Chronicles of a Late Bloomer

Because sometimes I need a burger.

This picture is not staged. This plate full of food is what I actually ate for dinner tonight. No, there isn’t a bowl of fries or a milkshake hiding off camera. There is a monstrously big cup of water, though. The carrots and grapes are from my local farmer’s market (the one only 5 blocks from my house), and the burger is fixed just the way I like it — with cheese, extra sauce, hold the onions.

To me, this is a good representation of my current [lack of] eating plan. I call it, loosely, the 80-20 Rule and it’s my most powerful weapon in the battle against perfectionism. Perfectionism has long paralyzed me. The 80-20 rule is, as you may have figured out, a tool to promote permission.

I try, 80% of the time, to eat perfectly. I pass by the cake, pack my lunches, and steam broccoli for dinner. I’m mindful and careful and purposeful 80% of the time.

The other 20% of the time, I try to eat pretty well. I don’t give myself unmonitored free reign at an all-you-can-eat buffet. I just try to act differently than I would have in the past.

In the past, after a day of thinking about and salivating over the idea of a hamburger, I would have driven straight to McDonald’s. I might not have even waited until the end of the day, but taken my binge break at lunch. I wouldn’t have asked if I could afford it or ensured that I had money available. No, I would have gone straight to the nearest drive-thru and ordered not one, not always two, but sometimes three super-sized value meals. I would have eaten them in the car — inhaled them, really. I would have included 3 or 4 desserts in the order, just for good measure. Those would be scarfed with milk — my bingeing beverage of choice.

It’s all just so Freudian.

Now, though, I make those 20% choices pretty good. It does me no good to eschew the burger after craving the burger for 24 hours. By that point, this is not just a passing thing. Nor is it the universe’s representation of evil on earth. It’s just some meat on a bun. Granted, the bun is made of refined white flour, but…

• I check my wallet, and make sure I have cash to pay.
  
• I choose a restaurant that is committed to using fresh ingredients, reasonably similar to what I would eat at home.
  
• Even though the fries are made from actual potatoes, I only order the burger, knowing what potato does to me.
  
• I don’t order two or more burgers. Well, I almost do. The conversation at the menu board goes like this: “I’ll take a cheeseburger with no onions. And… um… okay make that two cheeseburgers with no onions and a… wait. No. Make that one burger. Just one burger, no onions. Awesome.” (The “Awesome.” is my little pep talk to myself.)
  
• I don’t eat it in the car. Rather, I drive home, put it on a plate, and make an actual meal of it. I consider that this meal contains a portion of meat, a carb, and should also include vegetables and/or fruits. That’s what I’m doing these days. I eat veggies. Two meals a day. And tonight I sort of felt like the lettuce and tomato on the burger wasn’t really going to be enough. It wasn’t going to get me all the way to 80-20. So, I sliced carrots.

20% of the time, I cut a smaller piece of pie. I skip the mayo. I double up on salad. 20% of the time, I slice berries into my cereal. A certain measure of freedom is built into most every healthy eating plan. In Weight Watchers, it’s the Points Allowance. I mean, if the expectation is that you are going to be perfectly perfect all the time…

…you will fail.

Celebrating: The return of my WW leader from her 3-week trip to Europe. I am so glad I shopped around and found a leader whose focus is consistently helpful for me and who is a brilliant cognitive-behavioral group therapist without even knowing it.

Grateful for: The power of writing. I’m beginning to think that writing things down is the most important step between dreaming and achieving. Writing things down takes bold daring, courage, and moxie. It invites success into my life.

Starting weight: 354.6 pounds
Last week: 294.2
This week: 292.8
Change this week: -1.4
Total change: -61.8
Next milestone: 65 pounds gone

This week’s mantra: Let the storm blow all around you. If you cannot move forward, drop your anchor and just stay pointed in the right direction.

This summer, I launched a new initiative to “be a grown-up now.” It’s been a very empowering process — defining my core values, setting long-term goals, and projecting markers and milestones along the path toward achievement. I’ve committed to taking more personal responsibility. I’ve, in a sense, gotten my butt in gear.

One of the overarching goals is called, ubiquitously, Health. Naturally, losing weight falls under this category (exit 60 pounds, stage left). Another part of my accountability for health issues is to build a good relationship with a doctor, to receive checkups routinely, and to actively seek treatment when I am unwell.

This seems like an obvious life skill — GO TO THE DOCTOR — but like so many overweight women, I have studiously avoided doctors for years and years and years. It seemed that no matter what my complaint, The Doctor could twist and turn it around so that it was caused by my morbid obesity. Now, I know that obesity is not conducive to health, generally. However, I had a hard time believing that every single ache and pain would magically disappear if I were to lose weight. Infrequently, I would actually see thin people sitting in the waiting room of the doctors’ office. Sometimes, on TV and in the movies, thin people even DIED. Imagine that!

