My dietary equivalent of the no-fly list

Last night I was reading another blogger discussing the perfect cereal. It reminded me how much I love and adore cold cereal. Left to my own devices, I could easily, happily subsist on cold cereal and skim milk. There is far and away plenty of variety to keep me from getting bored, but I have the added bonus of being someone who can eat the same meals for weeks at a stretch without getting bored.

Is is entirely possible there are people in the world who continue happy, somewhat healthy lives living on cold cereal and milk. Unfortunately, I am not a member of this mythical slice of the population. Since I am diabetic, my intake of sugar and carbohydrates must be monitored and controlled. Cereal, even the healthiest, plainest, devoid of sugar versions of cereal are not the best choices of fuel for me. And if I can’t have even the semi-sweetened version (cheerios, raisin bran), cereal has become yet another item on my dietary equivalent of a no-fly list.

Once I gave up skim milk as a dietary staple, it was not that difficult to forego cereal. Of course, now that I am no longer eating cereal, M has taken up eating granola. For the majority of our years together, M has pretty much never eaten cold cereal. Now, it’s a regular thing for him to be eating granola of various types with his protein powder drinks. Thankfully I am far enough away from dairy products and the cereal I love to not be jealous or even wistful about what I’m not able to able to justify and include as part of my diet. Part of me thinks of it as a “cannot” eat it, but in reality it is more a “should not” eat it. I can eat whatever I wish, but there are going to be consequences for falling off the healthier eating wagon.

Which is why I find eating so complicated and tricky. Every body is different, and what works for me to keep body in its healthiest place is not necessarily tastebuds’ happy place. A typical healthy, balanced diet honestly has too many carbs for my unmedicated system to handle without blood sugar creeping upward and scale bouncing back and forth with the same 3 lbs. gained and lost. I have read labels. I have counted calories. I have counted carbs and protein grams. It’s not so much nothing works – I have learned a lot and gained good insight from the experiences and the experiments – but it becomes an additional burden and stressor upon me, another way for me to fail and weaken my firewalls against negative girl.

For awhile now I have known that I must do something to break the cycle. RD, my most fabulous dietician and friend, has told me over and over that maintaining a high protein and low carbohydrate diet is necessary and the transition is not easy. Some people are successful in going cold-turkey, but I am in some big giant camp of special snowflakes who want what they want and go down fighting, kicking, and screaming every step of the way to the healthier lifestyle place.

For almost a year now I have been working at this. For almost a year I have had mixed amounts of success, but I have made some progress. I eat a lot more vegetables. I eat more fruit than sugary snacks. I gave up dairy, not because anyone suggested I do so, but because I don’t really like most of the dairy I was eating (greek yogurt) and I only drank milk in coffee and with cereal or cookies. Giving up cereal and cookies has become a mandatory thing, coffee was not that difficult with the daily protein shakes and amino energy powder, and dairy therefore just got left by the roadside. Pasta became a once a quarter event where it was once a weekly meal. Still, bread and crackers and snacking lingered, and despite my daily protein shakes, I was still light on daily protein intake.

I’ve been working with Dr. Spencer Nadolsky for a few months now, and in a fit of frustration with myself I decided I would try what I referred to as my nuclear option – his crash course to drop 10 lbs. in a 3 week period of time.

Except I couldn’t locate it anywhere on my computer. It must have been a couple of laptops ago, or M wiped it off my former laptop when his PC crashed and we switched things around. I reached out and asked Dr. Spencer for the information again, and after some discussion, he prepared my smoothie solution which is accommodates my picky eating habits yet is based on a protocol he has been using for his in-clinic obesity patients. The eating plan is specific and fairly strict; I refer to it as the “fuck moderation” eating strategy. I’m sure Dr. Spencer will has a kinder, gentler name for it.

