Not Clicking

I'm just not doing well with my goals.  After I posted last week that I would exercise 3 times per week.  I didn't.  That was the only day I managed to get in an actual work out.  I managed to exercise 3 times this week.  The second time, I had a little more time so I did two miles rather than just the one I had been doing.  I made it through, and probably would have had to quit even if I had more time.  The next day, I had some time again and thought I'd try to squeeze in two miles.  I didn't.  I was sore!  That just did not make me feel good about myself.  Who can't walk two miles?  Me, apparently.

I was 100% on plan with my shakes until yesterday. The scales were creeping up and I was angry and frustrated, about that.  I had my drink for breakfast and then went shopping with a dear friend.  We wound up eating out at lunch, and not eating well.  Then last night, I had a school function to attend with 65MD.  A meal was catered and I ate it.  Surprisingly the scales were down a teeny bit.

UGH!!  Eating badly and not exercising were what I thought got me here!

Of course, I know better.  I'm back on plan this morning with both the shakes and exercise.  

Exercise

All along this journey, exercise for me has been all in or all out.  That's the way I am.  If I can't give a minimum of 100%, I'm not doing it.  So far, that hasn't worked so well in the weight loss arena!!

I've been needing to fold in some real exercise in to my day.  I love the flexibility of working from home.  The biggest downside for me has been boundaries between work & everything else.  It is too easy to put of things like exercise or dusting or anything that doesn't sound fun at the moment because I feel like I can do that anytime.  Of course, anytime never comes.  

When I worked in an office, I still found excuses not to exercise and when I really wanted to, I had to carve out time.  With my recommitment to losing weight, I knew that exercise was a key component, and I'd have to schedule the time to do it.  Here's the kicker, my December schedule is jam packed.  I won't go in to details, but I have a lot to do, and it will be hard to find an hour to do one of my workout DVDs.  That is not counting cleaning up afterwards.  (I confess I considered not showering after since I do work at home and am alone most of the day!!!)

I've heard over and over that some exercise is better than none.  So, I drug out my Walk Away the Pounds and did the warm up & one mile today.  That is all the time that I had.  I feel good and energized.  That is a good thing.  I'll need it to get through the end of the year. 

So, for the month of December, I will do some form of exercise 3 days per week for whatever time I have.  If I can work out 4 or 5 days, I will.  I should be able to at least do the first mile like I did this morning.  We shall see where this path leads.  I think to a good place.

What's Next?

We have finished phase one of our SNAP challenge and are on to phase two.  In it, we are challenging ourselves to eat as we typically do and see just how long the SNAP funds last.  Although, I lost nearly 2 lbs during the month, I'd really like to lose about 4 per month as an average.  So, it is time for me to put weight loss back in the forefront of my eating plan.

I have a lot of good data to sort through, since we kept just good records of our eating.  But the thing that jumps out at me immediately, is that I lost weight eating pie!  I ate a variety of carbs, and I think the reason I lost weight was that I was very strict on my portions.  I think that is key for me.  I always want a 'free' food that I can eat all I want.  Eventually, whatever plan I'm on, I find the loopholes and cheat on plan.

I also know that keeping such meticulous records drives me nuts and I will eventually rebel.  I have several ideas, but not enough time right now to explore them.  I have family already here and more arriving today if the weather permits.  The data isn't going anywhere.  I'll have plenty of time to sort through it and come up with a viable game plan.

My goal is to have a Lori Plan ready by January 1.  In the meantime, I want to keep the pounds coming off.  So, I am going back to the meal replacement shakes.  I have some on hand that I put aside during the challenge.  It should be plenty to get me through the remainder of the year and it will be easy to adjust to a party here and there.

I probably won't be around much until next week, so dear readers, please have a Happy Thanksgiving!!

"Such A Petite Little Lady"

Someone said those exact words to me yesterday, about me.  I was stunned.  I said no one had ever used those words to describe me.  I was focusing on the words 'petite' and 'little' not the word 'lady' since I agree with that one.  

She wondered why not.  She said "Look at you.  You have those short little legs and tiny torso."  I know I'm short.  Not disputing that fact at all.  I didn't dispute it and since I'm trying to learn to be more gracious in accepting compliments, I didn't push it when she finished her sentence, with "You're as cute as you can be."

Of course, I thought about it the rest of the day.  I parsed every single word trying to turn them into something negative.  Like she said I was short.  Yes, she did.  She said short and cute not short and fat.  She never actually used the word short.  She used more pleasant words.

Finally, I decided that I was just going to accept what she said at face value.  I am a 'petite little lady' and happy to be so!  

Checking In

Blogging about the SNAP challenge is taking up a big chunk of my blog time.  65MD and I are continuing to lose a little weight.  We're glad for that.  Check out our progress with the challenge. 

On Cutting My Toenails

When I was at my heaviest, I had pedicures regularly.  I said that I worked hard and deserved to be pampered.  That was, and still is, true.  However that was not the entire story.  I really couldn't cut my own toenails.  

I couldn't maneuver around my big belly to get down there, or move my legs up to get to them.  Neither one of my legs was going to move like that and the arthritis in my right hip made that one all the worse.

So, I told myself I was giving myself a treat even though I knew deep in my heart the real reason why I kept getting regular pedicures.  I had to.

Now, I still get pedicures because I do love the indulgence.  But now they are just that.  Special times for me alone, or with a special friend or family member.  Because now I can, and do, just did, cut my own toenails!

On Getting Hungry

A little more than a year ago I started working from home.  It has been a good decision and I'm glad things have worked out as they have.  It is impossible to know all of the implications of changes will be and I've had quite a few.  The biggest one as it relates to this blog is getting hungry.  It makes sense; let me explain.

When I worked in an office, I kept a fairly regular schedule.  There were individuals around me that helped keep me on that schedule should I try to veer off.  Specifically speaking - lunch time.  There was a group of us that generally ate together most days.  So, if I got overly involved in some activity, and didn't show up at lunchtime, there was someone at my desk to check on me.

Now, I can work and work and not notice the time.  Sometimes, my stomach will growl and I'll wonder why I'm so hungry so soon.  Then, I'll notice the time and know it is not too early to be hungry.  Even then, sometimes, I'll decide to finish what I'm doing rather than go eat right then.  Sometimes, but not often, eating is a chore.  It is something messing up my train of thought on a project.  I'd just rather not be interrupted right then.  It is still rare, but it happens.

I began to think about what my life was like when I first started down this weight loss road.  I was fearful of being hungry.  I actually remember having a conversation with one of the counselors about it.  I liked the feeling of fullness in my body.  Hunger was  an enemy and something to be vanquished.

Now, I know that hunger isn't going to kill me.  A little hunger is a good thing.  It tells me that my body is ready for more food.  It is OK for me to eat.  Now, I am learning how my body feels with the right amount of fuel.  I don't like the over stuffed feeling.  My brain has learned that the feeling of being too full is associated with weight gain and that isn't good.

My brain is learning now, what that just right feeling is like.  I like it here.  I like it in this place.  I like that I don't mind getting hungry.  I especially like that I know better how to make good choices about what and how much I eat.  I'm still learning, I'm not there yet, but I'm on the right path now.

What I'm Eating

As I mentioned in my last post, I'm not following any weight reduction eating plan right now.  The hubs and I are making our food budget the same as SNAP for 30 days.  As a result, when I went to the grocery store, I got the most basic of items, not wanting to go over budget first thing.  I got white bread because it was the least expensive.  I left all the non-sugar sweeteners in the store because sugar is cheaper.  I even got a bag of white potatoes!

I was a bit afraid of adding back all those simple carbs to my diet.  I've read for so long, and agreed, that those things are not good for us.  I had vilified those things in my mind to the point that I felt ashamed when I bought them.  I felt as though I should explain to those around me why I was buying these things.  I didn't and I ate them.

