Everything seems to have a dark side

Don't get me wrong, I'm delighted with the weight loss progress. But it turns out that it comes at a price. 

There's this little thing called discontinuation syndrome I just learned about. In a nutshell, tapering slowly off the headache medication was a good idea except for the fact that if you have been on it 5+ years like I have and you were on the highest dose for the better part of that time and you have a freaky system like I have then sometimes things go sideways after you are off it. 

Normally, I think of myself as a positive person who probably verges on irritating most people around me with my near inability to give in to discouragement. This last week has given me a nice clear view of an ugly, dark abyss that I'd just as soon not venture near again anytime soon. 

Imagine your mental state after a week of THIS:

Near constant nausea

Disrupted sleep

Endless nightmares

Fatigue

Flu like symptoms

Cognitive issues

Sounds crummy, right?  It sure is. I don't recommend it. And I may have 2-3 more weeks ahead of me.  Worst case scenario could be 8 more weeks.  

If I didn't have the family support keeping me going right now, I don't know what I would do. But if I seem off, I am. It's nothing personal, just a blip on my end that I have to muddle along with because the only way out is through. 

On the bright side, no headaches. 

#winning 

Am I right? 

 Somewhere in my subconscious, I have some major issues with car crashes. Every single nightmare has been about one. 

Update: Long overdue

I haven't updated about this whole weight/nurse practitioner drama issue. 

In the end, I did email the program manager. She was quite chagrined to learn of the deplorable level of professionalism that I had been met with in my dealings with the nurse practitioner. She confirmed that I was indeed correct in my estimation of the inappropriateness of the response that I received and assured me that I need have no further dealings with that particular provider given my level of discomfort going forward. She kindly offered me several alternatives and suggested I take time to consider it. After a bit more mulling and some advice from a friend on some potential nutritional issues, I decided to focus on one variable at a time and stick with backing off the medication that could be contributing to the problem. 

That brings me to today. 

Yesterday was my final day on the medication. I've lost 10 pounds since I started tapering the dose. And I've also happily misplaced almost 6 inches overall. The headaches seem to be under control and there has been a huge decrease in my shoulder and back strain. Any way you slice it, things are looking better and even if the NP was a dingbat, she did give me an important clue to investigate. I certainly can't say that the drug was the only problem but I think it is safe to surmise it was a contributing factor. 

Lots of work still to be done, but I am on my way. 

More on numbers

I met with the nurse practitioner for my official health assessment today. 

As it happens, I am not 5'3" as I have thought I was since probably high school. I am actually 5'4.5" tall. Ordinarily, this would be a semi useless bit of trivia. However, it has a significant bearing on height/weight charts such as the Body Mass Index. Significant enough for me to be bumped out of the Obese category. I don't know whether to feel aggravated or relieved. I guess it's both. 

It was not significant enough to get me off the hook with the weight loss for the breast reduction surgery. So, there is that issue to deal with either way. Still it was nice to know that my self perception isn't completely skewed and crazy. 

At this point a weight loss of only 26 pounds would put me into the healthy weight zone. I can live with that. 57 pounds was a whole different situation. Granted, that number would still keep me from falling off into underweight zone but not by much. 

We talked about my overall health given the RA and my headache issues. And my fitness and daily habits for eating. I'm doing everything I can correctly according to the NP and historically, it's always worked for me. The one issue she mentioned that might be making things harder is one of the medications that keeps my headaches in check. Apparently, it can really increase cravings for carbs and high calorie, nutrient deficient ones are at the top of my guilty pleasure list. 

She felt like the program would be very successful for me given my normal habits and propensity for tracking and graphing progress of everything. And she mentioned that although I probably will have less to lose than others in my group, it's often helpful to be an example for others. On the one hand, that's a nice sentiment but on the other hand I still feel kind of weird about the whole thing. She stressed that the diet would help me get reset to my goal and that my habits and the things learned in the 82 week program would help me manage it from that point onward. 

Now it's about making the decision to do it or not. And the money. This program is not cheap.  They estimate that a normal family environment spends about $117 per person per week on food. I feed a family of four (including the bottomless pit 13 year old boy) for about $135 per week. Granted, I make almost everything from scratch. But on the program, they estimate $90/week for just me compared to the $30ish I spend now. And that is before you add in the monthly fees and medical monitoring costs. 

I'm torn. Part of me feels like its a ridiculous expenditure. Part of me feels like if I can just get back to where I need to be, I can handle it from there. All of my doctors are in favor of it. The family is completely supportive of me either way. J's comment was, "What would be a better way to invest in than myself?"

Am I a number?

30

57

Are these numbers a representation of me?

30 is what the BMI (body mass index) says I am. Obese to put it bluntly. 