I have never been a follower of fad diets, and this is about as close as I come to that. However, I also know that this solution is not a long-term or permanent solution to my eating habits. This will be 4 to 5 weeks, max. My expectation is that being away from “regular” processed foods for this period will ease my craving and addictive habits toward them and allow me to make better choices. By the end of this 4 or 5 weeks I should have a better idea of what tolerable hunger is really like and more resistance to my eating triggers. A girl can hope, right? And think positively about the success potential.

While Dr. Spencer’s protocol indicates 3 meals per day – 2 protein shakes (up to 4 scoops protein powder) and a “lean and green” dinner with 6 to 8 oz. of lean protein, I had to modify this for my life and lifestyle and have essentially 4 meals per day, with a single scoop protein shake before my morning workouts, then 1.5 scoops for breakfast and lunch shakes. Small cakes, really, and again, every body is different in its unique needs. I require fuel for workouts first thing in the morning, and within the confines of how much fuel I am consuming under this protocol, I am making it work for me.

But even with my own personalization, this first week was not without setbacks; it is far and away a learning curve with my addictions and habits are lifetime ingrained and very powerful. I have snacked between lunch and dinner – a package of peanut butter toast crackers in my desk at work. I could not resist a piece of warm french bread with or the croutons on my salad while lunching with a client. A small slice of pizza at a working lunch. A 100 calorie bag of skinny pop after dinner.

I am not going to self-flagellate about my missteps; shit happens. But I am pleased with the 3 days where I did stay on track, stuck to the plan. I found myself not especially hungry-hungry, more addictive mind whispering that it was mid afternoon and time for a snack. Or seeing M’s spread cheese in the refrigerator and wanting to go raid his stash of crackers, which are actually a better, lower carb choice than saltines or snacking crackers. It became easier to simply look at my watch to and calculate how much time had passed since my last meal and get up and freshen my glass of water. This is my new, evolving method to overcome the urge to snack – I get up and walk around, add ice and water to my glass and just drink it down.

Even the imperfect eating days, I understand the circumstances and that this is a new thing for me. Like all things in life, I cannot change the past; I can only view each day as a new opportunity to do better.

I did have a social visit with my scale this morning – down 2.9 lbs. since last I weighed myself 10 days ago. Since I tend to trade the same couple of pounds back and forth, I cannot get excited about this as progress this week. However, I have my reminder sticky back in place to weigh in each morning going forward. Thinking about my A1c results and my daily meter readings, I should not be surprised about the uptick. A big giant part of this fuck moderation eating strategy can be traced directly to that result. If I had not been getting concerned about the up-tick in my meter readings, I probably would still be trying to do a better job monitoring and tracking my food intake. Fluctuations happen; trends are easy to spot with regular data collection. Or so says fab trainer J and equally fab RD.

Which is another tangential thing that has arisen in my electronic communications with friends. My village is staffed with younger folks – even Dr. Spencer is mid-30s at best – and some of my friends are dubious about how much genuine assistance I am receiving from such youth.

Hmmm.

First thought: why on earth would I pay professionals for help if their advice and directives (when followed) fail to produce results? Second thought: why the immediate discount because of their youth?

The first thought was intriguing and complicated, because now being mid-50s (as they are and older) trying to transform my health seems almost a waste of time and resources. Which shocked me, frankly. I mean, when I asked if it would be better to simply sit around and wait to die they kinda/sorta backpedaled. Retirement is looming large in their minds, saving for that is a priority. Their doctors tell them walking 30 minutes 5 days per week is enough. Portion control and balanced diets are adequate for their overall health. I don’t need a trainer to teach me to walk, right? The internet is full of resources and recipes to make healthy, tasty meals. I don’t need a dietician for that. Obesity? I’m not that fat. I surely don’t need an obesity doctor.

Their health issues are not mine, and such basic directions may indeed impact them in very positive ways. I have been there, done that; it didn’t work. What I have now, with my village, is working. Results matter.

But beyond that, let’s do some math. Being a numbers person, some immediate facts and figures came to mind.

