Apparently I’m Not Eating Enough Apples

I’m eating strawberries and peaches, not apples, these days, which may explain the medical appointments that appeared on my calendar.

Today was my Medicare Wellness Visit where you get asked all the questions you already answered on their e-checkin system. My BP was 136/62, which is great. I got the “Remember these 5 words” test that Trump nailed so successfully (my words were banana, tie, pen, house, car). This is a long way from an annual physical; I guess they think that we old people on Medicare don’t need to actually be touched but just answer a bunch of questions. My doctor is leaving her current practice tomorrow and I’m grateful that I was able to see her before she moves on, though I plan to follow her. She renewed all of the medications that she manages for me, then Cliff the Phlebotomist did the easiest stick for blood that I’ve had lo these many years. Tomorrow I’ll know what those red drops of blood reveal. At least this didn’t happen at 4am the way it almost always does when you’re in a medical facility. Oh, and I also got a referral to physical therapy for some ultrasound on the sore ankle. I really can’t feel a lot down there so I don’t know whether it’s better or not.

But one unexpected twist was being sent for a STAT ultrasound of my lower right leg to rule out possible deep vein thrombosis. My leg from toe to groin has been extra puffy with edema which we’re treating with diuretics, but a “squeeze test” of the calf almost had me jumping out of the chair, so DVT had to be ruled out. It’s a good thing that I went, because I just got a call telling me that they found a clot in my foot. What??? He called in a blood thinner for me to take once a day for three months which will dissolve the clot. But wow. Good thing I’m seeing my own cardiologist in 2 weeks. Good thing my doctor sent me for the ultrasound.

Tomorrow is a trip to see the pain doctor to review SI joint pains that have been giving me a hard time sleeping at night. I know I’m not sleeping in the best position to relieve those, but I don’t have much of a choice – I’m flat on my back with the bed raised up at the feet and a little at the head. I would give anything to sleep in my side but that’s just not in the cards. I don’t know if this doctor will think an SI joint injection would help (they have before) or if he’ll want to do something else.

Maybe I should just try eating more apples.

Eight months later

I don’t know if I will ever be able to do more than I can right now. The home therapist told me that while it’s certainly possible to see additional changes up to two years post-op, it’s also possible that I won’t see any improvement at all in the next six months. I need to be prepared for that while not being depressed. I don’t much like my new normal but I’m getting used to it. But it’s hard to keep the enthusiasm up for therapy and workouts and exercise when it seems that that’s all I’ve been doing for eight months.

On the other hand, even if I don’t get better, I don’t want to go backwards. I’ve worked too hard and am mostly independent; I want to stay that way.

I have to be weight-bearing every day one way or another to make sure my legs don’t atrophy. I work out on the NuStep five days a week (on the advice of therapy) to strengthen my legs. Everything I do takes so much time and most mornings, the words heard most often are “Oh, crap!” as my legs run into doors or get stuck on carpets, or I see cat vomit to be cleaned up. Dressing takes 20-40 minutes depending on whether I can wear the zipper shoes or need the AFO’s to start the day. And if I start with zipper shoes, I will need to change to AFO’s later to do therapy and walking. I hate them. And I hate putting them on.

On the other hand, I have feet. And I’m not freezing in a dark basement on a concrete floor while bombs go off around me. I’ve thought about what it would be like to have my limits and be trying to survive in Ukraine right now. I think I would be dead because I couldn’t escape. That certainly brings things home. My limits are still in a warm, comfortable home with food, water, heat, and Internet service, and I’m grateful for that.

At the same time, I’ve made some medical decisions about my body in light of being mostly in the chair now. I’ve told my doctor and my family that I am not going to do any diagnostic testing such as mammograms and colonoscopies because I don’t want to do anything if the tests find a problem. I know this could mean a shorter life, and frankly, that’s okay with me. While I have people who love me, I have no husband, partner, or children and the medical decisions are mine to make. I’ve been totally dependent on others to help me turn, stand, move, use the bathroom, etc., and I don’t want to go there again. I don’t have a death wish and I’m not planning to do anything to end my life. I just don’t want to have medicine prolong it just because they can. I am not afraid of death when it is my time.

