly when it is time.  On the weekend, I am out of my routine and sometimes forget to take it on time.  I am so used to coping with pain (and I have pain even while taking pain meds) that it doesn’t hit me right off that the dose has worn off.
 
I am being sluggish about getting going today – trying to talk myself out of it – but I know I have to get right back on track.  So, today is a low carb day.  Ironically, one of the hardest things about this for me is eating 5 meals, 3 hours apart.  Especially on a low carb day.  I’m so very busy at work, it is hard to take the time out to eat those “in between” meals.  On low carb days, they seem to require a little more preparation and that’s why it is more difficult.  On a high carb day, I can grab a container of Light & Fit Greek yogurt and a piece of fruit, if need be.  On low carb day, I can’t do that, unless I want plain yogurt without any sweetening.  I just need to prepare ahead of time.  I did got ahead and get one done this morning and it was a couple of stalks of celery with natural peanut butter.  A little later than it should have been, so I didn’t eat as much.  I don’t want to put lunch off for too late.
 
More later.
 
Lunch was a salad with some fajita chicken (I marinated and cooked it last night), fajita veggies, a little cheese and some chipotle vinaigrette.  Very tasty, although I haven’t gotten the taste I’m looking for on the marinade yet.  I took a short lunch, since I’m covered up at work.  Celery and peanut butter again for afternoon meal (need to do more planning next time).
 
My daughter, who has been living with me again since December, is taking a second job, so she will not be home much.  Plus she has made some new friends (which I am very happy about), so I’m kind of feeling like I live alone again.  It’s okay – I don’t mind being by myself – but it could get a little old if I don’t start getting out more.  Not sure how soon that’s going to happen with physical issues and working so much.
 
I have a friend at work who is historically a very large woman (larger than I’ve ever been).  I say historically because she has lost a lot of weight both through gastric bypass, and later from the complications from gastric bypass (but still is obese).  But at all times since I have known her, she comes across as very comfortable in her own skin and doesn’t care what people think of her (and most of the time, I don't think she is putting on a happy face when she doesn't really feel that way).  And people love her!  I know, because we talk, that she does have some self-criticism, but she is very open about it with almost everyone and she doesn’t act like it.  She loves everyone and seems to expect everyone to love her (not really, but she doesn’t come across as someone who feels like she already has two strikes against her, like I have often felt).  I am timid at times, not knowing what people think of me (although I usually find out that they think very positively of me).  I would just like to be a little more like her, in some ways.  I will never be as outgoing and in-your-face as she is, but that doesn’t mean I have to feel like I have some kind of handicap in a relationship, just because I am not slim.  I don’t treat other people that way, so why should I expect them to treat me that way?  Some may, but that’s their problem.  Most of my problems are my own making.  Now to overcome that….
 
I struggled a little more this afternoon.  Partook a little from someone's candy bowl.  When I got home, I wanted to continue that trend.  But at least the fight is somewhat back, because I knew I needed to act like those little pieces of candy didn't happen and keep on going, so dinner was a salad with some Asian flank steak and chipotle vinaigrette.  First time I've made a flank steak -- I did good.  It was tender and flavorful.  Yum!  The recipe was actually for lettuce wraps, but I figured it was the same to put it over cut-up lettuce and that seemed easier.  I'm glad I had food prepped ahead of time, or I might not have been as successful.  I can feel good about pulling it back together.

Saturday, September 6, 2014

Just a Quick Post - Weigh-In Day

Just a quick post.  Even though I got started on Tuesday, Saturdays are to be weigh-in days.  I lost 9 pounds!  Actually I can't remember the exact tenth of a pound I started at (it is recorded in a document at work), but if it wasn't 9 pounds it was a hair under or over.  That was in 4 days.  I think my body was ready to let go of some stuff.

Today is my off day.  I haven't done much with that except a snacked on some Kashi GoLean.  I need to plan a good meal to enjoy.  No money for eating out, so whatever I do, I will make it.

Some cooking I have planned is I have some flank steak and found a recipe for flank steak lettuce wraps.  Need to make some chicken too, so think I will make some chicken lettuce wraps too.  That will be great on low carb days.  Beyond that, I haven't planned that far.

I'm just happy to be going in the right direction again.

Friday, September 5, 2014

A Good Start

Yesterday was a busy and tiring day, so I didn’t get a chance to post.  I went to my four doctor’s appointments, which were spread out from north to south over the Dallas side of the Metroplex.  The timing of the appointments worked out great, but I didn’t have a chance to eat in between so I went from breakfast to 3:00 in the afternoon before I got a chance to eat anything.  I stopped on my way to my 4th appointment and got a cheese stick and a beef jerky stick to tide me over (it was a low carb day).
 