Under the high deductible plan I have had for the past year, I have a $3500 deductible every year before insurance even kicks in. When I was taking Insulin, I was taking 2 different types. The cost for a 3 month supply at the was $1058 for 5 vials and $929 for 3 boxes of the fast acting insulin pens. Add to that the oral medications for diabetes, blood pressure (protect the kidneys), syringes, pen needles, test strips, lancets – my total bill for 3 months of medications and supplies was $2387. I know because I called and received exact pricing for drug costs when I started with Kaiser last December. Strange thing about that? I could do better getting most of my supplies on my own without using my Kaiser insurance at Costco or Sam’s club pharmacy.

So, doing the math of using my insurance for prescriptions alone, that’s $9548 for the year of insulin and diabetes care medications and supplies. My deductible is $3500 and my copay is 30% after paying that, so I’m now at $5314.40 annually in prescription medications and supplies to manage my chronic health condition.

Not using that amount of medication more than covers the annual cost of working with trainer J twice a week.

I feel no particular need or compulsion to justify my choices and decisions, yet I do want to understand their perspective, as narrow and illogical as it may seem. These are people with whom I have years and years of money, budgeting, and financial decision-making discussions with through the years. I could understand their fretting about the financial impacts of personal training if I were not putting in the effort to go to the gym and practice what I am learning. I’m in the gym 4 of the 5 days I’m not working with J and quite literally working my ass off. Same is true of RD and Dr. Spencer. I am truly not the princess type, but in this regard I have ben flailing around on my own for so long I absolutely need and require personalized help for forward progress to happen. The argument for return on my investment simply does not compute.

What they do not seem to grasp, and this could be where the big disconnect comes from, I would not be off medication without the level of exercise I pursue. I will not stay off medication if I do not modify and improve upon my eating habits. The trade off in quality of life is not something that can be measured monetarily.

Bottom line for me: we are in different places in our lives. Our outlooks, health, lifestyle choices differ pretty dramatically. On this we simply have to agree to disagree. Choices I make are correct for me, even if they don’t make sense to them and their money-hoarding mindset.

As for the discount because of youth, I think this is a combination of things. The friends I’m thinking of are being slowly downsized and outsourced in their careers and opportunities for jobs and replacement of equivalent income is nearly impossible. It is a very frightening situation. Intellectually, we all know its purely an economic formula; younger, less experienced people are a lot less expensive to hire. Emotionally, it has created an almost crippling sort of fear to find that age discrimination is alive and well and mostly ignored in the workplace. Making less income at what should be the peak of their careers, facing the prospect of an underfunded retirement or being forced out of the job market creates unexpected, unanticipated anxiety and stress in their lives.

I understand that all too well, and I feel for them.

But my village has skills and experience that I lack. Trainer J is a veteran gym guy, with lots of weight lifting experience and education under his belt and acquiring more with every passing week. RD is a registered dietician and spends his days working with people who really do not want to change their eating habits but the consequences of not following his recommendations and advice are dire. Dr. Spencer is an obesity doctor and works with a lot of patients safely modifying their lifestyle through diet, exercise, and medication support.

In their areas of expertise, all of them know far more about diet and exercise than I do, now and probably well into the future at best, probably forever is more likely. Since I am not capable or willing to experiment long enough to objectively evaluate all the sources of information out there, I have had to choose teachers, guides, information gatekeepers. Aside from their education and experience, I truly feel their real talent is their ability to package and present information to me in ways that make sense to me. Maybe a lot of their other clients are enjoying far more success in shorter periods of time, and quite possibly I remain the village idiot in the various training and healthier eating tribes. But so what? Someone is always going to be ahead or behind the average curve. The day I stopped comparing myself to my peers in the groups was the day i began to feel satisfied and allowed myself to be happy to learn what I learn, know what I know now. I try to follow their advice and directions, and I report back when and where I’m having issues. Chasing miracle cures or immediate results is not me, and my expectation of just trying to implement and seeing small, incremental successes has helped enormously. Still imperfect, but I am so much better than I was a year ago. If I learn that from a couple of 27 year olds and a newish physician then great! Yay for the wisdom and education and experience of youth.

