Tuesday, November 6, 2012

The Updates

It has been a while since I have sent an update! So busy with work and home buying! Here is the scoop.

Since all my blood tests have been coming back perfectly normal for the last 10 months and nothing crazy has come up with the medicine, I have been lucky and we have given them up for a short while. Which means savings in my pocket! Since PCOS has been confirmed, I am back on birthcontrol. This is a really really good thing.

At my last long meeting with the doctor, we made a treatment plan. Basically a flow chart of options. Step 1: this is what we will try first. If yes it works then this is the next step. If no, then this is the next step. We did this yes/no chart for quite a long time. So we have a plan.

The first step is trying to increase the dosage of Victoza. I have just done that for 4 weeks. Only last week did I get up to the full 3.0mg (you gotta slowly work your way up). I have been doing quick weekly check ins at the office where they do some quick measurements. Up until this week's check, there was good progress. I had my last check up today and the nurse said the doctor would get back to me on the next steps.

The other good news is that I was able to reduce some of the supplements. Less Vit K, and no more Iron supplement. I still am on 10,000 D though. Which is fine by me with this dark by 5pm stuff. Icky!

So hopefully more info soon and more updates!

Capt Mel

Tuesday, October 2, 2012

Interesting New Blog

As a new teaching year starts, I get behind in my blogging. I just had another 6 week blood test and I go in Monday to get the results. I feel like I am not eating enough during my teaching day, but I am not sure how I accomplish any more food and teach. sigh.

I found a really cool blog. It does not seem to have metabolic syndrome or insulin resistance as its focus, but obesity and food. I have only read a couple posts, but I like it. Check it out.


Thursday, August 30, 2012

I Miss the Old Market Street Pharmacy ~ Or how I got yelled at

There was one thing that John Stimac would never do, and that was yell or get mean with you. He was the owner of The Market Street Pharmacy that now in its spot is some icky looking restaurant with a Monkey in title. It was one of the last Mom and Pop Pharmacies in Seattle before he retired and closed shop.

Now that I have a lot of prescriptions because of this whole Insulin Resistance, Metabolic Syndrome, PCOS stuff, I am using the QFC just a block down from me at the moment. Some sort of wires got crossed on my last doc visit.

Someone did not call in and order more refills on some of my prescriptions. So two of them had no refills when I called on Monday night to get them refilled. The automated thing asked me if I wanted the pharmacy to contact the Doctor to get them authorized. I said yes. It told me to call back two days later to confirm the prescriptions were being filled.

So I called today. They had not been filled. In fact, they had not even made contact with the doctor. They had faxed the request and had not heard back. What if they had not received the fax? I run out of pills after tomorrow. Might not be a big deal to you, but my Doc's office is only open Monday through Thursday.

So I explain the situation. They get the Pharmacist on the phone. He gets all mad and grumpy with me. I tell him I would have done something if I had known there was a problem with getting in contact with the doctor. But no one contacted me. I told him I was a teacher in back to work meetings and prep the last two days and was only following directions. He finally acquiesced and is going to give me an emergency prescription through Tuesday, but he basically threatened me and demanded the doc get a hold of him after the holiday.The nurse at my doc's office has several frantic emails from me. He is great and I know will take care of it. The nurse probably thinks I am kinda freakzoid now too.

This is all lamesauce.    

More Loathing in the Mornings

I never have been a morning person.

That is quite a laughable statement because has a competitive figure skater I would be up at 4am to get ready for figure-eight practices and such before school.

As a teacher, I have to get up early for evil start times and to get work done.

While my system has seemed to adjust some to the morning thyroid medicine and shots, mornings still seem a tad worse. Especially early mornings.  I know I am only on day three of 4:30am wake-up, but it feels like it is going to be real difficult.

The only positive is that with long work days, I have actually started to feel a little bit hungry at times and food has not seemed so gross. The silver lining right! :-)

Saturday, August 18, 2012

Stubborn Personified Medically

For better or for worse, I am not one to back down. That is sometimes labeled as stubborn. As long as it is monitored and kept in check, I don't think it is necessarily a bad trait. But when it comes to medicine and health, having a stubborn or persistence problem is a real pain.

You might be thinking the results of my latest six week blood test was all doom and gloom. Well that is not the complete case. Let's start with the good:

-Glucose Levels continue to be normal range and excellent
-Blood Pressure best yet. Keep meds the same
-Cholesterol panels still good
-Thyroid OK. Keep same meds
-Liver and Kidney functions are good ~ this is really important because of all the medicine and supplements I am taking.
-B12 is perfect. Keep taking same dose of supplement 

Now for the semi OK news. At first, this will seem like Kermit the Frog, throw your hands up in the air, and scream news, but then, let me explain: 

-Weight has seemed to stabilize and has even slightly decreased.  

I know what you are thinking. This is what your regular doc was so perplexed about in the first place, so actually loosing a little weight is super good. Well my specialist doc thinks this is from the drug Topiramate. If you remember from an earlier post, this is a drug that triggers a receptor in the brain and then works with your digestion (smoking can sometimes trigger the same receptor a little bit ~ But smoking is really really bad). To really deal with the Metabolic Syndrome we need to tackle what has not been really been conquered yet. Now for the not so good: 

-Insulin Resistance is very strong
-Leptin resistance is still ongoing
-Testosterone is elevated and Estrogen levels are low due to PCOS and insulin resistance

Oh yes! A new diagnosis! Many ladies with Insulin resistance also have Polycystic Ovary Syndrome (they are not sure which one causes the other). You may remember I was taken off birth control 12 weeks ago because my doctor believed I had it, but birth control is used to treat the condition (wow! This drug used for something other than non-pregnancy!). The results are positive. Boo.

So what is next? We are upping the Topiramate a little bit because that does seem to be working. We are leaving all other meds the same. I had a lot of trouble with Metformin causing an upset tummy/digestion with the added morning doses. So my doc wanted me to try and take more with my evening meal; three and maybe four pills because I had no troubles with the dinner pills. She said it did not matter taking all at once. Well, I have been taking three pills for a few days and all seems good. I will take four pills on Monday.

I have been experiencing some nasty lady trouble with PCOS, but I can't go back on birth control with treating Metabolic Syndrome. Well I could have a few months ago, but the FDA took all estrogen only birth control off the market for a while (I will go into this outrage in another post ~ Losers). So she is having me try a supplement called Inositol. There are two types. The one to try and help PCOS is the myo form. I am supposed to take 1000mg, but Super Supplements only had a pill form of 750mg. My doc thought they would have a powder. They were sold out of a powder that came in 500mg packets, but they were not sure if it was the myo form.

The last little potential hiccup (more of a pain in the butt for me) has to do common colds. One of my cabin mates on the cruise got a common cold during our trip. In turn, all the other cabin mates got a cold when we got back. Well, I am not allowed to take any over the counter cold or pain medicine through treatment. It is very bad for your blood pressure and even your liver. If things get uber bad, I can once during the cold take Afrin and maybe one other time at night take a 'drowsy' formula that does not have sudafed. But that is only as a last resort. As a teacher and former science museum employee, this is a sad state of affairs. Cold medicine has my been my trusty companions through the years. But I survived this cold and can survive others. So far, this has been the only cold in 8 months I have gotten since I have started treatment. I will keep my fingers crossed.

There is possible light at the end of the tunnel. We are making slow progress, but the concern is money, time, and what happens if there is a set back. I.E. something happens to me and I get put on Prednisone and gain weight. But there are some human studies being wrapped up that if all safeness is shown, could be a green light for me in six weeks. We talked a very long time about this and I am sure we will talk more if it is a go.

Capt Mel

Friday, August 3, 2012

The Waiting Game

I just finished 18 weeks of treatment and had my third blood test. But it takes at 8-10 days for the results to come back. That is right in the middle of my vacation, so I won't see my doctor for another week and a half.

Is this really a big deal? No. But I am anxious to see if our changes in treatment have really started to work on fighting the insulin resistance. A couple of negatives have happened with this round of medicine tweeking.

The first one is loss of appetite. I was warned that some of the medicine would could cause me not to have any appetite, but it has gotten really bad. Especially with some of the heat we have been experiencing. It is not a matter of just fixing something, and once I am eating, everything is ok (like before). Food has actually been gross. So making the eat goal of every 3-4 hours has been nightmarish. I did have a meeting with my nutritionist and we got some strategies to try and work through some things. More of a brainstorming session on foods that were more liquid in nature.

The second one has to do with my stomach. The Doc wanted to increase my Metformin again. I had been only taking it with my large meal in the evening, but she wanted a morning dose too. About a week into that, I started to get some digestive trouble again. Nothing like to where I was before I started treatment. It is a small annoyance, but it is there.

So that leaves me playing a waiting game. Until we can see the results, there is nothing to do, but stay the course. If we are seeing huge results, I can deal with these minor side effects. But if we don't, we have already discussed some other medicine routes, and we may need to look at those. Let the Wait Begin!

Capt Mel

Friday, July 20, 2012

Is It the Heat? Is it the Meds? A Cold?

A few weeks ago, I was in WA, DC and while it was not the hottest degrees I have ever been in, it was the highest temps and humidity I have ever experienced. I seemed to do OK, but by the end of the week, I started to have some stomach symptoms that could have been one of three things:

1. Heat getting to me
2. Effects of upping my medication in certain areas
3. I caught some sort of illness

I got home and I rested for a couple days, and I seemed to get better. But of course, with treatment, comes changes in medication again and Seattle weather got hot (for Seattle weather), and my stomach got upset again. So the three things were all options again.

The other thing I have been discovering with the hotter temps is that I have absolute zero appetite to eat. And that is a really really bad thing. Even trying to force food down is awful. I actually start to feel gag reflexes. For all this medicine to work, I need to be eating.

Luckily, I had an appointment scheduled with my nutritionist and we brained stormed some ideas. Smoothies are actually an OK option with a protein pack. But I have nothing at home to make smoothies, and I have no desire to spend money buying something. Especially when I might be having to downsize soon. But other things like yogurt and cottage cheese and even more snackie things have seemed to help some. Meeting people for lunch has helped quite a bit as long as I can eat slowly.

The other good news is another 6 weeks is almost up and I have my blood draw bright and early Monday morning. I won't get the results until I get back from a vacation, but I am hoping we have some progress, and even if we don't, I know my doctor has some plans for a different route. I don't have to do any changes in what my current med setup is until then. So I have plenty of time to get my body used to this current med setup, So there should be no issues for my vacation! That is a relief!

Sunday, July 15, 2012

When Eating Becomes the Obession

It has been awhile, but with travel and work, things can get crazy. But I read an interesting article I will link in a little while. My quick thoughts for the day deal with food and how athletes think about eating.

When we think of fat people, we think about how all they do is eat, eat, eat. We never think about the people who obsess over what they are not eating or what they will eat in front of people and what they will not eat later or how long they will go before they will eat again and so on.

This is where I will present a Gymnastics eating disorder article and show how it comes into play:


Notice how figure skating is mentioned.

What probably helped throw my metabolism way out of whack was the horrible nutrition and exercise training that happened during my figure skating years. 5+ hours of training a day, eating as little as possible (broccoli and ice diet was a major fad in my day), and embarrassing weigh ins in front of everyone.

In the area where I trained, there were not too many male coaches, but mostly female coaches and they seemed to be the worst. These women preyed on young girls and their fears. They knew how to get into the heads of all of us.

So while there is a huge focus on Bulimia and Anorexia (and there should be), there also needs to be a focus on people who don't have these life threatening illnesses/diseases, but also have eating disorders/metabolic problems that have happened because of poor coaching and nutritional training. Funny how ice skating coaches demanded parents buy high priced sports physiologists for the skaters to be at the top of their games, but not sports medicine folks/nutritionists. Maybe it is because those folks would have called their bluffs!  

Saturday, June 23, 2012

Lack of Common Sense: Travel Prob #1

I leave soon for a trip. I have two problems with airplane travel. The first one is having to keep my medication cool. I will deal with that soon. But I tried to tackle the second one a week ago. I have to inject said medicine with pen needles.

I am supposed to dispose of these needles in a proper manner. That means having my very own Sharps container. What is that? Well it is that hazardous waste container you usually only see at the docs office. I have my very own right now. It is a 3 quart version. It was the smallest my QFC had available for purchase.

So I went to another store that I frequent sometimes to and from work. I never get prescriptions from their pharmacy and thought I would ask their advice on how to get a smaller Sharp's container. They said they could only order a 1 quart container. My pen needles are only about 3 centimeters by 3 centimeters. I don't need to travel with such a large container. And that takes up a ton of space for a carry on. And you are supposed to travel with all your meds and supplies with carry on.

I got home and checked online. Sure enough. There is nothing smaller than a Quart that is hazardous waste appropriate. At the pharmacy, I asked what they suggested. The guy said, If I was your friend and not your pharmacist, I would tell you to take an old prescription bottle and store them in there until you get home and then put them in your Sharps container.

I am going to pretend he was my friend and do this. But if I had money, I would create my own Sharps travel product. There are enough travelers in the world that would benefit from something like this that is cheap. I am just flabbergast there is not a container already out there. Sheesh!  

Saturday, June 16, 2012

And I Thought I had it Bad

One of the most demoralizing things that happened in the last year was after I completed my first half marathon and was starting training for my second half marathon. It was actually the tipping point for my general medicine doc to send me to specialists (so I guess it had a silver lining). It was the fact that I had gained 30 pounds.

A little back story. I do not weigh myself anymore. Only once since I stopped figure skating have I attempted to do so and it was as bad as when I was figure skating. I become obsessed. How low can I get the number to go? When I figure skated, we had weekly weigh ins. They were horrible events where you stepped on a scale in front of a whole group of people in a little leotard. I have numerous little tales about abuses that went on during these weigh ins that I think I will keep to myself.

But back to my 30 pounds gained story. I was completely shocked when she gave me this news. I knew I had not lost as much weight as I thought I would with all the training and cutting of food, but never had I thought I had gained weight. I was eating so little at that moment, I did not think I could cut anymore food without getting a completely light-headed feeling that makes you almost feel like you could pass out. That gives you an idea of how much I could cut food out of my life.

Fast forward to meeting with my Metabolic Doctor and relaying these events to her. Once I got through the whole story with a few more details, she started chuckling. Not the reaction I would expect from someone who is an expert in this type of field. And she had been so sensitive before. And then she said, "You think you have it bad? I have another patient who was sent to me because she was training for an Iron Man competition and gained 80 pounds."

Well that pulled all the wind out of my self pity sails. I can only imagine how frustrating that would feel. It is easy to be down in the dumps when you see no one around you having the same troubles you have. Leave it to the doc to give you some perspective!

Capt Mel

Friday, June 15, 2012

12 Week Check up! Insulin Resistance Factor

Tuesday was my 12 week checkup, but 'all things work' has consumed my time. First piece of news is that nothing is bad. And that is really good news. So here is the updated list of info after 12 weeks of treatment:

- My Cortisol is much lower (this is good)- This improves metabolism a tiny bit, but also helps reduce excess fluid retention. 

-Reproductive hormones look OK, but still need to monitor in next few months and watch for PCOS.

-Fasting Glucose best yet and average glucose in normal range (no where near pre-diabetes). This is very very good!

-Vitamin D is getting much better

-B12 and K are very good

-iron levels are much better

-Thyroid is good

- Blood Pressure is a little better

-Insulin resistance is very strong. Test results are showing a need for aggressive medication to untangle the kinks in metabolic machinery. (This is the not so good part of the results). 

First, let's go back and investigate Insulin Resistance because people have no clue what it is all about (and don't worry, I will attach my resource links as endnotes because I don't plagiarize). Wikipedia gives us a nice overview. It is a physiological illness where insulin (a hormone) is less effective at lower blood sugar levels. Seems simple on the surface, but how is it different than diabetes?  Well Type 2 deals with insulin deficiency (which if insulin resistance is left untreated over time can turn into Type 2 Diabetes, and Type 1 deals with the body not being about to produce insulin.

Marcelle Pick (OB/GYN NP) also has a nice explanation of Insulin Resistance. She talks about if insulin spikes too often by high carbs than your cells and brain will prevent and decrease the amount of insulin receptors. And then "eventually, this prevents glucose from getting into your cells, leading to high blood sugar and depriving your cells of the energy they need to function. This is why many women with insulin resistance experience carbohydrate cravings, fatigue and weight-gain — their cells are literally starving for energy, even when plenty of glucose is available in the blood" (Women to Women). Unfortunately, what she fails to address is other factors that can cause insulin resistance besides just having a lifestyle of unhealthy food and no exercise. Doctors have known for over 20 years there are also genetic factors, environmental factors, and even lack of food, and extreme exercise factors that can cause insulin resistance. Maybe I will save the stuff I have been told about starvation and your mind choosing not to burn energy, but to store fat for a later blog. I hope that helps with insulin resistance.

So what is on the docket for my next 6 weeks (18 weeks of treatment)?

1). Step up treatment approach for insulin resistance
-Add Topiramate (have an interesting story on this drug and Pharmaceuticals and diet pills from the 1970s for a later time).
-This helps lower a NPY neurotransmitter that signals starvation and directly slows the metabolism.   

2). Keep increase Victoza to maximum dosage in next 2 weeks. This is the hardest to do because every increase causes nausea for me until my body is used to it. 

3). Keep my Metformin the same until Victoza to maximum level then 1 week later start adding in a morning dose. 

4). Reduce B12 from 3,000 IU to 2,000 IU daily

5). Reduce Vitamin K from 4,000 IU to 3,000 IU daily

6). Don't change anything else. So keep taking a multi-vitamin, 10,000 IU of Vitamin D, 1,200 IU Omega 3, prescription Iron supplement, Blood Pressure med, and Thyroid Med daily. 


And modifications will probably happen again. Most of the 6 week checkups are to find out what is working and what needs modification. While the Victoza is definitely helping with my digestion of food, if we can't get it to start helping the insulin resistance, we have another med I will have to try. Breaking the insulin resistance is what is going to be the trickiest, but is what will start having me loose weight (which I know some people are waiting for with bated breath). 

It is funny. When someone has a broken arm and is in a cast, no one ever states, "well, it doesn't look like it is being fixed," or right after it is taken out of the cast someone usually does not bellow out, "Oh my, your arm does not look that healthy!" But something my doctor and I talked about is how to deal with naysayers who don't believe I am sick. It is hard when my only improvement has been internally and not externally. Even though I have said from day one that this will take 3-4 years to work out, they think they will see some kind of miracle weight loss over night. This is not the first time my doc has had this conversation. It is one she has had to have time and time again with her metabolic syndrome patients that have obesity as a symptom. Believe it or not, she has metabolic syndrome patients that are not obese, but have a symptoms I thankfully do not have: high cholesterol and clogged arteries.  And that is something to be thankful for! 

Until next time... when I will have lots of funny tales and anecdotes, 

Capt Mel


Thursday, June 7, 2012


Next Tuesday, I have my 6 week check in with my doctor. I had my blood draw this last Monday and in total, I will have had 12 weeks of treatment. I must say, many of the things that I was told would happen have come to fruition. I first I had a burst of energy, but now, while I am not exhausted, but definitely tired at the end of the day.

I am still having trouble in the morning with my medicine. I wonder if this will stay the same or get better. I am within .2ml of where I am supposed to be with my injection medicine, but I rarely find relief with the nausea in the morning. I am also supposed to add metformin back into my morning dosage once I am at 1.2ml of victoza.

But, this statement is not one of wanting to call uncle. There are too many positive signs with my treatment. If you ever read the literature you get with your prescriptions, many times it has a statement that is similar to this: Remember your doctor believes this treatment will have more positives outcomes than the negative side effects.

But it is not easy. I am looking at 208 weeks of treatment. I will only have 12 under my belt. And some of my anticipation has to do with my visual appearance. I can't help but be a tad self consciousness. While I don't think I have gained any weight (unlike the first 6 weeks), I don't feel like I have had any significant weight loss. It feels weird to tell people I have to eat a meal. It could be just my own guilt, but I think people are more comfortable (or less judgmental) when they are around fat people who do not eat. I will persevere.

So cross your fingers, hope for the best, and maybe there will be some positive results!

Capt Mel

Thursday, May 31, 2012

What Are Your Rights: What Should They Be!?

Being a teacher who is involved with the political side of things, it is amazing how many people scoff at the idea of getting involved with their membership to the union, helping out with their profession, or anything else that is outside of their own classrooms. That is, until they actually need the help, and boy, they want the best help from their representation that they can get!

So why start a post on my health adventures this way? Well... when many people encounter health issues that need more than a doc once or twice a year, their health insurance and medical leave becomes very very important. As it has for me.

My doctor's office is only open Monday through Thursday 7:30am to 5pm. To put things into perspective, I have to be at work by 7am and while my contracted day is done at 2:30pm, many times I have mandatory meetings until at least 3:30pm. I am lucky to leave at 3pm on an average day. I have an hour afternoon commute. It is taxing to get to a 4pm appointment (usually the last one they will schedule). Every six weeks, I have to have a fasting blood test. The earliest I can get in is 7:30am. I have to take a 1/2 sick leave day.

You  might wonder why this is a big deal if I have the sick leave. It shouldn't be a big deal. As long as I have all my ducks in a row, it should not matter. But funny thing is, many employers might give you the sick leave, but I don't think they actually expect you to use it... ever.

But it gets even worse. I think employers will talk about the value of having that leave and not coming to work sick, yada yada yada, but when it is actually used, have a totally different attitude. There is a disconnect. I have also had the expereince of working at a science museum where if you had a job with sick leave entitlement, you could never take it because to call in sick meant there was no one to cover for you. We ran our schedules that thin. I remember many a night being so sick, I would sneak naps in some of the exhibits until I was needed to cash out a cashier because there was no one who could fill my position. It would mean overtime for someone else or the person doing the day shift staying all night. It was virtually impossible to use. And of course, you could never cash it out when you left. Use it or loose it. And at least at my science museum job, there were pretty strict rules about how you could use it. I had something like 4 weeks of sick leave accumulated by the time I had put in my notice. I thought about saying this is the last day I will work, I will take sick leave for four weeks and then my resignation would be the next day. Alas, against the rules.

So what do you do if you have an employer/boss who starts grumbling about the attendance of employees and you know some who have been legitimately out because of health and using sick leave? Do you confront the person and remind him/her of the rules? Or do you keep quiet and avoid the potential wrath of the person?  What do you do if you are the person who needs to use the sick leave for medical purposes?

I get 12 full sick days a year. I can accumulate up to 180 total sick days. I am no where near close. I got paid today, and I have 40 days of sick leave. To be fair, I have used 7.5 sick days this year.  But several of those were for sinus/ear/throat infections. Since my treatments, I have not been physically sick once!  If I had taken zero sick days in my career, I could have 96 days accumulated.

But that brings up an interesting point. I feel people should use sick leave if they have it. Not willy nilly or against the rules, but for a mental health day here and there as they so chose. I have always felt stress is bad on the body and I am learning even more about stress related health effects. Right now, get me really stressed and the next day, I will show you hives on my arms. Yup.

I have been pretty straight forward with the big boss at my work. I have been upfront with my diagnosis and told her it was a 3-4 year treatment. I thought she understood I would be gone for a 1/2 day here and there every six weeks. Now I am not sure if the bosses really understood what that meant. Do I say something else? I am going to choose not to say anything. Well, only if I am asked because our summer shut down is coming close and maybe I will wait till we start back. Why stir the pot if it is not at the boiling point?

From my general experience, it seems that Human Resource departments are not really Human and not really a Resource for the employee, but only for the employer. So if you don't have a union to watch out for our rights as an employee, who will protect you!? I don't really have to worry about my medical rights being taken away because I know I have help. But when I worked at other jobs, I felt very vulnerable and taken advantage of by my employers at different times.

Let's take it back another step. Forget about individual employers, but what should be universal human rights!?

Capt Mel

Monday, May 28, 2012

Yes! It is a Snack

I am not sure if it is because I have been telling people about my medical conditions or it is because my new eating habits are just noticeable, but the comments I have been receiving about my eating is mostly amusing.

First, I have to have snacks. Think about this. You have an appointment (let's say a sporting event) at 2pm. You sleep in, and finish breakfast at 10:30am. Set your clock for three and a half hours later. That puts you at 1:30pm. You have one more hour before you need to eat something. That means you have to have a snack at that event.

So, I keep snacks in my purse. I have nuts, freeze dried fruit, and Zone bars. I am not a big fan of the energy bar, but it has a lot of protein and I need to keep a good protein/carb combo. I pull something out of my purse, and I snack. This has gotten me some funny looks. I also need to eat within the first hour of waking up. That can put a real tight squeeze on my time. I have to get up and take my thyroid medicine and my victoza shot. I have to wait at least 10 minutes before I can eat anything. I have to get dressed and make breakfast or get breakfast. It is a time crunch sometimes.

I also don't think people realize what will happen if I miss my 3-4 hour eating window. It is not pretty. The other day, I had a funny work schedule and I sat down to eat lunch at about 4 1/2 hours after my last meal. I started to feel funny as I ordered my food, I ate, and it was good, but afterwards, my body wanted to just crash. I went home and slept for 2 hours. When I stick to my 3-4 hours eating time schedule, I feel way more even keel and not very tired.

I have also started to notice some interesting comments by non-believers of my medical problem. I am using the word non-believers specifically with a religious type connotation. Not picking on a particular belief or non-belief, but some people have a fanaticism with their beliefs, and they can not for once maybe question their perspectives.

For example, let's look at a Christian and a hardcore Atheist. Both will try and prove the other wrong. Both will refuse to listen to one another. The Christian disregards anything (even evidence) the Atheist has to say because he is going to hell for being godless. On the other hand, the Atheist does the same exact thing and will not listen to any information the Christian has because the he believes in magical make-believe fairy tales. Either way, this can become a vicious cycle where each will begin to resent each other.

While I hope that my relationship with some people do not turn into such a heated battle, I am forced to acknowledge that there are some pretty smart people who think my doctor is bogus. They are actually ignoring scientific evidence and calling it false. They don't believe that a person's body can get so screwed up that it will do many things (one of them creating obesity even with little food and lots of exercise). So now I hear little snide comments like, "Cheese has a lot of fat you know." I usually just say, yes, but not all fat is equal and cheese has protein. I need to eat a lot more protein than I ever had. I refrain from nasty counter remarks.I also like the comments about eating more fruits and veggies. Now, they are good for you, but fruit is almost exclusively carbs and that is not the end all be all. I am working toward better health all around.

So why am I getting these comments. Because I will not cater to people who believe in food diets and lots of exercise. I have tried that all my life and it has not worked. When someone tries to bring this up, I shut them down. So, they have to try and convert me in other ways (hence the snide comments). I have a doctor who has been in the field for over 20 years and has data that is positive about my treatments. I can not change someone's belief, but it is frustrating to not only to be disregarded, but to actually have someone think what I am doing will not work. that it is just make-believe. When I mention a side effect, I get scoffed at like I am an idiot for blinding following an evil ne'er do well. Even though I have told these people that it is a 3-4 year plan, they question why they have not seen any noticeable results in 9 weeks. They don't care to hear about my internal non-visible results. Is it because they loath fat people or is it something else?

Until the results outwardly start showing, and then I can throw the results in their faces, I will continue to eat my snacks!

Capt Mel

Saturday, May 26, 2012

Proof is in the Pudding

As I start to push back on people's beliefs about obesity, some people get huffy. The best one I've gotten so far was someone saying that maybe I was just not as active as I thought. I had convinced myself (i.e they mean lying) that I was doing more than I believed. And then, along with that, maybe I eat more than I think (I wish my nutritionist was there for that one). So if I really just watched my portion sizes and exercised more, I would not need medicine and all this doctor stuff.

Unfortunately for this person (and the others thinking, but keeping their mouths shut), I do have data to support my claims. In April of 2011, I bought the Fitbit: http://www.fitbit.com/. What I like about these folks is that they do not claim you have to become an iron man to stay fit. They believe if you can average 10,000 steps a day/70,000 steps a week, you can be a healthier person. The device is small and you can wear it on your bra strap. This is great for me because I swore off wrist watches on June 1, 2005.

It can record up to seven days of activity before having to be charged, and it syncs with your computer without having to put it on the charger. You can even wear it at night and it will record your sleep. You can also enter in your food. There is a new scale to measure body weight and mass. But since I don't weight myself (and you really should not either), I don't know too much about that.

So I have data. Boat loads of data. Over a year of data. So take a look:

Life Time Distances starting from April 17, 2011:

April 30, 2011 = Earned a total of 50 miles since purchase
June 17, 2011 = Earned a total of 250 miles since purchase
August 29, 2011 = Earned a total of 500 miles since purchase
October 26, 2011 = Earned a total of 750 miles since purchase
December 20, 2011 = Earned a total of 1,000 miles since purchase 

As of this writing post, I have earned 1,540.5 miles since purchase. Another official data point will be recorded when I hit 2,000 miles. I will help you with some of the math:

I earned 1,000 total miles in 247 days. That is an average of 4 miles a day, every day. 
Since December 20, I have averaged 3.4 miles a day (remember I am on exercise restriction). 

I know my average will start to go down even more because of promising to keep close to under the 10,000/70,000 average, but it goes to show you that I am no lazy oaf. In fact, my numbers are a tad inaccurate because there have been days I have failed to wear the fitbit, it doesn't record biking accurately (though I have done little of that) and it doesn't account for swimming (not water proof). There was a week in May 2011, where my fitbit encountered a crushing accident and it took me that long to replace it. Also, in July 2011, I did not take my fitbit to Hawaii and we did a lot of walking, etc there. I also question the accuracy when I am curling because I slide on my slider a lot and I don't think it counts that correctly. In late October 2011, I suffered my first curling injury and tore a muscle on the front of my right calf. I did a half marathon on a torn muscle.

So again... with this little of data, do you still want to question my activities levels? I am not some lone weirdo medically. I am pretty tenacious and like to be active, but there are lots of people like me. We are shamed into silence because of fat jokes and criticism about fat people just being lazy and eating lots of food. Though we are reassured that is not us because of the acquaintance factor. 

Maybe proof is not in the pudding, but in the data because I eat so little pudding! :-) 

Capt Mel    

Sunday, May 20, 2012

The Travel Conundrum

I was out of town this past Thursday through Sunday. It was the first travel I have done since the starting of all my medications. So this involved several new steps.

First, I had to make sure I had some supplemental food sources. I brought along bananas and Cliff Bars because I was not sure if a store was close to my hotel and what would be available between 7am and 8am (right before I had to start trekking to the Convention Center). Sure enough, they came in very handy in the morning and I was able to get my carb/protein combo I needed.

Second, I had to figure out how to travel with my my injection supplies. Luckily, I was carpooling the 300 miles and not flying. I still need to figure out the flying stuff soon. My local grocer/pharmacy said they were selling me a travel sharps container* for pen injection needles, but I found out too late it was a one time use for a larger needle.

*Sharps containers are those red (or white) Hazardous Materials containers you usually see at the doctor's office.

Why did I need a travel sharp's container? Well the one I have is HUGE and I did not want to pack it. I had to though, and it worked out alright. When we got to the hotel, I was shocked to see that I did not have a micro fridge. I have to keep my injection medicine cold. First, I filled up the ice bucket with some ice and put the meds there. I called the main desk feeling quite foolish about asking my question. I told them my meds needed to be refrigerated, and the response was they would be right back up with a medical frig.

So then I was curious about what a medical frig looked like. It was nothing special. Just a micro fridge. but it did the job I needed it to do.

Lastly, conferences can be very long, and many times, healthy (non fast food) choices are not near convention centers. While there were a couple healthy choices in the little food kiosk, I will not pay $3.25 for a Yoplait Yogurt. They are not even that healthy. So food was tricky sometimes. I need to eat every 3-4 hours with a carb/protien combo and that was hard. I had to miss a little bit of business I wanted to hear because I had to get food during one session.

This all should not sound like a big deal, but next time you are at an extended conference,business meeting, or day long class, I want you to set your alarm to ring ever 3.5 hours and see how difficult it can be to stay on a schedule. Try to pack lightly when you have to carry a sharps container, meds for 4 different times of the day for 4 days, alcohol wipes, and meds you need to keep cold, and see how difficult small packing can become. Add on that packing some of your own food. The one saving grace was that because there was an odd number of girls, I was the lucky girl this time and had a room to myself. I did not feel so self conscious about injecting myself each morning. I know my trips coming up will not be the same, but I feel more prepared.

I guess the lesson this time would be to not judge folks who seem to be traveling with some excessive baggage.There might be a very good reason why they have 2-3 bags!

Capt Mel

Tuesday, May 15, 2012

Oh The Things You Say To Your Kids

I am always amused at parents who tell me to watch what I say around their little kids. I am fully aware that a swear word will become the delight of that three year old. People forget that I have a lot of verbal self control due to the nature of my employment.

But do parents really think about what they are saying to their kids? Case in point:

When I was about 5 years old, I had my first dance recital. It was in the Old Gym of the high school in my rural town. It had these old wooden bleachers that circled the gym floor. Yes. Circled in a U shape. It was a very nice gym that was unfortunately remodeled and half the bleachers were taken out to become classrooms. And just this year, it was torn down. But I digress again.

I think I had two or three numbers. We had one costume change. I did tap, ballet, and maybe one other little thing. We did not get our costumes until that day. Some of them were one size fits all. I think I wanted the red sparkly top, and so did another little girl. Somehow, I ended up with the blue sparkly top and was quite disappointed. I had just turned five. It makes sense.

Instead of kind, but firm words from my mother, she belted out, "You don't want the red one anyways because it makes you look fat. Blue is more slimming."

Here is a pic of about when I was 5 with my dad. I do wish I had pants like that now. And hmmm... I just realized I am wearing a blue top!

Now sit back and imagine telling this little girl she is fat? I can't. I think it is awful.

And that folks, was the first time I can remember my mother mentioning how fat I looked. And very soon after that recital, I started figure skating. Another sport that is not forgiving when it comes to weight. And it was at that moment, that you could have probably said goodbye to any normal functioning metabolism. Because when you have a kid doing hardcore exercise training, it is disastrous to the body. But more on that later.

Words do hurt. And it is better to say something nice or not say anything at all. Especially when dealing with young children.

Capt Mel

Monday, May 14, 2012

Let's Get Everyone Scared of Fat

As I was trying to shop for my groceries today, I was horrified by a magazine on the rack. I didn't pay much attention to which one (It was Newsweek or something like that). And the premise of the main pic and title was shock and awe scare tactics.

The photo was of a cute little baby boy and the title said something like "In 20 years, he will be 300 pounds."

What an awful article. I wanted to yell out, "No he won't if you get the proper medical care! He is probably insulin resistant and just needs treatment." But you never hear that from people or the doctors. Is fat the new group we persecute and ignore? Are we scared to fight the diet establishment because it is such a money maker?

In the last 12 weeks, I have learned so much more about hormones and digestion and brain chemistry. But you can't just find this stuff on the internet. All you see on the first many pages is stuff about just loose weight. Eat less, exercise more.

People.... this is a failing solution. It is like saying a broken arm happened just because you were clumsy. It doesn't fix the broken arm. There are doctors out there that can help and if you are overweight or over exercising to try and keep weight off, you need to get tests done!

Saturday, May 12, 2012

The Ying and the Yang of Treatment

I envy the people who can take any type of medicine and not have any of the side effects. Though I have to say, through most of my life, most medicines I had to take (and usually in the short term) did not really have horribly negative effects. The worst I could say was that they didn't necessarily make me feel good. I could never understand why people got so excited to hear I had some powerful pain killer for something or other because it did not make me feel good to take. It just took away the pain. 

But now with Metabolic Syndrome, Insulin Resistance, and a whole other slew of things, I have tons of meds and supplements to take. And while the results seem to be better than the side effects, it still can be pretty icky and put you in a bad mood. 

While I am still on Metformin in the evening, I am not taking it in the morning because about 5 weeks into initially taking it, I got horrible nausea in the morning and even threw up a couple of times. I found out that it was creating an acid reflux effect. I had never had acid reflux before. Or at least not so bad as to make it noticeable. So instead of trying to give me another med to counter act that, I am on a new med in the morning and will hopefully be able to add a morning dose of Metformin .

What the doc did add was something called Victoza. The huge downside to this is that you have to inject the stuff. It really doesn't hurt, but it is awkward. If you don't pinch really hard and continue pinching while injecting yourself, you get this icky bruise. From a pen needle no-less.I have a couple places where I am bruised.

And unfortunately, the second day of taking it, I got nausea. We are not sure if it is just a side effect until my body gets used to it or something I will have to live with. The first thing I was told to do by the nurse was to move from injecting in my stomach to injecting in my upper thigh. I had only a tiny bit of nausea yesterday and today almost zero. So I am thinking of trying the stomach one more time tomorrow. It is completely awkward to inject in the upper thigh spots.

The nausea is weird too. It is not from the belly when you have an upset stomach virus or a bad hangover. This literally starts in your lower throat. And you have to hack and gag. You can't control it. Eventually you have a bout of retching. But it is all within a five minute period. Within another five minutes, you feel OK. It is the oddest thing. 

But there is nothing like feeling alive. Even if I have to go three to four years with morning nausea, I will do it. I am feeling better. It is hard to describe the idea that you don't have to just lie down and sleep. Or exhaustion from doing nothing.

Of course, the last thing I need to see happen is loss of weight. This is the first time since I was five years old, I have not actively been trying to train/exercise a lot to lose weight or do something specific. I have promised my doctor that I will try not to go over 10,000 steps in one day or 70,000 steps in a week. That averages to almost 5 miles a day. Now most people will read this and have their jaws drop, but you can see how much I was doing. I remind folks that I gained 30 pounds training extensively for a 1/2 marathon and eating only about 800-1000 calories a day. And when I can start biking again (my right hip is still wonky, but getting better since inflammation in all my muscles is going down), I have to limit my mileage. At first I can only do like 10 miles and then only 20 miles. In the summer of 2006, I was biking 75-100 miles a day.

The Ying and Yang of Western medical treatment. I will keep plugging along and will hopefully see some amazing results!

Capt Mel

Friday, May 11, 2012

When You Don't Realize What You Have Lost

To date, I have had my first round of 6 weeks of medicine treatment, and I am five days into my second round of medicine treatment. At the end of the first six weeks, my doctor was not please with the progress. It was nothing I had done, it was just the med combo had not worked as well as well as she had wanted. My doctor described it as trying to stop a freight train, but not just stopping it, reversing it too. That takes a lot. 

During the first 6 weeks, I did notice some changes in my energy level. But I don't think it was anything that significant. In just five days, I have noticed a lot more. My metabolic syndrome had progressed to such a state, that even 8 hours of sleep was not enough. Sometimes no amount of sleep was enough. I was groggy, foggy headed, and exhausted most of the time. At first, I attributed it to the stress of being a public school teacher. Lots of layoffs for my friends, huge class sizes, lower pay, and the threat of even more cuts/reforms from people who have no expertise in my field. It was and still is crazy. 

