I forgot to snap a pic of the actual knee class I went to this week, but it was in an actual gym at the medical center which looked kind of like this one. For an hour, under the guidance of a physical therapist, I worked on knee strengthening exercises along with 6 or so other people also recovering from knee surgery. We used a knee press, a leg lift machine, stepped up and down off of wooden blocks, and rode an exercise bike. I focused mainly on the other equipment as I have a bike at home. I was definitely tired afterward, but was quite proud as my surgery was more recent than anyone else and my flexibility (both straightening and bending) was the best of the group there that day. I can bend my knee 130 degrees and can get my leg perfectly straight – zero degrees. (My leg may be the only thing straight about me!) All the work before and after surgery is paying off. I no longer need a cane at home and my pain is improving even as I am decreasing the pain meds.
Other victories: I no longer need help in the shower or with dressing, I am also able to cook meals that don’t require a lot of standing. I know I will be back to walking the neighborhood before very long at all – we did a short almost loop yesterday. My Fitbit shows that my steps, miles, cardio minutes, and calorie burn are all dramatically up from last week. I expect to be off of all of the pain meds except Tylenol in just a few days. My knee still hurts, but I want to be able to drive. After weeks of being so dependent, the freedom and power to do things for myself is very important to me. Self-determination, agency, is what I crave, but I would not call it self-reliance as I know how much I will always need the support of others. My friends and family cheering me on during the recovery process (just like they have on my weight loss journey) has really made it all a lot easier.
My support system has proved the grist, but the grit I suppose is my own. I do know that success in meeting one challenge can help make other challenges feel more attainable. I am seeing the rewards. Hard work can pay off. Luck and grace also never hurt.
L’Chaim! This week’s stats: I am drinking about 96 ounces of water most days. My Fitbit report shows 27165 steps last week for 11.4 miles. I ate approximately 9415 calories and burned 12848 for a deficit of 3433. I am down 4.2 pounds for a total loss of 148.6.
I am back up on the horse. Um, back up on the bike. It was really rough for a few weeks after my knee replacement surgery, but now, a full month later, I definitely feel like I am on the mend.
I was able to bend my knee 129 degrees last week, only 3 weeks post surgery. The end of rehab goal is 120 degrees so I am already there. My home physical therapist was amazed and impressed with my progress, particularly because I had a very hard first week with 3 E/R visits and passing out twice. I am now using a cane rather than a walker and am starting to wean myself off of the heavy-duty pain pills. I even go on the exercise bike 15-20 minutes a day in addition to the 6 specific physical therapy exercises that I do 3 times each day. My life is awfully routine. Wake up, eat, take pain medications, exercise, ice and elevate, a little time on the computer, repeat and repeat again. Read for awhile, maybe watch a little TV, and then bedtime. I also find time to take a shower each day, mainly around when Anne is how to make sure still I don’t fall – or I guess so she can call the paramedics if I do.
It all feels so much better, though. I have turned my Fitbit hourly movement reminders back on, and try get the 250 steps per hour in for 10 hours of each day. I still have some significant pain, especially after doing the exercises, but it is becoming more manageable. I am also now doing out-patient physical therapy, including being scheduled for a “knee class” which involves using gym type machines to strengthen my leg muscles.
I really miss the weekly group meetings and hope to get back in another couple of weeks when I can drive again. On-going support and accountability partners are so important to this lifestyle change.
I am back to what feels like easy losing. My exercise is increasing and I have been keeping my calorie intake to a reasonable level. I am not feeling hungry, but look forward to when I am burning more calories each day and am off the pain pills. Then I can indulge in an occasional martini again. I really miss the olives!
L’Chaim! This week’s stats: I am drinking about 96 ounces of water most days. My Fitbit report shows 6634 steps last week for less than 3 miles. I ate approximately 8827 calories and burned 10752 for a deficit of 1925. I am down 2.24 pounds for a total loss of 144.4.
It finally feels like I am recovering. It has been 3 full weeks since my knee replacement. They keep saying it is major surgery, and I am not disagreeing. I still have a lot of pain, but I am even beginning to think it might be close to the time when I can start tapering off the narcotics. I asked when I can start taking ibuprofen again, rather than Tylenol. Tylenol has never provided sufficient pain relief for me. They said 6 weeks after the surgery. Everything is 6 weeks it seems, including being able to drive. I will be practicing patience in the meantime, which is not my strongest attribute.
I tried walking with a cane rather than a walker, under the supervision of my physical therapist. Scary, but I did OK. The fear of falling is real, but I am (slowly) getting my balance back. The knee bending exercises are going very well. I am almost at the 115 degrees they want after 6 weeks and it has only been three. I may be pushing too hard, which of course increases the pain level,
My weight is now down to my pre-surgery number. It helps that my surgical leg is no longer swollen to twice the size of my other one. I am still recording what I eat, but not stressing about it.
As I get better, I am getting grumpier about all the things I still can’t do. Like I said, patience is tough. I can only hope Anne has more patience with me than I have with myself. We went for a drive this afternoon, and it felt good to get out of the house, even if I did not get out of the car until we got back home.
L’Chaim! This week’s stats: I am drinking about 96 ounces of water most days. My Fitbit report shows 5600 steps last week for less than 3 miles. I ate approximately 9219 calories and burned 11068 for a deficit of 1849. I am down 3.4 pounds for a total loss of 142.2.
The pain is insane and this “iceman” is my friend. It keeps cold water circulating and lasts 4 or more hours. Ice helps, as do the meds, but pain really is a constant part of my life now. It isn’t unbearable, but it is hard, particularly right after I do my physical therapy exercises. “What is the difference between a terrorist and a physical therapist? ” ————————————————————You can negotiate with a terrorist.
Seriously, I like the therapist who has been coming to the house once a week. I can now bend my knee to a 95 degree angle. It was 85 last week, so progress, better than average he said. I still like numbers and retain a competitive spirit. It keeps me going.
The pain was pretty intense a few days ago and I wrote this poem. It made me feel better, as poetry often does.
White cotton candy spun
Ice cold across skin
Purple with pain swollen
With hope for relief
How long will this last?
Dinosaurs could tell us
The beached whales struggle
In the sand washed by tears
An ocean’s gift a sea of grief
Spins the ice numbing into stillness
A fissure opens ragged as
A nightmare vision
Bruised bodies heal
And will move
I wonder if in previous years, before the opiate crises, there would be less pain to endure. I understand the need to restrict the narcotics, but for a couple of weeks right after surgery, it would have been much easier if my pain could have been better managed. I really don’t think I am at a particularly high risk of becoming addicted. There were some points last week when I would have happily accepted anything that would have reduced the pain, so maybe that is part of the problem. If doctors are afraid to prescribe sufficient medications, some people will likely turn to street drugs instead. There has to be a better answer.
I got the staples out of my incision today, which is progress and means I can take actual showers again, but it was super painful too. It is hard to focus on anything else when you hurt.
Yeah, I am whining, and whimpering too.
My weight is creeping up slightly, about 4 pounds since my surgery, but I am not stressing about it. I find that having a few yummy meals cheers me up when I am dealing with so much. I am not going wild or crazy, but did enjoy the burrito for dinner last night and the take out Chinese food we had earlier in the week. Body and soul are one, and an extra peach after lunch isn’t a bad thing if makes me feel a bit better. I also believe it will be fairly easy to lose whatever small amount of weight I gain, once I can start serious exercise again. Some of the gain may also be water weight as my leg is still swollen. Every day now is a little better than the day before. Baths and the pool or hot tub will still be a couple of months away for me, but now that the staples are out, a shower sounds absolutely fabulous. The simple things are sometimes what one misses the most. Living a constricted life can fill you with gratitude for glimpses of a more expansive future. I am on the mend. Maybe in a few more weeks, I won’t be whining quite as much. No promises.
On a positive note, maybe we can finally get rid of the tyrant, although the impeachment process is likely to be more difficult than a knee replacement. You have to do it though, if you are going to have the freedom and the ability to go where you want to go and do what you need to do.
L’Chaim! This week’s stats: I am drinking about 96 ounces of water most days. My Fitbit report shows 6925 steps last week for less than 3 miles. I ate approximately 10,010 calories and burned 11228 for a deficit of only 1218. I am up 1.2 pounds for a total loss of 138.8.
Recovery from knee replacement surgery is going to take some time. The surgery was a week ago and I have been to the ER 3 times. Once for a blood clot scare and twice because I fainted. Health care in the US is not the best even if you have good insurance and a better than average provider. The Beatles song “Back in the USSR” has been running through my head. “You don’t know how lucky you are, boy”
I can feel lucky and pissed at the same time. Lucky it isn’t worse but furious it hasn’t been better. Most of the kaiser staff have been great but a couple of the ER docs were arrogant jerks.
With all the emergency room visits physical therapy and meals have both been pretty hit and miss. I can’t let my blood sugar or pressure get too low or I will pass out again. Luckily I was seated with someone with me both times so I did not hit the floor or get hurt. The ER nurse gave me a hospital hamburger yesterday. I had chocolate pudding there the day before.
This recovery is hard and there is a lot of pain. The medications help some but not enough. What is hardest is the emotional stuff though. Isn’t that always true? Not being listened to, not being treated with respect is even worse when you feel lousy and are scared. It is also hard not being able to take care of myself and being dependent on others for my very survival. I am so lucky to have family and friends that love and support me. Anne runs herself ragged helping me and I hate that too.
The lack of control and lack of agency is difficult for an obsessive control freak like me. It is particularly weird around food. For the last year and a half I have been in complete control of what I eat. I cooked what I wanted and ate when I needed to eat. I probably won’t be able to prepare my own food for at least another week. It has been a major mental adjustment and needing help with food is harder for me than needing help in showering and dressing. Makes sense I guess, but it took me by surprise to have a meltdown about the plans for dinner.
I am still trying to eat relatively healthy foods and I am going to up my calorie intake for awhile to give my body more energy to heal.
Defining and redefining each day as I work with a changing sense of what is normal. Rest and push myself. Elevate and ice. Remember to eat. A real joy is being able to sit at my office desk. I am going to limit it to an hour at a time but that one small thing helps me understand that although what is normal for me will keep changing, I can still do a few things that will make me feel better.
L’Chaim! This week’s stats: I am drinking about 96 ounces of water most days. My Fitbit report shows 8783 steps last week for less than 4 miles. I ate approximately 8561 calories and burned 11733 for a deficit of 3172. I am up 3 pounds for a total loss of 140.
They say women forget the pain of childbirth. I think that is a lie. That first child brings such joy that the pain is worth it and you want another child. Maybe knee surgery will be like that too. Like a new born, last night I slept 4 hours until I woke needing my 2 am feeding of painkillers and a replenished ice machine. Then another 4 hours of rest. This is all more than full time jobs for my dear Anne Marie Spatola and myself. I don’t think the other parent ever forgets the exhaustion of those first few days either. Joy and pain can be woven so finely together. Another drug induced metaphor as I drift again into a healing sleep
Not too confident doing a blog post on my phone but I am not up yet to sitting at my desk. The knee replacement surgery itself went well but I had to go to the emergency room the day after because I fainted. I think they sent me home too soon. All is fine now but everyone was right when they said a lot of pain was involved. The above paragraph I wrote this am. I have still weighed myself ever day and am recording my calories but am not trying to lose more weight during this recovery period. My body needs to heal with no extra stress added.
Interesting to learn how many calories Fitbit thinks I am burning with virtual no exercise at all. Roughly 1500 it seems. When I can get my RMR tested again we can see if that is at all accurate.I move from my bed to the bathroom. And to the living room for meals and watching debates. My weight is up 3 pounds. Mostly due to swelling. It is all good. The baby of my new knee has been born now we just want to be able to sleep through the night.
What a roller coaster these last few days have been! First my knee surgery, which has been scheduled for 9/16, was delayed until the 23rd. Then it was back on for 9/10 which is only a few days from now. I was supposed to check in at 11:30, then it was 9:30, and now it is back to 11:30. We will see if anything changes again. I have had a ton of phone calls and emails from Kaiser (my health care provider) in the last few days. I had to change other appointments because of the date changes. The surgery team thought I still have diabetes and sleep apnea as my primary doctor hasn’t corrected my records yet to show “history of” in front of those conditions. Luckily they listen when I tell them my latest A1C is 5.2 and explain how much weight I have lost, but it is more than a little frustrating. All this chaos has at least saved me from stressing too much about the actual surgery. I am ready I think. I have the walker and thing that goes over the toilet ready. We will pick up all the throw rugs this weekend and and make sure there is enough food in the freezer.