That time is not now, and I’m not giving up even though I’m tired of my new normal. But I also can’t operate on the kind of higher-stress levels that I had in early therapy. I’m trying to figure out how to have an open house of some sort here to show my new home to my local friends – who I really miss seeing. And also to work out some sort of life that doesn’t only include NuStep, lunch, walking, and therapy. That gets old fast. It already has.

I’m ready to weed out and declutter more, though it’s much harder to do from a wheelchair than when you can just stand up. I have clothes to bundle up and kitchen things to take to Hangers for Hope, as well as some broken or other weird things that just need to be tossed. And several bags of books to go to the used bookstore. I have a big pile of Birkenstock sandals that I can no longer wear and purses that I won’t use that can find new homes. But I need help to get things packed up and carted away to appropriate places. It’s hard to ask for help but I know that it will be there if I do. It’s time for a plan to make it happen so I can make some breathing room. You know, before the open house.

Image credit: Photo 51239796 / Calendar © Flynt | Dreamstime.com

Today’s Medical Update

I saw my surgeon this morning for my three month post-op follow up. It was a short appointment and to be frank, I’m not completely sure that it was all that helpful. He seemed a bit shocked when I told him I’d spent 9 weeks in residential rehab but was pleased to know that I was home and managing well. I showed him my leg range of motion, which was better than on my last visit, and let him know that I am going to PT three times a week with a focus on isolating and strengthening muscles, specifically with e-stim, which he thought was great. At my request (because it was from the therapists), he wrote a prescription for a custom articulated AFO brace for the right foot to help with foot drop. Of course, I don’t know where to take it and his office was not much help on that. I’m to go back in a few months but to remember that it will take up to a year to see all the results of surgery.

Yeah, yeah, I know that part.

Then this afternoon I went back for therapy and to give them a report on the doctor’s visit. My therapist’s husband works at the Olympic Center and she is going to ask him for suggestions of where I can take that AFO prescription to be filled, since it was his recommendation in the first place that I get one. For the next weeks, I’m to concentrate on walking at home without the left AFO (the one that has been giving me fits) but WITH the right one, using my aide to help me walk in the mornings in our hallways. My legs will be freshest in the morning, and this way I can get in more steps. Today I walked 260 feet with that combination and it felt fine, and was the most I’ve walked at one time in weeks. When I’m at therapy, I’ll leave the AFO at home and we’ll work on building things up without it. I like the idea of doing both.

So there’s progress. Not trying to use the left AFO feels like a real gift since it’s given me such fits. That alone was worth the visits.

Going for Option 3

My weight loss journey is stalled and I’m annoyed. But then I’m annoyed at myself for BEING annoyed, which is not very productive or helpful. It’s only really a plateau if you’re trying hard to lose and just are stuck in the same place or small range for more than 2 weeks. Well, how about 6 months? I’ve basically been within the same 4 pounds since January, going down to 243 and back up to 247, then down, then up, then down, then up. Of course, I’m not exactly trying very hard to lose but I’m still annoyed when I don’t.

So I see a few options:

  1. Give up completely and eat whatever I want. This not really an option because I refuse to allow myself to be that fat and out of control again.
  2. Buckle down and eat a lower calorie target, weigh and measure, move more, and eliminate all the things I’m enjoying as “treats.” I know, this is extreme. I can have things I enjoy in small numbers. Who really needs 3 donuts just because they are there? I did all of this when I started, going great guns and losing a lot fast. But it never keeps up at that rate and I knew it wouldn’t. I just really don’t want to do this.
  3. Relax and decide to keep doing what I’m doing as early maintenance. Without working overly hard at it, I seem to have found a weight range that I can stick to without too much trouble, where my body feels pretty comfortable (except the knee), and that I can sustain while giving myself permission to have a Jersey Mike sub (always #2, the Mike’s Way) or a Dairy Queen kid’s cone just because I want to, without going crazy.
  4. Beat myself up for failing to lose.

I’m just torn. Because I feel as though I am failing if I’m not actively working to lose weight. It’s what I’ve done my whole life. I’m really bad at maintenance, or at least my history with it is. I’m great at losing huge amounts, then gaining it all back again. And I so do not want that to happen. I cannot let it happen again. That is a definition of failure more profound than failing to lose more.

