Took My Fat Butt to the Doctor...

Okay, ya'll. I am feeling the need to relate an experience I had the other day at the doctors' office, that has me a little irritated. And you know, if this were the first time it had happened, I might brush it off. But it's not the first time something like this has happened.

So I go to see my gynecologist for my yearly exam. He mentions my significant weight loss since last year. He mentions my metabolic disorder (in my chart). He mentions the endocrinologist who I see for my metabolic disorder, and who my gynecologist describes as "the best". He mentions my vertical sleeve gastrectomy, and asks about my progress. You know what he does then?

He tells me I need to reduce my calorie intake (without asking me anything about my diet). He asks about my physical activity, then tells me I also need to exercise more to maximize my weight loss.

You know... if he didn't know that I had a diagnosed metabolic disorder, was under treatment by "the best" endocrinologist in the area, that I recently had gastric sleeve, that I'm already seeing a nutritionist, and have lost 70 lbs... if he didn't know all of that and as a medical professional wanted to insert his advice about my weight because he was concerned about my obesity, then fine. But when you know your patient has taken proactive steps to combat the condition, is being seen by someone you yourself consider "the best", and has had significant weight loss, well... do you really think another lecture about how fat she is, how she needs to reduce caloric intake & increase physical activity, well, do you really think that's helpful? Or is it degrading? Disheartening? Insulting?

It's not the first time this has happened. In my early 20s I  experienced some breast changes that, because of my family history of breast cancer, my family doctor felt should be evaluated by a breast specialist. So I went. She never even examined me. True story. She asked me to have a seat in her office, fully clothed, and lectured me on how I needed to lose weight, and somehow this would resolve my breast issues. She literally never even looked at my breasts, let alone did an exam.

Let that sink in for a minute. A patient is referred to you, as a specialist, because of significant changes in her breasts combined with a strong family history of breast cancer. And you, as a specialized medical professional, never even examine her, but instead lecture her about her weight as if that will cure all of her issues.

Needless to say, I never went back.

Thankfully my family doctor was as appalled as I was and ordered my first mammogram. He also said he would no longer be referring patients to that particular doctor.

Don't misunderstand me, I know that obesity is a major health issue in our country. But it isn't everything. It's not even close. Nothing about my yearly gynecological visit necessitates comments about my weight, diet, & exercise, especially when you know I'm already being treated for those issues. Nothing about the changes in my breasts were attributed to my weight, nor would losing weight somehow miraculously prevent breast cancer from being a concern in my life.

The sad thing is that these experiences are nothing new, not for me, and not for millions of other Americans. Our concerns, the real medical issues that need to be addressed, are dismissed; we aren't taken seriously; we endure lecture after lecture about our weight, whether we want it or not. We hear the surprise in the nurse's voice when our blood pressure is within normal limits, and the look of surprise on doctors' faces when we tell them that "No. I'm not diabetic. In fact, my sugar trends low."

It's bad enough the things we endure from John Q. Public, but the doctor is one place we should be able to go, discuss valid concerns, and have those concerns addressed, without judgement. But it's not. It's just not.

It's really sad to think that one of the benefits of me one day reaching a healthy weight is that doctors will now take me seriously. Really, really sad indeed.

As always, thanks for checking in!

Has it been three months already?!?

I can't believe it's been nearly three months since my last post. Life has been a whirlwind.

So how about an update on that situation. The side effects of my meds continued to worsen, so after much discussion with my endocrinologist & my husband we decided to discontinue.

So... what next? I have a metabolic disorder. Left untreated the expectation is my weight will balloon rapidly and I will be diabetic within 5-10 years. With my family history, heart disease & arthritis are already losing battles.

So I can try another cocktail of meds, but the truth is I've been on almost everything available over the past 5 years with moderate results. And no matter what they are there is a risk of side effects, many of them serious. You know when your doctor has you sign a waiver... Even prior to my issues I was struggling with my situation being that I was risking my life with side effects to save my life from the disorder. Is that really much of a trade-off?

I can try a liquid diet, hoping the drastic weight loss will lessen my symptoms. It's not permanent, no part of it is covered by my insurance, costs several thousand dollars, sets a bad eating example for my daughters, and even if it's effective in the weight loss will not actually resolve my condition at all, just lessen symptoms and basically buy me time. For what, I'm not sure.

I can try it on my own again. But considering I have been trying (and failing) to lose weight for the past 28 years, know that I have a metabolic disorder that makes it highly unlikely I will succeed without medical intervention... it seems like a recipe for depression & feeling like a failure.

Or I can have major surgery. My endocrinologist thinks I'm an excellent candidate, for a variety of reasons. The surgery he is recommending is 80% effective at treating my condition, and is permanent in 98-99% of those cases. And is likely covered by insurance. But it's surgery. Risks, and recovery, and what-not. Serious crap. So after much discussion with my doctor and my husband, and a lot of soul-searching on my part, we decided this was probably the way to go, and had a lot of peace about the decision... only to find out that my insurance plan does not cover it. I've been given the estimate that cash payment would be upwards of $13,000. Yikes. Not giving up on it yet, in fact I have my first appointment with the surgery center at the hospital tomorrow for an initial consultation, review of my case, etc. I guess we'll see what they have to say.

So right now, for the past 2 months or so, I've done nothing. No meds. Eating what I want (but not over-eating). I've already gained about 10 lbs, and the past week or so I've noticed the puffiness in my face returning that is one of the hallmarks of my disorder (it's water retention). I know I could make drastic changes to my diet & exercise to slow the gain, but I also know from past experience that it's not going to stop it. So I'm going to be really raw & honest with you right now when I tell you that I'm just trying to enjoy myself, love myself, and not worry about food. I'm trying to learn how to dress my body well, accept myself for who I am, and just enjoy my family and enjoy life. We'll see how my appointment goes tomorrow. Maybe I'll get surprise news about payment or something. Maybe we'll win the lottery, LOL. But other than that I'm going to enjoy the next few months and try not to worry about it. We have birthdays, anniversaries, multiple holidays... I just want to enjoy it, you know?

