Author Archives: Living 400lbs

Hand Laundry Never Ends

As many women know, hand washing of bras is recommended to keep them in good condition.  This is not necessarily a huge burden!

Hand washing of pantyhose is also recommended. Thank heavens I don’t have to wear pantyhose.

And then came…compression stockings.

Compression stockings drying on towel rack

Compression stockings drying on towel bar

Compression stockings are often recommended for people who are on their feet all the time, who are flying, who have had lymph nodes removed, and to prevent blood clots.

In my case, I eventually realized that part of my left knee pain was actually located below my left knee.  Where there was also swelling, and which felt better if I wore tight leggings. My ARNP diagnosed likely blood flow issues and varicose veins, and referred me to a vascular specialist.

The vascular team did an ultrasound of the veins in my leg. Leg veins have one-way valves which supposed to keep the blood going up my leg, back to the heart. It was confirmed that my valves are not all working well. In particular, the one-way valve just below the knee on my left leg – where I had swelling and pain – wasn’t really one-way anymore.  Compression was recommended to reduce the swelling and help the vein to move the blood to the heart where it belongs.

I didn’t realize at the time that this would mean the hand wash only laundry would never end.

I was prescribed 20-30mmHg, knee-high stockings. The mmHg is “millimeters of mercury” pressure, and 20-30 is about middle of the range.  I did go to a medical supply store to get fitted. I recommend it since you can get some knowledgeable advice on fitting and how to put them on without putting a fingernail through them.  If you wear a common size you may be able to wear them home. My size 14-16 friend got fitted with thigh-highs after her cancer surgery and wore them home.

Initially I didn’t fit anything over-the-counter due to the swelling in my calves; after wearing leggings daily for a week, the swelling reduced enough that I could wear a standard size instead of custom made. I wear Juzo Max knee-high stockings, which have more of a flare at the top of the calf than the standard knee highs, and which wasn’t in stock but could be ordered. I also pop for the “silicone band” of little silicone beads to keep them up.

Pros:

  • No below-the-knee pain.
  • Much less swelling in calves.
  • Legs feel less tired.

Cons:

  • Stockings are expensive (mine are $78.39 per pair).
  • Stockings require hand washing.
  • Stockings need replacing every N months. Currently N is 2 or 3 months. I know folks who go 6 months, others who buy them monthly.
  • None of my leggings fit right anymore.

All that said, the compression stockings have been a really positive thing for me. The below-the-knee pain is gone.  Walking is more comfortable. I still elevate my feet whenever possible, but my legs and ankles aren’t swelling every evening. These are all terrific.

Bandcamp: Music You Might Like

I post a lot about music. Recently the music distribution site Bandcamp donated their profits to the ACLU, so I put links together for some of my favorite performers.

Kinda nerdy folk/rock/filk:

Molly Lewis

Vixy & Tony – space exploration & fandom

Jeff & Maya Bohnhoff – brain-breaking classic rock parodies like “Midichlorian Rhapsody” and beautiful originals.

Tricky Pixie – Alligators, raccoons, and cats, oh my.

SJ Tucker

The Doubleclicks

Tom Smith – You might like “Hutt Slaya Leia” or the occasional serious track like “Starlight and Saxophone”

Bill & Brenda Sutton – including a song about having a CPAP

Angry Elf Punk:

Crime and the Forces of Evil

Kinda jazzy folk/rock:

Marian Call

Mary Crowell – including multiple songs about coffee 

Celtic:

Amy McNally

Alexander James Adams

Heather Alexander

Nerdcore / nerdy rap / chiptunes :

Shubzilla

Death*Star

Jonny Nero Action Hero

 

 

Workplace “Wellness” Programs

Slate has a good article on how “wellness” programs aren’t.  There’s good details on why they tend not to actually improve health. But the money quote is:

Under the ACA, wellness programs are a legal way to shift a significant portion of the cost of premiums onto employees deemed unhealthy. Wellness programs don’t save money by preventing expensive medical claims—and in fact, they might even increase claims costs due to encouraging unnecessary doctors’ visits. But wellness programs can save money if enough employees fail them or opt out.

I’m glad my current employer isn’t doing this sort of thing. I hope it stays that way.

Image courtesy of Rudd image gallery.

Vitamin B12. Joy.

Researchers have found a possible link between lack of vitamin B12 in early life and insulin resistance later.  (Link has both video and text; video does at times assume fat is a problem, but overall explores why type 2 diabetes is not brought on by eating too much.)

I’ve written before about being deficient in Vitamin B12, so you may understand that this is a bit closer to home for me that others.  And the endocrinologist has reminded me many times that I’m insulin resistant.

So. Yeah. Interesting.

Thankful Thursday

An occasional exercise in gratitude.

Work is going well; I have a new boss who is not only on my side, but inspiring.