I've eaten toast with cooked apples on it for two days now, and loved it.   I drank tea with sugar rather than agave nectar. The sugar sweetened tea didn't seem as sweet.  In short, I've had more carbs both simple and complex (more fruit). in the last three days than I've had in I don't know when.  And nothing happened; at least nothing bad has happened..

I haven't binged.  I haven't wanted to binge.  I haven't had any cravings.  My mind has been on food a good bit, but it has been on the cost monetarily rather than the cost of it calorie or carb-wise.  I eat what we have when it is time and I move on.

A few good things have happened for both of us.  We've both lost weight.  We've both noticed that our natural hunger has returned.  When we have noticed rumblings, we have noted that it is time to eat.  Neither one of us are obsessing over what we can eat.  We're making the best choices we can with our food dollars and that is that.

We're just three days in so I'm trying not to celebrate too much too soon, but 65MD is talking about making this a way of life.  I'm not opposed; I'm just waiting until more time passes and we have fuller information to make the call.  So far, so good!

What I'm Doing Now

Nothing!  Not really but I'm not following a structured plan right now.  My intention upon returning from Guatemala was to get back on the meal replacement shakes.  Life intervened and I never got started.  Since the regain was falling right back off I decided not to tamper with what was working.

The hubs and I took a fall break trip last weekend and hatched a plan that we embarked upon today.  We are keeping our food budget to $270 for the next 30 days.  That includes food we buy at the store and food we already have at home.  The $270 figure is what we've read is the national average for SNAP (food stamp) recipients.  ($4.50 per day per person)

We feel like keeping our food budget so low will automatically limit what and how much we eat.  We won't be unhappy if we lose a few pounds during the process.  We are documenting this adventure on another blog.  Feel free to follow us there.  I will continue to update here as well, but not in the detail that we plan to on the other blog.

I'm excited to see where this path leads us!

What I Did in Guatemala

Since a couple of my faithful followers asked for more specifics about the trip, I'll share some in this post.  I've got good news on the weight loss front as well.  I'll share that at the end.

(The natives to the area where we stayed pronounced it more like WHAT-emala.  I thought this was a clever title but no one other than me would get it.)

I was on a medical mission trip.  It is a christian based trip but not restricted to one specific group.  In fact, one does not have to claim christianity to go, although most on the trip I was on were believers.  My sister, who is a labor and delivery nurse made a trip with this organization (Health Talents International)  several years ago. It was one of the most positive experiences of her life.  Her husband had passed away and she had been in a very dark place for a very long time with his extended illness.  This trip rekindled something inside of her that she sorely needed.  Ever since that time, I have been trying to make a trip myself.

 

HTI makes 10 trips per year.  She went in February and continues to go each February.  I have never been able to work out a February trip.  For a couple years, a group of ladies from where I worship have been going.  I was gladly welcomed as a part of that group.  This year there were four of us that traveled together.

We met about 50 other individuals from all over the country in Guatemala City and rode a bus about 3 hours towards the Pacific Coast to the clinic.  The clinic performs surgeries and gives other medical care on site and conducts remote clinics throughout the villages each day.  

The group consists of all types of medical professionals from surgeons to nurses to EMTs and even medical students.  Then there are the rest of us!  Those without medical training care for the patients before & after surgery by perhaps calming the children with a teddy bear or a warm hug.  It is not necessary to speak Spanish,  We had several translators along too.

I worked in the sterilization room with 3 men.  They had all been in there before and there was an easy camaraderie among them. They welcomed me into their fold and showed me all of the ins & outs of sterilization.  It is way more than washing instruments in antibacterial soap!  The instruments have to packed and wrapped in a special way and then finally sterilized in an autoclave, which is a giant steam oven.  We joked about 'cooking' the instruments and compared our cooking with Walter White's on Breaking Bad.

There were three ORs and we were allowed to scrub and enter if there were no instruments to wash.  I saw several surgeries and was quite fascinated by the whole thing.  Our bodies are amazing.  I went to one remote clinic and saw many more of the locals and got a better idea of what life is like there.  It is a simpler way of life.  Everyone seemed so happy.  It was a refreshing break from the hustle & bustle that so often surrounds us in our society.

Even with Montezuma's Revenge exacting vengeance on me, it was a good trip.  I learned a lot and am glad I went.

Since I have been back, I have been thrown headlong in to the hustle and bustle of life.  Being gone two weeks in such rapid succession left me with a pile of work to sort through.  That has been a good thing for me as far as weight loss goes.  I am less than 1/2 lb over what I was when I left.  

I have not tried to follow any plan, not even drinking the meal replacement shakes.  I've been getting up in the morning and getting to work.  When I feel the need to eat, I go get something, eat and get back to work.  I just felt like I didn't have time to put the energy in to following a plan.  I have good healthy food in my house so that helps.  I am happy for the weight loss, no matter how it comes, but even more grateful that it hasn't been a battle to get it off.  I'm hoping to keep this momentum going for some time to come.

The Trip

I got back from Guatemala over the weekend.  Much to my dismay and chagrin, I gained weight!  I knew I had, my tummy was really pooching out by the time I got home.  I think part of it was bloat because I spent a lot of time sick.  The tummy pooch came after I got some medication and returned to some modicum of health.

I gained almost 5 lbs while I was gone.  I've lost almost 3 so that leaves only 2 to get back to my pretrip weight.  Since the weight has fallen back off so quickly, I'm wondering if it was the medication.  I took it from Wednesday through the end of the trip.  

I really don't feel like I ate too much.  Let me explain how life worked down there before I get in to what I ate.  It was a medical mission trip.  We stayed on the same campus as the clinic in dorm style rooms, with a common bathroom for men and one for women.  There were sweet, local women that worked hard all day long preparing three meals each day.  Everyone was served the same thing, in a buffet style.  Our options were how much we served ourselves, if any.  It was a nice arrangement.

Meals were served at 7:00 am 1:00 pm and 7:00 pm.  No snacks unless you brought them with you.  I thought I would starve, but I was so busy (or sick) that I didn't notice getting hungry.

For breakfast most days we had eggs of some style, black or red beans, salsa, tortillas and fresh fruit, along with some fresh squeezed fruit juice.  I put the eggs, beans and salsa on a tortilla trying to make a breakfast burrito the first couple of days.  I got tired of that quickly, so I focused on the fresh fruit, which was usually watermelon or pineapple.  The one day they actually had omelets I was too sick to eat,

The other two meals were mostly chicken based with a rice dish and another vegetable also served with tortillas and fresh fruit.  We had steak one night, but I didn't get any because I was too sick to eat.  We had dessert at a few of the evening meals.  It was cake that wasn't frosted.  It wasn't hard to pass that by after the first try.

All the meals, even the ones considered "American" had a decided Central American flavor to them.  Most of what I had I enjoyed, and trying the new flavors and styles of food was interesting.  The only time I refused something was when I took a big drink of cantaloupe juice.  I hate cantaloupe!  I could not drink it at all.  As far as portions go, I watched the women around me and took portions similar to theirs.  I didn't always know what a serving was.

I left feeling well fed at each meal, but not over stuffed.  I liked not having to worry about what to prepare, how many calories, carbs, fat grams, etc were in the food.  Food was of minimal importance.  I ate when it was time and moved on to the next task.  It felt good not to fret about it.  I think that is the way it is supposed to be.  I hope that is a lesson of this trip I can take with me for the long haul.

A Quick Goodbye

I'm leaving for the airport at 4:30 in the morning.  I have a ton of stuff to do to get ready.  I am dreading this trip like none other so I've procrastinated on getting packed.  Even though this is a bucket list item for me, as 65MD had repeatedly pointed out, the timing could not be worse, IMO.  Losing our dog has hit us both very hard, harder than I think either one of us realized.  I don't want to leave 65MD alone, even though he has assured me that this it totally OK with him.

If you could spare a prayer for us during the next 8 days, I would really appreciate it.

BTW, I'm not going to make under 200 lbs before I leave.  I have a friend that is confident that I'll come back lighter.  I'm hoping to reward her confidence.  I'll check back in sometime after the 12th.

I'm Sad

On Monday we had to put our 16 year old dog to sleep.  If he had lived until today, he would have been 16 years and 8 months exactly.  He had a full and happy life with us.  In the past months, however, his health declined dramatically.  Over the weekend his legs stopped working.  We knew it was time to let him go.  However logical and reasonable that sounded to our brains, our hearts just didn't accept it.  

The vet came to our house and it was quick and very peaceful and the most gut wrenching thing I have endured.  I have never participated in taking another life.  I had no idea how devastating it would be.  It was the humane thing to do.  The vet supported the decision completely and opened her schedule to accommodate coming to the house.

Our dog is gone and now I am living with the aftermath.  I'll mourn for him for some time, and in time, I am sure happy memories will replace the heartache I feel now.

Why am I putting this on my weight loss blog?  Two reasons.  1.  It is real life and real life happens to all of us.  Stuff like this can't be sugar coated.  2.  I haven't used this as an excuse to eat.

Once we had buried our dog, 65MD offered to take me to one of my most favorite places to eat.  My stomach actually lurched.  Eating was the last thing I wanted to do.  We both needed to get away for a while, so we went to a neat little area near our house where we could sit outside and watch the world go by.  My appetite has not yet returned.  It will.  For now, I'm drinking my shakes and waiting for my heart to heal.

Travel NSVs

I had quite a few NSVs while I was out of town.  I want to share three.  I believe two of the three represent real growth on my part in making healthy choices.  The third is totally an ego stroke for me!

1.  One evening I was at the hospital with the whole family, when some friends dropped by to visit.  They brought with them two dozen Krispy Kreme donuts.   Of course, they offered the donuts to everyone there and I politely declined.  There are two things to know about this story.  One is, I don't really like Krispy Kreme donuts.  I like Dunkin' Donuts, I like Donut Den, I even like Entenmann's from the grocery store, but not Krispy Kreme.  So, on the one hand it wasn't that hard to say 'no.'  On  the other hand, I was hungry.  It was past the time I typically eat and my brother in law was about to go to the cafe for food for us when the guests arrived.  Of course, he stayed to visit and have  a donut or two.  Turning down the donut meant it would be another hour most likely before I had anything to eat.  I could have justified it, but I didn't.  I just toughed it out.

2.  When my niece got home from the hospital, she decided she wanted a milkshake from a local fast food place.  This is local burger & fries joint known  for incredible milkshakes.  My brother in law was, of course, going to get her a milkshake and graciously asked if anyone else wanted one.  I politely declined again.  This was pure reflex, or muscle memory!  I declined without going through that huge mental battle about wanting one but not needing one.  I was actually shocked when I realized what I'd done and then I had the mental battle.  It wasn't epic like the struggles in times past, it was more of a "Drat, I missed a chance for a milkshake.  I won't get that chance again for a while."  Then I decided it was OK.  There is more to life than milkshakes and I'd be fine.  I was.

3.  Finally, once my niece was settled on the couch with her milkshake, we began to watch the Disney channel and chat about who all had come to see her, brought gifts, etc.  When a promotional bit for Teen Beach Movie came up she suspended our chat because I needed to see what was on TV.  One of the female leads was singing a song.  She was a pretty young lady with long dark hair.  She was very well groomed and looked quite nice.  My niece exclaimed that she always thought of me when she saw this particular character.  I couldn't see it, and asked if it was because she was wearing red lipstick which is my thing.  She said it was but more than that.  She thought we looked just alike.  I pointed out that we had different hair color and she said that was the only difference.  I quit trying to convince her otherwise when she said something along the likes of "But look, she is just so pretty."  There's nothing like being seen through the eyes of love!!  There was nothing fat about that young lady.

Since I've been back, I've returned to the meal replacement shakes.  My goal is to get below 200 before I leave for Guatemala, on October 5.  My goal for Guatemala is to stay below 200.  Hopefully, I'll check back in with an update before I go.

My Travel Report Card

I am home from my trip and am glad to report that my niece continues to improve.  This is a long road for her.  Therapy could last as long as 6 months.  She's doing so well, that I don't think it will.  Thanks to everyone for showing concern for her.  Now, on to how this trip impacted my weight loss goals.

As of this morning, I have lost exactly one pound  from the day I left!  Of course the scales are only one measure of success.  While I am thrilled with a loss of any amount, I know that the scales are the part of this journey over which I have the least control.I  have always maintained that for me there are three areas I can control and if I am successful in those areas the scales will follow.  They are:

*What/How Much I Eat

*Adequate Water Intake

*How Much I Move

I've given myself a grade in each area just like a school report card.

Food

I stated going in that I was planning to eat whatever was served in moderation since I had no idea what would be required of me.  I knew that the church was providing food and that I had no control over what was brought.  I only had control over what I ate.

I was most impressed by those generous individuals that brought meals.  They all included fruits and green vegetables.  Every meal that was brought was made at home.  I was a little fearful of convenience foods, but there were none of those anywhere in sight.  I ate what I felt like were moderate portions at each meal.  

They also brought dessert, which is my nemesis!  I've already mentioned the butterscotch brownies.  I had additional desserts as well.  Again, I had moderate amounts.  I confess that I wanted more than I allowed myself.  If I had let myself, I would have polished off the brownies and several other of the goodies around.  I did not.

I felt like I ate like an normal average person.

For eating, I give myself a "C"

Water

The first day that I was there all day was Wednesday.  That was the day of the surgery.  It was chaos that day.  My 5 year old special needs nephew had seizures all day and felt bad.  We spent a lot of the day with him laying on me while I laid on the couch.  It was the only way he would calm and I was exhausted already so I did not mind.  The thought of water never even crossed my mind.  It was probably a good thing because I never would have had time to pee!!!  I was thankful that I didn't have to plan and prepare meals for my other nephew.  The second day the 5yo was much better and I was able to drink some water, but caring for him is a full time job.  He gets fed through a feeding tube every 4 hours, plus various medications are administered throughout the day.  On Thursday afternoon, my older nephew came home from school with a fever!  I did not get a full 64 ounces in any day I was there.  

For water, I give myself a "D"

Exercise

I did not formally exercise at all while I was gone, however, I contend that I got in a major workout every day.  On Thursday, I noticed that I was sore in my core.  I realized right away that it was from carrying around my nephew.  He weighs 30-35 lbs and had very little motor control  It is like carrying around a 3 month old.  He can't hold his head up for long, nor can he hold himself in an upright position.  He is non-verbal and is not ambulatory.  He can't use the potty either.  I got plenty of exercise picking up that little fellow and carrying him around the house.  My arms weren't quite a sore since I am used to carrying around a 20 lb baby girl.  She can hold her head up and keep her back straight.  It is amazing the difference that makes.  I feel the best about this area. Even though it was unstructured,  I got in a workout 24/7 for 5 days!

For exercise, I give myself an "A"

I think overall I did well and am pleased.  I had a couple of NSVs while I was there which I'll share in a later post.  

Very Quick Update

My niece's surgery went quite well.  I haven't seen her since the protocol is to spend the first night in ICU.  She is strong and should go to a regular room today.  I'll see her then.  In the meantime, I am taking care of my special needs nephew.  

I have not binged although I ate a butterscotch brownie yesterday.  It was homemade and warm from the oven.  That has been my only indulgence.  The meals have been provided by my sister's church and have all been good.  They are both tasty and not prepackaged.  I've been impressed.  I've eaten only normal servings.

I weighed on my sister's scales and am up a pound.  It could be just the difference in scales.  I'm not concerned about it.  I plan to really focus in hard when I get home next week.  Because it won't be long before I go to Guatemala!  I want to be in tip top shape for that.

Weekly Average

My average weight for this week is 202.0.  Not good.  Not going in the right direction at all.  That is an average gain of nearly a pound.  Here's the worst part.  I had a great week of eating.  I was on plan 100%.  I did not exercise enough to blame the old muscle gain thing.  So,here I am once again wondering what in the world happened.

I don't have a lot of time now to explore that either which is doubly frustrating.  I'm have a major deadline with work on Monday and I leave town early Tuesday morning.  My niece is having surgery on Wednesday so I'm going to help my sister and brother in law take care of their boys.  I'm really not sure how all of that is going to play out.

I'm going with the idea of eating small portions of whatever is served and moving as much as possible.  Other than that, I really can't make any concrete goals.  Prayers for my niece and her family would be much appreciated.  I'll likely not be back in touch until the week after next.

I hope to have good news to share.

In My Dreams? Really!?!

I've blogged before about my vivid dreams.  I had another one last night that I just had to share.

In my dream my extended family (aunts, uncles, cousins, nieces, nephews, sisters & brothers in law) were all attending a performance of some sort.  An aunt had made the arrangements and the rest of us were just showing up.  She had blocks of seats in a couple of areas at the performance hall so that groups of family would be seated together.  

I was the first to arrive in my section.  I don't know where 65MD was; maybe parking the car?  I sat alone in a group of seats that were more like bleachers than theater seats.  My space was far too small for my body.  It was uncomfortable.  I knew that 65MD was on his way and was hoping that he would not need as much room as he was assigned since I was spilling over in to it.  

As I was waiting, I struck up a conversation with a little girl seated nearby.  She was not a member of my family.    She was trying to guess something about me, which I cannot remember.  It was something like guessing my age.  Anyway, as she was gathering information to make her attempt, she asked if I was pregnant.  I told her that I was not, that I just had a fat belly.  I told her that I'd always had a fat belly.  She was astonished and asked if that was true even as a little girl.  I assured her that it was.  

That is all of the specifics of the dream that I recall except for how I was feeling during the dream.  I was happy to be at this event and glad to see my family.  My feelings changed when I could not fit in my space.  It was physically painful and embarrassing to me as I looked for a solution to my problem.  I was happy for the distraction of the sweet little girl.  She was innocent and was only seeking information not taunting me for my size.  Even as I told her that I was fat, I was enjoying the chat with the child.  In my dream, I was laughing as I told her I'd always had a fat belly.  It was akin to telling her that I'd always had green eyes or something similar.

When I woke up and recalled the dream that I began to wonder if there was something deeper going on in my psyche.  I'm not smart enough to truly ferret out these things.  Initially, I wondered why my subconscious had joined the battle of beating up on me for my body shape.  As I analyzed my feelings during the dream though, I was not upset at all with the child or her question.  I was upset about not squeezing in the seat.

So, perhaps it means I am making peace with the shape of my body, but not with the size.  Any other thoughts would be welcome.

Survivor Challenge

65MD and I bonded over Survivor 2, which was in Australia.  It is still my favorite season.  We watch it every season and create our own Survivor challenge during the 39 days the castaways are on the island.  Our best challenge was to drink only water for 39 days, no coffee, no tea, no cola, not even flavor in the water.  Plain water for 39 days was a bigger obstacle than either of us anticipated.   I think that added to the 'enjoyment' of the challenge.  (I put that in quotes because it wasn't so enjoyable at the time!)

So, as a new season is upon us, we are trying to decide how to challenge ourselves this time.  We've done the usual things that spring to mind, like no this or that.  This time we are considering upping our workouts while the show is on.  Since the contestants have to walk every where and have physical challenges every three days, it makes sense to us.  Plus, we need to amp up our workouts for sure.  

We're thinking of challenging ourselves to workout 39 times during the season.  It seems rather doable on the surface.  The season is about 13 weeks, which is 3 workouts per week.  But, the first week out, my niece is having surgery so, I'm going to be out of town for a week with her.  The first of October, I'll be in Guatemala on a mission trip for a week.  I'm not making excuses, I'm being realistic and recognizing that some weeks, I'll have to do more than three workouts to make up for the weeks I won't be able to get in three.  Then there is the unknown, injury or illness could happen to us.

Still, we accept the challenge.  We have a week before the premiere so we may tweak it a little more between now and then.  We're open to suggestions too.  I love it when my readers give me good ideas.

Thanks to Sharon for reminding me about averaging my weight for the week.  I started doing that last week.  My average weight for the week was 201.06.  Not good, but it is where I am.  The important thing is what I do now.  It seems like at this season of my life Tuesdays are my best blogging days.  I'll try to report each Tuesday what my average weight was for the previous week, and update the tickers.

Thanks to everyone for supporting me!

Yesterday

Yesterday was a day, I'd rather not blog about.  But with my renewed commitment to accountability to myself, I'm going to share.

Yesterday was one of those days that sort of exploded on me all day long.  Generally, I wake up in the morning with an idea of what I'd like to accomplish sorted by the stuff that must get done today and the stuff that would be good to get done today.  If I accomplish the must list, I've done a good day's work most of the time.  Yesterday, I worked my tail off all day long and at bedtime, I was reassessing the must part of my to do list.

I have a shake for breakfast within an our of waking.  I don't always want anything first thing out of bed, and if I have it within an hour, I still get the benefit of breakfast according to what I've read.  I could easily skip breakfast most days, and having these quick, easy and not too heavy drinks keeps me from doing that.  I know that it is bad for the body not to eat for long periods of time.  Yesterday, that didn't happen.

From the time I got up until about 2:00 pm, I was hurrying and scurrying all over the place.  I was able to help some family members that needed it and I was glad to do it.  If I'd realized how the day was going to play out I would have gulped a drink before leaving the house.  Even though I got back rather quickly from the first outing, there was no time for a drink before the next issue arose.  I stamped that down and moved on to the next issue and on and on until mid afternoon.

By that time, I didn't want a drink.  I knew 65MD and I would be having our evening meal before I would want to eat if I had the drink.  I don't want to start the practice of eating when my body isn't ready.  I've had a hard time breaking that habit and I was not allowing one little crack in that dam.  So, I grabbed a handful of dry roasted, unsalted peanuts on my way out the door to run what I thought was a quick errand.

I should have known better.  I had two stops to make that turned in to four.  Every place there was a long line and lots of waiting.  There was also food in three places.  I had none.  Even though, my stomach was growling, and I was truly hungry the options weren't good.  I'd rather not eat than eat the wrong thing.  I endured.  Oddly, I felt fine.  No headache, no shaky hands, nothing to indicate low blood sugar or anything.  I was able to keep drinking water all day.  

65MD and I had our evening meal as planned.  It was a nice chicken dish that  we enjoy.  Our evening was relaxed, and I went to bed early because I was sleepy!!  Besides, not eating anything except for peanuts and one meal yesterday, here is my problem:

Yesterday, when I got up I weighed 199.4, which was up 0.2 lbs from the day before.  I don't let minor fluctuations like that bother me.  That has to be water or the inaccuracy of home scales.  I note it and move on.  This morning, however after a day of near fasting, I weighed 200.0!  I think that seeing the '2' bothered me more than the gain.  While it is still a small amount, I'm not happy with it at all.

It is a bad trend.  I have to stop it and stop it now.  But how????  If not eating causes a gain, what is a girl to do?  Don't tell me not to weigh every day.  That does NOT work for me.  I start cheating the minute I get off the scale thinking I don't have to weigh again for a week or whatever.  I have to have the accountability of a daily weigh in.

Now, I'm wondering if I've really screwed up my metabolism.  I just got a clean bill of health from my doctor.  I'm still on the vitamin D, which suppresses the appetite and is another reason I was able to forgo food most of the day yesterday, so I don't really think it is my metabolism.  What is it????