Well, as always, thanks for checking in!

My Fat Butt: 5 weeks on Victoza

Well, it's been about 5 weeks now since I started on Victoza, so I figured it's time for another update.

I'm down about 15 lbs total.

Since I started doing the injections at night, and gradually worked my way up to the full dose, the nausea is all but gone. I do get a slight queasy feeling in my tummy quite a bit, but nothing I can't handle.

The slowed digestion is very evident. I've learned that it's more about how full my digestive system is than anything else. On a normal day I'll eat 2 small meals (usually lunch & dinner), plus one snack (usually in the evenings).

I've noticed the past few days that I've been hungrier than normal (since starting the meds), looked at the calendar and realized that I'm probably going to start my period soon (my cycles have been unreliable since my miscarriage, so it's hard to tell). So it appears that I still need to deal with that hormonal change on a monthly basis, regardless of what meds I'm on.

Back to the slowed digestion - some nights I have heartburn. Bad enough to wake me up. I'll take a couple of Tums, and that usually eases the symptoms enough. It's usually completely gone by around 10am.

The other difference is my bowel movements. Prior to starting the meds I had one per day, usually around 8am (there's a story behind my schedule, believe it or not, if you're interested I'll share, LOL). Now I typically have 2 per day, at no regular timing. On top of that about once per week I have one painfully large bowel movement. Normal consistancy, just a lot of it. Since I also pretty much consistantly feel bloated, I'm blaming both on the slowed digestion.

But all in all, the side effects aren't bad at all.

I go back to my doctor in around a week, so we'll see what he thinks at that time.

As always, thanks for checking in!

My Fat Butt on Victoza

Well, it's been three weeks on my new meds, so I figured it's time to give you an update.

I have lost nine pounds in those three weeks. To me it's still surprising, considering how much I struggled to drop just one pound before starting the Victoza.

I haven't had a follow up with my doctor yet to see how my levels are faring, so no update on that front. Although I have pricked my finger a few times, but my sugar levels have stayed within normal limits, and I haven't felt any drops in my blood sugar, so I stopped pricking myself. Because I like to play it dangerous that way.

And sticking myself in the gut isn't as bad as I feared.

I will say my endocrinologist was not kidding about the side effects.  You have to work your way up to the full dose of 1.8 mg.

I started at 0.6 mg and by the 2nd day noticed a change in my appetite. I guess you would call it that. One of the things that Victoza does is slow your digestive tract, meaning your food stays with you longer. My doctor advised that if I started to feel even the slightest bit of that "satisfied" or "full" feeling, then stop eating immediately. "or you will throw up". And yes, that is a direct quote.

That was enough to scare me, and like I said, by the 2nd day at 0.6 I noticed that I would eat maybe 1/3 to 1/2 of what I normally would before I felt that satisfied feeling. So I stopped. Immediately.

I also experienced a bit of gas, in the form of belching. And it was gross. Tasted like... rotten garbage. Ick.

After a week I upped it to 1.2 mg. The first day I felt really sick all day. Enough to stay home from work. So I dropped it back down to 0.6 for another three days. But then Jena got sick a couple of days later, so I don't really know if I was having such severe nausea as a side effect, or there was a virus going around.

Got up to 1.2 mg and didn't notice any major change this time.

The disgusting belches persisted.

After a week at 1.2 mg, I upped it to 1.8. First two days I didn't notice a difference. But the third day (yesterday) at the full dose I was moderately nauseaus all morning, and didn't eat breakfast (because of the nausea). We went to Chipotle for lunch, and I ate about half a burrito bowl, stopping when I felt the slightest hint of the full feeling. No problem.

Wrong.

About half an hour after I ate, I was seriously nauseaus. I managed to stay at work, but about two hours after lunch went running for the bathroom. My entire lunch came back up. I felt a lot better after vomiting, but was still nauseaus the rest of the night, and slept off & on from around 6pm until we went to bed at 10pm. I did decide to try some Jello at some point, and although it stayed down, I definitely felt sicker after eating.

I can only imagine that I ate too much, even though I stopped when I felt the full feeling, and that was the cause of the vomiting.

I did some reading of message boards online, and found that quite a few people find that giving the injection at night eases the nausea. Still others recommend gradually increasing from 1.2 - 1.8 instead of doing it overnight as I did.

So I'm gonna do both. I had been giving myself the injection in the morning, but skipped this morning's injection so I can give it tonight. I'm also going to go back down to the 1.2 for a couple of days, and try gradually increasing to the 1.8mg.

I understand that because of the slowed digestion the loss of appetite / inability to eat is normal, and okay. And because of the way it helps regulate my sugar, hypoglycemia shouldn't be a concern from lack of eating.

Still, it's weird. Basically yesterday I ate half a burrito bowl (which exited my body relatively quickly), and a small cup of Jello.
Today so far I haven't eaten anything.
And I'm not hungry.

A few other issues besides side effects:

- my insurance isn't covering it. So far. The doctor has sent in several prior authorizations, but I ended up having to get another sample to cover until we can get it covered.

- the week I was at 1.2mg was also that time of the month. I wonder if that's why I didn't notice a difference. In fact, I probably ate more during that time than on the 0.6, and I definitely had cravings. Leaves me wondering if the hormones associated with menstruation are actually strong enough to override the side effect of appetite loss for one week out of the month. Interesting...

- Jena has noticed me not finishing my meals, and has tried to use it as an excuse not to eat.
Now, let me be clear, we have never forced this child to clean her plate. Never. I don't believe in it. But we do ask that she eat "a good amount". It varies, and is up to the parent's judgement. Reasons it might vary might be: what she's had to eat earlier in the day, how long it's going to be until we eat again, etc.

