Random Thoughts of a Disordered Mind


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Facing Weight Gain and a Bad Knee

Buddha on the rocksWhen I lost weight the last time, the successful time, I started out heavier than I am now but my body was pretty much the same size. The biggest difference is that my knee is in crappy shape and is seriously limiting my comfort level in standing or walking for any length of time.

Every once in a while I see myself reflected in a window or my shadow lurching as I walk, and it looks pretty sad.  I look old, fat, and disabled. The excess pounds aren’t helping, I know, but the knee is just not structurally sound anymore.  But having surgery isn’t something I can wave a wand to do.  And it won’t, and shouldn’t, abrogate my personal responsibility for shedding some pounds to relieve the strain on the joint.

It’s been almost 7 years since I went to WW and buckled down to make serious changes.  I was a quiet person in class for a long time and didn’t make a big deal about working the program; I just did it.  I started working out at the gym in limited ways until I could do more; I brought lunch most days, and pretty much eliminated a social life so I could make this the only thing I did.  I was afraid to deviate,  afraid of temptation, afraid of failure.

Well, it’s time to face facts. I have failed and failed spectacularly.  I’m not comfortable in this bigger body.  Finding cute clothes, in my closet or elsewhere, is impossible.  My stamina is minimal for walking and standing for any length of time.   It’s taken me 5 years to regain this weight, which for me is a pretty long time.  But having been through menopause and with this problem knee which limits exercise, I know it’s going to be a lot harder to get it off again.  And that’s discouraging before I even start.

I read blogs from others of you who are in maintenance mode or close to it, and even with your struggles, I feel pretty isolated.  I’m not sure what to do, to be honest.  I don’t think I can face WW again and wonder how to manage sticking to a restrictive plan on my own.  I have done a very poor job of it so far so that doesn’t bode well.  I may actually ask my doctor if I can come in and weigh in at the Health Plan once a month so I have that accountability – for free. But maybe I need the structure and community of WW, if I’m able to make myself go.

I’m giving myself this week to think through what changes I’m willing to make, knowing from experience that making too many at once is a recipe for failure.  I want to cook up success instead.

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The Knee’s the Thing

X-ray of an Arthritic Knee (not mine)There’s good news and bad news from today’s visit to the new orthopedist. Good news: very prompt, almost no waiting. Bad news: he is a joint replacement specialist.

Good news: He didn’t dismiss me or my problem as being caused by obesity. I was worried about that, actually, and did volunteer that I knew the excess weight was not helping. Which he agreed. But he didn’t say that surgery was impossible until I lost weight, and he didn’t yell at me for being so heavy when my joints were suffering. Clearly he’s been here before with other patients. And he understands that it’s hard to exercise when every step, every rotation causes pain. He also approved of my current meds, including the infrequent Percoset for pain.

Bad news: I need a knee replacement. There’s really no other solution given the bone-on-bone nature of my joints, especially the right one, which is the biggest problem right now. I’m not a candidate for Synvisc, which I’ve had several times before. My only real temporary alternative will be cortisone injections every 3-4 months until I’m ready for the surgery.

More bad news: Losing weight between now and surgery will undoubtedly help. If I am considering WLS, I should probably schedule that before a knee replacement, since it will make knee recovery easier. And the longer I can postpone the knee surgery, the greater the possibility (but only the possibility) that it wouldn’t need a revision (i.e., “do over”) in my lifetime.

Contributing factor: I’m still in my first year of my new job and my saved up vacation and sick time is minimal because, well, I haven’t been here long enough to earn much (*thinks wistfully of the 130 days of sick leave I had to leave behind*). Knee replacement surgery will require a minimum of six weeks out of work because you can’t drive for 6 weeks and I have no other way to get to work. If I have WLS, too, I have to factor in the time needed for that surgery. It would be a lot better if I could just get my act together and lose weight on my own.

Good news: I don’t have to do anything right now. I am the one who will decide when it’s time. I got a cortisone shot and that will help short-term. I also got a pedicure which did nothing for my knee but gave my spirits (and my toes) a lift.


