Fat and Crazy

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depression, hormones, PMDD, weight, weight loss

If you want your brain to work well, you’ve gotta be good to the rest of your body too.

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A Lighter Note

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appetite, goals, nausea, self-confidence, self-esteem, side effects, weight, weight loss

Although my emotional health has been a bit variable lately, things have been improving in terms of physical health.

I’ve been working on losing weight for what seems like forever, and only started making real progress in April when I finished my PhD. I’ve made quite a bit of progress, I’m proud to say. Much of that has been the result of better regulation of symptoms that led to overeating, but the most recent drug made me so nauseated I could barely eat for a week.

A new low – how apropos…

Net effect?

I lost about 5 pounds. The crotch on my favorite fleece lounge pants (once skin-tight) has dropped about 4 inches. The next-size-down bras fit perfectly, including a blessedly underwire-free sports bra, for the first time in years. I had to buy some new jeans.

And I finally crossed The Line.

I’m no longer obese! My BMI is below 30. I literally jumped for joy. It made my day week, boosted my mood, and almost made up for the nausea. Almost.

Still Losing It

Tags

body image, self-confidence, self-esteem, self-respect, weight, weight loss, winning

About 15 months ago, I decided I really needed to do something about my weight. Well into the “obese” range, my body was really weighing me down, in more ways than one. So I decided, this needs to change.

That’s all well and good, as long as you actually change your behaviors. I’m a great one for deciding to do something and then somehow believing that it will therefore happen without further ado (for the record, it usually doesn’t work out.)

Mission Accomplished! Next goal: BMI 30

Anyway, back to the point: I hit my round-number weight goal last week! Hurray! Of course, this is just the first (and most overly ambitious) such milestone, because I still have a long way to go. Even though the next week or two will pop up a few pounds back over the line, the general trend is still downward.

I wish I could say it was just a matter of effort, but piety alone won’t get you into heaven. I have always eaten healthy foods, but now I am in more control of what, when, and how much I eat. The switch to Wellbutrin proper has done wonders for managing my appetite. More stable blood levels of medicine means I don’t get depressive symptoms in the evening, and therefore don’t binge right before bed.

Magically, somehow, I can now tell when I’ve had enough to eat, before I’m even full, and can actually stop eating! It’s simply amazing. If you’ve always been 100% in control of your eating, there’s no way I can explain this to you, but it’s an incredibly empowering feeling. I am in control, not my belligerent gut! Yes, there are times when I feel extremely hungry and I just ignore it and down a glass of water, but when my stomach growls and my head starts complaining, then it’s time for a snack.

Keen Sula sneakers in pink camo, for $30! Image credits to Keen Shoes.

Feeling fully justified in celebratory spending for hitting my weight goal, I bought a few wardrobe necessities – lightweight longsleeve shirts in the correct size for layering, a belt to keep my ever-loosening pants from showing crack, and cute shoes, just because I deserved them and they were on an awesome sale. I’ve been swapping clothes in and out of storage for awhile; today I took all the remaining “too small” items back to my closet because they won’t be too small for much longer – if I can keep up the pace, that is.

This feels SO good. I feel like I’m suddenly in a new leaner body, though the actual change is small and gradual. It accumulates – I’ve gone down two cup sizes (32H, woohoo!), lost two underpants sizes, dropped two jeans sizes, and instead of 1X, I’m sporting tops in a standard size large! I might not be the epitome of healthy, sexy, mid-30’s womanhood just now, but I sure look and feel a hell of a lot better than I did this time last year. Besides, the confidence gained from feeling better about my health and appearance is a magnifier of all that’s attractive.

Losing the original 25 pounds actually required losing 35 pounds.

Just that little bit of positive feedback was all I needed. Success begets success. I am confident that I’ll lose the next 5 pounds and limbo myself right into the “overweight” category. As I lose more, it shows more – I’m starting to see the shape of my face change, bringing an overwhelming sense of relief. As if I’m becoming me again. Or perhaps a better version of me.

The concrete changes are minimal: I take more walks and I eat less. Very practical, right? I’ve been tracking my exercise against mood scores and coping for some time, and when I get more exercise, I cope better. I really do have to make exercise part of my daily routine, like it or not (usually not), so I’ve added a daily to-do list reminder to make it harder to ignore. I can already walk up the hills faster and breathe easier while I do it. That alone is a meaningful accomplishment for me, but it can vanish in just a few days of sloth.