Knowing that Jena was watching me has always been a reason that I've feared any sort of diet. I want her to eat healthy. Period. And I don't want her to grow up with food issues. We strive to give her healthy meals & snacks, and for the most part let her body decide how much is enough.

Navigating how to explain my lack of appetite to her without giving her the idea that she can or should not eat as much herself is going to be difficult. She watches my every move, loves when we eat the same things ("Mommy! We match!").

So, that's my latest fat butt update. I'll keep you posted on my progress, especially once I get my updated labs done in a few weeks.

As always, thanks for checking in!

My Fat Butt: Answers

Well, I had my labs run and saw my endocrinologist.

I was right, my pituitary system is all jacked up.

While my sugar levels were still okay, I am beginning to show signs of insulin resistance, and my body is back to living on starvation mode. Everything I eat it tries to store. No big surprise there.

What I was surprised by is a few other results. My testosterone is low. Two other levels (and I cannot remember what they're called to save my life) indicate that at this point I probably am not ovulating at all. His actual words were "I would be shocked if you were ovulating at this point."

When I told him about my miscarriage three months ago, he said that these levels would also explain an inability to carry a pregnancy to term.

So... at least I have answers now, right?

He said one of our options would be just what I mentioned in my last Fat Butt post: stop trying, go back on my previous meds, when my levels return to normal and I'm at a happy weight, then we start trying again. But he also confirmed my fears: once I stopped the meds & the birth control, we'd likely repeat the pattern I was already in.

While we are trying to conceive, we have limited options, due to the dangers of many medications during pregnancy. But we're gonna try one of of our options.

He's starting me on Victoza. It's a diabetes medication that he hopes will regulate my insulin and GLP levels, and that once those levels return to normal the others will (hopefully) fall into place.

There are a few issues with me taking this med though:

First of all, I'm not really thrilled about giving myself an injection in the abdomen every day. And when the nurse told me to try to avoid injecting into stretch marks, I just laughed. That doesn't leave many options on my belly. But really, this is no big deal.

Secondly, because it's a diabetes medication and I am not only not diabetic, but my blood sugar trends toward hypoglycemia (low), I need to check my sugar periodically to make sure it's not dipping too low. So now I have my very own brand new blood glucose monitor.

Stabbing myself in the stomach AND pricking my finger?!? Who wouldn't love that?

Joking aside, I'm hopeful we're on the path to getting things sorted out. I guess only time will tell.

As always, thanks for checking in!

My Fat Butt - what to do..

Well, something about writing down my thoughts in my last Fat Butt post got me thinking. And thinking. And thinking. And talking with my husband. And thinking.

I'm wary of getting pregnant with my weight this high. It makes it harder to conceive, poses more health risks for me & baby, and gives me a really bad starting point for post-pregnancy.

So I was thinking maybe we should stop TTC, I would see my endocrinologist, run my labs, etc. go back on the meds, then when I reached a healthy weight, start TTC again.

But then I realized the catch-22. So I do that, then stop the meds (again), then stop the birth control (again), then blow up like a balloon (again), and end up in the same boat I'm in now.

Plus, with my age, I don't really want to put off TTC. I ain't getting any younger, you know?

So... what to do... what to do...

Well, I decided maybe the best thing to do is to see my endocrinologist and just talk thru everything with him. I'll go this weekend to have my bloodwork done, then see him next week.

I have no idea what the outcome will be, so... wish me luck!

My Fat Butt - an update of sorts

Well, it's been about six months since I've done one of these, and the progress ain't pretty.

I'm not sure if any of you guessed it or not, but the reason I had to go off my endocrine meds was because we were planning to TTC. If you remember, I was on an aggressive drug therapy, and so my endocrinologist recommended being off of them for months before we even started trying.

And my weight has piled on.

In fact, when I went off the birth control, that was apparently the straw that broke the camel's back. While my weight gain had been slow up to that point, and had plateaued, when I took off that last Patch, I blew up 25 lbs in the first eight weeks off birth control.

Gained another 5 lbs in the following month, but the gain seems to have stopped. Better than gaining, not as good as losing.

And I'm miserable. I feel awkward in my own skin. My fat pants are tight. As much as I've always struggled with my weight, I feel like I'm in someone else's body, just waiting for mine to return.

At a friend's insistance, I joined Weight Watchers. Again.

To be honest, I've never had much success on their program. Then again, we know I have a metabolic disorder. And my body hates me.

It's only been four weeks, but I have managed to drop two lbs. So yay. I guess.

I'm also participating in a DietBet.

As pessimistic as I am about my weight, I'm also glad that the needle has stopped going up, and has actually gone down, if ever so slightly.

We've been hiking several times as a family. I really enjoy it, and have decided that hiking is probably my favorite form of exercise.

But... my back has been bothering me pretty regularly since our very first hike, over a month ago. I have these moments where I get this stabbing pain near the site of my injury. We're talking a level-10 pain. A knock me down pain. But it only lasts a few seconds to a few minutes. Then a little while later it hits me again, for another few seconds.

I've also been getting muscle spasms, which feel like someone is squeezing my tailbone with all the force they have, and contracts both gluts as well.

Resting did nothing to alleviate either pain.

So I went hiking again. And again. And again. The pain's no better, but no worse either. So why not?

Anywhoo... I am considering seeing my endocrinologist. Since I had gone off all of the meds, I cancelled my last appointment. But let's face it, this just ain't working.

I just feel like I'm in a catch-22. The meds that I know work, which I've been told I'll probably need to take for the rest of my life, I can't take while I'm trying. But the heavier I am, the more difficult it will be to get pregnant, and the harder a pregnancy will be on me and the baby.

I feel like I'm leaving you without much of an update. I suppose this is more of a rambling of my current thoughts on the subject. At any rate, thanks for checking in!

