Weekly Measurements Are Important

Numbers don't lie.  It is sooo true!

However, it has to be said that I have some say in what those numbers look like, depending on when I take my measurements. 

I've stopped taking official weight and measurements on Sunday mornings, because that is just too depressing. 

Oftentimes, I weigh more on a Sunday than I will on the following Tuesday, because the effects of the debauchery I've engaged in on Friday and Saturday take a day or two to disappear.  This weekend - for example - I went out for dinner on both Friday and Saturday nights, alcohol included.  I totally overdid it on Friday, including my first REAL cheat since January, in the form of the full-sized Reese's Nightmare sundae at my local ice cream parlor.  Talk about a carb nightmare for yours truly!

Also, it has to be pointed out that my weight fluctuates daily (and if you are a woman, there's a good chance that yours does as well), and throughout a given day, as well.  Most of this has to do with water weight gain and loss, which can be significant. 

I am a little addicted to daily weighing, which is not advisable (too easy to be discouraged).  Don't follow my bad example in this regard.  ((Note: for some people, especially those prone to regular swelling and those with cardiac issues, daily weighing can be critical to knowing when you've packed on too much water.  We learned this the hard way with my dad and his several bouts with congestive heart failure.  I'm not a doctor, and in no way qualified to give medical advice, so talk to your doctor about this issue!!))

The best thing to do is pick the same day, each week, to do your weigh in and measurements.  Weigh and measure yourself in the morning, naked, after you've used the loo and before you've had anything to eat or drink (including meds, vitamins and the water you guzzle them with), preferably when your hair is dry!  If you have your period, feel free to skip weigh in that week, as that can be horrifying.

Just - whatever you do - don't forget to measure yourself regularly.  It can be the only thing that keeps you sane when your weight has plateaued.  Frankly, I think that measurements are more important than weighing, as a general rule.  Back in the Spring of this year, I was stuck at the same weight - up one pound, then down one pound - for weeks!!  At the time, I was hitting the gym a lot.  Measurements showed me that even though my weight wasn't changing, I was still getting slimmer and healthier as my size decreased. 

How Sweet are You?

It may be a pain in the fingers, but I heart my glucometer. 

By teaching me how my body reacts to the things that I eat, this device has given me a new measure of gustatory freedom.  I've learned a lot, and have had a lot of surprises along the way. 

Our sense of taste does not always alert us when our food contains carbohydrate, and we can be lulled into a false sense of security when a meal appears to be heavy on the meat or vegetables.

One of the best uses of a glucometer is to understand whether the food you enjoy at your favorite restaurants or workplace cafeteria, or your aunt's famous [insert name of recipe], is as healthy and appropriate as you think it is for your WOE. 

Low Carb Pregnancy (Surprise!!)

If you’ve been reading this blog for any length of time, you may recall that I was recently diagnosed with PCOS-related infertility in March.  My blood glucose was being managed by a strict, ketogenic, low-carb diet, and by March, I had lost weight, and felt a number of health benefits, including increased energy.  However, I wasn’t ovulating, and probably hadn’t been ovulating for years.  In fact, I have menstruated only once in the past year – in April – and that was courtesy of a 10-day course of Provera.

Imagine my surprise when I found out on Father’s Day that I am pregnant!  We weren't trying to get pregnant (nor were we trying to prevent pregnancy, exactly), and I did not think that I was able to get pregnant.  Where did this new-found fertility come from?  We are very excited!!

I am still going to stay relatively low carb – between 50-100 net grams of carbs per day – because I have been advised to stay out of ketosis while I’m pregnant.  I’m still avoiding wheat and other grain products, potatoes and rice (I found to my dismay that eating grain products results in discomfort).  The extra carbs are coming from fruits and vegetables that I’m adding in to my regular diet, dispersed throughout the day. 

So, the focus of this blog is going to change from weight loss and fitness to maintaining a healthy pregnancy, using low carb principles to keep my blood sugar stable, to stay fit, and to prevent unhealthy weight gain.

Diabetes? Type 1, Type 2, or [Type] None?

