Archive for the ‘Weight loss’ Category
Sigh. I know, I know. It’s been way too damned long since I’ve even tried to write anything.
I do have a good excuse, though. I had spinal surgery (nerve decompression and laminectomy from L3 to S1) on 27 September, and sitting up to type has been more than I could do for a long time.
One of my conditions for letting the surgeon have at me was that my rehab would be at home; my six weeks in a rehab over the late spring/early summer convinced me that I never want to be in a rehab/nursing home again. Fortunately, my surgeon, the most excellent Soriaya Motivala, believes that you make more progress at home, and faster than in a rehab, so that was no problem. Once the infection was cleared up for good (I had to wait a month after the stint in the rehab to make sure it was all gone), everything – except me – moved pretty quickly. I saw Dr. Motivala in early September, and we set up the surgery date.However, her assistant, the otherwise wonderful Jennifer, forgot to tell me that now that I was a cardiac patient I would need more than just a clearance from my primary care guy. This meant that on the 16th I got a call from the hospital noting that none of my paperwork had come in. So, I then had to set up all of the clearances except my primary care guy (who I had seen the day before). Between Naomi Moslow and the roomie, I made all the clearances in time, which was amazing.
The surgery took place, as planned, and I’ve been recovering since. I was released from the hospital on 1 October – just in tie for the High Holy Days.
Unfortunately, due to the need for the surgery, I missed a lot of stuff during the summer/early fall, including a wedding, a funeral, and – most important to me – the dedication of the Torah that my cousin Mitch’s synagogue had commissioned in his memory. I’d really been looking forward to that, but it was two days before my surgery, and I realized that there was just no way I could do a ride up to Mount Kisco, sit through the ceremony and the meal after, and then ride back. Since I didn’t want to take attention from the ceremony, I stayed home, instead. This coming Monday, I will be missing the funeral of a fannish acquaintance for the same reason. I have spoken to one of the friend’s kids, and since he’s also had similar surgery to mine, he understands why I won’t be there.
I have to admit, the healing process has been much slower than I would like, which I attribute to my weight as well as my age. Let’s face it: you just don’t heal as easily at 64, while carrying a lot of extra weight, as you do at 24 while carrying much less extra weight. I have not given up on relosing the weight, however; to date, I have dropped 64 lbs. I still have a ways to go to reach my goal, but I will get there. It’s been an even more interesting journey this time, since I decided when I rejoined Weight Watchers, that when stuff came up, I would deal with it, rather than just brushing it aside for later. I also made a decision that seems, in retrospect, to be one of the smartest decisions I’ve made around weight – since I am not expending anywhere near the number of calories I used to when I could go walking every day, I cut down the amount of food I was eating proportionately.
I got a huge piece of the puzzle of me the other week, and I’m still processing how to deal with it. I had ordered a lamp, and it needed different bulbs than the lamp I was replacing. My ex went off to get the proper bulbs, and I was lying in bed crying. The roomie said to me, “Deb, it’s okay. It was just a stupid mistake.” My response, which I never expected, was, “But I’m not allowed to make mistakes.”
Now I know that sounds ridiculous, but my father used to beat the mess out of my sister and me if we made mistakes, no matter how small, so I had apparently internalized this, and carried it with me for my whole life. Now that I know it’s there, though, I can work on reminding myself that I AM allowed t make mistakes. I can also give thanks that while I carried this around for most of my 64 years, I don’t have to carry it around for my 65th year.
In other medical news, and this relates back to the weight a bit, my doctors have finally adjusted my blood pressure meds to reflect the weight loss. The industrial amount of diuretics they had been giving me were so extreme that I was totally dehydrated, no matter how much liquid I drank. For a while, the doctors were so pleased with my readings that they were weaning me off the drugs at the rate of one per visit, but when it took the cardiologist three tries to even find my blood pressure, they decided to cut all but one of the blood pressure meds. We are all still watching my readings (my cousin the doctor suggested I get a home monitor, so I could take morning and evening readings and show them to my primary care guy), but so far everything seems to be okay. As I rehydrated, I gained a little weight, but my legs now look like legs instead of bones covered with skin.