My Fat Butt - here we go again

So, after gaining another couple of pounds & giving up on trying to lose weight... I hit that plateau. Nice, in that I stopped gaining. Adds to my frustration in that months of trying to lose weight resulted in gains, then when I give up, my body says 'okay, I'll stop piling it on now'. Ugh.

So, I have still been trying to eat more veggies, get more exercise, and not eat out as much. But other than that, I eat what I want.

The news comes because I had my 6 month check with my endocrinologist today. Which I had somehow not marked on my calendar and had completely forgotten about until I got the appointment reminder call.

He thinks my insulin is out of whack again, and is putting me back on Metformin.

*to re-cap, no I am not diabetic. In fact my blood sugar tends to be on the low-side of normal, and I have been diagnosed as hypoglycemic (low blood sugar) since I was 15 years old. I have an insulin disorder that makes my levels go crazy high, then crazy low, and not remain steady. Contrary to popular belief Metformin does not increase insulin, it regulates your body's production of it (ie. evens it out). Or at least that's how my endocrinologist explained it to me.Basically, my weight gain actually began when I went off the Metformin just over a year ago. I guess I somehow hadn't realized it, but he went back thru my chart and showed me. While I've gained around 8 lbs in the past 6 months (feels like so much more), I've gained almost 30 lbs total in the 14 months since I stopped the Metformin. Just over half the weight I had lost.

So... back on the Metformin. Although, if you remember (for some reason I couldn't find the post, hmph), I went off of it because of severe gastrointestinal side effects. But apparently there's a new (or new to me) form of it that is supposed to be much gentler on the stomach. So we will try again.

I have the option of going back on the rest of my meds, doing the aggressive drug therapy all over again, but considering the side effects of the other medications as well, I'm not ready to do that.

He also basically told me that he recommends an actual weight loss medication as well. We didn't go into details, because I'm not ready for that, but essentially because I have a physical ailment (my spine injury) that prevents me from exercising the way I need to to lose & maintain a healthy weight, I'm an ideal candidate for weight loss medication.

He said that intense physical aerobic activity needs to be part of this plan, but weight loss medications' original intention were people just like me: patients who for one reason or another were currently unable to exercise. If I were healthy, no ailments, he'd tell me to start running. But he cannot in good conscious do that as a physician (although if I want to refuse my neuro's orders, that's up to me, LOL), since he is aware of my spinal injury. So we need to look at other, proven safe methods, for helping to bring my weight down to a healthy level.

I don't know. I am certainly not against the idea, and what he says makes sense, but... I guess part of me feels like it would be giving up. And I'm not ready to do that yet. Or maybe I just need to think on it longer.

I told him "screw my surgeon", so since it was my choice, he went over what exercises he recommends for his patients with similar metabolic disorders, and why (ie. did you know swimming lowers your metabolism? ack!).

So for now, back on a new type of Metformin, keep trying to eat healthier, and try to increase my exercise. I go back in a few months, and he's ordered a bloodwork panel to be done just before that appointment. We'll check insulin levels, A1C, etc. but he'll also run my thyroid again just to be safe. He said that even though my last bloodwork showed normal thyroid function, since I do have a family history of hypothyroidism, it's something we should probably check every couple of years just to make sure nothing new has developed.

I really love my doctor. He's very thorough, and also very good at explaining how the body works in this way, why we do (or don't do) certain things, etc. I'm a "why" kinda gal, so I like someone who pre-emptively explains, LOL.

Anyway, I feel like I just wrote you a book! And believe it or not, I left a good chunk of our discussion out!

So, as always, thanks for checking in! I'll keep you posted on my progress!

My Fat Butt - oh, well

Well, I reached a point in my frustration where I went back on my meds. I still had some left, so I just decided to do it. Told Fireman, and asked him to help me keep an eye out for side effects so I can stop them if I need to.

Three weeks of being on my meds.

Three weeks of even-more-strictly watching what I eat.

Three weeks of seeing our grocery spending increase while our restaurant spending decreases.

Three weeks of my husband making comments about how little I ate at such-and-such a meal.

Three weeks of getting even more exercise (but being careful, because my back is even worse - need to do a separate post on that).

Three weeks later... and I am holding steady. Haven't gained any more. But haven't lost so much as a pound. Not one.

And that's on my meds.

Got so frustrated that I took a pregnancy test (no, we're not trying. yes, I'm on birth control). It was negative. Not surprising, but I was hoping for an answer.

This has been my life. For as long as I can remember.

Add in side-eyes from thin people. Comments about how I should just eat less. Exercise more. It's easy!

It's not easy. Not for everyone.

What sent me to the endocrinologist in the first place was the tipping point of standing in the gym and having a trainer yell at me that I was lying to them. That after six weeks of following their program, if I had been following, I would have lost a ton of weight & inches.

I didn't. I lost one stinkin' pound. I went from not exercising at all, to working out 3 -5 times a week, including 1 -2 times a week with a personal trainer. I was doing my best to follow their eating plan. I'll admit I didn't manage 100% adherence, but it was a drastic change to what I had been doing beforehand.

And after six weeks I had only lost 1 lb.

And was being accused of lying. Because everyone loses weight when they make those changes.

Not everyone.

Not me.

See. Here I am again.

Part of me is depressed. I can't stand the way my body looks. Very few clothes fit (although I did give in & with FireMan's blessing spent $$ on a new work outfit).

Part of me is just... okay with it. I've tried. I an honestly say that I have tried. I have worked really hard. No matter what society says, I have nothing to be ashamed of. I gave it my best. And my body just refuses to be thin. Even with medical intervention.

So, what now? I'm not sure. I'm continuing to improve my eating: eating more & more at home, incorporating more & more fruits & veggies. Everything in moderation. I'm continuing to try to find ways to get exercise: we recently joined our local YMCA (year-round swimming! zero impact! yay!).