Everything went pretty much as expected:
 
1.      First I went to the podiatrist for my Achilles tendonitis problem.  I do not have to go back in the boot (which I was kind of expecting), but I have to do physical therapy and wear this elastic sleeve with a gel pad that cushions the back of my heel and holds the tendon close to the bone (which helps with pain).  He said the results of my x-rays were that I had a bone spur on the back bottom part of my heel and one in the area at the back of my heel where the tendon hurts the most.  I asked him if a cortisone shot was advisable and he said it was not because those tend to weaken the tendon and can cause it rupture.  I am not to be doing much walking, and certainly not walking on a treadmill or stair climber or that type of thing.  Swimming and recumbent bike is all he recommended.  He said these things can be difficult to clear up.

2.      Next I went to my back doctor.  Everything is going okay, except my weight gain has increased my back pain.  The main thing that came from that appointment is she told me the laws for pain medicines like I take (Norco) are changing and you now have to have a paper prescription in triplicate for every refill and therefore refills cannot be called in anymore (starting sometime next month).  Since having all of her patients come in once a month for medication authorization would flood her practice so that she had no time to see post-op patients, she is referring me to a pain management doctor.  She does know that the pain meds are necessary at this point, so that was not a problem (I would not be functioning without them at this point).  So I am going to a pain management specialist close to downtown, since I will be having to go once a month.

3.      Next was the doctor for my knees and shoulders.  We didn’t talk much about my knee.  I probably could have pushed for an injection in my left knee, but didn’t.  I did get injections in both shoulders.  He said it is likely tendonitis.  He also referred me to physical therapy, which I will have to do twice a week for 6-8 weeks.  He said it should clear up.  If not, then they will do an MRI to make sure there is no tear or anything like that.  He said I had no arthritis in my shoulders, which is good.

4.      Last was my internist.  We talked about my HRT since my hysterectomy, my depression, and my Fibromyalgia.  I got my refill on the HRT, she prescribed a second antidepressant (Welbutrin) which will help the first work a little better.  She said the Fibromyalgia will mostly be helped by working on my eating habits and getting some exercise and working on my stress and anxiety (although I don’t feel anxiety is much of a problem).  Stress, yes.  I was fine with that.  I do NOT want to take Lyrica or any of the other drugs they use for Fibromyalgia.  I do think I am going to try a couple of supplements, including 5-HTP, which are said to help.
 
So, that was my day yesterday.  When I got home, I had a steak salad made with lettuce, pico de gallo, fajita steak, a little cheese and some chipotle vinaigrette.  I was a little hungry before bedtime, so had a few bites of non-fat cottage cheese.
 
I got on the scale this morning and I am showing somewhere around a 9-pound weight loss so far.  Yay!  So nice to be going in the right direction again.  I know that is mostly water weight, but I will take it.  It shows I am doing what I need to do.  Even though I got started on Tuesday, my weeks are going to be Saturday to Saturday, so I will have my off-day sometime this weekend.  It works better for me to do it on the weekend.
 
Today is a high carb day.  Breakfast was the egg muffins I had Wednesday and some watermelon.  Morning snack (which I didn’t get to until 11:00) was some Greek yogurt.  I don’t want to push my lunch back to 2:00, so I will just leave it at that.
 
Lunch was some steak fajitas.  I didn't get to eat my afternoon meal until almost 6:00.  Dinner was some more fajita steak (too tired to cook anything new) and a sweet potato.
 
My head pounded all day with little letup, so I'm going to let it go at that today.  It's a good start.

Wednesday, September 3, 2014

Day Two, Check

Day 2 is underway.  It is 10:15 a.m. and time to eat my second meal.  Again, I am not even hungry.
 
Breakfast was some egg “muffins” we made using Egg Beaters, turkey sausage and some sautéed veggies.  We cooked them in muffin tins and just grab 2 or 3 (they are small) and warm them up when we need them.  I had some watermelon to go with that.  I had it in my mind that I wasn’t going to like the muffins.  Because it wasn’t “real” eggs and it was turkey sausage, I figured they weren’t going to be good.  I kind of had to force myself to try them.  But they were actually pretty good.  Not as good as the Ham and Swiss Pie from yesterday (which has real eggs and some LF cheese), but not bad.  I can only have egg whites or Egg Beaters on high carb days, so that was why we did that.
 
On high carb days I am supposed to have a protein and a carb with every meal.  If you are still hungry, then you fill up on veggies, but protein and carbs come first.  No fats to speak of on high carb days (he says you would have too many calories if eating both carbs and fats).  You get fats on low carb days, along with protein and veggies (make sure you get plenty of veggies on low carb days).
 
Meal 2 is some non-fat cottage cheese with fruit.  So glad I get to have fruit today!  That was actually really good and I thoroughly enjoyed it.
 
I caught a couple of glimpses of myself in the glass doors of my entertainment center this morning as I was getting ready.  Suffice it to say, I was not pleased with what I saw.  But I at least feel better that I am getting started again and hopefully that image will improve in the coming weeks.  Just wish I could work out like a fiend.  But just getting going in the right direction helps my motivation immensely.
 