57 is how many pounds I need to lose to be smack dab in the middle of the heathy weight for the BMI. 

I'm not sure they really represent me. I'll agree that I'm not skinny. As far as body image is concerned, I'm in a good place. I'm stronger than I used to be and faster. 169 pounds feels ok. I run and bike and hike with the kids. I don't feel unhealthy. I mean, yes, I have Rheumatoid Arthritis. And without the miracle drugs, I wouldn't be able to even walk. But, overall I think I'm managing it all right. The only big issue is the shoulder and back pain from my overly busty chest. That is the reason I'm going through this process. 

BMI doesn't address fitness. It's strictly a numbers game that evaluates your weight in regard to your height. It can't tell you that I run 10 + miles a week or that I'm perfectly capable of biking another 22 miles a week. I'm proud of those numbers. I had to do some serious fighting to get there. BMI says I'm too heavy to qualify for surgery to address this shoulder/back/chest issue. 9 pounds too heavy at the moment. Personally, the BMI thing feels like a scammy slap in the head. But, you have to do what you have to do, right?

So I'm going to do this. Both the doctor in charge (who is a runner himself) and the program manager have assured me that the Kaiser program will enable me to keep up the running and biking and lose weight at the same time. I haven't had much success with that on my own. A net loss of 3 pounds is what I've managed since February. 

I'm anxious to hurry up and get to July 31 and get started. I'm nervous, though. In the orientation class, I was the smallest person in the room. I felt conspicuous and out of place.  Lots of people appeared to be pretty sedentary and to have more than a hundred pounds to lose. I'm worried that I'll be taken less seriously because of that. And I'm worried that I'll be successful and lose it but fall back into bad habits and gain it back again. That would be beyond frustrating. 

I know my joints will thank me. And my back and shoulders will thank me, too. So, this is it. Here I go. 

Testing, testing.

I spent yesterday morning at the Kaiser lab for my fasting blood tests. 

This morning, I had a date with the EKG department. 

All of this is in preparation for my meeting with the nurse practitioner on Thursday to make sure there are no hidden health issues going on. 

I'm approved to start the Kaiser Medically Managed Weight Loss Program. If you want more information, http://www.kphealthyweight.com/

The program technically starts on 7/31 which will be my first meeting with my group.  

It's been a while, eh?

I've been remiss in my duties around here since Lent has been over. 

Lots of things have been afoot. 

Thing one:

Having had enough of the shoulder and neck pain, I finally contacted my doctors about an appropriate remedy. I was dolefully informed that, no, physical therapy would be of no use. The only solution is a round of breast reduction surgery.

Thing two:

I would only qualify for the surgery to be covered if I was below a specific weight. According to Kaiser, that was 12 pounds down from my weight at that time. I also found out that my BMI was a tad over 30 putting me into the Obese category. 

Thing three:

I tried to lose it. I tracked every thing that went into my mouth. I upped my running to 9 miles a week. The kids and I added another 22 miles of biking in each week. I lost 2 pounds. Gained 3 back. Lost 3 again. 

Thing four:

I browbeat (but in a nice way) my doctor into a bevy of tests to be absolutely certain there was no underlying issue creating havoc for me. 

Thing five:

I attended the orientation for the Kaiser Medically Managed Weight Loss Program. 

Thing six:

I'm meeting with the nurse practitioner next week to start the program. 

Here's my before:

Needles In the back of your head

It's been a crummy past few days filled with emergency doctor visits and needles in my head. I've had such a good run with out the mind numbing month long headaches. My last Botox shots for the headaches were in October 2011.

It's difficult to describe the panic and anxiety that commences for me when a headache starts hitting the second or third day in a row. It's doubly terrible when an ill informed and insensitive medical assistant insist that the soonest you could possibly see your neurologist is in another month. If you are one of those people who actually gets relief from narcotics, imagine what it's like for someone when they offer almost no relief for pain. A cloud of stupidness is all they can manage for me. It's not a pretty picture.

Things are improving but I am worn out. I'm hoping for a peaceful and quiet day tomorrow.

A Fabulous Surprise

My favorite coach, second only to my own, surprised me with the most thoughtful gift today. She brought back from the Odenton meet a little note and autograph from Debra Blee, my heroine. She is many years my senior and took her Gold Medal dance test last year at Regionals. I was so inspired by her.

I have 16 years left to reach that goal by the same age.

Delighted by this happy turn of events, I plunged myself into the Siesta Tango today. The corner is the hardest part and at the moment it's about the size and speed of a figure circle. It can only get better from here. And it wasn't half as scary as learning the Denver Shuffle or a 3 turn which remain my current yardsticks of terror.

Onward!