Petulance gets you nowhere fast

So I was petulant for a few days about my unfortunate exercise thing, until I went in and talked to them and they said, "What? We didn't say it was optional?  So sorry!" and then I told them what I felt my current limitations were, and we devised a different plan for strength training, and I felt like an adult and felt better about the whole thing.  I haven't been on schedule with the exercise, and I haven't always made food choices that made me feel better after eating, but any exercise and any good food choices are much, much better than I was doing.

I did the OA thing for quite awhile, some years back, and that helped a lot for awhile.  There's this thing, like in AA, where you might count the days you've been sober (or abstinent, they say, in the overeaters thing).  And I was very proud of my long stretch of abstinent days, until the day I slipped.  Talk about feeling like a failure!  What?  I have to start from zero days?  No way.  So I just shut that thing down, and gained back everything and much, much more.  I'm no longer doing the days of perfect abstinence, and it's so much easier to say, ok, that was not the best choice for me, but now I'm going to make a better choice for this next meal.
And so, after all these years of gaining, now I've lost 16.5 pounds, which is amazing.  And I can walk farther.  And (I know this sounds weird if you don't have the problem) but I actually tied my shoes, while they were on my feet, without any problem the other night.  This was the first of the goals I wanted to reach.  It's huge for me.  Another goal was to walk for a reasonable amount of time, keeping up with my friends, and I was able to do that for a good amount of time too -- actually much more than I expected -- on a Girls' Weekend trip.  (I even went to the fitness room at the hotel while I was there!)

So I'm seeing progress.  I had lost 10 pounds the first two weeks I was on this plan, and then plateaued for six weeks, and then suddenly I lost 6.5 pounds again.  So I can't start looking forward to some sort of constant progression, and I can't be disappointed with I don't see a perfect slope on a graph.  And if I don't go to the gym, or I eat too much, or I indulge in something, that's the time to avoid the stinkin' thinkin' and jump back in.

One of the exercise physiologists told me she was so pleased to see my confidence.  That amused me.  I do try to show enthusiasm, and I do try to keep the petulant child at home, where I can have a good talk with her one-on-one.  So I'm happy to see if I'm exuding confidence.  What's the point of doing it if I'm going to be portraying myself as a morose poopyhead?  But I bet she deals with a lot of morose poopyheads in her work.

So that's the latest on the challenge.  Did I mention:  No cancer?  Yeah, I probably did.  But nothing like a cancer scare to help change course.  Onward and upward!

Cranky and in pain

So the Metabolic Fitness group met for the second time last night.  There was exercise first, then a lecture on selecting nutritious food at the grocery store.  I have a miserable cold, so I wasn't in the mood.  I got there early, though, and started doing my regular workout at that point.  I didn't know -- no one told me! -- that we were going to transition to a group round-robin strength training thing.  I was under the impression that this was going to be geared toward individuals' abilities, but I didn't feel this was, and I pulled all sorts of muscles in weird ways, because there was no time to say that I needed some more time to do something, or that my knees can't handle certain things ... anyway, the upshot for me is that I'm achy and in some pain today, as was my fear about this stuff anyway, and that I need to spend some time doing a CBT process on the whole thing so that I can gain back some enthusiasm.  One of the ways I think I'm going to deal with this is by going back to the gym tomorrow morning, doing the regular workout that I've been doing (increasing time on each machine each time), and then doing at least one or two of the strength-training exercises each time so that I can get better acquainted with them and find out, in my own time, what my current limitations are, so that -- in the midst of the group thing -- I'm not surprised or trying to push beyond my pain threshold.  That, I think, will give me more confidence and, I hope, help me feel stronger faster.

So I was cranky, and sick, and sitting in the nutrition lecture wishing I were anywhere else.  Preferably at home eating something, I suppose, watching TV, going to bed early ...