So, on the whole, things are improving – even if it’s not as fast as I would have it happen.On the other tentacle, one thing I learned after my heart surgery in 2014 is that it remains important to be kind to myself. In this case, that means listening to my body and doing things when it is ready to do them, rather than trying to hurry things up.
I will try to write more regularly again, but I am making no promises at this point. I am hoping to write at least once a week, but it depends on how well sitting up goes on any particular day.
Well, it’s been a while since my last post, but I’ve been trying my damnedest to do what’s necessary to get the hell out of this rehab and back to my apartment. I miss the cats; I miss the Friday dinner group; mostly I miss being home where I can be comfortable.
I am now capable of getting around a bit on a walker, but I really need to be able to use just my cane to get about again, so I’m working my way toward that.My PT these days is mostly concerned with getting me to use the walker more, given that I pretty much refuse to use the wheelchair for anything but the occasional transport to and from the “gym.”
The food here is pretty much still inedible, so the Roomie and Naomi have been bringing me mostly healthy stuff to eat. Naomi even found two huge jars of artichoke hearts and another two of hearts of palm for me. As of the past Thursday, my weight is down to 242.6. I’m pretty happy about that, you can imagine. I had a great session with my coach, Robert, on Friday. One thing he acknowledged is that my action plans have been getting more specific as I am digging deeper.
So, that’s about it for now. More as it happens…
Yeah, I know – it’s been way too damned long since I’ve posted. Life does that sometimes.
Somewhere around March, I realized that I had fallen into a pretty bad depression. The weight gain, the impaired mobility, the inability to get the MRI I needed, the loss of several relatives and friends all served to hit me pretty hard. I started working my way out from under, and have been coming along slowly but surely.
One thing that helped is that I have been getting more social again. That started with the 25th anniversary party for two close friends. Two adventures lie therein, btw. The first was finding an appropriate gift for our friends, which entailed a trip to Eichlers, a Judaica store on Coney Island Avenue. Being a Sunday, parking was a pain, and we ended up parking around the block from the store. The Ex held my arm as we walked there, and the kind store staff found me a chair to sit on so I could catch my breath. We got the couple a lovely Havdallah set. The second was the saga of the lock. The morning of the party, I got up, got dressed (a beautiful long dress from Holy Clothing), and was checking my email when the Roomie came in and told me she couldn’t unlock the front door. I went up front to check, and sure enough, it wouldn’t unlock. Called the Landlady, who was in the Poconos. She called her dad and sent him over, so we cleared enough space by the front window to hand out our keys so he could try to open the door from the outside. No luck there. Next step was that we removed the doorknobs so we could try to manipulate the mechanism from the inside. That didn’t work.I was beginning to think I’d have to climb out the front window to get to the party. Called the Ex, who was also going to the party, and he came by. We got the Landlord’s dad to open the side gate, and the Ex came to the back door to try to push my bed forward by pushing the door open. To do this successfully, I had to try to move the 140 lb. Peloton exercise bike that sits in front of my bed. Not fun, but somehow I managed to do it. Marc got the door open enough that I could climb over the bed and out of the apartment.Then it was down some stairs, up the alleyway, then up a bunch of stairs. We got to the venue, and it was down some more stairs, which was a bit much, but I made it. The party was lovely, and while I was out the Roomie called a locksmith, and had the lock replaced properly. So we now have a properly working lock.
Since then, I have been out on several Friday dinner missions, a Saturday mission that included a book party, then a walk of about three blocks (2 half-avenue blocks and one street block) to a local ramen place we like and knew could hold a large group, and a Passover Seder that included a climb up stairs and down the same stairs. Pretty good for a mobility-impaired person who also has sciatica. In fact, these days, the sciatica is more of a problem than the heart is.
