Working it

Things have been going well.  Both my father and brother are out of the hospital, thank you, God.  My father now has about two months of recovery at home before they re-do the hip replacement.  He is in very good spirits and has such a positive attitude.  I respect him so much for having the strength to get through everything he has been dealing with without breaking down.  He had a hip replacement that got infected, had the hip replacement removed, a spacer inserted, has been in the hospital six separate times, rehab for the last six weeks or so and then has to have the hip replacement redone.  My brother has been put on new medication and they are hoping this will work instead of having a new heart transplant done.  If not, he will go back on the list in a few months.  I continue to pray daily for my family.

I started working with my personal trainer.  She is just so awesome and it was such a great decision on my part.  I'll be working with her for three months.  We will be checking my weight and measurements every three weeks.  I shared with her my experience of having weight loss surgery and my attempts of weight loss.  She was in awe of me and actually told me that I was an inspiration to her.  Wow, I had to pick my jaw off the floor.  I started a separate page on here for all of my strength training workouts if you'd like to follow along or at least get the benefit of a personal trainer without having to pay for it.  There's a link for it at the top of the page.  I'm doing things with her that has taken every ounce of courage to do in the middle of the gym.  When people work with personal trainers, others in the gym watch.  It's a very big gym so this isn't easy.  One time I was doing cardio while she was training someone else and I swear every pair of eyes was looking in the corner where she was doing the training and watching.  Yet, I don't let that stop me.  I've even done weight lifting in the section where all the men with muscles do the majority of their work.  What's been interesting for me is that they are not looking at me and mocking me for being the fat lady trying to work out (which is what I had envisioned in my mind).  Instead, they are looking at me and smiling, even checking out my legs when I stand in front of the mirror focusing on my form.  It's been so weird!  I almost feel, dare I say, normal.

I also have seen the dietician at Kaiser's Positive Choice center, which is part of a service I can employ after surgery for help with my nutritional needs.  I just have been feeling weak and lightheaded.  I wanted to make sure that I was doing the right things for my body with the increased exercise.  When I work out, I'm burning about 900-1100 calories a day with just exercise.  Given I was eating 800 calories a day, it makes so much sense that I was feeling the way I was.  The dietician told me that 800 calories a day is just not enough for a person that exercises as vigorously as I am.  He did a mathematical calculation based on how many calories are in protein and what I was taking in each day.  He told me to increase my calories to 1200 per day instead of the 800 my bariatric surgeon recommended.  He understands where the doctor was coming from, but we do need to take into account how much I'm burning during workouts.  When I asked him how I should increase the calories, he said it is as simple as making sure I'm getting enough healthy fats in my diet such as coconut oil or almond butter.  He also told me I need to take in 100 grams of protein per day now with the increased calories and to ensure I am hydrating enough.  He stated that I should try to get in as many fluids as possible earlier in the day but to shoot for at least eight cups.  He also agreed that the strength training I'm getting with my trainer is especially valuable in dealing with excess skin and having a toned body because we can lose a lot of muscle mass with significant weight loss if we are not also incorporating strength training.

So, my friends, I'm working it and taking good care of myself.  It's a long time coming, that's for sure.

Met with the dietitian today

I didn't know Kaiser moved so fast ... yesterday I went to see my primary care doctor and was told to call the nutrition services department on Thursday to make an appointment with a dietitian.  Instead, they called me late in the afternoon the same day, told me they had a cancellation and wanted me to come in this morning.  While I was there, my doctor wanted me to get a diabetic photo eye exam, the kind where they dilate your eyes.  Oh joy!  Guess kill two birds with one stone (what a horrible saying by the way). 

The meeting with the dietitian was pretty awesome.  She told me that she read up on me before I came in so she was very familiar with my whole journey and was impressed not only with where I have been, how much weight I've lost, but also my courage in walking forward through such a difficult time.  I could feel tears sort of sting my eyes when she said that and told myself, "No, Kathy, hold it together girl!  It's okay to cry, but you have got to be present to hear the advice she'll be giving you about nutrition." 