I've considered more drastic measures. Strict, programmed diets (ie. meal replacements & such). Even surgery (there are more options than I realized).

But as frustrated as I am, I'm not ready for anything drastic. At least not without guaranteed results, which no one can do.

Maybe I'll just learn to be content with this body. Maybe I'll hit a plateau, and stay there. Maybe I'll eventually learn to dress this body well (Geesh! It took me 25 years for this fashion-handicapped person to figure out how to dress my old pre-pregnancy body!). And maybe all of that is okay.

As always, thanks for checking in.

My Fat Butt - activity

Well, here I am again. So for the past month I have reduced eating out back down to 35%, and kept soda consumption at around 22%. I made a point of eating more fruits & veggies, and was active for 5 days.

I know 5 days doesn't sound like a lot to many of you, but it's more activity than I'd gotten in the previous months, so it is an improvement, even if small.

And... I gained another 3 lbs. Officially back into my fat pants.

Disgusted with myself, and wondering if it's worth trying anymore. At least that's how I feel a lot of the time lately.

But other days I want to keep pushing forward. I'm making a point of packing my lunch every day at work. Selecting healthier options when we do eat out. Trying to think of new ideas to be active.

But I'm gonna be honest, mentally, emotionally, I'm struggling. Here I am again. I've done the work. I know I have. I've tracked it. I'm eating better, eating healthier. And gaining weight.

I've had to dig out my fat clothes (thankful now I didn't get rid of all of them), had to go shopping. The jeans I bought just a month ago I can't wear now. I desparately need nice-fitting work clothes, but we don't have the budget. So most days I'm wearing ill-fitting pants and one of a few polo shirts. And I do laundry like crazy just to keep up.

I find myself thankful that the weather is getting cooler. That I can hide my body under sweatshirts. Wondering how long I will be able to wear my sweatshirts, and how much longer until I'm wearing my husband's again, like I had to a couple of years ago.

I find myself playing a mental game. Hear my internal voice question myself. Maybe I am just a fat, lazy, slob. I could have tried harder. I could have worked harder, right? But then I argue back that if the work I have done resulted in a gain, then what would more work have done?

I find myself longing to be like some of my thin friends & family members. Who have never really struggled with their weight. Who lost all of their pregnancy weight via breastfeeding alone (plus an additional 5 lbs!), who notice their clothes getting snug, so diet for a week or so to get their weight back down, or stop working out, to have their only weight gain be to add back the curves they lost (ie. now they just look better).

I know, I know. They're not the majority either. But they're real too. Their stories are real too. I know them personally. And I find myself wondering what it must be like to be them. What's it like to not worry about what you eat? To be the person bringing your own tub of sour cream to the Mexican restaurant, not work out, and still be a size 2? What's that like? I find myself thinking about that a lot lately.

It's more than a month before my endocrine checkup. How much will I gain before then? What do I do till then? Do I keep up what seems like a futile struggle? Or stop stressing about and just try to enjoy life before I have to decide between fat or side effects?

My Fat Butt - less soda pop

Well, dear readers, I'm here for another check in.

On my 2nd month of reducing my eating out, I didn't do as well as the first month, and finished at 47%. Still much better than my initial 60%, but those numbers need to go down, not up.

But on my 1st month of reducing my pop intake? I dropped it by just over half, from 43% of my beverages, to 22%.

So, to re-cap: I've reduced eating out by 21%, and reduced pop intake by 51%.

And gained another 4 lbs.

To say I'm frustrated is an understatement.

But I will press forward. Work on dropping my eating out numbers back down (and farther!), work on lowering my pop consumption even more. Work to increase activity (which should be lots of fun w/ a bulging disk), and work to increase fruit & veggie intake.

I will press on. But I will also consider moving up my next endocrinologist appointment. He'd taken me off of most of my meds about 4 months ago, because I was having some pretty bad side effects, and my levels had been very good, so we decided to stop them. And in those 4 months I have gained roughly 15 lbs, 6 of which have been while being very intentional at making some lifestyle changes.

So I will continue to do the work, but I also have to consider the possibility that I may need medical intervention to keep my weight from progressing back to where it was before I got diagnosed.

I'll continue to keep you posted. Thanks for checking in.

My Fat Butt

 

Well, I guess it's about time I updated you on my fat butt.

In November I started a second round of meds. Except... my bloodwork showed such improvement that we dropped two of the meds. Yay! me.

However... the meds I am on aren't having as great an effect on my weight as they did the first round. Like... at all.

At my initial weigh-in I had gained rebounded about 5 lbs since my last visit. I was disappointed, but he said that was actually really good, and was another testament to how much my body chemistry has improved since I first saw him, and how much I have been trying to improve my lifestyle.

But... since then, I've only lost 4 lbs, even on the meds. It fluctuates slightly month-to-month, but minus 4 lbs is pretty much where I'm at. I'm sure my blood levels are probably continuing to improve (they only check it every 6 months), but the needle on the scale isn't moving (and this is a Fat Butt update, after all).

I know part of it is because I don't have nearly as much to lose now. I am down roughly 50 lbs from my starting weight, there's no more excess water to lose, my body is no longer turning everything I eat into fat. I am, in fact, really close to the weight my body had been plateaued at for years prior to getting pregnant.

So I wonder if this is where I will stay.

To make it more difficult, my back injury means my exercise is extremely limited. Walking (but not too much), swimming, and I might try bike-riding now that the weather's warmer. And if we can work a bike into our budget.
In addition, I've been really super-stressed at work, and the truth is I've always been a stress eater. So it's been extremely difficult for me to maintain my eating plan.

And... I've stopped one of my meds. I can't believe it took me this long, but I finally had the realization that I was having a side effect. A pretty serious one. And of course, one of the "less common" side effects. And something that (for me) could easily be translated as being due to something else. I'm thinking about blogging about it, but... I don't know. It feels kinda personal, so I'm debating. We'll see.