I really wanted to wallow in self-pity last night.  I wanted to eat something that wouldn't make me feel better.  An interesting situation.  Everyone else seemed to be doing so much better than me, and I felt self-conscious.  I was so glad to think this was going to be individualized, and suddenly I'm tossed into a group thing, and it brought me back to all those godawful sadistic high school gym classes.  But, of course, this is not that thing.  This is really staffed by people who care about making us healthier.  My feeling about last night is changeable.  I'm going to have to go through those cognitive distortions and see what self-defeating thoughts I'm having, and change those.  I know that this will all make me feel better eventually, if it hasn't yet.  The one thing that I have had is enthusiasm.  Having a cold doesn't help, though; it really dampens everything else.  These days, the powers that be don't want their employees staying home when they're sick, so there's no chance to rest and recover.  So I suppose I have an overall crankiness at the moment.  But this shall pass.  By class next week, I'll be ready, and I'll know what to expect, and I'll have figured out how to get enthusiasm back.  Meanwhile, a trip to the chiropractor may be called for!

Happy New Year, etc.!

So.  Holidays are over.  Big storms have abated for the time being.  The most recent D&C/biopsy has been completed.  Trying to catch up on work.  Lots has been going on.

My concern that I would need that hysterectomy had grown.  Spotting continues every day.  Thinking about logistics again:  If family can come here and there, should it be while I'm in the hospital or afterwards?  Can I afford to get a visiting nurse if need be? What would I do for meals if I'm laid up for awhile? Etc. etc.  I found it much more fruitful to put my mind to these things than anything related to how I would feel, would I be scared, etc.

So now I sure do know a lot about how to manage daily life when you can't manage it yourself.

I had done a lot of cogitating on the Hunger Within thing, but I was having a little difficulty getting beyond the paying some attention and making some choices based on what would make me feel better.  But, before I was to go on holiday, I signed up for the Metabolic Fitness program at the Cardio Dept. at UM.  This is a six-month program of nutritional and exercise guidance, with weekly group meetings, for people with metabolic syndrome.  Metabolic syndrome is, briefly, what you've got if you've got high blood pressure, elevated cholesterol, round belly, diabetes or high risk of it, etc.  There are a lot of things they talk with you about before you sign up.  I did a treadmill stress test, which showed -- as I could have told them -- that I was *really* out of shape.  But they got the numbers they wanted to see, EKGs, etc.

I met with the dietitian/social worker before I left for the holidays, a few weeks before I'd start the program.  We talked about a Mediterranean eating plan, which is what they recommend, along with a partial meal replacement shake thing (a "medical food") that I could use for a few months to get kick-started.  What I found very interesting was that I was prepared to make big changes.  I had decided on my way to the appointment that, no matter what meaning certain foods might have for me (nostalgia or otherwise), I needed to let that go.  Whatever emotional or psychological responses I have to certain foods, I could rethink my relationship with them, and make all that less important than my health and well-being.

So I decided to get through Christmas, get back home, and start the eating plan on Jan. 1st (mostly, I think, so I could remember the anniversary date of when I started, I think).  Two weeks later, I met with the dietitian again, and I'd lost 10 pounds from the last time she weighed me.  Almost too much!  So we reviewed what I'd been doing, and made a little bit of an adjustment.

It means having balanced meals, which means more shopping and more planning than I'm used to, but it's not a problem.  What else am I doing in the evenings?  Mostly TV and mindless activities anyway, because I'm "too tired."  So might as well do a real meal, feel a little better, and maybe end up less tired.

And then the group met for the first time.  The other newbies hadn't seen the nutritionist yet, and they were pretty caught up in looking for ways to fail (it seems to me), although I probably am not giving them enough credit.  I could hear the digging in the heels thing, though. Still, they paid their money (I don't think insurance companies want to pay for obesity mitigation.) and they were there to do this thing too.

And now the exercise component.  This was my big fear, although I realized this set-up was made to resolve the semi-realistic fears I had, because the program is designed for me, there are health professionals around, I'm having my heart rate monitored, etc.  And I couldn't come up with any other excuses anyway.  So now I've been to their fitness center a couple of times and I've committed to going three mornings a week.  Before work.  Yawn!  And so far, so good.

Meanwhile, back at the ranch, the most recent D&C/biopsy was done about a week and a half ago.  A few days later, I got the results.  The IUD seems to be doing the job it's there for.  There is no cell growth/hyperplasia, no polyps, no sign of incipient cancer.  The doc wants me to keep the IUD in while I work on losing weight.  If I can get the weight off and keep it off, the extra estrogen shouldn't be produced, and the IUD won't be needed, and I should be all safe and sound.  Whew!

My doctor has really taken exceptional care of me.  I'm so glad to be her patient!  And the people who have designed these programs for rethinking relationships to food, and well-being, etc. etc. have been really amazing.  They're really dedicated to helping people who have found no other way to help themselves.  I'm so glad I could get the help here, right where I work.  It's amazing.

Is this how Ogden Nash got his start?

Well, not blogging, obviously.  But I have a dopy little ditty that I'm not ashamed to share, as silly as it is:

When it's two below in Tupelo
The weather is quite on the fritz
When it's three below in Tupelo
You've frozen yourself all to bits.

Mississippi's not the place
For frostbit toe and frigid face
So when it reaches four below
I'll take my hat, away I'll go
To find a warmer, sunnier space
Perhaps in Rio de Janeiro
Adios, cold Tupelo!

(Corny much?)

I wanted to say "How much gung is in my ho?", but I was a little too grossed out to just leave it out there without comment

So it's been awhile, and this post won't come close to covering everything I'd want to, but that's a lot to chew for any occasional reader anyway.  Here's sort of an update, more or less:

The IUD doesn't bother me at all anymore.  I don't even know it's there.  I'm still spotting, though, and the doc thinks this is cause for concern.  I have another D&C scheduled for January, which means removing the IUD.  I believe that means putting a new one in afterwards, but I suppose it might depend on what she sees while she's in there poking around.  It might mean hysterectomy after all, which is ok with me, with caveats.  The operation could be problematic, as previously noted, and the recovery will definitely be -- I'll need to rely on the transit company to pick me up and take me to doctors' appts. and to the grocery store and stuff for about six weeks.  Also, I'm really engaged in the stuff I'm doing at work (wut did you say, Willis?!), so I don't really want to take that much time off at the moment (!?!?!?), and I'm about to start a 6-month program ... that may just need to be deferred for a bit, which is ok, but I'm all gung ho about it.

Relatively gung ho.  No, really gung ho.  Well, it's a sliding scale of gung ho-ness.  I finished the Hunger Within course just before Thanksgiving.  It continued to be stupendous.  I loved every minute of it.  Putting it all into practice is not second nature or anything, though, but I am much more mindful and I am making some better choices.  The question I try to ask myself is, "If I eat this, will it make me feel better?"  Often the answer is no -- let me make other plans.  I don't need to eat the office party leftovers.

All this is good, because the 6-month program (which recommends the HW workshop to its participants) is a metabolic fitness thing run by the university's cardivascular folks.  It's a real full-service shop, with a team of helpful people helping you reach your goal.  My goal is, of course, to not get cancer and to lose the fat that is pushing me in that direction, to lower my blood pressure, cholesterol, and so on -- to stop having to take medication to control those things, and to be able to live a healthy and active life, again, finally.  It includes a regulated Mediterranean-style eating plan, with a "medical food" supplement (what they used to just call a protein shake), at least for 3 months anyway.  And exercise at least 3 times a week.  And a group session every week.  They figure if you do it for six months, it might actually become a habit.  I'm trying to push away my skeptical attitude about my "ability" to do this, and let in the enthusiastic kid who wants to try anything.  The program is very individually-oriented, so I'll have an exercise physiologist helping me set up a non-weight-bearing regime (at least for the time being), so that the pain I have in walking is lessened.  That helps!  And the HW workshop has really set the stage, emotionally and psychologically, for me to embrace this program.  I don't know how I would have handled it before HW.

I feel very fortunate that I'm in a setting that provides these remarkable programs.  I have plans for some good, active vacations in the next several years, so I've certainly got some motivation (besides, you know, not-cancer).

So that's that for now.  More to come.

Just so you know ...

I haven't been eaten by a bear or anything.  I started writing a novel, along with the thousands of others who do this in November during National Novel Writing Month (NaNoWriMo).  The idea is to try to finish a 50,000-word novel by the end of the month.  So, while I am nowhere near finishing it in time, I have actually started writing something that I've been thinking about for years and years, and I've gotten really engaged in the process.  So blogging, I figured, would take a back seat through November.  After that, though, I imagine I'll be back here and there (and hopefully more here).

The Hunger Within workshop is almost over, sadly.  It has really been a big deal.  I feel much better, although I don't suppose the scale is showing a big dip.  The important thing for me is not to concentrate on the scale, but to pay close attention to changing the script in my head.  And I do find that I'm eating better and enjoying the good foods more.  Mostly, at this point, my shorthand phrase as I choose what to eat is, "Will this make me feel better?"  Better physically, better emotionally, better psychologically?  Am I choosing as an adult or making choices based on a child's mind?  It's still a struggle at times, but when I actually eat mindfully, I'd much rather be eating real food than processed pap.  So things are looking up!  I do generally have more energy and feel happier, so this is all very good.  More later!

Mindful eating, serious movement, putting on socks

This week, I've been trying to do some mindful eating.  An interesting experiment!  Hold, for example, a grape in your hand and look at it, think about it - does it hold any meaning for you?  Does it look delicious? Boring? Etc.?  Are there any feelings associated with your thoughts about the grape?   Then put it in your mouth, but don't bite or swallow, and feel it.  What does it feel like?  Then bite down on it and consider the sensations of the food.  What does the skin feel like, and the flesh of the fruit, etc.?  When did you notice your salivary glands start up?  Before you put the grape in your mouth?  After you bit into it?  And then chew and swallow, and notice how far it gets before you lose track of it.  We were supposed to do this with a "green light" food (something good for us, that doesn't make us crave a non-stop supply) - for me, it was green beans; a "yellow light" food - I chose mashed potatoes; and a "red light" food -- ice cream for me.

In group last week, we did this with a raisin, a potato chip, and a Hershey's kiss.  It was really interesting to take one bite from a potato chip and let it rest in my mouth while it became a mealy pulpy unpleasant mess.  And then the other half of the potato chip sat there, and I kept desiring it and desiring it, and then lost interest.  Very strange!  When you concentrate on the bite, and you're not trancing out and just stuffing chips in your mouth, it is such a different experience.

The focus of this group is not the number of pounds lost ... but I find myself really wanting to see pounds lost!  And, really, it's a matter of serious health concern that I do.  Also, I would like to be able again to:

• walk for more than a half-block
• sit comfortably, including going to the theater, buying only one seat on a plane, sit at an outdoor cafe, get into a booth in a restaurant, etc.
• lie down and get back up again easily
• breathe
• kneel without agonizing pain, and get back up again
• sleep without the bipap machine/mask
• put on socks without a struggle, tie shoes, wear panty hose or something other than trousers
• buy non-hideous clothes
• etc. etc. etc.

It's difficult to list these things outside of my journal, for others to read.  It's often difficult to admit them to myself.  As far as I've come with my self-doubt and self-loathing, this is an area that is not only very painful but tremendously stigmatized.  In general, I'm pretty carefree about certain kinds of stigmatized behaviors or ways of being, and I've tried to be with this topic, but it doesn't come easily.  I have a lot I'd like to do in my life, and this can be very discouraging.  No one would choose this; it's not a matter of will power.  It's not a moral failing, as so many people seem to think.  This is a real, serious, complex disease.  Recovery isn't easy.  Quick fixes don't work.  Full-body physical rehab is involved, not to mention the mental health aspect of it, which is so deeply hidden that it's a major life-altering thing to get into it.  I'm glad I'm ready to take it on, after years of dealing with the big, obvious stuff, like major depressive disorder.  Oh my.  Life is an endless adventure.

If it's good, I'm gonna ignore it!

Well, it's been a few days.  Howzabout we talk about the Mental Filter category of cognitive distortions today?  Your mental filter helps you pay attention to only certain types of evidence.  Remembering failures but none of your successes.  This goes along with another one, called Disqualifying the Positive.  You might feel unloved, despite the fact that evidence shows you have many people who love you -- or you might feel somehow undeserving of that love.  Somehow it doesn't count, even though it's a fact.  Ignoring the fact that you are loved because you feel unloved does yourself a big disservice.  Or you might think you haven't done anything right, because you made a minor error on something.  What about the millions of things you haven't done wrong?

When I said to myself that every major decision I ever made was a bad one, boy oh boy, was I ever disqualifying the positive, and ignoring all evidence that showed that I was misrepresenting myself to myself.  The feelings of hopelessness engulfed me entirely.  When I reviewed the evidence and it turned out my feelings were based on misinformation, I felt entirely better.

The trick is, as I've said, to try to figure out the thought that came right before the feeling.  Write it down. Then see what sorts of cognitive distortions are involved.  Rewrite the thought, based on evidence, removing the cognitive distortions, and see if that is more true.  For example:  I may get a text from a friend that says that she can't make it to the movies tonight after all.  I don't know why, but I may assume that it has something to do with me (as opposed to a million other reasons), and start to think that maybe that friend is withdrawing from me.  Next, I start to filter out all the times that friend, and other friends, have gone out to the movies and drinks and dinner and other stuff, and start to only remember the times that people haven't been able to go out.  Now I'm starting to feel like a pariah -- not based on evidence, but assuming the worst.  I might even start to isolate, which just makes it seem worse.  If no one comes to save me from my self-imposed exile, then they don't love me.  No one loves me! I have no friends!  (I've done this; I know how it goes!)  You could rewrite the whole thing to say that my friend certainly had something more pressing to do, and it could be anything -- or she just didn't feel well.  I'm glad she feels comfortable enough with me to know she can change plans when she needs to and not feel obliged to go when it would be difficult for her.

It's possible that you have someone in your life that feeds these feelings of self-loathing, someone who knows which buttons to push to trigger these feelings in you.  If that's the case, you're giving all your power away to someone who is hell-bent on hurting you.  You don't need to be hurt by that, though.  That person may be working out his or her script, but you're not obliged to play along.  You can be in your adult mind and say, nope, not going to play those games.  That's the other person's thing; it's not mine.  (Yes, been there too!)

Meanwhile, on a personal note, the struggle continues.  It's not people I'm having trouble with as much as it is this intense relationship with food -- which is, of course, an intense relationship with myself.  It's daunting, but very interesting to peel away some of these layers.  I'll talk about that later.  It's an adventure, to be sure!

Update!

So here's an email I sent to my family, to keep them updated.  Might as well just copy it in here:

So I went to see my doc for the post-op appointment and, of course, things are always more complicated than I want them to be.  I was just sure she was going to recommend the hysterectomy and, if not, I was going to insist.  Well, insist is a strong word, I guess.

We had a long talk, though, and went through all sorts of permutations of what might happen for whatever course we take.  The short story is that, at the moment, the surgery isn't going to happen.  There's some relief in that, but also some concern on my behalf.

There are some risk factors for the surgery.  My weight, of course, is a big issue, although that would not probably be enough of a factor to keep me from having it.  The biggest risk is that I never gave birth!  The gory details are that hysterectomies are usually done these days vaginally, and it's just easier to do it with women who have given birth.  So the surgery for me would be done by a relatively large incision, which is prone to infection and the worst case scenario (and this is perhaps because of weight) is that the infection would have to be cut out and the wound left open and packed until it healed from the inside.  (Or I could not get an infection at all, or it could be anything in between.)  Anyway, she feels a conservative agenda is better. 

The biopsy had shown that I had complex cell growth, with focal atypia associated with polyps.  What?  Well, the complex cell growth means there's a lot of it, but most of the cells are not worrisome.  There were some that are troubling within polyps that I understand were removed during the D&C.  At the time of the D&C, she inserted a Mirena IUD that provides a continuous supply of progesterone to balance the hormones.  She said that very recent research has shown that this can be effective in reducing or eliminating the extra cells, even at this stage.  

