The News from Here

None.

We ended up not calling the doctor. I knew this would happen. We go through this routine all the time... things seem bad enough in the evening to call; by morning he feels better... next evening... well, you can guess. We did decide to give this until the kind of arbitrary date of April 13 to see if it just resolved itself. Again.

He is eating about 1200 calories a day if I push protein shakes down his throat, and every day, his weight is about a pound higher. No, this is not normal. And he complains about feeling absolutely stuffed all the time. And every night, his temperature goes up to 101 or 102 for a few hours.

I am trying to just sit this one out and wait and see what happens. He is so miserable and frustrated, though, that it's hard.

And so far, on my resolve to really keep track of food every day this week... total fail. Sigh.

Sunday again

Updating...

A thank you to everyone who has been so encouraging about the calorie thing... my plan, which I've been doing in sort of a half-hearted way this week, is to keep a rough count on the applet on my iTouch (have I mentioned how much I love, love, love, love this iTouch? Useful in ways that I never imagined.). This has been going pretty well so far, to the extent that I've been doing it. It's not ideal in some ways, but the ways in which it's not ideal kind of keep me from getting as insane about it as I would be likely to do with a more sophisticated program. I used to use... well, I've tried FitDay (not crazy about it but a lot of people really like it), MyFoodDiary (best of the online programs, if you ask me, but still not fast), SparkPeople (not my cup of tea but again, great for a lot of people), and then ultimately I bought the software for DietPower, which I think is a really excellent program if you want to track every possible nutrient, and you have the ability to do this without spending all your life obsessing about it. (In other words, if you are not me. You don't even want to hear about the Great Selenium Debate of 2008.)

Anyway, this little iTouch applet is great, it was free (Lose It, for anyone curious), it's really fast, and you can easily track the three things I care about, calories, carbs, and protein. And the days that I have kept track, I have lost small amounts of weight. And the days that I have not kept track... you guessed it, I haven't. So you would think that someone with half a brain (and I'd like to count myself in for at least half...) would put this all together and actually do that. Which is my goal for this coming week.

In all fairness, the day that I really didn't track... yesterday... was kind of a Epic Fail sort of day anyway. Michael's been having another incidence of these mysterious symptoms he gets... afternoon fever, edema, extreme fatigue, nausea... and he feels like death, and he's depressed as hell. Part of the trouble is that he gets up in the morning and feels relatively ok, but in a few hours, he's awful again. Anyway, yesterday, I took him for a drive, just to get him out of the house, and it just was one of those ideas that seems good and turned out just bad bad bad bad... he was uncomfortable and miserable, I was miserable because my happy plans had not turned out that way, he was more exhausted than he would have been otherwise... and we didn't exactly eat properly, either, although "not eating properly" for us these days isn't exactly an extreme thing.

The trouble is that I seriously have no idea what the right thing to do about this problem is. We go back to the doctor time and time again; he does tests, and he doesn't find anything. I don't think that he has a clue where to go with this next, and I also don't think that he takes it that seriously... he doesn't see the extent to which Michael is incapacitated; he doesn't see what it's doing to him psychologically, either. I just don't know where to go with it. I'd like to have someone else see him... but who? My sister keeps suggesting that we go somewhere like Johns Hopkins or the Mayo Clinic for a complete workup, but I have no idea if my insurance would pay for it, and the other problem is, doctors take one look at him and they think that it's all about weight, and they want him to have surgery. Yes, he's still over 400 lbs. But he has lost over 200 lbs., and he feels worse. If he were not losing weight, we would consider surgery. But as long as he is... and he is, when this stuff is not going on... that doesn't seem to me to be the right choice at this time. I need for someone to see past the weight and try to get to the bottom of what causes this fatigue, the fevers, the edema.

So I will call the doctor on Monday, for lack of anything else to do, and I will try to get him in to see him, although I have a hideous schedule next week, and doing this will be very difficult.

We will get through all of this. I know that. It just would be nice to be able to see the road ahead a little more clearly.

Calories and Carbohydrates

When you start reading about low-carb diets, you get the notion that you can eat whatever you want, as long as it's low carb, and still lose weight. I think it starts with the first weeks of Atkins (eat whatever you like as long as you keep carbs below 20) and follows along to the people who argue that there's a metabolic advantage to low carb diets, and it all builds to the idea that if you're counting carbs, you don't need to count calories.