Anywho, so that meant I had to stop of one my meds. I had actually suspected the side effect for a while, but was in a type of denial, even though I did reduce my dosage (after informing my doctor) in an effort to alleviate the side effect. Since the side effect didn't go away, I convinced myself it wasn't the meds. But it was. So I stopped. It's not until next month that we can discuss an alternative option.

And so... considering all these things... and because Jason was already talking about doing it himself... I'm starting Weight Watchers in a couple of weeks.

A couple of men at our church have lost a significant amount of weight on the program, and Jason has been lamenting his weight gain over the past few years, so he was tossing around the idea. Online of course. Because men hate to go to "women's" meetings (my scarcastic, teasing words - not his).

I've done the program a few times in the past. Never with much success. But I always liked the program because it was a great way to keep proper portions in mind, and would help me get on / stay on track with regards to healthy eating, even if I wasn't losing weight.

I'm hoping this time... I'll drop some poundage as well.

First of all, because since seeing the endocrinologist, he feels confident that my struggle to lose weight in the past was primarily do to my endocrine disorder. Now that that is well-controlled, he believes I should be able to lose weight "like a normal person".

Secondly, I know a few people who didn't have success with WW in the past, who decided to try the new PointsPlus program, and found it to work much better for them.

I hoping that those two factors indicate I'll have better weight-loss success this time.

So that will be my next adventure. And Jason's. We're doing it together.

Why in a couple weeks? Several reasons:
    1) in a couple weeks comes a clear break point for us that will give us a good clean start date
    2) we need to buy a scale. ours hasn't worked since the move. unless I actually weigh six pounds. in which case I don't even need to lose weight.
    3) I'll need to do some grocery shopping to prepare. More. Veggies. Always a struggle point for me.

And if nothing else, I know it'll be good for me as a reminder of healthy portion sizes, and good eating.

As always, thanks for checking in!

My Fat Butt

Well, it's been a while since I've done an update, hasn't it?

In my last update, I told you how I was below my pre-pregnancy weight. The weight loss has slowed, as expected, but I am happy to report that I am now at my next milestone, my wedding weight.

That... is exciting. To me, at least.

Part of me is totally tempted to rip into the storage preservation box and try on my wedding dress. But the larger part of me knows that it won't fit. I may weigh the same, but my shape is definitely different.

I've told you before about the extra skin I have around my belly from my pregnancy. It's still there. Probably will be unless until I have it surgically removed.

I'm also fairly certain that my breasts are bigger than they were when I got married. No complaints about that one.

Just that those two things mean that I am 99% sure that there's no way my wedding dress would fit.

But still. I'm at my wedding weight. A grand total of 51 lbs lost.

Mostly I've settled in to just watching my portions. I do try to eat more fruits & veggies, but quite frankly I don't find it that pleasant, so I still need to work on that.

And while I usually drink water anyway, lately I've made an effort to cut out caffeine when I do drink other beverages. Not a weight thing, per se. Just a health thing.

One thing I've noticed is that my tastes have changed. Not sure if this is because of the chemical changes in my body brought about by the drug therapy, or because of the changes I'd made to my diet, or maybe a combination of both.

Mostly, I can no longer tolerate as sweet of foods / drinks as I used to. I got a Mt. Dew a few weeks back, just because, remembering how much I used to love it, and about gagged on the sugary-ness of it. And even chocolate - I can't take too much chocolate without a glass of milk to balance out the sweetness. Oh, and cotton candy! We went to a festival and got cotton candy to share between the three of us. I needed a glass of water so badly!

In the past - and the not too distant past at that - I would have eaten the cotton candy with the Mt. Dew! Ha!

So that's about it for now. I'll keep you posted if there are any major developments or I meet another milestone.

As always, thanks for checking in!

My Fatt Butt

I saw my endocrinologist last week. In the past two months I have lost another eight pounds.

My doctor is still pleased with my progress, so we are, as planned stopping the stronger medications, continuing the maintenance medication, and I will go back in six months to see how I am doing, and will have bloodwork done before my appointment to see how all of my levels are.

That's really about it.

I'm to otherwise just keep up what I'm doing, and I can come in sooner if I have any problems. Specifically, if I have sudden weight gain, unexplained bloating / weight gain in my upper abdomen, or bloating / puffiness in my face then I should come in right away to see what's going on.

He said I can expect to continue a slow weight loss as my insulin levels continue to normalize, as long as I continue what I've been doing.

I'm a little nervous about the safety net of my stronger medications being taken away, but I've gotten used to the idea over the past couple of months, and his reassurance at this checkup that things were still going well helped to calm my anxieties.

I guess that's about it. Not a very exciting post, I know, but... that's the update.

Thanks for checking in.

My Fat Butt

Well, I had my checkup last week.

My doctor is very happy with my progress. A little too happy for my taste.

I was down another 10 lbs, for a total of 38 lbs since November.
I was below my pre-pregnancy weight (by 1 lb, but still) for the first time in over three years.

He's so freakin' pleased with my progress that he wants me to go one more month on the aggressive drug therapy, and then stop everything but the maintenance medication, that will regulate my insulin (hopefully) forever and ever.

I'll go back in two months instead of one, giving me one month on the meds, and one month off, so he can see how I'm doing.

Assuming everything is going well, my next appointment after that won't be for several months (3 or 6, I don't remember), and I'll do bloodwork before that one, to see how my levels are maintaining.

I know, I should be happy, right?

The drug therapy worked fabulously well, he said I did more than my part, because he still maintains that I lost about double the amount of weight that most of his patients do, which is why he's so confident that I will do well once we stop the therapy.

