I fell apart today

I hear a lot of people telling me that I’m strong and so focused and so determined. Maybe. But it comes at a high cost. Today I fell apart in therapy, grateful that for some reason it was the only day ever that my therapist and I were the only ones in the rehab room.

I’ve been pretty seriously depressed for months, and in denial of the toll it was taking on me to be strong and focused and determined. I didn’t feel that I had a choice. No one is here to do things for or with me, things like self-care and home-tending and figuring out how to get from Point A to Point B. Oh, I had help from home health and out patient therapy, and I hired someone to help me early on with showers and laundry, etc. But when roadblocks popped up, I found I could do more than I thought I could do. And it’s important to me to be as independent as possible for as long and for as much as I can do.

But the reality is that I’m in a wheelchair with feet that don’t work right. My right ankle hasn’t improved in ten months and may never get better. I can walk 300 feet or so but that’s not all that much – though it’s certainly better than Day One when I was unable to stand up. Yes, there’s been improvement. But it still sucks.

When I’m depressed, I eat, and over the past 10 months have managed to regain all the weight that I worked so hard to lose to get me qualified to have spine surgery. At first I wasn’t sure if my physical discomfort was just because I was in a chair and not moving as much as I had before. That’s certainly part of it. But I’m eating too much of the wrong things. I know how to do this. I’ve done it over and over and over in the past. Let’s face it – I’m not feeling joy in a whole lot of things right now, and food brings comfort even when it causes discomfort.

And I’m lonely and terribly isolated. I love my apartment and have NO regrets about moving here, but I’im one of the younger residents and I really miss being with people my own age. I had some friends over last week for a lunch and visit, and I loved seeing them so much that it really drove home that those visits were few and far between in the last months.

At my request, my doctor put me on an anti-depressant about a month ago and I’ve asked the therapy people for recommendations of people I could talk to about the huge life changes I’m dealing with. Of course, getting to them won’t be easy but not much is these days.

I know, whine whine whine, poor me, you can do it. Yes, I can. I can deal with all of this. But not today. Today I want to cuddle a kitty and eat cookies and cry a little. I’m allowed. Because tomorrow I have to get up and keep going.

Goodbye, Therapy

Therapy is over, at least for now. I’m so grateful to Grace for her excellent care of me these last two months, and the progress I made with her help. She challenged me to do more than I thought I could do (can we say stairs?) because she knew I could do it, but she also listened when there was something I wanted to do or had problems trying to accomplish a goal. It’s on me now to keep going because I do NOT want to lose ground, though my knee problem is limiting me somewhat.

I do know I’ve lost some upper body strength in spite of using my arms to wheel the chair around everywhere. I have Therabands and small arm weights, and instructions from Susan on how to use them – I just need to actually use them instead of admiring them and leaving them untouched. So I’m going to rearrange things to get those weights closer to where I mostly sit here in my living room. If all I have to do is reach down to get them, I can do those arm exercises several times a day. Let’s start with once.

I’ve also gained weight. This isn’t terribly surprising since I’m not moving all that much and eating all the time – and because the food here is amazing and plentiful. I’m up about 17 pounds and I can tell by the way my body feels and the way my clothes are fitting. I’m not ready to make a commitment to working on weight loss again, but the first step is acknowledging the issue. I worked so hard to lose my weight on Noom and with MyFitnessPal, and I don’t want to go back to where I was.

On my last day of therapy, we went down to my old rehab pod area to use the giant scale. You can roll on with a wheelchair, or get up and stand using a walker, which is what I did. Then we weighed the walker so I could deduct it from the total to give me a realistic number. Which is important, because I have two doctor’s appointments before the end of the year, and they will both want me to get on a scale because doctors ALWAYS want you to get on a scale. But because I know the offices and know the scales, I know there’s nothing to hold on to and the step up is higher than what I’ve done in the last four months. I just don’t feel safe getting up on it, and my therapist concurred. So we arranged to get my weight another way and I’ll pass it along when I get to the doctor.

I’m learning that before I go somewhere, I need to make sure that the space is wheelchair accessible. And I need to be sure I don’t drink much of anything before I go in case their bathrooms are not workable. Even ADA compliant bathrooms may not have much room to maneuver. I also need to schedule my transportation; no more hopping into a car and just going when I want to go somewhere. I haven’t done a car transfer yet and am not sure really how to manage it coming from the wheelchair – from a walker, I could turn around and back in, but from the chair? Lifting my knees up is also a serious limit.

My legs still aren’t very strong. Honestly, who knew how much strength it takes to just stand up and walk around? I need to continue working on the leg muscles, and my therapist confirmed that using the NuStep would definitely help. The machine here is still broken so I’ve found a place to order one for my own apartment, and they’ll deliver and set up completely for an extra fee (of course). I need help rearranging some things in the room where it will go, and think I’ll wait for my brother’s Christmas visit for that. If I decide to sell it later, the same company will buy it back and refurbish it for someone else. But I know that having it right here, and an aide who can help me get on and off safely, will mean I’ll get the workout I need.

Because I want to be able to not use the chair so much. I have this lovely shiny red rollator that I want to be able to use – but I’m not ready yet. Grace explained that my legs aren’t strong enough and I’m putting more weight through my arms on the walker. That doesn’t translate to the rollator, which expects you to have stronger legs and be able to walk faster than I can. So for now, I’m still mostly in the wheelchair but walking in the hall every day with the AFO on the right foot to prevent foot drop. But I’ll get there and have my fancy rollator for when I’m strong enough to use it.

But I made cookies this week with my aide. That involved endurance standing, moving around the counters without falling down, and opening the oven and bending to move cookie sheets without falling or burning myself. Making cookies is part of Christmas for me, and it was important to be able to do this – not to eat myself, but to give away. I felt like a normal person and got a great sense of accomplishment as well as the fun of baking with someone else. The cats didn’t help.

Fighting Inertia

When things are going well or I’m doing something interesting, I tend to write. When things are overwhelming me, I have no time and don’t write. When I’m stressed, whether overwhelmed or not, I eat. Guess what I’ve been doing lately?

I worked hard to lost the weight that seemed to come off fairly easily last year. But that was during COVID time, when the world was contracted and I did little more than be home or go to work in the mornings in an almost empty office. I made trips to the store once a week, so my shopping was carefully planned and I bought less random stuff. And since there were no social outings on the schedule – no parties, no lunches, no restaurant visits – I ate more carefully and was more faithful in planning and writing my food.

I’ve gained 8 lbs of that hard-won weight back and I’m not happy about it. But at the same time, I’m not UNhappy that I’m 55 lbs down from where I started. On the other hand (and I have lots of hands to juggle things), I don’t want to stay where I am. I know all the things to do, I just need to do them. Yeah, I say that a lot, don’t I?

But I have a plan. I’m not starting ALL of these at once because that will set me up to fail. So this week I’m working on the first three:

• Re-upped with Noom and asked my Goal Specialist to reset me to the very beginning. I will set aside 20 minutes every morning to read the articles and make notes for myself.
  
• Plan to eat 1450 calories/day and NOT eat any exercise calories. They get out of hand too fast.
  
• Go to the gym three days a week for 30 minutes, twice during the week and once on the weekend.
  
• Emptied the pantry of the snacks, even portion controlled ones, that have snuck in there. — DONE
  
• Plan my weekly food and shop from a detailed list WITHOUT picking up the extra random stuff (unless it’s produce).
  
• Eat at least one meal (lunch or dinner) per week from the club or restaurant. Favorites: Jersey Mike’s #2 mini sub on rosemary parmesan bread, pizza or mini-slider basket from the club, or Chinese food from Liang’s (now open in a new closer location – yayyy!).
  
• Switch my Diet Pepsi to cans from bottles as part of cutting back.