I’m great at beating myself up for eating something “bad” even though I know in theory that no food is bad. There are just some foods that are better for me to stay away from, generally food with lots of carbs. But beating myself up just makes me depressed and sad, reaching for food for comfort. The whole “go to the gym and get those endorphins going” thing isn’t ingrained to replace it.

But since giving up is Not An Option and working hard to really lose doesn’t seem to be one either, I am choosing to commit to maintaining in the little range where I am now. Saying it is one thing. Doing it is something else, and it’s really all up in my head. I know how to do this – I’ve been doing this for months. I just need to give myself permission to choose Option 3.

The reality is that I have maintained a loss of 65 lbs for 9 months. For someone who doesn’t maintain well, this is huge. I haven’t been at this weight for over 7 years. There’s damage in my body that I can’t change from carrying massive amounts of excess weight for most of my life. But although I am still morbidly obese, my blood pressure is normal. My A1C, cholesterol, and triglyceride levels are normal. My BMI dropped 11.2 points. I’ve made significant changes that will make my life healthier and easier. I need to give myself permission to celebrate those changes and to recognize that the only person judging me right now is myself. It’s time to get over it.

Checking in and Catching up

I forgot to get on the scale this morning. That sounds so small a thing to have thrown me off but it did. Almost every day since I started Noom in January 2020, I start the day by peeing and then getting on the scale. It’s gotten to just be habit, as a way to get information, instead of a judgment. But today I just forgot. I slept badly because of neck and arm pain and too many things parading through my head, and was awake before 4am. Instead of getting on the scale, I went right to the living room and started guzzling water while updating the scheduled church newsletter with something I remembered while in bed trying to sleep. And then it was 6am. After drinking 50 oz of liquid, there’s no way I’d get on the scale. But it threw me off.

It’s been a while since I checked in with my body. My right side is kind of a mess from top to bottom: neuropathy in the foot, torn MCL at the knee, sciatica, neck and arm pain. The left side has a weak hip and more sciatica, but that’s not much. Two days ago I went to the hospital for a steriod injection in my right SI joint and a right knee genicular nerve burn (neurotomy). The meds to help me relax and not remember what happens didn’t work as advertized; there was no relaxing and lots of remembering. The burn itself was a new kind of pressure/pain but if it makes the knee happier, it will be worth it.

Now that I have been fully vaccinated and am 3 weeks past my second shot, I’m starting to get out more. I ate out in a restaurant with a friend last Friday, the first time I’ve done that in a year. I got antsy from being around so many people after a year of limiting exposure, but the food was great and it was a window of normal after a very long time of isolation. This weekend I’m off to my brother’s house for a weekend, my first trip there in 9 months. As he said, it’s time to unbuckle the seatbelts and start to move around the cabin. I’m taking baby steps and we’ll see how it goes.

In other news, I bought an air fryer and have been having fun trying to figure out how to use it. Mostly so far this has been cooking frozen foods such as prepared chicken and salmon, egg rolls, or reheating leftovers. Tonight I’m trying a new air fryer recipe of marinated chicken thighs (remember, I found a whole bunch of those when I cleaned out the freezer). We’ll see. But so far I think it will be a good tool and will help me do my small-scale one-person cooking without heating up the whole oven every time.

I’m also planning additional work on the house. Two years ago it was replacing half the windows and my renovation. Last year it was replacing the other half of the windows. This year I’m hoping to replace all or most of my landscaping, swapping out a very dated set of “solid green wall hedge” style with something shorter, cleaner, and more spaced out. I’m excited about making some changes and having time to enjoy them, as well as adding value to the home. I hired someone to draw out a plan and come up with plant options that will work with me making final decisions. So many plants were killed in the long freeze in February that nurseries are having problems filling orders, so that may be a factor. But at least I have a plan.

And on the inside of the house, it’s time to get my air ducts cleaned out and the carpets cleaned. I have no idea when the ducts were cleaned last but know it’s been at least 10 years, and the cats throw up a lot trying to get rid of hairballs, so both cleanings are past due. This home ownership game is expensive.