Today was my three-month cardiologist checkup. He was delighted with my blood pressure (132/80), and even more delighted to find my heart murmur has gotten a bit softer. Best of all, at some point – about three weeks ago – my ankles stopped looking like grapefruit and have started looking like ankles again. My left ankle is totally unswollen at this point, and the right one is so slightly swollen that you have to really look to see it. The legs are unswollen, too, which is nice. I also had a bit of a walk – the car service missed the turn at East 27th Street, so I had him drop me at the corner of my block, and walked the one-third of a block to my house.
I’ve been doing the Weight Watchers Simply Filling plan since the end of March and have lost 20 lbs. so far. I still have a long way to go, and I’m still annoyed that I have to do this all over again, but I can be annoyed and be working on it or I can be annoyed and doing nothing about it…I’d rather be the former, so that it gets done. I am taking advantage of their coaching program, since I was able to book my coaching sessions with my favorite lecturer. At some point, I will be able to get around enough to go to meetings, but for now, this is working, so I am happy about that.
Anyway, that’s about where things are for the moment, so I’ll be heading off to eat breakfast. Talk with everyone again soon!
NYC, including Brooklyn, is caught in this Polar Vortex that the weather forecasters are talking about. What this means in real life is that we are in one of the worst cold snaps in a while. For folks like me, with heart issues, this means we should stay inside as much as humanly possible, lest we add stress to our already compromised systems. F), or once, I am actually taking their cautions seriously. Being 61, and wanting to make it to at least 62, I figure caution and treating myself kindly are pretty important right now.
I did go out – briefly – on Monday. Had an appointment with my internist. While I won’t mention names online, if any of you in Brooklyn are looking for a great practice (two really great doctors, and a third one who is more than competent, but a bit on the arrogant side), catch me privately and I will give you the info. And believe, me I don’t say “great” for nothing; my doctor has saved my life twice, my ex’s life once, and my roommate’s life once.
Anyway, I discussed the situation with my internist, and he agrees with me that a pacemaker would be totally uncalled for in this case. He also let me know that he plans to speak to my cardiologist and make sure that I get a referral to a surgeon, so I can at least discuss what I would need to do (besides the obvious losing weight) to become a viable candidate for the surgery that I need to repair the heart defect. Since my main issue was that I was being rejected by these surgeons without their even meeting me to discuss the situation, the risks, the possible complications, the possible outcomes, etc., this feels like an important step to me.
I have also been dealing with grieving over having to cut a very toxic family member out of my life. This process has been made a lot more tolerable by all the friends, both online and in RL, who have shown themselves willing to step up and fill various parts of that person’s shoes. I have three good friends who are willing to be my medical executors.
And I really got humbled by my friends. Monday, my RL friend C offered to be a designated blood donor for me. We are different blood types, so that won’t work, but instead, she offered to donate a pint in my name, which is superb, because her blood type is one of the rare ones they *always* need. I mentioned this on Facebook, and the next thing I knew, I had a list of ten people, some of which only know me from a Facebook game or two, who were willing to either be a designated donor or donate a pint in my name.
I also just got a phone call from my oldest friend, MK. We met back in sophomore year of high school, and – while our lives have diverged, we manage to find each other again and again. She is a nurse, and did some research last night (she said she couldn’t sleep, so she figured it might be useful) and has found two doctors who specialize in the specific kind of surgery I need. She also found out that I really need to have this done by a specialist, which may be rough to do given that I am on Medicaid. I will see who my internist recommends that I see – perhaps it will be one of these doctors. If not, I will see whoever he recommends first, then call these two doctors. One of them works out of New York Presbyterian. The other works out of St. Lukes. I can live with either of those.
Another thing MK told me to check, which I will, is whether or not my insurance will be accepted if I have to go out of state. This is something that, always having had private insurance before, I never would have even had to ask. Once again, I am humbled that the people who have the knowledge I need are so willing to provide it. She also spent an hour on the phone with me last night, explaining some of the things I will need to discuss with the surgeons when I do see them. These are things that, as a layperson, I would not necessarily thought of on my own, so I am doubly glad for her help.
And other friends have stepped up from all over the place to talk to me at night when things get hairy, to call me during the day to remind me I matter to them, and generally to help however they are able to.