Last night, I received a phone call from my MD at home.  The results of my fasting glucose and insulin tests from last Friday came in.  My fasting blood glucose was 118 mg/dl, and my fasting insulin was 10.  Apparently, the blood glucose was elevated, but the insulin was well within the normal range (the max normal is 17).  The fasting blood glucose result seemed strange in light of the prior post-prandial glucose test I took at the lab, which resulted in a reading of 95 mg/dl.

But...I expected a higher than normal fasting blood glucose.  I have read a number of blog entries and posts from low-carbers out there who have had the same results:
http://www.livinlowcarbdiscussion.com/showthread.php?tid=1381
http://high-fat-nutrition.blogspot.com/search/label/Physiological%20insulin%20resistance%20%281%29

My doctor is concerned that I may be diabetic.  According to her, I should do a glucose tolerance test, and get my HbA1c tested.  I told her that I was worried about getting a false positive from a GTT because of my low carb diet.  As observed by Dr. Atkins: 

"Note: The GTT results are not considered accurate unless you are consuming at least 150 grams of carbs a day for at least four days before you take the test. Therefore, doing it after you start Atkins would mean you'd have to go back temporarily to eating a high carbohydrate diet (and almost certainly regain some of the pounds you have just successfully lost)."  Dr. Atkins New Diet Revolution, p.113 (2002 ed.). 

This recommendation seems to be pretty mainstream:

"Those taking the OGTT to diagnose diabetes or prediabetes who are not pregnant should eat a normal, balanced diet the week before taking the test. Experts recommend that this diet include at least 150 to 200 grams of carbohydrates per day. Patients must fast for at least 8 to 12 hours before having the test."  http://diabetes.about.com/od/symptomsdiagnosis/a/ogtt.htm; see also, http://www.ehow.com/how_2077817_take-pregnancy-glucose-tolerance-test.html (recommending 150g for 3 days prior to GTT).

I know I'm getting about 20-30 grams of carbs a day, which is confirmed by my carb counting and daily ketosis testing.  I'm leery about guzzling all of that sugary stuff for the GTT, about high-carbing it for 3-4 days prior, and about sticking around a blood lab for 2 hours to get the GTT done (I have to work, people)!! 

So, we're compromising.  I'm going to do another fasting glucose and the HbA1c tomorrow morning before work.  I'm going to start monitoring my blood sugars three times per day with a home glucometer, which I have to pick up this afternoon from the pharmacy (yay, insurance paid for the glucometer and lancets – no copay!).  Then we'll see if we need to do the GTT after those results come in.  Hopefully, the HbA1c will look good enough so that I don't have to do the GTT.

I have read that exercising at night, and eating a good, low carb snack before bed, can help with fasting blood glucose.  Guess that means that yours truly is hittin' the gym tonight.

I hope I'm not diabetic.  Type 1 and Type 2 are both in my family.  Type 2 I can deal with, as it is likely to resolve itself once I've got my health and weight under control.  Type 1 is pretty scary stuff. Shudder.  My maternal grandfather and first cousin once removed have Type 1.  But I make insulin…  and I have PCOS, which is related to insulin resistance (I make too much insulin).  I don't know how you can have symptoms of insulin resistance and have Type 1 diabetes, because having insulin resistance implies that you are producing a lot of insulin and your cells just aren't responding to it.

I'm going to start keeping track of my blood glucose levels on this blog.  Hopefully, it will provide some insight and result in a healthier me.

Happy / Diversifying Fats / "Nourishing Traditions"

I just left my desk for a moment to run to the ladies room.  On the way, a coworker approaching from the opposite direction stopped me and said, "Kate, you look amazing!"  She continued, "you've lost a load of weight."  It was so spontaneous and honest!  It was so nice to hear!  I've been feeling crappy for a while, and this immediately elevated me to a happy state.  Even before the compliment though, I noticed that today was a headache and grump-free day.  I feel more like myself.  What have I changed!!?