Levothyroxine and asthma meds, which keep me functional.

New cpap, now with built-in humidifier.

Close friends who shared hugs and helped discuss the election.

Vaccines 

Himself, who made lasagna for dinner.

(I am very, very afraid of what Trump and his terrors are going to do, but I also want to not catastrophize. So.)

This cake is great

I occasionally get comments about the “and believe me I am still alive” subhead on the blog and how “defensive you have to be to have that on your blog”.  Er, mostly it’s a joking reference to the Jonathan Coulton song. (Lyrics here.)  And it’s a way of metaphorically rolling my eyes at all the people who (still) say I’ll be dead at age 30 or 40.

(Never mind that I just turned 50.)

 

It also expresses that despite being very fat, I’m still alive.

It also expresses that I may not be always posting, but yeah, still alive.

 

A Few Thoughts On Consistency

Today I received my last Sojourner medal in Ingress.  It’s a deceptively simple one to earn – get within a certain distance of a game portal and perform a certain game action daily. The number of days starts at 15 and  increases over time.

image

As of today, I have visited a portal 360 days in a row. The nearest portal is at the end of the block, so not a big trip. At the same time, I’m a bit surprised with myself for this.

I grew up being told I’m not capable of consistency because I was not able to keep to diet for years on end. But maybe it’s not that I’m incapable of consistency. Maybe it’s that some things are impossible. 

It’s Too Late

Ever dream of “If I win the lottery” or “If I met someone rich” or “If I got in on the next big startup” or “If I get on a reality show and become famous”?  Or heard that “Oh, you don’t want to be too set in your ways, when you meet a partner you’ll want to build your life around his”?

Next month I turn 49 years old.

Now I’ve slayed some dragons
And I’ve found a treasure or two
Journeyed to mysterious lands both far and near
Sometimes I’ve been lonely
Sometimes I’ve been afraid
And no fairy godmother came to save the day
Pulled up my own bootstraps and did things my own way

– Cathy McManamon

What I’ve done so far in life is part of who I am. I’ve been married 15 years; I’ve been a home owner 16 years; I’ve been in the software industry for 25 years; I’ve lived in Seattle for 1 month shy of 49 years. I may still change careers or go back to school or move away from the Pacific Northwest, but it’s a LOT less likely.  And I’m comfortable with that.

Are you a pirate?
Or a prince, charming and brave?
Did you think you could turn me so easily?

I don’t need someone to sell me something to prove my worth. I have my own self, and it’s worth enough.

It’s too late to convince me I might be a princess
It’s too late to help me discover my secret magic skill
It’s too late to make me believe I’m inheriting a kingdom
It’s too late to be my savior in shining armor bright
Go fade into the night
I’ll be all right

– Cathy McManamon

These musings were inspired by Cathy McManamon’s song “It’s Too Late”, available on BandCamp.

Hm, maybe I should post more often

The 2nd-most-recent post on the blog is from February and mentions that I’d gotten my silver Translator badge that week.  I got my gold Translator badge* last week.  Maybe I should post more?

Harriet Brown has been writing more about weight and health of late.  The most recent, in Slate, is worth reading (though the comments are NOT supportive and can be easily skipped).

Harriet also tackled 4 lies at Psychology Today:

  1. Americans keep getting fatter and fatter – nearly half with will be obese by 2030
  2. Being fat takes years off your life
  3. Being fat makes you sick
  4. Diets make you thinner – and healthier

Meanwhile, at Everyday Feminism, Liz Boltz Ranfeld asks what would happen if fat people were allowed to be happy?

My native Seattle is getting more inequal; the rich’s income is going up more than in other US cities. The median income is up to $100K here now too. I think it’s good that franchises didn’t win their injunction against raising the minimum wage.

Oh, and the Sounders season started :)

Major League Soccer (Football to the rest of the world) has scarves. It's a Football thing.

Major League Soccer (Football to the rest of the world) has scarves. It’s a Football thing. This is my 2015 season ticket and Alliance member scarf. 

*I realize that last may make no sense if you don’t know about Ingress, but in sum, I did a lot of game-playing to go from silver to gold.

QotD

So my advice to women is this: If a man ever tries to use the Bible as a weapon against you to keep you from speaking the truth, just throw on a head covering and tell him you’re prophesying instead. To those who will not accept us as preachers, we will have to become prophets.

— Rachel Held Evans wrote this in her book A Year of Biblical Womanhood: How a Liberated Woman Found Herself Sitting on Her Roof, Covering Her Head, and Calling Her Husband “Master.” There is a certain amount of rules lawyering in there — but it’s certainly a literal use of the passage.

Frustration

[Note: Includes discussion of weight loss and history of intentional weight loss. Please avoid if you don’t want to read it.]