Another thing that can help is if I lose weight.  I'm working on that through this group therapy thing, but she's concerned that it won't work, I think.  She's encouraged me to have bariatric surgery, which I'm pretty opposed to -- but I'll be thinking about it.  I have met so many people for whom it has been a nightmare, and one person for whom it seems to have worked pretty well.  Even that wouldn't happen until at least six months from the time I decided to do it, because of extensive pre-surgery hoops to jump through -- and one of those things is this same group therapy that I'm already taking.  A lot of the women in the group are there as a requirement of the surgery and they're all very excited to get their surgery.  They assume I'm there for the same reason.  The thing is -- if you get the surgery, you need to learn to eat less, etc.  My feeling is, if you have to do that anyway, why not learn to eat less and then not get the surgery. 

So, for the time being, this is what's happening.  I'm going to have *another* D&C/biopsy in 3 months (about early/mid-January).  We'll see if the treatment with the IUD is making things better.  Meanwhile, I'll be working on the weight loss thing too.  If things are worse, then we'll do the hysterectomy.  If I'm still having trouble losing weight, then I'll be willing to reconsider the bariatric thing at that time.  But I want to go through this group thing and see how it works out first.  After that, there are other programs here -- metabolic fitness, etc. -- that might be a good follow-up.

So that's a lot to say.  But the upshot is:  No surgery now.  A D&C every three months until the problem goes away, or gets worse and a more invasive solution takes place then.

Phew!  I'm a bit on a roller coaster about the whole thing, but I feel again that we're on the right course under the circumstances.  The IUD was a bit uncomfortable at first, but it's not bad at the moment, so I can live with it.  I'm not feeling depressed about it (I keep checking to make sure!).  As long as I have a clear understanding of what the options are, even if none of them are a quick fix, I'm OK with it.  

No, no, I'm fine, really. But thanks!

Dear friends have responded to my previous post regarding the last little bit where I expressed self-doubt about writing the blog.  I want to clarify what I didn't at the time, which is that I'm sort of amused when I hear myself come up with that stuff.  Even though I've been working on changing these thoughts for a few years now, they still crop up.  But I'm generally aware of it.  The reason I'm taking the Hunger Within workshop is because it's a major area where I'm not conscious of what I'm doing/saying to myself.  But in writing the blog, I'm trying to be more aware.

In fact, one of the reasons I'm writing the blog is because I want to keep conscious; I want to stay focused on the process for myself.  In my life, I've struggled with depression most of the time, I think.  I've been deeply, deeply mired in major depression probably at least three times, for extended periods (years!).  There have been triggers for each of them (social isolation in high school, my marriage/divorce, and the death of my father), although none of those have been the sole cause for the depression.  So I feel I need to stay vigilant, especially now that I have the tools to do so.  Writing about the tools helps me stay focused on the job at hand.

One of the best days of my life was the day I first did a CBT exercise.  I had been suicidal, and I was in a brilliant partial hospitalization program at Chelsea Hospital in Michigan, along with others who were similarly distressed.  I was asked to write down something that felt true to me, something that was weighing on me.  And then to look at how many of these cognitive distortions I could attribute to this feeling.  And then to rewrite the original, eliminating all the distortions.  Could I see a difference when I thought about it without the interference of the distortions?  And it was like night and day.  From that instant, I felt like a different person.  My sense of worthlessness pretty much disappeared.  A few more weeks of the program, learning mindful meditation and other skills, and I felt ready to be in the world again.  It was really one of the best things that ever happened to me.  It still took me some time to deal with some fears -- I had a lot of them!

But it's true that I still feel self-doubt and so on.  What's interesting is how quickly I (usually) pick up on what I was thinking that made me feel that way, and it almost always makes me laugh.  The previous post's did too, but I hit "publish" before I added that part.  In other words, I'm ok.