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: 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