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.

Doing a better job now (2011 Week 24 Update)

Here are my stats for the last week:

Calories: 354 under weekly budget
Protein: 10% of diet
Weight Change: -0.3 pounds
Exercise: 2,376 calories worth. yard work, gardening, weight training, stretching and house cleaning.

My mood has continued to improve. I feel more like myself these days; I am able to genuinely smile and laugh. I am still anxious sometimes but doing a better job of coping. I have been sleepier than I am used to though, and I wonder if that might be a reaction to the increased antidepressant medication dose. I suppose it also could just be spring allergies. Here's hoping it passes soon.

I've been going to physical therapy twice per week for my plantar fascitis, to learn and practice stretches and strength training exercises that will make my hips and legs more balanced, and everything stronger and more flexible. I have also been doing some core exercises there, like planks, bridges, etc. It is very hard work but I think it will be a good habit to get into, and not just for my foot problem.

My birthday was last month and one of my gifts was a lightweight, fabric hammock. I just got around to putting it up in a tree in the back yard several days ago and I have really been enjoying hanging out (literally!) outside in it, reading, working on the computer, or just relaxing. And I went back to aqua aerobics again today.

I want to do lap swimming at the pool, but I'm a little intimidated by the crowded lanes, especially since I swim more slowly than a lot of people. I used to go to an indoor pool when I lived in a different city, and it was open all day long, so I could choose non-peak times to go and do some laps. They also had lane markers: "slow", "medium" and "fast", so I felt like there was a spot set aside for me!

I still can't get back to walking and hiking yet (says doc) which is disappointing. Maybe I'll take a cycling class this week at the gym.

Renewed Hope (2011 Week 20 Update)

My Loseit Log says I was down another 1.5 pounds last week. My last recorded weight was 343.2. I have a feeling that may not be entirely accurate -- I wasn't logging food, exercise, or weight for the last two days.

It was my birthday, and my sister was in town to visit and help me celebrate. I did get a fair amount of exercise, walking downtown, walking at the beach, etc, but also probably ate and drank more than usual between birthday cake, birthday cake leftovers, and having a few glasses of wine/beer.

I was worried, being aware of my sister's eating habits. Friday night she got in around 4-ish and didn't ingest anything but alcohol for the rest of the day; I made thin crust pizza and a big healthy salad for dinner and she didn't have any. Saturday morning she had a couple of pop tarts she'd brought with her and a canned coffee drink -- I had made chocolate chip scones for breakfast for a treat, and brewed coffee, she didn't partake. She didn't have anything for lunch, and at my birthday dinner had a single slice of takeout pizza that my parents brought, not even any of the cupcakes we made.

She looked heavier than usual, but not anywhere near overweight. She's probably 5'5" and about 125 pounds. According to heresay she's had trouble with bulimia in the past but insists it's not an issue anymore. I worry about her.

I've written a little bit on here about my struggle with depression and how it relates to getting motivated to move my body around and eat the right things. On Friday afternoon I went and talked to my doctor about my symptoms having gotten worse again. I was nervous about talking to him because he's not a very touchy-feely kind of guy, kind of brusque even, but he just listened to the symptoms I described and adjusted my dose for me. It might take 4-6 weeks to really feel the change but already (maybe just due to hope of change) I'm feeling a little better, more energized and back on track.

I went to the gym today for the first time in month. I've got my next week's worth of meals and exercise planned out. And while I was at the gym I picked up a copy of the current schedule of classes both there and at the pool.

I varied my speed on the treadmill between 2.5 and 3 mph, and was having some low back pain and right knee issues again so I only went for 15 minutes, and then did 15 minutes of weight lifting. I did a lot of yard work today as well so I feel like I've put in a good effort that I can continue to build on.

I think I am going to turn another corner now.