I did reach my weight loss goal this week, the one I have had for over a year. Now I am simply overweight and not “obese.” I may set a new goal after I have recovered from the surgery and can get back to serious walking. One interesting thought that I have been smiling about: with all the excess skin around my knees now, maybe the scar will be less obvious. There have to be some advantages to saggy skin. But even with a large ugly scar, I will still wear shorts. Like my gray hair, I will have earned the scar and will be proud. No worries, I don’t think I will post any pictures of my early healing stages. .
Tonight we are going out to dinner. I will have the swordfish and maybe two martinis.
Time for another before/after pic.
My appearance still startles me when I look in the mirror. No wonder that old friends don’t always recognize me. There have been a lots of changes since April of 2018 when the earlier picture was taken. It isn’t just my appearance that has changed (my hair is shorter!), but most importantly my health is so much better. I can walk for miles, I don’t get out of breath on the uphills, I am off all regular prescription meds, and my C-Pap machine is history. I feel better; I feel stronger; I may even be happier. Back then my health was deteriorating which was depressing and my world, my life, felt like it was becoming more and more limited by things I could no longer do.
For 385 days, after the meal replacement period was past, I have logged every calorie I have eaten into an app on my phone. I have guessed sometimes, especially with restaurant meals, but have continued to lose almost 2 pounds per week on average. The graph of that loss is pretty dramatic.
My goal has been 180 pounds, which would get me out of “obesity” into overweight. I hate those weight charts, but it is kind of fun to be only a week or so from achieving “overweight” status. I may not be done losing, but I am will also fine with simply maintaining where I am now.
I exercise, at least an hour a day and sometimes more. I enjoy it. My knee surgery is coming up in a few weeks, which was one of the reasons I needed to lose the weight as they would not operate on me at the size I was. I got a little frustrated today because the surgery was delayed for another week because of a UTI. They want you to be in stellar health so the surgery goes well. More antibiotics should do the trick, and another week isn’t so long after all the time I have put in preparing, but it did seem a little unfair. Very little in life is fair, however, and I know I have been luckier than many. A little whining seems justified none the less.
It is a bummer partly because the scheduled surgery meant I could not have another cortisone shot and had to stop taking naproxen. As a result, my knee is toast and getting too painful to continue my long walks. I am going to switch back to mainly the stationary bike and swimming, with maybe a few short walks with a knee brace. Perhaps it is all a plot so I will be really happy to have the surgery and not complain too much during the recovery period which everyone says is fairly painful.
In group this week, we talked about RMR (resting metabolic rate – or the calories you would burn if you were in a coma. The coma explanation is mine and is not the official one.) You can affect your RMR some by the foods you eat, the amount of muscle mass you have, how much sleep you get, and how you deal with stress. Other things such as age, gender and hormones are pretty much out of your control. RMR also goes down as your weight goes down. I had mine tested last November when I was 75+ pounds heavier than I am today. I will get it tested again after my knee surgery, just so I know the number. It helps with the math. I seriously have both a lot less weight and a lot more muscle than I did then.
I am not on a diet. This isn’t a fad, a quick fix that can’t be sustained. This is my life.
L’Chaim! This week’s stats: I am drinking about 96 ounces of water most days. My Fitbit report shows 99,609 steps last week for over 42 miles, down from last week when we walked an extra lot in Monterey. I ate approximately 9527 calories and burned 17443 for a deficit of 7916. I am down 3.1 pounds for a total loss of 140.9.
We rode the shuttle up to Muir Woods on Saturday. Nice flat walking for most of it and what glorious giants. I felt even smaller around them.
I had a non-scale victory this week too as I had blood drawn in preparation for my knee surgery. They were able to use a vein in my arm! For years, they have had to use my hands to draw blood. The arm is MUCH preferred.
