It only matters what works for you.

Sleep

I’m in favor. It’s one of those insidious things that we don’t appreciate how much we need it until we don’t get it, and when we’re used to not getting it, we really forget how fantastic it is.

In and around my husband’s hear surgery, we both had sleep studies.

He had one at home. It was pretty easy. He wired himself up for two nights in a row, stuffed some sensors in his nose, and went to sleep. The results came back as no surprise to me. “Hey, you have horrifically bad sleep apnea.” We had to dance around with our insurance company for a while but now he has an auto-pap machine, which is like a cpap, but it changes the pressure around a bit as needed. It’s the latest thing.

If you’ve hesitated to have a study done because the machines are such a nuisance, then I really suggest you rethink your choice. Yes, the machine is kind of a nuisance, and I’m sure it will be a pain when we travel. Yes, when he’s wired up my husband looks like a science experiment and frightens the cat. But.

But instead of the nine hours a night he’s needed as long as I’ve known him, he now wakes easily after eight, even on weekends when he could sleep in if he chose. He just doesn’t need more. He’s also more rested and more alert. He’s just more energetic.

And if that doesn’t convince you, I’d like to point out that I am sleeping better than ever. It seems I was waking up a lot at night because he’d stop breathing. And for some reason, that bothered me… It took me about two weeks to adjust to the new noises in the bedroom, the machine, the occasional whistle if the mask gets askew, but now that I’m accustom, I don’t notice anything.

It’s lovely. So if you need one, or your partner says you need one, please get checked out. It could really change your life.

My story coming up next.

My beloved had heart surgery over the holidays. He’s all recovered now and doing very well. He’s attending his supervised exercise program to insure his physical recovery and his ability to achieve the recommended permanent changes to his activity level. He’s assiduously watching his food intake for all the categories his cardiologist is concerned in.

So, he’s exercising more than he has in years, he’s lowered his fats, he’s well below the calorie intake recommended for his size, age, and activity level, and after 6 weeks, he’s already stopped losing weight.

Yes, I know all the responses here. It won’t be linear, his body has to readjust, he’s adding muscle. There’s another line of responses, he’ll need to keep adjusting his calories down, his exercise up, maybe he shouldn’t eat this or that or the other thing…

It’s a little ridiculous. I don’t think something that works should be quite so easy to derail.

And then there’s the fact that since he’s lost 10% of his body weight, he’s considered a major success.

They rarely tell you that, those diet plans, how little you can truly expect to lose. They often don’t share statistics about how well participants generally keep it off, or for how long. They don’t even tell you what the true definition of ‘success’ is according to the diet research.

I am considered a success. Because a lot of years ago I lost a bunch of weight, and then I kept more than 50% of it off for more than 5 years. Statistically, a ‘successful’ diet doesn’t mean you got to thin.

This link isn’t so much an article as a commentary, but click on it for the cartoon which I don’t have permission to republish. If you’ve done multiple diets, you’ll know just how this feels.

We’re in the soup

I’ve never really talked about non-medical politics here before, but I’ve certainly talked about stress, so I think this post I made elsewhere fits right in.

Today a friend who I like and admire said “Politics doesn’t belong on Facebook” as part of a longer point.

And it really made me stop and think.

It took me a long time to start voicing my opinions on politics along with my opinions on science fiction, food allergies, and kittens. Because I have friends and family who I love and respect and on the one hand, I didn’t want them to feel attacked, and on the other, I really don’t like to argue in a public forum.

And then I look at the current face of politics. And I think about how very, very ugly the last election was. Somewhere along the line, politics became something we didn’t talk about in public. I think maybe we’ve gotten it very wrong. I thought I should double check the actual definition of politics. There are a lot. It’s a very complex word. Some of it is about power. Some of it is about leadership. But I want to draw your attention to this one,

the total complex of relations between people living in society.

And that’s where the problem comes in. We’ve made it socially unacceptable to publicly discuss how we think we should live together as a group. We’ve washed our hands of the messy process and handed it all over to professionals. The people who are really invested. The people who promise to make the best decisions for the good of the country.

I’m afraid what we did is turn over the hen house to the foxes. I don’t just mean the other guys. There are foxes at every level and for every stated ideology.

