Insert Title Here (Cause I’m at a loss)

Perhaps the last 20 pounds are the hardest. No, the first 20 pounds were. Wait, maintenance is – experience tells me so. No matter, something has been going on in my body-brain connection that has me stalled. Suddenly cupcakes look tasty. Processed food no longer is a turn-off. The drive to eat healthy is not driving me. Even my thoughts about eating are disheveled, chaotic, fragmented, manifesting in dreams.

I could blame this on my breast cancer (99.99% chance of cure from surgery in May) and the discomfort – fuck it – agony of reconstruction. I could recall all of the literature on sleep disturbance and how that messes with one’s existence, not to mention weight loss. I could blame my coping skills, realizing that my teeny-weenie anxiety disorder is off the wall now as I await the next surgery in 1 month. Or, I could give myself a break, realize that the past 4 months have indeed been sucky on me and Sue (who is starting to crumble also), that it’s OK to be fragile even if your partner thinks you shouldn’t be, and that I do have adequate coping skills that do not include eating protein bars – 3 at a time…

Exercise has become a relief. The 30-minutes on the indoor bike are a time to experiment with the digital output, play with my heart rate, see what activities make me go faster (music) and with less boredom. I can walk in the heat but pay the price in, um, chestal swelling. Walking is much more relaxing, uses more muscles, and is still my exercise of choice – just not at 5 a.m. Writing helps. The kind of writing that simply is free form then putting it away. Tracking my eating had become sporadic – I’m back to putting everything into Livestrong. How easy it is to slip on such an important behavior!  I now am more avoidant of political issues, which was only fueling my anxiety and deflecting my true emotions. (I can’t do anything about which moron is chosen in the Republican primary anyway.) Sue and I have agreed ways we can help each other with my eating (rather, not eating protein bars), dealing with my increased anxiety, and her tolerance, or lack thereof, of anything Jan 😉 , and acceptable methods for her to be more verbal about her needs. I have a serious goal for a certain waist size and optimal health for surgery because it is going to be another long recovery process for my new foobs. I expect this one to be less painful and for both of us to cope better.

I’m OK, really. I’m not. But I’m working on it.

anxiety cartoon

Horn of Africa Disaster

Aside

My regularly scheduled content will return next post. I am not letting go of the Horn of Africa disaster just yet.

I understand money is tight. An easy action any reader can do is to sign this petition asking world leaders to provide full funding to the U.N. to help Ethiopia, Somalia, and Kenya where over 12 million people are at risk of death from starvation and infectious diseases. These leaders fund wars; time to fund some health. (Use a throw-away e-mail address if you don’t feel like revealing your true self.) Go here to sign the petition and read more.

Peace.

Jan

Horn of Africa drought map

A Challenge…

Thoughts of hunger have weighed heavily on my heart for months – not my hunger, but that which afflicts millions who have few or no resources to help themselves. Finally I was knocked into action by a web site with a post titled Your Yoga ain’t $#!& unless… The rest of the opening sentence says “… or your Judaism, your Christianity, your Buddhism, your Suffism, your Islam, your Paganism, your New-Agism, your humanism, your atheism… unless you do something about this. What appears to be the worst human catastrophe in our lifetimes is occurring now and we each have the ability to do something about it.” You can read about the 12 million people suffering from lack of food, clean water, and basic sanitation. The almost 30,000 children under the age of 5 who have died in the last weeks from malnutrition and associated diseases.

My spiritual and humanitarian beliefs are meaningless unless I act on them.

I chose to go donate the amount of dollars equal to the number of pounds that I have lost through UMCOR. 100% of my money goes directly to relief efforts. I have zero affiliation with this organization, but their standing in regard to charitable efficiency is excellent. (Also, I am not a Methodist and barely can identify as Christian because I think even Jesus would be embarrassed by many who co-opt the name these days.)

Do something, anything. Clean out your pantry and donate to you local food bank. Give money through a local organization to fight hunger in your home town. Donate to combat poverty here in America. (Don’t cop out by believing your taxes do this.) Fight the crisis in the Horn of Africa.

Help really hungry people. Suddenly appetite hones to a different perspective; bodily pain becomes a distant hum; I am blessed beyond riches.

Not All Obese People Die From Fatness. Well, Duh

Aside

Most of us know how inaccurate the BMI is as a measure of fat & health. A 16-year prospective study just released shows that obesity alone does not determine mortality down the road.The study followed 29,533 volunteers from the Cooper Clinic in Dallas over an average of 16.2 years; 6,224 were considered obese; the obese folks were categorized into a 4 point classification system based on fatness-related illnesses – Edmonton Obesity Staging System (EOSS) levels 0-3.

One of the things I did in my former life was to critique scientific articles. I won’t do that in detail here but will point out a few limitations and summarize. Plus, I encourage you to read the results in the abstract plus look at Table 1 to see the EOSS classification system of health that they used rather than BMI and Table 2 to see the characteristics of the participants.