Further, I am grateful today to God who gave me the most useful power of all for this kind of thing: While I damned sure don’t have the answers to much of this stuff, I seem to be able to find the people who can help me get them. This is something I’ve always been able to do, and it has kept my head above water more times than I can think of.
And, just to remind me to lighten up: the roomie just walked in with a big box that the mailman brought. It’s a box of yarn from a dear friend who is an author, including some very beautiful, soft yarn that will eventually be a scarf for me. It’s hard to forget the good things in the world when people are so going out of their way to make sure I remember them.
Anyway, I have some work to do today, so I should get to it.
No matter how I know you, please accept my thanks for bolstering me up through this journey.
Okay. Just got back from the cardiologist, and here is the latest.
I am not the ideal candidate for open heart surgery, or even for the ablation. We already knew that. My age, my weight, yadda, yadda…
The other problem is that I am presenting oddly. For one thing, my heart’s septum distortion is 15. Normally, people with the amount of disability I’m having present with a much higher distortion. For another, the relatively small amount of drugs I am getting are slowing my heart down to 55. So they cannot presently give me greater amounts of drugs because there is a risk of slowing my heart down too much. Dr. S. has found a surgeon for me, but the surgeon has the same issues that Dr. S. and I both have about me undergoing surgery at this time.
The current plan, therefore, is to set up an MRI to doublecheck the amount of distortion, because there is a possibility that the echocardiogram under-represented that. Dr. S. is also changing out the 25 mg of carvedilol (twice a day) for 50 mg of Metoprolol (twice a day). After we get the result of the MRI, he will possibly schedule a CAT Scan of the head, neck and chest to see what is going on with my voice. Once we have those ducks in order, he will likely have a pacemaker put in, so that he can give me larger doses of some of the meds. My next few weeks will clearly be filled with doing some internet research, and making up some more questions to add to the list I’ve been keeping.
I know that caution is warranted. I know that I’m really glad my doctor is conservative in his treatment plans. But, dammit, I really want my life back. The problem is that, given how un-ideal of a surgical candidate I am, the big risks with open heart surgery are that a) I might not survive the surgery, and b) I might not be incredibly functional afterwards because of the issues that make me a less than ideal candidate. Dr. S. and I both agree that if stubborn were the major thing I need I have that in spades, but we also know that open heart surgery — especially when it means shaving off some of the heart wall as well as fixing the valve — is a big, damned, risky thing.
Meanwhile, I’ve been dealing with it about as well as possible. Marc, Abby, and a host of other folks make sure I get out of the house at least once a week, so I don’t just sit and obsess about how little I can do. I have been taking on as much work as I can, because work is always a good distraction. I’ve been reading, and even logged back into a couple of social games on Facebook, so that I’m not becoming too isolated.
I know I need to lose weight, but I am having trouble getting over myself and doing what I know works. I’m really resentful that I have to do it all over again. It took me two years to do it last time, and I was healthy and could walk a lot then. The gods know how long it will take without my being able to walk the way I used to. Honestly, the weight depresses me more than the heart issue. I was born with the heart issue and could not have done anything about it, because – until it triggered – no one even knew it was there. The weight – well, I’d lost most of it before I crashed and burned, and then, when I couldn’t go walking anymore, it all came back. So now I have to do it again, without the one exercise I love best in the world. I really need to get over myself, and go back to Weight Watchers, or at least start doing it at home or something, but I am just so frustrated about the whole issue. It’s the one whole part of this thing that makes me want to run away and hide. I’m trying to figure out how to get myself back to doing Weight Watchers, because I know that if I don’t go into it committed to doing it and doing it right, I will half-ass it and just be setting myself up for failure. And that’s the one thing I don’t have the option to fail at this time.
So, that’s where things are at right now. If any of you who know me well enough have ideas on how I can get over myself and get my ass back in gear, please let me know. Every day I can’t manage to do it makes a real difference at this point.
It’s been an interesting week. I saw the cardiologist on Wednesday, and we discussed where to go next.