Today, I've been 100% on track with my meal replacement shakes and water.  I have my evening meal planned and I am expecting great things tomorrow.  We shall see.

Disappointed

I am disappointed in myself.  I posted a gain during the month of August.  I'm not happy at all with that.  I thought the meal replacements were just the thing.  Maybe they are.  I'm not giving up just yet.  Since August 12, I have lost exactly 2 pounds.  As I noted last time, I've been yo-yoing ever since.  I had a big birthday and indulged.

Thursday is 65MD's birthday and a week from Wednesday is our anniversary.  I will not use those events as an excuse to eat badly.  I have got to get with the program and stick to it for it to work.  That means, I've got to make some changes.  The changes besides sticking to the program include changes in the way I blog.

I've discovered that, when I'm not doing well, I avoid blogging.  When I do blog, I don't mention the bad parts.  It is in my nature not to focus on the bad parts of life, so it isn't a conscious decision to be deceitful.  Still, I've not painted a clear picture of my struggles in weight loss lately.

Beginning now, I have a new ticker.  It will measure my weight loss with the meal replacements.  I started it at 201.2 and has my current weight of 199.2 listed.  I put the goal weight on this as 165 since that is what my doctor recommended initially.  (I'm still wanting 145.)

I am leaving the 'old' ticker up since I want to see my progress from the beginning to my ultimate goal.  I think seeing the 50+ pound weight loss on it, makes me a little complacent.  I don't want to forget how far I've come, but I can't stop there.

I will update both tickers weekly.  I will blog about the whole picture.  It may get boring.  It may get ugly.   It may not make sense to anyone but me.  This is my blog, and I'll do what works for me.  Thanks for joining me and supporting me on this roller coaster ride!

Fabulous Birthday

I had a wonderful weekend with family and friends celebrating me.  Who wouldn't love that???

I worked my plan at each gathering as I planned almost 100%.  I adapted a couple of times and I feel good about the choices I made.  Even though, I made a substitution here & there, I did not eat more than planned.  I even left part of a dessert that wasn't doing much for me.  I never thought I could do something like that.  Leaving a vegetable that isn't the best?  Sure!  No problem there.  But leaving a cookie?  I don't think so.  Somehow, someway, I managed not to eat all of it.  

To be totally honest, I ate more than I should have after I realized I really wasn't wild about it.  It was definitely a "don't be wasteful" attitude, not an "I can't stop" attitude.  I offered it to 65MD who didn't want it so I finally covered it with a napkin, so it wouldn't taunt me with my wastefulness.  Whatever works, right???

To be clear, I had three celebrations in three days, and I gained back all of the weight I'd struggled to lose, even though I was diligent about my choices.  I kept things very low carb with only one treat per party.  I happened to mention this weight gain to a nurse friend who insisted that was not possible.  She went so far as to say that my scales were broken.  I never considered that.  I think it is water and with a few days of closely following my meal replacement plan, I'll register a loss.

I'd rather not have gained the weight back, however, I am content with the choices I made.  It was a special birthday and I think I would have felt deprived if I had been too strict with myself.  Losing weight is a long term goal and life continues to happen.  I'm going to make the best decisions I can with the choices I have in front of me.  

BTW, I got a Leslie Sansone Walk from Home video.  I'll be adding that to my workout routine.  Thanks Staci for the suggestion.  I also got Richard Simmons Sweatin' to the Oldies.  Even though it was a gag gift, I'll gladly give it a whirl too.

Progress Report and Weekend Plans

I'm doing fairly well with the meal replacement drinks.  I have incorporated it in to my lifestyle much more easily than I had anticipated.  It is so much easier to shake up a drink a couple of times a day than it is to count everything for every single meal.  So far, I haven't gotten bored with the drinks.  I'll throw in a banana or some frozen blueberries for a change.  The other day, I put peanuts and ice in the blender with the powder and it was fabulous.

It has been the simplicity that I was craving so.  I am thankful for it and at this point see no reason not to continue for some time to come.  I have lost 2.2 lbs in 12 days.  While that sounds good and is right in line with my weight loss goal of slow and steady one pound per week, it isn't the whole story.  I lost that weight in five days.  For the last seven I have yo-yoed about half a pound.

I thought I was just experiencing the 'honeymoon' phase of a new program.  I tried not to get excited about it, knowing that it would slow down in time.  Little did I know how quickly the slow down would come and how I'd have to dig deep to be OK with vvvvvvvvvvvvvvveeeeeeeeeeeeeeerrrrrrrrrrrrrrrrryyyyyyyyyyyyyy slow loss.  I really think I'd be happier with a plateau than and up and down thing.  I don't know.  I might experience that and decide I like this better.  To be completely honest, I was hoping for a big drop initially.  It wasn't to be.  I've been on the weight loss wagon too long to have that happen.

Regardless, I am sticking with this plan for a while longer.  It will certainly help me navigate the minefields ahead.  This weekend is my birthday and the celebrations start tonight.  It is a biggie.  It is a two digit number and the last digit is a zero.  I'm not revealing my age, but I will share that I will be 10, 20, 30, 40, 50, 60, 70, 80, or 90 on Sunday.  LOL!!  (Don't guess in the comments either.  I'll be upset if any of the guesses are too high!)

I have a celebration tonight, tomorrow night and Sunday afternoon.  (Believe it or not, that still doesn't include everyone that wants to celebrate with me so we're planning another party for late September.  I am blessed to be so loved.)  I know the menus for each gathering and know what I will eat.  Another huge blessing is that my family is totally supportive of my weight loss efforts and won't try to foist anything on me I don't want.

I hope to be back in touch on Monday with an excellent report of how I kept to my eating plans this weekend and had a blast anyway.  The parties are not about the food.  They are about love, family and friendship.  Happy birthday to me!!!!!!!!!!!!

A Sudden Thought

Since my previous post was about my change in mindset and how I hardly gave food a thought I'd share what happened yesterday to demonstrate how quickly things can change.  Yesterday afternoon 65MD and I found ourselves with too many obligations and too little time.  We decided to divide an conquer.

We parted ways, with an agreement to contact each other if we were going to be gone more than our anticipated time.  I had hardly cleared the driveway when the thought popped in to my head that I should stop at the store for some candy, Mounds to be exact.

The thought came totally out of the blue.  I wasn't hungry.  I hadn't seen an advertisement for that particular candy, nor was I near a store.  In fact, going to the store was on 65MD's list.

It was a bit unsettling to have that thought pop up for no apparent reason.  I tried not to panic over it.  I simply told myself that wasn't an option and continued on my way.  There was no epic struggle to stop or not.  I just didn't.

Here's the funny part.  I got home to find candy on the kitchen counter.  Luckily, it wasn't Mounds but York Peppermint Patties.  If there is one candy I do NOT like it is that particular brand of peppermint and chocolate.  The mint it too strong and the chocolate too mild.  

I had to laugh when I saw that.  It was definitely an impulse buy for the hubs.  He's not a candy sort of guy generally.  I asked if they were for a purpose and he said they weren't.  He just thought it would make a nice sweet treat every now & then.  He can do that.  He can leave that candy on the counter for weeks and only have some every now & then.  (I can to for that candy but  not most others!)

He offered to take it to his office so it wouldn't torture .me.  I said that wasn't necessary that it would not tempt me in the least.  It sits on the kitchen counter right now, unopened, right where he left it.

That is another NSV for me.  I'll celebrate it without getting egotistical about it.  I know I still have many battles ahead.  I won't win them all.  At least I got this one!

Home Alone

This week marks the beginning of a new academic year for 65MD.  That means he has stepped in to a whirlwind of activity, including faculty meetings, seminars, social engagements, syllabi and the like.  I will get glimpses of him during the next couple of weeks, but I will be largely on my own.  As an introvert, I'm OK with that.  

I have spent the last two days alone from the time he left in the morning until 8:30 or 9:00 pm, with the exception of dropping by to change clothes for the next event.  Again, I'm OK with it.  I do feel badly for him that he has such a full schedule right now, but for me I'm fine.

Last night, I realized how much my alone time has changed through the years.  I've always been content with solitude, but the way I've spent that time has changed a lot.  Before I began this journey of weight loss several years ago, I really looked forward to this time alone so that I could eat.  I would think for days about what I would prepare or what I would get at the store to eat while I was alone.  I don't know why I behaved like that, but somehow being alone was free reign to eat like a pig.  I would actually be disappointed that I couldn't really binge like some people could.  Otherwise, I was 'happy' as could be with my feeding frenzy.

After I started actually losing weight and this time of year arose, I'd panic.  I knew that I could not/should not eat like I had been.  I'd seek out things to do to keep myself occupied so that I wouldn't slip back in to the old habit.  Sometimes, I'd fast.  That way there would be no option to pig out.  That was a hard place to be.  It was where I was on the journey, and the right thing to do as far as breaking old habits.  It was still hard, and maybe even a little over the top with the fasting.

Now, it has changed once again.  Now, I hardly gave what I was going to eat or not eat a thought.  There were certainly no plans to go stockpile food to eat when no one was looking.  There wasn't the need to go to the other extreme either.  Partly due to the meal replacement plan I'm on now, but even more so, I think there has been a change of mindset.  I had stuff to do, as is always the case when working from home.  I just did it and ate when it was time to eat.  It wasn't hard.

I know that there is still a long road ahead of me and a lot left to learn.  But, I am stopping now to celebrate this victory.  Small changes over time grow in to big changes.  It isn't always easy, in fact, most of the time it is hard.  It is worth it to wake up one day and see positive changes.  I'm sure that if I keep trying, I'll find the right plan for me and the weight will dribble off.  I'm not setting any specific goal other to weigh less from one week to the next.  I can do that.

What I'm Doing Now

I started journaling as I said I would in my last post.  I decided to eat as I typically would and not censor myself since I was writing it down.  Otherwise, it would be useless to use the time and energy.  Of course, in typical fashion, I decided not to only record what I ate, but also the time and how I was feeling - hungry, anxious, angry, etc.  That would be a useful tool.  But since I am rebelling against weighing and measuring my food, it wouldn't be as useful as it could be.  I also jotted down what I was doing when I decided to eat.

I created a monster that I could not sustain.  Not even for the weekend.  The fact that it was so cumbersome would have kept me from doing it long term, but I think I would have continued more than a few days if my weight had not shot up like a rocket to Mars!  Something had to change and something had to change fast.  

Yesterday, I started a meal replacement plan.  Yes, one that I said was not sustainable.  I still contend that it is not.  It is not something I can do for the rest of my life.  It is, however,something I can do now.  

A friend gave me this protein powder to mix with water some time ago.  I put it away and forgot about it.  I ran across it over the weekend and thought I'd toss it.  Then I saw that the container was almost full and it seemed too wasteful.  

65MD and I talked about it.  We agreed that I will do the protein drinks until I run out.  I think it will be at least three weeks, maybe a month.  He is back in school now and generally the only meal we share together is the evening meal, so this won't interfere with his lifestyle as much as other 'programs' have.

I'm hoping by the time I've finished what I have on hand, I'll have a clearer idea of how to proceed.  It could be that I get more protein powder and continue this plan.  I'm keeping all of my options open at this time.  The scales finally registered a loss this morning, so I'm content for now.

I Need Help

This moderation thing isn't working.  Maybe a more accurate statement is I'm not working the moderation.  Deep inside of me I know that this is the right way to go.  I know that it is not healthy to eat no carbs for long periods of time. Eating meal replacements is not a sustainable life style for me.  

I eat clean.  I eat vegetables from my little backyard garden.  I supplement that with purchases from farmers market.  I eat very little produce that is from an unknown source.  

The beef I eat is local, grass-fed organic beef.  I haven't found a good source for chicken yet, so maybe that is my problem.  We also have some fish and pork.  I've never worried so much about the protein since in most eating plans it is allowed.  I don't fry anything.  We grill, roast and broil almost exclusively, and mostly grill.

Bread, anything sweet, and white potatoes are rare indulgences.  We eat out once a week or less.

I drink enough water to drown a fish.

I admit to a few more indulgences while my family was in town.  They're gone now, so it is time to get focused again.   While they were here, my weight yo-yoed with the treats.  That seemed reasonable.   Have a treat one day and see a small uptick.  No treats the next and the scales would go back down.

As of Monday afternoon, life was back to 65MD and me.  We agreed that the indulgences were over and we were back with the moderation plan.  For us that means low carb, with the carbs coming from fresh fruit.  I fully expected to see the scales begin to tick down again.  I thought it would take a while to get back to the pre-visit weight, but I thought I'd see progress.  The last thing I expected to see was a gain.  I'm not talking about a little uptick either.  I'm talking 3 pounds.  It isn't right.

Something is wrong.  People don't eat the way I believe I do and gain weight.  Some where some how, I am lying to myself.  I have a big blind spot some place where I am messing up.  As much as I hate to start counting and measuring again, I am going to have to keep a food journal.

I am going to keep a little notebook with me at all times.  I am going to write down every bit of food I put in my mouth  until I figure out what the problem is.  This is not giving myself free reign to eat whatever I want whenever I want.  This is a tool to open my eyes to a problem, a big problem.  Once I have an idea of the problem, I'll fix it.  

I can't live like this anymore.  This is harder than any program I've ever done.  I hate this limbo.  I hate thinking I am doing the right thing only to get slapped down.  It isn't just the scales being wonky.  My clothes aren't fitting well.  I don't feel spunky.  I need help!

Side Effects

I got a letter from my doctor over the weekend confirming my excellent health except for one quite surprising thing.  I am severely deficient in vitamin D.  So far as I can recall this is the first time that has been measured.  I feel like I am outside much more now that I work from home than I was when I was confined to an office all day.  I looked up the symptoms on WebMD and had none unless the mental cognition part counts!  LOL!! Makes no sense, but it is true nonetheless.

The treatment is mega doses of vitamin D.  My doctor had already sent a prescription to my pharmacy for it.  I started Sunday.  I take one every week for 10 weeks, then I get my blood checked again.  I asked the pharmacist about sun exposure and she said not to worry about it.  I lamented that I needed a beach trip, to which she readily agreed.  

Of course, I read through the literature that came with it to make sure I took it properly as in with food or without, and the like.  There was nothing like that other than a warning to stay away from magnesium.  I've got that one covered!!

Then I read the list of side effects.  One of them was decreased appetite.  I immediately began wondering just how much weight I could lose during this 10 weeks.  Perhaps, I would actually make my pound a week goal.  Or maybe with a little more effort two pounds per week.  After all, opportunities like this don't come along every day.

I kept reading and saw that irritability was another side effect.  Of course, I pointed this one out to 65MD right away and began building my case for free reign for the next 10 weeks.  We had a good laugh and now I am back to reality.  So far, I've not noticed anything different.  If my appetite does decrease, I'll be very thankful and use it to my advantage.  If not, which I believe is the greater chance, I'll keep practicing moderation and enjoying life only now with stronger bones.

Doctor Visit & Monthly Stats

I had an excellent visit with my doctor yesterday.  He pronounced me healthy and said he didn't need to see me again for a year.  He is actually trusting me to lose weight without checking up on me regularly.  That felt great to me.  We had a nice discussion about weight loss and the issues surrounding it.  We agreed that I know what to do.  All I need to do is actually do it.