Tomorrow I have four doctors’ appointments and one of them will be for two different issues (shoulders and knees).  It’s going to be a long day.  A couple are just follow-ups to keep the medications current.  But I have things to talk about with all of them.  I hope to get a couple of injections (knee and shoulders) and hopefully that will make me feel some better.  I sure wish I could make these headaches settle down.  I have started using my occipivot I bought and it does seem to help.  It will probably take a while for it to do more good long-term.  That basically works on the area of my neck at the base of the skull.  There is another device in the same system called the cervical pivot, which works lower down in the neck.  I want to get that soon, because I have a lot of neck tightness and soreness there too.  There are also parts for the thoracic spine and lumbar spine.  I plan to get all of them eventually.  They have good reviews.  It just does some of what the massage therapist would do for me and helps everything properly and improves your posture.
 
I feel very tired this afternoon.  I don’t know what’s up with that except that I am having to take muscle relaxants.  Again for the headaches and neck issues.
 
Lunch today was fajitas made on corn tortillas.  It included 2 corn tortillas, fajita steak and veggies, one thin slice of cheese split between the two tortillas, pico de gallo and salsa.  It tasted good and was satisfying.  I also brought a peach with me, but it didn’t out to be a good one, so I did not eat much of it.  I ended up eating the banana I brought for my afternoon meal, so will not have that to go with my Greek yogurt.
 
Dinner was some fajita steak, a baked potato and a little bit of salad with chipotle vinaigrette.  I also had a little more fixed fruit.
 
So, Day 2 is done and I am feeling good.  Tomorrow is another low carb day.
 
Over and out.

Tuesday, September 2, 2014

Day One is In the Books

So, this is Day 1 of my new start.  I was lying there last night and actually felt kind of excited about it.  I definitely am feeling more positive and like I can get going again.  And, I keep reminding myself:  “There is no try…only do it or don’t do it” (paraphrased).
 
Today is a low carb day.  Breakfast every day involves carbs, so I had my ham & Swiss pie (made with eggs, cream and low fat cheese) (a small serving) and some watermelon.  I am supposed to eat 5 meals, 1 every 3 hours.  Every day.  So, at 10:30 I had some celery with LF cream cheese and some deli turkey.  On low carb days, except for breakfast, meals are supposed to be composed of protein (without fail), veggies and one serving of fat).  I was not really hungry by 10:30, but I ate what I was supposed to.  That is supposed to keep your metabolism revved up and keep you from burning muscle on your low carb days.
 
When I first decided to do this plan, my thought was that if nothing else, I could do the Easy Plan, which involves alternating low carb and high carb days, with a reward meal on every high carb day, and two high carb days in a row on the weekend.  You are supposed to lose very slowly that way, but lose nonetheless.  Since I was lacking in motivation, I thought I could at least do that.  Right now, I am feeling more motivated, so I think I will do the Classic Plan, which is alternating low carb and high carb days Sunday through Friday, with an off-day on Saturday (if your week starts on a Sunday).  I think I can do that and I will like having an off-day once a week, rather than just a reward meal.  That is not to say you go hog-wild on your off-day, but it is more relaxed and you can eat comfort foods you enjoy.  If I get on a good roll and want to go faster, I can do the Turbo Plan, which is 2 low-carb days, 1 high-carb day, 2 LC, 1 HC and 1 off-day.  But I will start a little slower until I get going.
 
I had a little bit of trouble going to sleep last night and thus overslept, so I did not do the recumbent bike.  It will take me a while to get rolling on the fitness part of this with my current pain level, but I will do the best I can.  I hope to get my shoulders feeling better after my doctor’s appointment Thursday, but I don’t know if they will give me any restrictions.  My left shoulder/arm is hurting quite a bit when I move it away from my body.  I do not know if that is nerve pain or something more structural (it feels more like the latter).
 
Still struggling with headaches.  I surely would like to get free of having these continually.
 
Lunch was salad with pico de gallo, fajita chicken and veggies and a tablespoon of ranch dressing mixed with salsa.  It was pretty good, except the chicken needed more flavor.  Afternoon “meal” was some deli turkey and thin-sliced cheese wrapped around a dill pickle spear.
 
Dinner was going to be another salad, but that didn't appeal to me when I got home, so I had more ham and Swiss pie.
 
I’m craving carbohydrates mildly, but I will be able to have some tomorrow.  My carbs for snack meals will likely be fruit.  The other meals will either be a typical carb like a slice of bread, rice, sweet potato or corn.  Since low carb days alternate, it won’t be as hard to resist cravings, knowing I will get something carby the next day, and even something sweet once a week.
 
The prize I have my eyes on right now is just getting back into some of my clothes that are too tight.  And pain reduction.  That is always a motivation.
 
I got on the scale this morning and I was down .3 pound.  Lol.  Better than going the other way, I guess.  I’m ready to get moving.
 
So, I made it through Day 1.  I didn't drink quite as much water as I should, but I was sitting on the switchboard and that makes it tough.  But I drank more than I have been.