Despite my description and reactions to the discussions here, they were not contentious or heated. One friend just received notice that his job is being eliminated at the end of this year, his third such layoff in the last 10 years. While we are the same age he and his wife were married awhile before starting a family and he has 2 children in private school. I sympathize and asked about prospects and at the present time there are none. His situation is sad to me, but our life and lifestyle choices are very different. Another friend is in bracing for round 3 of layoffs in her firm and expects to not miss the cut this time around. After nearly 26 years with the same firm, she’s completely paralyzed with fear about what to do next, how to even go about looking for another job.

Scary times, indeed.

These economic realities are partly why I started my better health quest in the first place. I knew I would be looking for other work at some point, and whether it’s ever acknowledged or not, obesity bias is a thing. Added to the fact that I am an older worker, not classical or mainstream pretty, and find trying to be charming on demand a huge drain on my mental and emotional resources, I was really worried about making a living when I decided to try and get myself into better physical shape. Whether my anxiety was a product of negative girl’s doom-and-gloom outlook or a reality that I just did not quite come face-to-face with, it was a strong impetus for change.

From where I’m standing (at my treadmill desk) right now – happier, healthier, and stronger – it is impossible for me to see a downside to my decision or to the village I have assembled. I know it’s a luxury, but far better than pricey spa treatments many of my friends promote. This afternoon I’m going to the mall to return a blouse my shoulders and upper arms are hulking out of, yet across the bustling and around the waist it fits just fine and is a complete and total 180 on my typical experience. And I’m going out on this mall adventure in another pair of jeans from the smaller size box.

Kind of impossible to argue about the expense and youth of my village when I am enjoying success and tangible results. Along with a chocolate and peanut butter protein shake for lunch.

All is well and the sun is shining in my realm.

More lows and highs

I was reading blogs this morning and thinking about conversations and experiences I have had this week.

New experiences with my blood sugar drops have been occurring all week. I am certainly not getting upset or anxious about it, but it makes me aware there is something new happening that should be addressed. Frankly, I am choosing to be kind of excited about it. I finished my workout this morning and tested in the locker room … 61. Out came the emergency grape juice, because it was just close enough to make me nervous about the short drive home.

Besides, my sugars have been consistently lower the past several months. I can afford a single can of juice. And I have an appointment with RD this afternoon to help me update my eating to try and avoid this.

But I cannot help being a little pleased as well as concerned. As a type 2 diabetic, I have worried more about the opposite problem and sugar numbers being way too high. It’s a new problem, seemingly more easily resolvable problem to have my blood sugar dropping into too low territory because of exercise. In my mind it means I am working adequately. In my mind it means I am somehow stepping up my intensity.

That thrills me to brand new heights.

If I had time this morning, I probably would have mixed up a protein shake for after my workout. That would have sensibly resolved the issue. But I was running late and we have guests, so things are a little off balance this week. No matter – half a can of grape juice in the car and a pear once I got home and I’m back in overall feeling good business.

One thing I’m absolutely certain of – my body will adjust. I am not working so intensely for such an extended period that I need to worry about fainting or worse. Besides, I am aware of the signs and heed them well before that happens, and in this I can absolutely trust the signals my body is sending (because there are no cookies or anything yummy I would voluntarily eat at the gym). But again, it feels like I have stepped up to a new plateau in the exercise and conditioning my inner systems to accept the new workload. Since my default position has historically one of retreat when things get difficult, I am amazed at my own resolve to charge on forward.

And that, my friends, is a system upgrade that I did not anticipate happening for me.