The straw that broke it was when I sought treatment in my early 20’s for a severely sprained finger. I had jammed it while playing a friendly game of volleyball and, although I was sure that the doctor couldn’t find a way to pin a sprained finger on my 100+ pounds of excess weight. I was wrong.

“Well, if you were in better shape, you wouldn’t have gotten injured.”

That’s about when I stopped going to the doctor.

So, deciding to seek medical treatment for my episodes of abdominal pain (ridiculously, this decision was only made after the pain became so intense that I resigned myself to the emergency room) is a big step for me. I know that I am hypersensitive about my body in every way — both offhanded and clinically-neutral commentary triggers major emotions in me — so I am trying to give the doctors the benefit of the doubt.

That said, this whole process of diagnosis is really taxing me. I want answers. I am afraid that there won’t be any and I’ll just be another pathetic, fat hypochondriac. I’m worried that, at the end of the day, all I’ll have for my troubles is a pat on the head and a slap on the back and an admonition to “just lose weight.”

I find some of the doctors’ comments utterly trivializing — as though I might seek medical assistance for a hangnail or a bad case of the hiccups. “Take this acid-blocker” is a popular piece of advice in this process of diagnosing abdominal pain. Now, I understand rationally that this is not an emotionally-loaded piece of counsel. Nonetheless, it has sent me into near-tears all three of the times that I’ve heard it. “Take an acid-blocker” is probably not meant to be dismissive, but it feels that way. As though I might go to the emergency room for a case of indigestion. As though I could confuse mere heartburn for a true medical concern. As though I were a whiny crybaby who imagined symptoms in order to get attention.

As though I hadn’t lain on the floor of my office, writhing in pain so unbelievable that I couldn’t form words or take a full breath for almost 45 minutes before seeking help. As though I hadn’t soaked through all of my clothes and lain in a puddle of my own sweat. As though all I needed was a Tylenol and a warm blanket (the remedy offered to me by the hospital). As though I didn’t know my body, my own ridicusly-high pain tolerance, and my history well enough to formulate the following opinion: SOMETHING’S WRONG.

To be fair, my Primary Care Physician took me a lot more seriously after she saw my lab results. When my liver counts came back in the high 300’s (the “normal” range caps out at the mid-teens), it was though she had pulled cotton from her ears and could actually hear me. I no longer felt dismissed by her. She shared my concern, and she sought out a specialist.

Did the specialist actually roll his eyes during my appointment with him yesterday? I’m not sure, but it sure felt like he did. Again — I’m happy to take ownership of my hypersensitivity on this one. Hell, I’ll even agree that I might have an acid problem. But, I won’t take your daily acid-blocking pill until you give me a more thorough work-up and put me through some damn tests.

And so, as soon as they’re approved by my insurance, I’ll be getting more bloodwork done, a CAT scan, and an upper endoscopy. Add this to the 4 rounds of bloodwork I’ve already had, two pelvic and one abdominal ultrasound, and three episodes of pain so intense that I (and the people who saw me) thought I might die, and then let’s talk. If you still don’t know what’s wrong with me, we might get around to taking acid-blocking shots in the dark. We can resign to taking medications on the hope that they might hopefully someday avoid another pain episode. Maybe. If you’re lucky. I guess. [Fatso.]

But, until then, please look past my shape and size and try to take me seriously. I promise to handle the hangnails and heartburn at home, but I need you to help me puzzle through my liver, pancreas, gallbladder and spleen.

My ex-boyfriend has been indispensable in counteracting my blindness throughout this process. Although I’ve lost 60 pounds — and although I’m aware that 60 pounds must come from somewhere! — it’s been hard for me to accept that I am making any visible progress toward health. As I mentioned before, all of my same rolls and lumps and bumps are still intact and, while they are smaller, I do so look forward to the day when I no longer sport a tiered belly. A layered belly cake with raspberry filling. Mmmmmm.

Last night, as we perched on the edge of my bed, my ex quietly absorbed the reality of my “new” arm shape. He said, kindly stroking his fingers along the fleshy parts, “It’s coming off nicely, isn’t it?” I had to laugh, because the phrase struck me as sweet and a little strange. Like something you might hear from a plumber, or a barber. I wish I could see it the way he does. Yes, the scale blows mathematical sunshine up my bum at 5-pound intervals, but the visible evidence of change is so slight and so slow.

“You don’t spread out right here the way you used to,” he muses, pointing to a certain spot on my hips when we relax on the bed. His words are drenched with true affection and care, so it’s hard to feel any sting in them. He assures me that my back, arms, hips, and even knees look slimmer than they ever have. I had to point out to him, with a sigh, that so do my boobs. He just smiled his genuine smile and said, “But isn’t it kind of exciting? You’re getting a whole new body!”

This alternate perspective means a lot to me, as I still have over 100 pounds to lose. It’s a little bit surreal I have resigned myself to being so big for so long. But, as I tune into the little signs of change — the arm-shaped arms and the emerging ankles — I hope to better acknowledge the non-scale victories just as much as I enjoy pushing toward that 5-pound mark every week.

It’s a little silly for me to post this on Monday, because I have a doctor appointment with a specialist on Tuesday. However, I have a feeling I won’t have many answers on Tuesday, so it can’t hurt to keep you in the loop.

You may recall that I have had episodes of severe (super severe) abdominal pain in the past few months. The last internal explosion landed me in the emergency room when my pain skyrocketed out of the 10-point pain scale all the way up to 11. I finally chose a doctor, got some lab work done, and have learned that my liver and pancreas are seriously malfunctioning.

My doctor wanted a $20 copay to give me her opinion. Of course, the Great and Powerful Dr. Google gave me his thoughts for free. If I were a betting lady (or, if one could actually make money on such things), I’d predict that I have pancreatitis that’s secondary to severe gall stones. There are several reasons for my amateur self-diagnosis, but we’ll know more tomorrow after I visit with a gastroenterologist. Cross your fingers that this process won’t be dragged on for 5 or 6 more weeks of overbooked doctors and time-consuming diagnostic tests.

In the meantime, I have been so terribly fatigued that I can barely keep my eyes open. I’ve literally slept 13-18 hours for the past 5 days. I’m now aware of a constant, low-grade abdominal pain that sometimes twinges up to a level 4 or 5 after eating. I’ve been instructed by my doctor, because of how high my liver enzymes are elevated, to “for the love of God not take any pain killers.” Let me tell you, that made last week’s 3-day migraine super fun.

Will keep you posted. If you think it’s anything but a dead or dying gallbladder, feel free to toss your hat in the ring!

I guess I had lost sight of my own advice — rather than feeling overwhelmed by the big, humongous, ultimate 170-pound goal, it’s vital for me to set my sights on the little bitty goals. Honestly, I get pretty pumped each time I lose another 5 pounds, and my WW leader has her own way of celebrating those little victories. Even though I don’t necessarily follow the WW plan, I pay for and attend the meetings because she is so spectacularly good and because her cheesy little rewards have come to really mean something to me.

So, I just had to refocus. I had to remind myself of all the cliches — the “slow and steady” and “inch by inch, mile by mile” cliches — and about how these 5-pound goals are truly adding up to big-time results. Lose 5 pounds 12 times, and you’ve lost 60 pounds.

I had to just go back to taking it meal by meal and talking myself through it: eat vegetables every chance you can, take it easy on the refined carbs, dodge the sugar, drink more water…

Don’t forget, I had bloat and a few other things working against me last week, which resulted in a gain. So, while it may look like I lost 7 pounds this week, I’ve really lost about 2. I’m just right back on track. Trending down. Re-focusing my thinking. In it for the long haul. Leaving the 300-pound mark in my wake and never looking back. On to the next 5 pounds!

Celebrating: 60 pounds gone!

Grateful for: Having this place to express and sort through my feelings. It helps me refocus on what’s important. Also grateful for the people whose insightful comments challenge me.

Starting weight: 354.6 pounds
Last week: 301.2
This week: 294.2
Change this week: -7.0
Total change: -60.4
Next milestone: 65 pounds gone

This week’s mantra: Stay calm and focus on smaller goals.

Several astute friends and commenters have tried to help me through this sudden onset of slump. After rocking the scale for so many months, I seem to have derailed a little bit. Is it a coincidence that this crash occured right after I achieved several major goals?

In the past few weeks, I have lost enough weight to be able to claim, proudly, that “I’ve lost over 50 pounds” and “I weigh less than 300.” Both of these claims are more grand and more notable than I’ve ever been able to make before. Some have postulated (wisely) that perhaps I’m experiencing a post-goal let-down. You hear about brides who experience a sense of loss after their wedding day — so much energy, time, and stress has been spent getting ready for the event, and what kind of wedded bliss could possibly rise up to take its place? New mothers often suffer from post-partum depression. There are many instances that could be cited to describe the bitter-sweet and mixed emotions that sometimes accompany the achievement of a long-term and otherwise-happy goal.

And, I’m not immune to that, I don’t think. I worked hard to lose that first 50 pounds. How many hours were spent shopping, preparing meals, and increasing my exercise? Was it fun to cart my lunch to work and my empty dishes back home? And, when I had a financial crisis, I could easily have become a super-couponer and bought highly processed and additive-rich foods on the cheap, but I didn’t. I ate through my freezer full of healthier alternatives, begged and borrowed for fresh fruits and vegetables, and subsisted on free (but high quality) meals at functions, parties, and generous friends’ homes.