And I am happy. I'm happy with how the meds worked, as I was tremendously skeptical when we started. I was hopeful, sure, but I really didn't think I'd see this great of results, and if I did I definitely didn't think I'd see results this quickly.

And I'm proud. Because I have worked to modify my eating habits along with taking my meds, and the proof that I'm doing so is not only in my weight loss, but in my blood work as well.

But I'm scared.

I don't feel ready to have the safety net taken away from me just yet. I'm scared to do this on my own, without the meds, without the doctor monitoring me.

Oh sure, he said if my bloodwork in a few months showed problems, or if my weight suddenly spiked, or if I noticed some of the physical markers (bloated face, upper abdomen, etc) that I had before I can come back in and we can maybe go back on.

But then that, I think, would feel like a failure, you know?

So... I'm just scared. Anxious to do this on my own.

I'm hoping to continue losing weight, even off the aggressive meds. He told me way back when that once my insulin got regulated I should be able to lose weight "like a normal person", so... I'm hopeful. Still skeptical (sorry, but a long history of difficulty isn't going away overnight), but hopeful.

As of my appointment last week I had reached my first goal: my pre-pregnancy weight.

I have 13 more lbs to my next goal: my wedding weight.
See, even though we started "trying" shortly after getting married, when I went off birth control, I put on 14 lbs in six weeks. My OB had assured me it was hormone fluctuations and would go away on its own in another 6 - 8 weeks, but... when you get pregnant on your 2nd cycle trying...

So, 13 lbs to my wedding weight. I have another couple of goals past that. But that one... that would be HUGE. No pun intended.

Thanks for checking in! And please keep me in your thoughts as I tackle this "on my own"!

Update on My Fat Butt

Well, with the whole IUD-expelling-itself-scare, I had to stop two of my meds cold turkey because of the risk of pregnancy. So at my last checkup, I had been three weeks off the meds.

And I'd gained two pounds.

I was pretty upset.

Then my endocrinologist said that wasn't bad at all. He said considering I had to stop them cold turkey, and they are pretty strong medications, it's natural that my body would have some backlash. And considering it was only two pounds, he's fairly confident that it was most likely just caused by water retention.

So... he was actually pretty happy, even though I wasn't. But I did leave there feeling some better.

And once I was able to finally confirm that I definitely was not pregnant, and get back on birth control, I started all of my medication back up.

Also at that appointment, I got the results of my three month bloodwork, which was taken right before I went off my meds. Everything was great! My blood sugar was normal, my vitamin D was still low, but on the very low end of normal, and my vitamin B12 was with normal levels. Thyroid within normal levels. Pulse and blood pressure remain excellent.

This is all very good news! And a very good sign that the intensive drug therapy we've been doing is working, and working well. My doctor is estimating that we should be done with the aggressive treatment by around June timing, and then will drop the stronger meds and just continue with the routine meds that I will most likely need to remain on forever to maintain my insulin levels at a normal level.

Thanks for checking in!

My Fat Butt

Had my appointment the other day.

I'm down 32 lbs in three months.

He said he wasn't gonna ask me about my homework from the previous month, nor give me any more homework. Said it would be like "punishing the honor student".

Apparently, percentage wise, I've already lost in three months what most patients will lose in six months on this treatment plan.

Yay me!

So he asked me what advice I would give other patients.

The only thing I could think of is to trust your body & listen to what it's telling you.

See, with the way this insulin disorder causes your body to process food, you get hungry sooner & don't feel as satisfied as a "normal" person. My doctor has explained the "how" to me, but I won't go into it here, partly because I'm sure I'd be lacking as I try to explain it. Anywho... so when I told people that I promised I was only eating when I was hungry, and was stopping as soon as I felt satisfied... I was telling the truth. It's just that my body was lying to me.

So when you start the medication, and your body normalizes, and you're not hungry as often, and feel satisfied sooner than usual, it plays a mental trick on you.

The first six weeks or so I would eat lunch, stop when I was satisfied, but keep the rest of my lunch on my desk all afternoon. Why? Because I was convinced I would be hungry later.
To me, in my experience, it wasn't possible that a lunch that small would suffice. Everything in my experience told me that I needed to either eat more now, or save it for later, in order to avoid real hunger in the near future.

The doctor found this interesting, and said that fear of hunger is a common theme among people with any sort of eating issue - medical, mental, or emotional. The fear of hunger is such a primal feeling, such an instinctual reaction, that it's very difficult for patients to overcome. He said this is just as true for the person who grew up in poverty and truly did struggle for food at one point, as for the person fighting obesity their entire lives and getting a handle on their eating for the first time. And everyone in between.

So that is my advice, to anyone else going thru this treatment, or anyone struggling with any sort of eating issues - listen to your body, and trust it (assuming you've got any medical issues straightened out that might cause your body to "lie" to you).

It's hard. It really is. There are still times when I think I need to eat more. Need. Not want, need. But most of the time, it's a lie, a mental trick.

Now that my system is getting straightened out, it's getting easier & easier, a little bit at a time. I now stop eating as soon as I feel satisfied (95% of the time anyway), and can trust that if I feel hungry, then yes, I really do need to eat. It's a game though. Playing a game with yourself.

So far though, it seems that I am winning. Finally.

My Fat Butt

Realized I hadn't updated ya'll since my last check up with my doctor.

Well, it's still working. Like, really well. As of that appt, which was about two weeks ago, I am down 24 lbs. I've actually started having to dig my old clothes out of boxes. Finally.

He said I'm doing "amazingly well" on the medication, better than most patients, but also reiterated that because I am doing so well, he knows that I've been doing my work counting my calories as well.

So... on to the next step. Since I'm doing so well, I get new homework.
         #1 - eat more fruits & veggies
         #2 - get more exercise

I asked him for specifics. He refused to give them. He said that in his experience, if you give people too much to do too soon, then if they fail at one or two areas, they get discouraged & quit. So just "more than you're doing now". He said now that my body is "normalizing" we're going to start focusing not on my weight, not on my insulin levels even, but on my overall health. So more fruits & veggies, and more exercise.