He very much discouraged the 10 minute trainer by Tony Horton.  He really subscribes to the moderate way of thinking in both diet and exercise.  He encouraged daily walks of 30 minutes or more.  He went on to say I didn't have to do all 30 minutes at once.  This is quite doable for me. 

It is almost too easy.  Almost to the point where I feel like I can just do it any time.  I know better though.  I know that as simple as it sounds, I must make deliberate decisions about what to eat, how much to eat and how much to exercise.  

The hard part will be adjusting my expectations.  The moderate approach, I believe is the best for me at this time.  But the results are slow.  I need to keep that in mind as I make my choices.  If I can do this anytime because it is so simple.  I need to do it now.  Putting it off will only make it more difficult.

Slowly, slowly meal upon meal, day upon day, I will make the healthy choice.  Slowly, slowly week to week and month to month, I will see the results.

Now for the July stats.  My weight and measurements remained flat month over month.  I'm trying to make this a good thing since I really let go of any formal eating plan during the month.  I'm having a hard time with that concept because I did gain weight during the month.  I want to beat myself up for that.  I tell myself that I've wasted time and if I'd not spent all of this time relosing the weight, I'd be happily posting a loss rather than trying to put lipstick on a pig!

  I have a year before seeing my doctor again.  That is 52 weeks.  That is less than a pound a week.  It is the slow progress that wins.  The tortoise and the hare.  I'm learning to be the tortoise.  I will get to the finish line.  I can do this.

Here I Am

Most of my family was in town last week.  Some went back home yesterday and everyone else will leave on Monday.  My long term readers know just how much I love my family and how my world revolves around them for the week or so they are here.  So, I have been very busy having fun since I last posted.

I've been practicing moderation lately with regard to my eating.  I think I did well most of the time.  I ate what was served in normal sized to even small portions.  I ate peach cobbler and mashed potatoes, but only small servings and no seconds.  In fact the peach cobbler was a little tart and I never ate any more after my initial serving.  I could have done better though, I could have stopped eating after I decided it wasn't the best, but that seemed wasteful.  Stopping is the next hurdle I must overcome.

There were times during the week, that my niece would mention that she was hungry and I'd realize I was too.  We would be so involved in whatever activity, that I wouldn't be thinking about food at all.  In these situations, I would think that perhaps this is how 'normal' people relate to food.  They just go about their business, realize they are hungry, eat and then go back to whatever they want.  

It was freeing.  I really enjoyed this time with my family since I wasn't obsessing about food all of the time.  There was no pushing food on me either.  It was a nice easy going time.

Lest, I leave the wrong impression however, I did GAIN weight this week.  I know that I had too many indulgences.  At my goal weight, it might be OK, but not now.  Not while I am actively trying to lose.  The treats are gone so they are not here to tempt me.  I am fully back on the healthy choice wagon now with my food choices.

 I did not drink enough water all week.  It wasn't on my radar. Today, I have made that a priority.  And I have already seen the results.  I'm flushing out that excess water.  I have read from more than one source that if a person isn't taking in enough water that person will retain water.  It must be a survival mechanism that kicks in.  I'm getting plenty in now, and my body is regulating itself.  LOL!!

Finally, I did not do any formal exercise.  I did move a lot more than typical though.  Most days, I spend several hours a day at a desk.  Not last week.  We played games and moved a lot, so I feel like that part evened out.

Speaking of exercise, I'm investigating Tony Horton's 10 Minute Trainer.  Has anyone got any input to share with me on that?  He's the guy that did P90X.   Even though that sent me to the doctor, I'm thinking this might be OK.  There is not as much kicking.  I'm going to see my doctor tomorrow.  I plan to ask his opinion too.

Guest Post

Recently, I was approached by Jen asking to do a guest post.  She works in an office specializing reconstructive surgery after weight loss.  It seemed like a good fit; something my readers might like to know about, since I've discussed it on this blog before.  Enjoy her post, while I enjoy a little more free time.

Loose Skin Blues

Massive weight loss is a huge decision, most of you reading have either gone through a massive weight loss or are contemplating going through a massive weight loss. One of the most common hesitations in losing weight is the resulting loose skin that occurs once your body has gone through a significant weight loss. It is common knowledge that losing weight = loose skin. Loose skin not only occurs with a massive weight loss but also with natural body occurrences such as pregnancy. This is because once your body stretches through weight gain or through pregnancy; your skin loses its elasticity. I work for a medical reconstruction and cosmetic surgery practice in Kansas City, here our surgeons see many individuals on a day-to-day basis that have these exact concerns. First they come in to talk about weight-loss and bariatric surgery, how it works and your results. Many patients, however, decide they want to go the less expensive and natural way by strict diet and exercise but are concerned about the loose skin. Our doctors always tell patients to be realistic, being healthy is far more important than having loose skin. Even when you have loose skin after weight- loss there are ways to remove it such as tummy tucks. The loose skin, although it may not seem like it, is a proud reminder of how far you’ve come and if you take that extra step to remove the loose skin, your body will be an entire trophy dedicated to yourself. In this post, we will see why and where that extra skin came from and how to reduce or remove it.

How We Burn Fat

As we all know, matter cannot be created nor destroyed, so when you exercise and diet fat is not simply “disappearing” off your body. What occurs is a form change, just like water and steam. The glucose and sugar that is harnessed from carbohydrates are the first fuel sources. Once the glucose runs out, fat takes over. Your body is a constant interconnected conveyor belt that removes essential nutrients from the fat and delivers them to specific body parts. Hormones that regulate our blood sugar levels activate an enzyme in fat tissue called lipase. Lipase ignites fat cells to release triglycerides, which is what makes fat cells fat. When they receive a signal from lipase to exit the fat cells, the triglycerides break-up into glycerol and fatty acids and then enter the bloodstream for use in your body. The process of breaking down triglycerides into reusable energy is called lipolysis which is shuffled and reshuffled to produce heat, water, carbon dioxide, and ATP. Since the fat tissue has lost some of its components, the cells shrink.

Why the Extra Skin?

When fat tissue is worked and the cells shrink, wouldn’t it make sense that your skin would shrink as well? Yes and no. In the cases of moderate weight loss, skin can certainly shrink back to fit the body’s new size because of its elasticity due to collagen in the skin. However, collagen does have its limits. Collagen fibers weaken with age and results in wrinkles. Rapid growth or weight gain also outpaces collagen production in the skin causing areas to over-stretch, leading to stretch marks commonly seen in pregnancy and adolescents going through puberty. In cases of massive weight-loss, the skin that has been stretched has lost its collagen strength making it very difficult if not impossible for the extra skin to shrink back to its former shape. Those undergoing gastric bypass surgery or bariatric surgery feel this pain. As the number of patients going through weight loss surgery increases, so do corrective surgeries for the unwanted and uncomfortable skin. This extra skin can actually be a serious problem and can actually cause infections, rashes and even back problems.

Treatment Options

The most important determinant of how much loose skin an individual will have following weight loss is their age. Younger patients tend to have less loose skin than those who are older because of the strength of collagen in your skin. The next most important factor is the amount of weight loss. An individual who loses 200 lbs. is more likely to have excess skin than someone who has lost 80 lbs. There are other factors of who is more likely to have loose skin such as smoking, sun damage and skin color.

-          Exercise: Exercise that includes increasing muscle town can tighten connective tissue. For patients who have undergone bariatric surgery are recommended to add a regular exercise regimen that is helpful to maintain ones weight and can also serve to tighten  loose skin to some extent.

-          Losing weight slowly: Your skin has already lost its collagen from either age or being stretched to its max. By losing weight slowly the loose skin from each pound of fat burned has more time to shrink itself back. This will only be noticeable by small measures and the amount of loose skin shrunk depends on the individual.

