Earlier, I had posted about getting through the holidays and my leave, and not only did I not get completely derailed on my goal, but I also even managed to knock a couple more pounds off and break my plateau. But since then? I have hit a wall. Actually twice. The first time was significant, but merely figurative; the second time was slightly less significant, but literal.

The figurative wall

Winter tends to hit me hard, with a strong desire to just hibernate until Spring, and I don’t have a lot of coping mechanisms that are that effective at beating that lull. I’ve tried lots of things, most didn’t help.

Trips to warmer Southern climates DO help, but we tend to do those every couple of years, not every year. Too many other demands on our budget. It also sometimes backfires, particularly if the timing doesn’t coincide well with the winter blasts — if I go too early, the post-vacation blasts can run pretty long; if I go too late, I’m often too run-down before I go. 

Another coping technique I have is that I like to embrace the idea of PolySpring — my so-called “light at the end of the tunnel” by which I’m near-guaranteed likely to have no more lasting snow. The end of the hibernation and a good date to aim for — if I can hold on until then, my expectations don’t get too high earlier, and I can also remain on a relatively even keel.

Lots of advice swirls out there in the ether about how to cope with the winter blues, including embracing the outdoor life. Some of that I like the sounds of, most of it I don’t, and what I have tried left me with those two as the main techniques that help. I prefer spring and fall over a too-cold winter or a too-hot summer. And with my weight being what it has been, some possible outings have not been in the cards (I’m looking at you, Mr. x-country skiing). I know, I know, a self-fulfilling prophecy and an excuse more than an explanation.

However, in addition to the two above, one thing that has frequently worked for me has been to do a “January 1st reset” of my life each year. I would drag out my to do lists and bucket lists, and personal planning guides, and wrestle with them throughout January to update or set goals for myself. Planning, brainstorming, blogging, trying out new personal storylines on myself, coming up with new ideas on how to approach the coming year. Sometimes reading the latest and greatest in new approaches to personal planning. A chance to jump into a rabbit-hole and emerge on the other side of the winter field with a concrete plan to move forward. 

But, this year, I don’t have any goals to wrestle with mentally to distract myself. I had decided to have no other goals, just the single one that is now sitting there mocking me. My overall momentum has dropped to zero. The problem is that I’m stalled. Kind of like climbing a hill with a 4×4 and getting stopped part way up. You can’t just give it more gas, you almost have no other choice but to back down a ways and then take another run at it.  I have seriously given thought to just going for ice cream and starting “over”. Count it as a broken goal and then recommit again, doubling down.

I may be stuck on the hill, just giving it gas, but what has been worse this week is that I’m starting to slide backwards. I’ve got the brakes on to slow my descent, but I’ve started staying up late again, watching TV. Buying my lunch at work, and while slightly better choices than before, still not as good as a home made lunch, with my snacks set for the week. My motivation is almost zero. And my weight has crept back up five pounds. Not horrendous, I know, but when I’m focused on getting the weight to go down, seeing it go back to my plateau weight is not encouraging. And while I had been doing really well on my foods, I’m now HUNGRY way more often.

I tried with Andrea to vary our menu last week, testing some new recipes, but we over-programmed and I wasn’t looking forward to the various ones as much as I might have been with fewer new choices. Plus I feel like I’ve been fighting a bug the last two weeks. It could just be my body adapting to new drugs, hard to tell. And some of it is just my brain sabotaging my efforts. The hill metaphor is just that, a metaphor. It doesn’t quite hold for a goal like this, and I have no intention of giving in. 

But then, I almost had a catastrophe happen.

The literal wall

Jacob had a course at Nepean SportsPlex on Sunday morning, and we were running a bit late. We were just about to head out, Andrea and Jacob were already in the car when I realized that Jacob didn’t have his sunglasses with him. It wasn’t that bright out, he wasn’t planning to take them, but when I asked him if he wanted his sunglasses or not, he paused and then agreed he did want them after all. No problem, I could get them.

They were in his bag near the front door, and I sat down sideways on the steps in our entry way while I looked through his bag. I found them, and when I went to get up, I sort of rotated back straight, leaned forward and tried to rise.

Except my weight wasn’t entirely over my feet when I did it. And my feet weren’t on the carpet; instead, the carpet was pulled back a bit and my slightly-wet boots were on slightly-wet tile.

My feet went out from under me to the left, and I fell to the right.

Not far, not kersplat. I more “fell over” than “fell”, basically from a half-standing, half-sitting position. And I didn’t go all the way down. I couldn’t, you see.

There’s a wall there. As I fell, I stuck my forearm out to stop my descent, and caught the edge of the wall about an inch or two in from my elbow. 315 pounds falling on a single wedge of wall on a single point on my forearm.

I thought I had broken it. It hurt so bad, so instantly, and the whole thing went almost dead from that point downward, I was sure it was broken. I couldn’t even move it for a good minute. It still hurt like crazy, and I managed to get my feet under me properly and lean way forward before standing and going out to the car. When I went to put the key in the ignition, I had a lot of trouble moving my arm forward to do it. I eventually had to lean my body forward too, I couldn’t raise my arm that far. As I drove, I stretched my arm out as far as I could to get it moving again, and slowly got it moving again over the next 30 minutes. 

One hour and an ice pack later and I was good to go. I figured it would bruise, but it didn’t, not really. Sure, there’s a small bruise and a little scrape, but other than that, there’s just missing paint from the edge of the wall and some residue on my coat arm. 

But it scared the crap out of me. My most immediate fear is not about my heart or weight or BP or any of that — it’s falling on my knees and doing major damage. I have gone skating a few times in the last couple of years, and basically set aside the fear. Yet after this incident, I won’t chance it. I barely fell and came close to doing major damage to my arm. It’s still sore three days later, and if I rest the arm the wrong way on the armrest in the car or at my desk, or even just on the desk, I feel it almost instantly. If I had gone down on my knee? Hell, it hurts just KNEELING on a good day. I can’t take the risk until I get the weight down.

And of course, my brain is attacking me pretty hard. Clumsy, fat stupid PoS is basically the message it is sending, which is not doing much for my mood. Add in a rough transition from six weeks off back into work, and I’m not having a good month.

A figurative wall and a literal one. Both taking me out.

On a good day, I could turn that anger into something resembling forward motion, driving me forward. I know the only way out is through, but my brain isn’t listening at the moment. It wants to give up, but that’s not an option.

I’ve decided that I need to set a non-health goal or two to distract me from time to time and let me feel a sense of momentum when the other momentum slows. I thought the Reading Challenge might be enough, but it wasn’t. So maybe I can do a bit of mini-planning without going full-rabbit hole. See if that helps.

In the meantime, I’m mostly just pissed at myself. Almost enough to hit a wall, if I hadn’t done that twice already.

The only way out is through. The only way out is through. The only way out is through. The only way out is through…Breathing in through the nose, out through the mouth. 

I was trying to decide between several different topics for this week. One that is on my mind is a variation on “it takes a village” and the support that I’ve received since going public with my journey. Another is about my actual mechanical process for food, nutrition, tracking, etc. and appointments. Another wants to update on a bunch of miscellaneous things. But I jettisoned all of them because I have BREAKING NEWS.

On Monday of this week, I had my medical checkup and this was my 3-month benchmark since I had my original blood work done in September/October. I did the new blood work last Friday, and while they are checking lots of things to be safe, the big marker for the test is my A1C number.

For those not familiar with bloodwork and diabetes, the A1C measures “blood glucose levels”. Your red blood cells have hemoglobin proteins in them to transport oxygen around your body. Sugar / glucose can attach themselves to hemoglobin, and the specific type they attach to is hemoglobin A. When the two attach, it is called glycated hemoglobin (A1C). Some people have to monitor blood glucose levels every day by pricking their thumb at home, and it’s good for daily management, but the real BIG test is the A1C marker which has a lifespan of about 120 days. While your day to day stuff can fluctuate wildly, even within a single day or after a meal or workout, the A1C is basically treated as a 3-month average. So you do the bloodwork every three months to see how you’re doing. That’s an oversimplified explanation, but close enough.

Back in October, my number went to 7.1% i.e, 7.1% of my red blood cells were glycated. Below 5.5% is considered normal.  5.5 to 5.9 is “at risk” for diabetes, 6.0 to 6.4 is pre-diabetes, and 6.5 or higher is diabetes. There’s a bit of confusion out there about 6.5 or 7.0, and I don’t know if the number changed at some point or not, but some sites list diabetes as 7.0 or above, with a prediabetes as 6.5 to 7 and at risk from 5.5 to 6.5. Regardless, I’m going with the official Canadian Diabetes Association numbers, which are the under 5.5 / 5.5-5.9 / 6.0-6.4 / 6.5+ cutoffs.