Well, I am still taking the progesterone.  The MD got back to me, and told me that, yes progesterone can cause headaches and that is probably what is going on at the moment.  It should stop once I'm off of the progesterone.  The MD told me I could go off of it if I really needed to right now.  I only have a few days left, so I am going to stick with it.  She said that there is really no way to know whether the progesterone will cause headaches again when/if I have to take it next month. 

I had a high-fat, high protein meal last night for dinner, and frankly, I felt amazing afterwards.  I made meat, veggie and cheese-stuffed eggplant, with raisins, middle-eastern spices, and almonds.  It was flipping fantastic.  I had a hardboiled egg for breakfast today, and leftover eggplant for lunch.  (I'm telling you, this recipe was a killer.  I took care to use a few different fats – lard, organic butter, EVOO – to make sure I get the benefit from each one, ala Nourishing Traditions.  I'm going to post it once I clean it up a bit.  The procedure I used is a little confusing, and would benefit from being streamlined.  These would make GREAT meatballs.  My family loved the recipe, even Picky Daughter Who Disdains Mama's Creative Cooking.)

I am starting to wonder if I need more and better fat in my diet.  Heretofore, my focus has been on increasing protein and lowering carbohydrates.  I have been eating a lot of dairy, and getting fat from there, as well as from the protein I eat.  Truthfully, though, the animal protein usually ends up being lower in fat, just because I like chicken and fish, and because red meat tends to be more expensive than poultry, so I buy it less frequently.  I wonder if I'm not getting enough fat, especially healthy saturated fat.

I've started reading Nourishing Traditions.  Reading this book has been a learning experience for me.  I saw interviews with its authors, Sally Fallon (from Weston A. Price Foundation) and Dr. Mary Enig, on Tom Naughton's documentary, Fathead.  I also saw a link to this book on Mr. Naughton's website, which I enjoy reading.  So, I picked NT up and started to go through the book.  Well… it is so much more than a book about low-carb (its actually NOT about low-carb, particularly...although it discourages refined sugar consumption, it encourages the consumption of fruits, unrefined sugars, and sprouted grain products, which are starches).  It is really a book about returning to traditional foods and methods of food preparation, for the purposes of eliminating toxins from the body and of getting the maximum nutrition out of the food that we eat.  The recommended way of eating is, well, a little intimidating.  Here are a couple of things that I have picked up so far, that I have been incorporating into my diet:

1. Diversifying fats: I have begun to diversify the fats that I use when cooking, where before I relied mostly on olive oil, supplemented periodically with cheap, salted butter.  The authors of NT really take the time to explain the benefits and risks associated with consuming various types of fats.  Here's what I remember: animal fats are very high in stearic acid; fresh, organic butter contains healthy medium chain triglycerides; coconut oil contains significant quantities of lauric acid; olive oil contains health oleic acid; and flaxseed oil contains a good amount of omega-3 fatty acids and has an appropriate balance of omega-6 and omega-3 fatty acids.  So, when I made my low-carb brownies the other night, I used coconut oil and butter together.  When I made my eggplant last night, I used butter, lard and olive oil.

2. Eating organic: Although NT recommends that all of your foods be of the highest possible quality, organic, free-range, cage-free, animal products from animals fed on pasture, that is really hard to do and super expensive.  They give really good reasons for that.  I'm going to put my toe in to these waters, and make sure that my eggs and dairy are organic, that my meat is hormone and antibiotic free, and that my onions and potatoes are organic (not that I eat potatoes…but my family does).  Apparently, the stuff they spray on non-organic onions and potatoes to keep them from sprouting early can be harmful. 