Visited the endocrinologist again to follow up on my med changes. On my way into the office, the doc asks how the meds have made me feel; I said that I haven’t noticed much change except my step counter says I’m walking more. She weighs me and happily congratulates me for losing 8 pounds in a month. I mumbled something like “Uh huh” and we moved onto the rest of the appointment.

The doctor’s congratulations brought up feelings that I didn’t try to unpack during the appointment. After the appointment I began to think about it, and why it upset me.

  • First: Why congratulate me? I haven’t changed my eating habits. I haven’t been counting calories, or carbs, or points, or anything that I would normally do when I’ve intentionally tried to lose weight. I have been a bit more active, but I’ve been MUCH more active in the past without losing weight. This is not something I have made or built or achieved.
  • Third: There have been times in the past when I was trying very hard to lose weight, and lost weight, and felt like I’d won something. I reveled in congratulations and people’s happiness. Right now? I feel like a bystander.
  • Fourth: There have been times in the past when I was trying very hard to lose weight and didn’t. I followed the diets. I’d do the exercises. And, despite doing it all “correctly,” I did not lose weight. Did I get congratulated on my effort then? Nope. I’d be blamed.  I’ve been told I was not measuring correctly, or I should use a scale, or a different diet, or more exercise.  I’ve been told I was lying about my intake and exercise, because I “couldn’t” not be losing weight if I was really eating and exercising like I said.
  • Fifth: Maybe I was a bystander before, too.
  • Sixth: I’ve been trying to build my arms up for the next higher weight dumbbells but noooo, body has other plans….

So, I guess I’m having some feelings here.

Finally, I reminded myself that the reason I pursued treating my borderline hypothyroid (which led to seeing an endocrinologist etc) is to feel better and have more energy. That my weight went up about 30lbs in the last few years without a change in eating habits is one of my symptoms; my weight may change as part of correcting it.  It’s OK to be a bystander here.

Tonight I tried out some shoes from Zappos on the treadmill and this Mary Lambert song came on.

We are, we are more than our scars.
We are, we are more than the sum of our parts.
— Mary Lambert, “Sum Of Our Parts (Alternate Version)”

Timings & Structure, Thyroid Edition

I started taking levothyroxine this fall, and got the standard spiel from the pharmacist:

  • Take first thing in the morning.
  • Do not eat anything else for 30 to 60 minutes after, including other oral medication.
  • Do not take with calcium or iron supplements for 4 hours after taking levothyroxine.

“You CAN have coffee!” the pharmacist chirped happily.  I was happier when she confirmed I could have my inhaled asthma meds.

This has been an adjustment. I was concerned it would bring up the anger-rebellion response I usually have had when dieting for weight loss. As it turns out, it hasn’t.  This has probably been helped by the fact that this is about a medication which has been showing direct benefits ever since I started taking it.

It also resulted in me forgetting the rest of my morning pills once or twice. Fortunately the vitamin B12 and D I can miss occasionally, but the SSRI can be dangerous if I stop it abruptly. Having a weekly pillbox helps me to know whether I’ve taken them.

I did take the “no calcium or iron supplements” a bit to the extreme by also skipping dairy and meat for 4 hours, which created the concept of “dairy o’clock” for me.  I have gradually relaxed that, but continue to adhere to the much more important “no food or meds for an hour”. I have a Detachable Pill Box which I can use to take my other morning pills with me to work if I need to leave before I can take them.

In the first month I took levothyroxine, I felt that I had more energy. According to my step counter, I walked more.  Also important is that my focus improved; I was able to complete tasks at work in less time than before.  And according to the scale at the endocrinologist’s office I lost 3lbs.

The endocrinologist seemed extremely pleased by the 3lbs. I tried not to pooh-pooh her parade by pointing out that it’s less than 1% of my weight, but damn, I was much more focused on the “able to get more work done” and “able to walk more” parts of the equation.

No, Really, Treat the PROBLEM

A comment for Treat Weight First? that I did not approve, but found striking for its ability to completely misunderstand, was:

There must be some powerful drugs in that koolaid you’re drinking. You admit you are morbidly obese, you have multiple health problems directly related to obesity, yet you shun the doctors that are trying to help you and others like you to lose weight. Amazing!

I posted here before that I’ve recently been diagnosed with multiple conditions that cause fatigue, muscle loss, and weight gain.

I repeat: cause fatigue, muscle loss, and weight gain.

What I haven’t posting about is that it’s been TWO MONTHS since the test that confirmed I’m deficient in human growth hormone — and I haven’t started treatment yet.

(Why? Combine a rare condition with an expensive, injectable drug treatment and you get fun “Who’s on First?” times with the doctor, insurer, pharmacy, and the drug manufacturer. I am not thrilled to have the drug manufacturer’s help line in my cellphone contact list. On the other hand, I do have the drug manufacturer’s help line in my cellphone contact list.)

