21 February 2021

First Blood Tests Post-Surgery: Result!

When I began this blog, I wrote about a health scare that jolted me into taking action about my weight: I had an elevated fasting glucose level. It wasn't diabetes, but it was considered the "pre-diabetes" range.

A fasting glucose level of 7 or higher on two consecutive readings spells diabetes.

Since 2017, my fasting blood sugar readings have been between 6.3 and 6.7.

(US readers: 6.3 equals approximately 113. 6.7 = 120. The best conversion site on the internet can help! Or here's a conversion chart.)

This terrified me. I already have more than one chronic illness that requires a lot of maintenance. I can't even think about having diabetes on top of that.

I used this fear as motivation to change my eating and exercise habits, as best as I could. I drastically changed and reduced my diet, so it more closely resembled how I ate when I was much thinner.

No result. 

I also started taking supplements that are supposed to reduce blood sugar.

No result.

My frustration with this, and my seeming inability to control my hunger and stop gaining weight, led me to research bariatric surgery.

So. This week I got the results of my first bloodwork since surgery, at the three-month mark. 

Fasting glucose: 5.4 (97.2 US). Normal.

Another relevant test is the Hemoglobin A1c (HbA1c), which measures blood sugar over time. Health Canada considers a fasting HbA1c level of 4 to 7 (72 to 126 US) normal. Mine was 6.4, is now 5.9.

My liver enzymes have been elevated since around 2007. Normal ALT levels are between 10 and 55. Mine was 98, now 21. 

I was so happy to hear this!

All other readings were normal, except certain vitamin levels were very high. I am taking all the supplements recommended post-bariatric surgery, but because I'm also eating a very healthy diet, I can lower my supplement levels.

Every doctor, both when I had the surgery and with my follow-up, has said that I will no longer need cholesterol or blood pressure medication. That is typical of people post-bariatric. However, I don't expect this to be the case for me. I've had high cholesterol my entire adult life, including when I was thin, and when I was a vegetarian. 

Similarly, my hypertension (high blood pressure) has never responded to diet and exercise. My mother and my sister have the same, and they are both very slim and get a lot of exercise. My hypertension appears to be genetic. My doctor suggested continuing to monitor my blood pressure, and to note if I feel any symptoms of low blood pressure, and we could try lowering the dosage.

I'm so pleased about this and actually looking forward to my March 1 weigh-in.

13 February 2021

Feeling Really Well: Increasing Daily Calorie Target Range and Allowing Myself a Mid-Month Weigh-In if I Want One

I am feeling really well! 

You may recall, I had a little freak out a couple of weeks ago (here, here, and here), and with the help of friends and readers of this blog, and a meaningful session with WRD, I was able to get back under control. 

Now it feels like that little earthquake threw me into a new place. 

I'm ticking off all the boxes on my healthy habits checklist almost every day, and days when I can't or don't, I can accept it: 85% thinking.

I increased my daily caloric range by 100 calories: from 1000-1300 to 1100-1400. This slight adjustment makes it much easier to stay within the range every day, which means it's probably what I need. 

WRD suggested I de-emphasize the calorie target in favour of mindful eating, but I don't feel ready for that. I still feel the need to track my food daily, and that means checking portion sizes, grams of protein, and calories. It's like wearing a seat belt -- a simple act that takes very little time and keeps you safer. I'm still working on mindful eating (driving under the speed limit?) (enough of this metaphor), but tracking my eating decreases my anxiety, increases my peace of mind.

After excellent advice I received from you all, I'm also letting myself hop on the scale an extra time or two, if I feel the urge. Once my weight hits a plateau, weekly weigh-ins are a good idea, and I'd like to be able to do that without going back to daily or more-than-daily weight checks. We'll see. I'm willing to experiment with this one.

7 February 2021

My New Kitchen Scale and Why I Wanted One

I decided to add a kitchen scale to my arsenal of healthy eating and cooking tools. 

The last time I saw a kitchen scale, they were little plastic things with a needle, something like this.

 



When I looked for one online, I discovered that, like everything else, kitchen scales are now sleek-looking and digital. I bought one that looks like this.

Dietitians like to use everyday objects as visual reference points -- three ounces of meat is about the size of the palm of your hand, a medium-sized apple is the size of a tennis ball, and so on. You can find many good guides on the internet, such as this one.