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Paying the Price for Shoveling

Shoveling penguinAs I went to bed last night, my shoulder, side, and knees were beginning to be stiff from shoveling all the heavy wet slush/sleet/snow from the storm. My soaked clothes hung up in the bathroom, trying to dry out, making a little forest of wet fabric. The wet stuff outside had already solidified into interesting shapes of thick ice and the news reporters were busy telling us of the dangers of being outside. Not that I planned to GO outside at 10pm in a winter storm.

When I woke up this morning, I could hardly move. Sleeping soundly and waking up in the same position in which I fell asleep convinced my muscles to stiffen up and my right knee didn’t want to bend much. It’s still not back to normal after the August surgery and gets unhappy with cold or wet weather. That would be now.

Looking out the window I could see the ice sparkling across every surface within sight. Cars were having difficulty getting out of the parking lot and the way to my car resembled a skating rink instead of a cleared sidewalk. This did not bode well given the gimpy knee, I decided to just stay home with ice on it (how ironic was THAT?) and not risk falling and smashing it again. Once I’m on the ground, I have trouble getting up even without ice; today was not a day to push my luck.

So it was a quiet day. I did some email, watched TV and paid bills, with my leg up and ice on and off, and I followed stories of the horrible roads and sidewalks that people in Boston encountered today making their way amid thick ice on unshoveled or untreated surfaces. Our parking lot still looks scary but I will be out on it tomorrow, very very slowly wending my way to the car which is sitting on a 3″ slab of ice that filled up my hard-shoveled parking space. So much for all that work!


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T’ai chi Report

Woman practicing T’ai ChiI’ve only been to the gym once this week but I’ve managed to get exercise in every day. This is progress. Monday was the gym with 40 minutes of cardio (bike, elliptical, treadmill). Yesterday I did some walking but mostly that was getting myself to my T’ai Chi class, which is downtown in the adult ed center, housed in an old Back Bay mansion. We had class in the recently renovated ballroom, which was pretty awesome.

Jen asked what I thought about T’ai Chi and I’ve been pondering. I can’t say I was blown away or suddenly found the path to enlightenment or that my knee was magically healed or that we stood there and did those smooth, slow poses that people on TV commercials do when they are using T’ai Chi to sell arthritis medicine. But I did feel lighter and more in tune with my body because, unlike my usual gym stuff, we pretty much stayed within a relatively small space and paid attention to what was happening inside our bodies and how they responded.

There were warm up exercises that concentrated, not on stretching muscles but on moving the joints. This was different and it was awkward – our instructor was very smooth but we were lurching around. But I could feel things I hadn’t noticed before, in my hips and my shoulders and feet, and that was good. We learned how to walk and how to do this rocking balancing thing. And practiced meditation and got in touch with our chi. It was all pretty new agey. But I liked it.

There are apparently different flavors of T’ai Chi and we are learning one of the smaller, less well known ones – Hwa-Yu T’ai Chi. The movements are basically less expansive than what I had expected, and we’ll only learn one of the animal … positions? poses? I forget the right word. There are twelve animals but learning one well takes a couple of weeks and this session is only 7 weeks long. So we will learn the Tiger, which is all about spine things. That sounds good to me, my spine liked what we did yesterday.

I’m not totally sure that my knee is going to like doing this. Standing up for the whole hour, and doing some of the bendy things, I could feel it getting less and less happy with me even while my spine was feeling good. The instructor gave us some tips on how to practice the exercises if we have a bad leg; I wasn’t the only one. So I’ll give it a shot and take it a little at a time. I’m glad I arranged to have a car nearby so I could just get home to my bag of frozen peas quickly; that helped.

Today I did some of my little T’ai Chi homework exercises here and there where I could, to practice. And I also hiked down to another doctor’s appointment and back again, about 2 miles or so total. I hadn’t planned to do that and was wearing clogs and not good walking shoes, and it was cold and my nose was running. But I did it and it felt good to be outside – and I also knew I could count that as my activity for the day.

Tomorrow I think I need to do some arm things. My legs have done a lot already.