Here are the two things that make me nervous: 

1. Lacto-fermentation: I am not a shy cook, by any means.  The daughter of a professional chef knows many food preparation methods and has a number of handy tricks up her sleeve, gastronomically-speaking.  However, lacto-fermentation (pickling, culturing, etc. without pasteurization) is something that I am just not trained to do.  Honestly, I made crème fraiche a few months ago (this is a product of lacto-fermentation), and I was a little scared to eat it (you take heavy cream, add buttermilk and salt, and let the mixture sit out at room temperature to culture for about 8-12 hours, it thickens and sours and is like a lighter version of sour cream).  I did eat it, and it was delicious.  I would probably eat it again.  Even if I would eat it, I don't know that I would feel comfortable feeding it to my child.  Pickling is something that people have done for millennia – my grandmother even periodically makes her own, homemade, crock pickles (very Polish).  However, it doesn't mean that the prospect of allowing certain foods to sit out unrefrigerated for long periods of time is something that I am comfortable with.  I would like to try this out, but I am a little hesitant.  (And I have very clear memories of my mother being horrified by Babci's pickles).  I am going to try to make NT's salsa recipe, and feed it to my husband.  The high salt and acid content in the recipe makes me a little more comfortable with it, and I can probably get my husband to eat it.
2. Raw milk and raw milk products.  Well, let's just say that this is pretty non-negotiable in NT, as the authors decry pasteurization.  I would personally try raw milk products like butter and cream, I suppose.  However, I would not want to give this to my child.  I have heard horror stories of raw milk tainted with e-coli, and e-coli is scary stuff.  But, if you want to try to make their pickles… a lot of those recipes require the use of whey, which is produced from making curds and whey from lacto-fermenting raw milk.  Plus, I've had raw milk cheeses before, and they are awesome.  Ever been to France.  OMG.  Raw milk goats cheese...just a little stinky + good, crusty bread = pure heaven!  As a general rule, I do love to experiment...  I am thinking that I will come around. 

End of Week 10 - weigh in (a day late)

I weighed in yesterday, on April 3rd, at 215.5, which is one more pound lost from last week.  I also lost about 3/4 of an inch from around my waist.  Last week was a tough one.  I had not been feeling well - the week was plagued with headaches, moodiness... you name it.  I seem to have a headache all of the time, and ibuprofen and tylenol do little to help.  I'm not sure if this is the result of my new meds, or if it is the start of allergy season, and I have some kind of sinus thing going on.  I am going to call the MD who prescribed the new meds, and see what she says.  Hormones are serious stuff. 

I was hoping to pen a new post this week, entitled, "high energy... I love Mondays!"  That is not going to happen.  I'm still tired, moody, and headachey.  I hope I can get some resolution from the MD.

Cheers, and here's to feeling better in every way!!  :)

Get thee to the doctor!

I've been doing a lot of research on PCOS and "estrogen dominance" and "progesterone deficiency".  Turns out having PCOS causes you to have a lot of estrogen running around in your body.  Too much estrogen and not enough progesterone tends to make you fat around the midsection, hairy, moody, headachey, etc.  As if these symptoms weren't bad enough, having such an estrogen imbalance can apparently increase your likelihood of heart disease and breast cancer.  (And, let me be the first to tell you, having PCOS can make you infertile).  If these symptoms sound familiar, consider getting yourself to your MD for a check up, and have them run some blood tests on you. 

Hey - I'm not a doctor, but I believe that if you feel like crap you should get yourself to the MD and find out what's going on. 

I know a lot of people who prefer to stick their heads in the sand and just live with their symptoms.  An example: I have an Aunt Pam.  She is one of my mother's sisters.  After my mom was diagnosed with breast cancer (for the second time) in 2008, she had genetic testing performed to determine whether she had a gene abnormality on BRCA1 or BRCA2 (these are human tumor suppressor genes - women and MEN who have an abnormality in these genes are much more likely to get breast, ovarian, and other types of cancer than the general population).  Mom had a deletion on her BRCA 2 gene - she had hereditary breast cancer.  With the exception of my Aunt Pam, my mom's children and her brothers and sisters all were tested.  We were all negative, thank God.  My Aunt Pam didn't show up for her appointment, she didn't reschedule, and she has never been tested, to this day.  Aunt Pam has two biological children, each of whom would also have benefitted from knowing whether their mom carried such a gene abnormality (because that would mean they have a 50% chance of having the same gene abnormality...the same elevated risks). 