I’m not counting calories because I’m neurotic enough about tracking and details already. I don’t snack much in the evenings anymore, and I try to stick to things like frosted shredded wheats rather than cookies. I cook whole-food veggie-laden dishes using my trained-from-toddlerhood healthy cooking skills as often as I have the energy and ingredients. I eat much lighter, but more often, which also keeps my blood sugar more stable.

It’s more work keeping on top of tracking my physical activity, reminding myself to get outside and move around, and preparing healthy meals. I just have to care enough about myself to put a priority on doing these simple things that so dramatically improve my quality of living.

What’s Up, Doc?

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aphasia, car, Lamictal, lamotrigine, meds, PCOS, side effects, travel, weight

I haven’t been keeping on top of blogging lately – getting up to speed on the new job plus recent travel are my main excuses. After traveling I always have tons of catch-up to do, reimbursement forms to file, follow-up emails to send, and all manner of busywork to attend to.

This time, it also includes car repair. I had to take a cab home from the airport because the car wouldn’t start. Monday I had to cancel my therapy appointment and Mr. Chickadee called in sick – we were just so exhausted – so we took a nice nap. Then we walked 6 miles round-trip to an auto parts store to try the relatively cheap fix of a tuneup. If it weren’t for the Internet, we wouldn’t have known that the problem might be spark plugs and/or wires.

My poor sad CR-V gets a tow.

Well, it wasn’t, but the spark plugs showed that they were overdue for a change anyway. And we got quality time together, good exercise, and an ice cream cone on the way back home. But the car still didn’t start.

So Wednesday morning, the tow truck took my beloved CR-V to the shop. It might not be fixed for a couple of days, complicating my arrangements for a follow-up gynecology appointment on Thursday.

I’m having a pelvic ultrasound to further investigate the possibility of PCOS. I don’t have high hopes for resolution and I’m less than impressed with the gynecologist, but at least I’ll have tried all the conventional medicine avenues readily available to me. My PCOS-related searches have also turned up a potential deficiency in inositol. It can supposedly cause myriad symptoms – and just about every pesky issue I deal with is on the list. It might help and wouldn’t hurt (natural hormone) so I’m going to give it a shot.

All that aside, I’ve been relatively stable since adding in the sertraline (Zoloft). There was a tinge of hypomania during the last round of travel, but nothing near what I used to experience, so it wasn’t all that bad. Aside from the not sleeping thing that made me so darn exhausted. On the plus side, I only gained a couple pounds back (some of which may be purely hormonal) and that is great after a week of eating only restaurant food. I tried really hard to make smart eating choices, and it seems to have helped a bit.

Unfortunately, the increase in lamotrigine (Lamictal) seems to have worsened one of the most irritating side effects – aphasia. I’m having a really hard time remembering names and finding the right words in spoken conversation, which is enormously frustrating for someone who is otherwise quite articulate. Next time I go to the psych, I’m going to ask about going down to 175mg instead of 200mg – we’ll see if that flies. My fingers are crossed that eventually I can also decrease the bupropion (Wellbutrin) dosage but I’m not counting on that happening any time soon. One thing at a time…

Losing It

Tags

meds, milestones, sertraline, side effects, success, weight, weight loss, Zoloft

I’m losing it.

Not mentally – I’m already certifiable. But I’m fed up with being fat, so I’m doing something about it – and finally losing weight after years of gaining.

HUZZAH!

I use a Withings scale for a daily weigh-in, which wirelessly uploads to a website and then automagically populates my weight log on Fitbit. Recently Fitbit gave me two congratulatory badges – one for 25 lbs all-time weight loss (since a miserable lifetime high in August of 2011), and one for 15 lbs lost since I set a goal in October 2011. I’m back to where I was in March 2011, so I’ve basically lost the dissertation weight. Hurray! Now I “just” have the rest of the grad school pounds to eliminate…

My current weight goal is 200 lbs, just above the line between “overweight” and “obese.” It was too ambitious a goal when I set it, but I couldn’t make myself compromise either. Current predictions suggest that could happen by September, which would be beyond awesome. I’ll set more moderate and achievable goals after that.