But ultimately, I'm pretty sure that's not true, or not true for everyone at least. (One of the things I've really learned over the last few years is that everyone is a little different, and what works for one person may not work at all for someone else.)

When I started eating low carb, I lost about 20 lbs. or so pretty quickly, and then I've spent about a year plus pretty much maintaining my weight. Which is not exactly what I have in mind. I've proved again and again that if I keep the carbs low, I can eat mostly whatever I want and not gain weight. This is kind of a long-run good thing, I suppose, but it doesn't solve the problem of really wanting/needing to lose more. And, sure, there are many reasons why, for the last year, it's been easier for me to maintain weight than to lose it, but at the end of the day, it still leads to the conclusion that that I have to do something different if I want to get anywhere. The lower carbs have also been fantastic for my blood sugar and general level of energy, and so, particularly because we eat very clean anyway, in the "very little processed food" sense, I'm pretty happy with the general shape of my food choices. But clearly there's too much of it.

I was starting to get somewhere when I was making the photo food diary, but... well, I got lazy about it, and I realized that I eat a lot of the same thing a lot of the time, and that it's hard to get a sense of scale... so it was definitely a step in the right direction, but it wasn't enough. And I got kind of derailed when my son and I went to New York, too, and haven't quite started up on the pictures again, although I probably will.

But I think that when you get right down to it, I have to start counting calories again. I am not totally averse to doing this, but it's taken a while to really convince myself that I need to do this. First of all, I love the idea that I can eat pretty much whatever I want... but "whatever I want" is simply too much for me to actually lose weight, at this point in time anyway, because I have too many bad habits that are allowed free rein with this idea. I graze (moo!). I eat when I'm bored. I think I'm hungry when I'm bored. I don't have enough accountability. And so on. The other thing is that I have been very reluctant to start keeping a food diary, because it tends to make me a little obsessive and weird and controlling about food... about Michael's food, too, and this is not a recipe for marital bliss. I am just going to have to figure out how to avoid doing that. And how to not make myself crazy in the process.

I think that "not making myself crazy" is going to have to mean, keeping a rough tally on my iPod, not spending the hours that I used to obsessing over every micronutrient. I have been trial-running this for a couple of days, and thus far, I'm a little lighter and not much more insane than normal. Yet. :-)

And Another Sunday....

Somehow, a week has slipped by.

And what have I done this week? Kind of nothing, amazingly enough. It's spring break here, and as always, I'd had all these plans to get caught up with everything in the world, and mostly that hasn't happened at all. Discouragingly enough.

And so that's what I've been thinking about. Procrastination.

I've been reading this book lately about, basically, fixing what's wrong with your life, I guess. And the premise thus far is that we create our own problems/obstacles by the way we think about them. "The way we frame the problem" is the way I'd put it. Which I pretty much agree with. And that change is hard because we are resistant to change, because most of our difficult behaviors serve us in one way or another. Thus we have to be willing to let go of the... the reasons why we've kept the behaviors, I guess.

I have been thinking specifically about procrastination, which is probably the specific behavior that is annoying me the most these days, because it invades about every facet of my life. I procrastinate about doing work-related things, home-related things, exercise-related things, writing down food... you name it. And it's easy to focus on the behavior and say, obviously what you need to do is stop procrastinating. But I guess that my thought from reading this book, to the extent that I have, is that it's not the procrastination that's the issue, it's the underlying stuff, the ways in which not doing these things allows me to... I don't know. Maybe fail to take responsibility for my own successes or failures, because I'm always going, oh, if I'd done this, it would have turned out better. I kind of can't explain that so that it makes sense, but it does make sort of an internal sense to me. "It's not really my fault since I didn't do everything that I could have." Something like that.

I need to figure out how to get past this and, trite though it sounds, allow myself to succeed.

Sunday

Some days, I sit down to write, and I think, this is the wrong stuff to put here. This blog is supposed to be about something. About weight loss or something like that. But I think... I don't know, I guess that for me, weight loss is about 10% what you actually do and 90% what you learn not to do. And at the end of the day, that's all behavioral modification, and your ability to do that is all about consistent effort... which in turn is all about the rest of your life.

It's a sunny afternoon, Michael's asleep, my son is at his father's, and I'm cleaning the kitchen. Or I'm supposed to be, anyway. I got derailed by thinking too much, as usual. And missing my mother. It's been 8 months, and I suppose that the grief has lost its immediacy. But it's like a wound that scabs over but still hurts all the time. I begin to think that there's no end to this. I can't talk about it, and I can't stop feeling it. It seems to be one of those things that is a marker, after this thing, you will never be the same. It's like having children... it's impossible to understand really what it's like to have kids until you do, and then there's no going back; your understanding of life is different forever. (Yes, I know, Circle of Life; I'm one second from humming Lion King songs.)