I have had my longest days so far this week and while I am tired at night, I have been able to keep the going power. I have been getting up at 4:30am and getting home no earlier than 7:30pm. I am pretty tired right now, but it is a body tired and not necessarily a mind tired. I almost had forgotten what it was like to be active and on the go all the time. That used to be my life up until about a year ago, but then I started to slow down. I needed more sleep. 

I feel good again. Five days. I can't wait to see how I feel 5 weeks from now. 

The other thing I have noticed is enjoyment with eating. Now that may sound pretty funny from a very large, fat girl, but I don't think I have ever had this feeling before when was having meals. This even includes my childhood!

My doctor had told me that I would more than likely feel a change. Because of my wonky hormones in my stomach, when I used to eat food, the wrong signals were going to my brain and my mind would not be able to recognize that food was going into my body. So when people feel that 'I am stuffed feeling,' I would feel it much later (like an hour later). I always felt uncomfortable after a regular sized meal. If it wasn't the too much food feeling, it was an unsettling feeling. My stomach would churn and gurgle.

Now, I have no stomach problems after I eat. When I eat, I have this completely different feeling. My doctor said the best way to describe is that I am feeling satisfied as I am eating. And those are the best words I have right now. I am supposed to be very careful how I drink liquids/water and to sip, not gulp because my one medicine might make me feel nausea if I gulp. But I have gulped a little today because I have been so thirsty. But no negative side effects. 

The only other bad news about this second round of treatment is that even with the new shot I am giving myself, I am experiencing nausea about an hour after the shot. It was pretty bad Wednesday and Thursday, but I emailed the nurse, and he had the placement of the shot change from my stomach to my upper thigh area. A little nausea today, but not too horrible. It is sure a weird type of nausea and not very pleasant.

So stay tuned! I have more historical stories about how I could get into such a condition and more info about obesity and the insulin/metabolic issue to come.

Capt Mel

Monday, May 7, 2012

A Different Kind of Journey

Recently, I have had many acquaintances and co-workers give me a sheepish look and very quietly and politely ask if I have a life threatening illness and if I am going to die. I know some of them are just nosy, but many others are truly concerned.

And then I wonder if a person can be labeled as nosy if you are not trying to keep a secret. I digress.

In the past 5 months, I have been given such a different outlook on my life. An outlook that is amazing, scary, hopeful, and depressing all at the same time. And about what!? Weight. Hence the title of the blog: Weighing In. If you or anyone you know has ever made the following statements, this is the blog for you:

  • When I look at a hamburger, I gain five pounds. 
  • If I could work out 4 hours a day, I would not have any weight problems.
  • I believe that people think I go home and eat buckets of ice cream every night.  
  • I wish I could eat like other people. If I do, I gain lots of weight. 
  • Eating less and exercising more is not giving me any results. 
  • I wish I had a new body. What I want to do in my mind, is hindered by my size.  
  • I exercise more than anyone I know, but I am still the largest. 

I have thought or said out loud many of these statements and more. This is my story on the struggle of weight loss, and this should be the path people take before they start fad diets, extreme exercise, or gastric bypass surgery. It is a long and complicated story, but I will start with the most recent history.

In June of 2011, I trained and completed my first official 1/2 marathon. My goal was under 4 hours and I made that goal. In the fall, a few of my friends wanted to do their first 1/2 marathons and I agreed to join them. We started training together. It was during this time, I had my annual physical and my doctor gave me that 'I have something very serious to say' look. 

You see, I had gained another 30 pounds over the last year. And after all this exercise and training I was doing. She really wanted me to start seeing a nutritionist. In the next two months, I completed my second 1/2 marathon (again just under 4 hours) and started to see a nutritionist.  

My nutritionist was horrified at my eating. And not how much I was eating, but how little. She put me on a plan. I told her right there I would gain more weight. No matter how much she talked about carbs being a log that keeps the fire going and protein being the kindling, I knew that with that much food (eating every 3-4 hours) would equal weight gain and not weight loss. We tried this for two months and those were exactly the results. More weight gain. I thought all hope was lost, but she was only encouraged. She then sent me to my current doctor who specializes in metabolic disorders (among other things). 

At my first meeting, I laid everything out on the table. And surprisingly, the doctor had even more questions about my life. She was 99.9% sure I had a whole score of things wrong, but I was not to worry because with treatment, it was guaranteed I could get back to a normal weight and have a healthier life. I was scheduled for my first blood test. Here were the results:

  • Cortisol High
  • Leptin lower than predicted
  • Insulin resistance (genetic, but reversible)  
  • Average Glucose over 3 months elevated (pre-diabetic levels)
  • 2 of 3 components of Metabolic Syndrome
  • Seems to be no Poly-Cystic Ovarian Syndrome (PCOS) but birth control could be masking it. 
  • Thyroid is low
  • Vitamin D is low
  • Vitamin B12 low
  • Vitamin K and Zinc ok for now
That all seems pretty scary, but completely treatable. But it sure takes a lot of work. So now I am on a 6 week blood test and modification schedule. And this is what I am going to write about. 

For too long, all people have heard from the general population and media is that obesity is a three pronged approach: Eat Less, Eat Healthy, and Exercise More. But what happens when that doesn't work? In fact, 95% of all people who decide to try and lose weight by eating less and exercising more will fail to keep it off long term. Doesn't that tell you something is not working? It does. And many doctors know about it. It has been known for over 20 years. I have a hypothesis on why we don't know about it. First, it would ruin the weight loss industry. Second, it costs money to fix this problem. 

Here is some outside reading until I write next time. 



So, I welcome you all in joining me on my journey and discover where I have been and where I am going! 

Capt Mel