My mom died last August, at age 54.  If she had had the benefit of a "heads up" ten years earlier, maybe she would still be alive today.  (Case in point: Christina Applegate).  To squander the opportunity to learn more about your own health, when it could provoke action that could save, extend and/or improve your life (and the lives of your loved ones), is tragic!

We only have this one life and this one body.  We should take care of them the best we can.  You're never too old to start taking care of yourself for the first time in your life.  Hey, I'm 31.  I'm obese and not that healthy at the moment.  But, I'm working on it, and my life is improving as a result.  There is no shame in being a work in progress.  There is no shame in investing in YOU!

Life Choices, Establishing Priorities, Acting Like an Adult, Headaches, Test Results

I just don't feel like myself this week.  I had Monday Misery, which is not my usual deal.  I have been grumpy, tired, and short-tempered.  Today, I have a headache, which I never get.  It is right in the dead center of my forehead and face, and completely encompasses both eyes.  The pressure is very uncomfortable.  I haven't been able to get my butt out the door to exercise this week.  I have been creaky and achy in my back and knees and neck.  I have had such high energy since starting low carb ten weeks ago.  In contrast, this week just feels so strange.  I am uncharacteristically low energy and just plain, old miserable.  Sigh.  I don't think it's the diet.  I am wondering if I'm sick, hormonal (see also, my birthday post and evil kate post), or starting up with my seasonal allergies. 

I just had a comprehensive blood screen at the doctor's and looked at my results.  Mostly everything is good and normal.  My glucose, after eating lunch, tested at 96 (which is normal for fasting blood sugar, so pretty good for midday after lunch).  My blood pressure has been consistently low.  My cholesterol is pretty good: its a little high, but the ratio is really good, and my HDL level is high. 

My estrogen count is way way up.  My new doctor confirmed my PCOS diagnosis yesterday after an ultrasound.  She said that my estrogen is elevated because I haven't ovulated in months.  So, I have started taking progesterone to induce a period, then I'll take clomid to induce ovulation.  Hopefully, this will start the old ball rolling.  Can extra estrogen make you beastly?  I am wondering.

So, the whole point of figuring out this PCOS thing, and getting my body in gear, is because I am, at least now, not ovulating and therefore infertile.  Hubby and I have been thinking about having another child. 

After going to the doctor yesterday, and talking about conception and stuff, stewing for a while, then getting Satan's own headache and being short with the wonderful daughter I already have, I began to feel that I am not ready to have another child at this moment.  I love kids.  I love my own kid to the moon and back and I am so proud of her that it makes my teeth hurt.  Part of me really would love to have more children.  The other part of me, which has been silent for a while, thinks that I should get my shit together, lose my weight, enjoy being thin and healthy, and revisit pregnancy when I am healthier overall and will have a safer pregnancy.  I also want to be able to hang out and do adult things that I have only recently been able to do… like join my friends for a movie or happy hour.  That same part has also suggested that I should think about focusing on my career.  Career and new baby don't necessarily jibe, you know.  (Not unless your significant other is willing to be a Mr. or Mrs. Mom… and mine isn't).  Both parts of me have been positively screaming "PRIORITIES, ESTABLISH YOUR FREAKING PRIORITIES", although they clearly disagree on what those priorities should be.  Is it just panic?

Let's make a list of priorities:

1. Keep a close eye on the health of my dad and grandma, and be the health bouncer in my family.
2. Spend time with my family.
3. Get healthy.
4. Get my billable hours on track at work.
5. Get City and related stuff in order.
6. Enjoy being an adult.
7. Take on a hobby.
8. Think about having another baby.
9. Think about running for office again (I really want to take a term off).

That feels right to me.  I have to sit with it for a while, but for now, this feels like what I have to do.  I feel this need to take care of and preserve what we already have, before we add anyone or anything else in to the mix.  

Why do I feel selfish and kind of sad?  Am I depressed?  I just don't feel like myself!  I am going to go back through my old blog posts, and remind myself that I am usually a happy person who feels well!!!

Ow.  The headache has moved on to the top of my head, my temples, and behind my ears, despite the acetominophen I just took.  Maybe I should wait until I feel better before I make any Life Choices.