I weathered a sad and painful (though, thankfully, not ugly or hurtful) breakup and I did it without resorting to ice cream, for the most part. I re-joined Weight Watchers and shopped around for a leader whose wisdom and word-o-philia are helping me to change some of my mindsets. I’ve suffered for months with pants and shirts which are sizes and sizes too large.

No, losing the first 50 pounds has certainly not been easy.

But, therein lies the rub. Can you spot the word that’s causing me the most grief? I think I can — it’s “first.” I think the mini-depression I’m experiencing is distantly related to goal-letdown. I think it’s sort of like a second cousin to goal-letdown. Maybe we call it goal-fatigue.

Losing 50 pounds has been a dramatic experience for me. It’s been wonderful and exhilarating and totally rock-and-roll. However, in order to achieve my ultimate and long-term goal of BMI normalcy, I’ll have to lose 50 pounds approximately three and a half times. In spite of my achievements, I really am just getting started on this journey. The after-photos on weight loss commercials proudly proclaim “I’ve lost 50 pounds!” because they are finished. 50 pounds, for most people, would be enough. For me, it’s the first in a series of stepping stones that, for one reason or another, feel sort of insignificant right now.

Sure, people who’ve known me for longer than a year are beginning to notice a change in my physical appearance. Coworkers and clients have remarked on my baggy pants and slimmed-down sillhouette. However, new acquaintances, business colleagues, and even potential dates still experience me as very, very fat. They don’t know just how hard I have worked. They don’t know how much smaller I am today than I used to be. When I meet new people in these situations, it’s all I can do to restrain myself from saying, “I’m Mal, and I used to be a lot fatter. I’m working on it, I swear!” I still can’t change my body distinction on my match.com profile, or bump into the next tier of perceived attractiveness for potential dates.

I’m having to adjust my expectations of what it means, for me personally, to have lost 50 pounds. In reality, none of my bulging lumps, bumps, or rolls have gone away. They have become smaller versions of themselves, yes, but they retain their same basic shapes and forms. Close friends who have lived with me through this journey so far have taken to addressing me affectionately. “Hey, Skinny,” they’ll say into my answering machine, or with a clap on the back. “Skinni-ER,” I correct them. I’m not anywhere near thin yet. Just thinn-ER. They remark that my hips are narrow-ER, that my arms are slimm-ER, and that my stomach is flatt-ER. Not narrow, slim, or flat. Just -ER. I have -ER overload.

And, I guess that’s the let-down that I’m experiencing now. 50 pounds seems like such a gargantuan amount to have lost, but it’s just the tip of the iceburg for me. Looking forward feels a bit overwhelming, and major financial and health concerns have only added to that strain.

How can I possibly maintain the focus and energy required to lose 170 pounds, when losing 50 pounds took so much? I feel a little tired, I guess, and I don’t know what to do now. Will I always be an -ER? Is it best to accept that being skinni-ER is achievement enough? How do you combat -ER fatigue?

One positive note from all of this medical drama and the endless lab tests of the past two weeks. As reference, the “normal” range for cholesterol is 125-200, and the preferred range for triglycerides is less than 150.

October, 2006:
My Cholesterol: 211
My Triglycerides: 239

April, 2007:
My Cholesterol: 205
My Triglycerides: 519

Last week, September, 2008:
My Cholesterol: 166
My Triglycerides: 148

Unbelievable. My doctor didn’t even raise an eyebrow at these numbers. Since learning that I fall so squarely into the “normal” range on this one measurement, I feel like that guy in the Cheerios commercial telling every random stranger about his lowered cholesterol.

What can I say? I think it’s awesome.

Celebrating: Living in an era of modern medicine where simple lab work, blood draws, and tests can begin to yield answers when you’re not well.

Grateful for: Let’s not anyone be shocked that my weight is up this week. In addition to everything else going on, I got my period this morning. So, today I’m grateful for perspective. After all, aren’t I the one always preaching about the power of perception? Three weeks ago, I would have been squealing with delight at these numbers. And that’s what I’m grateful for. Knowing that I have the power to put a positive spin on this. Knowing not to let a negative perspective smash my forward momentum. And, so, I am grateful to have a body, to be making peace with it, and to have a good doctor and amazing health insurance.

Starting weight: 354.6 pounds
Last week: 296.8
This week: 301.2
Change this week: +4.4
Total change: -53.4
Next milestone: 60 pounds gone (since I already reached 55 pounds gone)

This week’s mantra: Trust the doctors to figure things out, trust the universe to give you strength, trust your body to respond as you GET BACK TO BASICS.