Dieting Is Not Natural…

Of course neither is being overweight or obese. My body and mind are rebelling a bit after 9 months of caloric restriction under the guise of becoming healthy. So, incoming expression of my current state of mind.

Sorry, but humans did not evolve to eat low caloric diets for a prolonged period, well, except those of us with especially “thrifty genes” 😉 Yes, I am aware of the numerous studies in various species of animals suggesting that caloric restriction (-30%) with a diet that maintains appropriate nutrients might prolong life through revving up cellular mechanisms which stave off chronic diseases and aging. (Free JAMA article here) Dieting is not the same as eating a rich diet lower in calories than the typical American one. Plus, the concept of caloric restriction to live longer – there is not enough evidence that this is generalizable to all people, or that it really does work in humans, or that people want to trade their quality of life by going hungry for an extra few months to few years of living. (Suggest you at least read the abstract of the article for both sides of the argument.)

Back to me and my body/mind. Convincing myself that losing weight is healthy is easy to do, but I finally need to stop pretending that I am just embarking on a “way of eating”. True, I am eating healthy, but 1200 calories a day is not normal. This older body of mine knows that better than I do and is showing this by losing weight at a slower and slower rate. If I am going to survive getting to my goal weight, I think that I need to reframe what I am doing. I am on a diet. I am eating healthy (hopefully), but a diet it is. While dieting, I am preparing for maintenance because I certainly do not intend to eat 1200 calories all my life. Also, I am preparing for maintenance by reading about those who have lost and successfully maintained for years. (Need the role-modeling, skills, and knowledge, and something to look forward to.) I am trying to routinely incorporate physical activity while my damn knee ever-so-slowly heals from whatever “itis” has afflicted it for the past few months. I continue to seek support from others close by and on the web for this journey. Hell, I’m even back in therapy routinely as of this week (good grief did I just type that out loud?) to deal with the emotional turmoil surrounding my response to my parents’ illnesses and the crap that is emerging.

Bottom line: Don’t be surprised if I use the word “diet” more often. Once I hit maintenance then I truly will be eating healthy.

cartoon of woman at diet doctor

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I Had A Dream…

Does anyone else have food dreams when dieting? (We are talking about dieting here, not the overall focus on becoming healthy.) On past food restriction efforts, I would have dreams about food early in the process. Not taunting dreams – just food would be omnipresent. I would awaken feeling deprived and frustrated and acutely aware of my caloric deficit.

This time, since embarking on my health plan last September, I have not dreamed dreamt (happy 10th grade anglophile English teacher?) about food. Last night, however, I had the strangest dream about  life style changes. To put this in context, the past 3 weeks have been difficult for me:  being out-of-town, being around my family of origin, understanding more about my “unhealthy-ness” (OK, let’s call it what is, lack of self-care), slacking on monitoring and physical activity, starting to want to overeat, a bit of discouragement setting in. In last night’s dream — you know I have decided not to bother readers with details and my analysis (actually I did write it out, but there was too much psychobabble – emphasis on psycho – makes for truly boring reading). I’ll just reveal that instead of dreaming about food, I dreamed about my problems with changing my behavior and difficulties staying on track.

By writing out the details and realizing all the characters in the dream were parts of myself, I got a wake-up call (from a dream ;)) about how to get back on track. Seems like my psyche knows better than I do what would help. Wait, my psyche is me – so YAY for me. Now I feel more encouraged and capable of continuing  the long process of maintaining all of the mechanisms that work for me to lose weight and be more physically active.

One of these days I will write a post about why certain types of writing are, indeed, healthy – with evidence. Promise.

patient on therapist's couch

Blog Love (Blush)

I received 2 awards, 1 of which I found buried in a comment back from April – I am soooo embarrassed!

This process is new to me, so bear with me if I screw it up. In chronological order, first came the delightful (and hidden) Sunshine Award from Angie’s Healthy Living Blog

Sunshine Blog Award

The rules…
Nominate 12 blogs;
Put the award logo on your sidebar or within a post;
Link the nominees within your post;
Let the nominees know they’ve received this award by commenting on their blog;
Share the love and link the sidebar logo to the person from whom you’ve received this award.