So, how am I doing it? The only sustainable way to lose weight is to burn more calories than you consume, and that can be done by consuming less and/or burning more. It’s a long-term persistence-based outcome, which is hard to sustain, but the immediate jump-start of losing 5 lbs in 5 days (from hiking 50 miles with a 50 lb pack) helped fuel my determination.

I always try to be reasonably active, so the main change is dietary. I’m just plain cutting back on the calories. During June I logged everything I ate, which helped me maintain a 500-750 calorie daily deficit. Tough as it was to be hungry all the time, I just gritted my teeth and kept at it.

Then along came sertraline (Zoloft). While all 4 of my daily meds have the potential side effect of reduced appetite, sertraline was the tipping point. Suddenly, I know when I need to stop eating. I actually feel full and want to stop eating, regardless of how delicious the dish, which is something I haven’t experienced since childhood. I’m satisfied with much less than I had previously consumed as well – for the first time in our 12 years together, I’m eating less than Mr. Chickadee on a regular basis.

It’s amazingly liberating to be freed from a distorted appetite.

The jeans I’ve been living in since my birthday are now out of circulation – they’re too big. Even my new hiking pants have noticeably loosened around the middle in the last month, and several pairs of jeans and slacks that I haven’t worn in a year now fit comfortably. According to my measurements, I’ve lost 0.5″ off the hips and 1.5″ off the thighs – no wonder my pants fit differently! Best of all, my bra cups no longer runneth over; the underwires rest comfortably on my sternum, where they ought to be, and I’ve gone down a cup size.

I’m finally losing it, and I’m thrilled.

And Now For Something Completely Different

Tags

dx, endocrine, health, PCOS, polycystic ovary syndrome, psychiatrist, v58.69, weight

Yesterday I had my intake appointment with the new psych’s office. I walked away with my mind practically blown. The big news was that I might have polycystic ovary syndrome (PCOS), which is sometimes misdiagnosed as bipolar disorder. So I’ve had another v58.69 ordered up, but this time for endocrinology: estrogen, progesterone, testosterone, DHEA sulfate, and LH/FSH. With a follow-up appointment in just two more weeks, I should have an answer soon. If my testosterone levels are abnormally high, that seals the deal.

So of course, the first thing I did when I got home was look up PCOS. The big issues that it might be causing for me are mood swings around menstrual cycles, high levels of masculinizing hormones leading to acne and excessive facial hair, and insulin resistance as part of metabolic syndrome.

That would explain why it’s so damn hard for me to lose weight even when I do everything right – and Mom had the same problem. The NP said that PCOS aligns well with a lot of my symptoms, and of course, even things I didn’t realize were symptomatic. Things like very painful cramps, depressive PMS, weight gain, difficulty losing weight, blood sugar problems, past thyroid issues, acne, and a whole bunch of other details. There are often also fertility issues related to PCOS, but I’m unconcerned about that part.

So if I’m diagnosed with PCOS, the main treatment approaches are metformin (a diabetes medicine) to improve insulin resistance, sometimes birth control pills (which cause disastrous mood swings), and weight loss. Yeah, because that has worked out so well for me in the past. This would be a serious incentive to put a lot more effort into getting into better shape. And if I end up on metformin, it might actually make it a lot easier to lose weight. I already get moderate exercise and eat much healthier than the vast majority of the American public, and yet I stay fat. I would be delighted if anything could be done to help remedy it.

The kicker is that sometimes PCOS is misdiagnosed as bipolar disorder. There’s also some evidence that they are often comorbid conditions. I haven’t seen anything (yet) in my quick searches to suggest that manic symptoms are involved with PCOS, but there’s a general link to mood swings and depression. So, what if I’m not actually bipolar? That would take some mental readjustment. I just got used to having “certifiably crazy” status! Given the way I’ve responded to Lamictal, plus the triggering effects of travel, time changes, and weather conditions, it seems unlikely that there is no mood stability issue at all – but it might be exacerbated by endocrinology issues.

Oh, and I’m back on Adderall. Thank goodness. They will be doing urine tests to ensure that I’m taking the amphetamines, but they use far more precise tests and they aren’t going to flip out over positive results for marijuana. I discussed it up front with the NP and she said she didn’t consider it a problem, so long as I’m not self-medicating or using it excessively.