-          Body Contouring Procedures: For those that are losing 80 lbs. to over 100 lbs. surgical procedures are available to tighten skin and remove the extra pockets of skin that inhibit your body from being as toned and tight as the individual would like. Below are the most common procedures for massive weight loss patients.

Abdomen, Thighs and Buttocks- The abdomen is usually one of the greatest concerns for individuals following massive weight loss. In both men and women, excess fat is stored both in the abdomen and beneath the skin of the abdominal wall. Consequently following weight loss in those areas, extra skin appears. Large amounts of hanging skin can lead to the collection of moisture between the skin folds resulting in a condition called intertriginous dermatitis, which leads to irritation, redness and pain. Occasionally, the skin may even breakdown, bleed and become infected. With proper documentation, many insurance companies recognize this problem and provide full coverage from surgical removal through a tummy tuck or abdominoplasty. The abdominoplasty will solely remove the excess skin from your stomach which is ideal for women following pregnancy. However, for those who have undergone weight loss surgery or a massive weight loss, excess skin is not limited to the stomach but also results in the buttocks and thighs. Because of this, surgeons will perform a procedure specifically for weight-loss patients called a body lift. This involves an abdominoplasty, thigh and buttock lift all at one time. This addresses and removes loose skin and cellulite along the thighs and buttocks as well as the abdomen. Although the resulting scar is lengthy, it is confined to the waistline and is hidden by underwear, panties, or a bikini.

Breasts- Following a great weight loss, breast size and shape often change significantly in both men and women. Everyone worries about sagging breasts as we age but few know that massive weight loss greatly accelerates the process. As women advance from girls to teens to twenties and into their later years, the glandular portion of breasts is replaced by fat. The original glandular tissue is significantly more firm than fat and consequently the skin becomes unable to retract completely and produces severely ptotic or sagging breasts. This is called breast involution. There are many treatment options for women following weight loss. If a woman desires less sagging and wants to be larger, a breast lift or mastopexy is needed. Again, surgeons will tell you your options and also remind you to be realistic with or breast augmentation may be satisfactory.  The problems in men are similar however treatment is slightly different. Men tend to have larger breasts when over-weight. Depending on a man’s age, degree of weight loss, and a few other factors he may result in large breasts, large and/or sagging breasts, or satisfactory breasts following weight loss. Large and/or sagging breasts in men is called gynecomastia. Here liposuction alone may be satisfactory, however this is not typical. Most men with both sagging and large breasts go through a two-staged procedure. The first stage is liposuction and is performed to remove excess fat and some glandular tissue. Over the next few months, the breast skin will retract slightly. Three to six months later, the patient will return to evaluate the situation and determine if the outcome is satisfactory. Delaying the second stage allows for significant skin retraction and if a skin tightening procedure is desired it is likely to require smaller incisions.

The Bottom Line?

Being healthy has far greater importance than excess skin. Although, having excess skin can lead to some serious issues there are non-surgical ways of preventing infections such as keeping your excess skin dry. For those who are able and want to remove the excess skin, it is important to remember that these procedures should only be considered after ones weight has stabilized; especially after weight loss surgery. This can range from 7-18 months after weight loss. The most important factor in finding a plastic surgeon who can perform these procedures is that they must be board certified. If your plastic surgeon’s website or office does not advertise that they are board certified you must RUN! For everyone who has heard horror plastic surgery stories, this is probably where it started, having a surgical procedure done without a board certified surgeon. Use ASPS (The American Society of Plastic Surgery) to find a board certified surgeon near you.

Post written by: Jen is a writer for a medical reconstructive and cosmetic surgery center in Kansas City. She has two kittens and loves to write about all things beauty, women, health and fitness! She spends her days outside and at the center where she learns as much as she can from the board certified surgeons. This plastic surgery center specializes in breast augmentations and breast reconstruction.  Jen also has a personal blog Littlefurrymusings.tumblr.com where she writes about all kinds of things that she thinks others would enjoy.  

Typhoid!!

I am planning to go on a mission trip in the fall.  Last week, I met with my doctor to discuss the needed immunizations since some take time to become potent.  We started the injections that day.  I got two hepatitis shots and a prescription for an oral typhoid vaccine, which I started the next day.  (The pharmacy didn't have that in stock, go figure!) I'll go back in a couple more weeks for more shots.

Both my doctor and the pharmacist discussed proper dosing and potential side effects of the medication.  But, I still had no idea!!  I was told 'fatigue' along with some other things like headache, upset stomach and the like.  All of which I thought were typical side effects of just about anything.

The typhoid vaccine is four doses administered every 48 hours.  A few hours after the first dose, I noticed a headache and felt very tired.  I realized what was going on and took some Excedrin for both symptoms.  I functioned pretty well and 48 hours later took dose number 2.  Again the same symptoms appeared but this time with a little more ferocity and did not go away as quickly with my old favorite Excedrin.

By the fourth dose, I could hold my head up but I didn't want to.  I sat most of the time with my head leaning back against something.  I won't discuss the other issues except to say that my digestive system was upset.  Needless to say, no weight loss happened during this time.  Even with the digestive issues, I'm sure being so sedentary burned very few calories.  My weight is up slightly.  It should fall right back off now that I've finished the regimen.

I am now, or soon will be, immune to typhoid for 5 years.  Now that all of that is over, I can get back to the business of weight loss and blog about it again.  

Musings on Moderation

I believe moderation is a good thing.  I am not very good at practicing it.  When I'm in to something, I am all in.  When I am excited about something, it is my primary topic of conversation.  When I don't care for something, I avoid it completely.  Extending this mindset to weight loss, I'm either on a 'diet' or not.  In trying to practice a little more moderation in all areas of my life, I have come to some realizations in the weight loss piece as well.

Mainly, that my goal now is to lose weight.  Silly isn't it?  Not exactly.  I am not setting a goal to lose two pounds a week, or even just one pound per week as I understand many physicians are touting now.  Nope.  My goal is to lose weight from one week to the next no matter how large or small.

This change in mindset did not come about overnight.  Although, I have wanted to moderate in my weight loss efforts for some time, I was afraid to.  I had an event coming up and couldn't risk it for one.  But mostly my all or nothing thinking had me concerned that if I loosened up at all, I'd just pig out.  

So, I began to think about my likes and dislikes in food and eating plans.  I also began to think about my lifestyle and what would be reasonable.  Some of my conclusions:

• I grow weary of counting stuff.  No matter what it is.  I don't want to weigh and measure every bite and decide how many points, calories, carbs, fat grams, etc are involved.
• Counting stuff feeds my perfectionistic tendencies, if 1200 calories is good, then 1000 is better, and 800 would be even better.
• My household at this time, seems to have a revolving door of guests.  This is a good thing and a goal for which 65MD and I have longed for some time.  It is not, however, conducive to strict eating plans.
• Right now, I have no major events on the horizon.  No weddings, graduations, etc for which there will be pictures made.  The closest thing is my birthday in August.
• I know what good food choices are and are not.
• I believe I will be happy with a slow loss.  (I think a slow, steady loss will be faster in the long run, since I bounce up and down the scales so much.)

I have decided that my eating will center around lean protein and green vegetables.  That won't be hard.  I eat that way most of the time now.  I will allow myself one fruit per day, but harking back to my issue with counting stuff, I'm not going to be militant about it.  If there is watermelon in the house and I want more than a cup, I'll eat it.  White bread, white potatoes and other starchy vegetables will be severely limited.  There aren't many of this type of food in my house anyway.  Sweets will be limited to special occasions only, like my birthday in August.  I'll continue to drink water.  I like it so that is almost a non-issue.

I will monitor my weight closely, at least in the beginning to ensure that my plan is working.  I've been doing this since July 1.  So far, I've lost 0.4 lbs.  I think this is the right thing for me.  I feel like I am ready to relax the rules a little bit and get on with life.  I probably needed the strict parameters for this time to develop better habits.  I'll know soon enough if that is true.