Most of the blogs that I read have already received this award (I’m such a newb), but I will mention blogs that I admire for bringing sunshine into my daily reading and attempt to identify which bloggers have received the award previously and which ones have not (although they probably all have):

  1. Karen at Waisting Time who of course was probably one of the first holders of this “bloggy”. She is my role model for blogging about life style changes regarding healthy behaviors and is my second daily read after the NYTimes.
  2. Cammy at The Tippy Toe Diet, who undoubtedly has been awarded this flower numerous times, but her blog is such a must-read, that I’m giving it to her again. (Newbie me). Her tips, story, insights, writing – all keep me coming back for more.
  3. Loretta at Loretta’s Journey has an amazing story, is always inspiring, and I cannot believe that she has not received this blog award! (I probably have missed it somewhere.)
  4. Gracie at Fat to Fabulous has a blog that I have been reading since my journey began in September, 2009. I found her blog on 3FatChicks, and her story  keeps me pushing ahead.
  5. Sarah at Round is an American in France and knows much about weight loss. She shares her knowledge and motivation in a wonderful style.
  6. Shelley of My Journey to Fit is younger than me (hey, who isn’t?) and has lost 100+ pounds, is a Texan, and is a great read for lifestyle changes.
  7. Lyn of Escape from Obesity provides great recipes along with the story of her ongoing journey.
  8. debby weighs in, ah someone my age who has lost 100 pounds, loves dogs, is in the medical field, and is a wonderful blogger.
  9. Lynn’s Weigh is the God Mother of maintainers’ blogs – you just have to check it out to read about her 168 pound weight loss and years of maintenance and subsequent helpful posts. Go… now. She has been featured nationally, and this award probably is beneath her, but it’s the only way that I have to let her know (besides comments) how grateful I am that she keeps posting.
  10. The Redhead Riter is different from all of the other blogs that I routinely read (excluding the social-political ones) in that is more family focused (can’t bear to call it a mommy blog) and less about health. BUT, I still find her writing, pics, and BlogFrog community interesting. She, of course, received this award eons ago.

Sorry but I’m out of non-professional, life-style, non-monetized blogs that I routinely read.

Beautiful Blogger Award

Now for the Beautiful Blogger Award from Karen at Waisting Time – see I just had to get back home so that I could post images again. (Still mastering my iPad.) This recognition requires that I reveal 7 things readers do not know about me yet and pass it on to 7 bloggers. Here goes.

  1. I have become a daily coffee drinker since embarking on my healthy eating.
  2. I love to visit new places (the more exotic, the better) but hate traveling to get there.
  3. My favorite place on earth is the Kona side of the Big Island of Hawaii.
  4. I strongly support universal health care. (Hey, if it’s good enough for our Congressmen for life…)
  5. I despise the state of Oklahoma even though I cherish my ancestry as a bona fide Cherokee from Oklahoma.
  6. Listening to music is sometimes as good as sex.
  7. I have a list of every patient who died under my care so that I will not forget them.

My list of Beautiful Bloggers who have not received this award includes those from above who have not received this award, and I will be letting them know in separate comments or e-mails.

Thanks again to Karen and Angie for these awards and forcing me to recognize my appreciation of other blogs. We spend too little time expressing our gratitude.

Jan

Headed Home & Random Updates

Twelve days later, and I am returning home to my “Pack” of critters and my spousal-equivalent (what a romantic term…). In the almost 20 years that we have been together, I had never been away from my family of choice for more than 1 week . Despite all of my concerns over being homesick, leaving the safety of my food controls, and entering into the heart of my past, the time flew by.

I intentionally took my professional physician-hood with me – both as a self-protection against the illness surrounding me and to deal with my parents’ doctors (something I had never done as I am loath to play family doctor with my relatives). This worked surprisingly well, and I had warned my family ahead of time of my intentions. Using my jovial and best Texas drawl (doesn’t take long to lope back in to it), I would introduce myself, “Hello, I’m Dr. X, please call me Jan.” I met wonderful nurses, food service personnel, respiratory therapists, and hospital aides during my father’s inpatient stay. He loved the neurosurgery or surgery resident who visited with him every morning. The attending neurosurgeon (see post and comments below) only saw him immediately post-op and right before discharge – just as well. There is a reason the medical school involved graduates the second FEWEST number of primary care doctors out of the 141 schools in the USA.

Comments from family and friends who have had quality experiences with surgeons (including me – thank you again, Dr. Katie Artz) have been swirling rapidly across my phone and e-mail since the post about my father’s surgery. Let me reiterate that many surgeons are wonderful physicians – there just aren’t enough of them, and there are not enough excuses for poor bedside manner among physicians of ANY specialty.

