Giving protein another try

Some time has gone by, obviously. I haven't made major headway in the weight department, but I have begun my new career in nursing and it is going well, despite my size. Whew.

At the end of last summer my primary care doctor retired and referred me to another physician in the same practice that specializes in obesity medicine. We met in January for a specially set aside appointment to discuss weight management: he wanted to have a larger block of time and really focus on that. It appeared to be a busy day at the office and we only really met for between 5 and 10 minutes, but I'm refocused on specific goals again. He wants me to aim for greater than 100g protein per day as well as less than 100g carbohydrate.

For a couple of years (and the last time I was updating this blog regularly) I was tracking everything I put in my mouth using the LoseIt app on my ipod. Although I think it was helping, it just began to feel to cumbersome and time consuming for diminishing returns. But I've used it recently to check in on those macronutrient amounts.

My doctor recommended a specific protein supplement (which comes in a whey powder to make smoothies out of, or a pre-packaged "shake" drink). He told me to drink 2-3 of those per day and then have a dinner of real foods, with about half protein (lean meats) and half non-starchy vegetables.

I am mostly vegetarian, but eat fish now and then. After the appointment I went to the grocery store and bought a couple weeks supply of the pre-packed drink and a tub of the powder, as well as some individually freeze-wrapped fish portions.

I'm about a month in now, and I'm doing really well with the protein drinks (and meeting the >100g protein requirement) but I can't bring myself to eat animal flesh, of any kind, daily. One or two tuna salad sandwiches a month, yes. If they have lots of celery and sprouts and lettuce and honey mustard to sort of distract me from the fact that I'm eating flesh.

I went veggie at age 9, and I think when you haven't eaten substantial meat for that long you just lose a taste for it. In my mid twenties I started eating fish again every now and then. Can't bring myself to eat more at this point though.

Anyways, so with the protein supplements, 2 of them per day definitely left me HUNGRY, but 3 per day plus a meal is doable. I make my own blended ones when I'm at home and use the pre-packs to bring to work for my 12 hour shifts (easiest lunch I've ever packed). I also eat almonds through the day. I do end up craving and splurging on carbs and sweets though. I'm working on that and making some headway.

With what I've done so far, I've lost about 5 1/2 pounds over the last 5 weeks. And that's with not complying with the carbohydrate limit yet (I'm working on it!). So I'm feeling optimistic. A pound a week adds up to 50 pounds a year if I can keep it up.

Another thing I've been thinking about though: a coworker of mine got a sleeve gastrectomy at about the same time I started this diet regime. She's lost about 30 pounds so far and has 30 more to go. Her whole process went smoothly and she feels great. I know weight loss surgery is a major, major intervention to contemplate, but I've been thinking about it more seriously after seeing her success.

I'm 35 now. Although I've been making major changes in my professional life over the last 5 years I feel like my personal life (love, family, babies eg) has been set permanently on the back burner due to my size. And I'm increasingly feeling like time is running out. I'm thinking about taking a more drastic approach that would get quicker more permanent results. I've lost 30 to 40 pounds before, repeatedly, the "traditional way" and gained most of it back when I went through a period of depression or had a medication change.

I think part of what really peaked my interest about the surgery my coworker had was that they remove part of the stomach that produces ghrelin, which is the hormone that makes us feel hungry. It is irreversible. I suppose if you were non-compliant with the post op diet you could potentially re-stretch your stomach beyond the banana size one they give you in surgery. I like that there are no foreign objects in there like there are with the lap band, and you don't have to get fills and adjustments.

So my plan for now is to keep going with the nutritional changes, and keep aiming for >10,000 steps per day (easy on work days, harder on my days off), but at the same time start researching weight loss surgery more in depth. My coworker had hers done in Mexico for $4,000 even, and while it sounds sketchy, she said it was the best medical experience she's ever had in terms of cleanliness, safety, comfort. There's also a surgeon in my county who does them and has information seminars about once a month, so I'll go to one of those soon and check it out.

That's where I'm at right now. I've updated my weight chart down at the bottom of the blog -- I'm at 358.4 lbs right now and I've been averaging about 6-7,000 steps per day for the last 3 months.  Next update sooner.

That argument with yourself...

After a long clinical day (I am a nursing student), my plan was to go to the gym to do an ab workout class. I've been to the class before, and really felt it the next day. My gym clothes were in the car, all I had to do was drive there, change quickly, and jump in. But I talked myself out of it :-/

I got a lot of exercise at the hospital today. Almost the self-required 10,000 steps, and I knew I could get above it doing chores this evening in between studying.

I've got two tests this week, and felt like I needed to get home to study ASAP, but that is not an uncommon occurrence. I need to learn to prioritize exercise as well as academics.

I told myself I didn't want to be ultra-sore for my 1st day attempting total care of 3 patients tomorrow. But really, sore abs would not get in the way of a nursing shift. That was a made up excuse.

Next time (Wednesday) I will do better.

Strange lack of body awareness

The other day I went for a hike, at a trail that I often use. It's hilly, public trail out on a ranch near town. Mountain bikers use it, too. I've done this trail about 10 or 12 times total probably. The first time, when I went with family, it probably took the whole group of us 2 hours or more to get around the whole thing. My fitbit rates it at about 10,000 steps and about 32 flights of stairs worth. So, it's a good, challenging workout for me at this point in my fitness.

One of the last times I went, though, I had the odd sensation that it was just OH SO MUCH HARDER than usual. It was warm out, sure, in the 80s, but not any warmer than the last time I had done the trail. Was it the week I had had previously, I wondered? Or because I was listening to an audiobook on my ipod that I had already heard before, rather than one of my nursing school lectures that I really had to concentrate on....yes, perhaps it was distraction that was key? Or maybe I hadn't slept as well or as long the night before? I even started wondering if maybe I had accidentally taken the 'long loop' instead of the 'short loop'.

It was only when I got to the end, back in my car, and peeked at my clock that I realized why. I had gone around about 20 minutes faster than the last time I did it, without even realizing it.