My October numbers were the first ones I had done in two years, and I was now at 7.1. Previously I had only gone as high as 5.9, and while nobody ever explained the numbers, it was “hey you’re at risk” … but I had always been “at risk” anyway, with both being overweight and having a family history of diabetes. But since I hadn’t been tested in several years, and my weight increased in that time, I blew past the “at risk” cutoff (5.9) and the prediabetes cutoff (6.4) and into official diabetes territory. I commented previously that it didn’t really mean much to me, as it seemed almost incidental to my commitment to losing weight. It didn’t really change anything for me, other than triggering some extra meds.

But when I was blogging about non-scale indicators, my sister-in-law and others pointed out that the A1C number would be a good indicator. I confess I felt almost stupid … since I had dismissed the impact of the diagnosis, I hadn’t really paid much attention to the number either. But OF COURSE it would be a good non-scale indicator, duh!

Test results

So Friday was my test date. And I have my new A1C number. My previous was 7.1. My new one?

5.9, baby! Woot woot!

Oh, sure, I’m still in the “at risk” category, but I’ve basically put myself back to where I was 2.5 years ago. And since I have kept losing weight, all my various numbers are looking good.

For example, my untreated blood pressure once went as high as 160/110, which is stroke territory. At the time, I was maxing on decongestant, so maybe not a completely “fair” number, but without decongestant, I was still  in the 140/100 range. With meds, I range from 115/85 to 130/98 or so.

Monday? My average at the office, which is often a bit higher than at home, was 111/75. Woot woot!

Medications

Which puts me in a different conversation about meds. I discussed them at some length with the doctor and then I also did a full check-up with one of the pharmacists at my regular pharmacy. My favorite pharmacist is in Peterborough of course, and my second favorite one is on vacation, so Hassan had to pinch-hit.

First up? My Metformin that I take to make my body process insulin better, and helps keep my A1C numbers under control. Some of the drop from 7.1 is from my weight loss, some from the diet changes, some from the medicine. They started me on a dose of 500 mg. I couldn’t tolerate it on my stomach, lots of cramps initially, so we cut it back to 250 mg with a plan to move to something called Jardiance. I finished my Metformin trial late last week and started the Jardiance on Saturday. One of the side effects of Jardiance is fatigue and apparently it can hit shortly after taking the medicine. Based on Saturday night and Sunday night, I wouldn’t want to be driving anywhere! Sure wiped me out fast.

However, since the Metformin was working, and even doing so at the low level of 250mg, we don’t need to actually switch me to Jardiance after all. So, I turned those pills back in, got a new Metformin prescription, and we set it at the lower dosage of 250 mg. It’s working, no need to increase is the logic. Interesting considering it is half the starting dose for most people, and some people even have to take 1500 mg a day. I’m happy with 250 mg.

For my blood pressure, I take two meds. Amlodipine and Hydrochlorothorazide. The Amlodipine is apparently not as effective as another drug, Ramipril, for those with diabetes, so we’re switching me over. Plus Amlodipine causes swelling of the ankles and calves which I have experienced. I will be happy to not have that, if it helps. I have to monitor though for the risk of the new medication taking my blood pressure TOO low, since at 111/75, I’m at the very low end of the med’s usage. When I lose another 25-30 pounds, we’ll need to revisit that amount…might have to reduce the dosage. I’m only at 5mg on the new one, so we’ve already reduced slightly. We’ll revisit the Hydrochlorothorazide in 3-6 months too but I might be able to get off that one completely and just use Ramipril for the future, and maybe even get rid of that one too eventually. Woot woot!

That leaves my Lansaprazole / Prevacid. I’d like to get off that too, but considering without it that my first “incident” had me thinking I was having a heart attack, I want to ensure the efficacy of whatever approach we take to weaning me on to something else. It might just be something like Tums or Gaviscon.

Although I confess that while I’m okay with doing that, I’m of two minds…first I need to be sure of the efficacy, but second that we are basically substituting a med that I have to pay for myself for one that is already covered. I can afford it, but I know there are lots of people out there who wouldn’t be too thrilled about shelling out extra cash for something each month if it is already “addressed” through their existing meds. I understand the health implications, and the reason to switch, I just find it a bit less obvious a decision than the medical professionals seem to think. None of them have asked at all about the cost implications to me. Again, fine for me, but what about others?