But I am so not a visual person, and I actually find these guidelines difficult to use. I've been trying to keep my guestimates low, but I've been growing curious. How many ounces (or grams) is that chicken thigh, really? 

I also wanted to standardize some of my cooking. For example, my partner I love the energy bites that are featured all over the internet. My standard are these by the Minimalist Baker: dates, peanut butter, dark chocolate, oats, and flax or chia seeds. They're delicious, super nutritious, and give you an amazing energy boost. (They're also vegan and gluten-free if that is important to you.)

I normally just throw ingredients in the food processor without any measuring. But now I want to know how many calories are in one ball, so I can eat one without guilt. So this morning I measured each ingredient on the scale. I looked up the calories for each amount, added them up, and divided by the number of balls. I was so happy and amazed to learn mine had only 80 calories per ball! It's very helpful to know that.

For some people, the scale might help keep you honest, so you're not fooling yourself, eating more than you think. I'm more prone to estimating high -- not allowing myself to eat more. I don't think the kitchen scale is a necessity -- you could definitely succeed on a bariatric diet without one -- but it can be a useful tool.

3 February 2021

The Single Most Important Part of Healthy Eating: Preparation

Last weekend was a food-prep weekend for me. I try to do this when I have three days off, so I can spend most of a day (or two half-days) cooking without spending the entire weekend in the kitchen.

The first day I prepped food just for myself. I made:

  • tuna salad
  • salmon salad
    • both from canned fish, stored in portions in muffin tins
  • brussels sprouts
    • part of my return to eating vegetables I love that my partner doesn't eat
  • sweet potatoes
    • ditto!
  • chicken broth, using healthy bones from truLocal and my Instant Pot
The second day I cooked these dinners, to freeze. Each is a double batch, which should be enough for three or four meals, for two people, times two.

  • spaghetti and meat sauce
    • made with ground bison in one pot, using the Instant Pot on pressure cook -- super easy and delicious
  • turkey meatballs
    • also pressure cooked
  • chicken burrito bowl, made with brown rice
    • Instant Pot on slow-cook
  • pork tenderloin with honey-garlic sauce
    • my first time making this! very easy

I was so pleased with myself!

I have more truLocal meat waiting for another round of cooking. Right now my entire arsenal of Pyrex containers are in use, along with an assortment of repurposed glass jars. Plus four dinners in one morning was my limit. I'll do another round three or four weeks from now. (I also have really nice frozen seafood from truLocal, specifically for quick dinners on days I'm not working.)

All this food-prep reminded me of something I wrote several years ago on another blog. I'm re-posting it here in slightly edited form. 

* * * *

Healthy eating has one cornerstone, one key concept from which everything flows: advanced planning.

You can't eat healthfully without planning in advance. The more you can plan ahead, the more you can control what you eat. The more last-minute and spontaneous your eating, the less healthy it will be.

This applies to whatever manner of healthy eating you're trying to achieve, whether it's cutting down on sodium, fat, white sugar, or processed food, eating less meat, eating more vegetables, or anything else. It all comes down to planning. There are probably exceptions to this, but it's as close to an infallible rule as you'll find.

Here's one small example from my own life. Healthy breakfasts are [were -- at the time I wrote this] an ongoing challenge for me. One healthy breakfast that I like is scrambled eggs with veggies. If I'm going to eat that once or twice a week, I have to remember to put the vegetables I want on the shopping list and -- this is the key -- prep them and put them in containers in the fridge in advance. Without that, it doesn't happen. 

In the morning -- after I exercise, take the dogs out, have my coffee and check my email --  I'm hungry, but I'm also anxious to start my day. If I have to chop onions, wash and slice mushrooms, and wash and slice bell peppers, this healthy breakfast is not gonna happen. But at another time, if I run an onion through the food processor, slice a load of mushrooms, and dice a whole bell pepper, then put them in separate containers in the refrigerator... in the morning, everything is there when I need it. The actual cooking takes only a few minutes.

Not only does this encourage me to eat the better breakfast, it's also much more efficient, since the onion, shrooms and pepper will stay fresh for around two weeks. In fact, it was while I was throwing some already-chopped onions into the skillet, so pleased with myself for having organized this yummy breakfast, that I thought of writing this post.