So I laid it all out on the table for her, especially my concerns on no longer being in the safety of the liquid program that Optifast provided and so deathly scared of gaining all the weight back.  I wanted to know how to do "real life" with the food so that I can not only continue losing weight but doing it in the healthiest and safest way possible, all the while trying to keep my low blood sugar at a normal level.  Not too much to ask, right?  Ha ha!  One of the best things she did was draw a chart for me on how the body reacts to the food that is put in it in terms of blood sugar.  For fast-acting carbs, like the food I was having to have to raise my low blood sugar (glucose tabs, orange juice, regular soda, etc.), it raises your blood sugar fast but then you crash in about two hours.  However, if you have protein, it takes four hours to lower your blood sugar and even takes fat five hours.  So, when I wake up in the morning, she does want my blood sugar to be around 80-120.  Then, with each meal, I should have a minimum of a high fiber carb, lean protein and healthy fat to keep the balance going throughout the day.

We talked in great detail about the food plan I was given from the Optifast clinic (which is part of Kaiser) versus the food plan in the diabetes education materials and where that leaves me.  Basically, I'm super confused. I explained to the dietitian that I track all of my food in the "Lose It" app on my phone and it tells me how many calories to consume based on my height and present weight.  And it's different than the other two plans.  The dietitian told me that she'd like to see me having about 1300-1500 calories per day since I'm tall (5ft 9.75 in).  However, when I exercise, I can add those calories that I burn back in.  So that's when I brought up a question that has been on my mind a lot:  If I'm told to have, say, 1400 calories in a day and then I burn 700 calories through exercise, is she suggesting that I am "allowed" to consume 2100 calories??  That seems like a lot to me.  She told me that, in fact, that's true.  However, I don't have to eat every calorie I burn, but that I could have up to that amount.  One thing she was adamant about, however, is that I should have no less than 1000 net calories per day.  She went on to explain that when we lose weight really fast, like on a fast or some sort of bariatric program, it really messes with the metabolism, so the weight loss is going to be a lot slower than what I've been used to.  At this point, in all honesty, I would be thrilled to be losing a healthy 2 pounds or so every week if I was doing it through regular diet and exercise.  The whole goal here was to be healthy, at least for me.

Given all the information she had on me and the questions that I had, she put together a program for me and gave me handouts as guidelines for what I should be eating.  I created a new page here on my blog with my current food plan, but didn't list specific foods.  I didn't want someone coming along and just following what I'm eating because everyone is individual.  However, I did put on that page the basics of what I'll be doing.  Here's my general food plan:

Breakfast:  1 protein, 3 carbs, 1 fat
Snack:  2 carbs
Lunch:  2 protein, 3 carbs, at least 1 veggie, 1 fat
Snack:  2 carbs (especially important for me before working out because I tend to dip really low with my blood sugar during exercise)
Dinner:  3 proteins, 2 carbs, at least 1 veggie, 2 fats

  Some other guidelines:

• Non-starchy veggie quantities are unlimited
• No more than 45g carbs per meal
• Good idea to add a protein or veggie to each snack and adjust where needed
• To keep blood sugar at an even level, aim to have  a high fiber carb, lean protein and healthy fat at each main meal
• Carbs consist of starches, fruits, milk and sweets/other 
• Don't skip meals
• Eat every 3-4 hours
• Choose fish two or more times per week
• Keep a record of what you eat and drink
• Weigh and measure your food as much as you can

It seems like a very simple and easy plan to follow.  I can meet with her again, but I also will be continuing in my Optifast support classes and seeing my regular doctor, too.  I'll continue monitoring my blood sugar like I have been doing, logging in my food and just taking this journey one day at a time.  After meeting with her, I felt really comfortable and it doesn't seem as daunting.