And I think, as I do so much these days, about where I am and what's next. About getting to some different place, where I'm not just replaying the same choices over and over again, where something actually changes. I was reading this on Escape from Obesity this morning... and, yeah, I can relate to missing the "happy" binging, to when food, a day of food, was a real source of pleasure. It's not anymore... but there's a part of me that wishes that it still was. Or, more accurately, that there was something that gave me the simple kind of pleasure that I used to be able to get by sitting down with high-carb foods and a good book and just letting the world go away. And, yes, I'm ashamed, in a way, to say that. I have different pleasures now, but it doesn't mean that I miss the old simple ones. Everything these days seems complicated and full of thought and just not easy.

Everything is ok. But some days, I just feel so profoundly tired, tired to the core, and I want to go back to a time when life seemer simpler and the choices less limited.

Not a Happy Bunny

Somehow it turned into a rough day yesterday.

The good part: we went to see New Knee Doctor yesterday, who said, there is nothing wrong with your knees that losing another 200 lbs. would not mostly cure. (Then he looked like he had very little belief that he could do that, but let's not go there...) So that is good news, or good reinforcement anyway because it's not really anything that we didn't know.

Went to the store, came home, and the day kind of spiraled down. Michael was exhausted and tense and low, and he is still not well. I am pretty convinced that this is not flu but rather a milder version of this thing that happens again and again. The good thing is that his breathing has not been so bad, but the rest of it... rapid heart rate, blood sugar that is out of whack, water weight gain (stomach edema), wanting to sleep all the time... it's all the same. Just not so bad. I am pretty sure that it will pass (and relatively soon, with luck), but it's discouraging for him to watch the scale just go up and up (he's about 10 lbs. higher) when he's eating very little. Hard to know what to do. His weight will not be lower today, I know that... and he will be discouraged all over again.

And I don''t know what happened to me. Started ok, but got tired and tense and anxious, and then all I wanted to do was eat. Which I did. I have seen so many former binge eaters say basically this... I did not binge in any realistic calorie sense, but I could feel that the motivation behind it was the same. I even made an excuse to get up after we'd gone to bed so that I could sit up for 20 minutes and eat more. It is hard to write that. And this morning I feel sick and low and very alone.

But what can you do? It's another day. It's time to dust off the pieces, try to figure out why this happened, start again.

Continuing...

I'm trying to find the next step.

I've worked so hard... nearly a decade... on the cognitive, behavioral things, and I think because of that, it is hard for me to believe that there really is something biochemical wrong with me that medication does help... or can sometimes, anyway. But I see the things that come back, the things that you don't realize are gone until they return... the ability to laugh more, to just be happier in the moment, to be silly and spontaneous. Michael sometimes complains that I'm not fun anymore... I think he means, not spontaneous... and, you know, he's right. I'm not fun. It's all a balancing act, me on this tightwire between ok and not ok, teetering all the time, trying to keep my ducks all in a row. I beat myself up mercilessly a lot of the time for not getting things done... but I forget, it's hard. It's hard to get up in the morning and put myself together and do the basic things. It shouldn't be. But it is.

I wish that I had the words for the feeling, that inchoate formless longing to be on the other side of this, to be that person I can feel sometimes, the person who I am without the sadness and the regrets and the anxiety and fear. I can see her, sometimes, just on the edge of my vision. Sometimes, just for a moment, I am her. And then I lose my balance again.

But the last few days, I can see the form and shape of it, see the choices that I have to make, see these things as real and possible rather than things that require unimaginable, insurmountable effort.

I think this is all good. But it's tentative and a little frightening, too.

Come ON. Do SOMETHING.

Ugh, I woke up early this morning thinking I would get all sorts of things done, but I've actually been just napping listening to the news of one sort or another and trying to really wake up. Michael is no better; he dragged himself out of bed a couple of hours later and promptly went to sleep in his chair. He's been sick with something stomachy for days; I think maybe I have a touch of it, too, and my son has a sore throat.