Because I try to be a good patient, I read up on this new condition.  It has fun, familiar symptoms like:

  • A higher level of body fat, especially around the waist  (Like the 30lbs I gained since my dad died? Or the 50lbs between 97 and 2001? Or, er, my entire life?)
  • Anxiety and Depression (I didn’t have a problem with anxiety until about 4 years ago. Uh…)
  • Fatigue (So, not just hypothyroid?)
  • Feelings of being isolated from other people (So…not just getting older and less patient?)
  • Greater sensitivity to heat and cold  (So… not just getting older or hypothyroid?)
  • Less muscle (lean body mass) (Yeah, my weight lifting hasn’t had results it used to, it’s harder to build muscle…)
  • Less strength, stamina and ability to exercise without taking a rest (Like how I could walk a mile a few years ago and now I need to rest after a couple blocks? YES IT’S VERY NICE TO KNOW WHY.)

And a symptom that’s very, very scary for me: hypothyroid can cause impaired memory.

So let’s go back to that “koolaid” I’m drinking. And about how weight loss is going to “help” me.  Because weight loss will obviously fix the “obesity-related” health problems I have.  Except, wait — those hormonal deficiencies are “obesity-related” in terms of “people who have this tend to be fat”, not “caused by fat”.  And they’re screwing up my life. 

  • Weight loss isn’t going to fix hormone deficiencies.
  • Weight loss drugs won’t fix hormone deficiencies.
  • Weight loss surgery won’t fix hormone deficiencies.

If I were to lose weight without treating those hormone deficiencies? My quality of life would not be improved.  FUCK THAT.  Or, to be precise I am going to continue to focus on improving my HEALTH.  Because THAT will improve my life.

(How RUDE to put MY priorities first!)

And if, in the course of improving my quality of life — things like restoring my former energy levels (horrors!) and my former stamina (eek!) and regrow my muscle mass (Aack!) and reduce my anxiety and depression (gasp!) — I may end up losing some weight?  That’s up to my body.

Treating Weight First?

The Twitterverse has been busy talking about some new treatment guidelines for fatties. Ragen Chastain posted about a piece from Medscape called “New US Obesity Guidelines: Treat the Weight First,” which also has quotes from the lead author.  I also clicked over to the guidelines themselves. They start with an extremely helpful objective, to wit:

Objective: To formulate clinical practice guidelines for pharmacological management of obesity.

That’s the goal here. That tells you what this is primarily about: weight-loss drugs.  Two more were approved in 2014, at least in the US – Europe has been slower to approve the drugs.

There are a few things in the guidelines that I like.

First: Some medications have weight gain as a side effect.  I consider this is a useful fact for medical practitioners.  It makes no sense to prescribe a drug that has weight gain as a side affect and then chastise patients for the resulting weight gain.

Second: Yes, it makes sense for medical practitioners to be aware that medications can cause weight gain or loss, and to discuss that with patients. A fat patient may prefer a drug that doesn’t cause weight gain. A slender patient may want to avoid drugs that cause weight loss.

Third: They’re measuring that a weight loss drug is “effective” if the patient loses 5% or more of their body weight in 3 months.  If that seems low? Yes, yes it is. Worth anal leakage? I think not.

Fourth:

Historically, patients and providers thought that weight loss medications could be used to produce an initial weight loss that could subsequently be sustained by behavioral means. The available evidence does not support this view.

This is an important admission. The human body doesn’t like to have its weight set point messed with.

The things I disagree with?  It’s hard to limit myself to just a few, but:

  • I disagree that patients need to be moved from drugs that control chronic health conditions just because the drug may cause weight gain. What are the side effects of the new drug? Is it as effective?  Does the patient have support during the transition?  That matters too — especially with psychiatric meds.
  • I disagree that patients should postpone treating conditions like hypertension until they lose weight. If the patient wants to try lifestyle changes first, fine — but it should NOT be under duress. The medical profession is already known to mistreat fat people. This can become another justification.

On the flip side, I was prescribed a drug that can cause weight loss (Levothyroxine) this fall. The endocrinologist was thrilled that I lost 3lbs after a few weeks of taking the drug.  I don’t care about that.  I care about FEELING BETTER.  Obviously I’m un-American.

Guidelines: Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline,

Medscape: New US Obesity Guidelines: Treat the Weight First

Medpage Today: New Guidelines: Treat the Weight First

Day 12: Celebration of the WinterTide

Today is the 12th and last day of Christmas.  Thanks to you who’ve been following along.  This last recording is from Alexander James Adams’ album WinterTide. 

Comparisons keep us at odds-
There’s room inside for all our Gods-
Embrace the things that we all share,
For then we find compassion there-
To those that thirst, you offer drink,
It’s not as hard as you might think!