On the other hand, I just filled a prescription last week for two months of Jardiance but I only took it for two days and then gave it back for destruction. I’d like to think they would reuse the meds as they are in sealed individual blister packs, but I know they probably can’t. Meanwhile the benefit plan paid for them and I’m sure it’s not cheap.

Overall, I was at three meds before this started, and I’m up to four with a chance to be down to three in three months, two in six months, one in nine months, and maybe, maybe,  maybe, none as of a year from now. Although, as my favorite pharmacist pointed out, I may still have one med to act as a protective / preventative med to make sure my body doesn’t get too worse at processing sugar. And so far at least, no injections. A friend was telling me about Trulicity working well for them, but so far, I don’t need it, everything I have is working well.

Woot woot! Even if the original diagnosis didn’t matter to me, I’ll take the 5.9 as an external indicator of progress.

One of the first things you see when looking at weight loss stories or advice/tips/tricks from professionals is that it isn’t “all about the number”. People commenting on my posts on FB have echoed that advice too — reminding me to also look for success indicators that are not tied to my weight scale. What some experts call “off-the-scale” or “off-scale” success. These “other” indicators become not only philosophically important, moving you from a technical definition of obesity tied to your weight or Body Mass Index to a more functional definition of fitness, but also psychologically crucial if you bust your ass between weigh-ins and yet the needle doesn’t move because you’ve hit a plateau.

And with my typical analytical zeal, combined with my love of all things performance measurement related at work, I adapted my approach to take into account these “other factors”. I also used my research time to look at various milestones to give me way stations along the journey, markers to tell me I’ve achieved some arbitrary measure of success, something other than the obvious 157 little milestones for each pound lost or one big milestone at the end.

So with a bit of extra zeal, here are the first three sets of indicators for my journey.

A. Weight-loss milestones

While these are still “weight-based”, they are more about specific milestones. With my overall weight goal of going from 342 pounds down to 185, i.e. a drop of 157 pounds, that number is too big to be much motivation on a short-term basis. Instead, I broke it down in 10% increments…10% of 157, 20% of 157, etc. This gives me 10 clear targets between my start and finish. I have also added in 5 other weight targets, mini-objectives that fall between those 10% increments (1 each between 20 and 30%, 30% and 40%, 40% and 50%, 60% and 70%, and finally 90% and 100%) based on another more psychological total, numbers that are symbolic to me. Which means, for those doing basic math at home, I have 15 weight-related milestones to focus on.

Progress so far:

My first milestone was Level 1, the loss of 10% of my full goal. This worked out to 15.7 pounds, and would take me to 326.3. Back in Week 17, I hit below that number for the first time — 319.8 on October 10th. LEVEL ONE ACHIEVED!

Next goal: 310.6 (20%)

My next working target is 310.6, or 20% of my overall target. I’m at week 26 this week and the last 8-9 weeks have been frustrating on this front as I have hit a plateau, which goes hand-in-hand with finding it hard to regain my original commitment and momentum to be eating the way I’m supposed to be each day.

B. Body measurements

One type of indicator that most weight loss programs use to track non-scale success is measurement of various parts of the body. The premise is simply that you may be still making progress, but muscle is denser than fat, and you might be getting “leaner” without getting “lighter”, or you might be moving/shifting weight around on your body. If the goal is to be fit, not simply “lighter”, those shifts and changes may indicate forms of progress that your simple weight scale won’t pick up. It’s also one of the reasons why so many people hate BMI as a measurement tool — people with the same overall weight and height have the same BMI, yet they could be in two totally different sets of proportions and degrees of fitness. Scales, and the BMI, can tell you one story, but not necessarily the whole story.

Awhile ago, I had helped someone with a diet program and their program used a bunch of measurements. I was shocked by two things. First and foremost, that the numbers were not as precise as I expected. Measuring my own neck, for instance, can give me widely different numbers (shifting as much as 5%) just by slightly altering the angle or how tight you pull the tape measure. It is, regrettably, incredibly imprecise. Secondly, I discovered that all those ads on TV where someone lost 14 inches in one week, etc. was incredibly misleading. I never really thought about them, I assumed they meant around the waist. In some cases, sure, but in other cases it was some misleading math — two inches off their chest, four inches off their waist, two inches off each leg, etc. until it added up to a “loss of 14 inches”. Really? REALLY? Hmm…not even sure that qualifies as legal, but it is certainly misleading.