Bottom line: the more obesity-related diseases at the start (for example, diabetes, heart disease, hypertension, sleep apnea, limitations in daily activities, even mental health issues), the higher risk of mortality over follow-up in  EOSS groups 2 & 3. Those in the EOSS classes 0 or 1 actually had lower risk for heart deaths. All EOSS categories had higher risk of cancer. (See Figure 1 from the article below for a picture of risk of death at the end of the study.)

The participants were highly educated, White men (sigh), which means this is not representative of most of us. Not all participants were available for follow-up over the entire study, and the length of time the participants were followed varied by group. (For example the normal weight people were followed for an average of 17.6 years, EOSS 0 and 1 for 18.4, EOSS 2 10.2, and EOSS 3 11.9) I don’t see that the authors attempted to account for this statistically. (But I didn’t read it that closely in my attempt to get this on the blog quickly.) Weight or fat measure was not analyzed over time, so fluctuations could have occurred differentially among the groups.

This doesn’t mean stay fat. This lends credence to the saying, “fat and fit” (If you are a wealthy, educated White male living in Texas…) But the cancer risk is hard to ignore. More importantly it provides a measure for other studies to use rather than BMI for measuring risk in fat folks. Also, if I were a practicing doc, I would start incorporating this scale to assess risk and advise patients. (Because BMI sucks so badly.)

A final caveat. Although this study shows increased risk of death among those with more fat-related (my words) conditions, it does not prove that treatment of fatness or the related conditions will decrease the risk of dying or dying from cancer or heart disease. This study does not address that question. But it is always tempting to extrapolate…

HR=hazard ratio. How much more at risk than the normal weight group. NW=normal weight. CVD=cardiovascular disease

Born Free No More

Once upon a time, a couple of humans and a beloved legacy of stray critters roamed the country together during precious days, sometimes weeks, stolen from demanding work. Imagine a time before routine use of cell phones, iPads, free Wi-fi. Totally unplugged “The Pack” would bundled up in their cocoon of a 24′ motor home and head for the out-of-doors, away from the 4th largest city in America, searching for dark skies, fireflies, quiet waters, and peaceful dreams. From Oregon to Florida they drove and camped and hiked. Six beloved pets (even the cats) understood the words “going camping” and “get in the Born Free”.

 

We learned all of the hiding places a kitty could find in such a small space, and that sometimes they could disappear into the forest, onto the beach without leaving a clue as to their escape route. They always came back, not always before their humans had started wailing over their demise. Pups seemed content to lounge and eat in the safety of their second home.

Yesterday, after 15 years, when we pulled her up to the house to remove all of our crap gear (so that’s where my fly rod went to!), the last of the puppy pack leapt into the cabin and rolled on her back, tongue out, tail wagging – where are we going? Nowhere, Lucy. In less than 24 hours on the market, we had sold our Born Free for asking price. We had stopped using her for anything but accommodations for overflow family and one final trip to the Grand Canyon. So many memories of outdoor adventures and our Pack frolicking together. But, like the phase of fast and fancy cars, eating out every night, and working 80 hours a week, our regular camping and RV days have ended.

Hiking, however, is still in my future. We moved to Arizona for the environment. Glorious trails surround us. Our love of travel remains. My stamina will return even though the next surgery requires another serious bout of down time. I found my Leki walking poles in the Born Free!

Born Free, Adios

Exercise & Surgery Plan Update

Status

The recumbent bike stayed in the Arizona room, which now has temporary pleated shades (the cats eat any shade with strings) covering the six windows and a darker film on the door. A 20″ floor fan keeps me cool, and I open the room to the rest of the house before starting my 30 minutes on the bike. After 5 minutes of grumbling about aching knees, I lose myself in whatever I’m reading or watching on the iPad or giggle (yes, I am capable of giggling) at the dogs as they run wild in what usually is restricted cat territory. The 30 minutes pass quickly, and I’m ready for the next day. Walking has not been as consistent, but I’m working on it. My chest swells in the heat – nothing but a thin layer of skin between my foobs and the rest of me so the saline inside feels as if it is boiling in the direct sun!

Speaking of foobs, I moved up the surgery date to September 28. That means we give up our trip to Hawaii – heavy sigh. It was Sue who suggested spending our vacation time for surgery. I probably wouldn’t be able to enjoy Hawaii very much with the tissue expanders causing so much discomfort, and I refuse to wear a swim suit with the extra skin that I can hide so easily under camisoles and shirts. (Hey, no bra needed with these rocks.) This next surgery is supposed to be a “breeze” compared to the mastectomy. How much of a breeze can a 2½ surgery be when the plastic surgeon has to replace the expanders with nice, soft silicone implants, remove excess skin, make needed repairs (incisions and secure the division between breasts)? The recovery should be much quicker although — you know I just don’t want to think about that aspect until it gets closer.