Oh, and he said that as well as I'm doing, we might be able to back off the aggressive treatment sooner rather than later. He had originally told me that he thought it would take 9-12 months of aggressive treatment with meds (I'm currently on three different meds for the insulin disorder) for my body to normalize. He said as well as I'm doing he's thinking closer to six months and we might be there. Which is good news.

So, that appt was two weeks ago.

Yesterday, I didn't take two of my meds. Today either.

See... they're really strong medications. To give you an idea, the one is considered a controlled substance in my state, and I had to fill out more paperwork to get it than I ever did when I was on prescription narcotics for pain after my accident or surgery. Like... really strong stuff.
One of the reasons he is amazed at how well I'm doing is that I've had minimal side effects. See, when you have medicine this strong, there tends to be a lot of side effects, sometimes serious ones.

The only side effects I've had:
        - my head sometimes feels tingly

        - I'm cold all the time (really weird for me, because I'm usually the one that's hot while everyone else is comfortable)

        - I spend much of the day with a sorta sick feeling in my stomach. Hard to describe. Not nausea, but... sick

So... with the crap that's been going on lately, I've been stressed. And anxious. And when I'm really anxious I tend to get sick to my stomach. Combine that with the meds, and... I've been really sick the past few days. Like, had to force myself to eat anything, and really wanted to puke that back up, but couldn't, so stayed sick all the time, and then started getting headaches from not eating. Like that kinda sick.

So... I haven't taken those two meds for two days. I still have that anxiety-sick in my stomach. But it's much more tolerable / livable now. And I can eat. Hopefully I can get myself under control soon and then will start back up on the meds.

So, that's my Fat Butt update. Thanks for checking in!

My Fatt Butt

It dawns on me that I forgot to update you on My Fat Butt after my first monthly checkup with my endocrinologist.

So, about a week or so ago, I had my first monthly checkup. At that point I had lost a total of 14 lbs! Like I mentioned before, a significant portion of that was water weight, but still.

We talked about any side effects, my weight loss, how I'm feeling, etc. Checked my vitals, did a physical exam, etc.

Then I asked him about the water weight thing. He went into this long explanation (one of the reasons I heart this doctor - he's really good about explaining things to me) about how our body processes food, and how my insulin disorder screwed up how my body processed food, and said that the water molecules are actually attached to the sugar molecules in the cells, and had they stayed there long enough, would have eventually turned into fat. So the fact that I lost so much water weight (and yes, we actually discussed how much I peed, in order for him to confirm that it was water weight, ha!) is a very good sign that not only is his original diagnosis right on, but that this course of treatment is working very well for me. He went on to say that not all patients lose the water weight like that, and they have to "tweak" their medicine, adding this, taking away that, to get the right combo to get their body to process food correctly. But so far it looks like this combo is working very well for me.

His hope is that over time my body will re-learn how to process food correctly, and we can eventually wean off of most, if not all, of the medication. Hopefully. Although because of my family history of diabetes he said he would want to keep a close eye on my insulin performance pretty much forever and ever, just to be safe.

So, before I left he told me not to be surprised if I didn't lose as much weight this month. He said some patients do, but most don't, especially if they, like me, have lost a lot of water weight the first month. But not to get discouraged, keep with it, etc.

He explained that for some reason that even the medical community doesn't understand, weight loss tends to come in stair steps - large loss, plateau, loss, plateau, rinse, repeat. He said it is rare to find evenly trending weight loss over time, no matter what the method. Interesting.

And he said he was "pleased with my progress, and my efforts". He said that yes, I would have lost some amount of weight just from the medication regulating everything, but I would not have lost 14 lbs if I weren't also been following my calorie restriction as instructed. So, yay! for me last month.

But...

To be honest, with all the stress I've been under the past few weeks... I haven't been counting my calories. At all. I know I'm not eating as much as before. Not nearly as much. But... I just haven't been counting. Bad FireWife, I know. It's such a little thing, but it just seems like... one more thing.

Is that stupid? Sometimes I think it is. But sometimes it feels like it's one of the few things that I have the privilege of saying "no" to. One of the few things I can let go by the wayside for now as I get my life together.

So, that... is the update on My Fat Butt. Thanks for checking in.

My Fat Butt

So, if you remember my original Fat Butt post, you remember that we finally figured out that I have an insulin disorder, and started medication.

Well, 10 days after starting the medication and seven days of calorie restriction, and... I'm down NINE pounds! Already!

No, really! I'm not lying! No! I'm not! I know! It's crazy! NINE pounds! In only TEN days!

Now, no, I don't think I lost nine pounds of fat in ten days. Nor do I expect to keep up this rate of weight loss.

One thing I forgot to put in my original post is that my endocrinologist said that one of the outward signs of this insulin disoder is a puffy face, neck, and upper abdomen - all caused by major water retention. He said that as the insulin began to get regulated, this would go away.

Well, within just a few days of starting the medication, I started peeing all. the. time. Seriously! It's ridiculous!
By day five, I looked in the mirror and I realized my face looked skinnier (ie. no more puffy face).

Day nine, I realized the top of my "B" shaped belly seemed smaller. Weird, I thought, because even though he had said this was a marker of the disorder, mine had been this way since giving birth, so I just assumed everything got all weird & stretched out from my gigantic pregnant belly.

me, seven months pregnant with FireGirl - told you it was gigantic

And day ten, I stepped on the scale and was down nine whole pounds.

I'm excited. Not just because I've finally managed to lose some poundage, even if it is water weight, but because I'm taking this as a sign that my doctor is right, we are on the right track, and that this course of treatment will get things going in the right direction for me. That, to me anyway, is very exciting.

Thanks for checking in!