Anyway, regardless, I went through a whole bunch of websites that talked about these types of measurements and came up with a list of 16 areas of my body to measure and track progress. I do the measuring, which isn’t that effective, and Jacob does the recording on a sheet of paper, every two weeks. He then takes three pictures of me in my non-stylish, least flattering gray shorts: first straight-on and then right and left profiles.

I’ve been looking really hard at the measurement data, and the only solution I can come up with the random fluctuations each week between my shifting it a slight half-inch or pulling a bit tighter or looser than last time is to average them out. Perhaps a three-measurement average. Over time, those “effects” should, I think, cancel each other out a bit. If the average goes down, it should indicate progress not controlled by vagaries of measurement. I guess. I honestly don’t know, I just know that the measurements are wonky, not static/stable. Equally, if I take the marketing approach and add everything up, it will iron out glitches in individual measurements even more i.e. if there is a “net change” overall, I’m making progress.

Progress so far: 1 inch

If the mathematical approach is to add up all the “inches”, I guess I’ve lost an inch overall. However, given that I don’t really know what my “goals” are for each of these areas, my real progress is that I have done the measurements four times (the Seinfeld Method for consistency of measurements, yay me!). Since I do the measurements two weeks apart, the rolling average of 3 basically means “over the course of the last four weeks” i.e. a monthly measurement, updated biweekly, which sounds about right.

But here is the completely wonky part. I know the math doesn’t make any sense to add up all the measurements, not really, just in a generic sense that if the overall totals go down, you are “smaller”. Or if one specific area is something you are targeting, sure. And while I know all that, the fact that all of it adds up to an overall loss of 1 inch, 1 measly inch, is encouraging. As I said, I plateaued a few weeks ago, so I’ll take any progress I can find. Even ones of dubious lineage.

Next goal: ?

While I’m hoping the numbers change overall, I don’t really have specific numerical goals for each part, except perhaps my pants size. I have a 30 inch inseam, and I’d like to get to the point where I could wear 30″/30″ pants. I vaguely remember being in pants at the 28/30/32″ range and I know someone I consider reasonably fit who is also 30″. I feel like 34″ would be too big, but I really don’t know. I guess I’ll fine tune this as I get close. However, in the meantime, I’ll track it. Maybe it will show movement when I’m stuck on a plateau, like now.  A friend really likes the idea of dropping a “dress size”, but since that doesn’t really work for men, the pants size is about the best I can do for now.

C. Qualitative Indicators

I mentioned above that I researched the heck out of various websites and other resources to find “other” indicators that I could use to mark progress, and as I did so, many of them were completely irrelevant to me. Some of them were lifestyle issues that I don’t have, or choices that are not part of my mindset, or involved specific types of partnerships that I don’t have or don’t want. Which left me picking and choosing from a laundry list of possible indicators to come down to some that are applicable to me. My final list is a mish-mash of some 40 items and it looks chaotic even to me. Some of them I’ve already achieved, so it’s not as bad as having 40 still out there, but I feel like they need a bit of a framework to help me understand them, let alone explain them to others. This is what I have come up with.

Progress so far: Multiple items

I don’t know if those six categories are the right categories exactly, but they’re good enough to get going. And, as you can see from the list, I have made some progress already:

– Commit to the journey
– Announce goal
– Get professional help
– First weigh-in
– First pound
– First set of measurements
– Discussed it with Andrea and Jacob
– Discussed it with professionals
– Discussed it with friends and family last week (family gathering)
– Have received an unsolicited compliment that someone noticed a change
– Andrea finds it “easier” to hug me now, not quite as big around as I was

Next goal: Complete Tier 1

The big hold-outs for me in Tier 1 is mainly around getting going on the fitness. I had hoped to meet with the kinesiologist soon to get some help with that, but with some scheduling issues, that won’t happen until January. In the meantime, I will get started on my own. Which requires a crapload of work in the basement to get it all arranged properly. But that’s why I took the time off, right? 🙂

And that’s a wrap for almost all of the measurements/indicators. If you know of others, I’m happy to consider them!

Next week, I’ll blog about taking ALL of the measurements, turning them on their head, and going hard-core on 18 unique ones.