My mother’s cardiologist is a good clinician and excellent communicator, though he looks younger than our puppy. Her primary care doc is amazingly aware of her myriad conditions and addresses most, especially when prompted – it’s good for those visits to have another face in the room to slow him down. I’m glad that I no longer practice primary care – the office setting remains overwhelming; patients management is becoming more complex; needless paperwork continues to grow; and insurance companies are more intrusive than ever. (I had another “lovely” encounter with the folks’ Medicare HMO that ended up with much threatening on my part and finally some service on their’s.)

Spending time with my sister who does the primary care-taking of our parents was a joy and a privilege to be able to give her some respite. The few hours that I was able to be with my hard working bro and his wife (my 3rd seester – our family’s spelling) was an absolute delight and far too short. The family has many tough decisions ahead as my father attempts to recover back to baseline, and my mom probably faces her 3rd heart valve surgery for severe congestive heart failure.

Eating was mostly OK. I experimented with sweets and diet drinks – blech. I pined to be able to walk but self-imposed obligations and ungodly heat/humidity kept me from exercising. I cannot wait to get back on track to “clean” eating in a structured format. Oh, I did buy a swimsuit – my sagging skin would put me in a freak show, but HEY! I have curves again!

Update on Miss Mattie: Her ocular tumor was a melanocytoma meaning almost no risk of spread. We are all most grateful, wondering if something less invasive could have been done (radiation?), but she is learning to bump along with one eye and ominous wink.

I will get back to posting more sanely and also honor Karen@Waisting Times‘s blog award when I get off the iPad. Learned much about my history from my dad…

Candy Is Disgusting – Who Knew?

I caved; I freely admit it. After almost one week of exposure to sweets galore, I finally gave in and allowed myself to eat some chocolate (and not the dark 73% cacao type). This turned out to be a sickening experience. The sugar rush was horrid. The taste was overwhelmingly sweet. My pancreas went into overdrive, and I wanted nothing more to do with candy – I hope.

Unlike quitting cigarettes more than 30 years ago and finding that my nicotine receptors were easily stimulated by smells, activities, and certain people, my ultra-sweet receptors(?) seem to be highly offended by exposure to these substances. BUT, I’m afraid that I could quickly become immune to my nauseating response and relapse to eating sweets of all types. I certainly still struggle with starches and keep them out of reach. The slippery slope to eating very high glycemic index substances might be close by…

Until I return home, my solutions are to fall back on the 5 D’s –move my mother’s stash of sweets into her bedroom (distance); distract myself with any number of tasks that need to be tackled in their house; drink, drink, drink water (or iced tea since this is Texas); take calming deep breaths; destroy any sweets I grab for, or at least get them out of my reach.

When will my problems with stimulus control go away?

Post-op Day 1

Who could have imagined that my biggest source of frustration so far would emanate from… other physicians. That is, if surgeons are really physicians and not just technicians.

A physician is respectful of her/his patients – does not make jokes about their age, refer to them as ancient, nor sneer when speaking to family members. A physician does not ignore standards of care when managing postoperative pain – the very pain she/he inflicted. In fact a physician cares about the well-being of his patient beyond the organ or disease or injury he is trying to treat; listens to input of others involved in the patient’s care (nurses, therapists, even lowly family members who know the patient’s baseline health care status best); and takes time to conduct more than cursory examination of the wound site (perhaps then he could recognize the signs of significant blood loss).

Yes, it is a rare surgeon who also is a physician. Fortunately for Dad, my not-so-subtle involvement in his care has brought a hospitalist to his bedside so I can sleep tonight without worrying that he is suffering needlessly or at risk of complications because a real physician is not available 24 hours a day during his recovery.

Closing rant summary:

A surgeon at a top ranking medical facility is not necessarily a good physician.
Families must be ever vigilant in their loved ones’ (and their own) medical care.
No amount of health care reform will make a good physician out of someone with a medical degree.

Care-taking & Taking Care

Today the big adventure (?) begins as I head off to Texas for my father’s long overdue back surgery. To complicate my parents’ situation, Mom was just released from the hospital after a bout with sepsis and 2 weeks of needed rehab. Now they cross paths entering and leaving the hospital, neither one in good physical condition.

I have been dreading this visit – not because I don’t like/love my family, but because I am selfishly concerned about how returning to my family of origin will impact my new way of eating. Certainly I am not looking forward to seeing how much my folks have aged over the last 4 months, and being a daily care provider is not my forte. (Hey, I became a doc not a nurse… don’t do these things well.) Also, being around my parents makes me eat – how ridiculous is that statement? Nothing and no one makes me eat but me. I am, however, an emotional eater and so many issue from my very young life rear their angry and hurt heads when I visit in my parents’ home.

‘Nuff said except to see more postings from my new 3G iPad over the next 2 weeks.