The trouble is that as soon as Michael gets sick, he starts gaining weight... not because he's eating too much; actually he's eating hardly anything at all. But I think it throws off his blood sugar and increases the edema in his stomach, and it's just all really discouraging. You can know perfectly well that it's not "real" weight, but the scale still says ugly things. And it sets him back weeks. He's discouraged and achy and miserable.

I am feeling... better. Tentatively better. I very tentatively, not wanting to put much belief in it, but just kind of sort of... think that this medication is making me feel better.

I have a list a mile long of things that I either need to do or want to do, and I am just sitting here.

Ok. Here is what I need to actually DO today.
Stretching/exercises *done*
Spend an hour in the studio working on glass * done happy happy*
Clean the scary bedroom *started. Very scary.*
Write Phi Beta Kappa letter
Write other letters of reference
Cook chicken wings and soup (not together!) *done*
Freeze or cook chicken breasts

Back later.

Tuesday night

I feel like I ought to post something, but I have no idea what to say, really.

It's been a busy beginning of the week... it's when all my classes are, and I'm so far behind on everything. Plus Michael has something that is probably just flu (but every time he feels unwell at all, my heart stops because I'm afraid of another recurrence of these breathing issues and mysterious weight gain, still unsolved).

But mostly, I just can't put any thoughts together that make something like a coherent post.

How do I feel? Not so nauseated and drugged as I felt for the first few days. Ok, I guess. Better than without it? Just too soon to say. Maybe. Just maybe. But the nausea and lightheadedness and fatigue make it hard to say, oh, yeah, this is a good thing. On one hand, I feel like springing out of my chair and getting a lot of things done, and on the other... well, I'm pretty lethargic.

I am trying to get it back together to start posting food again, but on top of everything else, with Michael sick, I'm mostly eating leftovers. Tonight was Carnivore Night... everything in the refrigerator was meat of a sort, leftover roast beef and salmon and chicken. There are never any vegetable leftovers. Yes, I could have made a salad... which actually sounds great at the moment. No, I couldn't be bothered.

Mostly, I'm just musing. On where to go from here. On what it all means. On who I want to be. Some days, I feel like everything is falling into place at long last. Others, just no clue.

Someone I loved a long time ago used to say, "I have no idea what I will do next. Watch this space." Not a particularly novel way of putting it, I suppose... but I always associate that with him (that, and England in the spring, and jester hats, and cheap red wine, and airplanes, and unbearable sadness and loss). I feel like that, though. Watch this space. Something will happen next.

Updates

Good morning. Welcome to Daylight Savings Time... or is it the other way around? I can never remember if this is when it starts or it ends, particularly as it never makes any sense to me anyway.

I think that this is Day 3 of Cymbalta. And mostly I feel weird. It's been a decade since I've taken antidepressants, and so I've forgotten this initial side effect stage. It all feels vaguely familiar, but not in a good way. Intermittent nausea is the worst part. Underneath it, I feel... sort of weird, sort of ok. Sort of just weirded out. I think that a decade ago I was considerably more willing to experiment with the biochemistry of my head. Now... I just don't know. On the one hand, however I feel without the medication is me... I guess. On the other... well, when I started taking Prozac more than a decade again, I felt briefly and wonderfully free of the general irritation and annoyance with life that had plagued me forever. And it didn't last, but I knew that I could feel that way, and so I had something to work at, and slowly I learned how to feel that way on my own, most of the time.

My sister would say that depression and anxiety are diseases, and you wouldn't choose not to treat something like diabetes, would you? (I tried to point out that I live with a diabetic who pretty much does refuse to treat it with medication, but she really didn't think that amusing or appropriate. She totally lacks a sense of humor about this.) I say, sure, it's not like I don't buy into that, but a nice comforting broken leg would have visible symptoms, a clear progression, a point where it was fixed. It wouldn't be this roulette wheel of trying to find a medication that works, of separating the biochemical from the behavioral, of side effects so on.

Anyway, I haven't been keeping a food diary because I haven't really been eating much, so I can't seem to work up an interest. This is not that great really, because I know perfectly well that I can eat a lot without thinking that I am. Still, I'm just about back to my pre-NYC weight, so that's good. And I'm playing racquetball today, if my hip will let me and if my friend remembered to reset his clock. This should be really interesting; in addition to the nausea, I'm dizzy as hell. But I really want to play. Need to move around. Last time around with this kind of thing, I used to put on headphones and go running in the dark... and those of you who know just how much I hate running will understand how really weird that was.

Ok. Let's Give It a Try...

Thanks, everyone. Your support means a great deal to me.