[You can create an exception to the Advanced Planning Rule if you can afford to buy salads already prepared, lettuce already washed, or vegetables already washed and cut up. This can be very helpful, but still requires some advance planning, as these won't stay fresh as long as whole vegetables.]

To people who are natural planners, the idea that healthy eating requires advanced planning may seem incredibly obvious. But to people who are not naturally inclined to plan ahead or who are resistant to planning, or both, it can be a major obstacle.

If you're accustomed to a lifestyle where you shop weekly with a list, make dinner at home most nights, bring your lunch to work, then planning ahead is so ingrained in your life, you may barely think about it, even though it's something you do all the time.

If your schedule is erratic, or you're constantly pressed for time, if you generally don't think about food until you're hungry, if you have the means to dine out frequently, or any combination of these, planning ahead may seem impossible or undesirable. But you may not realize how much that spontaneity is preventing you from having healthier eating habits.

For many of us, the movement from no or minimal planning to a greater degree of planning occurred with age. In general, young adults plan less, eat more convenience food, are less concerned with nutrition or economizing. But learning how to plan ahead doesn't necessarily come naturally with age. I know lots of people my own age who find it very difficult. I'll bet many planners, like me, have partners whose response to "What do you want to do for dinner tonight?" is "I don't know, I can't think that far ahead."

So I've learned not to ask, just to plan. I take responsibility for planning dinners for the week, because I don't like what happens when I don't. I like efficiency. Even though I'm not the one doing the shopping, I hate needing multiple trips to the same store that could have been avoided with better planning, or getting takeout not because we want to, but because there's nothing in the house to eat.

Flexibility is important. Sometimes when you have a bad or crazy day, the best thing you can do for yourself is to say, "Let's make this chicken tomorrow night, let's get Chinese food tonight." But on a regular basis, if you "can't think that far ahead" to dinner, chances are good that you'll spend more money, eat more, and eat less healthfully than you would have if you had planned. 

If this is an issue for you, like any new habits, you might try starting small: make one change, live with it a while, let it take root as a habit, before adding in another change. If bringing your lunch to work is a stumbling block that you'd like to get past, maybe aim for bringing lunch one day a week. See how that works, then add a second day. Make one dinner in advance, and see if you like the trade-off. 

I Tried on Some Clothes and Almost Cried from Happiness and Relief

On a post from December 12, I wrote:

The other exception is a collection of professional wear, especially beautiful jackets (the kind some people call blazers or suit jackets). 

Beginning a new career in 2013, I needed new clothes, first for interviewing, then for working. Making peace with my body -- at that time largest I had ever been -- I found a great store that sold plus-size petites. I know that sounds like an oxymoron, but when you are short and heavy, this is an incredible lifesaver. They also made shopping easier, with salespeople you can book in advance, so you can shop by yourself, but still have someone going back and forth to get different sizes and ideas for outfits.

This store's clothes were exactly the right mix of dressy and casual, and I started building a new professional wardrobe. The jackets were especially brilliant -- really stylish, but still classic, and they fit beautifully. 

I wore these jackets for several years. I must admit, dressing well and having clothes that fit nicely increased my confidence. 

Then one day I noticed with horror that the jackets no longer fit as well as they should; they were too snug. Then no longer fit, full stop. I kept them, but stopped wearing them.

Yesterday I tried on my favourite jacket... and it fits. It's actually looser than when I bought it. I felt so good. No longer being able to wear these jackets was like a symbol of defeat -- of hopelessness. Buttoning it up felt like a big win.

I actually don't have any reason to wear this jacket now! Maybe I'll just wear it around the house for no reason. 

1 February 2021

February 1 Weigh-In

Pounds lost since last weigh-in: 5

Total pounds lost so far: 40

My weight loss has slowed, but the rate is still twice what I'd typically lose in the past. I'm mentally preparing myself that future weigh-ins may show only one or two pounds per month. That's why I'm doing monthly weigh-ins, instead of weekly.

I wish there was a way to know where my weight will settle, how much I'll lose altogether. But there is no way to predict. So, I'll just be happy in the moment. 

Forty pounds! Pretty cool.