Have you ever been at a new restaurant with a group and everyone is slowly eating until someone speaks up and says “Ok, is it just me, or is this the worst soup ever?” And then everyone puts down their spoons and there is a babble of relief where everyone is so glad one person had the guts to say it out loud.

Maybe that’s what the women’s march was. Maybe it was a group of people who finally said, “I’m not sure I can be polite any more.” And their friends said, “I’m so glad you said that. What are we going to do?” They marched. They got a lot of attention.

They got a lot of us talking. Arguing. Looking for facts to refute the opposition.

Engaging with each other in a public forum.

We need a lot more of that. We as a populace need to spend a lot more time engaging in discussion, rather than arguments. We need to figure out how to agree to disagree. We need to figure out how to get back to the basics of learning to get along.

My friends in the opposition are caring, educated people who I respect. We all looked at the same data and came to disparate conclusions. I would like to work harder at finding places where we agree. Work harder at finding places we can compromise. Because I hate the fact that I’m not comfortable having a reasonable discussion. I hate the fact that we feel each other’s data is skewed. I hate the fact that this country is so divided that every public disagreement is met with violent spewings of hate rather than any attempt to bridge the gap.

And if we don’t want to see this sort of scary division in our country again in four years, and in eight, we need to learn to find some points of commonality. To try to understand each other. We need to disinter the idea of compromise, instead of our current system of ‘winner take all’.

I don’t know exactly how we are going to do that. I just know I’m going to put my best foot forward and try. So I’m afraid, dear friend, that I think maybe, at this point in time, Facebook is exactly the right place for politics.

Dear young self

If I could go back in time and tell my young self one thing, it would be to not diet, no matter how many people told me “If you just…” and other annoying untruths. Because the science is clear now. While short term a diet can and often does improve some health markers like cholesterol and blood sugar, over the long term what repeat dieting is mostly likely to do is make sure you stay fat.

And if you think about it, really, would dieting be a multi-gazillion dollar industry if it actually worked long term? Of course not. If it worked, you’d do it once, the weight would stay off, and that would be it. They make all that money because you have to keep going back and doing it again longer and harder.

I found this article written by a neuroscientist to have some interesting things to say.

The root of the problem is not willpower but neuroscience. Metabolic suppression is one of several powerful tools that the brain uses to keep the body within a certain weight range, called the set point. The range, which varies from person to person, is determined by genes and life experience. When dieters’ weight drops below it, they not only burn fewer calories but also produce more hunger-inducing hormones and find eating more rewarding.

Evolution designed us around periodic famine. If too many died too quickly, then we’re a failed experiment. So those who had some way to slow their metabolism when necessary are the ones who didn’t starve to death. Fat is important for survival, if you don’t live in a world with a McDonald’s and a Starbucks on every corner. Your basic functions do not believe that a size 2 is more desirable than a size 22, and every time you ‘starve’ (ie Diet) it is more convinced that you need all the help you can get to survive.

On my most serious diet, in my late 20s, I got down to 125 pounds, 30 pounds below my normal weight. I wanted (unwisely) to lose more, but I got stuck. After several months of eating fewer than 800 calories a day and spending an hour at the gym every morning, I hadn’t lost another ounce. When I gave up on losing and switched my goal to maintaining that weight, I started gaining instead.

The author’s own story mirrors mine. There was a joyful time when I quickly and fairly easily (if you consider involuntary vomiting easy) lost 100 lbs in just a few months. I was on a strict low carb diet, and I was being introduced to my soy allergy. Soy is in everything, so every salad with soybean oil dressing, every handful of snack nuts roasted in soy bean oil…a huge list of common every day foods caused me to be violently sick almost every day. It took me quite a while to figure out why. It wasn’t intentional, but I took the weight loss gratefully. But then I got down to a certain point and that was it. Nothing else I did over a several years following ever took me down below that point. No matter how dramatic.

The causal relationship between diets and weight gain can also be tested by studying people with an external motivation to lose weight. Boxers and wrestlers who diet to qualify for their weight classes presumably have no particular genetic predisposition toward obesity. Yet a 2006 study found that elite athletes who competed for Finland in such weight-conscious sports were three times more likely to be obese by age 60 than their peers who competed in other sports.

I find this particularly interesting. Devoted athletes, no genetic predispositions, and yet repeated dieting seems to cause overall weight gain over time.