I'm giving it a try. With HUGE reservations, I have to say. (Come on, make a decision and stick to it rather than second-guessing yourself, ok?) I started last night. I feel awful today. But that's the price, waiting out the side effects. The only good thing about this is that I think that food is not going to be an issue in the short run.

Bleah.

I usually tolerate medication pretty well at least for a while. I need to remember that. I need to not focus on the fact that I feel mega-weird. And I need to get back to my food/semi-workout routine, now. And see where I'm at in a few days.

Accountability. Cymbalta. Whining.

I've been doing ok at removing the excess weight that I managed to gain in NYC... mostly water, fortunately... but it is really clear to me that I am nowhere close to being able to do this on my own without some kind of accountability. So I'm back to the food diary today, although probably not photos just get because my son swiped my camera for a school project and hasn't brought it back yet!

If you were reading back in January, I'd finally decided that my level of depression had gotten so far out of hand that I was willing to try anti-depressants again, called up Psychiatrist Sis, and got her recommendation... Cymbalta... which my insurance company promptly refused to pay for. I was Not Happy (well, obviously). Since then I've been working on getting approval... or my doctor has... and this finally came through.

But this is my dilemma. I really don't feel as bad as I did in January. Not even close. For one thing, Michael is a lot better, and that increases my coping abilities hugely. Other than this persistent, horribly painful hip thing, I feel physically better. Things are... ok-ish. Most of the time.

But I have a hard time stabilizing my mood at the best of times. I still can't seem to get past the lethargy that's been characteristic of everything since my mother's death. I can't seem to get past the fact that any small thing rattles the foundations of whatever peace of mind I have. And maybe something would help with that. Plus a number of people have put some effort into making sure that I can try this.

I really don't know what to do.

Back. Food. Lessons.

Back from NYC. A great four days with my delightful son; otherwise, kind of a mixed bag. A whole lot of chaotic weirdness on the professional front, not good news for my student program although how it all works out remains to be seen. Long story.

But we had a lot of fun and ate some really good food and saw some plays and went to museums and got to spend some real time together in a way that we haven't been able to in a long time. He's such a great kid, so fun to be with, and we just get along really well, always have. It's so special to me... especially since I didn't have anything like this kind of relationship with either of my parents.

Anyway, on the food front, a couple of thoughts.

One thing is that it's surprisingly easy to eat reasonably low carb as long as you (1) skip the fast food, (2) skip the bread basket, and (3) skip the desserts. I kind of forget this because we really don't eat out much.

The second thing is that I've still got a long way to go along the cognitive behavioral road. I know, it's a few days on vacation (sort of), and no one is expecting perfection, and those of you who remind me that I'm too hard on myself will say that again. But the fact of the matter is that when I don't eat properly-- that is, when I don't eat the foods that my body is used to eat and skip the foods I don't generally eat-- I feel very bad. Physically. And bread and dessert is not worth nausea and bloating. Ex post, anyway. Ex ante often seems like a different story. Someday I will get this into my thick skull. The problem is that I do know this, but at some point I just kind of wear down, and once that happens, all the "what the hell" parts of my brain take over.

(Interesting side note: NYC now requires that chain restaurants put calories on the menu. We went to the Hard Rock Café for lunch one day, and in general, I don't pay that much attention to calories, but I have to say that having these numbers on the menu is a huge deterrent to eating. Anything, really. I recognize that it's difficult for all restaurants to do this, plus it's not that exact, but there's a lot to be said for it.)

Also, I totally racked up my hip walking a lot and going up and down a lot of stairs in the subway. So incredibly painful. I had to cancel classes yesterday because I basically didn't think I could walk across campus and stand up for an hour. No idea what this is or why it kicks off, although it really is walking and stairs that makes this worse. So maybe bursitis; regardless, it's unbearably painful plus makes it hard to sleep at night.

Now I need to get back to my routine.

And by the way... I sort of mean to write up some NYC review notes, just for the fun of it, but I wanted to put in a plug for the most fun museum thing that we did... the Frick Collection. I've been to all the big museums a million times, but I've never been there before... it is the most enchanting place, the mansion of industrialist Henry Clay Frick, which houses the most staggering collection of (mostly) European paintings, some of which are so famous that you can't believe that you're actually standing in front of them. The Vermeers are stunning (look at the one on their home page right now, if you click the link). It's small, it's beautiful, and there aren't a ton of people there. An absolute gem.