I had a huge (6.6 pounds) weight loss this week, which would be kind of scary except for the 4 pound gain I had last week. That gain was all water due to a medication that I have now stopped taking. It wasn’t helping anyway, and my ankles were seriously swollen as a side affect. OK, maybe some of the gain was the moules frites but the med was clearly the biggest part of it.
I also cleaned out my closet this week. All those 3x clothes will go to someone else.
My closet looks much better. It isn’t hard to decide what to wear with fewer clothes to choose from. Getting rid of the clothes I have shrunk out of was an emotional experience. I loved some of those outfits and had memories of the fun and significant times I had worn them.
I did keep a few things that I will likely never wear again – including the outfit I wore for my ordination back in 2007. I wore it on many other special occasions afterward. I mostly had to be quick with the cleaning out, taking no time to fold or sort, or I knew I wouldn’t have been able to do it. Too many memories were woven into too many of those clothes. I hope they bring joy to whoever will wear them next. Large sizes can be hard to find in second hand stores, so maybe they will be appreciated.
As hard as it was, it was important to for me to do this. It was an act of faith, of faith in myself really. If I kept the old clothes around, part of me would have been expecting to wear them again. I am not putting all that weight back on! It is funny, but I went through a reverse process a few years ago when moving. I got rid of the clothes that I didn’t think I would ever be small enough to wear again. I guess I was wrong about that prediction, but it was still a good decision to let them go. Lugging them around through a couple of moves was too depressing, and it was good for my mental health to get rid of them. At that point in my life, I just needed to accept myself as I was and just be fat and happy. Now I am again learning to accept myself as I am now, thinner but still happy. Change is always hard.
Group this week was good again. We talked about the Maya Angelou quote, “when you know better, you do better.” So many meanings, and so much nuance to be found in those words. More knowledge is almost always a good thing, and damn, don’t we all want to do better? I wish our POTUS had even a smidgen of that approach.
We also talked about the food industry and how it keeps us confused and unhealthy.
This program is not a diet. Diets don’t work. This isn’t about depriving yourself for a short period of time and then going back to old habits. It is a complete change in approach to food, exercise, and to life. I don’t feel deprived. I feel good.
L’Chaim! This week’s stats: I am drinking about 96 ounces of water most days. My Fitbit report shows 116,448 steps last week for over 49 miles, which was way up from the week before and included a very long walk in Monterey. I ate approximately 9996 calories and burned 18180 for a deficit of 8184. I am down 6.6 pounds for a total loss of 137.8 .
This week proved that doing the math is not always enough. Even though my calculated calorie deficit was larger than last week, I gained 4 pounds, my largest weekly gain since beginning the program. Maybe it was the 3 dinners out I ate while in Monterey on a short get away. Eating out always involves calorie guesstimates and I could have grossly underestimated. Maybe it was because I cut back on calories the week before while increasing my exercise and that sent my body went into starvation mode. Maybe it is a new medication that causes some water retention, and most likely it is a combination of all 3.
There is so much mystery in life.
Monterey was beautiful and I walked a lot amid simply gorgeous scenery. I enjoyed myself and I enjoyed the dinners I ate. It was all good food, just a little too rich and a little too much. This week, I will get back to my more usual habits, because they really are habits now.
The class was helpful tonight. I had been a bit overconfident due to being so successful for so long. Humility is important and this week was a bit of a wake-up call to keep paying attention. We talked about emotional eating and I don’t think I do that anymore, although it was a habit in my past. Eating is not how I deal with stress anymore. I don’t eat out of boredom and I avoid junk foods. I just need to be a bit more careful in French restaurants as good Moules Frites are just too yummy for me to resist. And I did underestimate the calories in them – by a lot. The mussels were cooked in both butter and cream. They were REALLY good though, and it is OK to indulge once in awhile. One of my friends in the group said that when she indulges, she gives herself a penance, something as simple as a walk around the block can make up for a handful of tortilla chips. Some things obviously require longer walks.
L’Chaim! This week’s stats: I am drinking about 72 ounces of water most days. My Fitbit report shows 89431 steps last week for over 37 miles. I ate approximately 9247 calories and burned 17547 for a deficit of 8300. I am up 4 pounds for a total loss of 131.2 .