It seems there has been a shift in the field away from doing the surgery I need, which is called a septal myectomy, towards doing alcohol ablations. Unfortunately, while ablation is certainly the less invasive of the two procedures, it won’t allow for dealing with some of the issues that have arisen as side problems, such as the now enlarged heart compressing something affecting my vocal cords and breathing.
My cardiologist is trying to find a surgeon who does the septal myectiomy in enough numbers that he can be confident enough to set up a consult for me. He is not getting the answers he wants at his hospital, so he is going to be taking the next month to look for surgeons in various other places. The downside is that this may mean I need to travel to another city to get the procedure done.
While he does that research, however, I will be reading up more on both procedures, and will also be trying to lose a bit of weight. We are not going for any spectacular drops here – my mobility is pretty limited. However, Medicaid has provided me with a rolling walker (rollator) with a seat, so I should be able to start getting around locally, at least. I am not happy with the idea of trying to get something as wide as I am on and off public transit yet, but I have no problem with walking around the neighborhood with it to get used to it.
The rollator arrived yesterday, and I got the arms and backrest set. I would have taken it out for a spin today, but the weather has been threatening to be very nasty. Also, before I go running around with it, I want to acquire a coupe of short bungee cords, so that when I need to collapse it, it will stay collapsed – something that will be important if I want to go to restaurants, or on busses with it. Still, the rollator will allow me to start getting a bit of mild exercise, which will help with the weight loss.
One reason, we want to try a little weight loss is that I was discussing my experience with weight loss with the cardiologist, and the results that occurred the last time I was able to lose a large portion of my weight. If we can cut out some of the medications that had to be increased when I gained the weight back, maybe we can lower the severity of some of the symptoms. Certainly, whatever weight I do lose will make it easier to get around.
Unfortunately, my sister does not seem to understand that all open heart surgery is not the same. She keeps insisting that if he called a particular hospital near her, they would do the surgery in a few days. I have tried to explain to her that the open heart surgery that is most commonly done, the bypass and or stents, is not the open heart surgery I need to have done, but she keeps insisting that the problem the cardiologist is having is finding a surgeon who will do it while I am on Medicaid. She refuses to get that there has been a shift in what the field considers to be the right way to treat my particular issue.
My cardiologist knows that I have not written off the idea of ablation, but that I agree with him that the septal myectomy would allow for a more complete treatment of the issues at hand, including repair of the malfunctioning heart valve.
Fortunately for me, my sister doesn’t get to make the decision as to what course I will pursue. However well meaning she is, she does not understand that just because a hospital does a lot of open heart surgery, it doesn’t mean they do the particular surgery in the numbers that would make my cardiologist feel confident.
So, for now, I get to sit and wait.
At least I have some good news this week. I lost 5.4 lbs., and am back to weighing 231.8, so I’m just about caught up to where I was before I had a small setback.
I’m feeling very revved up this week, and I’m actually looking forward to the two Seders. I’m making Seder the first night, so I have total control over the food, and the meal will definitely be WW-friendly. We are planning a brisket (we got a gorgeous one yesterday, which is sitting in the coldest spot of the fridge), the roomie’s matzoh ball soup (which is yummy), veggies of various kinds, grape juice (we are not big wine drinkers here), and — of course — matzoh. I am also looking forward to having a few matzoh breis over the course of the holiday — tracking everything, of course.
This week has been kind of weird, walking-wise. I have not earned any activity points, but I wasn’t really expecting to; I’ve had crazy deadlines, and since I’m enjoying revving my business back up to where it was before I got sick last June, those come first. But I am still feeling healthier and more energetic, overall, which is the main point of the process, after all.
I have started reading Geneen Roth’s Women, Food, and God. It’s interesting, and I find myself agreeing with a lot of her insights, although I don’t have time to write about them right now. I expect to do so here when I have finished the book, though, so that’s something to look forward to.
Anyway, I must get back to work, so I will see everyone on Monday. Have a great weekend, and I wish you all luck with your programs over the upcoming holidays!
Oh, and just for the heck of it — one of our cats has found a new use for my Pilates toning ring and my exercise towel: