Back from Vacation

I enjoyed a much needed - much deserved - vacation last week. A full 10 days off work with only a few minor committments to deal with. Otherwise I languished in my glorious time off and relaxed as much as possible. I slept in nearly everyday, read a couple good books, watched a few movies, scrapbooked and did pretty much whatever I wanted. It was wonderful! Unfortunately, with the lack of routine, I had a bit of difficulty with the diet. My 40-40-20 percentage calorie split went out the window but I did pretty good with staying away from carbs. I took a few road trips, which put me in fast food restaurants more often than I liked. But overall, I did fairly well. I need to get back on track with some exercise though. Didn't do anything last week. (Unless you count shopping at Ikea for 6 hours on Wednesday!) I feel refreshed and energized. And I've resolved to never wait 18 months to take a vacation again! Nice to be back in the swing of things... ~Pam

Grilled Garlic Shrimp

2 pounds jumbo shrimp, peeled and deveined 1/4 cup extra virgin olive oil 6 cloves garlic, finely chopped 2 tablespoons fresh parsley, finely chopped 1/2 teaspoon salt 1/2 teaspoon fresh ground black pepper Combine the olive oil, garlic, parsley, salt and pepper. Add the shrimp and let them marinate for one hour. Thread the shrimp on skewers and grill over medium high heat for 2 to 3 minutes on each side, or until done. Makes 6 servings Nutrition Facts per Serving Calories 244 Fat 11g Carb 2g Protein 31g NOTE: This is on my dinner menu for tonight! Instead of a traditional bbq grill, I'll use my George Foreman Grill. I'll probably cut the olive oil a bit too - 1/4 cup sounds like a lot to me. I'll let you know how it turns out! I found this recipe at www.smoker-cooking.com.

Week 3

Today marks the first day of Week 3. Only 49 more weeks to go. I checked in at the BEEP (bariatric exercise and education program) on Friday and have officially started my 12 monthly check ins. I plan to check in around the 10th of every month to stay consistent with the insurance requirements for the diet documentation. Bob the Trainer was pretty impressed with my level of documentation. (I'm tracking daily weigh-ins, calorie intake with the percentage breakdown, exercise type, length and calories burned for each day.) So in the past couple weeks of the new diet plan, I've discovered that it's pretty difficult to hit that 40-40-20 balance food goal. I've hit it a few days, but normally I struggle at the end of the day and realize that I've eaten too many carbs. Granted all the carbs I'm eating are from fruits and veggies, so they can't be all that bad... but I know that a carb-is-a-carb-is-a-carb. My calorie intake has been pretty good - ranging between 1000 to 1400 calories per day. Bob the Trainer wants me closer to the 1400 range, but my goal is to stay closer to 1200 which gives me a cushion to go a bit higher some days. Plus I feel like I'm eating SO much food because much of it is low-cal veggies. When you take out the high-cal pasta and bread from your diet, it's amazing how much more you can eat and still remain in the same calorie range each day. I've started taking a multi-vitamin. And I think between that and the increased protein intake, it has really affected how I'm feeling lately. I seem to be less fatigued. And my mind doesn't always go to food, food, food - so the cravings have really decreased a lot. I think both have a lot to do with eliminating the carbs from breads, potatoes and pasta. I definitely feel like I have more energy. My goal is to exercise at least 3 times per week for now. I'll increase that to 4 days in the next couple months and increase again when I'm comfortable with that regimine. I want to slowly build the workouts into my daily routine and let it become a habit that I enjoy rather than a chore that I loath. Last year I started out at 6-days a week from the very beginning and I think I was over doing it and getting discouraged because it felt like too much of a time committment. I ended up with an arm injury which turned out to be the result of not stretching properly before my workouts and I ended up with a pinched/damaged nerve in my neck/shoulder which radiated down into my arm. So I'm being careful to stretch properly this time around. So now to the question of how much I've lost? UGH! I'm fluctuating back and forth with 3 pounds. From my starting point I went up 3 pounds at the end of last week. But now I'm back down to the starting point again. The good news though is that my body fat percentage has dropped a bit even if my weight has not. Talk to you soon! ~Pam

I Hate Politics

As I've read through my blog subscriptions, I was surprised at how many bloggers have said that I need to vote today. In fact, one blogger has posted a voting reminder message for 4 days in a row now. Kim over at ScrapBiz quotes a statistic that only 40% of eligible voters will turn out today. I even heard a news report on TV yesterday stating that one local newspaper published the names of eligible voters who did not vote.

To me, voting is a very personal decision and I don't feel that I should be "commanded" to do so. If I make the decision to NOT vote, I shouldn't feel shamed or looked down upon because of that decision. It's my decision and I will be the one who lives with the consequences of not letting my voice be heard. By not voting I give up my right to complain about the candidate who were elected. But it's my own personal choice - please don't tell me that I have to vote. It's a free country, remember.

And, I obviously don't need to be reminded that today is Election Day - any human living and breathing couldn't miss the media frenzy that's been invading our daily lives for the past several months! (Technically more like 10 months!)

So why aren't more people voting today? I think it's an obvious answer. Instead of acting like responsible adults and upstanding citizens, candidates act more like children on a playground these days. You've seen the political ads - is there a single ad that has a positive spin on it? I haven't seen one where a candidate is telling me why I should vote for him/her and what they will do when they get to office. Instead it's all about mud-slinging, negative campaigning, back-stabbing and why I shouldn't vote for the "other guy."

I'm sick to death of the nonsense.

Why can't politicians act like adults instead of third grade bullies? If there were a candidate who was running a clean, non-mud-slinging campaign, I'd vote for him no matter what he stood for - just to prove the point that someone who can act like an adult will get my vote.

People are dissatisfied with the quality of the candidates, tired of legacy politicians who are out of touch with the common man. People are so tired of the constant commercialization of politics that we've gotten to the point of ignoring it all together (I mute my TV when ad comes on). The media spin is outrageous and so far removed from the reality of our everyday lives that the commentary doesn't even reach our consciousness anymore.

Do you realize how much money is being spent on these campaigns? $70 million on the Michigan gubernatorial race alone! Can't we find a better use for campaign funds? Why are candidates wasting money on commercials that just get muted or turned off when they appear? Why isn't as much effort put into fundraising for worthy charitable causes as it is for politics?

Yes, I'm sick and tired of this election season. Yes, I'm tired of people dictating that I must vote because it's my right and responsibility. Yes, I'll be thrilled when all they hype is over. And no, I'm not posting this message to cause a ruckus or uproar... just letting you know how I feel today.

But despite all that .... I'll still vote today.

~Pam

Music for Exercise

Ok, I made it through the first week of the diet. That 40-40-20 goal is harder to hit than I thought it was going to be. It's going to take a bit of tweaking before I can get it right without obsessing over food. Today I was on a quest to find some playlists of music to workout to. I found a couple good message boards that had lists posted by people who had already done the work of putting the music together. After I'd scoured the net for over an hour I stumbled across a great website that was very helpful. Best Music Workout has sorted a huge database of music into genres as well as the tempo of each song. You can choose how fast you want your workout to be (walking at 3.5mph, for example), then choose what type of music you want to listen to, and the search results give you dozens/hundreds of songs to choose from. Plus they link to sites where you can download the songs for as little as .10 each. By surfing around from that site I found several additional sites with amazing music download prices. Great resource! Now I just need to choose from the hundreds of songs I found suggested today and create my own playlists. I'll share those here when I get that done. Talk to you soon! ~Pam

The Diet Plan

I’m on day three of the diet (started October 31st) and I’m still trying to nail down exactly what I’m going to do. My previous plan didn’t work, obviously, so I want to alter it a bit and hope for better results this time around. I hate doing things that are doomed to fail, so my goal is to at least lose some weight in the next year.

Based on my research of my PCOS, I know that I need to limit the amount of carbs I’m eating because of the way my body reacts to those types of foods. I know I can’t do the full-out low-carb diet and eliminate carbs completely from my life. Fruits and vegetables contain a lot of carbs and I have no plan to stop eating these nutritious foods. But I’m putting a ban on all “white food” (white bread/flour, white pasta, white potatoes, etc.) and replacing those foods with their healthier counterparts (whole grain bread, whole wheat pasta, sweet potatoes, etc.).

Here’s my basic plan so far:

• Keep daily caloric intake around 1400 to 1600 calories per day. 
• Calorie breakdown goal: 40% carbs, 40% protein and 20% fat. 
• Make healthy choices on all food. 
• Drink my water. No less than 64oz. per day. 
• Exercise. 
• Be accountable to myself and Mike, my “coach.” 
• Free days: No exercise on Friday. No calorie counting on Sunday. 
• Track my own progress. (food & exercise journal) 
• Check in with BEEP once a month to make sure the paperwork is being done. 

I’ll tweak it a bit as I go along, I'm sure. I’ll flesh it out a bit more in the next couple days and present it to Bob the Trainer (yes, that’s how I’m going to refer to him all the time) to see if he approves or has suggestions. Based on our initial conversation on Tuesday I think I’m in line with what he thinks will work for me, so I doubt there will be any surprises.

I’m using www.fitday.com to keep track of my calories and exercise. I’m not totally convinced this is the best site for me, but I’m going to give it a shot before I try something else. In the past I’ve used www.nutridiary.com and have liked it – I might go back. We’ll see.

I’ve developed a printed form that I’m using to write down daily achievements. Basically a place where I can record my weight, calories (and the percentage breakdown), exercise type, time and calories burned. Rather than having a ton of printed reports from a website food journal, this seems more streamlined. I’ve got one page for each week and put all 52 copies into a 3-ring notebook so I can write the info for each day. If you’d like a copy of it, just holler and I can send it.

2.5 days down…. 362.5 days to go. Wait, 2007 isn’t a leap year, is it!? LOL!

~Pam

Plan B

From my last post you can probably guess that I’m frustrated and angry right now.

Last Wednesday (October 25th) I got news from Hurley that my doctors had NOT recorded the conversations about my diet over the past year and that my insurance company would not approve me for surgery without that documentation.

A little history...

I've spent the last 14 months of my life on a diet and exercise program that my doctors didn’t care enough about to record in my medical charts. My own food journal entries, weight charts, workout tracking, scrapbook pages and all the hard work I put in doesn’t matter one little bit to the insurance company – they require that my doctor record this information, not me.

As I said earlier, I have been to my doctors (2 of them) a total of 8 times in the past year. In all those notes there was only one time when a notation was made ("Patient continues to diet") - which obviously is not sufficient for anything!

And after 14 months of dieting and working out I’m right back where I started at the beginning. I lost 24 pounds within the first few months of dieting, but that didn’t last very long… the weight has all come back plus a few extra pounds. And yes, the weight came back even while I was dieting continuously. So you can imagine how devastated I was feeling when I finally resorted to the weight loss surgery option. I have dieted for years and the results are always the same – failure.

Plan A ...

In July, nearly a year after I started dieting I realized I couldn't do it on my own and decided to pursue surgery. Then I got my hopes up. Everything was going smoothly for weight loss surgery. It might have taken a bit of persuasion to get my medical records sent and reviewed, but there were really no major set backs. So I was all set for a surgery date sometime before Thanksgiving or at the latest the first week in December. But the news last week hit me pretty hard.

Devastation sets in again!

It’s been a really tough week for me emotionally. Even the thought of having to start over on yet another diet-doomed-to-fail was just too much to wrap my mind around. I cried a lot. Prayed a lot. Leaned on my best friend a lot. And, in the midst of it all, started making plans for how to deal with this next hurdle. As much as I wanted to curl up in the corner and hide, I knew I couldn't let them win. I knew I needed to keep fighting.

My new plan was two-fold. 

1. Talk to my doctors to request they amend their medical notes about the diet I’d talked to them about throughout the past year, using my own charting records as back up. 
2. Get started on a new diet/exercise program and have it documented from the very beginning, just in case this was the route I had to take. 

Well, from my last post you can tell that the first option didn’t work out so well. My doctors said they would "support" me in having the surgery and do whatever they could to help. But obviously that didn’t include amending their notes – even after I showed them all my own record keeping information.

Plan B ...

So yesterday I met with Bob at Hurley Health and Fitness Center. The Hurley Bariatric Center has a program that patients can go through to fulfill the insurance requirements of the diet history for surgery. It’s called Hurley Bariatric Exercise & Education Program (BEEP). I pay one flat fee for the entire year of appointments and once a month I check in with Bob to record my weight, blood pressure, heart rate and discuss my dieting program and nutrition. All this is recorded monthly and at the end of the 12 months the information is forwarded to the Bariatric Center so I can move forward with surgery.

Of course the hope is that I lose enough weight that I don't need to have surgery. But right now (and with my history), I'm not holding out much hope on that front.

I chose the BEEP program rather than my doctor for a few reasons. 

1. Obviously I don’t have much faith in my doctors right now and I don’t trust them to do the right thing for me
2. With a fee of $55 for the entire year, this turns out to be cheaper than visiting my doctor monthly and paying the insurance co-pay on appointments 
3. I know the paperwork will be done correctly and that at the end of the program I’m done – no more fighting with my doctors.

So to answer the question of the commenter on the previous post.

YES! I’m still planning to have surgery.

But it’ll have to happen next year instead of next month. Today, November 1st marks the first day of my 12 month documented dieting history. Yes, I’m sad and frustrated. But I refuse to let the insurance company or my idiot doctors win this fight. So I’ll march on.

And I’ll keep posting here over the next 12 months to let you know how I’m doing. Posting here helps me as well – makes me more accountable because the whole world knows what my goals are, so the pressure is on. LOL! And it gives me a record of how things are progressing so I can look back and see how far I’ve come.

My diet and exercise plan is going to be pretty simple and straightforward. I’ll share it with you soon.

Thanks to everyone for the outstanding support you’ve shown me. Hold on for the ride… it’s just begun.

~Pam

Do Doctors Even Care?

In the past month I’ve come to realize that either:

1. Doctors don’t really care about the health, well-being and dieting efforts of obese patients.

Or

2. Doctors don’t know how to treat obese patients in a respectful and educated manner.

I haven’t figured out which of these two are closer to the truth. It is obvious that medical doctors have not been properly trained in nutrition, exercise and diet; therefore they are unable to offer educated advice to patients who are struggling with their weight.

Who knows… maybe there are some doctors out there who specialize in these areas, but in my experience (and from the anecdotal experiences of others I’ve met) doctors are not the best resource for people who struggle with their weight. Oh sure, they’ll treat your diabetes, heart disease and high blood pressure – but they can not intelligently guide you on a path to lose the excess weight that is causing these health issues.

Over the past couple months I’ve become increasingly disillusioned with the medical profession.

My primary care physician (PCP) told me that if I just ate less and exercised more that the weight would come off. But on a 1200 calorie diet and exercising 1 hour a day, 6 days a week resulted in no weight loss for me. After losing 24 pounds in the first 4 months of a low-cal, low-fat diet with vigorous exercise, all the weight came back plus some. Even while continuing to diet, I was gaining weight. So how can my PCP tell me that everything I was doing should be working and to just try harder?

My gynecologist diagnosed me with PCOS (polycystic ovarian syndrome) over six years ago. It was only within the last couple months that I’ve learned exactly what this syndrome is doing to my body. And when I confronted my gynecologist about the various symptoms I’ve been dealing with he just said, “Yes, I know. PCOS is a difficult thing to treat. Eventually you’ll develop diabetes and heart disease.” Gee! Thanks for letting ME know all this when you first diagnosed me! He went on to say that Bariatric surgery might help me lose the weight and that conventional diets don’t really help someone with PCOS. Again, thanks for the info but it’s a little late for that now!

You know what else really really bothers me? I met with my PCP 4 times over the past year and with my gynecologist 4 times as well. (Lots of doctor appointments this past year!) At each and every one of those appointments I discussed my diet and exercise program with both doctors. Yes, I might have been at their office for something other than diet, but the conversation always turned to what I was doing to lose weight. Of those EIGHT appointments there was ONE notation in my medical records that said “Patient continues to diet.” That’s it. Just once. And just one little sentence. Why wouldn’t a medical professional record everything that was discussed with a patient during an appointment? I simply don’t understand that.

Can you tell I’m a bit angry? I honestly don’t know who to trust with my medical care anymore. I received more compassion and advice from the receptionist at my gynecologist’s office than from any medical professional in the past year. That’s a very sad state of affairs if you ask me.

More later…
~Pam