Lots of other stuff to talk about today in a longer post. However, this ongoing saga with blood sugar this week is exciting and was worthy of its own brief update.

Happy Wednesday everyone!

 

Feeding frenzy prelim

Last night I got an email from my dietician with my “calorie budget” for the period I am to be tracking my meals and food consumed. I cannot say I was happy about it, and I will freely admit to have a text tantrum on multiple phones as well as a whine-fest with M about it.

I know, I know … first world problems, right? But it upsets my apple cart because I had told him in vivid detail how I do not count calories, weigh or measure food, or even really want to do the whole meal consumption list. Perhaps he thought I was joking about how wigged I would be over this idea; after all, people probably make up stuff to tell him every day of the week. However, I am really not most people; I am likely loonier about this sort of thing than the average bear. My instinct is to follow the advice provided when I am consulting experts for help, but I also know my limitations and obsessive/compulsive behaviors about stuff like that. I agreed to food tracking for 5 days so we would have something to discuss, and I will stick to that agreement in all it potentially ugly glory. So why the calorie budget now? To set me up for failure?

As of last night I was having a foot-stomping, dig-my-heels-in declarative incident that I’m not doing it, I am not going to concern myself with his calorie budget during this period. He gets a food list, that’s it. We can talk portion control or eating more of this and less of that after we review it at our next meeting. I am going to forget he ever sent me that email.

But what am I doing today? I am looking at labels and weighing food and doing the math on a simple lunch I probably eat some variation of just about every day.

IMG_1027

02/02/2016 – Smoked turkey & cheese, fruit, water/sparking water.

The verdict? The estimate is this is 636 calories, and that includes weighing the turkey slices so I have a ballpark estimate of portions if/when the RD asks. I am not sure if I am crushed as if I am massively overeating already or just accepting this is a decent, typical lunch for me and that’s how much it costs in terms of calories. Of course, breakfast this morning was a scoop of protein shake mixed with a cup of coffee before the gym, so that was only 200 calories for a grand total today of 836. But then we are eating with friends tonight, and I will be (unfortunately) thinking about this crap the entire time I am reading the menu.

Do you see where this is going? If I allow myself to be quick like a bunny and dive down the rabbit hole of food measurement and calorie counting, I am so screwed and will be a stark raving basket case by the end of the week. And that’s just looking at calories, not a word about the underlying nutritional details as relates to protein, fat, sugar, carbohydrates, sodium, etc., etc., etc.

I am right to not do this to myself, except now I am not sure how to resist the compulsion to look at every label and think about every bite of food that crosses my lips. The voices of reason in my life suggest that my blood sugar numbers are good, I am not doing anything crazy (no super fad diets, no binging on cookies late at night), and just doing the 5 days of food list is adequate and to forget about the calorie budget.

So much easier said than done.

When I have experimented with food tracking applications like my fitness pal, there were also these trade-offs for the exercise completed each day. I do periodically have it flitter through my mind that if I eat this cookie it’s going to mean an additional number of squats or lunges or whatever else might be vexing me in the moment. But I am never thinking “I’m here doing this so I can eat regular meals and then some today.” My mind does not work that way, at least not anymore. If it did, believe me I would be consuming a lot more crap food and justifying it with the amount of time I spend at the gym.

The food tracking apps have a negative effect on my perspective with food, as evidenced right now by my level of discontent with the lunch I eat some variation of 5 days out of 7. Maybe I need to print out this post and email it to the RD so he understands I wasn’t kidding when I said I am neurotic about this food tracking and calorie counting stuff.

I do not officially start the food tracking until Monday, so I have the weekend to get all my angst and drama about it bled out of my system. Hopefully my feared level of cranky will simply be another projection of my anxiety about being judged harshly. If only I were not so honest with my reporting. If only I could write the good choices and lie about the less great things I eat.

Sometimes being a consistent rule follower is more harmful than good. I’ll get through it, but even less delightedly than before that email.