I’ve been acting from inertia for the last months. It’s as though I forgot how to handle social and work stress during COVID time, and I’m finding it hard to make decisions. My world seems to revolve around my cats, going to work in the mornings, eating unplanned things on my own, and not getting enough sleep or exercise. Where do I want to go on vacation? Dunno, and am not motivated to figure it out. When am I going to ask for a few days off? Later, always later. What am I doing about landscape changes? Procrastinating. Have I worked on my big genealogy project of publishing sourced histories for each grandparent? No. Do I have a plan to do it? No.

Sometimes I wonder if my part-time job is helping or hurting. I know I don’t want to be working full-time now, and the “full time part-time” job at the church seems ideal – close to home, easy hours, chance to play with new technology, time with other people, work not that difficult. But at the same time, I really like the few days when I can sleep until I wake up. It’s never LATE, but it’s later than I’m doing now. I have fewer options for doing things with friends who aren’t working and who take day trips or meet for lunch or other outings. I’d have more time to work on genealogy and putter.

But I would be lonely, I think. And as a single retired person living alone, that matters a lot. I might be peopled-out by the time I get home, but at least I have time with other people every day. There’s no pressure for me to change anything and I have the power – and am the only one WITH the power – to decide to do something differently. Like, make a plan for taking time off and then actually doing it.

Right now, though, I’m going to focus on getting myself back on track with eating more carefully. Not dieting, I’m not doing that. But carefully and with intention. I can do this.

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.

In today’s medical fun and games

I went to the doctor today about intermittent waves of weakness and pain in the upper right arm between shoulder and elbow but also up the neck into the scalp. No loss of motion or function, just sensation and pain. But not all the time. This started not long after my recent fall on the concrete floor of the garage. Hmmm, cause and effect? We think so.

With my comprehensive medical degree from WebMD, I had concluded it was a pinched nerve. The fact that I have pinched nerves in other places helped me reach this diagnosis. The doctor thought adding in a spinal x-ray might be helpful.

As you can maybe see in the grainy copy of a copy, my spine has lots of knobby little bone spurs and loss of cushioning between the vertebrae. This is not new and it looks like the rest of my spine, which explains the nerve burns for the lumbar area. And there are some black blobs, too.

The vertict is that the hard crash to the concrete floor jolted the spine and pinched a nerve. Yayy me for a good guess. There may also be a partial tear of the right bicept, but there’s not much we can do about that so we’re not going to test for it. If the weakness and pain continue or get worse, we’ll go for an MRI. But for now we’re just sticking with muscle relaxants, heat or ice, stretching, and massage.

In another medical update, I got my first Moderna Covid vaccine shot last Friday from NetHealth at Harvey Hall in Tyler. It was a very well oiled drive through process with many volunteers and great directions. I was very tired on Saturday and a little on Sunday but otherwise felt fine, and am to go back on February 26 for my second shot at a time TBD as we get closer. I would have taken either vaccine but really wanted Moderna because it was developed at Vanderbilt, my alma mater, with partial funding from Dolly Parton, who donated $1 million to help develop a vaccine. I love Dolly.

Last night I created a chart of 10 years worth of weight, BMI, and blood pressure rates. I went back to my Yale Patient Portal and dug through medical records to get some of that, adding more from the UT Health records here, plus my Noom info. Oh, it’s not weekly by any means. But as I get smaller, I find myself wondering when I was this size last and what I looked like then. When I see pictures of myself, I have zero idea since I mostly just see fat. There are a few that I think look really bony and skinny and I don’t like how I look there.

I’ve been going to physical therapy for my knee which is actually helping other body parts as well because, well, they’re all connected. I feel safe at the gym and go in the afternoons when it’s not at all crowded. And I just bought a new pair of New Balance shoes which should arrive today. I’m pretty sure the ones I’m wearing are too long for me so keep your fingers crossed that these new ones will work. If not, Zappos does a great job with returns. But I’d rather have the shoes when I hit the gym today.