But our culture’s view of obesity as uniquely deadly is mistaken. Low fitness, smoking, high blood pressure, low income and loneliness are all better predictors of early death than obesity. Exercise is especially important: Data from a 2009 studyshowed that low fitness is responsible for 16 percent to 17 percent of deaths in the United States, while obesity accounts for only 2 percent to 3 percent, once fitness is factored out. Exercise reduces abdominal fat and improves health, even without weight loss. This suggests that overweight people should focus more on exercising than on calorie restriction.

And here’s the real winner. Despite the media telling us what a horrible drain on the system fat people are, the data actually shows that it’s being sedentary and out of shape that is the issue. Sure, those often go together, but our sedentary life style is the real problem.

So if I could go back an talk to my young self, I’d ask her to take another dance class. To ride her bike every day. To ignore how she thought she looked in sweats and go to the gym anyway.

So this January, don’t start another diet. Find something physical that you enjoy, and put your time and attention to that instead.

 

 

 

Good news and bad news.

The good news is, I reacted beautifully to the cortisone shot. I’m moving better than I have in probably 3 years. I genuinely had no idea how much my knee hurt. Being pain free on one side is amazing.

The bad news is, it doesn’t actually fix anything. And they wear off. And there is a limit to how many you can get in a year. And it doesn’t fix anything.

At my next appointment I’m having a shot in the other knee. I want to see what that feels like. I also have a long list of questions about which OTC pain relievers are recommended for long term. There is a joint lubricant they can inject and I want to get that set up and try it. I need to know when and how they can overlap.

I’m going to ask if they know an actually China trained doctor of Chinese medicine. Acupuncture is supposed to do really well for arthritis and I’ve had good results from it before.

I saw a podiatrist. Unfortunately my insurance doesn’t cover custom orthotics  Pity, because even just the commercial ones he gave me have helped some.

Plans are building. Things are happening. We shall see.

 

Irreverence for the win!

Last week I went to see yet another new doctor. This one was a pain specialist.

This summer, before things went crazy, I went to the Orthopedist and said “my left fibula won’t stay put.” So he took some xrays and turns out I have severe osteoarthritis in both knees. Not terribly unexpected at my weight and with my other issues. My question was “Why does only the left one hurt.” He didn’t have a good answer for that, and sent me off to physical therapy.

Looking back, I seem to have failed to mention physical therapy. Oh well. It went ok. I did it in between moving. It helped me get back some basic mobility, but nothing major. I expect it would have helped more if I hadn’t had to do it around moving when I was already exhausted all the time. Anyway, it got me to the point where I could manage the pool, and that’s what I’m doing now.

Back to the orthopedist. I went back this week to ask about a brace. Someone is supposed to call me, but at my weight, and with the shape of my leg, he’s not sure what a brace can do for me. And he once again referred me to the pain specialists. Because they are in charge of non-surgical management of severe arthritis.

She is fantastic. We chatted and I gave her my history so we were building a rapport while someone tracked down the files I’d had sent over from the orthopedist. And when she finally saw my pictures she said “Holy crap, your knees look like shit.” Which made me laugh and laugh. And I knew then that we’d have a long and healthy relationship. Because they are really terrible.

And then we talked briefly about options and I got a cortisone shot in my left knee. Right now it’s sort of numb. We’ll see how it goes.

What an amazing thing

I’m sorry that I didn’t find time to write this post immediately after my second appointment with my new doctor. Because it was a completely new experience and I was so excited in the moment.

My new primary care doctor is amazing. An annual physical is not something anyone gets excited about, but I think it may have been the best medical experience of my life.

When I went in for my appointment, the first thing I said was “The most important thing for you to know about my health today is that yesterday my husband failed his angiogram and he needs to have bypass surgery.” And for a miracle, she agreed that was very important, and she spent a significant amount of time talking me through my side of the experience and helping me dial down my stress. Who does that any more?

Then she took the time to discuss and or address all the things on my relatively long list. It was only our second visit after all and I have a number of active health issues.

It is both horrible and wonderful to realize that for the first time I really felt listened to, and yet also supported. She didn’t dismiss anything I offered, but she didn’t hesitate to correct me when I had a misconception or suggest alternate ideas for me.

Finally, I don’t feel like I’m on this health journey alone without a map.