I have a goal to lose 10 pounds in the next 6½ weeks, so I’m off to bike, walk, and plan the rest of today’s food. Here’s to anticipating my new chest and getting rid of pain discomfort!

Absence Is A Relief

The past 2 days I have struggled with a certain food sitting in our pantry. My first mistake was allowing an afternoon to hit when there was absolutely nothing in the house I could or would eat, having reached the tipping point with tuna. And then, for some reason not having the initiative to get out of the house to go buy groceries. The third mistake was allowing myself to eat a protein bar. I read the label 4 times, duly noting the high protein content and also that it contained cane sugar, beet sugar, oats – all of which drive up my sugar cravings. Three times I put the bar back into its box. The fourth time I savored every bite. Then counting up my calories, I ate another one. Yesterday I did the same thing – 2 bars, staying within my calories but now totally off my no sugar/grains and processed foods. My cravings were back. This morning I am disgusted by my behavior (not with me) and the physical sensation that I felt afterward, but those damn bars sit there. For months I had ignored them. The absence of sugar desire, lust, cravings had been such a relief for so long.

Last night I sat quietly in our living area after reading and abruptly noted a total absence of pain in my chest (post-mastectomy pain). I was afraid to move, to change my breathing, fearful the magic would be gone, or that I was dreaming. The relief was so enormous that I fell asleep for 3 hours in the early evening – sleeping without discomfort for the first time in over 2 months, sleep that I had never obtained with pain medications.

This morning as I try to sort through what caused my brief sugar attack and the wondrous bout of pain relief, I realize how the absence of symptoms or negative emotions (cravings, pain, grief, loneliness, fear) can be as uplifting as the feelings of self-control, joy, love, peace. Not that I want to establish a sense of nothingness – not at all! I am just reflecting on how the easing of any type of prolonged distress can be so soothing.

I will not let myself get into a situation where those protein bars call to me and am confident that I can regain my no added sugar diet immediately. Getting that no-pain thingy though – quite the mystery.

Walking & The Art of Compromise

Status

Yesterday we walked for 34 minutes through Canyon Ranch. Sue brought the dogs, which always slows things down (gotta scoop the poop), but it’s a good trade-off for the company and makes me feel more secure walking on the uneven terrain.

We are still negotiating where to put the recumbent, stationary bike. That sucker is big, and the bedroom seems a no-go for Sue. (Even though there is more than enough room, and it would make a fine hanger for clothes.) So, I am surveying the house today looking for alternatives to offer her highness my sweetie.

Time Warp

♪♫ It’s astounding (cue music from “Rocky Horror”); I’ve got to keep control… Let’s do the time warp again.♪♫

Besides a referral to the classic cult film, I am truly in a time warp and back to the start of a behavior change – physical activity. Cleared by my plastic surgeon to return slowly to whatever my body can tolerate, I cannot stay on a regular schedule of anything. Sound familiar? Oh, kinda like, “I just can’t stay away from sweets.” “I can’t lose weight again.” “I can’t stop bingeing.” ARGHHH!!!!

Yes, I am discouraged by the complete loss of stamina after 2 months of next to nothing besides walking for daily activities. And, the Tucson heat does not encourage my favorite activity, which is walking. Swimming is out because I still have incision sites that have not fully healed – heck, even my therapeutic tub is off limits. Upper arm toning is beyond me now for foob reasons – trust me, I’ve tried. WAIT! I need to go back and approach this like I did my weight loss.

What is the specific behavior(s) I want to do now? Walk at least 30 minutes a day; cycle indoors at least 30 minutes a day.

Where am I in my readiness to change? Preparation – meaning getting ready to act and maybe still a bit ambivalent. (Hey, I’m still losing weight while being inactive. JUST KIDDING)

What should I do to help me move into the action stage?

  • Prepare a plan of action: Move the recumbent bike into our huge bedroom where I can watch TV or listen to music. It will be more visible than where currently stashed and in a more comfortable (read air conditioned) environment. Walk whenever the temperature allows, which means the morning hours. I plan to drive to a beautiful nearby track to avoid snakes and uneven terrain for now. Can’t imagine falling on my foobs. Whenever there is no time of day that is comfortable, I will pull out a walking video that is timed to 30 minutes.
  • Seek support: By choosing to come forward here about my difficulty with exercise, (which is not easy after so much success in changing my eating) and knowing most readers have successful experience with physical activity, I am hoping you will poke and prod me along. I also will pay more attention to exercise blogs and start commenting (maybe) on those. Engage Sue’s support – at least she can help me move the damn bike and perhaps walk with me on weekends.
  • Make a list of motivating statements. Well, duh. OK, off to do that in private.

If I really do all of the above, I should be heavy-duty in the action stage next week.

All suggestions from your own experiences are more than welcome!

dancers from rocky horror movie

Maybe dancing would be good exercise?